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: We give the story credit for at least citing a $30,000 cost for the “surgeries” but wish it had explained what that included and what it might not. Surgery to change the battery every two years certainly adds to cost. Undoubtedly patients require more intensive expensive followup and perhaps specialized checks to ensure the device is working. With broad strokes across discussion of three different uses for three different conditions, the story did an adequate job quantifiying benefits. As stated in the “Evidence” criterion above, this is where a control group and reporting response rates for treated versus control groups would be very informative. Instead, we only get a qualitative description of benefits which is useful but which might leave careful readers asking for more. This is one area where the story could have been improved. There was no detailed discussion of what can go wrong with deep brain stimulation. There was a brief mention of “if” the electrodes cause neurological side effects. But how often does that happen? And the story noted that the surgery does “sometimes” cause dangerous brain bleeding or infections. How often is “sometimes”? At a very high, overview level, the story explained the current state of the evidence. But more information would have been better. Current evidence for depression/OCD is based on case series. These studies don’t have a control group, making the results more subject to bias. No disease mongering of any of the conditions discussed. The story was repeatedly clear about deep brain stimulation being used when standard medications or behavior therapy had not worked. But it would be helpful to give estimates of the proportion of patients with depression or OCD who aren’t helped by available treatments. Several sources were cited. Dr. Mayberg’s connection to St. Jude Medical was mentioned. The story could have mentioned that Dr. Okun’s center and Dr. Greenberg have received funding from Medtronic. Greenberg’s current funding from the National Institute of Mental Health was noted. We think the sourcing and disclosure was adequate. A strong point of the story was that it repeatedly provided the context for the use of deep brain stimulation — “when standard medications fail…worst-case patients…doesn’t mean patients can abandon traditional therapy…people with intractable (problems)…(people who) failed behavior therapy.” This story already attempted to accomplish a lot, but to be complete, it could have offered explicit description of currently approved options: antidepressant medications (multiple classes); psychotherapy (multiple options); combinations of medications or medications and therapy; transcranial magnetic stimulation (limited availabilty), vagal nerve stimulation, ECT – and estimate of the proportion of patients who fail these treatments. Nonethless, we feel it met the criteria for a satisfactory score. The story states that 70,000 have had deep brian stimulation for Parkinson’s or other movement disorders, and that studies are underway on at least 60 people with intractable obsessive-compulsive disorder and 100 with severe depression. The experimental nature of these approaches is clear from the story. A nice touch would be to give a link to clinicaltrials.gov to allow readers the option of looking up more information on the studies in progress and finding out if recruitment is open and how to access the study. The story did a good job putting the new uses of deep brain stimulation into the context of other research and other therapeutic approaches. It’s clear that the story did not rely on a news release. Claim: Trying brain pacemakers to zap psychiatric disease

SOLUTION: We especially appreciate the lack of hype in this story. The reporter clearly worked hard to stick to the evidence – not merely to promote the potential. About 65-70 percent of patients with major depressive disorder improve substantially with 1 to 2 course of standard treatment (medication, psychotherapy or combinations). Subsequent treatment options have progressively lower rates of treatment response. Therefore, a significant number of people need other treatment options. Deep brain stimulation is an invasive treatment, but one that has shown promise in a small number of patients.

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: Duck droppings from the central Dutch province tested positive for the highly contagious H5 strain of the disease, the deputy economic affairs minister wrote in a letter to parliament. “Based on this information I am considering follow-up measures,” deputy minister Sharon Dijksma wrote. Dutch authorities said earlier on Monday they will slaughter 50,000 birds at a poultry farm after bird flu was discovered nearby. Separate testing indicated that farm infections, which have led to the culling of around 300,000 birds at four locations, were not all from the same source, the letter said. The H5N8 strain of bird flu detected at the farms has never been founded in humans. It has led to the destruction of millions of farm birds in Asia, mainly South Korea, after an outbreak earlier this year. A government statement said tests had confirmed an outbreak of the H5N8 strain at one farm in the western municipality of Zoeterwoude, where 28,000 laying hens were ordered destroyed on Sunday. A cull at a nearby farm announced on Monday was a precautionary measure, it said. Animal health authorities are testing poultry at other farms in the area. Transport restrictions were imposed on the sector two weeks ago that have hit around 2,000 poultry businesses. The Netherlands is the world’s largest exporter of eggs and the largest exporter of poultry meat in the European Union. Some experts believe that wild birds migrating from Asia carried the disease to Europe, where it infected flocks in Germany, Britain and the Netherlands. Claim: Dutch discover bird flu in wild ducks, cull continues.

SOLUTION:
Dutch animal health authorities found bird flu in two samples taken from wild ducks, a government statement said, but it was unclear if that was the source of an outbreak at four chicken farms in the Netherlands.