Sunday talkies: Bessent, Abbott, Mullin, Gorsuch, Pirro, Hassett, Duffy

 NewsNation “The Hill Sunday”: Senior Elections Analyst at Real Clear Politics Sean Trende, staff writer for The Atlantic Thomas Chatterton Williams

Fox News “Sunday Morning Futures”: Treasury Secretary Scott Bessent, British Ambassador to the U.S. Sir Christian Turner, Texas Gov. Greg Abbott (R), Rep. August Pfluger (R-Texas)

Fox News “Fox News Sunday”: Homeland Security Secretary Markwayne Mullin, Supreme Court Justice Neil Gorsuch

CNN “State of the Union”: U.S. Attorney for the District of Columbia Jeanine Pirro, Sen. Thom Tillis (R-N.C.), former Rep. Barney Frank (D-Mass.)

CBS “Face the Nation”: National Economic Council Director Kevin Hassett, Sen. Rev. Raphael Warnock (D-Ga.), President and CEO of Minneapolis Federal Reserve Neel Kashkari, Rep. Jason Crow (D-Colo.)

ABC “This Week”: Transportation Secretary Sean Duffy, Sen. Jack Reed (D-R.I.)

https://thehill.com/homenews/sunday-talk-shows/5861008-sunday-shows-preview-vra-ruling-fuels-redistricting-battle-iran-war-crosses-60-days/

Trump: Iran Sent New Offer, Doubts It’s ‘Acceptable’ as Foe Has Not ‘Paid Big Enough Price’ for War

President Donald Trump briefly met with reporters on the tarmac in Doral, Florida, on Saturday, where he was asked about Iran’s new peace proposal.

“They told me about the concept of the deal. They’re going to give me the exact wording now,” Trump said, indicating he would review the latest proposal aboard Air Force One.

“I’ll let you know about it later,” he said.

One reporter said, “Last night, you said we might be better off not making a deal with Iran.”



“Well, I wouldn’t have to,” Trump said, before adding, “I didn’t say that. I said that if we left right now, it would take them 20 years to rebuild. But we’re not leaving right now. We’re going to do it so nobody has to go back in two years or five years.”


Another reporter asked, “Under what circumstances would you restart military strikes on targets?”

“Well, I don’t want to say that. I mean, I can’t tell that to a reporter,” Trump scoffed.

“If they misbehave, if they do something bad,” he answered. “But right now, we’ll see. But, you know, it’s a possibility that could happen. Certainly.”

Trump was then asked about telling Congress that the hostilities in Iran have been “terminated.”



“How can you say that, given that the naval blockade is still being militarily enforced?” he was asked.

“Well, it’s a very friendly blockade,” Trump said. “Nobody’s even challenging it. Nobody at all is challenging. Just so you understand, many presidents have been involved in things at are very big. They never had to go through anything with respect to Congress. They considered it to be totally unconstitutional. And the Democrats in Congress had pushed this. and probably a couple of Republicans. They’re hurting our negotiating ability, which is infinite right now. And they shouldn’t be doing it. It’s never happened before. No other president’s done it. And I’m not going to be the first.”

As soon as he was aboard Air Force One, Trump posted the following on Truth Social:


I will soon be reviewing the plan that Iran has just sent to us, but can’t imagine that it would be acceptable in that they have not yet paid a big enough price for what they have done to Humanity, and the World, over the last 47 years. Thank you for your attention to this matter!

https://uk.news.yahoo.com/trump-reveals-iran-sent-offer-230915010.html

Jordan conducts strikes along Syrian border

 Jordan's military said that it carried out air strikes on sites suspected of smuggling weapons and drugs to illegal groups along the border with Syria.

"The operation targeted manufacturing facilities, workshops, and warehouses from which traffickers transport weapons and drugs into Jordan," the armed forces said in a statement, according to the official Jordan News Agency. "The Jordanian Armed Forces affirm that they will continue to deal proactively, decisively, and deterrently with any threat to the security and sovereignty of the Kingdom," the statement concluded.

https://breakingthenews.net/Article/Jordan-conducts-strikes-along-Syrian-border/66204685

Ahead Of Trump-Xi Summit, Beijing Tells Chinese Firms Ignore U.S. Sanctions On "Teapot" Refineries

 President Donald Trump is set to travel to Beijing in mid-May for a summit with Chinese President Xi Jinping, the first U.S. presidential visit to China in eight years, and a meeting already delayed once by the Iran war.

