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Thursday, March 20, 2025

The Left Knew They Were Lying to Us All Along

 by Victor Davis Hanson

For years, the left has advanced utter untruths for cheap partisan purposes that it knew at the time were all false. And now when caught, they just shrug and say they were lying all along.

Once it was known that the first COVID-19 case originated in or near a Chinese communist virology lab engineering gain-in-function deadly viruses—with help from Western agencies—the left went into full persecution mode.

They damned as incompetent, racist, and conspiratorial any who dared follow logic and evidence to point out that the Chinese government and its military were both culpable for the virus and lying.

A million Americans died of COVID. Millions more suffered long-term injuries. Still, the left-wing media and Biden administration demonized any who dared speak the truth about a lab origin of the deadly virus.

The lies were designed to protect the guilty who had helped fund the virus’s origins, such as Doctors Anthony Fauci and Francis Collins.

The Biden government also tried to use the lab theory to ridicule a supposedly pro-Trump “conspiracy.”

Western corporate interests deeply invested in China did not want their partner held responsible for veritably killing and maiming hundreds of millions worldwide.

Almost as soon as Joe Biden was inaugurated, the left knew that he was physically and mentally unable to serve as president.

Indeed, that was the point.

Biden’s role was designed as a waxen figurine for hard-left agendas that, without the “old Joe Biden from Scranton” pseudo-moderate veneer, could never have been advanced.

His handlers operated a nightmare administration: the destruction of deterrence abroad, two theater wars, 12 million illegal aliens, a weaponized justice system, hyperinflation, and $7 trillion more in debt.

By 2017, the public knew three truths about the so-called Christopher Steele dossier.

One, it was completely fallacious—fabricated by a has-been, ex-British spy Christopher Steele. He childishly had cobbled together lurid sex stories, James Bond spy fictions, and Russian-fed disinformation to destroy the Trump candidacy and later presidency.

Two, it was paid for by the Hillary Clinton campaign. She hid her checks behind the Democratic National Committee, the Perkins Coie law firm, and Fusion GSP paywalls.

Three, the FBI under James Comey hired Steele as an informant. It helped disseminate his concocted files and was also instrumental in trying to subvert the Trump campaign and later administration.

No sane person ever believed that Hunter Biden’s laptop was the work of “Russian disinformation.” Its contents a year before the 2020 election were verified by the FBI, but it kept mum about its confirmation.

The pornographic pictures, the evidence of prostitution and drug use, the electronic communications implicating Joe Biden in his family’s illicit shake-down operation of foreign governments—all were never challenged by anyone who was associated with the laptop’s contents.

Yet future Secretary of State Anthony Blinken, along with former interim CIA Director Mike Morrell, sought to fabricate a colossal lie to arm their candidate, Joe Biden, with plausible denial in the last presidential debate before the 2020 election.

They rounded up a rogue’s gallery of 51 now utterly discredited former intelligence authorities to lie to the nation that the laptop was likely fake.

All knew the FBI had verified the laptop. But they also knew that their titles would empower their lies that the Russians likely invented the laptop to aid the sinister Trump.

And the ruse worked like a charm.

In the debate, Biden cited their lies chapter and verse to claim the incriminating laptop was fake. A lying media damned Trump as a puppet of Vladimir Putin. Joe Biden, little more than a week later, won the 2020 election.

The Biden administration deliberately destroyed the southern border and welcomed 12 million illegal aliens. And then it lied that Biden had no power to stop the influx.

The media fabricated the excuse that “comprehensive immigration reform” was needed to enforce federal immigration laws already on the books.

Upon inauguration, Trump, in a matter of days, stopped what Biden had deliberately engineered for years.

Biden’s handlers wanted new millions of poor illegal aliens, dependent on social services, to swarm the borders.

They saw them as future voters and constituents to fuel their victim/victimizer Marxist binaries.

And they now quietly see their efforts as a huge success—knowing that it will be near impossible to find the millions of illegal aliens they welcomed in.

All these lies have divided the country and permanently damaged the U.S.

The perpetrators have neither apologized for their lies nor tried to either deny or substantiate them.

