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: Dr. Neelu Pal poses for a portrait in New York, July 23, 2010. Pal was fired weeks after authorities at New York University Langone Medical Center Surgical Weight Loss Program learned she had contacted patients about the dangers of Lap-Band surgery in January 2006. REUTERS/Shannon Stapleton Pal had previously raised her concerns with hospital officials, complaining — to no avail — about the lack of care given after surgery and incomplete or inaccurate medical forms that were taken prior to surgery. She was fired weeks after hospital authorities learned she had contacted patients in January 2006. She has filed a wrongful termination lawsuit — the case is pending — and enrolled in law school. Pal, who came to the United States from India a little over a decade ago to practice medicine, says she has been blackballed from her chosen profession. The NYU bariatric surgery practice where she worked is widely considered one of the world’s most experienced. But in an interview with Reuters, Pal described the facility as a hectic Lap-Band factory. “My impression at the time was that the practice was disorganized, but once I knew more about the system, I could see what they were trying to do was get as many patients on to the operating table as possible,” she said. During her three months at NYU Langone Medical Center’s Surgical Weight Loss Program in late 2005 and early 2006, two surgeons — Dr. Christine Ren and Dr. George Fielding, who are married — implanted gastric bands into as many as 20 patients in a single day, according to Pal. Known as pioneers in the field, Fielding and Ren are also paid consultants of Allergan Inc, the Botox and breast implant maker which is the leading manufacturer of the gastric band. Though rivals have been gaining, Allergan’s Lap-Band still commands more than two-thirds of a $300 million to $400 million market. To critics, Pal’s allegations — some of which were corroborated by a New York State Health Department investigation around that time — underline the potential risks that go along with the industry’s rapid growth. And the business could soon swell even more if U.S. regulators grant permission to perform the procedure on the nation’s bulging ranks of overweight teens. Ren was an investigator in an Allergan-sponsored clinical trial studying the use of bands on teens. And the company has an application with the U.S. Food and Drug Administration seeking approval to market the device to teens as young as 14. A decision could come any time. Winning regulatory approval for the gastric band in teenagers would allow the companies that make the devices — Allergan, Johnson & Johnson and others — to target that specific age group. Today, regulators consider performing the procedure on teens “experimental” as it has not been approved for that age group. But, like any device, it may be used on teens at a doctor’s discretion. Allergan declined to comment on Pal’s lawsuit or disclose how much it pays the surgeons, though the company did confirm that both remain on the payroll. Through a NYU spokeswoman, Ren and Fielding — who have been the subject of some controversy — declined to be interviewed for this article, also citing the lawsuit. But in some medical circles, concern over gastric banding for teenagers is growing nearly as fast as American waistlines. In particular, some doctors worry about the device’s long-term safety and effectiveness. A gastric band is just what it sounds like: an inflatable silicone band placed around the top portion of the stomach to create a pouch that restricts food intake. It has become increasingly popular in the United States in recent years, and results in reasonable weight loss. The procedure is considered less invasive and risky than gastric bypass. Banding could also be an especially attractive option for teens, say proponents, because it is reversible, whereas bypass is not. The 30- to 60-minute procedure, typically performed with a laparoscope, might require one night in the hospital but can also be done on an outpatient basis. But certain data show gastric bands are less effective and more problematic for teens than adults, said Dr. Thomas Inge, chair of a government study to assess bariatric surgery in adolescents called Teen Longitudinal Assessment of Bariatric Surgery, or Teen-LABS for short. The Teen-LABS study aims to determine if adolescence is the best time to intervene with surgery. It was launched in 2007 and is expected to report results in about five years. In more than one in five teens in another study, Inge noted a high rate of “symmetric pouch dilation” — a complication in which the small pouch created at the top of the stomach by the band gets bigger, allowing patients to consume more food. This issue was reported in the journal Obesity Surgery, and later in the Journal of the American Medical Association. “We await the U.S. trial data, PMS (post-marketing surveillance) data, and confirmation from non-industry-run trials to make final recommendations,” said Inge, who is the surgical director of the weight loss program for teens at Cincinnati Children’s Hospital. As Inge and others are quick to point out, trials that studied how teens fared with a gastric band over the short term have been few, and those that were conducted show the device generally is safe and effective, with a relatively low risk for complications or death. But there is a dearth of long-term data on the outcomes from gastric band surgery. And that worries Dr. Mary Brandt, an investigator in the Teen-LABS study, among other experts. “I think there’s a fundamental problem with putting a rigid plastic object around a moving organ. You’re asking it to stay in place and not erode over a long period of time,” said Brandt, who is also director of the pediatric surgical program at Texas Children’s Hospital in Houston. “I’ll be happy to reverse my position as soon as I see 10 or 20 year data. Unfortunately, that’s not something that industry is excited about funding.”   