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.

Input: Consider Input: Paragraph: Phusion Projects LLC, which is based in Chicago, agreed not to sell caffeinated alcoholic drinks, agreed not to promote binge drinking or other misuses of alcohol, and accepted marketing limits designed to keep people under 21 from buying alcoholic products. Among these limits are a ban on promoting flavored malt beverages on school or college property except at licensed retailers, and not using models or actors under age 25 or who appear to be under age 21 in its advertising. Phusion also agreed to pay $400,000 to the regulators as part of the settlement. The danger of mixing caffeine and alcohol was spotlighted in 2010 when some college students were hospitalized for alcohol poisoning after drinking alcoholic energy drinks. Phusion that year removed the caffeine and other stimulants from beverages, including Four Loko, after the U.S. Food and Drug Administration warned the company and rivals that “blackout in a can” drinks combining alcohol and caffeine were unsafe. “Alcoholic energy drinks are dangerous - especially for the teenagers and young adults they target,” New York Attorney General Eric Schneiderman said in a statement. “Today’s agreement ensures that one company will no longer market a dangerous product to youth.”  In the settlement, Phusion denied the regulators’ allegations and that it violated any laws, including state laws governing consumer protection and trade practices. “We consider this agreement a practical way to move forward and an opportunity to highlight our continued commitment to ensuring that our products are consumed safely and responsibly only by adults 21 and over,” President Jim Sloan said in a statement. “Phusion continues to believe, however, as do many people throughout the world, that the combination of alcohol and caffeine can be consumed safely and responsibly.” Claim: Maker of Four Loko flavored malt liquor accepts marketing limits.

Output: The maker of Four Loko has agreed with 20 U.S. state attorneys general and the city of San Francisco to a series of reforms to resolve allegations that it improperly marketed flavored malt beverages to young people and encouraged alcohol abuse.


Input: Consider Input: Paragraph: The story does not talk about costs, which was disappointing. The costs of intensive medical therapy can easily be identified. Using an online pharmacy we calculated the costs to be about $1,500 to $2,000 annually for medical therapy, using generic drugs. Using the Health Care Blue Book, we found the average cost of coronary artery bypass sugery and hospitalization to be about $62,000. We think that this is important information for readers that should have been included. The quantification here was presented in such a way to make it clear to readers that there was no significant benefit found to surgical intervention, which is a fair conclusion to draw from the study. The story says, “In the Stich study, 41% of patients assigned to treatment with drugs alone died during the follow-up period, which averaged five years. That compared with a mortality rate of 36% among patients who received bypass surgery plus medication. Although the relative reduction in risk of death was 14%, the result didn’t meet tests for statistical significance, meaning it could have resulted from chance alone.” That’s a great way to describe the lack of statistical significance. It would have been even more powerful to show readers the actual number of patients who died in each group. The story provides great information about the study itself and about the overall state of the evidence supporting heart surgery. “How best to treat these patients has been fraught with uncertainty,” is one of the more notable phrases from the story. It also says, “Many patients aren’t evaluated for heart surgery to treat diseased arteries because they don’t suffer classic chest pain or because doctors worry that hearts weakened by heart failure won’t benefit from the procedure. Other doctors recommend immediate bypass surgery despite a lack of vigorous studies to support that strategy.” The story does not engage in disease-mongering and takes a very careful approach to describing the types of patients who would be affected by this study’s results. We also like the way they provided snapshots of patients who were in both arms of the study — surgery and non-surgery — at the end of the story, making it clear, as the study did, that both routes can be equally successful. The story brings in some strong independent voices who help make sense of this complicated study: James Fang, a cardiologist at University Hospitals Case Medical Center in Cleveland, who wrote an editorial accompanying the study, Raymond Gibbons, a cardiologist at the Mayo Clinic, and Clyde Yancy, chief of cardiology at Northwestern University’s Feinberg School of Medicine. Rarely do you see a story that spends as much time with independent experts as it does with the authors of the study. The story does a great job showing how the standard interventions for heart disease stacked up against each other in this study. We wish that some mention had been made of diet and exercise and that at least a sentence had been included about whether there might be differences in outcomes seen as a result of different medication patterns. The story doesn’t make it clear what exactly the patients were taking. The story makes it clear that the range of treatments studied by the authors are widely available. The story makes it clear that there is a great need for more evidence in this field and that this study will be surprising to many clinicians because of a long-held assumption that surgery is the superior option. tudies published in the early 1990s supported the view that bypass surgery provided a better long term outcome. The story does not rely on a news release. Claim: More Options Before Bypass Surgery, Study Finds

Output: The piece gave readers some powerful information to help them sort through the range of factors that should be considered for any medical intervention. The only weakness our reviewers found with the story is the lack of comment about cost. Too often stories present medical options as false choices of best versus worst. They don’t take into consideration the very real differences between patients’ medical histories, diagnoses and expectations. This story should be applauded for giving readers a clear understanding of the complexities of shared decision-making between providers and patients. As noted by one of the experts quoted in the story, “You don’t have a good therapy and a bad therapy, you have a choice.” This is a message that the story gets across very well and is an important one for readers.