The pair will obviously discuss the U.S.-Iran conflict and the resulting energy shock, which has hit Asia fastest and hardest. There is no shortage of issues for the two leaders to discuss, including Taiwan, trade, AI chip controls, rare earths, and sanctions.

One important topic the two leaders will likely spend time on is the energy shock and the maximum pressure campaign imposed by the U.S. Treasury Department's Office of Foreign Assets Control on Chinese independent "teapot" refineries, particularly in Shandong Province, due to their continued purchases and refining of Iranian crude.

Perhaps last week's sanctions on China's teapot refiners are part of a leverage campaign by the Trump team ahead of the upcoming meeting.

By Saturday morning, Beijing announced that companies in the country should ignore and not comply with U.S. sanctions targeting five domestic refineries. 

The refiners, including Hengli Petrochemical's Dalian refinery and several privately owned processors, had been hit with U.S. asset freezes and transaction bans earlier in the week, according to Bloomberg.

Beijing's Commerce Ministry called the sanctions unlawful, saying they restrict normal trade with countries and lack authorization under international law.

"The Chinese government has consistently opposed unilateral sanctions that lack authorization from the United Nations and a basis in international law," the department said.

It appears that Beijing is shielding its refiners to mitigate Washington's pressure campaign on Iranian crude flows as the energy shock still festers across Asia.

The good news last week is that China reopened its fuel export spigot to surrounding countries, as domestic inventories are now at comfortable levels. This will provide some relief to countries dealing with fuel shortages caused by the Hormuz chokepoint, which remains partially frozen to this day.

https://www.zerohedge.com/energy/ahead-trump-xi-summit-beijing-tells-chinese-firms-ignore-us-sanctions-teapot-refineries

KUDLOW: Harvard-Harris poll shows America is behind Donald Trump and the GOP

 America loves President Trump and the Republican Party on all the key issues, according to one major poll, the Harvard-Harris CAPS poll, presided over by a former adviser to President Clinton, Mark Penn, who is most certainly a moderate Democrat, not a crazy one. This is a well respected poll. Of the 2,745 registered voters who were surveyed, the split was 977 Republicans, 984 Democrats, and 785 Independents. So it’s 50-50.

What’s interesting about this poll is that it picks up and agrees with many other polls about the key issues. Affordability, the economy, immigration, healthcare, Iran, et cetera. Where it differs from many other polls and lefty press reporting, though, is that while some people may blame Republicans, they blame Democrats more on all the key issues.

Let’s start with Iran, 74 percent of the voters believe the U.S. is currently winning in Iran. Virtually every press organization is telling us Iran is winning, believe it or not. Then the poll goes on, 74 percent believe Iran should be prevented from obtaining nukes. Some 66 percent want Mr. Trump to insist on all major conditions in any negotiation. And 57 percent approve of the blockade. There’s a warning here for Democrats, because as Speaker Newt Gingrich has mentioned, Democrats have become the pro-Iran party. Not a good place to be. And as I’ve said many times, Iran will be a sleeper issue come the midterms.

Now on the economy — people are very worried about prices and affordability. Got it. When you ask them who do you trust more to manage the economy, though, the responses are: Mr. Trump and Republicans 53 percent, Democrats 47 percent. That’s a 6-point deficit.

Normally a typical news desk, I don’t care whether it’s the Wall Street Journal, the New York Times, or the Washington Post. All the legacy lefties. The typical news desk will assume because affordability is the issue, Mr. Trump is to blame. Nope. People have even less confidence in Democrats.

