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.

[EX Q]: This is a tricky one. The story does not explicitly address cost, except to call text messaging “a scalable and affordable approach.” For many (or most) patients, the cost of receiving four text messages a week would likely be negligible — covered by an individual’s phone plan or by nominal text rates. However, not everyone owns a mobile phone, a fact that makes access (and cost) a more significant issue. However, the story does deliver on this point. The story discusses both the number of U.S. adults who own mobile phones (90 percent) and the fact that text messages are more accessible than other forms of mobile health communication (such as apps, which require patients to own smartphones or other smart devices). So, while we’d prefer a more in-depth discussion here, we’ll award a Satisfactory rating for the story’s nod in this direction. The story addresses the range of benefits reported in the study, such as reduced cholesterol and blood pressure, but doesn’t quantify that information or offer readers any context. For example, while the story says “patients who had received the text messages had reduced their cholesterol,” the JAMA paper reports that patients who received the text messages had a “mean difference [of] −5 mg/dL” in “LDL-C.” In other words, the information in the paper, while quantified, probably isn’t very useful to many readers outside the health industry. Is “a mean difference of −5 mg/dL in LDL-C” good? Bad? Irrelevant? This is where reporters have an opportunity to shine. If a news story can take those numbers and translate them into language that is accessible to non-experts, it provides a very real service. It would have been great to see that here. As long as people aren’t driving and checking their cell phones, there don’t appear to be any harms associated with receiving well-meaning text messages four times a week, so we’ll mark this one “not applicable.” This is a strong suit. The story not only offers a concise, but good, summary of the study — but it also goes out of its way to address the study’s limitations. For example, the study notes that the study “can’t tell us whether text messaging could eventually lead to fewer subsequent heart attacks among the patients receiving those messages or whether the positive health outcomes would continue past the six-month study window.” Good points, and we’re glad the story includes them. No disease mongering here. The story includes input from an outside expert who was not involved with the research. The story clearly meets our bar here, although it would have been stronger if it had reached out to at least one more independent source — preferably one who hadn’t written an editorial that ran in conjunction with the paper in JAMA. Yes, the editorial was independent and provides some insightful commentary. But it also means we already knew where this source stood on the issue. Finding another reputable expert, who hadn’t already weighed in publicly on the work, would have been great. The focus of the story is not so much on how the text message intervention directly reduced heart disease risk, but on the extent to which it resulted in patients taking steps to reduce their own risk — such as by exercising more, smoking less, making dietary changes, or taking prescription drugs on a regular basis. The story does discuss other “mobile health interventions,” such as smartphone apps — but notes that there don’t appear to be many mobile health projects that rely simply on text messages. The story also looks at how the text messages helped patients pursue lifestyle changes — like exercising more and smoking less — that reduced their risk. It was fairly clear from the story that this was a clinical trial, and that this particular service doesn’t seem to be available to offer customized, encouraging text messages for heart disease patients. From the start, the story frames this research in the context of the much larger “mobile health” field. For example, the story notes that “While there are more than 100,000 health-related apps on the market, the evidence to date is lacking as to whether many of those apps are safe or effective.” Since the story includes quotes from an interview, we can be fairly certain it went beyond the related JAMA news release.
[EX A]: Text Reminders Help People Lower Cholesterol, Blood Pressure

[EX Q]: The lawmakers demanded that the executive explain why blackouts intended to prevent downed power lines from sparking deadly wildfires caused so much trouble of their own. The explanation CEO Bill Johnson offered the Capitol hearing room: Several smaller outages that PG&E triggered in the year before its debacle began in mid-October went well, giving his company misplaced confidence. “I think we got a little complacent that we had figured it out,” Johnson testified last month. PG&E had not figured it out. An Associated Press review shows widespread problems with the four “public safety power shutoffs” the utility started rolling out in 2018, a year before massive blackouts paralyzed much of California in recent months. Interviews and documents obtained under public records requests reveal persistent failures and broken promises that in some cases compromised public safety. Even as PG&E assured regulators it was fixing the problems, the utility kept making many of the same mistakes, further undermining trust after its outdated equipment and negligence has been blamed for fires that killed nearly 130 people during 2017 and 2018. Communication, a foundation of emergency management, was poor. PG&E’s notifications of impending outages were haphazard at times, with some sent after the power was already out. Telecommunications companies, water providers and emergency managers did not always receive the early word they needed. “We were surprised that PG&E provided no advanced warning to us,” an official with the city of Oroville’s drinking water provider wrote state regulators