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: Central to the plan to protect the city, some or all of the 78 barriers will one day be raised when the sea rises more than 110 centimeters (43 inches), to prevent damaging high tides from pushing into the lagoon city, a world heritage site built picturesquely — but somewhat precariously — upon more than 120 islands. Concerns that high tides are becoming more frequent because of climate change have increased the urgency. While the concept is simple, its realization has been anything but. The system of movable underwater barriers, dubbed Moses, has been beset by corruption, cost overruns and delays. Projected at 1.8 billion euros ($2 billion) and meant to be completed by 2011, the project has so far cost 5.5 billion euros and is running a decade behind schedule. In the wake of last month’s flooding of Venice, the worst in 53 years, the consortium that oversees construction of Moses is eager to demonstrate that the project — after years of bad news — is on track and will be fully operational by the end of 2021. Venetians say they cannot afford to be wrong. Skeptics and critics say they may be. A recent test of the deepest expanse of barriers — at the Malamocco entrance to the lagoon — was declared a success by the New Venice Consortium. It was the last of the four sections of barriers to be completely raised — but so far only in calm seas. The real test will come when all four are raised at once, and not only in serene waters, but under flood conditions. That isn’t scheduled to take place until the end of next year. It took six years to test each of the four movable sea walls covering the three openings to the lagoon, partly because work was slowed by a 2014 corruption scandal that implicated the three main contractors and sent 35 people to jail. Work is continuing largely with the original subcontractors now contracting directly with the consortium, which itself has been placed under government control as a result of the scandal. The fact that the barriers have not yet been physically tested in rough seas is a concern to critics. Paolo Vielmo, an offshore marine engineer who has long criticized the project, said that tests carried out in a laboratory in the Netherlands in the 1990s indicated that the barriers, under certain conditions, would oscillate out of control — possibly even breaking apart. “Its behavior is not predictable,’’ Vielmo said. He said that the trials so far declared successful have been under only modest sea conditions that fail to represent anywhere near the threat of the phenomenon of extreme oscillation called subharmonic resonance. Vielmo and two other offshore engineers have compiled a report for the Codacons consumer and environment protection advocacy group, which is asking officials to run additional calculations to see if the project is indeed viable. And if it is not, Codacons says Moses should be stopped. “We don’t want to delay by one minute the possibility to make Moses operational. But we say we cannot make it operational until we are sure it will work,’’ said Franco Conte, president of Codacons in Venice. “Naturally, the Venetian community is exasperated and they say, ‘If we did 95%, let’s do 100% and see if that works.’ But that is unconscionable. If we don’t know if it works, we cannot experiment.”  The barrier system is made up of giant flood gates, each 20 meters (66 feet) long. The gates are attached by hinges to giant cement blocks placed on the seabed along the three openings from the sea into the lagoon, Malamocco, Chioggia and the Lido. The gates can be lifted to create a temporary barrier in high tides. Once the water has receded, they can be lowered again — allowing shipping traffic to continue and for the tidal system to flush out the lagoon. The idea behind the project was to create a mobile system that would not impede views of the unique and protected landscape. But Moses has suffered criticism from the start that there were simpler, cheaper systems that could have been deployed. Venetians have been waiting since the record 1.94-meter (6.36-foot) flood of 1966 for a system to protect them from regular inundations. The flooding in November, the second-worst recorded, proved the urgency. In the 150 years that they have been recording the tide levels in Venice, two high tides above 1.5 meters have never been recorded in a year. In November, there were three in one week. Climate scientists note that exceptional tides — those over 1.4 meters — have become much more frequent in the past two decades, with more than half of all recorded occurring since 2000. “One has to realize the kind of existential question that that serious flooding has given rise to,” said Jane Da Mosto, an environmental scientist and executive director of the non-profit group We Are Here Venice, which is working to defend the city against myriad issues, including depopulation, cruise traffic through St. Mark’s basin and overtourism. “People are asking: will Venice be defendable against these kinds of episodes?’’  It’s not just the still-uncalculated damage to landmarks like St. Mark’s Basilica, where corrosive salt water creeps through porous brick and tile. It’s also the boxes of ruined belongings and piles of soaked mattresses discarded in alleyways and loaded onto motorboats and trash barges for disposal. The relentlessness of the Venetian fall and winter tides make one-third of ground floors uninhabitable in the historic canal city. “I am very old, I cannot say that I want to die, but I certainly do not want to be witness to the fact that it does not work,” 84-year-old resident Paola Scarpa said of the Moses barriers, as she walked to check on a family property in the Canareggio neighborhood on a recent December morning. “It would be a pain too great.”  ___  Associated Press journalist Trisha Thomas contributed to this report. Claim: Venice tide barriers pass another test but skeptics remain.

