instruction:
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.
question:
Paragraph: "As schools across the country open for the uncertain, unprecedented school year to come, opinions are split on how to do so safely. Some districts have opted for completely virtual learning. Others will try a mix of both online and in-person classes, or will send younger children to school while older kids stay home, or will phase students back to the classroom gradually. Others still are calling for schools to reopen completely for those who feel well enough to teach and attend, and who aren’t especially vulnerable to COVID-19. One such voice is U.S. Sen. Ron Johnson, R-Wisconsin, who in an Aug. 13, 2020 radio interview with Milwaukee talk show host Steve Scaffidi on WTMJ-AM discussed why he believes students need to return to school in person this fall. For younger people, Johnson asserted, ""seasonal flu is actually, in many cases, a deadlier virus if they contract that."" Is Johnson correct that COVID-19 is less deadly for children than the flu? Let’s dig in. COVID was less harsh on kids than the flu, this year’s stats show To back up his claim, Johnson’s office sent statistics from the Centers for Disease Control and Prevention on flu and COVID-19 deaths among Americans under age 18. During the 2018-19 flu season, the CDC reported approximately 480 flu deaths among children ages 0-17, about 30% of whom had a lab-confirmed case of influenza. Comparably, 90 American youth have died from coronavirus complications from the beginning of the pandemic through mid-August, according to the American Academy of Pediatrics. More than 46,000 children were hospitalized for flu in that 2018-19 period. The hospitalization rate among children 5 to 17 was 39.2 children per 100,000 children. For COVID-19, that hospitalization rate is 6 per 100,000 children ages 5 to 17, the CDC says. In a report detailing the differences between COVID-19 and the flu, the CDC states that ""the risk of complications for healthy children is higher for flu compared to COVID-19."" And data from Wisconsin echoes that sentiment. Since the pandemic began, no children have died from COVID-19 complications, according to state Department of Health Services death data, and 147 people ages 0-19 have been hospitalized. In contrast, three pediatric flu deaths occurred during this year’s flu season, DHS data show, and 605 kids ages 17 and under have been hospitalized. The data show there have been fewer childhood deaths from COVID-19 so far this year than from the seasonal flu. The hold-up, of course, lies in nuance, said Dr. Jon Temte, associate dean for public health and community engagement within UW-Madison’s School of Medicine and Public Health. ""U.S. schools have been out (and) mostly closed since March, thus extremely limiting cases of SARS-CoV-2 in children. Conversely, we rarely close schools for influenza, thus allowing an attack rate of 30-40% in school-aged children,"" Temte wrote in an Aug. 27, 2020 email to PolitiFact Wisconsin. That is, the flu has been able to spread through children more commonly than COVID-19, creating more cases, more complications and more deaths. Other experts agree. Dr. Chad Vercio, chair of pediatrics at Riverside University Health System in California, said children’s risk from the coronavirus depends on how widespread the virus is in any given area, and that ""it is unknown"" if COVID hospitalization rates would rise once schools reopen. And though the early data suggests that COVID-19 is not as bad for children as the flu, it’s just that: Early. Dr. Vidya Mony, an infectious disease expert with Santa Clara Valley Medical Center in San Jose, Calif., said there isn’t enough data yet to say indisputably that COVID risks are lower for kids. Johnson claimed that in many cases, the seasonal flu was a deadlier virus for youth than COVID-19. The numbers show that this year, that was the case. More children died from flu complications than from COVID-19, and were hospitalized at higher rates for the flu. But experts caution that we don’t have enough data to paint the full picture so early in the game, and that schools shutting down in early spring may have driven down coronavirus case rates in children — meaning we can’t be sure exactly how the virus will move through young people when more of them are potentially getting exposed. Our definition for  is ""the statement is accurate but needs clarification or additional information."" That fits here." Claim: For younger people, seasonal flu is “in many cases” a deadlier virus than COVID-19
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Hospitalizations and deaths among children are higher for the seasonal flu than they are for COVID-19   The CDC states that the risk of complications for healthy children is higher for flu compared to COVID-19, though kids with underlying medical conditions will be at greater risk for both    But experts caution that we might not yet see the whole picture of how dangerous the coronavirus is for kids because schools largely shut down when it started to spread, shielding them from that potential place of exposure.


