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: The article states that acupuncture costs $45 to $100 per session. It does not say how this compares to other treatments and whether the cost of care is the same, more or less than alternatives. The story states the proportion of patients who successfully responded to each therapy, and clearly explains that “real” acupuncture was no better than sham needling. But it does not define success or otherwise quantify how much people improved clinically in either relative or absolute terms. For a treatment to be considered successful, a patient must have reported either a 33% improvement in pain or as little as a 12% improvement in function during an interview conducted over the telephone 6 months after enrollment. Nonethless we’ll grade this criterion as satisfactory. The story did not mention harms from any of the treatments patients received. Previous research suggests that acupuncture poses few risks when performed with sterile, disposable needles. The article describes the largest randomized controlled trial to date investigating the effectiveness of acupuncture for treating chronic low back pain, and reports its published results. It discusses the three treatment groups studied and potential reasons for the outcomes observed. There are no obvious elements of disease mongering. The story explains that the study participants were people with chronic low back pain. These results wouldn’t apply to other back pain conditions. The article cites one of the study’s coauthors and two physicians who appear to be users and/or proponents of complementary therapies. It would have been interesting to hear from a skeptical observer. The story lists the therapies received by patients assigned to the conventional medicine group. The literature suggests that these treatments generally provide very modest benefits. The article does not mention other therapies that may be effective for managing chronic pain and improving flexibility and strength. These include cognitive therapy alone or in combination with intensive exercise and strengthening. Acupuncture is estimated to be the third most popular complementary therapy for chronic low back pain. Though the article does not say much about its availability, readers are likely to be familiar with it. The story notes that this is the largest study yet of acupuncture for chronic back pain, suggesting that the treatment is not new. There is no obvious use of text from a press release. Claim: Acupuncture, real or fake, called best for lower back pain

SOLUTION: This article reports on the largest randomized controlled trial to date investigating the effectiveness of acupuncture for treating chronic low back pain. It explains that both acupuncture and sham needling are more effective than conventional medical therapies, but that “fake acupuncture works nearly as well as the real thing.”       In addition to describing the quality of the evidence, the story mentions several other treatment options, tells the reader the cost of acupuncture, and hints at its novelty. The story neglects to mention harms. (A recent systematic review reinforces the study’s finding that acupuncture poses few risks; see Spine 2005;30:944-63). And it also provides an incomplete picture of the treatment’s apparent benefits. Although it notes the proportion of patients who improved with each therapy, it does not define success or otherwise quantify how much people improved clinically–in either relative or absolute terms. For a treatment to be considered successful, for example, a patient could have reported as little as a 12% improvement in function during an interview conducted over the telephone 6 months after enrollment. This is important information if people are to weigh the apparent benefit of a therapy against its cost. The article cites one of the study’s coauthors and two physicians who appear to be users and/or proponents of complementary therapies. They attempt to explain why needling seems to work. To provide some balance, the study’s coauthor suggests that the apparent benefit could merely be the result of patients’ expectations of improvement from acupuncture, on the one hand, and of poor results from conventional medicine on the other. (Unfortunately, the researchers did not measure patients’ expectations.) It would have been interesting to hear from others. Some might point out that the new study shows that acupuncture and sham needling are only more effective than treatments that are not themselves very effective. Others might make the case that acupuncture provides no specific treatment effect and is unethical to use—because it could be construed as prescribing a placebo. People with chronic low back pain are desperate for anything that will help. When a large new study provides apparently strong evidence to buttress a therapy that previously had little high-quality evidence to support it, readers might also benefit from more context. A major systematic review that analyzed 35 randomized trials involving 2861 patients recently concluded that acupuncture appears to confer modest, short-term pain relief, but that the quality of the studies was not very good. The reviewers were careful not to overstate the benefits of acupuncture (Spine 2005;30:944-63). Overall, this was a good article that would have been helped by some more context.