No one involved has ever been held legally accountable.

The legacy media permanently ruined its reputation and will likely never be seen as credible again.

The Biden administration, overseer of many of these lies, will be regarded as the most duplicitous and dishonest presidency in modern history.

https://amgreatness.com/2025/03/20/the-left-knew-they-were-lying-to-us-all-along/

Democrats’ silence is damning as leftist violence explodes

 Another Donald Trump presidential term, another spate of violence going largely ignored — or even smirked at — by Democrats and their media friends.

Tesla dealerships are being firebombed and shot at, while Tesla vehicles are vandalized and their owners assaulted.

Trump-supporting influencers are getting “swatted,” set up for dangerous police encounters by opponents who phone in hoax distress calls.

Relatives of Trump-aligned public figures — including the sister of US Supreme Court Justice Amy Coney Barrett and Elon Musk’s brother — are receiving bomb threats.

This cannot go on.

The multiple attacks on Teslas aren’t mere vandalism. This is terrorism exactly as the dictionary describes it: “The unlawful use of violence and intimidation, especially against civilians, in the pursuit of political aims.”

These “vandals” are terrorizing Tesla the company, as well as Tesla owners — going so far as to dox them with an online map — all because they don’t like the opinions of its CEO.

It’s calculated to scare, to terrorize, people away from driving Teslas in order to apply political pressure on Musk.

It’s “nothing short of domestic terrorism,” Attorney General Pam Bondi said Tuesday.

The Justice Department has already charged several perpetrators, she said, in cases that could carry five-year mandatory minimum sentences.

Five years is a good start — but it’s not enough. This kind of antisocial political barbarity is utterly unacceptable in a free country.

Threats of violence cannot be allowed to curtail our freedom of speech.

Nor should the extended families of public figures face threats to their lives and safety. The siblings of a Supreme Court justice or the head of DOGE did not choose a public life, and bullying them is disgusting.

Swatting, too, is on the rise, with more than a dozen incidents aimed at right-leaning media figures reported in just the last 10 days.

“This isn’t about politics,” FBI Director Kash Patel said Friday on X. “Weaponizing law enforcement against ANY American is not only morally reprehensible but also endangers lives, including those of our officers.”

Swatting isn’t just a scary inconvenience; it has had deadly consequences. Police killed a Kansas man in 2017 after someone called in a fake hostage situation at his address. The “swatter” was sentenced to 20 years in prison.

But every swatting has the potential to turn deadly — in fact, that’s largely the point. Just because swatters use technology, and law enforcement’s guns, shouldn’t give them a pass on the attempted murder of their political foes.

Meanwhile, there is no federal anti-swatting law, making it harder to prosecute.

Republicans in Congress must take action. They can reintroduce the Anti-Swatting Act, a 2015 bill that was sponsored by both Democrats and Republicans but never got a floor vote.  

Can Democrats really support using our law enforcement to target political enemies?

Worst of all, much of this violence and abuse is being laughed off by people who would be weeping if the targets were their own political allies.

Jimmy Kimmel, ostensibly a late-night comedian but in truth more like an angry crank, sarcastically told his audience Tuesday, “Please don’t ever vandalize Tesla vehicles” — while looking mockingly into the camera, after a long pause, to let them know he meant the opposite.

Minnesota Gov. Tim Walz, last seen as the great male hope of the failed Kamala Harris presidential campaign, told a crowd this week he keeps a finance app on his phone to follow Tesla and to “give me a little boost” whenever the stock declines.

“Two-twenty-five and dropping!” he exulted.

Such jeers, as well as the deafening silence from most other Democrats, are simply intolerable.

If progressive influencers and leftist leaders were on the receiving end of such horrid tactics, every Republican in the country would be made to answer for it. “This is not who we are,” right-wing media would proclaim.

And rightly so. But no such calls are coming from the Democrats and their media allies.

Donald Trump ran on a platform of law and order. The increasingly rabid reaction to his presidency calls for a serious response.

For the last five years, the violent left has run rampant with few consequences for the chaos it has sown.

Republicans in Congress, and the Trump Justice Department, should show them that ends now.

