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.

[Q]: 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.
[A]: 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.


[Q]: Paragraph: The company earned $728 million, or 67 cents per share, in the fourth quarter. That compared with $827 million, or 74 cents per share, in the year-earlier quarter, when Lilly took charges for asset impairments and restructuring. “Company sales were stronger than thought, but a lot of that upside came from drugs that are already off patent or about to lose patent protection,” said Edward Jones analyst Judson Clark. Excluding special items, Lilly earned 74 cents per share, matching analysts’ average forecasts, according to Thomson Reuters I/B/E/S. Shares in the company dropped 1.4 percent to 53.21, after earlier reaching their lowest in two weeks at $53.05. Lilly’s global sales fell 2 percent to $5.81 billion, but topped Wall Street forecasts of $5.46 billion. Sales would have been flat if not for the stronger dollar, which lowers the value of sales in overseas markets. Sales of Cymbalta, which lost U.S. patent protection last month, fell 38 percent to $883 million. But they came in about $100 million higher than Wall Street expected, analysts said. Lilly’s sales, earnings, and its share price, have been badly hurt since late 2011, when its Zyprexa schizophrenia drug lost U.S. patent protection. Once Lilly’s biggest product, with annual sales of $5 billion, it now has sales of only $1.5 billion. The situation worsened last month, when Cymbalta - which also had $5 billion in annual sales at its peak - began facing cheaper generics in the United States. The company’s “patent cliff” will become more daunting in March, when $1 billion-a-year osteoporosis drug Evista faces U.S. generics. “We haven’t wasted the crisis,” Chief Executive John Lechleiter said Thursday in a conference call with industry analysts. “We’re more agile, we’re leaner and I believe we’re better operators today.”  Lilly has cut more than 5,000 employees from its workforce in order to reduce annual costs by $1 billion over the last three years to deal with patent expirations on its drugs. It has also restructured itself to focus on cancer and diabetes - lucrative specialties that are two of the company’s longstanding strengths. Clark said sales of Cymbalta could eventually decline 80 percent, which has been the case for many other blockbuster medicines in recent years. He questioned whether gains for other products seen in the fourth quarter will be sustainable. Sales of many products over the quarter showed double-digit sales increases, including Lilly’s Humalog insulin, Cialis anti-impotence treatment, Forteo and Evista osteoporosis drugs, and Straterra for attention deficit disorder. But price increases in the United States accounted for much of those sales gains. The Indianapolis drugmaker is expecting a return to company sales growth next year, from increased sales of drugs that still have patent protection and from launches of new treatments for cancer and diabetes. It hopes to launch three new drugs this year: ramucirumab for stomach cancer, and dulaglutide and empagliflozin for type 2 diabetes - the most common form of the disease, which is closely linked to obesity. Although analysts have forecast annual sales of more than $650 million for ramucirumab, they are concerned the new diabetes drugs may have a hard time competing with similar drugs already on the market. The company has introduced no new products in recent years. In a recent interview, Lechleiter said it was time for Lilly “to go back on offense”, helped by a pipeline of nearly 40 medicines in mid- and late-stage studies, compared with only seven in those stages of development a decade ago. Claim: Lilly's quarterly sales largely offset Cymbalta slide.
[A]: Drugmaker Eli Lilly and Co’s quarterly revenue fell far less than expected, it reported on Thursday, as plunging sales of its Cymbalta depression treatment were largely offset by higher revenues for most of its other prescription drugs.