She acknowledged a bias against gastric bands, citing a Swiss long-term follow-up study of 167 adults that showed the band failed almost a third of the time after 10 years. About a fifth of the patients required another operation. And while fewer than 8 percent reported complications in the 30 days following surgery, more than 40 percent had problems after a decade. Long-term complications included the erosion and slippage of the band, both of which might require another operation, and a dilation of the esophagus, which could result in difficulty swallowing. Infections around the port that sits below the skin and allows the doctor to add or remove saline with a syringe to tighten or loosen the band, as well as leaks, were also common. “Bands are definitely safe in the short term and definitely work in the short term. What we don’t know is about the long term,” Brandt said. “I’m not saying it should never be used. We just have to be more careful about how we’re using it.”   The Swiss study of adults who had gastric banding, published in Obesity Surgery, came to the same conclusion. Because of complications, the need for another operation, and long-term failure rates, gastric banding should be performed in “selected cases only” until more data are available, it said. Another group of 276 adults who underwent gastric band surgery had similarly disappointing results in a long-term Austrian study published in the same journal. Only a little under 54 percent of the patients still had their original band after nine years, with nearly 18 percent having the original replaced with a new one and nearly 29 percent having it removed. Of those who no longer had any band, more than half had a second bariatric operation. Gastric banding demands that teens do something they often aren’t very good at — sticking to a rigorous follow-up routine. Dr. Roberta Maller Hartman, a psychologist and Lap-Band patient herself, counsels teens and adults after receiving the gastric band. “I’ve worked with a lot of high school students and they just want to be like everyone else and go out and eat pizza with their friends,” she said. “They can, but they have to take little bites and chew a lot.”   Success depends most on a patient’s ability to modify their behavior. “The band doesn’t reduce the desire to eat emotionally. That has to be addressed,” said Dr. Maller. “Teens tend to need more hands-on, one-to-one support.”   Indeed, there are many success stories of obese teens losing weight, keeping it off and staving off a host of related illnesses, such as diabetes, arthritis and high blood pressure. Surgery — banding or bypass — has been shown to produce the most sustainable results when compared with diet and exercise. Nevertheless, critics abound. Dr. Susan Woolford, Medical Director of the Pediatric Comprehensive Weight Management Center at the University of Michigan, conducted a study, published in Obesity Surgery, to find out how readily primary care physicians and pediatricians — those in the front lines of obesity treatment — would refer patients for bariatric surgery. Nearly half, or 48 percent of the 381 physicians surveyed, said they would never refer an adolescent for any type of bariatric surgery. The controversies swirling around NYU’s influential bariatric surgery center — as well as its two top surgeons — have done little to ease concerns. An investigation by the New York State Department of Health in 2006 found that Fielding falsified data on Vincent Esposito, a 14-year-old boy who was part of the FDA-authorized study that was looking at the use of the device in obese teens. A week after Esposito’s Lap-Band surgery, he developed an infection with an abscess — a common complication with gastric banding — and returned to the NYU facility, where Fielding performed an appendectomy. The investigation by New York health authorities determined there was no evidence of appendicitis, according to the report. “They told me I was a ticking bomb,” Esposito had told the Daily Times in Salisbury, Maryland in 2007, referring to his obesity. Reached by telephone, his father said his son was “fine” and that they are being represented by an attorney and declined to comment. NYU also declined to comment. In its response to the NYDH report, the university maintained no wrongdoing, saying “the surgeon probably misinterpreted his operative findings.” In a statement at the time, the school added, “...we are persuaded that he assumed that the infection did not begin in the gastric band device.”   