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: Cancer patients increasingly are having their care guided by gene tumor boards, a new version of the hospital panels that traditionally decided whether surgery, radiation or chemotherapy would be best. These experts study the patient's cancer genes and match treatments to mutations that seem to drive the disease. "We dissect the patient's tumor with what I call the molecular microscope," said Dr. Razelle Kurzrock, who started a board at the University of California, San Diego, where Cairnes is treated. It's the kind of care many experts say we should aim for precision medicine, the right drug for the right person at the right time, guided by genes. There are success stories, but also some failures and many questions: Will gene-guided care improve survival? Does it save money or cost more? What kind of gene testing is best, and who should get it? "I think every patient needs it," especially if cancer is advanced, said Kurzrock, who consults for some gene-medicine companies. "Most people don't agree with me yet. In five years, it may be malpractice not to do genomics." Few people get precision medicine today, said Dr. Eric Topol, head of the Scripps Translational Science Institute. "The only thing that's gone mainstream are the words." HOW IT WORKS NOW If you have a cancer that might be susceptible to a gene-targeting drug, you may be tested for mutations in that gene, such as HER2 for breast cancer. Some breast or prostate cancer patients also might get a multi-gene test to gauge how aggressive treatment should be. Then most patients get usual guideline-based treatments. If there's no clear choice, or if the disease has spread or comes back, doctors may suggest tumor profiling comprehensive tests to see what mutations dominate. That's traditionally been done from a tissue sample, but newer tests that detect tumor DNA in blood liquid biopsies are making profiling more common. The tests cost about $6,000 and many insurers consider them experimental and won't pay. Gene tumor boards analyze what the results suggest about treatment. They focus on oddball cases like a breast cancer mutation in a colon cancer patient, or cancers that have widely spread and are genetically complex. The only options may be experimental drugs or "off-label" treatments medicines approved for different situations. But as tumor profiling grows, it's revealing how genetically diverse many tumors are, and that oddball cases are not so rare, said Dr. John Marshall. He heads the virtual tumor board at Georgetown Lombardi Comprehensive Cancer Center that also serves cancer centers in Pennsylvania, North Carolina, Michigan and Tennessee. "There is a little bit of faith" that testing will show the right treatment, but it's not a sure thing, said Dr. Lee Schwartzberg, who heads one participating center, the West Cancer Center in Memphis. Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer, is optimistic yet wary. Drugs that target BRAF mutations work well for skin cancers called melanomas, but less well for lung or colon cancers. "Just because a mutation occurs it doesn't mean that drug is going to work in that cancer," he said. LUCKY CASES When it does, results can be dramatic. Cairnes' cancer was between her stomach and esophagus, and had spread to her liver, lungs and lymph nodes. Tissue testing found 10 abnormal genes, but on the liquid biopsy only EGFR popped out as a good target. Two drugs aim at that gene but aren't approved for her type of cancer. A tumor board advised trying both Erbitux and Tarceva, the drug her husband also had taken. Within two weeks, she quit using pain medicines. After two months, her liver tumor had shrunk roughly by half. There are signs that cancer may remain, but it is under control. She feels well enough to travel and to take care of her granddaughter. "I'm very, very grateful to have a targeted therapy," Cairnes said. "I cannot expect a better outcome than what we're seeing right now," said her doctor, Shumei Kato. WHAT STUDIES SHOW But is gene-guided treatment better than usual care? French doctors did the first big test, with disappointing results. About 200 patients with advanced cancer were given whatever their doctors thought best or off-label drugs based on tumor profiling. Survival was similar about two months. Another French study, reported in June, was slightly more encouraging on survival but exposed another problem: No drugs exist for many gene flaws. Tests found treatable mutations in half of the 2,000 participants and only 143 got what a tumor board suggested. Some doctors worry that tumor boards' recommending off-label treatments diverts patients from research that would benefit all cancer patients. For example, the American Society of Clinical Oncology's TAPUR study tests off-label drugs and shares results with their makers and federal regulators. LETTING PATIENTS CHOOSE Ann Meffert, who lives on a dairy farm in Waunakee, Wisconsin, endured multiple standard treatments that didn't defeat her bile duct cancer. "She was going to be referred to hospice; there was not much we could do," said Dr. Nataliya Uboha, who took the case to a tumor board at the University of Wisconsin-Madison. The panel gave several options, including off-label treatment, and Meffert chose a study that matches patients to gene-targeting therapies and started on an experimental one last October. "Two weeks in, I started feeling better," she said, and when she saw test results, "I couldn't believe the difference." Many lung spots disappeared and the liver tumor shrank 75 percent. She is not cured, though, and doctors are thinking about next steps. And that could involve a fresh look at her tumor genes. ___ Marilynn Marchione can be followed at @MMarchioneAP __ This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content. Claim: Ultra-personal therapy: Gene tumor boards guide cancer care.

SOLUTION: Doctors were just guessing a decade ago when they gave Alison Cairnes' husband a new drug they hoped would shrink his lung tumors. Now she takes it, but the choice was no guesswork. Sophisticated gene tests suggested it would fight her gastric cancer, and they were right.

