Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.
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Question: The study tracked about 20,000 severely obese patients with Type 2 diabetes. Those who had weight loss surgery had a 40 percent lower chance of developing a heart attack or stroke in the five years following surgery compared to those who got usual care with diabetes medicines or insulin. For every 1,000 patients in the study who had surgery there were roughly 20 heart attacks or strokes compared to 40 such events per 1,000 who got regular care. More than 30 million Americans have diabetes, mostly Type 2 where the body loses the ability to produce or use insulin to turn food into energy. Other research has shown obesity surgery can reverse and even prevent diabetes. Taken together, it means doctors should discuss weight loss surgery more often, said study co-author Dr. David Arterburn of Kaiser Permanente Washington Health Research Institute in Seattle. Doctors usually mention insulin and pills, “but it’s not always brought up that weight loss surgery is another available treatment option,” Arterburn said. Researchers analyzed records from four U.S. health care systems: HealthPartners in Minnesota and Kaiser Permanente in Washington state, Northern California and Southern California. Results were published Tuesday in the Journal of the American Medical Association. The study can’t prove cause and effect because patients weren’t randomly assigned to get surgery. The researchers tried to match patients for gender, age, blood sugar levels and other factors. But other things they didn’t account for could have contributed to the surgery patients’ better results. Everyone in the study had a BMI, or body mass index, of at least 35. For instance, someone who is 5-foot-8-inches and weighs 230 pounds has a BMI of 35. Of the more than 5,300 who had surgery, most had gastric bypass, the most common type of stomach-shrinking operation. Some had gastric sleeve or gastric band procedures. The rest, nearly 15,000 people, had usual care. Obesity surgery can cost $20,000 to $25,000. Insurers are increasingly covering it, but some impose strict limits. The new findings suggest insurance coverage should be expanded for the right patients, Dr. Sayeed Ikramuddin of the University of Minnesota wrote in an accompanying editorial. Surgery is thought to help by affecting hormones, gut bacteria and other substances that affect how the body handles insulin and blood sugar. Weight loss without surgery also helps, but is difficult for many people to achieve. Most weight loss surgery today is done through small incisions. The dangers are similar to other surgeries, including a small chance of life-threatening complications, and some people need to have their surgeries repeated. ___ Follow AP Medical Writer Carla K. Johnson on Twitter: @CarlaKJohnson ___ The Associated Press Health &amp; Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Answer: Obesity surgery may lower heart attack danger in diabetics.


Question: Instead, he said, he met them on their front lawn, where he popped the girl’s joint back in. “It is a very easy thing to do, but it made a huge difference for them,” he said. Gulbransen has had to rethink how he runs his pediatric practice on Long Island since the coronavirus crisis started. “We’re in the heart of the storm,” said Gulbransen. His practice remains open and now also welcomes some non-pediatric patients who have had trouble being seen by a doctor. He said his practice has been physically rearranged to keep sick patients away from those who are well. Other recent adjustments include doing telemedicine, although he is unsure how insurance reimbursements will work with such consultations. He said he was worried about his pediatric patients picking up on their parents’ anxieties, as well as the health and financial welfare of his staff. “The anxiety level is palpable,” said Gulbransen. “But it’s a privilege,” he said, adding, “you’re here for your patients. You gotta push and do whatever it takes.”  New York state, the epicenter of the pandemic in the United States, had a coronavirus death toll exceeding 10,000 as of Tuesday, out of more than 28,000 across the country. The disease looks different in children than it tends to with adults, said Gulbransen. “We had a 6-week-old with COVID, and really (the infant had) no other symptom than a runny nose,” said Gulbransen. He has also treated “quite a few toddlers and plenty of schoolage children,” who were all doing well. Cases of the illness involving children are “dwarfed by adult cases, although some of the (child) cases can be quite severe,” according to Dr. Lorry Rubin, director of pediatric infectious diseases at Cohen Children’s Medical Center, part of the Northwell Health network. Sometimes previously healthy children, often adolescents, develop pneumonia “and that can be severe and possibly lead to them needing oxygen or ventilatory support,” Rubin said. Still, most pediatric COVID-19 patients do well. Rubin said he was aware of only one child who had died, who also had a terminal congenital illness. Among infants under 60 days old in whom COVID had been detected, “all of them have done quite well,” he added. “The frequency of pediatric illness requiring hospitalization is low,” Rubin said. “No question, it’s not as bad in children and less common than in adults.”  But with New York’s healthcare system at full throttle treating coronavirus patients, Gulbransen wants to take no risks. His motto is: “Whatever you do, don’t send someone from this office to the ER.”

Answer: 'Don't go to the ER': how a New York pediatrician is dealing with the coronavirus outbreak.


Question: The government-funded study by the National Academy of Sciences also found that the Mexican gray wolf of New Mexico and Arizona is a subspecies, which advocates say should support conservation efforts. Another wolf species, the Western gray wolf, is thriving in the Northern Rockies and Great Lakes and could lose federal protections under a proposal released earlier this month. For red wolves, the affirmation of their genetic uniqueness comes after some North Carolina officials and a small but vocal group of landowners pushed the government to abandon recovery efforts, arguing the animal is a coyote hybrid. U.S. Fish and Wildlife Service spokeswoman Laury Parramore declined to comment on the agency-funded study beyond a statement saying it was under review. Red wolves once occupied much of the Eastern U.S. but were driven to near extinction by trapping, hunting and habitat loss. Some of the last red wolves in the wild were removed from portions of Louisiana and Texas in 1980 and used in a captive breeding program. Their descendants were later reintroduced to a wildlife refuge along North Carolina’s coast. An estimated 35 wild red wolves remained as of late 2018, down from about 120 a decade ago. Their range is currently limited to five North Carolina counties. Another 200 live in captive breeding programs. Acknowledging longstanding questions among some scientists about red wolf ancestry, federal wildlife officials said last year they would treat it as a distinct species while awaiting Thursday’s report. The nine-member national academy panel found that the red wolf is unique based on its DNA, its behavior and its size, which is larger than a coyote and smaller than a gray wolf. While the red wolf appears more closely related to coyotes than gray wolves, red wolves diverged as their own species long ago, said Joseph Travis, chair of the national academy panel and a biology professor at Florida State University. “There’s clearly been introduction of coyote genes and gray wolf genes into red wolves. But they also have genes not seen in coyotes and gray wolves,” Travis said in an interview. “They must have continuity with some ancestor which was not a gray wolf or coyote.” Ron Sutherland, a biologist with the nonprofit Wildlands Network, said he had been waiting on “pins and needles” to see what the panel decided. “That should be a kick in the butt for the Fish and Wildlife Service to stop the quiet negligence of letting the species go extinct in the wild,” he said. A government plan to further shrink the territory where red wolves roam stalled last year when a judge ruled officials were neglecting their duty to protect the animals under the Endangered Species Act. That same plan would have allowed landowners to kill any wolves that strayed from the proposed smaller territory consisting of federal land in two counties. Conservationists accused the federal agency of neglecting the animals under political pressure and abandoning proven conservation techniques, such as releasing captive bred pups. In 2015, North Carolina’s Wildlife Resources Commission passed a resolution urging an end to the federal program, saying “the purity of the red wolf genome is questionable” after hybridization with coyotes. Republican U.S. Sen. Thom Tillis has also urged its end. The study released Thursday had been ordered by Congress as part of a 2018 appropriations bill. ___ Brown reported from Billings, Montana.

Answer:
Government-funded study says red wolves are distinct species.