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.
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Question: Paragraph: We’ll give this story a Satisfactory rating in this category since it does mention the $1,000 cost of a colonoscopy and that one of the two at-home screening tests costs about $25. But readers would benefit more by knowing the average costs of the two alternatives, rather than just the cost of one. This story focuses on the available methods of colorectal screening, comparing them based on available data, and points out that the two at-home screening kits are comparably effective to the two invasive procedures: sigmoidoscopy and colonoscopy. One of the at-home tests — the FIT, or fecal immunochemical test — when used, is estimated to prevent 20-23 deaths per thousand people screened, while estimates among those using colonoscopy suggest 22-24 deaths are prevented per thousand people screened. The story is clear in saying that there has been no head-to-head comparative study pitting the techniques against each other. The story gets a Satisfactory rating here since it does mention that with colonoscopy, there’s “a small but real risk of harm, such as a perforation” from the screening test. But, as with all screening methods, there is the possibility of false positives or false negatives with the at-home tests which could produce either false confidence or needless worry, not insignificant issues. We would have liked the story even better had it mentioned these factors. The story is quite open with the fact that comparative data assessing the various screening methods against each other are not available, but it strengthens its offerings by citing recommendations from both the US Preventive Services Task Force and the Canadian Task Force on Preventive Health Care. The recommendations of these independent groups are based on a rigorous evaluation of the highest-quality evidence available. Colon cancer is the second-leading form of cancer-related death in the country; the story does not disease monger. The story quotes three independent sources for information and the recommendations of agencies from two different governments. There is no suggestion that in a story offering a selection of screening techniques, with no one preferred above another, that there is any issue with conflicts of interest. Since this story is totally about the available alternatives for colorectal cancer screening, it easily gets a Satisfactory rating. Both colonoscopy and sigmoidoscopy have been available for years and the at-home screening tests mentioned in the story are said to be available through a patient’s doctor’s office. These details establish the methods’ availability. It also quotes one source as recommending against the use of over-the-counter home screening tests for this disease. The story notes that what’s novel here is that the U.S. Preventive Task Force recently finalized their guidelines on colon cancer screening. There is no indication that this story relied on a news release. Claim: You Could Skip Your Colonoscopy If You’re Willing To Collect Your Poop

Answer: This story points out that, based on available data, two at-home screening tests appear to be equally effective compared to the more traditional, and more invasive, sigmoidoscopy and colonoscopy. We have only minor quibbles with the story–overall, it provided an excellent assessment of the at-home test options, particularly the fecal immunochemical test. However, for any story about screening methods, particularly blood tests, we think it’s important to include the risks of false-positive and false-negative results, which carry harm. The story didn’t go there. Given that the public has reservations about aspects of the invasive screening methods, information suggesting that they might be adequately replaced by non-invasive approaches is important to the public’s health. All too often, colonoscopy is promoted as the “gold standard” and no mention is made of effective alternatives. This news story does a good job explaining options, and also explores the reasons why so many Americans think that screening with colonoscopy is the best way to be screened for colon cancer and why that attitude is not supported by the evidence and may (in rare cases) be much worse than non-invasive screening methods.