The response and NYU’s plan to correct the issues were accepted by state regulators. In the NYSHD report, Fielding was also cited for failing to address a post-operative patient’s persistent lack of urine output. The patient went into cardiac arrest and died 36 hours later. This was the death that alarmed Pal and led her to warn patients. The same report said the program director, Ren, had permitted two surgeons to practice without the appropriate licenses, in violation of the law. For four months, the unlicensed physicians “performed multiple surgical procedures, made pre- and post-op assessments, and wrote orders to be carried out by nursing staff,” the report said. After Ren learned she was being investigated by an internal committee, she went back and removed the name of the unlicensed surgeon from the operative report, according to court testimony. She was found to have committed professional misconduct and received a letter of reprimand that was put in her file for a year. Fielding, who got a gastric band himself in 1999, is from Australia, where he left behind multiple personal injury lawsuits, most of which have been settled. Dr. Robert “Skip” Nelson, a pediatric ethicist at FDA, said he had no specific knowledge about the incident at NYU Medical Center. If the agency did learn that an investigator has entered false data, he said, there would be an investigation. He added that if the FDA doubted the integrity of the data, they would not be considered in the decision-making process. An investigator, as doctors who run clinical trials are called, could also be disqualified as a result. Despite the reports of misconduct, the NYU Langone Weight Management Program has retained its status as a “Center of Excellence,” a designation conferred by the Surgical Review Corp, an entity created by the American Society for Bariatric and Metabolic Surgery. Surgical Review Corp CEO Gary Pratt said that he was unaware of the incidents and the NYSHD report. He said the corporation’s reviews maintain the highest standards with the goal of advancing the safety and efficacy of bariatric surgery. The company intends to put out a new list of approved bariatric clinics that treat teens later this year — which may coincide with the FDA granting approval, or not. If the FDA does greenlight it, insurers would be more likely to pay for the procedure, which costs the insured patient $2,000 to $4,000. The uninsured, making up about a third of patients who have the surgery in the United States, pay about $15,000 for the surgery. Some health professionals worry that band manufacturers will target teens with direct-to-consumer (DTC) ads on television and radio or in subway stations that have proven effective at luring people to doctors’ offices. The FDA said there is no guidance or regulation on DTC ads to young users. For Allergan, based in Irvine, California, the implications are significant. And the company is acting accordingly. It recently launched a campaign with bariatric surgeons to invite their patients to enter an essay contest and win a chance to go to Washington, D.C. to “share their personal stories with legislators and media.”   Allergan has seen its stock underperform the S&P 500 year to date. Botox remains its key product and has weathered increased competition amid the recession, while obesity intervention was hit hardest by the economy. At the same time, Lap-Band has also been slowly losing market share to Johnson & Johnson’s competing device called Realize. In 2009, Allergan’s obesity products generated revenue of $258 million, down 13 percent from 2008. Management is betting that continued investment in direct-to-consumer advertising will stimulate growth in the obesity segment, said Gleacher & Co analyst Amit Hazan. He estimates there will be 83,500 gastric band procedures in the United States in 2010, up 6 percent from 2009. Sanford Bernstein analyst Aaron Gal said FDA approval of the Lap-Band for teens could increase sales by as much as $20 million for Allergan. Even critics of gastric band surgery acknowledge that there are few good solutions to adolescent obesity. It is a mounting problem, affecting nearly 1 in 5 American teens, and many doctors believe that it should be addressed sooner rather than later when other health problems can develop. Some experts are wary but believe the benefits may outweigh the potential harm. “My conclusion is that it makes sense to intervene sooner because surgery can head off other related problems. Kids are better surgical risks, but the downside is that I suspect most teenagers are doing it less for health and more for social and psychological reasons,” said Dr. Jeffrey Zitsman, who is leading an independently funded teen study at Columbia University. Those who do it out of vanity, he cautioned, may have a harder time. “When health reasons don’t motivate them,” he said, “sometimes there are compliance issues.”   Yet, Dr. Robert Murray, director of Nationwide Children’s Hospital Center for Healthy Weight and Nutrition, argues that the heavy psychological problems obese teens carry should not be ignored. “They’ve been teased out of school, they have social issues, many are depressed, and their quality of life is equal to that of a kid with cancer,” he said. “If you get them at 14 and reverse weight and health problems, they’ve got a shot at a normal life.”   To critics, at least, the question is at how big a price. Claim: Special report: Targeting teens for gastric bands.

