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 deal would resolve alleged violations of civil environmental statutes, including the Clean Water Act, related to the pollution from a company factory in Waynesboro. It would amount to the largest environmental damage settlement in Virginia history and the eighth largest in the nation, officials said. The money would go to projects including wildlife habitat restoration, water quality enhancement and improvements to recreational areas. “In bringing this settlement to a close, we are finally righting a wrong that has impacted the South River and the South Fork of the Shenandoah River for so many decades,” Democratic Gov. Terry McAuliffe said at a news conference announcing the settlement. Wilmington, Delaware-based Dupont Co. used mercury in its process of making synthetic fiber at the plant between 1929 and 1950, according to the state Department of Environmental Quality. Strict storage and disposal regulations weren’t in place at the time, and some of the mercury seeped into the South River and flowed downstream to the South Fork of the Shenandoah River. DuPont discovered the mercury — which accumulates in fish and is especially dangerous to pregnant or breastfeeding women and young children — in the facility’s soil in 1976, officials say. The pollution impacted over 100 miles of river and thousands of acres of floodplain and riparian habitat, affecting fish, mussels, migratory birds and amphibians, the Department of Justice said in a statement. The pollution also has limited some recreational fishing in Waynesboro, a city of about 20,000 in the Shenandoah Valley. The terms of the settlement are outlined in a proposed consent decree that was filed in federal court in Harrisonburg on Thursday. It is subject to a 45-day public comment period and must be approved by the court. The amount of money proposed is “quite impressive,” but mercury is very persistent in the environment and very difficult to remove, said Dr. Thomas Benzing, a professor of integrated science and technology at James Madison University who works with a team of researchers who have been monitoring the mercury levels since 2001. If the settlement goes forward, DuPont would pay slightly more than $42 million toward projects including streamside plantings and erosion control to improve water quality and fish habitat; mussel propagation and restoration; migratory songbird habitat restoration and protection; and recreational fishing access creation or improvement. The company also will pay for renovations at the Front Royal Fish Hatchery to improve production of warm-water fish such as smallmouth bass, at an estimated cost of up to $10 million. “Every dollar is going to be used to clean up the land, the source issues and the water, to where it would have been” if not for the pollution, said Assistant Attorney General John Cruden of the Justice Department’s Environmental and Natural Resources Division. No one from DuPont — which is awaiting final regulatory approval for its merger with Dow Chemical in a deal to create DowDuPont, a $130 billion conglomerate — spoke at the announcement. But Mike Liberati, South River project director for the DuPont Corporate Remediation Group, said in a statement that DuPont “is committed to a long-term presence in the Waynesboro area and to maintaining transparency with its citizens.” The first phase of remediation, involving part of the riverbank in Waynesboro’s Constitution Park could be complete in February. Soil there containing the highest concentrations of mercury is being excavated and hauled away and replaced by clean topsoil, Liberati said. “It’s going to be a long-term project. It’s not something that’s going to happen overnight,” Benzing said. Claim: DuPont to pay $50M over mercury-contaminated Virginia rivers.

SOLUTION: Chemical giant DuPont will pay more than $50 million but admit no fault under a proposed environmental settlement after releasing toxic mercury for decades that made its way into Shenandoah Valley waterways, state and federal officials announced Thursday.

PROBLEM: 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

SOLUTION: 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.”

PROBLEM: Paragraph: The alert urged Americans to seek medical help in the event they suffered any “unusual, unexplained physical symptoms or events, auditory or sensory phenomena, or other health concerns.” The alert comes as a U.S. medical team is screening more Americans who work at the Guangzhou consulate. A previous case in Guangzhou, disclosed last month, prompted the tests. The incidents have raised fears the unexplained issues that started in Cuba in 2016 have expanded to other countries. China says it has uncovered no information that could point to a cause. The most recent evacuations followed medical testing that revealed they might have been affected. State Department spokeswoman Heather Nauert said “a number of individuals” had been brought to the U.S. but didn’t say how many were affected or evacuated. Friday’s alert called for people to be attentive of symptoms including “dizziness, headaches, tinnitus, fatigue, cognitive issues, visual problems, ear complaints and hearing loss, and difficulty sleeping.” It urged them “not to attempt to locate the source of any unidentified auditory sensation. Instead, move to a different location.” The U.S. government has deemed the Cuba incidents “specific attacks” on American workers but hasn’t publicly identified a cause or culprit. Most of the incidents were accompanied by bizarre, unexplained sounds that initially led U.S. investigators to suspect a sonic attack. Asked about the latest incidents, Chinese Foreign Ministry spokeswoman Hua Chunying said Thursday that the U.S. had not formally raised the matter with Beijing. “If the U.S. makes formal contact with us, China will continue necessary investigations in an earnest and responsible manner and maintain close communication and cooperation with the U.S.,” Hua said at a regularly scheduled news conference. China earlier said it had looked into the case announced last month but came up with no clues about the cause of the symptoms. A U.S. official, who wasn’t authorized to discuss the situation publicly and requested anonymity, said the evacuated American government workers were being brought from China for testing to the University of Pennsylvania. That’s where doctors have been treating and studying patients previously evacuated from the U.S. Embassy in Havana. The preliminary findings of the medical reports on the 24 personnel affected in Cuba showed they had sensory and memory problems similar to the brain dysfunction seen with concussions. The Penn team said the patients from Cuba experienced persistent disability though rehabilitation therapy customized for them seemed to help. Canada in April also ordered families of diplomatic staff in Cuba to return home after mysterious health symptoms were detected in 10 Canadians stationed on the island. Canada said the 10 continued to show unexplained brain symptoms and that “medical information raised concerns for a new type of a possible acquired brain injury.” In testimony before the Senate Foreign Relations Committee last month about the first case in China, U.S. Secretary of State Mike Pompeo said China had “said all the right things and have demonstrated their willingness to help us identify the vector which led to this medical incident.” The China incidents affect one of the most important of the seven U.S. diplomatic outposts in the country. The Guangzhou consulate opened months after the establishment of diplomatic relations between Beijing and Washington in 1979 and moved to its new purpose-built facility in 2013. It serves four southern provinces with a combined population of more than 204 million and processes more than 1 million visa applications of all types annually. It is also the only U.S. diplomatic installation in China authorized to process immigrant visas and handle adoptions. People working in The Canton Place complex, a few kilometers (miles) from the consulate, said Thursday they were just hearing about the incidents, reflecting a lack of coverage in China’s entirely state-controlled media. Aled Williams, a British teacher at a kindergarten said Thursday that the reports sounded “sci-fi-ish.” “Hard to get my head around how it works,” he said. “Better watch myself.” Linda Chen, who runs a coffee shop in the area, said she was mystified as to why only certain people seemed to have been affected in an area known for its comfort and safety. “For me I feel it’s very strange. But I don’t feel that there’s something to be very afraid of because it’s probably a very special case,” Chen said. ___ Associated Press writer Josh Lederman in Washington, D.C. contributed to this report. Claim: US Embassy in China sends new alert for mystery health issue.

SOLUTION:
The U.S. Embassy in China sent its second alert in two weeks Friday to its citizens over unexplained health issues that have prompted the evacuation of a number of U.S. government employees working at a consulate in a southern city.