Here’s another point, open borders. On this issue, 58 percent think Democrats are in favor of open borders. Here’s another one. Voter ID. Some 65 percent of those polled think Democrats are against voter ID requirements. And they like it very much that Republicans are in favor of voter ID in order to vote. Here’s another one. The race for Congress, you’d think the Democrats are ahead by 10 points given the press coverage day in and day out. Wrong. The Harvard Harris poll shows 50-50, which historically could mean the GOP is well ahead because over the years polling has taken half a dozen points off of the final Republican tally.

As I always say, polls are not votes. Only votes are votes. I’ll also say that press coverage is not fair. It’s heavily biased against Mr. Trump and the GOP. And I will add to that, most public press-sponsored polling is heavily biased against Mr. Trump and the GOP. The Harvard Harris poll is the exception and there are other exceptions, but I believe the country is very much behind Mr. Trump. And there’s going to be a big surprise come this November.

https://www.foxbusiness.com/politics/larry-kudlow-harvard-harris-poll-shows-america-behind-donald-trump-gop

'MASH Screening Made Simple'

 

Today we’re going to talk about MASH. That is metabolic dysfunction-associated steatohepatitis, which has emerged as a critical topic for us in primary care. We need to feel confident in our ability to screen for and care for patients with MASH because it is very common, our ability to screen for it is defined, it has severe consequences, and there’s now a lot we can do for it.

What’s fascinating is if we see 20 average primary care adult patients in a day, there’s a good chance we’re going to see one or two people with MASH. And there’s a good chance we didn’t realize we were seeing them. Approximately 30% of adults and about twice that percentage of people with type 2 diabetes have metabolic dysfunction-associated steatotic liver disease (that is, MASLD). About 20%-30% of those people have MASH.

I’m going to discuss the just-published Clinical Care Pathway for Risk Stratification and Management of Patients With MASLD from the American Gastroenterological Association that I had the privilege of contributing to as a member of the committee that formulated the pathway. Now, let’s face it: This is an area that is often confusing to us in primary care. The aim of this guideline is to help us clearly identify the people with MASH who have moderate to high-grade fibrosis and who therefore qualify for treatment.

Let’s start off our discussion today by clarifying the difference between MASLD — what used to be called nonalcoholic fatty liver disease — and MASH. First, what’s MASLD? MASLD is defined as having liver steatosis that is not due to excessive alcohol intake. MASH is then a subtype of MASLD where, in addition to there being steatosis, there’s inflammation going on that leads to ballooning of the cells and something called Mallory’s hyaline on biopsy. This in turn leads to fibrosis, which can progress to cirrhosis and hepatocellular carcinoma. The fibrosis goes in stages, beginning with stage F1, which is mild, then F2 and F3, moderate to severe fibrosis, and then F4, which is cirrhosis.

The next question we can ask is, why is this important? Well, it’s important for two reasons. The first is liver-related. In the United States, MASH has become the most common cause of end-stage liver disease in women, and the most common cause of liver transplant in women, and the second most common cause in men. The second reason is elevation of cardiovascular risk factors. Individuals with MASLD have elevated cardiovascular outcomes with a risk that is between 30% and actually 2.5-fold higher depending on the severity of fibrosis when compared with comparable populations without MASH.

So, the goal of screening is to identify people with moderate to advanced fibrosis — that is F2 and F3 — because that’s where the risk of progressing to advanced liver disease rises dramatically, along with an important increase in cardiovascular risk. Also, this is the level of fibrosis that’s used as the criteria for enrollment in the intervention trials.

So how do we screen for F2 and F3 MASH? The pathway suggests a four-step process:

1. Identify patients at risk. The groups at risk for MASLD-related fibrosis who should be screened are: (1) people with diabetes; (2) individuals who have overweight or obesity and one additional metabolic risk factor (usual risk factors include high triglycerides, low HDL, hypertension, high cholesterol, prediabetes); or (3) incidentally found steatosis on imaging or incidentally discovered elevation of LFTs, which leads us then to step 2.
2. Assess alcohol intake and check a CBC with platelets as well as LFTs. You’ll see why we need the platelets in a moment. If someone has significant alcohol intake, address it. If someone has elevation of LFTs, then you need to do a workup for that. Once that is out of the way, that leads us to step 3.
3. Calculate a FIB-4 score. The FIB-4 score takes into account age, platelet count, AST, and ALT. The calculator is included in many electronic records. In Epic, if you put in the dot phrase “.fib4,” it’ll be automatically calculated for you. Or you can look at an online calculator. I’ve left a link below. If the FIB-4 score is < 1.3 (important here, though: For people older than 65 years, we use a cutoff of < 2.0), then the individual is unlikely to have F2 or greater fibrosis, and the recommendation is to repeat the FIB-4 score in 1-2 years. If the FIB-4 score is ≥ 1.3 (and that is ≥ 2.0 in people older than 65 years), then go on to step 4. Given the high prevalence of F2 or greater fibrosis in people with type 2 diabetes, in that group we are able to go directly to step 4 if we want to. When might I do that? Well, perhaps if someone has diabetes and a very high BMI and severe metabolic abnormalities.
4. Step 4 involves testing with a more specific test for fibrosis. That would most often be a measure of liver stiffness using ultrasound-based imaging called vibration-controlled transient elastography — that’s VCTE. Most commonly, that is the FibroScan. The cutoff used here is 8 kPa. If VCTE is ≥ 8 kPa, the person is at high risk for having moderate to advanced fibrosis (that’s F2 or F3) and warrants treatment. Usually, that’s referral to a liver specialist. If the number is less than that, then the recommendation is to repeat the VCTE in 3 years. An alternative is now available to VCTE, and that is the ELF test. ELF here stands for enhanced liver fibrosis test, which looks at three biomarkers of fibrosis to provide a score that indicates the risk of F2 or F3 fibrosis. It is simple; it is just a blood test. If the ELF is < 9.2, then repeat it in 3 years. If it’s > 9.2, then that individual may be eligible for treatment. 

It’s important to know that treatment for F2 and F3 fibrosis is now available that can slow progression and sometimes even reverse the severity of fibrosis. The two treatments that are currently FDA approved are resmetirom and semaglutide. There are many other treatments as well that are in the pipeline and phase 3 trials, including tirzepatide, the dual GIP/GLP-1 receptor agonist; survodutide, which is a dual GLP-1/glucagon receptor agonist; and others with mechanisms that most of us are unfamiliar with and which I have trouble pronouncing.

The other thing important to remember is that moderate to advanced fibrosis identifies a group of people who are at elevated cardiovascular risk and for whom the usual approaches to cardiovascular risk reduction — things like addressing hypertension, hyperlipidemia, obesity, diabetes, chronic kidney disease, physical activity, and diet — are critically important.

So, this is an important practice pathway. To review briefly: Understand who to screen [and] check for alcohol use and other causes of LFT elevation. If the LFTs are elevated, calculate a FIB-4. If it’s > 1.3, or > 2.0 in people older than 65 years, check elastography or an ELF to determine who needs treatment.

Remember what I said at the beginning of this discussion? If we saw 20 adults in primary care today, it’s likely that one or two of them have MASH with elevated fibrosis, and we might not have known that. This pathway from the AGA gives us clear guidance on how to identify those people.

Neil Skolnik, MD

Professor of Family and Community Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia; Associate Director, Department of Family Medicine, Abington Family Medicine, Jenkintown, Pennsylvania 

Disclosure: Neil Skolnik, MD, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca; Teva; Lilly; Sanofi; Sanofi Pasteur; GSK; Bayer; Abbot; Novo Nordisk
Serve(d) as a speaker or a member of a speakers bureau for: AstraZeneca; Lilly; GSK; Teva; Bayer; Heartland; Astellas
Received research grant from: AstraZeneca; GSK; Novo Nordisk; Novartis

https://www.medscape.com/viewarticle/mash-screening-made-simple-4-step-guide-2026a1000cz3

Brain Changes Linked to Ultraprocessed Foods, Even in Otherwise Healthy Diets

 

• A 10% increase in ultraprocessed food intake was tied to lower attention scores and greater dementia risk in a cross-sectional study.
• The relationships persisted even in people who followed a Mediterranean diet.
• No relationship emerged between ultraprocessed food intake and memory scores.