[Q]: Paragraph: The story focused on costs, including information about the relative cost comparison between what are called “open” surgeries and those done laparoscopically (with a thin flexible tube.) The release summarized how minimally invasive techniques reduced the length of hospital stay and complication rates for patients. “Researchers also found that, on average, the minimally invasive approach reduced length of hospital stay by approximately two days, and open operations were more than $9,000 more expensive than minimally invasive procedures. The researchers also found that laparoscopic procedures were better for patients in terms of fewer complications. Laparoscopic anti-reflux operations were less likely to result in postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” We rate this, but just barely, for citing cost differences between the two types of surgery and the average reduction in the number of days a patient must remain hospitalized. We do wish the release had delved more into the specifics of reduced complications. How common were the surgical complications in each surgical method? The release names complications associated with both types of surgery for GERD, while stating that patients undergoing laparoscopic procedures encountered fewer of them: “postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” The news release gave details about how the study examined records of about 75,000 patients from 1,000 hospitals to compare outcomes in the records for open vs. the minimally invasive laparoscopic surgeries. That’s all to the good. However, the news release didn’t mention any of the study’s limitations. The key one is that this is a retrospective, observational review of records that isn’t capable of supporting cause and effect statements such as the minimally invasive approach “reduced length of hospital stay by approximately two days.” Nor should this kind of evidence be used as the basis for statements such as laparoscopic procedures “were better for patients” and “should be the standard of care.” Patients receiving open vs. laparascopic procedures could differ in unknown ways, which is why the superiority of one approach over the other should ideally be established by a prospective, randomized controlled trial. There were other limitations outlined in the journal article that were not mentioned in the release. Because the NIS database doesn’t link to hospital records, researchers weren’t able to track and measure outcomes “including complications, readmission, and mortality, occurring after the initial hospital discharge.” The researchers were also unable to determine which open surgeries were “re-dos” of previous surgeries. The potential for errors in coding which procedures were used was also cited as a possible limitation. There was no disease mongering. The release also provided useful context on the prevalence of GERD and further specified that smaller group of patients, from the many heartburn suffers, might be candidates for the surgery. Well done. The release does not list any funding source for the research and the published study notes that authors had “nothing to disclose.”  We’ll rate this not applicable since this is an examination of existing data, and there may have been no additional outside funding. The news release does a good job here. It compares different surgical methods and it also names alternatives for treating GERD such as medications and changes in the diet. It also states which group of patients the surgery is aimed at: “Anti-reflux surgery should be considered in patients who do not achieve complete control of their symptoms [regurgitation or cough] with medications; who do not want to take medications for the rest of their lives; or who experience complications of medical therapy.” It’s clear from the release that both methods of surgery have been widely available nationally and the outcomes of 75,000 surgeries were tracked by the National Inpatient Sample (NIS) database. The release also notes that “urban academic or teaching hospitals” perform laparoscopic anti-reflux surgery more often than “open” procedures, 54.4 percent versus 45.6 percent. And it recommends that anti-reflux surgery should be performed laparoscopically in specialized centers. The news release was not about a novel procedure and made no claim of novelty. However, this isn’t the first study to examine laparoscopic vs. open surgery. For example, the British Journal of Surgery published results of a randomized trial of the two methods and the Scandinavian Journal of Gastroenterology published research on long-term outcomes following laparoscopic and open procedures for GERD. We did not observe any unjustifiable language. Claim: Laparoscopic anti-reflux operation for GERD linked to fewer postoperative complications
[A]:
A new study by the American College of Surgeons, a professional organization, compared records for 75,000 patients who underwent surgery for GERD, or gastrointestinal esophageal reflux disease. The study looked at two different surgical procedures and found the less invasive one seemed equally effective, but kept patients in the hospital a shorter time with fewer complications. The news release did a good job of discussing surgical alternatives and costs, which were estimated to be $9,000 lower for the less invasive laparoscopic procedure. The release would have been better had it spelled out some of the study limitations, the key one being that a retrospective, observational review of hospital records — as this study was — isn’t capable of supporting the cause and effect statements sprinkled throughout the release. Millions of Americans complain of occasional heartburn, sometimes called a burning sensation in the throat from food coming back up from the stomach. But some estimates are that about 20 percent of US adults fit the definition of GERD, which means they suffer symptoms at least every week. If patients consider a surgical fix, this study shows that a less-invasive procedure could reduce their complications and shorten their hospital stay. It’s hard to pin down stats on GERD prevalence. A 2014 review of 16 epidemiological studies of GERD prevalence published in the journal Gut suggest GERD prevalence ranges from “18.1%-27.8% in North America, 8.8%-25.9% in Europe, 2.5%-7.8% in East Asia, 8.7%-33.1% in the Middle East, 11.6% in Australia and 23.0% in South America.”