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: The article did not discuss costs. Screening mammograms impose a significant cost on the U.S. health care system and insurers, particularly Medicare. The story detailed the relative harms of earlier mammograms, but did not translate those percentages into absolute numbers. For instance, women who were diagnosed with breast cancer 25 months or more after their last mammogram were “50 percent more likely” to need chemotherapy, “32 percent more likely” to need mastectomy, and “66 percent more likely” to need lymph nodes removed. However, relative risk can be misleading, sometimes inflating numbers to sound scarier than when absolute numbers are used. Also, we don’t know what kind of risk these women had at baseline, so it’s hard to know if they were higher risk. The story made no mention of the harms of earlier or more frequent screening, which have been documented time and time again. More screening can mean more false positives or more finding of breast changes that lead to more testing, such as biopsies, more costs, and more worry. The story did make clear some of the weaknesses of the study: The study found an association but did not prove causality and the study population was limited to a single health care institution. The story also mentions that the findings were presented at a meeting, which means they have not undergone peer-review. The story does not directly engage in fear-mongering. However, some of the quotes advocating for earlier and more frequent screening play into a scenario that breast cancer is lurking in every woman. A discussion of what a woman’s average lifetime risk is would have been helpful. The story quotes the study author and an outside source. The story makes clear that different advisory groups have differing guidelines for what age to start getting mammograms (40 or 50 years old). It would have been nice if the story had included examples of what makes someone higher risk or not (personal cancer history, family history, history of radiation), but we think this was satisfactory. We believe that mammograms are well-known to be widely available. And the earlier and more frequent screening described here is not earlier or more frequent than what many guidelines recommend, so would not be expected to be denied by health insurers. The story makes clear the distinctive aspects of this study —using avoidance of more aggressive treatment regimens as a deciding factor, as opposed to the more extreme avoidance of cancer death. The story goes beyond what was contained in a news release on the presentation at the American Society of Breast Surgeons annual meeting. Claim: Earlier Mammograms May Mean Less Need for Aggressive Treatments
[A]: This HealthDay news story reports on findings among women diagnosed with breast cancer: those who had longer intervals between mammograms end up getting more aggressive treatments, including chemotherapy and surgery. The story would have been stronger had it described the findings using absolute rather than relative numbers. But, we were glad to see an independent source offer some reservations about the small observational study raised. A final note — the image accompanying the story was laughably unrealistic. Mammograms are the primary screening method for detecting breast cancer. However, when to start getting mammograms and how often to get screened have been subjects of controversy for the past decade. That’s because the data on how to balance risk of developing breast cancer and the risk of harms from screening (unnecessary tests and procedures) are interpreted differently by doctors and other experts. A story that adds new data to the field and that might tip current guidelines one way or the other is newsworthy.


[Q]: Paragraph: Most Americans are familiar with the exploits of John Glenn, a former U.S. Marine Corps pilot who, as one of the original Mercury 7 astronauts, was transformed into a national hero after becoming the first American to orbit the Earth on 20 February 1962. Later in life he represented Ohio in the United States Senate for twenty-four years, and in 1998 he became the oldest person to go into space when he flew on a Space Shuttle Discovery mission in 1998. Much less well known is John Glenn’s wife, the former Annie Castor, whom Glenn had known since childhood and married when he was a 21-year-old combat pilot during World War II. In February 2012, the fiftieth anniversary of Glenn’s orbital flight prompted CNN contributor Bob Greene to pen the article referenced above about the Glenns’ lengthy marriage (currently 68 years) and Annie’s long battle to overcome a terrible stuttering problem which had she had struggled with since she was a little girl, an affliction she finally managed to overcome at the age of 