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.

Input: Consider Input: Paragraph: An asthma sufferer wears a paper face mask as she is attended by nurses in this undated file image. REUTERS/Jason Reed The findings were published in the journal Lancet together with two other studies, which found that runny noses and wheezing early on in life may be strong predictors of asthma. In the first study, researchers pored through data provided by parents of more than 205,000 children and found paracetamol use in the first year of life was associated with a 46 percent higher risk of asthma by the time the children were 6 or 7 compared to those never exposed to the drug. Known as acetaminophen in the United States, where it is widely sold under the brand Tylenol, it is used to relieve fever, minor aches and pain, and is used in a liquid suspension for children. Medium use of paracetamol in the past 12 months increased asthma risk by 61 percent, while high dosages of once a month or more in the past year raised the risk by over three times. Medium use was defined as once per year or more, but less than once a month. Suspicions of a possible link between paracetamol and asthma emerged in recent years when experts observed an increased use of the drug to a simultaneous rise in asthma prevalence worldwide. One theory is that paracetamol reduces antioxidants in the body. Some experts think antioxidants, which stop unstable molecules known as free radicals from doing too much damage, can lower the risk of cancer, heart disease and other ailments. “Paracetamol can reduce antioxidant levels and ... that can give oxidative stress in the lungs and cause asthma,” one of the researchers, Richard Beasley at the Medical Research Institute of New Zealand, told Reuters in a telephone interview. As with asthma, monthly use of paracetamol doubled the risk of eczema and trebled that of rhinoconjunctivitis — repetitive sneezing, rhinorrhea, nasal congestion and hay fever — by the time children were 6 or 7, the study found. However, the researchers stressed paracetamol should remain the preferred drug to relieve pain and fever in children because its alternative, aspirin, was linked to the risk of Reye’s syndrome, a rare but serious complication in children. “The findings do lend support to the current guidelines of the World Health Organization, which recommend that paracetamol should not be used routinely, but should be reserved for children with a high fever (38.5 Celsius or above),” they wrote. Another study in The Lancet found that rhinitis, or hay fever and other allergic reactions causing a runny nose, was a strong predictor of asthma that develops in adulthood. Researchers monitored 6,461 people in 14 countries who were free of asthma at the start of study for more than 8 years. Those who suffered rhinitis and were allergic to an assortment of agents like house dust mites, cat, grass and birch were 3.5 times more likely to develop asthma later on compared to those who suffered no allergies nor rhinitis. The third study in Arizona in the United States found wheezing early in life may be an ominous sign of asthma developing in adulthood. Researchers pored through data on 849 people going back 22 years to the time they were babies. Of 181 cases of active asthma, 49 were newly diagnosed, of which 35 were women. “In over 70 percent of people with current asthma and 63 percent of those with newly diagnosed asthma at age 22 years, episodes of wheezing had happened in the first three years of life or were reported by parents at age six years,” wrote the researchers at the Arizona Respiratory Center. In an accompanying comment, Suzanne Lau of Charite University Medicine in Germany, wrote: “These findings identify a population at risk of chronic obstructive airway disease in early adulthood, and they already showed a predisposition during preschool years.” Lau was not involved in the study. Claim: Paracetamol use may raise asthma risk in children.

Output: Infants who have been given the common pain reliever paracetamol may have a higher risk of developing asthma and eczema by the time they are 6 or 7, a large study covering children in 31 countries has found.


Input: Consider Input: Paragraph: Given that this is an illegal substance banned by the U.S. Drug Enforcement Agency, cost as a therapeutic would be difficult to ascertain. We liked that the story took pains to explain that approval of this drug faces many hurdles. This is a tough one. While the story tells us what percentage of patients benefited from treatment, it does not, in fact, quantify the extent of those benefits–which is precisely what this category is designed to assess. However, the story does do a good–and thorough–job of describing the benefits in qualitative terms. That said, if the story had only chosen one or two examples of changes in the standardized measures of depression or anxiety, this would have received an enthusiastic “Satisfactory” rating. One strong word of caution though: The story cites one source as saying that psilocybin may one day be used to treat a wide range of mental health issues ranging from drug addiction to obsessive-compulsive disorder. The story offers no evidence to support these claims, which were made by a source associated with an organization that exists specifically to promote research on hallucinogens. Substantial claims require substantial evidence. The story would have been much stronger if it had eliminated the unsubstantiated remarks from the source — particularly since they had no bearing on the subject of the story. The story addresses this issue thoroughly. Well done. The story does a good job of both describing the design of the studies and explaining why the study design is relevant. For example, the story notes: “But both [studies] were considered to be double-blind placebo trials — the gold-standard of medical research in which subjects are left to guess whether they have gotten the active study drug or an inactive lookalike.” This is the sort of thing we like to see. However, we did want to note that in the NYU study, researchers did state in the limitations section that there was “limited blinding” — how did that possibly affect the outcomes? No disease mongering here. However, the story should have been more cautious about claims of benefit for conditions ranging far beyond the scope of the research at hand, which focused on mental health problems among people with advanced cancer. The story clearly states who funded the studies, and what that organization’s long-term goals are. Further, the story clearly identified individuals quoted in the story who have ties to the studies or the funding organization. Lastly, the story incorporates input from an independent expert. However, the story would have been stronger if there had been a skeptical take on the research, which saw in some other coverage, such as this New York Times piece. The story does not address other treatment options for anxiety or depression, such as talk therapy or other pharmaceutical interventions. The story does a good job here. For example, the story notes: “[F]inding drugs like psilocybin effective is by no means the final hurdle to their widespread availability. None are currently in production, and no for-profit pharmaceutical company would likely invest millions of dollars to bring to market a pill intended effectively for one-time use.” Well done. This is a close call. The story does do a good job of placing the work in context in regard to overall research involving hallucinogens. That’s enough to earn it a “Satisfactory” rating. However, the story doesn’t mention any of the work done in the past 10 years on the use of psilocybin specifically to address anxiety in cancer patients, such as this 2007 study, this one from 2011, or this one from 2013. Are the results from the two new studies consistent with these earlier findings? Do they differ in a meaningful way? That would be good to know. The story does not appear to rely on a news release. Claim: Ingredient in magic mushrooms is shown to ease anxiety and depression in cancer patients in one dose

