TASK DEFINITION: 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.
PROBLEM: Paragraph: Republican Gov. Charlie Baker administered oaths to the 40-member Senate and 160-member House in ceremonies signaling the start of the 191st term for one of America’s oldest legislative bodies. Formally known as the General Court, the Legislature traces its roots to the Colonial era. The first order of business in each chamber — both firmly controlled by Democrats — was the re-election of presiding officers. Rep. Robert DeLeo, of Winthrop, already the longest-serving House speaker in the state’s history having first taken the gavel in 2009, returned for another two-year term. Ashland Democrat Karen Spilka will serve her first full term as Senate president after first assuming the post in July. Speaking in the ornate Senate chamber, which reopened Wednesday for the first time in more than 18 months following a $20 million renovation, Spilka called for several “bold” initiatives in response to what she said were demands from Massachusetts residents to move beyond “small ideas and incremental change.” Spilka said her priorities would include legislation to better control health care spending by reining in the high cost of prescription drugs and redistribute state education funding to better serve children who live in poorer school districts. Recalling the untreated psychological trauma her father suffered as a result of his military service, the Senate leader also appealed for a broad expansion of mental health services throughout the state. “We simply cannot end the epidemic of addiction or solve the problems of chronic homelessness and unemployment, child abuse and neglect, veteran and first responder PTSD, childhood bullying, or repeated incarceration, without first addressing the underlying issue of mental health,” said Spilka. While not specifically calling for tax increases, Spilka said the state would need to “capture new revenues” to support new and existing programs. Spilka, a liberal Democrat, was widely expected to stake out a progressive agenda that could meet resistance in the House, which is also controlled by Democrats but is seen as more conservative than the Senate. Baker, a moderate Republican who remains opposed to any broad-based tax hikes, could also prove a stumbling block. In brief comments following his re-election on Wednesday, DeLeo declared that “no one’s rights will be infringed upon in Massachusetts,” an apparent swipe at the policies of President Donald Trump and other Republicans in Washington. DeLeo generally waits until a few weeks into a new session before outlining his legislative priorities. Sen. Bruce Tarr, of Gloucester, and Rep. Brad Jones, of North Reading, will again serve as the minority leaders in their respective chambers. There are 32 Republicans in the House and only six in the Senate, with the GOP having lost a handful of legislative seats in the November election. Claim: State Senate leader outlines agenda as lawmakers sworn in.

SOLUTION: The Democratic leader of the Massachusetts Senate promised Wednesday to work for lower prescription drug costs, expanded mental health services and a reform to the state’s education funding formula as she laid out an ambitious agenda at the start of the Legislature’s new two-year session.

PROBLEM: Paragraph: The release does not mention cost. The FDA evaluates drugs without consideration of cost, so it’s understandable that they wouldn’t comment on it — and that’s why we’re rating this Not Applicable. But let’s be real here: The value of a new drug is a function not just of how well it works, but its cost-effectiveness. So we look forward to the day when any news release about a new drug — even one from the FDA — will include some mention of cost in its message. This release gives the preliminary results from a single study of 310 patients. Because the drug is experimental, long-term results haven’t been studied. Of the 310 patients enrolled in the lone trial upon which the approval is based, 14.8 percent showed some shrinkage of tumors during the assessment period lasting from 2.1 to about 13.8 months. For a subset of patients who were classified as having a positive response to PD-L1 expression, the response was 26 percent. As noted above, tumor shrinkage doesn’t always lead to improvements in survival or quality of life. It is a surrogate endpoint — a substitute — for the main outcome which is survival. Although this drug looks promising, to be fully transparent about its benefits as currently known, the release should have explained this. As noted in the “Summary,” another larger study is underway to assess the drug’s impact on extending life and improving quality of life. The release includes a description of side effects of this treatment. The most common ones included fatigue, decreased appetite, nausea, urinary tract infection, fever (pyrexia) and constipation. The release also mentions that patients taking the drug have an increased risk of infection and serious side effects that are “immune-mediated.” We would have liked a bit more context on what this term means for patients. The release outlines that this is the very first clinical trial of this compound for safety and efficacy, and under which regulatory paths the drug was assessed, including “breakthrough therapy designation, priority review status and accelerated approval.” We’re giving this release the benefit of the doubt and rating it Satisfactory for its bare bones description of the trial (and since we already addressed the lack of long-term survival data in the “Benefits” section.) As it stands, the results from the small trial were preliminary and short-term and did not reflect long-term survival. We would have liked to see a reference or link to the completed trial where one could look at the results to assess independently or learn more about the outcomes. We think the release should have provided more data on the patient demographics, the treatment regimen (dosing amount and schedule) as well as the range in tumor reduction. There is no disease mongering. This release describes the approval of a new drug by a regulatory agency, but we’d still like to know who sponsored the study that’s the basis for the approval. It’s not enough to state who markets the drug. The release does not give us very much information about alternatives. These patients had already received other therapy and their cancer had recurred, so it is implied that they had no other alternatives. But this isn’t stated very clearly. We can assume (and it seems evident) that the platinum-based therapy that the patients didn’t respond to initially is the usual treatment. The FDA’s approval of a drug clears the way for the drug sponsor to scale up production and begin marketing and selling the product. (The FDA doesn’t state this explicitly but it can be inferred.) A NYT article said the drug would be available in about two months. The release clearly states this product is first of its kind for this type of cancer. We found no unjustifiable language. Claim: FDA approves new, targeted treatment for bladder cancer