Karol Markowicz is co-author of the book “Stolen Youth.”

https://nypost.com/2025/03/19/opinion/democrats-silence-is-damning-as-leftist-violence-explodes/

Rite of Passage or Road to Early Liver Damage?

 As a transplant hepatologist in Los Angeles, Brian Lee, MD, MAS, has seen his share of alcoholics with advanced liver disease, people who have spent decades drinking their body toward an early death.

In recent years, however, the demographic of these patients has shifted in a particularly worrisome direction. More than ever, young adults and even late adolescents too young to drink legally are showing signs of organ damage after just a few years of problem alcohol use.

photo of Brian Lee
Brian Lee, MD, MAS

“I’ve been seeing a lot of 20-year-olds with end-stage liver disease and liver failure,” said Lee, an associate professor of medicine at the Keck School of Medicine of USC, Los Angeles. “Young adults with alcohol-associated liver disease [ALD] are the fastest growing demographic contributing to liver-related mortality.”

However, because ALD may not cause any symptoms until cirrhosis develops, and young adults may not divulge the full extent of their drinking, primary care providers should actively screen for alcohol use and organ damage in young adults before they wind up on the liver transplant list.

Between 2013 and 2018, the number of people younger than 40 years on the liver transplant list with a diagnosis of ALD quadrupled, from 3 per 100,000 to 13 per 100,000, making the condition the most common indication for a liver transplant in this age group.

A review of death certificates in the 3 years prior to the pandemic also showed a steady rise in deaths from ALD in young adults. But mortality rates accelerated in 2020, with some of the biggest increases seen in those aged 25-34 years; deaths among men and women in that age group saw increases of 51% and 38%, respectively.

Not surprisingly, growing alcohol use during the pandemic was well-documented. Lee reviewed retail sales data in the United States between April and June of 2020 and showed a 34% increase in sales of alcohol, from $7.10 billion to $9.55 billion, compared with 2019. The largest increases occurred among people younger than 44 years.

After the lockdowns had ended, Lee and his colleagues were curious to see if drinking patterns changed. Using the National Health Interview Survey from 2018 to 2022, they found alcohol consumption remained elevated in 2022, with adults aged 18-39 years and 40-49 years most likely to report any drinking in the past year.

But the biggest increases over the 4 years were among people aged 18-39 years, with 73.3% reporting any alcohol use in 2022 compared with 70.2% in 2018. An even bigger concern, however, is the prevalence of dangerous drinking: The 2023 National Survey on Drug Use and Health found that 28.7% of adults aged 18-25 years reported binge drinking in the past month, and 10.9% met the criteria for alcoholic use disorder.

Not Just Alcohol

Alcohol is not the only factor driving the rise in liver disease in young adults. Lee also linked the jump to the obesity epidemic.

Trends identified by the National Health and Nutrition Examination Survey are striking. The 1976-1980 survey found that the prevalence of obesity in persons aged 18-25 years was 5.5%. By the 2017-2018 survey, the prevalence rose to 32.6%.

That increase is helping drive the increases in liver transplants and ALD-related deaths. “There’s an interaction between metabolic risk factors, particularly obesity and diabetes, and increased alcohol consumption,” Lee said. “They’re not just additive in terms of developing liver fibrosis or liver failure; they’re really multiplicative.”

photo of Ashwani Singal
Ashwani Singal, MD, MS

Non–alcoholic fatty liver disease, recently renamed metabolic dysfunction–associated steatotic liver disease (MASLD), is the most common cause of chronic liver disease worldwide. Ashwani Singal, MD, MS, a professor of medicine in the Division of Gastroenterology, Hepatology and Nutrition at the University of Louisville School of Medicine in Louisville, Kentucky, served as a panelist on the consensus panel that came up with the name change. Given the stigma associated with the terms “fatty” and “alcoholic,” the group proposed the use of the overarching term “steatotic liver disease” (SLD) to describe conditions involving fat accumulation in the liver.