A: After one patient died and others suffered serious complications following Lap-Band surgery, Dr. Neelu Pal had seen enough. A petite surgical resident now aged 40, she began quietly calling patients about to undergo the weight-loss procedure at New York University’s Medical Center, telling them she feared for their safety.
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Q: Paragraph: The National Health Commission on Sunday also issued a notice asking for improvement in testing capacity and quality nationwide. Nine of the new cases were imported infections, data from commission showed. Authorities reported that total confirmed cases across mainland China had risen to 82,735 with 4,632 deaths as of April 18. The northeastern province of Heilongjiang has seen a rise in infected travellers arriving from Russia in recent weeks, and is now battling to contain a flare-up in local cases. Heilongjiang has reported 39 new local cases in the past 10 days, or more than 50% of all new 73 locally transmitted cases reported in the mainland during the same period. Most were related to one imported case in the provincial capital, Harbin. On Friday, 18 officials in Harbin, including a vice mayor, were punished. To help contain the outbreak, the Heilongjiang government is cautioning against family gatherings, cross infections at hospitals, and slow reporting in epidemic investigations, it said on the provincial government’s website. “The biggest political task at present is to stop the rebound and spread of the epidemic,” Wang Yongkang, vice governor of Heilongjiang, was quoted as saying. Elsewhere in mainland China, all areas in central Hubei province including Wuhan, the epicentre of the outbreak in China, are now considered low risk. However, a Beijing central district is seen as high-risk, according to a social media post by the State Council, or Cabinet. On April 15, the Chinese capital reported three local cases, all of which were linked to an imported infection. Areas that are considered of medium-risk in China include two districts in Harbin, the city of Suifenhe in Heilongjiang, two districts in the southern city of Guangzhou and Jiaozhou city in eastern Shandong province. Separately, authorities reported 44 new asymptomatic cases of coronavirus, including three which were imported. Such cases, where patients test positive but show no clinical symptoms such as a cough or fever, are excluded from China’s tally of confirmed cases. In urging better testing, the National Health Commission said all large general hospitals need to set up laboratories that meet certain requirements and can conduct coronavirus testing independently. Since March, an average 54,000 tests have been conducted a day in Hubei province and that rose to 89,000 tests on April 17, Liu Dongru, a Hubei health commission official, told a news conference on Sunday. In Beijing, the number of institutions able to conduct nucleic acid testing has risen to 50 from 17 in early February, a municipal health commission official said on Sunday. In areas under great pressure, especially at land borders, local governments should help county-level medical institutions obtain nucleic acid testing capability, the commission said. Testing should be conducted by qualified medical institutions and independent medical laboratories, it said, adding that training for medical staff should be stepped up and testing operations standardised to reduce problems with the accuracy of testing. Claim: China's new coronavirus cases fall, eyes on northeastern province.

A: China on Sunday reported 16 new coronavirus cases but no deaths while authorities remained on guard against a major resurgence and monitored the spread of cases in Heilongjiang province.