about a June outage. PG&E made important information hard to get. It was slow to distribute electronic maps showing who would lose power, making it harder for emergency responders to know exactly where to send resources. The utility also balked at providing the addresses of medically needy customers to local officials who planned to check on them in person. Breakdowns afflicted even basic technology. In a region that’s home to Silicon Valley and its thousands of computer programmers and engineers, PG&E had not prepared the website where it posted outage updates for a crush of customers, so it crashed. Tech experts from the state had to intervene. The sound quality of some calls PG&E hosted during shutoffs was so poor that emergency responders and legislators had a hard time understanding updates. Even then, not everyone was invited. “In the future, AT&T requests that it and other communications providers be included on any conference calls providing real time information,” the telecommunications giant protested to regulators after the June shutoff. These and other early failures weren’t widely recognized as harbingers of the issues that would overwhelm PG&E come mid-October, partly because the outages affected rural areas with less political and economic clout. While the headline-making shutoffs affected more than 2 million people across much of PG&E’s 70,000-square-mile service territory, the four initial blackouts affected tens of thousands in Northern California’s Sierra Nevada foothills and famed wine valleys. They hit in October 2018 and then in June, September and early October of this year. Among those who saw trouble building were regulators at the California Public Utilities Commission. The first shutoff was chaotic and the next three were not going according to the guidelines regulators had passed. Commission staff met more frequently with PG&E starting in the spring, using advice and persuasion rather than mandating changes. “We, as the state, never got to the point where we had complete confidence in PG&E’s ability to execute,” said Elizaveta Malashenko, the top California regulator overseeing blackouts. Malashenko, deputy executive director of safety and enforcement policy, told the AP that the commission didn’t act more aggressively because it has to balance punitive intervention with giving utilities a chance to self-correct. “There needs to be some basic operational assumption that you can set up a conference call,” Malashenko said. Some critics faulted regulators for not doing enough. The utilities commission, a sprawling bureaucracy with a complex rule-making process, was “not aggressive enough early in setting clear requirements and standards,” said Melissa Kasnitz, legal director for the Center for Accessible Technology, which advocates for people with disabilities. PG&E promised to fix a range of problems promptly, and an executive said it worked hard to deliver. In many ways, that didn’t happen. Not only did the problems continue throughout the smaller shutoffs, but they were replicated on a huge scale starting with the mid-October shutoffs. The problems galled local officials, who vented deep frustration that a utility they often work closely with kept failing them. After all, they are the ones dealing with a shutoff’s consequences. They must dispatch ambulances, run jails and water plants, direct traffic through darkened intersections, set up community shelters and much more. “It’s almost as if it’s intentional disregard of all the warnings we gave them,” said Napa County Supervisor Diane Dillon, whose district north of San Francisco has experienced nearly every shutoff. ___ Sixteen million people — more than the population of nearly any U.S. state — depend on PG&E for power. The shutoffs were an inconvenience for some and extremely costly for others. For society’s most frail, they brought questions of life and death. Those who rely on medical devices in their homes were particularly vulnerable. “PG&E did nothing to help us who depend on electricity to run our life support,” recounted Grace Lin, a polio survivor who needs a ventilator to breathe and uses an electric wheelchair. “It’s not like we could simply grind our teeth and tough it out by holding our breath.”   Lin said she was confused by the notifications PG&E sent ahead of the first shutoff that affected her San Francisco Bay Area home on Oct. 9. The company website they referred to for updates was frozen. Lin considered herself lucky that she had the means to evacuate 20 miles away, to a quadriplegic friend’s house that had electricity. PG&E could identify “medical baseline” customers such as Lin based on billing records. Local officials working to identify everyone who might need help repeatedly asked PG&E to share its list, so no one was overlooked. Regulators said PG&E promised it would release medical baseline addresses during a shutoff. Yet when each of the first four hit, PG&E insisted that locals sign a legal agreement not to disclose the addresses, causing delay and uncertainty that regulators said could risk lives. On the eve of the first massive power outage, Malashenko of the utilities commission was urgently emailing company officials in frustration. “This issue has been discussed many times over the last several months” yet “has once again become an issue with PG&E,” she wrote on Oct. 8. Malashenko said state officials also pushed PG&E to improve in other areas. Starting in April, they met at least weekly with PG&E, pointing out needed improvements and stressing that aspects of the utility’s preparation was inadequate. PG&E argued that the commission’s own privacy rules meant it couldn’t share the addresses without a non-disclosure agreement, spokesman Jeff Smith explained. Resolving the problem took an order that the commission’s executive director sent three hours before the first massive blackouts began. Other groups of vulnerable Californians endured shutoffs without the help they needed. “A lot of them don’t have support, a lot of them don’t have family,” Betty Briggs, 84, said of her elderly neighbors in the well-touristed Napa Valley town of Calistoga. “It makes it very difficult, and it puts them in danger.”   