PROBLEM: Paragraph: Roy treads carefully as the water rises to his knees, seeming for a moment to lose sight of his prey. Then in one swift action he steps back, takes aim and shatters the outback calm, and a crocodile, with a single booming shotgun blast. I am definitely not in Sydney anymore. For more than 10 years I have dreamed of photographing the daily lives of Aboriginal Australians in the northern-most tip of the Northern Territory, Australia’s rugged “Top End”. Their Arnhem Land reserve - closer to Bali than Sydney - covers an area of around 97,000 sq km (37,500 sq miles), has a population of around 16,000 and access for non-Aborigines is by invitation only. Australia’s Aborigines are the custodians of the longest unbroken cultural tradition on Earth, having migrated Down Under from Africa via Asia between 40,000 and 60,000 years ago, and connection to the land is practically written into their DNA. But the arrival of European settlers in the 18th century marked the beginning of a painful disenfranchisement. Massacres are still tearfully remembered and today the majority of Aborigines live in abject poverty. Last year, while on patrol with the Indigenous Australian Army unit known as NORFORCE, I met Sergeant Norman Daymirringu, a Yolngu Aborigine, who invited me to go hunting with him near Ramingining, located a bumpy and dusty 600 km drive east of Darwin. Norman is allowed by tradition to share his ancient culture with those he deems worthy, and I was honoured to have been told the Yolngu people’s creation stories and shown their sacred sites. But entering Arnhem Land as a “White Fella” means changing gears and seeing the world through a completely different set of eyes, a great challenge for a photographer. For example, an outsider might struggle to understand a site such as “Dog’s Tongue”, an orange rock amid a barren salt pan, but for Norman it is an integral part of the creation of the universe. The rock has tipped over from its normal position and Norman, as custodian of the land, affords me the rare honor of watching as he puts it back in place, where it has stood for countless millennia. At Yathalamarra, a community consisting of around a dozen houses, we pick up some relatives for the hunt and head on foot to an isolated billabong. With the sun blazing and temperatures reaching 40 degrees Celsius, or 104 Fahrenheit, I am getting pessimistic, when suddenly Roy fires his shotgun. At his feet lies a dead crocodile. Roy pulls the beast from the water, while Marcus keeps lookout. Not far from the shoreline the water starts moving. Suddenly Marcus pounces and, from just beneath the surface, he pulls another crocodile, this one a bleating baby. Roy is nervous about crossing the billabong carrying a heavy dead crocodile, but wanders downstream and grabs a boat hidden in the bushes. Using a stick as a paddle he navigates towards us, throwing the two crocs onto the muddy shore. Wow, its over, I think. We can head off with a great catch and potential feast awaiting. Roy has other ideas: “It’s easier to carry them without all that skin,” he tells me. Any butcher would have been extremely impressed with the skill he showed at filleting this massive beast. The baby was carried out alive. As we are leaving, Roy wraps the intestines in leaves, as nothing that can be eaten is wasted, and he and his sons walk the few kilometers back to the car with crocodile meat and a goanna lizard slung over their shoulders. As for me, I walked away with a unique insight into their culture and some photographs that not many others have had the privilege of taking. Claim: Hunting for pictures, and crocodiles, in remote Aboriginal country.

SOLUTION: We are deep in a forest crowded by Australian paperback trees, the air thick with humidity but eerily silent save for the screeching of tropical birds, when Marcus shouts: “Look, crocodiles!”    As a Reuters photojournalist, I’m a trained observer, but I can’t see any crocs. I can’t see anything beyond mud and what little water is left in the small billabong. Aboriginal hunters Marcus and Roy, a father and son team, take off running past a herd of water buffalo and by the time I catch up Roy is standing ankle-deep in murky water, his shotgun pointed at the surface. Hang on a minute: wasn’t your son pointing at crocodiles in that water ten seconds ago? Is this safe?

