instruction:
Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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Nguyen’s suicide has sparked a contentious legal battle headed to Massachusetts’ highest court over whether schools can be held responsible when students take their own lives. The case is being closely watched by colleges and universities, who say a decision against the Massachusetts Institute of Technology would place an unreasonable burden on untrained employees to stop suicides. “It would be groundbreaking,” said Gary Pavela, a consultant on law and policy issues in higher education and author of a book about legal questions surrounding student suicides. “It would cause alarm in higher education,” he said. The student’s family says his death was preventable and that the school had a legal duty to use reasonable care to protect him from harm. Nguyen’s professors and other MIT officials knew he was a suicide risk, but failed to get him the help he needed, an attorney for Nguyen’s family argues. Months before Nguyen’s death, a professor encouraged his colleagues to pass him or they might have “blood on their hands.” Moments before Nguyen jumped, the professor “read him the riot act” over an email Nguyen sent to another MIT official that they deemed inappropriate, court records say. “Academic freedom is not a license to needlessly and recklessly endanger students known to be at risk of death with impunity; and this court should not allow it to become one at institutions that routinely admit students — many with mental health issues — as young as their mid-teens,” attorney Jeffrey Beeler wrote in court documents. Beeler declined to comment and said Nguyen’s family didn’t want to speak to the media. MIT says the school wasn’t aware of the severity of his condition and he was treated by outside professionals and refused on-campus resources. None of the nine professionals who treated Nguyen while he was at MIT believed he was an imminent risk of killing himself, the school says. “Mr. Nguyen’s suicide was a tragedy. That does not warrant a legal conclusion that MIT or any individual associated with MIT had a legal duty to prevent it,” attorneys for the school, two professors and one dean named in the lawsuit say in court documents. MIT, which refused to answer questions about the case, said in a statement it “remains committed to the well-being of its students, offering a robust network of support resources, including comprehensive mental health services.” Nguyen’s family attorney disputes the idea that the man didn’t want help and has accused MIT of blaming the victim. No state supreme court has ever found that colleges and universities have a legal duty to prevent student suicides, MIT’s attorneys say. Courts have generally been reluctant to do so because, among other things, suicide is an impulsive act that’s difficult to predict, Pavela said. A Massachusetts trial court judge ruled in 2005 that an MIT housemaster and dean could be held responsible for the death of a woman who lit herself on fire in her dorm room. But Elizabeth Shin’s case, which was later settled for an undisclosed amount, never reached the state’s highest court. The Supreme Judicial Court will hear arguments in Nguyen’s case on Tuesday after a lower court judge tossed the lawsuit last year. A group of 18 colleges and universities — including Harvard University and Boston College — is urging the court to reject the case, saying a decision in favor of the family could have devastating consequences. Fear of liability may cause professors and others without mental health expertise to overreact to concerns, which in turn could discourage students from coming forward with their problems, the schools say. Dr. Paul Appelbaum, a psychiatry expert at Columbia University, agrees. “To the extent that you heighten every resident assistant’s sensitivity to the risk of suicidality, with the threat of liability hanging over them, they are far more likely to over predict, over intervene, see it where it’s not,” Appelbaum said. The Nguyen family attorney and their supporters — including the Massachusetts Academy of Trial Attorneys — say the schools’ concerns are baseless. Beeler, in his filing, said he merely wants the court to affirm that the duty to provide reasonable care “extends to the ivory tower as it does every other civilized corner of the Commonwealth.” Thomas Murphy, chair of the amicus committee of the Massachusetts Academy of Trial Attorneys, says a jury should get to decide whether MIT was negligent and caused Nguyen’s suicide. “Maybe the school can convince them that they didn’t cause (Nguyen’s suicide) and it was going to happen anyway,” he said. ___ Follow Alanna Durkin Richer at http://twitter.com/aedurkinricher. Read more of her work at http://bit.ly/2hIhzDb
answer:
Case stirs question of school liability for student suicides.


