My Nominee for Word of the Year 2024: Stochastic

Around New Year’s Day annually, you see articles or news reports on Word of the Year as chosen by various organizations. E.g., Merriam-Webster’s WOTY for 2023 was “authentic.” Runners up included “rizz” and “deadname.” WOTY for 2022 was one I’ve enjoyed for several years: “gaslighting.”

I read “stochastic” at a blog w/in the last few days. I had heard or read it before but had to look up its meaning. It’s rarely if ever used by the crowd I run with. I thought it had something to do with science, maybe chemistry. The definition from Merriam-Webster:

  • 1) RANDOM. Specifically, involving a random variable
  • 2) PROBABLISTIC; involving chance or probablility

When I read “stochastic” the other day, it was in the term “stochastic terrorism.” I thought the writer was just using a highfalutin substitute for “random.” But no, stochastic terrorism is a thing. William M. Briggs (Statistician to the Stars!) recently wrote about it:

Academics at universities, which are the best kind of academics, invented the idea of stochastic terrorism. According to academic James Angove (who with the others cited below may appreciate emails of congratulation on their prescience), in the peer-reviewed paper “Stochastic terrorism: critical reflections on an emerging concept“, stochastic terrorism is… 

…broadly, the idea that influential individuals may demonise target groups or individuals, inspiring unknown actors to take up terroristic violence against them…I understand the phenomenon to be specifically authoritarian in nature, which not only demonises but dehumanises its targets. 

Does that remind you of something that happened in the U.S. July 13, 2024?

Steve Parker, M.D.

Russia Refused to Help the British During the American Revolutionary War

Larry Johnson has an inspiring post for true American patriots. (I’m sorry if that offends my British readers!) Larry informs us that Russia refused to join the British in their 18th century effort to retain their 13 colonies in the New World. If like me you didn’t know that, click the link above for a few details.

By happenstance, I was listening to the Russians With Attitude podcast while walking the dogs just before sunrise today. From a RWA tweet (Xheet?) today:

Russia played a significant role in the American Revolutionary War. In the summer of 1775, King George III of Great Britain sought the support of Russia to send a 20,000-strong military corps to crush the rebellion in North America.

This corps would consist of combat units from the Russian army and would be led by a British general. Great Britain would pay for the recruitment of the troops and their transportation by ship to North America. The British believed that the Russian troops would guarantee Great Britain success in the upcoming campaign.

However, Russia refused to send any troops and proclaimed “armed neutrality,” meaning resistance to British attempts to restrict trade with the rebel colonies at sea. Northern European countries such as Denmark, Sweden, the Netherlands, and Prussia supported this policy.

Have you heard of the International Russophile Movement (MIR) convened in Moscow in 2023? From one of the movement’s founders, Pepe Escobar:

This project, supported by the Russian Foreign Ministry, aims to counter the relentless waves of Russophobia and quash the culture unleashed by the usual suspects since the start of the Special Military Operation (SMO) in Ukraine in February 2022.

As readers will be able to verify, it is a multipolar information project that can become a source of inspiration for the countries of the South. The idea is to counteract arrogance and intolerance with an affirmative attitude deeply rooted in culture, civilizational values ​​and the vision of a more equitable system of international relations.

It’s time to change the narrative.

Pew Research Center recently surveyed Americans for their views on Russian President Putin and Russia:

  • Negative ratings for Russian President Vladimir Putin remain very high: 67% of Americans have no confidence at all in the Russian leader to do the right thing in world affairs.
  • Americans continue to see Russia in a negative light, but an increasing share see Russia’s influence in the world getting stronger.
  • Roughly six-in-ten believe Russia is an enemy of the U.S., rather than a partner or competitor, but the share who say Russia is an enemy has declined over the past two years.

I don’t get it. The Americans I hang out with rarely talk about Russia. I doubt they know much about it. I’m afraid the Pew survey respondents are unduly influenced by the mainstream media and Big Social media, which in turn are controlled by the Deep State. Many Boomer’s probably still confuse Russia with the old USSR, which broke up in 1991. It’s time to move on. Give peace a chance.

Steve Parker, M.D.

