instruction:
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.
question:
Though the article does not mention costs or compare costs of garlic and garlic supplements with other treatments, many readers will be familiar with these. The story reports that the consumption of garlic in any of three forms (raw, powdered supplement, aged extract supplement) had no effect on LDL cholesterol or triglycerides. To quantify this non-effect in mm/dL is unnecessary, and would have been numbing for the average health news consumer. A majority (57%) of individuals in the trial who ate garlic-laced sandwiches reported bad breath and body odor, a “harm” the story neglected to mention. The article reflects an appreciation for the hierarchy of evidence, noting that “there was good evidence in test-tube and animal studies” that garlic could lower LDL cholesterol, and explains the randomization methods in the new clinical trial. No obvious elements of disease-mongering. The article cites four sources and provides sufficient information about their potential conflicts of interest. The article fails to mention alternative methods for lowering cholesterol, though many readers may be familiar with these (most prominently exercise, diet, and drugs). Most readers will be familiar with the availability of the health interventions studied—raw garlic and garlic supplements. The story rightly notes that garlic is not a new “treatment” for high cholesterol. No obvious use of text from a press release.
answer:
Garlic powerless against cholesterol


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Clearly, the costs involved in cancer treatment already are high. By removing a layer of treatment from an estimated 40,000 patients, those costs would have to drop, but it is unclear from the story by how much. Also, it would have been worth mentioning whether this is likely to affect how insurance companies handle lymph node removals. The story did a good job providing some numbers on benefits, but we wish it had provided more and explained some things a bit more. It says, for example, “In 27 percent of the women who had additional nodes removed, those nodes were cancerous.” How many women had additional nodes removed and, of those, how many had cancerous nodes? A figure like 27% means 1 out of every 4 women had nodes that were, indeed, cancerous, which seems to conflict with other statements in the story about chemotherapy and radiation wiping out the cancer. The story discusses several harms from lymph node removal, and shows that the difference in survival for women who had nodes removed and those who did not was not significant. “Indeed, women in the study who had the nodes taken out were far more likely (70 percent versus 25 percent) to have complications like infections, abnormal sensations and fluid collecting in the armpit. They were also more likely to have lymphedema.” This is where the story really outperformed some of the competition covering the same news. It placed the study into the broader context of a movement in cancer care away from surgeries that don’t provide a clear benefit, and it also explained the study design and the limitations of the study in several ways. “The study, at 115 medical centers, included 891 patients. Their median age was in the mid-50s, and they were followed for a median of 6.3 years. … One potential weakness in the study is that there was not complete follow-up information on 166 women, about equal numbers from each group. The researchers said that did not affect the results. A statistician who was not part of the study said the missing information should have been discussed further, but probably did not have an important impact. It is not known whether the findings also apply to women who do not have radiation and chemotherapy, or to those who have only part of the breast irradiated. Nor is it known whether the findings could be applied to other types of cancer.” It was too bad that it did not mention limitations in terms of lack of enrollment. The targeted enrollment was 1900. There also was an imbalance in the randomization that should have been mentioned. The story is careful to explain to readers that the research findings only apply to a subset of women with breast cancer. “Now, researchers report that for women who meet certain criteria — about 20 percent of patients, or 40,000 women a year in the United States — taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling.” The Q&A that ran with the story provided more detail about the different types of cancers and cancer patients, noting, for example, “First of all, 20 percent (the estimate of the study’s lead author, Dr. Armando E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive breast cancer each year. This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in situ. The total is about 207,000, so 20 percent is roughly 40,000 women. That is about how many women would match those in the study, in terms of tumor status, affected lymph nodes and course of treatment.”  The story also says, “The results mean that women like those in the study will still have to have at least one lymph node removed, to look for cancer and decide whether they will need more treatment. But taking out just one or a few nodes should be enough.” Good quotes including from Dr. Monica Morrow, chief of the breast service at Sloan-Kettering and an author of the study, but also a few fromindependent experts toward the end. Dr. Grant W. Carlson, a professor of surgery at the Winship Cancer Institute at Emory University, and the author of an editorial accompanying the study, provides some soul-searching context by saying that, in taking out so many lymph nodes, “I have a feeling we’ve been doing a lot of harm.” Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan, said, “It’s definitely practice-changing.” And Dr. Alison Estabrook, the chief of the comprehensive breast center at St. Luke’s-Roosevelt hospital in New York said, “In the past, surgeons thought our role was to get out all the cancer. … Now he’s saying we don’t really have to do that.” The story does a great job explaining the history of this form of treatment and how it has evolved over time. “But doctors have continued to think that even microscopic disease in the lymph nodes should be cut out to improve the odds of survival. And until recently, they counted cancerous lymph nodes to gauge the severity of the disease and choose chemotherapy. But now the number is not so often used to determine drug treatment, doctors say. What matters more is whether the disease has reached any nodes at all. If any are positive, the disease could become deadly. Chemotherapy is recommended, and the drugs are the same, no matter how many nodes are involved.” The story goes on to do something that stories like this rarely do, it compares compares the harms from different forms of treatment, saying “After armpit surgery, 20 percent to 30 percent of women develop lymphedema, Dr. Port said, and radiation may increase the rate to 40 percent to 50 percent. Physical therapy can help, but there is no cure.” The story makes it clear that removing all under-arm lymph nodes is the standard of care for women with breast cancer and that feelings about that standard are entrenched. The story establishes that a change in treatment protocol away from removing all the lymph nodes under the arms of women with breast cancer would be novel. There is some nuance, here, though that could be missed by a casual reader. Women who have one to two positive lymph nodes would avoid having additional lymph node surgery. The overall tone of the story may make it appear to some readers that women get to avoid lymph node surgery altogether, but they don’t. The story goes well beyond any news release.