PROBLEM: Paragraph: Today, gene testing mostly focuses on rare mutations in one or a few genes, like those that cause cystic fibrosis or sickle cell disease, or the BRCA gene responsible for a small fraction of breast cancer. It is less useful for some of the most common diseases, such as heart disease or diabetes, because they are influenced by vast numbers of genes-gone-wrong working together in complicated ways. Monday, researchers reported a new way to measure millions of small genetic variations that add up to cause harm, letting them calculate someone’s inherited risk for the most common form of heart disease and four other serious disorders. The potential cardiac impact: They estimated that up to 25 million Americans may have triple the average person’s risk for coronary artery disease even if they haven’t yet developed warning signs like high cholesterol. “What I foresee is in five years, each person will know this risk number, this ‘polygenic risk score,’ similar to the way each person knows his or her cholesterol,” said Dr. Sekar Kathiresan who led the research team from the Broad Institute, Massachusetts General Hospital and Harvard Medical School. If the approach pans out and doctors adopt it, a bad score wouldn’t mean you’d get a disease, just that your genetic makeup increases the chance — one more piece of information in deciding care. For example, when the researchers tested the system using a DNA database from Britain, less than 1 percent of people with the lowest risk scores were diagnosed with coronary artery disease, compared to 11 percent of people with the highest risk score. “There are things you can do to lower the risk,” Kathiresan said — the usual advice about diet, exercise, cholesterol medication and not smoking helps. On the flip side, a low-risk score “doesn’t give you a free pass,” he added. An unhealthy lifestyle could overwhelm the protection of good genes. The scoring system also can predict an increased risk of Type 2 diabetes, inflammatory bowel disease, breast cancer and an irregular heartbeat called atrial fibrillation, the team reported in the journal Nature Genetics — noting that next steps include learning what might likewise lower those risks. It doesn’t require the most sophisticated type of genetic testing. Instead, Kathiresan can calculate risk scores for those five diseases — eventually maybe more — simply by reanalyzing the kind of raw data people receive after sending a cheek swab to companies like 23andMe. A geneticist who specializes in cardiovascular disease, he hopes to open a website where people can send in such data to learn their heart risk, as part of continuing research. Kathiresan and co-author Dr. Amit Khera, a Mass General cardiologist, are co-inventors on a patent application for the system. Other scientists and companies have long sought ways to measure risk from multiple, additive gene effects — the “poly” in polygenic — and Myriad Genetics has begun selling a type of polygenic test for breast cancer risk. But specialists in heart disease and genetics who weren’t involved with the research called the new findings exciting because of their scope. “The results should be eye-opening for cardiologists,” said Dr. Charles C. Hong, director of cardiovascular research at the University of Maryland School of Medicine. “The only disappointment is that this score applies only to those with European ancestry, so I wonder if similar scores are in the works for the large majority of the world population that is not white.” Hong pointed to a friend who recently died of a massive heart attack despite being a super-fit marathon runner who’d never smoked, the kind of puzzling death that doctors have long hoped that a better understanding of genetics could help to prevent. “Most of the variation in disease risk comes from an enormous number of very tiny effects” in genes, agreed Stanford University genetics professor Jonathan Pritchard. “This is the first time polygenic scores have really been shown to reach the level of precision where they can have an impact” on patient health. First, the Boston-based team combed previous studies that mapped the DNA of large numbers of people, looking for links to the five diseases — not outright mutations but minor misspellings in the genetic code. Each variation alone would have only a tiny effect on health. They developed a computerized system that analyzed how those effects add up, and tested it using DNA and medical records from 400,000 people stored in Britain’s UK Biobank. Scores more than three times the average person’s risk were deemed high. ___ The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. Claim: Multi-gene test may find risk for heart disease and more.

SOLUTION:
You know your cholesterol, your blood pressure ... your heart gene score? Researchers say a new way of analyzing genetic test data may one day help identify people at high risk of a youthful heart attack in time to help.