TASK DEFINITION: Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
PROBLEM: Paragraph: Hyperemesis gravidarum is estimated to affect about one to three percent of pregnant women and can result in nausea and vomiting so acute that hospitalization is required. It is thought to be caused by pregnancy hormones, but doctors aren’t sure why some women experience worse symptoms than others. The condition usually begins in the early weeks of pregnancy and in many cases, subsides by about 20 weeks. But for some women, the effects may persist until the baby is born. The condition can be “absolutely devastating,” said Dr. Roger Gadsby of Warwick University, who has studied the issue for decades. “Your life is on hold while the symptoms are present,” he said, noting that some pregnant women may vomit dozens of times per day and be restricted to bed rest. Kensington Palace made the pregnancy announcement Monday, saying the duchess was not feeling well enough to attend an official engagement later in the day. Kate is being cared for at her Kensington Palace home in London. There was no word of when the baby is due. She and Prince William already have two children: Prince George, 4 and Princess Charlotte, 2. In 2012, Kate was hospitalized for several days when she was believed to be suffering from dehydration. There is no evidence that the nausea and vomiting from severe morning sickness will affect the baby’s future health. Women with the condition actually have a slightly lower risk of miscarriage, according to Britain’s Royal College of Obstetricians and Gynaecologists. In severe cases, however, babies can be born with lower than expected birthweight. Women with the condition are advised to eat small meals often, to avoid any foods or smells that trigger symptoms and to consult their midwife or doctor if their symptoms do not subside. If treatment requires hospitalization, women are typically given vitamins, steroids and anti-nausea drugs intravenously. Patients are also sometimes treated with shots of heparin, to thin their blood: pregnant women are at increased risk of developing blood clots in their legs, and being dehydrated further elevates the risk. Gadsby said he would expect doctors to be able to treat the duchess at Kensington Palace and that there shouldn’t be any lasting effects. She would likely have to cut back on her royal schedule, though. “As long as the mom receives adequate treatment, the mom is usually fine and the baby is fine,” he said. ___ This Associated Press series was produced in partnership with the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. Claim: Science Says: Kate’s morning sickness brutal, not dangerous.

SOLUTION: Prince William and his wife, the Duchess of Cambridge, are expecting their third child. And for the third time — as with her previous two pregnancies — the former Kate Middleton is suffering from hyperemesis gravidarum, or severe morning sickness.

PROBLEM: Paragraph: This release makes no mention of the costs of the drugs compared in this study, even though the drugs have been in use for years and are widely available. Since the study is a comparison of various treatments for this form of cancer, it seems relevant to offer a cost comparison as well as a comparison of efficacy. It appears that the high dose methotrexate is given over a 24-hour period, presumably in the hospital, while the standard methotrexate is given as a single dose. Also, the high dose methotrexate is followed by leucovorin administration while the standard dose is not. According to the site GoodRx, the cost for methotrexate in low-dose (2.5 mg) pill form averages out to about $50 for a month’s supply. Newer, injectable variations of the drug cost upwards of $500 a month for the 25 mg dose. The release states that patients receiving high doses of the drug methotrexate “had a significantly better outcome, by 5 to 6 percent” than did patients receiving the current standard of care, which is gradually escalating doses of the drug. The release also explains that patients nine years old or younger who were also treated with a steroid called decadron (dexamethasone) for half as long as normal (14 versus 28 days) benefited from the treatment while patients 10 and older did not. We’re not sure of the meaning behind these results as portrayed in the release. Which outcome was better by 5 or 6 percent? The study has several. Does that mean the relapse rate was reduced or is it the event free survival that was better? It would be more meaningful to readers if the release had included the actual relapse and event free survival rates for each group analyzed in terms most people can understand. For example: “relapse rates were 5 percent lower in Group X compared to Group Y.” We’ll give this category a satisfactory rating largely due to the release including information that patients 10 and older receiving dexamethasone “were at much higher risk for a debilitating bone condition called osteonecrosis,” although we would have been happier if that greater risk would have been quantified. However, the published study explains that there were toxicity problems beyond that of dexamethasone and the release would have been stronger including that information as well. The release stated the study was randomized and controlled, and provides a broad overview of the study design, for which we give the release a borderline satisfactory under this criteria. However, these are the superficial results. On deeper delving into the study methodology, the statistical significances of the results were very close to not statistically significant. This is due to their planned interim stopping of the treatment and the fact that they were looking at multiple outcomes in multiple groups. This release doesn’t demonstrate disease-mongering. While the release does say that this clinical trial was run by the Children’s Oncology Group, which is funded by the National Cancer Institute and the National Institutes of Health, it makes no mention of possible conflicts of interest. Compounding that is the fact that the published study says, “Disclosures provided by the authors are available with this article at www.jco.org,” but that information is behind the journal’s paywall for most readers, so it’s unknown if there is, or is not, a conflict. It appears as though five of the authors (out of a total of about 20) have some conflicts of interest, mostly from several types of drug company payments. The release is comparing the efficacy of treatment regimens using different drugs so alternative treatments for B-acute lymphoblastic leukemia are noted. The release makes clear at the end that the treatment of this disease is improving thanks to refinement of the use of existing drug treatments, meaning that they are readily available for patient use. The release suggests the study findings could change the way childhood leukemia is treated. Modifying existing treatments to enhance a patient’s survival is certainly novel enough to warrant a release. There is no use of unjustifiable language in this release. However, the tone may be a bit overly optimistic given the study findings. Claim: Relapses of childhood leukemia improve with high doses of common chemo drug