Question: Paragraph: "Accusations about the responsible party behind the United States’ struggle to accelerate coronavirus testing have come from every which way and the blame has fallen, often inaccurately, on the shoulders of different public officials. In a March 13 tweet, President Donald Trump said the Centers for Disease Control and Prevention studied its testing system for decades but wasn’t prepared for a large scale pandemic, an issue that was complicated by policy changes made by former President Barack Obama. U.S. Sen. Chuck Schumer, D-N.Y., retweeted Trump’s remark and added his own comment: ""Trump is once again trying to blame the previous administration for the number of tests available. This is his #DailyLie."" U.S. Rep. Dan Crenshaw, R-Houston, retweeted Schumer’s remark and said: ""It’s not Obama’s fault and it’s not Trump’s fault. We have stringent FDA regulations, long in place, that created barriers to the private industry creating a test quickly."" PolitiFact looked at a different Trump claim blaming Obama for a lack of testing. We also looked at a claim from Democrat Joe Biden about the Trump administration rejecting tests from the World Health Organization (they were never offered). Trump also inaccurately stated that any individual who wants to be tested for the coronavirus can get a test. We wanted to dig deeper into Crenshaw’s claim, which attributes the delays in the availability of widespread testing to Food and Drug Administration regulations. Justin Discigil, spokesman for Crenshaw, pointed to articles from ProPublica, the New Yorker, The Atlantic and the Washington Post, all of which highlighted the role FDA regulations played here. He added: ""Just to be clear – nowhere did we say that these regulations were the sole/only reason for the testing issue, we said that they created barriers."" A timeline of events The first confirmed case of COVID-19 in the United States came at the end of January, when a man in Washington state developed symptoms after returning from a trip to Wuhan. One month later, federal health officials at the Centers for Disease Control and Prevention said it was inevitable that the U.S. would experience a spread of the virus and urged people to take precautions. In these early days of the virus, tests were not widely distributed to local and state laboratories. Instead, testing for the new coronavirus was conducted almost entirely by the CDC — samples collected at the local level were sent to the agency. Initial test kits developed by the CDC for use in local and state labs were flawed and produced inaccurate results in some labs, meaning they couldn’t be distributed. As the agency worked to correct the tests, health officials turned to the FDA. The U.S. Association of Public Health Laboratories submitted a letter asking the agency to use ""enforcement discretion"" and authorize local and state labs to develop and use their own tests. During a public health emergency, labs and drug manufacturers must seek an Emergency Use Authorization from the FDA to use diagnostic tests and medical treatments that have not gone through the typical clearance process — to share them faster in the emergency. (These authorizations were begun in 2004 under President George W. Bush.) For laboratory-developed tests, like the ones in question, FDA policy has stated that they cannot be used in clinical diagnoses without the FDA’s approval during an emergency. Although the goal of these regulations is to ensure only accurate lab tests are conducted, health officials have said they prevented them from quickly responding to the virus. One doctor in a Seattle lab described the process for getting an Emergency Use Authorization from the FDA and said the agency asked for a level of testing that didn’t make sense in the context of an emergency, according to a GQ profile. A doctor in North Carolina told NBC News that she had developed a test using the World Health Organization’s protocol but had yet to receive the use authorization from the FDA, putting the state ""way behind"" in its ability to test patients. On Feb. 29, the FDA announced a change in the process: Labs would still need to seek the agency’s approval for their tests, but the labs could begin testing while waiting for the official green light. On March 16, (three days after Crenshaw made his claim) the FDA announced another change to its policies and put state officials in charge of coronavirus tests developed by laboratories in their states, meaning labs would engage with state officials and not the FDA. It also removes the requirement for these labs to apply for an Emergency Use Authorization for their tests. The changes also expand which labs and manufacturers are included in FDA guidelines and which kinds of tests can be developed. ""We believe the unprecedented policy set forth in today’s updated guidance, which addresses laboratories and commercial manufacturers, will help address these urgent public health concerns by helping to expand the number and variety of diagnostic tests, as well as available testing capabilities in health care settings, and reference and commercial laboratories,"" reads a release from the agency. After the changes After the FDA announced changes to its policies, Labcorps and Quest Diagnostics both announced plans to start testing for the new coronavirus, crediting changes in federal policy with their ability to do so. ""We applaud the FDA for providing the flexibility for innovative, quality lab developed tests to be brought to patients and providers quickly to advance effective response to the coronavirus outbreak,"" said Steve Rusckowski, chairman and chief executive officer of Quest Diagnostics, in a statement. But even as state and local authorities move to ramp up testing, the number of available tests is still lacking. In Austin, for example, there is still a gap between available test kids and demand for testing, as officials prioritize testing for health care workers, people living in nursing homes and people at high risk for complications from the virus. Our Ruling Crenshaw said in a tweet that longstanding FDA regulations ""created barriers to the private industry creating a test quickly"" for the coronavirus. Crenshaw’s statement is accurate. FDA procedures adopted in 2004 meant laboratories had to seek the agency’s approval before developing and using tests in communities, a policy many health care officials have said prevented the country from taking early action in response to the novel coronavirus. It is important to keep in mind that other factors have contributed to the low levels of testing for the virus, beyond the FDA regulations. But Crenshaw’s statement is accurate." Claim: Dan Crenshaw Says longstanding Food and Drug Administration regulations “created barriers to the private industry creating a test quickly” for the coronavirus.

Answer: Food and Drug Administration regulations in place since 2004 require labaratories to get an Emergency Use Authorization from the agency to use diagnostic tests and medical treatments that haven't gone through the typical clearance process. The policy was intended to speed up the process, but researchers reported significant delays between seeking an application and getting approval and these regulations played a role in that. The FDA has since changed the regulations to allow labs to start utilizing tests before receiving clearance.


