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: An early barrage of illness in the South has begun to spread more broadly, and there’s a decent chance flu season could peak much earlier than normal, health officials say. The last flu season to rev up this early was in 2003-2004 — a bad one. Some experts think the early start may mean a lot of suffering is in store, but others say it’s too early to tell. “It really depends on what viruses are circulating. There’s not a predictable trend as far as if it’s early it’s going to be more severe, or later, less severe,” said Scott Epperson, who tracks flu-like illnesses for the U.S. Centers for Disease Control and Prevention. There are different types of flu viruses, and the one causing illnesses in most parts of the country is a surprise. It’s a version that normally doesn’t abound until March or April. That virus generally isn’t as dangerous to older people — good news, since most flu hospitalizations and deaths each winter occur in the elderly. However, such viruses can be hard on children and people younger than 50. Louisiana was the first state to really get hit hard, with doctors there saying they began seeing large numbers of flu-like illnesses in October. Children’s Hospital New Orleans has already seen more flu cases this fall than it saw all of last winter, said Dr. Toni Gross, the hospital’s chief of emergency medicine. Last month was the busiest ever at the hospital’s emergency department. Officials had to set up a triage system and add extra shifts, Gross said. “It is definitely causing symptoms that will put you in bed for a week,” including fever, vomiting and diarrhea. But the hospital has not had any deaths and is not seeing many serious complications, she said. Health officials tend to consider a flu season to be officially underway when — for at least three weeks in a row — a significant percentage of U.S. doctor’s office visits are due to flu-like illnesses. That’s now happened, CDC officials said this week. The agency on Friday estimated that there have already been 1.7 million flu illnesses, 16,000 hospitalizations, and 900 flu-related deaths nationally. The most intense patient traffic had been occurring in a six states stretching from Texas to Georgia. But in new numbers released Friday, CDC officials said the number of states with intense activity rose last week to 12. Flu is widespread in 16 states, though not necessarily at intense levels in each, the CDC said. Last flu season started off as a mild one but turned out to be the longest in 10 years. It ended with around 49,000 flu-related deaths and 590,000 hospitalizations, according to preliminary estimates. It was bad, but not as bad as the one before it, when flu caused an estimated 61,000 deaths and 810,000 hospitalizations. Those 2017-2018 estimates are new: The CDC last month revised them down from previous estimates as more data — including actual death certificates — came in. In both of the previous two flu seasons, the flu vaccine performed poorly against the nasty predominant virus. It’s too early to say how well the vaccine is performing right now, Epperson said. Epperson said there’s a chance the flu season will peak this month, which would be unusually early. Flu season usually doesn’t hit fever pitch until around February. The early start suggests a lot Americans may be sick at the same time, said Dave Osthus, a statistician who does flu forecasting at Los Alamos National Laboratory. “This could be a precursor to something pretty bad. But we don’t know,” he said. Gross is pessimistic. “I, personally, am preparing for the worst,” she said. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. Claim: US flu season arrives early, driven by an unexpected virus.

Answer: The U.S. winter flu season is off to its earliest start in more than 15 years.


Question: Paragraph: The story says the procedure to insert stents costs from $11,000 to $41,000 in the U.S. The story makes clear there was no significant difference between a sham procedure or stent insertion, but it only describes the benefit as “less pain.” We would like to see how the pain was measured, some numbers on how much pain was reduced, and how many patients benefitted in each group. The story briefly mentions there are potential harms, including death. The story describes the study’s methods in some detail — the sham surgery of the control group, for instance — and mentions the size of the study and the characteristics of the subjects. It adds heft to the sense that this was a very good study with multiple reactions from expert sources — “humbling,” “unbelievable,” “impressive” and “very well conducted.” Importantly, it quotes one source describing a few desired measures that the study didn’t address, such as whether stents would be more effective in patients with more severe disease or who were studied for a longer period of time. The story could have done a better job of explicitly calling attention to the relatively small number of participants and the need for confirmatory follow-up studies. Heart disease is very common in our society and opening up blocked arteries is a common almost routine procedure. No disease mongering occurred in the article. We were pleased to see discussion from many experts, however, the story left out two important potential conflicts of interest. The story states that: Dr. William E. Boden, a cardiologist and professor of medicine at Boston University School of Medicine, called the results “unbelievable.” Readers should have been informed that Boden has received fees from Abbott, a major stent device maker. Also, the story states that: Dr. David Maron, a cardiologist at Stanford University, praised the new study as “very well conducted” but said that it left some questions unanswered. The participants had a profound blockage but only in one artery, he noted, and they were assessed after just six weeks. The story didn’t disclose that Dr. Maron is an “employee of and stockholder in Cardiovascular Services of America, which provides outpatient cardiac catheterization and computed tomography angiography services,” which was disclosed here. The story (and the study) suggest that medication can manage pain from blocked arteries. Stenting procedures are clearly widely available in the U.S. and across the world. What’s less clear, the story says, is whether guidelines or practice for stenting will change in the U.S.: “The idea that stenting relieves chest pain is so ingrained that some experts said they expect most doctors will continue with stenting, reasoning that the new research is just one study.” We thought this was an interesting point and are glad it was included. The many expressions of surprise by practicing cardiologists makes clear that the study offers a novel finding. The story did not rely on the news release. Claim: ‘Unbelievable’: Heart Stents Fail to Ease Chest Pain