SOLUTION: This release reports the findings of a large clinical trial testing whether alternative dosing regimens of standard chemotherapeutic drugs can improve the treatment of B-acute lymphoblastic leukemia. The study showed that using high doses of the drug methotrexate, rather than the standard regimen of gradually increasing doses, improved the outcomes for patients with the disease. The study also showed that using the steroid dexamethasone increased a debilitating bone condition in patients 10 and older but not in patients nine or younger. While the study results are promising, they are by no means clear-cut in the release. The release needed some qualifiers in order to give a clear picture of the benefits. The release also neglected to discuss costs and potential conflicts of interest among the investigators. This form of cancer — B-acute lymphoblastic leukemia — is the most common cancer in children and a major cause of cancer death in patients under 40 years old. And while the majority of patients survive with appropriate treatment, anywhere from one-fifth to one-quarter of patients do not. This study showed that refining the dosing of standard cancer drugs may improve the outcome for some high-risk patients.

PROBLEM: Paragraph: A month after the first death from the highly infectious virus was registered in Italy, the government also issued an order freezing all business activity deemed non-essential in an effort to keep ever more people at home and off the streets. Amongst the sectors targeted were the car, clothing and furniture industries. They have until Wednesday to wind down operations and will have to remain shuttered until April 3. The interior and health ministries issued a separate statement, telling people they had to stay where they were, unless urgent business or health reasons forced them to move to another town or region. Italy has registered more deaths than any other country in the world, while the number of confirmed cases is second only to China, with the tally rising by 5,560 to 59,138 on Sunday, the Civil Protection Agency said. However, offering a ray of hope, the latest figures represented an improvement on Saturday, when the death toll rose by 793 and new cases increased by 6,557. “We don’t want to get over enthusiastic or overestimate a trend, but compared to yesterday there is a slight drop in the figures,” said Franco Locatelli, the head of Italy’s top health council, which advises the government. “We must not lower our guard, we must continue with the measures taken and respect the government’s instructions,” he told a news conference. Regional leaders having been pushing Prime Minister Giuseppe Conte for days to tighten the screws as infections have spiralled, but some business leaders and financiers expressed alarm at his decision to shutter more companies. “The closure of production activity is devastating. Our companies will lose market share and won’t be able to reopen for lack of liquidity,” Alberto Forchielli, head of Mandarin Capital Partners private equity fund, wrote on Twitter on Sunday. “This is the end of Italy’s industrial system.”  Amongst the companies that said they were halting production in Italy were the world’s largest eyewear company, Luxottica. However, union leaders accused Conte of not going far enough with his closure order, noting that dozens of sectors had won exemptions. They threatened to call a general strike if they thought too many workers were exposed to health risks. In a video posted late Saturday night on Facebook, Conte said Italy was facing its most serious crisis since World War Two, with the health system in the wealthy north at breaking point and almost every intensive care bed now filled. China has already sent medical equipment and doctors to help Italy, while more than 50 Cuban doctors arrived in Milan on Sunday to provide assistance to the stretched hospitals. The Russian military said it would also start sending aid to Italy on the orders of President Vladimir Putin. Domenico Arcuri, head of the government’s coronavirus relief effort, told state broadcaster RAI that Italy was “at war”. “All wars are won in two ways, with one’s own army and with the help of ones’ own allies,” he said. Claim: Italy bans internal travel as a further 651 die from coronavirus.

SOLUTION:
Italy banned travel within the country on Sunday in yet another attempt to slow the spread of the coronavirus, as data showed a further 651 people had died from the disease, lifting the number of fatalities to 5,476.