Briggs can get around without help, but her husband requires 24-hour care due to dementia. He lives nearby at Cedars Care Home, where seven residents in their 80s and 90s experienced three shutoffs before mid-October. The outages created anxiety for people reliant on routine, as well as practical problems. Beds and wheelchair lifts require electricity. So does the heat and air conditioning. When the freezer got too warm, staff tossed 30 days of backup food. Owner Irais Lopez still hasn’t restocked fully. “Now, we only buy small quantities,” Lopez said, “because we don’t know what will happen.”  ___   At PG&E’s high-rise headquarters in downtown San Francisco, the emergency operations center springs to life with each shutoff. Employees in different colored vests that distinguish their expertise cluster around banks of computer monitors showing real-time updates. Maps track wind speed and direction, as well as which circuits are down. Conversation hums in the background. This is where decisions are made and answers can be found — and local officials said they felt they had little access to either. Fed up with communication gaps, one hard-hit county requested a presence at PG&E headquarters during the September shutoff. Regulators required that the utility hold seats in its emergency operations center for local representatives, but a lawyer for Sonoma County instead spent her day in a conference room several locked doors away. “There was just a lack of understanding on behalf of PG&E of why local government needs timely information,” said Petra Bruggisser, a deputy county counsel. PG&E already had a shaky reputation in its Northern and central California territory. The company spent three years in bankruptcy starting in 2001, after California’s attempt to deregulate its power market went awry. Maintenance failures led to a natural gas pipeline blast near San Francisco in 2010 that killed eight people. PG&E was found criminally liable and paid a $1.6 billion fine. In late 2017, its equipment was suspected of starting the Tubbs Fire that killed 22 people and destroyed more than 5,600 buildings. The utility revealed in spring 2018 that it would start using power shutoffs when fire danger was high and extreme winds blew. PG&E then began to explain what to expect, sending millions of emails to update its customer contact files, running advertising in multiple languages and holding hundreds of meetings with community leaders, public safety agencies and residents. The California Public Utilities Commission started writing guidelines for how utilities should roll out “de-energization.” The guidelines were published as a 176-page document in June. By that point, PG&E had again filed for bankruptcy protection, crushed by liabilities for fires in 2017 and 2018, including the Camp Fire that nearly wiped out the town of Paradise and killed 85 people. The utility now has a market value of about $6 billion — a drop of $30 billion in just over two years — and is working with the state and a federal judge to emerge from bankruptcy by June 30. California Gov. Gavin Newsom said he expects PG&E’s entire 14-member board of directors, including Johnson, its CEO, to step down before the state will approve the utility’s plan to regain its financial footing. “PG&E’s recent management of the public safety power shutoffs did not restore public confidence,” the Democratic governor warned the company in a Dec. 13 letter. “Instead, PG&E caused extreme uncertainty and harm for Californians who rely on power for their health care and their livelihood.” PG&E said Johnson was not available for an interview. The utility’s point man on the shutoffs told AP that he believes Johnson, while testifying before lawmakers last month, was referring to its ability to kill and safely restore power to an extremely complex electrical grid. Sumeet Singh, a vice president who oversees PG&E’s community wildfire safety program, listed a litany of ways the utility is investing in fixes that he said will lessen the need for future shutoffs. Those include trimming more vegetation near power lines and burying some lines in areas most at risk of igniting. Singh also acknowledged that the utility had some struggles during the early shutoffs but that it strove to improve and disputed any characterization that it did not succeed in some ways. He cited how quickly the utility restored power as one improvement, along with the timeliness and accuracy of customer notifications. “Did we hit the mark on every single improvement? No. Do we have more work to do? Yes,” Singh said. Power shutoffs are likely to be a feature of life in California for years to come. PG&E must invest billions in infrastructure upgrades, and communities are spreading into lands once populated by trees and brush. Regulators promise to be watching closely. “If we have an outcome that doesn’t meet the public expectation and what we need to run as a state,” said Malashenko of the utilities commission, “that means that we need to rethink our approach and try something different and drive to a better outcome.” In November, the commission launched an investigation into whether it should sanction PG&E for violating shutoff protocols. PG&E said it will need to improve how it reacts after it shuts off the power. “I think we thought the big event was turning off the power,” Johnson told lawmakers. “And I think we focused on that as the main event instead of the impact of that, right, on the people it affected.” ___ Pritchard reported from Los Angeles. Associated Press journalists Terence Chea and Eric Risberg in Calistoga and Adam Beam in Sacramento contributed to this report. ___ Contact Pritchard at https://twitter.com/lalanewsman.
[EX A]: AP Exclusive: PG&E’s history with blackouts signaled trouble.

