Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.

Example Input: Paragraph: The article doesn’t discuss what the study authors new “way” of assessment might add in the way of costs. The story didn’t provide any data to give a sense of the potential benefit of the new approach. No numbers were given to explain how well it worked. Because there is so little information about the imaging technique and what it requires, it’s hard to say what the harms or benefits might be, but certainly the story might have mentioned the potential risk of drug intervention (or non-intervention) if the inflammatory cell “marker” is valid as a predictor of heart attack risk. Also, it would have been worth discussing if the new imaging technique exposes patients to radiation, which has been shown to increase the risk of cancer if used repeatedly. The story does not adequately establish the quality of the evidence, except to indicate that more research is needed, implying that this is preliminary work. From the journal article itself:  “The main limitation of this study is the lack of data demonstrating a predictive value of these imaging markers for clinical outcomes, which falls beyond the scope of this current work.” There was no such caveat in the news story. Rather, the headline trumpets that it “May Predict Heart Attacks.” No disease mongering here. The story stated that “about 750,000 Americans have a heart attack every year.” The article appears to quote only those who conducted the study. The article does describe current means of assessing heart attack risk, as well as some interventions (surgical and medical) to address those risks. However, the article doesn’t mention how this new technique would stack up against standard tests like stress tests or nuclear perfusion scans. There also is the option of simply treating people with risk factors and not utilizing imaging tests. The story explains that more research is needed before the technology might be available to everyone. The story focuses on the use of inflammatory heart tissue as having potentially better predictive value than current risk assessment tools for heart attack. But it’s a reluctant satisfactory, because the narrative is confusing and no numbers were given to estimate the scope of the potential benefit–how well the new approach worked. We could not locate a release from the University of Oxford or Science Translational Medicine. Claim: New Heart Imaging Method May Predict Heart Attack
Example Output: 0

Example Input: Paragraph: The movements of Brazilians have been completely restricted in fewer than two dozen cities scattered across the vast nation of 211 million — even though Brazil’s death toll stands at more than 12,000, Latin America’s highest. While public health experts are demanding bolder action, most governors and mayors have not imposed mandatory stay-at-home orders. Their apparent reluctance comes amid Bolsonaro’s relentless message for Brazilians to defy regional and local public health efforts to stop the virus’ spread. Stricter lockdowns are needed because Brazilian doctors are now being forced to choose who lives and dies and triage situations could generate social unrest if they increase, said Miguel Lago, executive director of Brazil’s non-profit Institute for Health Policy Studies, which advises public health officials. “We need to avoid a total disaster,” he said. Lago said mandatory lockdowns across much of the country would help: “It is late in terms of avoiding hospital collapse, but certainly it isn’t too late to avoid a bigger catastrophe.” Brazil had more than 177,000 confirmed cases on Tuesday, with the actual figure believed to be much higher because of limited testing. Many intensive care hospital units are full and cemeteries are increasingly overwhelmed with bodies. Bolsonaro, who called the virus a “little flu,” has insisted for more than a month that governors are stoking economic carnage with voluntary quarantine recommendations and urges Brazilians to go about their everyday. He reiterated criticism of governors Tuesday for ignoring his decree that gyms, barbershops and beauty salons should be treated as essential services. Amid Bolsonaro’s rejection of coronavirus danger, most of the country’s 27 governors have criticized his stances but none have imposed mandatory statewide lockdown measures recommended by experts. Instead, the governors have either applied selective lockdowns in cities or deferred to mayors to make