Singal spoke with Medscape Medical News about the changes in nomenclature and the different subsets of SLD. The presence of one of five cardiometabolic risk factors — obesity, hypertension, diabetes, low high-density lipoprotein cholesterol, or high triglycerides — in a patient found to have steatosis by imaging such as liver elastography (FibroScan) indicates the presence of SLD, which has further subdivisions depending on alcohol intake.

“Depending on alcohol consumption, based on below 20 grams per day for women and 30 grams per day for men, or 60 grams per day for men and 50 grams per day for women, individuals are categorized as MASLD or ALD. If alcohol intake is between these cutoffs, they are classified as metabolic dysfunction–associated ALD,” Singal said. This scoring is based on 14 g of alcohol in the United States and 10 g according to the World Health Organization, as the equivalent of one drink.

These distinctions matter because the risk for progression to cirrhosis and choice of treatment vary by subtype. For patients with advanced fibrosis, the 5-year risk of developing decompensated cirrhosis rises dramatically with increasing alcohol use. For MASLD, metabolic dysfunction–associated ALD, and ALD, the risks are 5%-15%, 10%-30%, and 15%-50%, respectively.

Not only does alcohol independently damage the liver, but it also contributes to the metabolic issues at the root of SLD. “If somebody is drinking five drinks a day, each drink has about 100 calories. Those are all empty calories, right?” said Singal, describing the link between alcohol and obesity. He also pointed out that alcohol can worsen hypertension and dyslipidemia, two of the other risk factors for SLD.

Signs of a Silent Disease

SLD is a silent disease, and patients are most often detected due to abnormal liver chemistries or a finding of steatosis in the liver from an ultrasound performed for another indication. This lack of definitive symptoms raises the question about the most efficient strategy to screen for SLD.

The prevalence of the condition is > 70% in patients with type 2 diabetes, and > 90% of patients with SLD have one of the five cardiometabolic risk factors. Practice guidelines for MASLD from the American Association for the Study of Liver Diseases recommend noninvasive screening for any patient with one of the five key cardiometabolic risk factors, imaging findings of hepatic steatosis, unexplained abnormal levels of alanine aminotransferase or aspartate aminotransferase, a family history of cirrhosis, or heavy consumption of alcohol.

“The most common referral to a hepatologist is because of elevated liver enzymes,” Lee said. “But many patients with advanced liver fibrosis won’t have abnormal liver enzymes.” He recommends primary care clinicians start by obtaining a fibrosis-4 (FIB-4) score, which is calculated based on the patient’s age, platelet count, and liver enzymes. If the result is > 2.67, he recommends referral to gastroenterology or hepatology.

Although the FIB-4 has both high sensitivity and negative predictive value, its rate of false positivity also is high. If the FIB-4 result is borderline — between 1.3 and 2.67 — Singal recommended a more specific test such as the enhanced liver fibrosis (ELF) score, which has a much higher positive predictive value. An ELF score > 7.7 indicates the need for the services of a gastroenterologist or hepatologist.

A drawback of the ELF score, which is based on levels of hyaluronic acid, tissue inhibitor of metalloproteinase-1, and procollagen III N-terminal peptide, is specimens will likely need to be shipped to a reference lab. The relatively simpler FIB-4 remains the initial choice for primary care settings.

For patients who do not meet these criteria for referral, primary care clinicians should repeat the FIB-4 every 1-2 years for patients with type 2 or pre-type 2 diabetes or two or more other risk factors. If the patient does not have type 2 diabetes and has only one of the five cardiometabolic risk factors, the FIB-4 can be done every 2-3 years according to the guidelines.

Since the required lab values for calculation of the FIB-4 are commonly performed in primary care settings, the electronic health record (EHR) can be leveraged to streamline workflows in identifying patients at risk for SLD. A prospective study performed in a university general medicine practice that focused on identifying patients with diabetes with abnormal FIB-4 levels found that 86% of patients with diabetes referred to specialists received a diagnosis of MASLD, of whom 36% were found to have advanced fibrosis.

Best Practices for Alcohol Screening

Although many primary care physicians ask new patients about alcohol use, only a minority use formal alcohol screening tools.