Answer: Floated along by barge , one of the 10-ton barriers designed to relieve Venice’s perennial flooding looks like a giant plaything: an oversized hinged yellow Lego.


Question: Paragraph: Mentions cost for one year of Herceptin as $40,000-$50,000. Mentions quantitative benefit of 9 weeks of Herceptin vs. no Herceptin with certain chemotherapy. Also, while no women in the Herceptin group had cardiac failure at 3 years, the follow-up period may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Mentions potential harms of Herceptin on the heart, especially when given after certain chemotherapy. The story does not mention that there were side effects with certain chemotherapy drugs and doses needed to be decreased during the course of the trial. One aspect of this trial focused on randomization of women with Her2/neu overexpression to 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery. The drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy”, which is not completely accurate. There is an adequate mention of the study design and discussion of disease-free survival at 3 years follow-up. Good job putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup – 116 in each arm. Appropriately discusses the percentage of women who are eligible for Herceptin due to overexpression of HER2/neu. The story would have been helped by some context for the risk these women face. As Herceptin is used earlier and earlier these women have less to gain because they have less risk to begin with. Relative risk reductions may be very high but the absolute is not as big. Sources in addition to study authors are cited. No mention that this trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding drug companies. Other doctors cited express caution about the early results of Herceptin studies, so there is some balance to the piece. The women in this trial had undergone breast cancer surgery and those with ER+ tumors were taking Tamoxifen. This is not explicitly mentioned, only that treatment took place following surgery. Still OK. Herceptin is only FDA approved to treat advanced breast cancer, but is used in clinical trials in early-stage breast cancer. This is not mentioned in the story. Novel use of Herceptin for short-term treatment prior to anthracycline chemotherapy. No evidence that this story relies on a press release. Claim: Short stint of Herceptin holds promise for breast cancer

Answer: This story discusses the results of a recent study involving women with high-risk early breast cancer (node positive or >2cm, age younger than 66 – there were 25 year olds on the trial). One aspect of this trial focused on the short-term use of Herceptin with chemotherapy. Women with overexpression of the HER2/neu gene, as measured by the CISH immunohistochemistry, were randomly assigned 9 weeks of Herceptin or no Herceptin immediately following breast cancer surgery and in conjunction with certain types of chemotherapy. This regimen of treatment differed from other trials in which Herceptin was given for 12 months following chemotherapy. In this study, the drug was given in conjunction with certain types of chemotherapy, but before radiation and chemotherapy regimens known to damage the heart. The journalist states the Herceptin was given “prior to chemotherapy,” which is not completely accurate. Herceptin is only FDA approved to treat advanced breast cancer, but it is used in clinical trials in early-stage breast cancer. However, this is not mentioned in the story. There is adequate discussion of the study design and reporting of disease-free survival at 3 years follow-up. There was little discussion in the piece of the side effects of chemotherapy as reported in the trial, but the addition of Herceptin was the main focus of the story. While the journalist provides quantitative benefit of 9 weeks of Herceptin vs. no Herceptin, and notes no cardiac failure in the Herceptin group, the follow-up period of 3 years may not be long-enough to determine the effects of chemotherapy and Herceptin on the heart. Overall, the journalist did a good job describing the randomization, as well as putting the results into context of other trials, and into context of how this may or may not change providers’ practice. The story could have better stated the limitations of analysis for such a small subgroup (116 in each arm). The small sample randomized to Herceptin certainly warrants more study, and although the relative benefits were large, these women still had fairly good recurrence free survival — 80% w/o and 90% with — so although it looks like that will translate to overall survival. The question for women with overexpression of the HER/neu gene is: How much do you want to do to avoid recurrence? Sources in addition to the study investigators are cited, which provides some balance to the piece, however, there is no mention that the trial was funded in part by pharmaceutical companies. Some study investigators also receive research funding from drug companies.