53. Annie Glenn began speaking out publicly about her lifelong struggle with her speech impediment in the early 1980s, discussing the subject on national television and in the press, crowning her achievement by making speeches on behalf of her husband as he campaigned for the 1984 Democratic presidential nomination. A 1982 Los Angeles Times article on the subject of Annie Glenn’s speaking out about her disability reported that: Annie Glenn is one of the country’s estimated 2 million people who suffer what may be the most misunderstood disability: stuttering. Until she underwent a new form of intensive, live-in treatment three years ago at the Communications Research Institute at Hollins College in Roanoke, Va., Mrs. Glenn could not speak well enough to call the plumber, order a meal in a restaurant or go by herself with her injured child to a hospital emergency room, much less give a campaign speech for her husband. Although she still stutters slightly and speaks haltingly, Mrs. Glenn can perform all those once impossible tasks. She even gives campaign speeches, maybe not with as much polish as other wives, but certainly with more pluck. At a private athletic club in Cleveland, 150 people attending the annual meeting of the Cleveland Hearing and Speech Center sat in silent attention at their dinner tables as their speaker told them something really quite remarkable. “For the first time in my life,” said Annie Glenn, age 62, “I can carry on a conversation.” It wasn’t so long ago that Mrs. Glenn, classified as an 85% stutterer, would have found it impossible, even, to travel by airplane from Washington to Cleveland by herself unless she wrote down what she wanted for the airline employee at the ticket counter. She told the audience of such an experience and how the men wrote notes back, thinking she was deaf. During the slow, agonizing process in which stutterers try to force out sounds, often with their hearts beating at an accelerated rate, their palms sweating, their cheeks blushing and their heads bobbing, Mrs. Glenn has been laughed at. Store clerks have reacted by pointing an index finger at the head and moving it in circles (the “crazy” sign), or by asking if she were cold when her jaw would quiver, or saying quite simply, “Lady, I haven’t got all day.” Sometimes Mrs. Glenn would walk away rather than continue the ordeal of shopping. Her husband had to make all the telephone calls to repairmen and friends. Her neighbors had to call the doctor when her children became ill and go to the hospital with her to talk with the doctors. Mrs. Glenn had undergone several traditional speech therapies but experienced little or no improvement until she enrolled herself for two different sessions at the Hollins Institute, most recently in September of 1978. The therapy lasts 11 hours a day for three weeks. After taking the therapy twice, Mrs. Glenn still sees a therapist twice a month at Walter Reed Hospital in Washington, and she practices every day — on the telephone. She makes several calls every morning. There is a sign next to her phone at home that says “Take a full breath, relax your throat, keep the sound moving.” “She talks to her buddies all over the world,” John Glenn said, pretending to resent the phone bills. “This is a dramatic, new life for her.” A 1983 Associated Press article on the same subject read (in part): For 53 of her 63 years, Annie Glenn was a prisoner of her own tongue, a stutterer who tripped over eight out of every 10 words, relying on facial expressions to make a point. She disciplined her two children, she recalls, “with my eyes and my hand.” Today, the wife of Ohio Sen. John Glenn has broken through a sound barrier. “Being able to talk to people is something I could never do,” she says. “My life is like a dream.” In numerous conversations [on the campaign trail] throughout a day that started before dawn and ended long after sunset, [the couple] talked about Mrs. Glenn’s newly acquired ability to speak fluently and the impact of her lifetime of stuttering on their marriage, children and career. “John would make all my telephone calls,” Mrs. Glenn says, shooting a stern look at her husband as he reached for a third chocolate bar. “I would try to go shopping but couldn’t ask the clerk what I wanted, so I would hunt and hunt. A lot of the time I’d go out of the store empty-handed because I couldn’t find what I wanted.” It was in 1974, after Mrs. Glenn enrolled in a speech program at Hollins College near Roanoke, Va., that her speech improved noticeably. But she didn’t keep up the daily therapy sessions or return for refresher courses, and she regressed. After a second session at Hollins and a program of daily therapy, Mrs. Glenn is making speeches. Claim: Article details efforts of John Glenn's wife to overcome stuttering.
