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.

[EX Q]: Paragraph: "Ohio Sen. Rob Portman has been busy in Washington touting the Comprehensive Addiction Recovery Act in response to a shocking number of heroin overdoses in Ohio. The bill just passed in the Senate, 94-1. (Nebraska Sen. Ben Sasse was the sole ""nay,"" saying he believes that fighting addiction is a local issue.) Ohio ranks high on the list of states reeling from the national epidemic. In Montgomery County, which encompasses Dayton, Ohio, heroin-related deaths increased 225 percent between 2011 and 2015. Back in the 1970s, the heroin on U.S. streets was the ""black tar"" variety, and much of it came from southeast Asia. In 2010, 80 percent of the heroin in the world came from poppy fields in Afghanistan, according to the Office of National Drug Control Policy. So when Portman said that most of the heroin in America comes from Mexico's border, we were skeptical. Portman, it turns out, has done his homework. The Drug Enforcement Administration's National Drug Threat Assessment of 2015 says that Mexico is the primary supplier of heroin to the United States. ""Southeast Asia was once the dominant supplier of heroin in the United States, but Southeast Asian heroin is now rarely detected in U.S. markets,"" the report state. ""Mexico and, to a lesser extent, Colombia dominate the U.S. heroin market, because of their proximity, established transportation and distribution infrastructure, and ability to satisfy U.S. heroin demand."" The report also says that Mexican ""transnational criminal organizations,"" (the DEA's term for drug-dealing gangs) ""pose the greatest criminal drug threat to the United States; no other group is currently positioned to challenge them."" The National Drug Threat report notes that Colombian gangs were traditionally the suppliers of wholesale cocaine and heroin to Mexican and Dominican groups. But cartels in Mexico are ramping up their roles on the supply side -- opium production in Mexico increased by 50 percent in 2014. Mexican labs also produce fentanyl, a synthetic painkiller that is 80 to 100 times stronger than morphine. Fentanyl is sometimes mixed with heroin or substituted for heroin, and the DEA reports more than 700 overdoses attributed to fentanyl between late 2013 and early 2015. Drugs get past the U.S. borders mostly ""by land, not by sea,"" said Homeland Security Secretary Jeh Johnson, in the same March 8 hearing with Portman. And a 2015 Washington Post series on the surge of heroin puts the border detection rate at a scant 1.5 percent. Smugglers' creativity defies gravity: One successful bust came when agents caught two men flying a drone carrying 28 pounds of heroin from Mexico to California. Our ruling Portman said that heroin is coming to the United States primarily from Mexico. He hasn't been studying drug facts for nothing." Claim: We understand that this heroin is primarily coming from Mexico, over the border.
[EX A]: Portman said that heroin is coming to the United States primarily from Mexico. He hasn't been studying drug facts for nothing.

[EX Q]: Paragraph: The story does not talk about costs, which was disappointing. The costs of intensive medical therapy can easily be identified. Using an online pharmacy we calculated the costs to be about $1,500 to $2,000 annually for medical therapy, using generic drugs. Using the Health CareBlue Book, we found the average cost of coronary artery bypass sugery and hospitalization to be about $62,000. We think that this is important information for readers that should have been included. The quantification here was presented in such a way to make it clear to readers that there was no significant benefit found to surgical intervention, which is a fair conclusion to draw from the study. The story says, "In the Stich study, 41% of patients assigned to treatment with drugs alone died during the follow-up period, which averaged five years. That compared with a mortality rate of 36% among patients who received bypass surgery plus medication. Although the relative reduction in risk of death was 14%, the result didn't meet tests for statistical significance, meaning it could have resulted from chance alone."That's a great way to describe the lack of statistical significance. It would have been even more powerful to show readers the actual number of patients who died in each group. The story provides great information about the study itself and about the overall state of the evidence supporting heart surgery. "How best to treat these patients has been fraught with uncertainty," is one of the more notable phrases from the story. It also says, "Many patients aren't evaluated for heart surgery to treat diseased arteries because they don't suffer classic chest pain or because doctors worry that hearts weakened by heart failure won't benefit from the procedure. Other doctors recommend immediate bypass surgery despite a lack of vigorous studies to support that strategy." The story does not engage in disease-mongering and takes a very careful approach to describing the types of patients who would be affected by this study's results. We also like the way they provided snapshots of patients who were in both arms of the study surgery and non-surgery at the end of the story, making it clear, as the study did, that both routes can be equally successful. The story brings in some strong independent voices who help make sense of this complicated study: James Fang, a cardiologist at University Hospitals Case Medical Center in Cleveland, who wrote an editorial accompanying the study, Raymond Gibbons, a cardiologist at the Mayo Clinic, and Clyde Yancy, chief of cardiology at Northwestern University's Feinberg School of Medicine. Rarely do you see a story that spends as much time with independent experts as it does with the authors of the study. The story does a great job showing how the standard interventions for heart disease stacked up against each other in this study. We wish that some mention had been made of diet and exercise and that at least a sentence had been included about whether there might be differences in outcomes seen as a result of different medication patterns. The story doesn't make it clear what exactly the patients were taking. The story makes it clear that the range of treatments studied by the authors are widely available. The story makes it clear that there is a great need for more evidence in this field and that this study will be surprising to many clinicians because of a long-held assumption that surgery is the superior option. tudies published in the early 1990s supported the view that bypass surgery provided a better long term outcome. The story does not rely on a news release. Claim: More Options Before Bypass Surgery, Study Finds
[EX A]: The piece gave readers some powerful information to help them sort through the range of factors that should be considered for any medical intervention. The only weakness our reviewers found with the story is the lack of comment about cost. Too often stories present medical options as false choices of best versus worst. They don't take into consideration the very real differences between patients' medical histories, diagnoses and expectations. This story should be applauded for giving readers a clear understanding of the complexities of shared decision-making between providers and patients. As noted by one of the experts quoted in the story, "You don't have a good therapy and a bad therapy, you have a choice." This is a message that the story gets across very well and is an important one for readers.