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Clearly, the costs involved in cancer treatment already are high. By removing a layer of treatment from an estimated 40,000 patients, those costs would have to drop, but it is unclear from the story by how much. Also, it would have been worth mentioning whether this is likely to affect how insurance companies handle lymph node removals. The story did a good job providing some numbers on benefits, but we wish it had provided more and explained some things a bit more. It says, for example, “In 27 percent of the women who had additional nodes removed, those nodes were cancerous.” How many women had additional nodes removed and, of those, how many had cancerous nodes? A figure like 27% means 1 out of every 4 women had nodes that were, indeed, cancerous, which seems to conflict with other statements in the story about chemotherapy and radiation wiping out the cancer. The story discusses several harms from lymph node removal, and shows that the difference in survival for women who had nodes removed and those who did not was not significant. “Indeed, women in the study who had the nodes taken out were far more likely (70 percent versus 25 percent) to have complications like infections, abnormal sensations and fluid collecting in the armpit. They were also more likely to have lymphedema.” This is where the story really outperformed some of the competition covering the same news. It placed the study into the broader context of a movement in cancer care away from surgeries that don’t provide a clear benefit, and it also explained the study design and the limitations of the study in several ways. “The study, at 115 medical centers, included 891 patients. Their median age was in the mid-50s, and they were followed for a median of 6.3 years. … One potential weakness in the study is that there was not complete follow-up information on 166 women, about equal numbers from each group. The researchers said that did not affect the results. A statistician who was not part of the study said the missing information should have been discussed further, but probably did not have an important impact. It is not known whether the findings also apply to women who do not have radiation and chemotherapy, or to those who have only part of the breast irradiated. Nor is it known whether the findings could be applied to other types of cancer.” It was too bad that it did not mention limitations in terms of lack of enrollment. The targeted enrollment was 1900. There also was an imbalance in the randomization that should have been mentioned. The story is careful to explain to readers that the research findings only apply to a subset of women with breast cancer. “Now, researchers report that for women who meet certain criteria — about 20 percent of patients, or 40,000 women a year in the United States — taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling.” The Q&A that ran with the story provided more detail about the different types of cancers and cancer patients, noting, for example, “First of all, 20 percent (the estimate of the study’s lead author, Dr. Armando E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive breast cancer each year. This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in situ. The total is about 207,000, so 20 percent is roughly 40,000 women. That is about how many women would match those in the study, in terms of tumor status, affected lymph nodes and course of treatment.”  The story also says, “The results mean that women like those in the study will still have to have at least one lymph node removed, to look for cancer and decide whether they will need more treatment. But taking out just one or a few nodes should be enough.” Good quotes including from Dr. Monica Morrow, chief of the breast service at Sloan-Kettering and an author of the study, but also a few fromindependent experts toward the end. Dr. Grant W. Carlson, a professor of surgery at the Winship Cancer Institute at Emory University, and the author of an editorial accompanying the study, provides some soul-searching context by saying that, in taking out so many lymph nodes, “I have a feeling we’ve been doing a lot of harm.” Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan, said, “It’s definitely practice-changing.” And Dr. Alison Estabrook, the chief of the comprehensive breast center at St. Luke’s-Roosevelt hospital in New York said, “In the past, surgeons thought our role was to get out all the cancer. … Now he’s saying we don’t really have to do that.” The story does a great job explaining the history of this form of treatment and how it has evolved over time. “But doctors have continued to think that even microscopic disease in the lymph nodes should be cut out to improve the odds of survival. And until recently, they counted cancerous lymph nodes to gauge the severity of the disease and choose chemotherapy. But now the number is not so often used to determine drug treatment, doctors say. What matters more is whether the disease has reached any nodes at all. If any are positive, the disease could become deadly. Chemotherapy is recommended, and the drugs are the same, no matter how many nodes are involved.” The story goes on to do something that stories like this rarely do, it compares compares the harms from different forms of treatment, saying “After armpit surgery, 20 percent to 30 percent of women develop lymphedema, Dr. Port said, and radiation may increase the rate to 40 percent to 50 percent. Physical therapy can help, but there is no cure.” The story makes it clear that removing all under-arm lymph nodes is the standard of care for women with breast cancer and that feelings about that standard are entrenched. The story establishes that a change in treatment protocol away from removing all the lymph nodes under the arms of women with breast cancer would be novel. There is some nuance, here, though that could be missed by a casual reader. Women who have one to two positive lymph nodes would avoid having additional lymph node surgery. The overall tone of the story may make it appear to some readers that women get to avoid lymph node surgery altogether, but they don’t. The story goes well beyond any news release.
answer:
Lymph Node Study Shakes Pillar of Breast Cancer Care


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The Mississippi Department of Environmental Quality late Friday lifted water contact warnings that were issued Aug. 6. Warnings also were lifted for Pass Christian Harbor, Long Beach Harbor and Bay St. Louis Harbor. All summer long, harmful blue-green algae blooms have plagued the coast. MDEQ says recent results indicated that while the bloom was present and/or in bloom, many of the cells were dying. MDEQ moved to the toxicity testing phase of the protocol this week. Sampling results, officials say, were all below the EPA guidelines set to protect public health.
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Mississippi Coast beaches open, contact advisories lifted.