[A]: “Annie was never silent to me,” [Glenn] says. “But to see her at this age branch out to things she was interested in but could never participate in …”


[Q]: Paragraph: The state’s attorney general had filed the lawsuit, seeking $17 billion to address the impact of the drug crisis on Oklahoma. It had been considered a bellwether for other litigation nationwide over the opioid epidemic. “The expectation was this was going to be a $1.5 billion to $2 billion fine,” said Jared Holz, healthcare strategist for Jefferies & Co. “$572 million is a much lower number than had been feared.”  J&J said it would appeal the decision. Shares of J&J were up 2% in extended trading following the decision, after an initial gain of more than 5%. Other drugmakers that sell opioid painkillers and are defending against similar lawsuits also rose after-hours, including Teva Pharmaceutical Industries Ltd (TEVA.TA) up 2.6%, and Endo International Plc (ENDP.O), up 1.4% higher. Opioids were involved in almost 400,000 overdose deaths from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention. Since 2000, some 6,000 Oklahomans have died from opioid overdoses, according to the state’s lawyers. Roughly 2,500 lawsuits have been brought by states, counties and municipalities nationally seeking to hold drugmakers responsible for opioid abuse nationwide. Oklahoma’s case was the first to go to trial. Some drugmakers have chosen to settle cases. In holding J&J liable after a seven-week, non-jury trial, Judge Thad Balkman of Cleveland County District Court in Norman, Oklahoma, said the state proved that J&J’s misleading marketing and promotion of its Duragesic and Nucynta painkillers created a public nuisance. “The opioid crisis is an imminent danger and menace to Oklahomans,” Balkman said. Oklahoma wanted J&J to help it address the epidemic for the next 30 years by funding addiction treatment and prevention programs. Balkman said in his written ruling that the award covered only one year of addressing the crisis because Oklahoma did not demonstrate the time and costs needed beyond that. Lance Lang, a 36-year-old recovering user of opioids turned activist in Oklahoma City, said it was “short sighted” for the judge to have only ordered funding for a year. “There’s going to be people struggling with this for years,” he said in an interview. J&J said it will ask that the award be put on hold during an appeal process that could stretch into 2021. The company also said Oklahoma failed to show that its products and activities had created a public nuisance. “You can’t sue your way out of the opioid abuse crisis,” Sabrina Strong, a lawyer for J&J, said at a news conference after the verdict. “Everyone must come together to address this. But J&J did not cause the opioid crisis.”  The case was brought by Oklahoma Attorney General Mike Hunter, who alleged that J&J’s marketing practices helped fuel the opioid epidemic by flooding the market with painkillers. “Johnson & Johnson will finally be held accountable for thousands of deaths and addictions caused by their actions,” Hunter said. The trial came after Oklahoma had resolved claims against OxyContin maker Purdue Pharma LP in March for $270 million and Teva in May for $85 million, leaving J&J as the lone defendant. The verdict came as two Ohio counties prepare for a scheduled October trial before a federal judge in Cleveland. About 2,000 lawsuits out of some 2,500 filed nationwide are consolidated in the case in Cleveland. Endo International Plc (ENDP.O) and Allergan Plc (AGN.N) last week agreed to pay $15 million to avoid going to trial in October in a case by two Ohio counties, subject to court approval. Some plaintiffs’ lawyers have compared the opioid cases to litigation by states against the tobacco industry that led to a $246 billion settlement in 1998. Joe Rice, a lead plaintiff’s attorney for municipalities in the federal litigation, said if the Oklahoma award were extrapolated to other states, it could mean an annual abatement cost of around $38 billion. “It does indicate that if I’m in the pharmaceutical business, I’ve got to think long and hard about annual payments of my share of that,” he said. The judge overseeing the federal litigation in Ohio has been pushing for a global settlement. J&J, which is among multiple pharmaceutical companies that are defendants in the federal litigation, said it remains “open to viable options” to resolve the Ohio case, including through settlement. During the Oklahoma trial, lawyers for the state argued that J&J carried out a years-long marketing campaign that minimized the painkillers’ addiction risks and promoted their benefits. The lawyers called J&J an opioid “kingpin” and argued that its marketing created a public nuisance as doctors over-prescribed the drugs, leading to a surge in overdose deaths. J&J countered that its marketing claims had scientific support and its painkillers accounted for a tiny fraction of opioids prescribed in Oklahoma. The company said in a statement that since 2008, its painkillers accounted for less than 1% of the U.S. market, including generics. Teva said the ruling supported its rationale for settling the case before trial, and said it was preparing to defend itself in the upcoming trial in Ohio. Purdue, which is also among the defendants in the Ohio litigation, did not immediately respond to a request for comment. Claim: J&J liable for $572 million in Oklahoma opioid epidemic trial; shares rise.
[A]:
An Oklahoma judge on Monday ordered Johnson & Johnson (JNJ.N) to pay $572.1 million to the state for its part in fueling an opioid epidemic by deceptively marketing addictive painkillers, a sum that was substantially less than investors had expected, driving up J&J’s shares.