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Paragraph: Mentions cost for one year of Herceptin as $40,000-$50,000. Mentions quantitative benefit of 9 weeks of Herceptin vs. no Herceptin with certain chemotherapy. Also, while no women in the Herceptin group had cardiac failure at 3 years, the follow-up period may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Mentions potential harms of Herceptin on the heart, especially when given after certain chemotherapy. The story does not mention that there were side effects with certain chemotherapy drugs and doses needed to be decreased during the course of the trial. One aspect of this trial focused on randomization of women with Her2/neu overexpression to 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery. The drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy”, which is not completely accurate. There is an adequate mention of the study design and discussion of disease-free survival at 3 years follow-up. Good job putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup – 116 in each arm. Appropriately discusses the percentage of women who are eligible for Herceptin due to overexpression of HER2/neu. The story would have been helped by some context for the risk these women face. As Herceptin is used earlier and earlier these women have less to gain because they have less risk to begin with. Relative risk reductions may be very high but the absolute is not as big. Sources in addition to study authors are cited. No mention that this trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding drug companies. Other doctors cited express caution about the early results of Herceptin studies, so there is some balance to the piece. The women in this trial had undergone breast cancer surgery and those with ER+ tumors were taking Tamoxifen. This is not explicitly mentioned, only that treatment took place following surgery. Still OK. Herceptin is only FDA approved to treat advanced breast cancer, but is used in clinical trials in early-stage breast cancer. This is not mentioned in the story. Novel use of Herceptin for short-term treatment prior to anthracycline chemotherapy. No evidence that this story relies on a press release. Claim: Short stint of Herceptin holds promise for breast cancer
answer:
This story discusses the results of a recent study involving women with high-risk early breast cancer (node positive or >2cm, age younger than 66 – there were 25 year olds on the trial). One aspect of this trial focused on the short-term use of Herceptin with chemotherapy. Women with overexpression of the HER2/neu gene, as measured by the CISH immunohistochemistry, were randomly assigned 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery and in conjunction with certain types of chemotherapy. This regimen of treatment differed from other trials in which Herceptin was given for 12 months following chemotherapy. In this study, the drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy,” which is not completely accurate. Herceptin is only FDA approved to treat advanced breast cancer, but it is used in clinical trials in early-stage breast cancer. However, this is not mentioned in the story. There is adequate discussion of the study design and reporting of disease-free survival at 3 years follow-up. There was little discussion in the piece of the side effects of chemotherapy as reported in the trial, but the addition of Herceptin was the main focus of the story. While the journalist provides quantitative benefit of 9 weeks of Herceptin vs. no Herceptin, and notes no cardiac failure in the Herceptin group, the follow-up period of 3 years may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Overall, the journalist did a good job describing the randomization, as well as putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup (116 in each arm). The small sample randomized to Herceptin certainly warrants more study, and although the relative benefits were large, these women still had fairly good recurrence free survival — 80% w/o and 90% with — so although it looks like that will translate to overall survival. The question for women with overexpression of the HER/neu gene is: How much do you want to do to avoid recurrence? Sources in addition to the study investigators are cited, which provides some balance to the piece, however, there is no mention that the trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding from drug companies.


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Paragraph: A drunk man lies in the hallway of a housing estate outside the Siberian city of Tomsk some 3500 km (2175 miles) east of Moscow June 5, 2008. REUTERS/Thomas Peter A survey by the Association of International Pharmaceutical Manufacturers (AIPM) and the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) found that about 95 percent of Russians think they are in good or fair health, while only 44 percent saw a doctor last year. This could be one of the main reasons why diagnosis of chronic illnesses such as heart disease, cancers and diabetes is low, the researchers said. Such illnesses are also known as non-communicable diseases, or NCDs, and are the cause of the majority of deaths across the world. “Heart disease, strokes, diabetes, cancers and chronic respiratory disease together are responsible for 80 percent of all deaths in Russia,” said Vladimir Shipkov, AIPM’s executive director. “There is a significant gap between what people think is their state of health and the negative impact of their actual behavior.”   The survey also found that most Russians know about links between the incidence of chronic disease and risk factors such as smoking, harmful drinking, unhealthy diets and low levels of physical activity. But respondents to the survey tended to perceive these risks as a part of their regular lifestyle, the researchers said. The survey found that between one and three key risk factors feature in the everyday life of 82 percent of respondents, and only 9 percent could say that they had no risk factors. The survey also found that doctors could be an important factor in changing these unhealthy habits — with more than 50 percent of respondents saying they were ready to give up risk factors if a doctor told them their health was at risk. “This study is very important in terms of preventing NCDs from spreading further, because the fight against non-communicable diseases starts on a personal level. Half of deaths and disability cases caused by NCDs can be prevented,” said Mario Ottiglio of IFPMA. He said the survey showed how it “makes sense to put considerable efforts into prevention programs.”   “The benefits reaped would not limit themselves to improved health for individuals...There would also be relief from the mounting pressure on health care systems and the economic burden of such diseases on society as a whole,” he added. Claim: Unhealthy Russians think they're in good shape.
answer:

Most Russians overestimate how healthy they are and many run high health risks by smoking, abusing alcohol, being obese and failing to take enough exercise, according to a report published on Tuesday.