those decisions. Governors had been hoping the virus would not spread in Brazil’s warm climate, but their response is also a reflection of Brazil’s political landscape because the governors depend on mayors to endorse re-election campaigns. Many worry that imposing mandatory lockdowns could hurt local leaders in this year’s municipal election, decreasing support for incumbent governors in their 2022 campaigns, said Thiago de Aragão, director of strategy of the Arko Advice political consultancy. But as the death toll rose from less than 7,000 to more than 10,000 last week, local authorities began adopting stricter anti-virus measures. The riverside community of Tefe in the Amazon region was among the first, with a lockdown decree specifying criminal charges for residents leaving home except for visits to hospitals, pharmacies and supermarkets. The mayor imposed it because only about half of Tefe’s 60,000 residents complied with an earlier recommendation by the governor of Amazonas state to take virus precautions. Those who did not comply “think they’re immortal, that they won’t get it,” Tefe Mayor Normando Bessa de Sá said on Facebook. Over the next three days, the governors of the northern and northeastern states of Maranhao, Para and Ceara decreed lockdowns for their capital cities as intensive-care units filled with COVID-19 patients. Despite the new lockdowns, Rio de Janeiro and Sao Paulo still don’t have mandatory stay-at-home-orders at the state or city level — even though they are the hardest hit places in Brazil. Lockdowns “should have been imposed at least three weeks ago, when the epidemic was already increasing, but not at this speed that it is now,” said Margareth Dalcolmo, a respiratory physician and researcher with the widely respected Oswaldo Cruz Foundation biological research group. “I gave that recommendation more than once,” said Dalcolmo, among the experts on a COVID-19 panel that advises Rio’s governor. Rio Gov. Wilson Witzel has decreed non-binding quarantine recommendations and commerce restrictions through the end of May. He pledged to make police available so the state’s 92 mayors can enact lockdowns, instead of imposing them himself. In another example of Brazil’s scattershot local lockdowns, Rio de Janeiro Mayor Marcelo Crivella on Monday prohibited non-residents from entering 11 neighborhoods and ordered the closure of all businesses except supermarkets and pharmacies in the teeming slums called favelas. “People still haven’t perceived the need to avoid gatherings, stay home,” Crivella complained. For most people, the new coronavirus causes mild or moderate symptoms including fever and cough. The risk of death is greater for the elderly and people with other health problems. The cities of Niteroi and Sao Goncalo near Rio on Monday authorized fines and criminal charges for violating stay-at-home orders. Niteroi police took the temperatures of those entering the city, and put a man and his two dogs inside a police van after he allegedly refused to show documents to justify being out of his home. In Sao Paulo state, Gov. João Doria last month urged but did not require residents to self-quarantine while shutting down schools and most businesses. Nearly 70% of the state’s 44 million people initially complied, but that dropped below 50% in recent weeks, according to cellphone carrier data provided by the state. Doria, a presidential hopeful, saw his popularity increase as he challenged Bolsonaro. But police stopped enforcing his recommendations after Bolsonaro criticized the handcuffing and detention of a middle-aged woman exercising in a park who resisted removal. With noncompliance rising, Doria said last week that “if we need to step up to a lockdown, we will not hesitate.” Sao Paulo’s mayor this week limited vehicles circulating in the city to 50% of the normal flow. Television images showed long lines of people entering crammed buses with standing room only in clear violation of social distancing guidelines. Public health analysts from the Imperial College London, whose COVID-19 research has guided global policymakers, last week called Brazil’s anti-virus efforts “partially successful.” “In the absence of the introduction of further control measures that will more strongly curb transmission, Brazil faces the prospect of an epidemic that will continue to grow exponentially,” they wrote. ___ Savarese reported from Sao Paulo Claim: Brazil cities lurch to lockdowns amid virus crisis red flags.
