instruction:
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.
question:
Paragraph: The three western U.S. cities top the list of the 100 best towns for men in a new ranking compiled by Men’s Health magazine, while Charleston, West Virginia, Philadelphia and Birmingham, Alabama are considered the worst. “Anytime we do a best and worst city ranking and a city comes in at the very top like this, it immediately says to us they were consistently strong across the board in pretty much all of the 38 criteria that we looked at,” Men’s Health Executive Editor Matt Marion said. Boise, which jumped from fifth place last year, scored high marks for the physical and mental health of its residents, its low crime rate and short commuting times - an average of just 18 minutes. “Boise finishing number one was interesting to us because it is a city that would have finished in the top 20, but to come in right at the top is impressive,” Marion said. San Francisco, which consistently ranks high in the annual list, impressed with its small percentage of obese people, low number of smokers and highly educated and generally fit population. San Jose had very low death rates from cancer and heart disease, the lowest percentage of smokers in any of the 100 cities in the ranking, and not much crime. Plano, in Texas and Seattle rounded out the top five, followed by Burlington, Vermont, which dropped from the top spot last year. At the opposite end of the list, high cancer rates, violent crime and poor fitness levels assured Birmingham last place. In addition to Philadelphia and Charleston, West Virginia, the bottom five included Toledo, Ohio and St. Louis, Missouri. New York ranked 33rd and Los Angeles was in the middle of the ranking. The magazine compiled the list, now in its 12th year, by ranking the cities on criteria ranging from the cost of living, number of jobless, obesity, crime and death rates, to air quality and the ratio of men to women. It used data from various sources including the U.S. Centers for Disease Control in Atlanta, the National Center for Health Statistics, state cancer registries and federal crime statistics. “The things that we do focus on ultimately are the ones that will make a difference in terms of whether or not you will be happy and healthy,” Marion said. The full list can be found here Claim: Idaho, California cities deemed best in U.S. for men.
answer:
U.S. men looking for the best place to find happiness, health and a good quality of life might consider heading to Boise, Idaho, or San Jose and San Francisco in northern California.


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Paragraph: 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. Claim: Obesity surgery may lower heart attack danger in diabetics.
answer:
Obesity surgery may dramatically lower the danger of heart attacks and strokes in patients with diabetes, new research suggests, reinforcing evidence that benefits extend beyond weight loss.


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Paragraph: We give the story credit for at least citing a $30,000 cost for the “surgeries” but wish it had explained what that included and what it might not. Surgery to change the battery every two years certainly adds to cost. Undoubtedly patients require more intensive expensive followup and perhaps specialized checks to ensure the device is working. With broad strokes across discussion of three different uses for three different conditions, the story did an adequate job quantifiying benefits. As stated in the “Evidence” criterion above, this is where a control group and reporting response rates for treated versus control groups would be very informative. Instead, we only get a qualitative description of benefits which is useful but which might leave careful readers asking for more. This is one area where the story could have been improved. There was no detailed discussion of what can go wrong with deep brain stimulation. There was a brief mention of “if” the electrodes cause neurological side effects. But how often does that happen? And the story noted that the surgery does “sometimes” cause dangerous brain bleeding or infections. How often is “sometimes”? At a very high, overview level, the story explained the current state of the evidence. But more information would have been better. Current evidence for depression/OCD is based on case series. These studies don’t have a control group, making the results more subject to bias. No disease mongering of any of the conditions discussed. The story was repeatedly clear about deep brain stimulation being used when standard medications or behavior therapy had not worked. But it would be helpful to give estimates of the proportion of patients with depression or OCD who aren’t helped by available treatments. Several sources were cited. Dr. Mayberg’s connection to St. Jude Medical was mentioned. The story could have mentioned that Dr. Okun’s center and Dr. Greenberg have received funding from Medtronic. Greenberg’s current funding from the National Institute of Mental Health was noted. We think the sourcing and disclosure was adequate. A strong point of the story was that it repeatedly provided the context for the use of deep brain stimulation — “when standard medications fail…worst-case patients…doesn’t mean patients can abandon traditional therapy…people with intractable (problems)…(people who) failed behavior therapy.” This story already attempted to accomplish a lot, but to be complete, it could have offered explicit description of currently approved options: antidepressant medications (multiple classes); psychotherapy (multiple options); combinations of medications or medications and therapy; transcranial magnetic stimulation (limited availabilty), vagal nerve stimulation, ECT – and estimate of the proportion of patients who fail these treatments. Nonethless, we feel it met the criteria for a satisfactory score. The story states that 70,000 have had deep brian stimulation for Parkinson’s or other movement disorders, and that studies are underway on at least 60 people with intractable obsessive-compulsive disorder and 100 with severe depression. The experimental nature of these approaches is clear from the story. A nice touch would be to give a link to clinicaltrials.gov to allow readers the option of looking up more information on the studies in progress and finding out if recruitment is open and how to access the study. The story did a good job putting the new uses of deep brain stimulation into the context of other research and other therapeutic approaches. It’s clear that the story did not rely on a news release. Claim: Trying brain pacemakers to zap psychiatric disease
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We especially appreciate the lack of hype in this story. The reporter clearly worked hard to stick to the evidence – not merely to promote the potential. About 65-70 percent of patients with major depressive disorder improve substantially with 1 to 2 course of standard treatment (medication, psychotherapy or combinations). Subsequent treatment options have progressively lower rates of treatment response. Therefore, a significant number of people need other treatment options. Deep brain stimulation is an invasive treatment, but one that has shown promise in a small number of patients.