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: The story does not say how much this new procedure costs or compare it with existing treatments for patients who don’t respond to medication. Deep brain stimulation, the current treatment standard, can run anywhere from $30,000 to $70,000, according to various online cost estimates. There also may be additional costs incurred by those patients who have adverse effects. The story is long on description but short on numbers. Saying the treatment “has had an immense impact on patients’ lives,” the story devotes quite a bit of print along with video footage to show rapid functional and quality-of-life improvements experienced by patients, focusing on one women who said her tremor “has almost disappeared” since she had the procedure in June. Video showing this patient before and after treatment–including her attempts to write her name, trace a spiral and pour water from one cup to another–do a great job of conveying the improvements. This is terrific news for this woman, but we’re not told how representative her experience is of overall outcomes. Is she a best-case scenario? Middle of the road? There are also inspiring quotes from a researcher, including a description of the “remarkable moment” patients experience when they realized the tremor has subsided. “They can write their names again, they can feed themselves, they are not embarrassed about being in public. So it really is extraordinarily helpful for people,” he says. In terms of study data, the story says researchers “found that the severity of essential tremor reduced significantly” in patients who underwent the treatment as well as reported improvements in quality of life. But there are no figures. In fact, according to the study, patients experienced a 47 percent improvement in tremor scores, dropping from 18.1 points on a 32-point scale at baseline to 9.6 points three months after the procedure. That data should have been included. Also, the story should have spelled out that 56 patients received the treatment, versus 20 who experienced a fake procedure. Also worth pointing out: We don’t know the meaning or clinical significance of a reduction of this magnitude in the total score. The story addresses adverse effects, and that’s sufficient for a Satisfactory rating. We do wish the story had quantified the harms that were measured in the study. The fourth paragraph says the procedure “brings lasting side effects in some patients” and later the story quotes a physician who is not involved in the research as saying, “It’s a pretty high incidence of side effects.” But nowhere do exact numbers appear. Rather than citing data from the study, the story quotes the physician as saying that “over a third of patients actually experienced either gait disturbance or paresthesia,” or numbness. This information isn’t very useful because the story does not explain when these rates were measured. According to the study, three months after the procedure 36% of patients had gait disturbance and 38% had numbness. After 12 months, the numbers dropped, to 9 percent and 14 percent respectively. Also worth mentioning is that one patient was reported to have permanent diminished sensation of the dominant thumb and index figure, which was categorized as a serious adverse event. That did not appear in the story. The story clearly spells out that there isn’t data on the long-term efficacy of this procedure, and that more study is needed, so we’ll give this a barely passing Satisfactory. Several important study limitations were not included in the story, such as the fact that the treatment did not provide significant improvement for some types of tremors, and the treatment is not appropriate for people who are unwilling or unable to undergo an MRI. We’re also not told that the sham group was only followed for 3 months, while the experimental group was followed for a year. This is not usually recommended in clinical trials and both groups should be followed for the same length of time. The story cites a figure from the International Essential Tremor Foundation, an advocacy group, that an estimated 10 million people in the United States suffer from the condition. However, a 2014 analysis of existing research put the number of cases at around 7 million as of 2012, or about 2.2% of the U.S. population. While this may not qualify as disease mongering, the story could have pointed out that the exact number of cases isn’t clear. Also, the story should have noted that not all people with essential tremor have symptoms severe enough to require treatment. The story only fulfills part of our criteria. It does use one independent source, a physician who was not involved in the study. It also accurately reports the trial’s funding sources: InSightec, which developed the device; along with Focused Ultrasound Foundation, which is funded by device makers and philanthropic organizations; and the Binational Industrial Research and Development Foundation, an Israel-U.S. government partnership that receives corporate support. However, the story falls short because it does not report the fact that nine of the study authors reported conflicts of interest, with most receiving financial compensation of some sort from device makers in the field. Lead researcher G. Rees Cosgrove, M.D. who is quoted in the story, reported receiving consulting fees from InSightec. The story states, “Doctors usually treat essential tremor with medication, but the drugs don’t work well for all patients.” That’s true, and so we’ll give this a Satisfactory rating for at least mentioning alternatives. But it should be noted that other procedural treatment options were not compared or even mentioned in the story and received only a brief mention in one of the videos. The current standard for tremor patients who don’t respond to medication is deep-brain stimulation, in which a probe connected to a pacemaker is implanted in the thalamus to suppress the tremors. Gamma Knife thalamotomy, which delivers precise doses of radiation to the thalamus, is also considered to be a safe and effective therapy for patients who don’t respond to medication. Also, some patients have mild symptoms that can be treated with relaxation techniques and the avoidance of triggers such as caffeine. The story states that the device was approved by the FDA in July. The story could have done readers a service by giving a sense of how many medical centers around the country are geared up to perform the procedure, or will be soon. This is indeed a new treatment option for essential tremor, though the story may leave readers with the false impression that the concept of killing off neurons in the thalamus is new. Rather, it’s the use of focused ultrasound to destroy brain tissue, rather than a probe inserted in the brain, that constitutes an advance. The story does not appear to rely solely on the news release, which we also reviewed. Claim: New treatment offers some hope for an unshakable tremor