answer:
Lymph Node Study Shakes Pillar of Breast Cancer Care


question:
Through ups and downs in popularity, health troubles and weight fluctuations and the sorts of seismic shifts that take place over decades in the entertainment industry, Lewis always figured out a way to battle back, to reinvent himself, to stay relevant. It’s what enduring stars know how to do instinctively; perhaps it’s that very drive that makes them stars in the first place. Through it all, Lewis remained the consummate showman, and his distinctive comic legacy surely will continue to survive for decades to come. The manic, rubber-faced performer who jumped and hollered to fame in a stage, radio, TV and film partnership with Dean Martin, settled to become a self-conscious auteur in movies he wrote, produced and directed, and found new fame as the tireless, teary host of the annual muscular dystrophy telethons, died Sunday at home in Las Vegas surrounded by family. He was 91. Lewis, who had battled the lung disease pulmonary fibrosis, heart issues, a debilitating back problem and addiction to pain killers, died of natural causes, according to his publicist. His career spanned the history of show business in the 20th century, beginning in his parents’ vaudeville act at the age of 5. He was just 20 when his pairing with Martin made them international stars. After their cold parting in 1956, Lewis made such favorites as “The Bellboy” and “The Nutty Professor,” was featured in Martin Scorsese’s “The King of Comedy” and appeared as himself in Billy Crystal’s “Mr. Saturday Night.” In the 1990s, he scored a stage comeback as the devil in the Broadway revival of “Damn Yankees.” In his 80s, he was still traveling the world, planning to remake some of his earlier movies and working on a stage version of “The Nutty Professor.” He was so active he would sometimes forget the basics, like eating, his associates would recall. In 2012, Lewis missed an awards ceremony thrown by his beloved Friars Club because his blood sugar dropped from lack of food and he had to spend the night in the hospital. In an interview with The Associated Press from 2016, Lewis, at 90 and promoting the film “Max Rose,” said he still woke up every day at 4:30 or 5 in the morning to write, and he had a handful of standup shows on the schedule. Although a clear influence on Jim Carrey and other slapstick performers, later generations knew Lewis primarily as the ringmaster of the Labor Day Muscular Dystrophy Association, joking and reminiscing and introducing guests, sharing stories about ailing kids and concluding with his personal anthem, the ballad “You’ll Never Walk Alone.” From the 1960s onward, the telethons raised about $1.5 billion. He announced in 2011 that he would step down as host, but he would remain chairman of the association he joined some 60 years ago. His fundraising efforts won him the Jean Hersholt Humanitarian Award at the 2009 Oscar telecast, an honor he said “touches my heart and the very depth of my soul.” But the telethon was also criticized for being mawkish and exploitative of children, known as “Jerry’s Kids.” A 1960s muscular dystrophy poster boy, Mike Ervin, later made a documentary called “The Kids Are All Alright,” in which he alleged that Lewis and the Muscular Dystrophy Association had treated him and others as objects of pity rather than real people. Responded Lewis: “You don’t want to be pitied because you’re a cripple in a wheelchair, stay in your house!” He was the classic funnyman who longed to play “Hamlet.” He cried as hard as he laughed. He sassed and snarled at critics and interviewers who displeased him. He pontificated on talk shows, lectured to college students and compiled his thoughts in the 1971 book “The Total Film-Maker.” “I believe, in my own way, that I say something on film. I’m getting to those who probably don’t have the mentality to understand what ... ‘A Man for All Seasons’ is all about, plus many who did understand it,” he wrote. “I am not ashamed or embarrassed at how seemingly trite or saccharine something in my films will sound. I really do make films for my great-great-grandchildren and not for my fellows at the Screen Directors Guild or for the critics.” In his early movies, he played the kind of fellows who would have had no idea what the elder Lewis was talking about: loose-limbed, buck-toothed, overgrown adolescents, trouble-prone and inclined to wail when beset by enemies. American critics recognized the comedian’s popular appeal but not his pretensions of higher art. Not the French. Writing in Paris’ Le Monde newspaper, Jacques Siclier praised Lewis’ “apish allure, his conduct of a child, his grimaces, his contortions, his maladjustment to the world, his morbid fear of women, his way of disturbing order everywhere he appeared.” The French government awarded Lewis the Chevalier of the Legion of Honor in 1983 and Commander of Arts and