Answer: This New York Times story describes startling news that a very common procedure–inserting a stent to open a blocked blood vessel–does not add benefit over medication in patients with angina. Angina is chest pain due to blocked heart arteries, and is common among people with heart disease. Sourcing is a strong point for this story: It features perspective from many American cardiologists who were shocked to learn of the negative results from this study. However, two important potential conflicts of interest among the sources were not disclosed. In addition, the story contains lots of helpful detail on the limitations of the study, the possibility that placebo effects are at play, and how medical practice may or may not change as a result. It also discussed the costs and potential harms of stenting procedures. That said, the story could have provided more information on what the study itself measured–and what, precisely, the results were. The Wall Street Journal story, which we also reviewed, was stronger on this point. Heart disease is still the leading killer of Americans so any news about treating aspects of heart disease, such as blocked arteries, is newsworthy. In addition, this story suggests that stenting — common, but expensive — is a prime example of over-treatment. Also the procedure carries some risk and may be causing complications if overused.


Question: Paragraph: Fitness experts say users of the fitness machine, which is a favorite among Army Rangers, Navy Seals, and “The Biggest Loser” television series, reap total body, calorie-busting rewards. “It’s a great and tough cardio piece,” said Neal Pire, an exercise physiologist with the American College of Sports Medicine. “Picture a step mill that combines the lower and upper body, and you have Jacobs Ladder. Except instead of steps, you have rungs.”  Because the user climbs with arms as well as legs more muscles are working and more calories are burned. “As a rule the more muscle mass you utilize during any activity, the greater the oxygen consumed, which is directly correlated to the calories you consumed,” said Pire, president of Inspire Training Systems, in New Jersey. “Unlike stair climbers, you can’t hold on to the sides.”  Jacobs Ladder was invented by Steve Nichols, a fitness champion who injured his knees and back, according to Bob Palka, president of Jacobs Ladder, LLC. “He wanted to come up with a good workout that didn’t impact back and knees.” said Palka, who bought the patent and assets from Nichols in 1994. “Effectively it’s just climbing a ladder,” Palka said. People using the machine are placed at a 40-degree angle to put the spine in a more neutral position, relieve the back of stress and engage core muscles. Palka said on Jacobs Ladder the person’s body weight is lifted over a 12-inch (30.5-centemeter) step for fuller range of motion than the eight-inches of a step mill. “You control the speed,” he said.” The faster you go the faster the runners (on the ladder) come.”  Palka said about 50 to 60 percent of his Jacobs Ladders go to health clubs; some 10 to 15 percent go to the military and physical therapy facilities, respectively. Jacobs Ladder landed a recurring role on the TV show “The Biggest Loser” after trainer Jillian Michaels fell in love with it. “It tends to get your heart rate up,” said Palka, adding that other users, such as the FBI and the Army Rangers, are drawn to the intensity of the workout. John Trail, general manager of a Fitness First health club in Arlington, Virginia, uses Jacobs Ladder in functional circuit and interval training. “You can go for time or you can go for feet,” said Trail. “It’s not a fast-moving piece, but the fact that you’re using every muscle group means you can do 100 feet, rest, jump off, do 10 kettlebell swings, 10 short interval sprints, and burn a lot more calories than you would on an elliptical.”  Trail said a rock climbing buddy likes to climb Jacobs Ladder wearing a back pack for an endurance workout. A self-described competitive person, Trail has even raced with it. “We have two machines side-by-side, so we’ll go for 1,000 feet as fast as possible,” he said. “In under 10 minutes you can get a really good workout.”  He also uses it on clients with joint issues to get their heart rates up quickly. But despite its virtues, Pire said it’s unlikely Jacobs Ladder will supplant the treadmill anytime soon. “The tougher the machine, the more seldom you see it,” he said. “I haven’t seen many seniors hop on. The older population is concerned about balance and falling. And there’s some skill involved in climbing a ladder. But fans are ardent. “Those who use it are almost religious,” he said. Claim: Jacobs Ladder climbers reap tough fitness rewards.

Answer:
Jacobs Ladder, a moving, angled, climbing machine, may be named after the Biblical stairway to heaven, but it packs such a challenging workout people have dubbed it the stairway to hell.