COVID-19: FDA Rebuked by Appeals Court for Its Stand on Ivermectin

artist rendition of coronavirus
Artist conception of the dreaded virus

From The Tennessee Star:

Dr. Mary Talley Bowden, Dr. Paul E. Marik and Dr. Robert L. Apter sued the FDA in June of 2022, asking the court to: “Hold unlawful and set aside any FDA actions directing or opining on whether ivermectin should be used for certain off-label purposes, including treatment of COVID-19.”

“After nearly two years and a resounding rebuke by the Fifth Circuit Court of Appeals, the FDA has agreed to remove its misleading social media posts and consumer directives regarding ivermectin and Covid-19,” said Bowden.

The Appeals Court had written in its decision: “The FDA is not a physician. It has authority to inform, announce, and apprise—but not to endorse, denounce, or advise.”


Steve Parker, M.D.

Literally Hitler Reacts to the Biden-Trump U.S. Presidential Debate

Brink of War: U.S. Killing Civilians in Russia

More commentary by Larry Johnson:

Imagine the reaction in the United States if Russia detonated cluster munitions over Miami Beach, killing and wounding more than one hundred, including children. The American people would demand a strong response. Well, that is exactly what is happening now in Russia….

Meta-Analysis Finds Ketogenic Diet Doesn’t Help Control High Blood Pressure

Not bad

From an April, 2024, Nutrition, Metabolism & Cardiovascular Diseases issue:

Abstract

Aims

Cardiovascular diseases (CVDs) are major causes of mortality around the world. High blood pressure (BP) or hypertension is one of the most significant predisposing factors to CVDs. Ketogenic diets (KDs) have been the center of attention for their possible health benefits. The aim of this analysis is to study the impact of KDs on BP through the existing literature.

Data synthesis

We investigated the impact of KDs on systolic and diastolic blood pressures (SBP and DBP) conducted in the format of randomized controlled trials (RCTs). Four online databases (PubMed/Medline, SCOPUS, Cochrane Library, and Google Scholar) were searched from inception up to November 2022. Subgroup analyses were carried out to find the sources of heterogeneities.

Twenty-three RCTs with 1664 participants were identified. KDs did not exert any significant impacts on SBP (WMD: −0.87 mmHg, 95% CI: −2.05, 0.31) nor DBP (WMD: −0.11 mmHg, 95% CI -1.14, 0.93). Subgroup analyses did not reveal any further information. Also, non-linear dose-response analysis could not detect any associations between the percentage of calorie intake from fat in the KD format and BP levels.

Conclusion

KDs do not seem to be effective in improving BP. Nonetheless, further investigations are recommended to examine the proportion of fat intake needed to induce favorable clinical impacts.


Steve Parker, M.D.

New Drug Rezdiffra for Liver Disease

Stages of liver damage. Healthy, fatty, liver fibrosis and cirrhosis

DiabetesDaily informed me of a new drug available for treatment of a liver disease that affects “up to 20% of people with diabetes. But by no means is the disease limited to diabetics (er, “people with diabetes”). The disease is MASH: metabolic dysfunction-associated steatohepatitis, something else I’d never heard of. (Shouldn’t the acronym be MDASH?) The drug is resmetirom, sold in the U.S. as Rezdiffra. Click for the FDA announcement. MASH can lead to liver scarring (fibrosis), which then qualifies the patient for resmetirom. The DiabetesDaily article is well-written and includes alternatives to this new drug.

I’ve long been aware of NASH: non-alcoholic steatohepatitis. THIS is the liver disease target according to the FDA announcement, which states “Rezdiffra is a partial activator of a thyroid hormone receptor; activation of this receptor by Rezdiffra in the liver reduces liver fat accumulation.” Furthermore:

The most common side effects of Rezdiffra included diarrhea and nausea. Rezdiffra comes with certain warnings and precautions, such as drug-induced liver toxicity and gallbladder-related side effects. 

There may be potential significant interaction of this new drug with others, particularly statin cholesterol-lowering drugs.

Color me skeptical. If only because the drug was on the “accelerated approval pathway.” But I’ll keep an open mind.

I’m not sure, but it appears that candidates for the drug will need a liver biopsy showing fibrosis (scarring).

Steve Parker, M.D.

…Listen to the Father’s Voice

Not quite what you were expecting, was it?

Wishing a glorious Father’s Day to all you dads!