But, just as with many other health screenings, leveraging the EHR can ease the burden. A quality improvement study in six urban primary care clinics evaluated the use of a — validated screening test, the three-item Alcohol Use Disorders Identification Test–Consumption items. For patients flagged by the EHR with moderate- to high-risk alcohol use (defined by standard cutoffs for moderate-risk use of alcohol), clinicians could take advantage of a brief counseling script also built into the clinical decision support tool.

photo of Jennifer McNeely
Jennifer McNeely, MD

“We achieved very high screening rates, with an overall screening rate of over 70% in the first year, whereas in most practices that haven’t made a concerted effort, it’s less than 10%,” said Jennifer McNeely, MD, a professor in the Departments of both Medicine and Population Health at the New York University Grossman School of Medicine, New York City, who led the research. McNeely discovered some additional factors that improved the identification of patients at risk.

“Don’t limit use of the screening tool to preventive care visits because the clinics that used that had 20%-40% screening rates versus over 90% screening rates for the ones that used any routine visit,” she said. She also found that the use of a self-administered questionnaire is better at detecting risky alcohol use: The clinic that trained medical assistants to ask the questions identified moderate- to high-risk drinking in only 1.6% of its patients compared with rates of 14.7%-36.6% in the remaining facilities.

The counseling script was used infrequently by the various clinics, with rates ranging from 0.1% to 12.5%. McNeely acknowledged that primary care providers are already overstretched and that counseling about alcohol and drug use is more difficult than many health issues. But she said clinicians are credible messengers for young people, perhaps more so than teachers or parents, and expressing concern about a patient’s health is often a good starting point.

Primary care clinicians also should become more comfortable with pharmaceutical approaches to help patients reduce drinking and maintain abstinence, she said.

“There are effective medications that are totally underutilized,” McNeely said. According to a review by the Agency for Healthcare Research and Quality, oral naltrexone, acamprosate, and topiramate have the strongest evidence for reducing alcohol consumption in outpatient settings.

Most importantly, McNeely encouraged clinicians not to ignore unhealthy levels of alcohol use, because doing so can send the wrong message. “Oftentimes providers don’t know what to say, so they say nothing,” she said. “That can be a tacit endorsement.”

Lee, Singal, and McNeely reported no financial conflicts of interest. 

https://www.medscape.com/viewarticle/rite-passage-or-road-early-liver-damage-2025a10006n5

Refer Obesity Patients to Dieticians?

 The demand for glucagon-like peptide 1 (GLP-1) receptor agonists for overweight/obesity has created a clinical conundrum for many primary care providers.

Between 2011 and 2023, obesity-specific prescriptions for GLP-1s increased by 700%. Since then, roughly 1 in 5 Americans have reportedly taken these drugs to lose weight. Given that primary care doctors only have an average of 18 minutes allocated to seeing each patient, how is it possible to conduct routine assessment and comprehensive obesity management?

Though highly effective for weight loss, GLP-1s represent a single piece of the comprehensive management required to not only shed pounds but also prevent weight cycling. This is where lifestyle guidance — nutritional and dietary management coupled with exercise training and behavioral change — becomes essential, and where referrals become a clinical lifeline.

“GLP-1s are tools, not magic pills,” said Clayton F. Runfalo, MD, lead primary care physician at Ochsner Health Center in Gonzales, Louisiana, just outside New Orleans. Runfalo emphasized that he “treats illness but emphasizes wellness.” 

“Every patient, every visit I touch on information about healthy choices and healthy living, even if I only spend 30 seconds,” he said.

photo of Clayton F Runfalo
Clayton F. Runfalo, MD

But practicality is the rule.

“The demands on primary care doctors to see more patients more quickly means that we don’t have time to get into the nuts and bolts. So we frequently refer them out (or in the case of Oschner, to another department) to physicians who understand nutrition and registered dieticians who have the time to spend an hour educating and putting them on a path to succeed,” he said.

A Comprehensive Toolbox

Lifestyle interventions have long been the cornerstone of obesity management, not only to help develop lasting behavioral changes but also to improve overall cardiometabolic outcomes, including dyslipidemia, prediabetes, and hypertension. But many patients are not aware of the impact that GLP-1 agents have on hunger cues, dehydration, and skeletal muscle mass.