Letters the following year. Film critic Andrew Sarris observed: “The fact that Lewis lacks verbal wit on the screen doesn’t particularly bother the French.” Lewis had teamed up with Martin after World War II, and their radio and stage antics delighted audiences, although not immediately. Their debut, in 1946 at Atlantic City’s 500 Club, was a bust. Warned by owner “Skinny” D’Amato that they might be fired, Martin and Lewis tossed the script and improvised their way into history. New York columnists Walter Winchell and Ed Sullivan raved over the sexy singer and the berserk clown. Hollywood producer Hal Wallis saw them at New York’s Copacabana and signed them to a film contract. Martin and Lewis first appeared in supporting roles in, then they began a hit series of starring vehicles: “At War With the Army,” ″That’s My Boy,” ″Sailor Beware,” ″Jumping Jacks,” ″The Stooge,” ″The Caddy,” ″Money From Home,” ″Living It Up,” ″Three Ring Circus,” ″You’re Never Too Young,” ″Artists and Models,” ″Pardners,” ″Hollywood or Bust.” But in the mid-1950s, their partnership began to wear. Lewis longed for more than laughs. Martin had tired of playing straight man and of Lewis’ attempts to inject Chaplinesque pathos into their movies. He also wearied of the pace of films, television, nightclub and theater appearances, benefits and publicity junkets on which Lewis thrived. The rift became increasingly public as the two camps sparred verbally. “I knew we were in trouble the day someone gave Jerry a book about Charlie Chaplin,” Martin cracked. On July 24, 1956, Martin and Lewis closed shop, at the Copa, and remained estranged for years. Martin, who died in 1995, did make a dramatic, surprise appearance on Lewis’ telethon in 1976 (a reunion brokered by mutual pal Frank Sinatra). After Martin’s death, Lewis said the two had again become friendly during his former partner’s final years and he would repeatedly express his admiration for Martin above all others. Lewis distinguished himself after the break, revealing a serious side as unexpected as Martin’s gift for comedy. He brought in comedy director Frank Tashlin for “Rock-a-bye Baby,” ″Cinderfella,” ″The Disorderly Orderly,” ″The Geisha Boy” and “Who’s Minding the Store?” With “The Bellboy,” though, Lewis assumed the posts of producer, director, writer and star, like his idol Chaplin. Among his hits under his own direction was the 1963 “The Nutty Professor,” playing a dual Jekyll and Hyde role, transforming himself from a nerdy college teacher to a sexy (and conceited) lounge singer, Buddy Love, regarded as a spoof of his old partner Martin. Lewis’ more recent film credits included such low-budget releases as “Arizona Dream,” co-starring Johnny Depp, “Funny Bones,” and “Max Rose,” from 2016. He was seen briefly in Eddie Murphy’s remake of “The Nutty Professor.” He was born Joseph Levitch in Newark, New Jersey, on March 16, 1926. His father, billed as Danny Lewis, was a singer on the borscht and burlesque circuits. His mother played piano for Danny’s act. Their only child was often left alone in hotel rooms, or lived in Brooklyn with his paternal grandparents, Russian Jewish immigrants, or his aunts in New Jersey. “All my life I’ve been afraid of being alone,” Lewis once said. In his later years the solitude haunted him, and he surrounded himself with an entourage at work and at home. Joey Levitch made his professional debut at age 5, singing the Depression tearjerker “Brother, Can You Spare a Dime?” to great applause. By 16, Jerry Lewis had dropped out of school and was earning as much as $150 a week as a solo performer. Rejected by the Army because of a heart murmur and punctured eardrum, Lewis entertained troops in World War II and toured with his lip-sync act. In 1944 he married Patti Palmer, a band vocalist. The following year he met Martin, on a March day in 1945 in Manhattan. Fame brought him women and Lewis wrote openly of his many partners. After 36 years of marriage and six sons, Patti Lewis sued her husband for divorce in 1982. She later wrote a book claiming that he was an adulterer and drug addict who abused their children. In his late 50s, Lewis married Sandra Pitnick, 32, a former airline stewardess. They had a daughter, Dani, named for Jerry’s father. “When the truth comes down to the truth, I am so grateful that I’m on that stage or in front of that camera,” Lewis told The Associated Press in 2016. “To have a career that I had in film, I’m the luckiest Jew that ever lived. I’m so grateful for it. I don’t take advantage of it. I don’t use it improperly. And I love the fact that there’s nowhere I can go where people don’t know me.” ___ Lemire is a former Associated Press writer. Associated Press writer Bob Thomas and AP Film Writer Lindsey Bahr in Los Angeles and AP National Writer Hillel Italie in New York contributed to this report.
answer:

Jerry Lewis, Hollywood survivor, showman, dies at 91.