[EX Q]: "Pushing back against a lawsuit seeking to block his ""Safer at Home"" extension, Gov. Tony Evers laid out his case for isolation measures in Wisconsin. He said striking down the order would ""cripple our ability to respond to the pandemic."" Places without such measures, he said, have yielded ""reports of doctors rationing ventilators and having to choose which patients will live or die"" and ""reports of needing refrigeration trucks for the deceased."" And he made a bold claim about the impact his shelter-in-place order has had in Wisconsin. ""It's working,"" Evers wrote in an April 21, 2020, Facebook post. ""We have flattened the curve here in Wisconsin and have prevented the death of at least 300 Wisconsinites, and perhaps as many as 1,400 lives."" Disease experts have been clear that social distancing can save lives, but is Evers right about saving at least 300 lives? We checked it out. We’ll start out with the obvious: There’s no way for Evers to know this for sure. He is referring to a hypothetical scenario in which actions taken to this point never occurred. But this is a standard type of statement in disease management and other fields that use predictive models — comparing initial projections with actual observations later. ""It’s quite common to project with a model sort of what would be expected in epidemiology,"" said Patrick Remington, a former CDC epidemiologist and director of the Preventive Medicine Residency Program at the University of Wisconsin-Madison. ""What better way to predict than … to say, particularly early in an epidemic, what if we did nothing? The early transmission velocity in an epidemic, what if that were to continue throughout the course of the epidemic?"" We should also note this language is in line with claims from the other side of the aisle. President Donald Trump asserted in an April 16, 2020, news conference, ""Our experts and scientists report that our strategy to slow the spread has saved hundreds of thousands of lives."" The models used to project the number of cases and deaths from COVID-19 are constantly evolving, tweaked to factor in the most up to date trends, new information about the virus and changes in government policies and society’s response to them. The models get better as more data on what is happening is added, which is why the wild swings in projected cases and deaths from early models have leveled out now. Evers is comparing the number of deaths we’ve seen so far to what the earliest version of those models said would happen in Wisconsin. So what did they say? Evers spokeswoman Melissa Baldauff said his numbers were based on a model created by the Wisconsin Department of Health Services. A version of that released March 18, 2020 projected between 440 and 1,500 deaths in Wisconsin by April 8. The actual death toll on April 8 was 99. Some quick subtraction shows that is in line with Evers’ claim. ""While early models of the virus’s spread are less reliable the further out they project, those models showed that, by April 8, Wisconsin would have seen 22,000 cases which would have resulted in 440-1,500 deaths,"" Julie Willems Van Dijk, deputy DHS secretary, said in an affidavit filed in opposition to the Republican lawsuit. ""Therefore, we estimate that the First Safer at Home order saved between 300 and 1,400 lives by April 8th."" Evers’ claim also lines up with early projections from the Institute for Health Metrics and Evaluation at the University of Washington, a model that has been widely used by the government and public alike throughout the pandemic. On March 25 it projected 853 deaths in Wisconsin over the following four months. Now that model projects less than half that number. Another model, detailed in an April 24 report from Johns Hopkins University, said their simulations showed about three times as many deaths in Wisconsin by May 1 if ""Safer at Home"" had not been in place. As of April 30, 316 people had died in Wisconsin of COVID-19, DHS reports. Ajay Sethi, associate professor of population health sciences at the UW-Madison School of Medicine and Public Health, said the range of lives saved Evers cited is ""consistent with near-term forecasts I had seen."" Remington agreed those figures are ""absolutely within the range of what I’d expect,"" noting that Evers was wise to cite it as a range since it is an estimate and based on many factors. One key factor here is the matter of credit. Just as the number of deaths is an estimate, so is figuring out how many of those lives saved were due specifically to ""Safer at Home."" ""You can’t tease out the effect of that order from the daily White House briefings to all the stuff on social media to late night comedy shows,"" Remington said. ""But you can say the result of all this public education is a change in our behavior."" ""Safer at Home"" was the cornerstone of the Wisconsin response to coronavirus, though, so it’s certainly fair to credit it with a large share of the change in behavior here. ""Without social distancing the virus would have continued to spread like wildfire,"" Sethi said. Evers said his ""Safer at Home"" plan ""prevented the death of at least 300 Wisconsinites, and perhaps as many as 1400 lives."" This claim lines up with projections made by DHS, and experts say it’s in line with what other models projected as well. And Evers was smart to cite a wide range of possible outcomes, since we have no way of knowing precisely how this theoretical future would have played out. But any claim like this is based on a hypothetical scenario of how COVID-19 might have progressed in Wisconsin without the array of government limitations and changes in personal behavior we’ve seen in recent months. And Evers stated this as a knowable fact rather than an estimate. With that missing context in mind."
[EX A]:
"Tony Evers Says Wisconsin measures have ""prevented the death of at least 300 Wisconsinites, and perhaps as many as 1,400 lives."