Answer: This story describes a recently FDA-approved device to treat essential tremor in patients who have not responded to medication. The ExAblate Neuro, made by Dallas-based InSightec, uses magnetic resonance images taken during the procedure to deliver focused ultrasound that destroys tissue in the thalamus, the part of the brain where tremors are believed to originate. Results of a randomized clinical trial on the device’s safety and efficacy were published this month in the New England Journal of Medicine. The story and accompanying video (seen at right) vividly illustrate rapid symptom improvements, highlighting a 72-year-old woman who says the procedure changed her life by allowing her to “eat like a normal person” and easily perform basic tasks such as signing her name and folding a scarf. This powerful patient anecdote throws the balance off: Imagine how different the story would seem if the video instead showed a patient who had improved, but also was affected by one of the serious adverse effects caused by the treatment. Also, the story needed specific numbers on the measured benefits and harms, along with a discussion of costs and alternative treatment options. Note: We also reviewed the news release that was issued to journalists about this study. While not life threatening, essential tremor can be debilitating, especially affecting people in their advanced years. The ExAblate Neuro, which the FDA calls the first focused ultrasound device to treat essential tremor in patients who have not responded to medication, offers a somewhat less invasive treatment option than traditional surgical approaches. It’s certainly newsworthy. But all of the facts, including long-term efficacy data, are not in. Stories that feature glowing patient anecdotes and positive physician commentary need to be balanced with plenty of data that can help patients and their families decide whether this treatment might be worth seeking out.