Output: The story focuses on two recent studies that find a single application of the hallucinogen psilocybin is effective at providing meaningful relief to cancer patients suffering from severe depression or anxiety. The studies were published in the Journal of Psychopharmacology, and can be found here and here. In some ways, the story is thorough, addressing potential side effects and conflicts of interest very well. The story discusses the potential benefits in depth, which is good, but fails to quantify those benefits — which is problematic. The story also does a good job of placing the work in context, highlighting the increasing profile of research into the use of hallucinogens as therapeutic tools for mental health problems. However, the story would have been even stronger if it had discussed the existing literature on the use of psilocybin to address anxiety in cancer patients. We also reviewed two news releases related to the research:   Depression and other mental health struggles are common and significant among people with cancer, especially terminal cancer. This makes it especially important for reporters to write responsibly about studies like those discussed in this story. You want to give readers enough information to help them make informed decisions. You don’t want to raise false hopes, or sensationalize the work. Overall, this story does a nice job of handling a delicate subject well.


Input: Consider Input: Paragraph: It’s  not that costs are high, it’s just that they weren’t discussed. The costs of Prozac are well known and could have been included in this story. Taking just one pill a day for 30 days would cost $214 through Drugstore.com.Prozac is generic at $10 for 3 months at one big box chain. There are also medical followup costs and possibly costs of managing adverse effects. After explaining that the story was quite small and covered only a few months time, the story provides a quick summation of the benefits found in the study saying, “half of the participants taking Prozac had significant reductions in obsessive-compulsive symptoms, compared with 8% taking placebo.”  But given the very small sample size, natural frequencies would have been more informative and less likely to be misinterpreted. Also, a bit more detail on what a “significant reduction” means in an autistic disorder would have been welcome. The story does say that, “Side effects were mild to moderate and participants taking Prozac did not show increases in suicidal thoughts or ideas.”  It could have noted, though,  that 12 weeks may not be long enough for side effects to emerge. We liked how the story put up high some of the basics of the study, that it was limited to 37 subjects, that they were “high-functioning autistic adults, mainly diagnosed with Asperger’s syndrome,” and that they were followed for 12 weeks. Even though it sometimes feels like boilerplate language, it would have been appropriate to emphasize how small and short-term was this study and that it needs to be replicated in a larger, longer-term study. The story does not engage in disease mongering but it could have provided a little more detail about the differences between Asperger’s syndrome and other forms of autism. The story briefly quotes another story in which Yale Child Study Center director Fred Volkmar commented on the study, indicating that more research was needed. We would have liked to have seen more independent voices helping readers understand whether there was anything new here. The story also says, “Hollander has previously received funding from pharmaceutical companies, but the current study was paid for by a grant from the Food and Drug Administration’s “orphan” drug program.”   Here’s where the story both excels and disappoints. It takes note of prior research on antidepressants and notes that the “only drugs approved to treat irritability and repetitive behaviors in autistic children are the atypical antipsychotics Risperdal (risperidone) and Abilify (aripiprazole), which tend to have more severe side effects than Prozac does.” What the story does not explain, though, is that Hollander himself has researched this exact topic and arrived at very similar conclusions, which may bolster his case in some ways and weaken it in others. In 2005, he found in the journal Neuropsychopharmacology that “Liquid fluoxetine in low doses is more effective than placebo in the treatment of repetitive behaviors and that “Limitations include small sample size”. There was also no mention of the possibility of behavioral treatments. The story makes it clear that Prozac is widely available and that other drugs are approved for use in autistic patients. The novelty of the finding is at least implied. This small study increases the number of patients studied in randomized clinical trials by about 15% and it is in adults. With the exception of the earlier RCT published in Archives Gen Psy (N=149) – in children – there are just a handful of small studies on this topic. The story does not rely on a press release. Claim: Prozac May Reduce Symptoms of Autism in Adults


Output: This story covers a study that adds to prior research. A quick PubMed search finds an astonishing lack of randomized clinical trials evaluating antidepressants for autism. Although the study is small, it is a randomized clinical trial and addresses a gap in the evidence. We would have like to have seen: Overall, though, nice job of reporting. The autism community is active, motivated and passionate about finding treatment solutions for their children and themselves. There is a huge amount of debate about the benefits of medication and whether some forms of autism need be treated as a medical disorder at all.