Question: Paragraph: “This used to be my land,” said the 51-year-old farmer, frowning at the murky waves. All but six of the 24 acres where he used to grow rice and vegetables have slipped into the water in recent years, he said. Another farmer, Than Tun, said he had lost 15 acres of his land to erosion. While official records were not available, other villagers backed their accounts. Farmers and politicians in Chaungzon township, just outside the southern town of Moulmein, worry that erosion in the area is being exacerbated by the ships that dredge its bed for sand each night. The sand is mainly bound for Singapore, the world’s biggest importer, for use in reclamation and construction projects. Both the Myanmar government and the company whose ships do the dredging in Chaungzon deny the dredging is causing the erosion. But the dispute highlights the fractious issue of sand-mining in Southeast Asia as Singapore is forced to look farther afield to slake its thirst for the mineral following bans on the trade in countries like Malaysia and Indonesia over environmental concerns. Sand mining has been blamed by scientists for damaging sensitive ecosystems around the world, accelerating coastal and riverine erosion, and exacerbating the frequency and severity of floods and droughts, according to a 2019 report by the U.N Environment Programme. Malaysia, formerly the biggest source of sand for Singapore, in 2018 introduced an outright ban on the export of sea sand, used for land reclamation, and imposed tighter controls on river sand, used mostly in construction. Cambodia made a similar move in 2017, while Indonesia banned exports to Singapore in 2007, causing a “sand crisis” that brought building activity almost to a halt. Singapore, an island state that has grown 25 percent since its independence in 1965 thanks largely to aggressive land reclamation, has since bolstered its stockpiles, according to sand traders. Officials in Myanmar and industry sources in Singapore say the bans have prompted Singapore to seek new supplies from countries like Myanmar. Almost 1 million tonnes of sand went from Myanmar to Singapore in 2018, earning over $6 million, according to the most recent UN data on the trade. That amount is expected to have increased substantially following the Malaysia bans, according to the Myanmar government. “Since the Philippines, Cambodia, and Vietnam almost completely stopped exporting sand to Singapore, the sand from Myanmar has become much more in demand,” said Aye Lwin, joint secretary-general of the Myanmar Port Authority, which grants licenses for sand-mining operations. The benefits of the mining – including tax revenues for the government – outweighed the costs, he said. “I believe it only causes little environmental damage,” Aye Lwin said. “But it generates funds for the government.”  The Singapore-registered company dredging in Chaungzon, Starhigh Asia Pacific Pte Ltd., has extracted hundreds of thousands of tonnes of sand since 2013, according to the local member of Parliament, Kyi Kyi Mya. She said at least 150,000 tonnes were extracted in 2018-2019, but did not have the exact number for other years. Starhigh dredges the sand legally through a license with the local government that does not limit the amount of sand the company can extract. Most of the sand Starhigh extracts is sent to Singapore. The company last year bid to supply sand to JTC Corporation, a Singapore government agency for infrastructure development, according to a tender on a government procurement site. Starhigh also supplied sand for a JTC reclamation project in Singapore completed in 2018, according to Starhigh’s managing director, Si Thu Phyo. He said the sand for that project came from Myanmar as well as Vietnam and the Philippines. JTC referred questions from Reuters to Singapore’s Ministry of National Development, which said the country imports sand on a commercial basis and that suppliers are expected to abide by laws and regulations in source countries. The Myanmar government says the environmental impact of the dredging is minimal and necessary to clear waterways of built-up sediment. In 2014, the company paid compensation to local farmers who claimed that mining too close to the shore had led to landslides, according to Kyi Kyi Mya, the MP in Chaungzon. Starhigh did not comment on any compensation paid to farmers but said “whenever it is possible, we will help locals with small landfill work at our own cost.”  Si Thu Phyo, the Starhigh managing director, told Reuters that erosion was present in the area before dredging work started. “Dredging is always an easy target when it comes to environmental complaints,” he said. “People don’t understand and are worried.”  Riverbank erosion along the Salween is not an entirely new phenomenon, with factors including climate change worsening the problem by contributing to higher levels of flooding and siltation, said Vanessa Lamb, a geography lecturer at the University of Melbourne who has studied the river. She said that a lack of baseline data about the river made it difficult to track just how much sand dredging was affecting riverbank erosion. But in a 2019 research paper, Lamb said locals blamed accelerating erosion on the rise in sand-mining. It was not possible to verify those claims from local records or old photographs. Dr Aung Naing Oo, deputy speaker of the Mon state parliament and the author of a parliamentary report on sand extraction in the region, said there was little transparency around the industry. He said that there was no consistent monitoring process and that authorities were not checking how much sand was being extracted or whether companies were taking material only from agreed sites. For now, the government says it does not have plans to end the dredging or compensate farmers for lost land. Than Zaw Oo, the farmer in Chaungzon, said he is now in debt after borrowing more than $2,600 to pay for embankments in an attempt to keep erosion at bay. “I am lost and I don’t know what to do,” he said. “The sadness is just beyond words.” Claim: As Myanmar farmers lose their land, sand mining for Singapore is blamed.

Answer:
From a boat on the Salween River in southeastern Myanmar, Than Zaw Oo pointed to a brown stretch of water he said was once full of lush paddy fields.