People who included more ultraprocessed foods -- chips, candy bars, frozen meals, sugary cereals, or soda, for example -- in an otherwise healthy diet had worse attention scores and a higher risk of dementia, an analysis of cross-sectional data in Australia suggested.

Each 10% increase in ultraprocessed food intake was associated with a 0.05-point decrease (95% CI -0.09 to -0.01, P=0.012) in composite attention scores among adults 40 and older, reported Barbara Cardoso, PhD, of Monash University in Notting Hill, Australia, and co-authors.

For each 10% rise in ultraprocessed food consumption, the risk of dementia rose by 0.24 points (95% CI 0.16-0.32, P<0.001) on the modified CAIDE (Cardiovascular Risk Factors, Aging, and Incidence of Dementia) scale, a tool designed to estimate a middle-age person's long-term risk of developing dementia, Cardoso and colleagues said.

The relationships persisted even in people who followed a Mediterranean diet, the researchers wrote in Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring.

A 10% increase in ultraprocessed food intake corresponds to approximately 150 g/day, equivalent to a standard packet of potato chips, Cardoso and colleagues observed.

"For every 10% increase in ultraprocessed food a person consumed, we saw a distinct and measurable drop in a person's ability to focus," Cardoso said in a statement. "In clinical terms, this translated to consistently lower scores on standardized cognitive tests measuring visual attention and processing speed."

The findings indicate that food processing itself may influence cognitive health beyond nutrient displacement, she noted. Food ultraprocessing often destroys the natural structure of food and introduces potentially harmful substances, she pointed out.

"We demonstrated that the association between ultraprocessed foods and attention is not related to diet quality, which reinforces the notion that food processing, per se, is a factor in the association between diet and cognitive health," Cardoso told MedPage Today.

Earlier research tied ultraprocessed food to dementia risk, indicating that replacing these foods with unprocessed or minimally processed alternatives may reduce dementia risk. Other work showed that people who ate more ultraprocessed foods in midlife had faster rates of cognitive decline.

Ultraprocessed foods make up an estimated 60% of Americans' diets. They have been linked with early colon cancer, cardiovascular and all-cause mortality, lung cancer, and other adverse health outcomes, even in young children.

Cardoso and colleagues aimed to investigate how ultraprocessed food consumption was associated with cognitive performance and dementia risk scores and to determine whether these links were independent of overall diet quality.

The researchers evaluated data from 2,192 dementia-free adults ages 40 to 70 in the Healthy Brain Project in Australia. The average age of participants was 56.6 years and 75.4% were women.

Diets were assessed with validated online food frequency questionnaires. Foods and beverages were classified according to the Nova system into one of four groups: unprocessed/minimally processed foods, processed culinary ingredients, processed foods, and ultraprocessed foods.

All participants completed the Cogstate Brief Battery online; results were computed into two composite scores, one for attention and one for memory.

Dementia risk was estimated using two CAIDE risk scores for a subgroup of 1,891 participants. CAIDE is a validated assessment of dementia risk based on a combination of modifiable and non-modifiable factors.

The researchers found no significant link between ultraprocessed food intake and memory in this study. "Given that attention is foundational to many cognitive operations, such as learning, problem-solving, and memory formation, it is plausible that early disruptions in attention may precede broader cognitive impairments," they wrote. "However, the evidence base remains inconclusive, and further research is needed to clarify the temporal dynamics of these associations."

The findings were based on self-reported food frequency questionnaire data, which have limitations, Cardoso and co-authors noted. The sample had a large percentage of female respondents who had more education and higher socioeconomic status compared with the broader Australian population, and results may not apply to other groups.

Disclosures

The researchers acknowledged ongoing support from PearlArc, SRC Innovations, Cogstate, and Cambridge Cognition to the Healthy Brain Project.

Cardoso and co-authors declared no conflicts of interest.

Primary Source

Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring

Source Reference: Cardoso BR, et al "Ultra-processed food intake, cognitive function, and dementia risk: a cross-sectional study of middle-aged and older Australian adults" Alzheimer's Dement 2026; DOI: 10.1002/dad2.70335.

https://www.medpagetoday.com/neurology/dementia/121075