Question: Paragraph: Health and fitness experts advise to starve a fever of exercise. But feeding a cold moderately, with a brisk walk, may not be a bad idea. “The classic line from every sports medicine doctor is, ‘If you can do it, do it. If you can’t, don’t,’” said Dr. Lewis G. Maharam, author of “Running Doc’s Guide to Healthy Running.”  Usually if symptoms are confined to above the neck, exercising is OK, he explained. But if you’re running a fever of 101 degrees Fahrenheit (38.3 degrees Celsius) or higher, skip it. Body heat rises during exercise due to increased metabolism, explained Maharam, who practices medicine in New York City. If you start high, your body’s way of cooling you down is out of balance. “If fever gets too high, you break down proteins, maybe in the kidneys or liver,” he said. The U.S. Centers for Disease Control and Prevention estimates that more than 425 million case of colds and flu occur annually in the United States. The average person has about three respiratory infections per year. Dr. David C. Nieman, a professor of health sciences at Appalachian State University, North Carolina Research Campus, said research shows that regular, moderate aerobic exercise strengthens the immune system, and that people who exercise report fewer colds than their inactive peers. Nieman said five days or more of aerobic activity per week was found to be a powerful factor in lowering the number of sick days. “Even three to four days was effective. To be avoided was being sedentary,” he explained. But when animals infected with a systemic virus are forced to exercise in fever and pain, studies show that their symptoms are exacerbated, prolonged, and sometimes life-threatening. “It’s very dangerous.” said Nieman, who has written about the impact of exercise on the common cold. “If you have flu or virus with fever and pain, the best remedy is bed rest. The worst thing is to sweat it out with exercise.”  He said common cold and flu viruses can stay on objects, such as door handles, treadmills and computer keyboards, for hours. The main route to infection is through touching one’s mouth or nose with unwashed hands. Patrick Strait, of Snap Fitness, a franchiser of gyms with locations worldwide, said this time of year fitness centers step up cleaning efforts because they see a lot more traffic and so many people catch colds and the flu. “It’s a public place where a lot of people are sweating,” said Strait. “We tell manager/owners to clean once an hour, wash down the equipment with bleach, etc.”  He urged clients to wipe down equipment and wash hands often. “And if you’re sick, don’t come to the gym,” he said. Jessica Matthews, an exercise physiologist with the American Council on Exercise, said some days symptoms dictate scaling back your workout or, if you’re contagious, skipping the gym entirely. “Always listen to your body,” she said. “It might be a good idea to exercise at home or privately.”  Nieman said that while moderate exercise strengthens the immune system, elite athletes will experience a rise in stress hormones and a dip in immunity after about 90 minutes of high-intensity activity. Maharam said the immunity of marathoners is decreased for up to 72 hours after a race. During that time, the athletes are more susceptible to colds, flu, and, most commonly, the so-called “marathon sniffles.”  He said symptoms usually subside within 48 hours. “At the end of a race, when you’re all sweaty and they’re all sweaty, you don’t need to be hugging and kissing people,” Maharam said. “Your immune system isn’t as strong as it was.” Claim: Working out when to exercise in the cold and flu season.

Answer:
Sniffles, runny noses and flu-like symptoms can deter, delay and even derail many exercisers just when enthusiasm for that New Year’s resolution is beginning to flag.