Question: Paragraph: “It’s time to go back on offense,” Lechleiter said in a recent interview. New treatments for diabetes and cancer now awaiting approval and increased sales of animal-health products and drugs in China and Japan are some of the aggressive moves he has in mind. He is also counting on a robust success rate among three dozen other experimental drugs now in mid- and late-stage trials, including a cancer drug called ramucirumab. “We’re on the cusp of launching products in cancer and diabetes, two therapeutic areas where we’re well established and where we have built out the infrastructure we need,” Lechleiter said. “And we believe that’s going to be the beginning of our return to growth.”  Skeptical investors only now appear to be catching on to Lilly’s potential upside. After rising only 3 percent in 2013, badly underperforming a 27 percent average advance for other large drugmakers, the stock is up 6 percent this month. “Instead of having to play defense and manage through this difficult patent cliff, the company will be able to use additional cash flow to invest in its pipeline, to partner with others or make bolt-on acquisitions,” said Atlantic Equities analyst Richard Purkiss. “The outlook is much brighter, and they’ll try to get that message across in coming months.”  Lilly, which reports quarterly and 2013 results on Thursday, has forecast earnings of $2.77 to $2.85 per share this year, the final and worst year of its patent cliff. That’s 41 percent less than 2010. Lilly last year sought U.S. approvals for four drugs, three of which Lechleiter said could be approved in 2014: ramucirumab for stomach cancer, and dulaglutide and empagliflozin for type 2 diabetes - the most common form of diabetes, which is closely linked to obesity. Analysts have forecast annual sales of more than $650 million for ramucirumab, saying sales could be far higher if the drug also wins approval for cancers of the colon, lung or liver. But they caution that the diabetes drugs may have a hard time competing against existing options. Lechleiter said Lilly plans to seek approval of necitumumab for squamous-cell lung cancer this year. The medicine, like ramucirumab, was acquired by Lilly through its $6.5 billion purchase of ImClone Systems in 2008. If approved, necitumumab could capture eventual annual sales of more than $1 billion, analysts say. Such sales could make a big difference for Lilly, whose annual revenue of $20 billion is far lower than Big Pharma rivals like Pfizer Inc and Merck & Co. In the meantime, Lilly is testing nearly 40 medicines in mid- and late stage studies, compared with only 7 in those stages of development a decade ago. They include new treatments for cholesterol, psoriasis, lupus, rheumatoid arthritis and Alzheimer’s disease. Animal health unit Elanco, with annual sales of about $2 billion, is thriving as Lilly introduces new products and has expanded the business in China and other fast-growing markets. Many analysts are wary, however, of the company’s ability to win approvals of prescription drugs because it has not launched any major products in recent years and has suffered setbacks in clinical trials, including ramucirumab’s failure to delay progression of breast cancer. Of 20 analysts tracked by Thomson Reuters, 12 have hold or sell ratings on Lilly, versus 8 with buy ratings. Lilly shares trade at 19 times expected 2014 per-share earnings, compared to a price-to-earnings ratio of 14.6 for other large drugmakers. That could be more a reflection of the company’s poor earnings this year than excitement about the stock. “We believe that overall the pipeline will disappoint investors,” said Alex Arfaei of BMO Capital Markets in a research note, citing low sales expectations for ramucirumab and the new diabetes drugs. When Lilly’s Zyprexa was confronted with cheaper generic treatments for schizophrenia in October 2011, it faced one of the industry’s steepest patent cliffs ever, quickly losing 80 percent of its onetime $5 billion in annual sales. Similarly precipitous declines are expected for Cymbalta, Lilly’s $5 billion-a-year antidepressant, which lost U.S. patent protection last month, and for blockbuster osteoporosis treatment Evista, which goes generic in March. Many other large drugmakers, when faced with patent expirations and earnings declines of lesser scope, have resorted to megamergers to cushion the blow from generics and prop up earnings with cost savings. Huge layoffs, sapped morale and poor track records in introducing new drugs are more common results. Pfizer Inc stands out, having snapped up U.S. rivals Warner-Lambert, Pharmacia and Wyeth since 2000. Lechleiter, who began his career at Lilly in 1979 as a senior organic chemist, has steadfastly spurned any suggestion of a big merger: “It’s never entered our minds, and we remain adamantly opposed.”  John Boris, an analyst for Suntrust Robinson Humphrey, said he expects Lilly earnings to grow an average of 10 percent a year between 2015 and 2020, which would make it second to Bristol-Myers Squibb Co in profit growth over that period. Atlantic Equities’ Purkiss said he anticipates Lilly will deliver industry-topping earnings growth in the “mid-teens” percentage range in 2015, 2016 and 2017. “The sentiment has been very negative on Lilly, but it looks like it will go from one of the most growth-starved to the fastest growing of the major U.S. drugmakers and the European players,” Purkiss said. By avoiding a disruptive megamerger, Lilly has allowed itself to press ahead with ambitious research, said Barclays analyst Tony Butler. He said to date the company has met long-term sales and earnings forecasts it provided in 2009 - before patents went over the cliff - while maintaining its generous dividend, with a current yield of 3.6 percent. “At the time, the market was incredibly skeptical about Lilly’s ability to fund its dividend and to have enough remaining cash flow to fund its business,” said Butler. “Lilly proved everybody wrong.”  (This story has been refiled to change second subhead) Claim: Lilly CEO: 'It's time to go back on offense'.

Answer: After three years of seeing major drugs like Zyprexa for schizophrenia lose patent protection and wipe away billions of dollars in revenue, Eli Lilly and Co Chief Executive Officer John Lechleiter wants to change the game plan.


Question: Paragraph: Swedish Thunberg said on Instagram she had now recovered from symptoms milder than her latest cold, and may not have suspected COVID-19 had it not been for her father, who had travelled with her, developing more severe symptoms. “Many (especially young people) might not notice any symptoms at all, or very mild symptoms. Then they don’t know they have the virus and can pass it on to people in risk groups,” she said. “We who don’t belong to a risk group have an enormous responsibility, our actions can be the difference between life and death for many others. Please keep that in mind, follow the advice from experts and your local authorities and #StayAtHome to slow the spread of the virus.”  The founder of the Fridays for Future youth movement said she had not been tested for the virus but given the combined symptoms and circumstances it was very likely she had it. She had self isolated because she had visited countries hit by coronavirus infection. Fridays for Future calls on politicians to listen to climate scientists and take urgent action to against global warming. Claim: Greta Thunberg says probably had COVID-19, urges #StayAtHome.

Answer:
Teen climate activist Greta Thunberg said on Tuesday that while self-isolating after recent travels in Europe she probably came down with COVID-19, and urged other young people to stay at home too if even just a little unwell, to help stop the coronavirus.