Example Output: 2

Example Input: Paragraph: There is no mention of costs for the surgical implants or any of the other treatment methods. Whether insurers are likely to cover such treatments and whether they cover current treatment approaches would have been helpful information as well. The cost of medical devices needs to be considered for a host of reasons. A similar technology (vagal nerve stimulation) costs about $20,000 and could have been used as a useful example. No data on benefits are given for the “undisputed best treatment, called CPAP. ” Regarding the new devices, because they are in early studies, any suggestion of benefit must be made carefully. While a number of provisos were included in the story, the single patient anecdote and the “What we’re looking for is actually cure” quote from one of the investigators provide the reader with an imbalanced perspective. There is no mention of potential harms. This is troubling because the devices described would require a surgery. To be eligible for one of the devices, a person would need to undergo some fairly extensive testing, much of which is rather unpleasant, including having “a tube snaked down the airway” to see whether their sleep apnea  is being caused by a qualifying condition. The device is surgically implanted in the chest with wires run up the neck and into the base of the tongue. Once implanted the device now needs to be programmed to deliver the stimulation at the right time. There is a potential for nerve damage with long term use and the devices (as we have learned from the recent recall of heart defibrillator leads) are not infallible. There is no attempt to evaluate the quality of the evidence. We are given one anecdote of a man presumably enrolled in a clinical trial, but we don’t learn how much research has been done – only that a “key study” of 100 people is planned. There is also no evaluation of the evidence for “today’s undisputed best treatment, called CPAP” – only estimates of how many people won’t or can’t use it. This lead made us stop in our tracks. “Loud snoring may do more than irritate your spouse: It can signal sleep apnea, depriving you of enough zzzz’s to trigger a car crash, even a heart attack.” Car crashes and heart attacks? This sounds like a national emergency. The story goes on to say, “More than 12 million Americans have obstructive sleep apnea, according to the National Institutes of Health….Yet going untreated is more dangerous than just feeling tired. Sleep apnea stresses the body in ways that increase the risk of high blood pressure, heart attack, stroke and diabetes. More immediately, severe apnea increases the chance of a car crash sevenfold. Last year, the National Transportation Safety Board recommended that pilots, truck drivers and other commercial transportation operators start being screened for apnea, saying it has been a factor in incidents involving every mode of transit.” How many incidents? Is sleep apnea more dangerous than, say, texting while driving? Without any context, these facts serve only to scare, not to inform. There are many quotes in this story but none comes from an independent source. Meir Kryger, a sleep medicine specialist at Gaylord Hospital in Connecticut, is the most quoted and is receiving money from Inspire Medical Systems, a device maker, for clinical trials. Rik Krohn, a 67-year-old from suburban Minneapolis (where the company is based – how was he chosen?) is quoted as a sleep apnea sufferer who may have been helped by the Inspire device. We’re not told what connection Dr. Rick Odland, Krohn’s surgeon at Minneapolis’ Hennepin County Medical Center, may have with the company. He is the co-founder of his own medical device company, Twin Star. There is apparently one independent perspective – a voice of caution relegated to the very end in a two sentence paraphrase. “These experiments are only now beginning, with a handful of implants performed so far—and while it’s an interesting concept, frustrated patients should try some proven steps first, cautions, Dr. Amy Atkeson of Columbia University Medical Center in New York. Her advice: Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” The imbalance in the quotes provided, and the absence of any conflict of interest disclosure leads us to give an unsatisfactory score. The story does not do an adequate job comparing these devices to other treatments or to weight loss. The story ends with this brief statement:  “Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” But, as noted, no data is given on CPAP’s benefits – only discussion of what doesn’t work with CPAP. And no data were given – only this one line – about the role of overweight, obesity, and weight loss in sleep apnea. The story provides a very good overview of the ongoing trials of the various companies’ devices and notes an upcoming clinical trial. The story makes it clear that there are several devices in competition to be the dominant sleep apnea device. “By the end of January, Minneapolis-based Inspire Medical Systems plans to begin enrolling 100 apnea patients in a key study in the U.S. and Europe to see if so-called hypoglossal nerve stimulation really could work. Two competitors are developing similar implants: ImThera Medical of San Diego says it hopes to begin U.S. studies later next year, and Apnex Medical of St. Paul, Minn., has announced some small-scale testing.” The story does not rely on a news release. Claim: Experiments test if implant can block sleep apnea
Example Output:
0