“I see a lot of patients who are on different GLP-1s, so I can review nutrition deficits. Are they hydrated; electrolyte balanced? Are they getting enough fiber and still having regular bowel movements?,” said Grace Derocha, MBA, RDN, CDCES, national spokesperson for the Academy of Nutrition and Dietetics.” 

“About half of the patients on GLP-1s that I see don’t even know what a protein food is or what a fiber food is,” she said, further reinforcing the need for comprehensive education about avoiding undernutrition while taking these agents.

“I really peel back the layers to get into basic nutrition fundamentals and help build the healthy habit components to address what the patient’s goals are along with how to sustain the improvements in the long run,” said Derocha.

Exercise Beats the Weight Loss Plateau

Maintaining functional muscle mass is also important; data attributed up to 40% of total weight loss to a reduction in lean mass in people taking semaglutide treatment, according to research, increasing risk for frailty, metabolic disturbance, and cardiovascular diseases.

photo of Grace Derocha
Grace Derocha, MBA, RDN, CDCES

“Sometimes people feel that if the drug is helping them lose weight, they don’t need to do things people normally would do for losing weight, ie, purposeful diet with exercise,” said Evan Matthews, PhD, a cardiologist and exercise physiologist and associate professor, exercise science at Montclair State University in Montclair, New Jersey.

Matthews pointed to additional benefits of initiating an exercise program, especially to counteract the weight loss plateau that inevitably occurs when taking GLP-1s.

“Exercise has been shown to allow patients to reduce their weight further,” he said.

Among 195 patients enrolled in a randomized, placebo-controlled study comparing body fat loss in people who took a GLP-1 and exercised with those who either took the drug but didn’t add exercise or those who exercised but didn’t take the drug, those who followed the combined exercise/drug regimen experienced an additional 3.9 percentage points in lost body fat, which was roughly twice the reduction.

The combination group also saw improvements in the glycated hemoglobin level, insulin sensitivity, and cardiorespiratory fitness.

Matthews said that though more data are needed to guide the combination of the GLP-1s and exercise in terms of “precision” recommendations, “the sooner you start exercise, the sooner you see the benefits. The time it takes to reach a plateau where the patient has to either up the drug or exercise habits will probably be longer,” he said.

“This needs to be thought about as long-term behavior that patients will hopefully do for the rest of their lives. And it will get the patient to a level of fitness that allows them to regain some of the muscle they lost or at least push the body to start maintaining the muscle better,” Matthews said.

Mountains vs Molehills

The need for education, nutritional and dietary changes, building exercise habits, and behavioral changes to sustain changes go part and parcel with GLP-1 treatment. However, Angela Fitch, MD, obesity medicine specialist and chief medical officer and co-founder of Knownwell health clinic in Needham, Massachusetts, near Boston, shared some words of caution.

“A lot of times, we’re making a mountain out of a molehill. The biggest thing to realize is to not make it too onerous,” she said. “You need to have some basic tools at people’s disposal, make sure that they’re eating regularly and not skipping meals because their appetite is suppressed, and focus on whole foods,” said Fitch.

photo of Angela Fitch
Angela Fitch, MD

“And if they are not hungry, make sure they are getting protein to supplement. But the point is to simplify and at the very least, hit the basics,” she said. “It’s about having some tools in your toolbox, eg, straightforward handouts or guidance on plants and protein.”

For patients whose insurance coverage is uncertain, Fitch recommended that primary care doctors consider referrals to virtual dietician programs (eg, Nourish or Berry Street) that work with patients to find coverage or offer cash options. Physical therapists (typically covered by insurance) can also fill in the gaps to get exercise routines underway.

The bottom line? “We have to reinforce that these medications are tools. If we don’t have time to spend a half hour or hour teaching them about healthy habits, then by all means, we should be referring them to a dietician, a physical activity specialist or kinesiologist who can dedicate an entire appointment for that,” said Runfalo.

Runfalo, Matthews, and Derocha reported no relevant financial relationships.

https://www.medscape.com/viewarticle/should-you-refer-obesity-patients-comprehensive-weight-2025a10006nt