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Q: Paragraph: Part of the caution in this story is not linking the research too closely to a potential on-the-shelf treatment. The story says in several ways that a drug therapy would be a good distance away. So we don’t think it appropriate to talk about costs at this point. The story does not break down the actual number of positive findings in either study, and we wish it had. It may be that the way in which the benefits were measured was hard to explain. But we still think the story should try to give readers some specifics. We want to know more than just that the beta cells performed “every bit as good as the body’s own cells.” The story makes a nod in the direction of harms when it notes that there was a minimal immune system response to the transplanted cells. An immune response is currently one of the harms that limits the usefulness of this procedure. But the story should have gone further to describe how the transplantation procedure is performed. This is an invasive approach that is not without risks and adverse effects. The story does a really nice job of quickly summarizing the state of the evidence and then going into more detail. It’s almost a blueprint for how these stories should be written. In just three sentences, it captures nearly all the relevant information about the evidence. It says, “In one of two related studies published Monday, Anderson and his colleagues described in the journal Nature Biotechnology how they had tested 774 variations of alginate in rodents and monkeys and identified a handful that elicited a greatly reduced foreign body response. For the other paper, published in Nature Medicine, the group embedded tiny capsules made from that durable alginate with beta cells derived from human embryonic stem cells. They then transplanted them into mice with a disease akin to type 1 diabetes.” Note: published in a respected journal, tested in animals (the story could have specified how many and acknowledged that these were animal studies higher up in the story), focused on a disease that’s not exactly diabetes but close. This should signal to readers that a cure for diabetes is still a long ways away. There is no disease mongering in the story. In fact, it does a nice job of explaining the disease and the specific problem this research is trying to address. It says, for example, “In people with type 1 diabetes, formerly known as juvenile-onset diabetes, the immune system dismantles the pancreatic cells that normally produce insulin. So researchers have long sought a way to put back healthy insulin-producing cells, known as beta cells, into patients.” Most of the sources are connected to the study, either from the research institutions involved or the funders. But we give the story points for taking the next step and talking to people in the pharmaceutical research world who would be among those actually taking a discovery like this and making it therapeutic. The story quotes someone from Semma and someone from VitaCyte, both of whom provide a good dose of realistic context. While ideally we would’ve heard from someone with no stake at all in this line of research, we think there are enough voices with enough distance from the studies to earn the story a Satisfactory rating. And to the article’s credit, the sources’ affiliations are all clearly stated. The story does contrast this research with other research into treating diabetes. The story might have provided a bit of context about other work on developing an artificial pancreas for Type 1 Diabetes patients (there’s a lot on this). The story at the top makes it clear that the treatment is not available, saying, “Scientists on Monday showed they had overcome some of the major hurdles standing in the way of a long-sought therapeutic fix for patients with type 1 diabetes, outlining an approach that the body’s immune system could tolerate and providing a possible pathway toward clinical trials in the next few years.” Not the qualifier of “possible” in that sentence. News stories often don’t address the novelty of a treatment or research finding. But this story actually uses the word “novel,” which sort of puts a spotlight on the category for us. The story quotes one of the study’s funders calling the protective cell bubbles studied in the research “novel materials.” We think the story actually does establish their novelty with enough context and caveats. The story does not rely on a news release. Claim: Cell therapy in protective bubble offers hope for diabetes fix

A:
This article does a really nice job of explaining the science behind two studies and appropriately depicting the pace of scientific process. With other news coverage talking about the research getting us “close to a cure” for diabetes, this story took a measured approach that should be posted on the walls of newsrooms everywhere. Yes, you can make a lab study exciting and engaging for readers without overstating the findings. A little more quantification of benefits and risks would have elevated this to five stars. Type I Diabetes is a relatively common illness that takes significant time and expense to manage and is associated with major complications. For years it has seemed we are on the verge of a major breakthrough, but, even with better treatments, this condition remains a major public health problem. All the more reason to be circumspect when describing new research into this area. This story says, “Just because the system produced strong results in mice does not mean people will respond the same way.” Hear us applauding.
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