[EX Q]: Paragraph: Although not discussed in the study precipitating the story, the costs for gastric banding and appropriate follow-up care are readily available. The story reported the average long term loss of excess weight that was observed in the study along with an insight from a clinician indicating that there is some variability observed among practices. The story provided quantitative information about the harms observed in the study population who had had gastric banding surgery. It says, "However, 39 percent of the patients had experienced serious complications, including abnormal pouch expansion (9), band erosion (23) and band infection (1). Another 22 percent experienced relatively minor complications. Almost 50 percent had to have the bands entirely removed, while 60 percent needed to undergo subsequent surgery. The procedure "appears to result in relatively poor long-term outcomes," the researchers concluded." The story provided only hints about the study on which it was reporting. It should have providedbetter context and asked tougher questions about thestudy. The timeline in the storyalso may confuse readers. It says that gastric banding has been an alternative to gastric bypass since 2001, but then it saysthe studyfollowed patients who received operations from 1994 to1997. This appearsto bebefore the band was approved. Thestory should have said that the 2001 date was when the FDA approved banding for use in the US and that the study population was in Belgium. Italsoshouldhave mentioned that the pool of patients studied were treated at a single clinic. The story did not engage in overt disease-mongering. The storyquoted an author of the study, the author of a critique on that study, and a surgeon who did not appear to have ties with the study. But the story missed a key fact that WebMD found in the study and reported, which is the conflicts of interest for the study's lead author, who, as WebMD pointed out, "reports consultant work for Ethicon Endosurgery, which makes another gastric band, Realize, and for Covidien, a health care products company." Not pointing out that the author has worked for a competing gastric band maker is a significant drawback to the story. The story relied on a critique published alongside the study from Dr. Clifford W. Deveney, a professor of surgery in the department of surgery at Oregon Health and Science University in Portland, to provide readers some good comparison information between gastric bypass surgery and gastric banding. We would have liked to have seena more detailed discussion of the evidence for both and alsoat lesat some mention of diet and exercise. The gastric banding procedure was appropriately described as an available treatment. It is clear from the story that the procedure is not new. The story does not appear to rely solely on a press release. Claim: 40% of Gastric Banding Patients Have Complications
[EX A]:
This is a story reporting on a study detailing the long-term outcomes observed in a group of patients more than a decade after having gastric banding to help with weight management. The story provided some useful insight about how gastric banding and gastric bypass compare in terms of rates and magnitude of weight loss. It also informed readers about the fact that outcomes following banding surgery are highly variable. Obesity is anincreasingly common and increasingly serious risk factor for disease and early death. Providing readers with realistic expectations about the benefits of gastric banding is useful for those making decisions about what approach to take to help manage their weight. While gastric banding may be less invasive and appealing in the short term, the long term outcomes of the approach are in question, especially for morbidly obese patients. This new study adds to our understanding of the limitations of this minimally invasive procedure.