Input: Consider Input: Paragraph: Although this therapy only exists for patients in clinical trials, we still think cost should have received more than a single word of attention. “The method is complex and costly,” the story stated. Our quick review identified a Wall Street Journal article suggesting that the cost could be as high as $500,000 per patient — roughly equivalent to a stem cell transplant. The story’s focus on the anecdotal success story of one patient, Bill Ludwig, had the potential to confuse readers — since his experience was not typical. However, we think that the story managed to combine his real-life story along with some generalizable information on the treatment success in a straightforward fashion. The story includes these details: Of the first 14 CLL patients given the T-cell therapy, four had their cancers disappear – including the first two, who are now about five years cancer-free. Four others got better but then their cancer progressed. And six had no response to the T-cell therapy. In addition to those results, published last week in Science Translational Medicine, the Penn team has orally presented data for a total of 38 CLL patients. Cancer disappeared in nine (24 percent), and temporarily regressed in another nine. We especially liked the last line, “They’ve never said ‘cured.’ But ‘cancer-free’ works for me.” The patient, Ludwig, who was ultimately “cancer free,” suffered some serious complications. The story talks about these, but we would have preferred more discussion of the overall risks or harms and not just an anecdotal description. Ludwig “suffered catastrophic side effects as his immune system went into overdrive,” the story stated. He had to spend time in intensive care with his organs failing. The story is silent on whether many or most patients who received the therapy suffered harms. Researcher Walter Urba says, “Everything we do in oncology is a risk-benefit balance.” These clinical trials for T-cell therapy have enrolled a small number of patients nationally, so there is not the typical history of studies in thousands of people that might be available for other treatments. The story clearly describes the small number of subjects treated to date and provides absolute numbers in terms of success and failures of treatment. Researcher Walter Urba gives some context: “I suspect that over time we’ll have better T-cell therapies, maybe given with other immune therapies.” There is no disease mongering. The story quotes an expert who was not involved with the study. It contrasts statements the researcher made 4 years ago about the treatment with his thoughts following publication of the new findings — an interesting comparison. However, we must rate the story Not Satisfactory here for its lack of discussion of funding for the study, which came in part from the pharmaceutical company Novartis. In addition, one of the study authors is a Novartis employee, and the expert mentioned above is a paid consultant to Bristol Myers Squibb, which is also developing immunotherapies. The story does note that “pharmaceutical giant Novartis partnered with Penn, aiming to commercialize the breakthrough,” but the extent of commercial involvement in the study that’s discussed isn’t clear. The story provides a bit of insight into the tough road that many patients with leukemia travel: “The retired corrections officer from Bridgeton, N.J., was losing his decadelong battle with CLL when he agreed to try the novel therapy in August 2010. “I didn’t hesitate because I had no options left,” he recalled last week. “And also, these people at Penn had been so wonderful to me and my family for 10 years.”…..“CLL typically progresses more slowly than other types of leukemia, and may be held in check for years with chemotherapy.” Since the story does at least mention one alternative approach — chemotherapy — we’ll give the benefit of the doubt. However, we would have preferred to see just a bit more information on alternative strategies. Single and combination drug therapies are available along with stem cell transplantation; these are all existing alternative to T-cell therapies. The story is clearly about clinical trials only open to select patients. The story explains how the T-cell therapy is novel. The story shows independent reporting beyond any news release. Claim: T-cell therapy results more modest than hoped for chronic leukemia


Output: Patient Bill Ludwig is the focus of this story on a leukemia therapy. Early results of T-cell therapy raised hopes for some leukemia patients, but immunotherapy for chronic lymphocytic leukemia is proving helpful only for a minority of those who receive it. In this story, an early pioneer patient shares the terrifying lows and ultimate high of his journey. While the use of a single patient anecdote in a news story is often a red flag for us, this patient’s perspective is uniquely engaging and informative. Even though he has benefited from the procedure, he details the significant side effects he faced and calls attention to the fact that most others with the disease have not fared as well. It’s not the cheerleading-type narrative that we often see with single-patient-focused stories. Overall the coverage provided a very human story interwoven with a bit of medical science. This story about the emerging science of immunotherapy provides a vivid look inside the near-death complications for one man and the disappointment that only a minority of chronic lymphocytic leukemia patients go into remission after the experimental therapy in which each patient’s T-cells are engineered to attack their own disease. We would have liked more detail in places, but this story (and headline) helps the public understand the uncertain world of clinical research. “Thrilling, humbling and a bit of a let-down,” the patient called it – and that’s a great summary.