I Told You So: Mediterranean Diet Prevents Cardiovascular Disease

Branzino, aka European Bass, live in Mediterranean waters

Yet another epidemiologic study supports the contention that the Mediterranean diet reduces cardiovascular disease. The higher the adherence to the Medi diet, the less cardiovascular disease over the next 20 years. I scanned the report down to the Discussion section and, surprisingly, didn’t catch their definition of cardiovascular disease. It usually refers to heart attacks, strokes, angina, congestive heart failure, and hypertension. Some would include aneurysms. The study at hand was done in Greece. You can read the whole thing.

Regarding the fish above…. I was eating at a fancy French restaurant in Pensacola, FL, about 30 years ago and a table mate ordered fish (du poisson?). When it arrived with head ON, she immediately demanded it be taken back to the kitchen for removal of the head!

Abstract

Background and aims

Only few studies have assessed longitudinal dietary trends in relation to cardiovascular disease (CVD) risk. We aimed to evaluate the association between adherence to the Mediterranean diet, both baseline and longitudinal, and 20-year CVD incidence.

Methods and results

This was a prospective study among 1988 Greek adults (50% men, age: 45 ± 14years). Adherence to the Mediterranean diet was evaluated at baseline and 10 years through the MedDietScore, based on which longitudinal Mediterranean diet trajectories were identified. CVD incidence was recorded at 20 years. Each one-unit increase in baseline MedDietScore was associated with an 8% reduction in 20-year CVD incidence. Compared to subjects in the lowest tertile of baseline MedDietScore, those in the highest exhibited a 44% lower 20-year CVD risk (relative risk: 0.56, 95% confidence interval: 0.32, 0.97) adjusted for age, sex, baseline body mass index, smoking, physical activity, presence of hypercholesterolemia, hypertension and diabetes mellitus, and family history of CVD; further adjustment for high-sensitivity C-reactive protein, uric acid and estimated glomerular filtration rate attenuated this association. Results were similar in models adjusted for longitudinal changes in body weight, physical activity and smoking, and 10-year medical status. Mediterranean diet trajectory analysis revealed that 24.7%, 8.6%, 45.8% and 20.9% of participants longitudinally sustained a low adherence, moved closer, moved away or sustained a high adherence, respectively; among those, the corresponding CVD incidence was 63.3%, 65.5%, 28.1% and 9.4% (p-value<0.001).

Conclusion

The Mediterranean diet offers long-term protection against CVD, part of which is mediated by inflammation, uricemia and renal function.


Steve Parker, M.D.

PS: The study is in Nutrition, Metabolism & Cardiovascular Disease: “Mediterranean diet trajectories and 20-year incidence of cardiovascular disease: The ATTICA cohort study (2002–2022),” published in January 2024.

Larry Johnson on Today’s Russia

Lately I’ve been reading and watching Larry Johnson. For example:

A large number of Americans still think that Russia is the Soviet Union, that the country is a crumbling wreck and the people are atheists and miserable. Boy, are they wrong. I received the following note this morning from a friend who exemplifies this mistaken prejudice. He wrote:

“I have been in Russia a few years ago before any wars, and the standard of living even for well educated people remains quite low. So, they may have a bigger better economy than we all know, but it is not translating to a much better life for its citizens compared to the EU or America. Relative to what it was before Putin it is very much better, but compared to the west or Japan it is still far behind. What will 500,000+ dead and wounded and 100,000 more fleeing and a very low birth rate in a rapidly declining demographic, do for the economy. Nothing good.”

Wrong, wrong, wrong!!!! Although I have only visited the two largest cities in Russia — Moscow in the winter and St. Petersburg on the cusp of summer — I can report that the average Russian appears to be living as well, if not better, than their counterparts in the United States or Japan. Especially when it comes to quality of life. Unlike the big cities in the United States, you can stroll along the streets and boulevards of Moscow or St. Petersburg without worrying about getting mugged or stumbling over some homeless addict sprawled on the sidewalk. The streets are clean. No used needles or face masks. Try explaining to Russians a “poop” map. They cannot grasp the concept.

With the threat of nuclear war higher than it’s ever been in my lifetime (and I was alive during the Cuban missile crisis), I’ve been thinking more about Russia. Unlike most of our national (U.S.) politicians, I don’t hate Russia or the Russian people. (Same goes for China.)The more I learn about Russians, the more I like and admire them.

Steve Parker, M.D.