PROBLEM: Paragraph: "The water affects everyone," she said, which is why she believes her job is so important. Reese is studying public health and environmental health at East Carolina University in North Carolina. She will be an intern for the East Shore department, working on the Connecticut shoreline until the end of July. Reese spends her Tuesday mornings driving around to all the public and private natural swimming areas in Branford, North Branford and East Haven, collecting water samples and putting them on ice in her purple cooler. The samples are then collected by state Department of Public Health couriers and brought to the state lab in Rocky Hill for testing. Water quality testing has always been a priority for the East Shore department every summer, but this year, Alex Cinotti, the assistant director of health, has something he's trying to prove. Every year, from Memorial Day to Labor Day, the department collects weekly water samples from 12 water bodies used for swimming, both freshwater and saltwater, to ensure bacteria levels are low enough for public safety. Samples are collected and tested once a week, and as long as bacteria levels fall below state-determined risk levels, the beaches and other water bodies remain open. This year, however, Cinotti would like to take the sampling a step further to show a direct correlation between rainfall and elevated bacteria levels, he said, as rain will often wash contaminants into public waters and cause bacteria levels to rise. "This is our opportunity to take samples and establish a pattern," Cinotti said. "Bacteria is bacteria and we consider it pathogenic." As such, in addition to the weekly sampling of water, Cinotti said that the department is collecting samples after heavy rains to see if bacteria levels rise after rainfall. This kind of analysis could not be done last summer, Cinotti said, because there were few rain events due to the drought. On the state level, the Department of Energy and Environmental Protection will close public beaches after a significant amount of rainfall, in anticipation of potentially higher bacteria levels. Scott Szalkiewicz, a health program supervisor for the state Health Department, told the Register last summer that because samples take 24 hours to process, it's helpful to be able to close beaches before test results come in when officials believe bacteria levels will be high based on the amount of rain and visual indicators. The East Shore District Health Department serves Branford, North Branford and East Haven. The 12 bathing waters surveyed each week include the east and west East Haven beaches, the Clark Avenue beach, Branford Point, Stony Creek, Hotchkiss Grove, Turtle Bay, Sunrise Cove, Lanphier Cove, Cedar Lake, Linsley Lake and Clear Lake. According to water quality records from the East Shore District Health Department in 2016, there was only one time when bacteria levels reached a level at which one of the beaches had to close. Sunrise Cove reached a level of 1,000 colonies of bacteria in the sample of 100 milliliters of water on Aug. 2, 2016, according to the records. Cinotti said that the safe levels for salt water are 104 colonies of bacteria per 100 milliliters of water and 235 colonies for fresh water per 100 milliliters of water. Some things that cause heightened bacteria levels include wild animal and dog feces, sewer overflows and leaks, Cinotti said. Rain may wash contaminants such as sewer overflows, nitrogen-rich pollutants and goose and dog feces into the Sound and other bathing water bodies. Potential health risks from swimming in water with high levels of bacteria include possible infections to open wounds and gastrointestinal illness when water is accidentally swallowed, Cinotti said. He added that it's possible swimmers could contract eye- or ear-related illnesses from high levels of bacteria. "We really need to protect children," Cinotti said. "They are more vulnerable than adults." ___ Online: http://bit.ly/2rFTp4s ___ Information from: New Haven Register, http://www.nhregister.com Claim: Officials study link between rain and bacteria in water.

SOLUTION: For Kellyn Reese, waking up on Tuesday mornings and going to the beach because it's her job is a nice perk of being a summer intern at the East Shore District Health Department.

PROBLEM: Paragraph: Koch, a North Carolina-born engineer who joined NASA's astronaut corps in 2013, set the record for the longest stay in space by a woman. Her mission will provide researchers valuable data on how weightlessness and space radiation affect the female body on long spaceflights. "Women acclimate well to space, so I think this is a milestone that will be overtaken by women in the future and it's what we aspire to," said Lori Garver, NASA's former deputy administrator. The Soyuz MS-13 capsule touched down on the snowy Kazakh Steppe at 4:12 am ET (0912 GMT) carrying Koch, 41, European astronaut Luca Parmitano of Italy and Russian cosmonautAlexander Skvortsov. They will be flown by search and recovery teams to the Karaganda region to begin their journey home. "I'm just so overwhelmed and happy right now," Koch said, sitting in a chair wrapped in blankets as she waited to be carried into a medical tent to restore her balance in gravity. Koch also achieved a gender milestone in a spacewalk with fellow NASA astronaut Jessica Meir last October that marked the first time two women stepped out of the space station at the same time. They completed two more all-female spacewalks in January. NASA's first attempt at an all-female spacewalk in March 2019 was called off here due to a lack of a spacesuit in the right size, which ignited a gender-equity debate. Koch's 328 days in space eclipsed Peggy Whitson's record for an American woman on a single spaceflight at 289 days. Scott Kelly holds the overall American record at 340 days, and Russia's Valeri Polyakov holds the global record of 437 days aboard the defunct Mir space station. Astronauts on the space station, whose 20th anniversary in low-Earth orbit comes later this year, have made 227 maintenance spacewalks, nearly two dozen of which included women astronauts, according to NASA. Studying the impact of lengthy spaceflights could prove useful for NASA's aim of building a permanent space station on the moon within the next decade. Kelly's 340 days demonstrated that long-term spaceflight causes thickening of the carotid artery and retina, changes in gene expression, and slightcognitive impairment for men. Claim: NASA astronaut Christina Koch returns to Earth after record mission.

SOLUTION:
American astronaut Christina Koch, who led the first all-female spacewalk in 2019, landed in Kazakhstan on Thursday after a record stay on the International Space Station, ending a 328-day mission expected to yield new insights into deep-space travel.