SOLUTION: The Food and Drug Administration approved a new immunotherapy drug that acts as a “checkpoint” inhibitor in patients whose bladder cancer (urothelial carcinoma) has not responded to other chemotherapy. The drug, atezolizumab (marketed as Tecentriq), showed effectiveness in about 14 percent of 310 patients in a very preliminary study. The release notes that the trial measured tumor shrinkage as the main outcome. It didn’t note, as a NYT article did, and important for this type of trial, that it is unknown whether the treatment makes a difference in survival. A larger study is being done to examine this. Whether it makes a difference in quality of life is also important and will presumably be examined in the larger trial. The National Cancer Institute (NCI) estimates 76,960 new cases of bladder cancer and 16,390 deaths from this disease in 2016. This approval of a new drug for treating bladder cancer is part of a wider area of research into immunotherapy, in which drugs target mechanisms of the human immune response. Patients with the PD-L1 protein highly expressed in their tumors appear to be responding best to the drug. This drug is an example of targeted chemotherapy which is becoming more important as treatments can be fine-tuned to the cancers of individual patients. In patients with intractable cancers, immunotherapy appears to offer some new hope while also bringing sobering questions about affordability and disparity of access by income. The drugs are typically very expensive — with some estimates putting the treatment cost for a single patient as high as $1 million. When the FDA gives a compound a “breakthrough” designation, some physicians and patients can misunderstand what that means. That’s a topic recently explored in this post.

PROBLEM: Paragraph: A cataract was removed on Dec. 10 from the left eye of a 3-year-old western lowland gorilla who lives at the San Diego Zoo Safari Park, the park announced Monday. The gorilla, named Leslie, was given a muscle blocker to keep her still while a team that included vets along with anesthesiologists and an ophthalmology team from UC San Diego Health removed the cloudy lens and replaced it with an artificial lens that should last for life. The operation was performed at the San Diego Zoo Global’s Paul Harter Veterinary Medical Center. Cataract surgeon Chris Heichel, who led the team and has performed thousands of operations, said it was his first on a gorilla. “Fortunately, the similarities between the anatomy of human and gorilla eyes are great enough to allow us to safely navigate the procedure without complication,” Heichel said in a statement released by the park. “The remainder of the eye appeared to be in excellent health, indicating exceptional vision potential for the rest of Leslie’s life.” Cataracts can occur naturally with aging. But given that Leslie is a youngster, her problem more likely stemmed from an injury, either from a fall while practicing her climbing or from “an overly rambunctious play sessions with other young gorillas in her troop,” the park said. Leslie will need antibiotics and steroids to prevent infection and inflammation, but she is already back with the troop at the park. Claim: California gorilla treated for cataract.

SOLUTION:
A team of eye experts has operated on an unusual patient — a gorilla.