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: Older adults who underwent a brief course of brain exercises saw improvements in reasoning skills and processing speed that could be detected as long as 10 years after the course ended, according to results from the largest study ever on cognitive training. The findings, published on Monday in the Journal of the American Geriatrics Society, offer welcome news in the search for ways to keep the mind sharp as 76 million baby boomers in the United States advance into old age. The federally sponsored trial of almost 3,000 older adults, called the Advanced Cognitive Training for Independent and Vital Elderly study, or ACTIVE, looked at how three brain training programs - focusing on processing speed, memory and reasoning ability - affected cognitively normal adults as they aged. People in the study had an average age of 74 when they started the training, which involved 10 to 12 sessions lasting 60 to 75 minutes each. After five years, researchers found, those with the training performed better than their untrained counterparts in all three measures. Although gains in memory seen at the study's five-year mark appeared to drop off over the next five years, gains in reasoning ability and processing speed persisted 10 years after the training. "What we found was pretty astounding. Ten years after the training, there was evidence the effects were durable for the reasoning and the speed training," said George Rebok, an expert on aging and a professor at Johns Hopkins University in Baltimore, who led the study. Participants in all three training groups also reported that they had an easier time with daily activities such as managing their medications, cooking meals or handling their finances than did participants who did not get the training. But standard tests of these activities showed no differences between the groups. "The speed-of-processing results are very encouraging," said study co-author Jonathan King, program director for cognitive aging in the Division of Behavioral and Social Research at the National Institute on Aging (NIA), part of the National Institutes of Health, which helped fund the research. King said the self-reported improvements in daily function were interesting, but added, "We do not yet know whether they would truly allow older people to live independently longer." However, researchers said even a small gain would be likely to ease the burden on caregivers and healthcare providers. "If we delay the onset of difficulties in daily activities even by a small amount, that can have major public health implications in terms of helping to curb healthcare costs, delaying entry into institutions and hospitals," Rebok said. The training course was designed to bolster specific cognitive abilities that begin to slip as people age. It does not aim to prevent dementia caused by underlying disease such as Alzheimer's. At the start of the study, all 2,832 participants were cognitively normal. The study included four groups: three training groups plus a control group of volunteers who came in for regular testing to see how they were faring with age. People were trained in small groups over a period of several weeks and then were tested immediately after the training and again one, two, three, five and 10 years later. About 60 percent of the volunteers who underwent training also got booster training sessions, which enhanced the initial benefits. At the end of the trial, all groups showed declines compared with their initial baseline tests in memory, reasoning and processing speed, but those who got training in reasoning and processing speed experienced less decline. Among those given training in reasoning strategies, 73.6 percent were still performing above their pre-trial baseline level, compared with 61.7 percent of those who received no training and were only benefiting from practice on the test. The effect was even greater in processing speed. Among the training group, 70.7 percent of participants were performing at or above their baseline level, compared with 48.8 percent of those in the control group. There was no difference in memory performance between the memory group and the control group after 10 years. Two of the three training programs - the memory and the reasoning strategies - were done with paper and pencil, while the processing speed training was done on a computer. The programs, developed by the researchers, were focused largely on teaching strategies to improve cognitive performance. For example, the memory training taught people how to remember word lists, sequences and main ideas, while the reasoning training focused on things like recognizing number patterns. In the processing speed training, people were asked to focus on the main object in a computer screen while also trying to quickly recognize and identify objects on the periphery of the screen. Such training can help older drivers with things like recognizing road signs while driving. A version of the speed training program developed for this trial is now commercially available through the brain fitness company Posit Science, but the researchers are working on making other types of training available as well. Rebok's team just got a grant from the National Institute on Aging to make a computerized version of the memory test, with the hope that repeated training can improve the results. The study was not designed to explain why cognitive training can have such a lasting effect. Rebok said it may be that people take the strategies they learn and practice them over time. As they age, trained individuals can rely on these strategies to compensate for their declines. Whether this training actually strengthened the brain in the way that exercising builds muscle is not clear, but the government intends to study this, too. Last week, NIA put out a request for proposals that would study whether cognitive training causes physical changes in the brain. Claim: Brain training helped older adults stay sharp for years: study.
[EX A]: A brief course of brain exercises helped older adults hold on to improvements in reasoning skills and processing speed for 10 years after the course ended, according to results from the largest study ever done on cognitive training.

[EX Q]: Paragraph: In March 2020, as cities around the world announced "shelter-in-place" or "self-quarantine" orders in an effort to reduce the spread of COVID-19, social media users started to circulate an image that supposedly showed a newspaper clipping from 1918 with a similar announcement in the town of Kelowna, British Columbia: The clipping reads: Public Notice. Notice is hearby given that, in order to prevent the spread of Spanish Influenza, all Schools, public and private, Churches, Theaters, Moving Picture Halls, Pool Rooms and other places of amusement, and Lodge meetings, are to be closed until further notice. All public gatherings consisting of 10 or more are prohibited. D. W. Sutherland, Mayor. Kelowna, B.C., 19 October 1918. This is a genuine newspaper clipping that was published in the Kelowna Record in 1918 as this Canadian town, as well as the rest of the world, fought to prevent the spread of the H1N1 virus, commonly and misleadingly called the "Spanish Flu." The clipping was archived by the University of British Columbia and can be viewed here. Kelowna, of course, was not the only city to issue such an order. We searched the archives of Newspapers.com and found several similar announcements in cities across the United States. On Oct. 10, 1918, for instance, Des Moines, Iowa, Mayor Thomas P. Fairweather announced that "in order to prevent the spread of Spanish Influenza and to protect the public health and safety," he was directing "all public places of amusement, including theaters, moving pictures houses, dance halls and public dancing places, pool and billiard halls, skating rinks, outdoor athletic events, all public congregating places subject to unusual congestion, be closed." Thu, Oct 10, 1918 Page 6 The Des Moines Register (Des Moines, Iowa) Newspapers.com Mobile, Alabama, took these closures one step further. In addition to closing restaurants and businesses, Mobile also asked people to refrain from kissing: Tue, Oct 8, 1918 10 Knoxville Sentinel (Knoxville, Tennessee) Newspapers.com In 1918, just like today, individual cities and states made the decision to close schools, businesses, and public gathering places. According to a recent study from the Journal of the American Society of Cytopathology,cities that implemented strict social guidelines during the early days of the 1918 pandemic saw lower transmission rates and reduced total mortalities. Claim: "A newspaper clipping from 1918 documents a ""public notice"" from the city of Kelowna, British Columbia, announcing that schools, movie theaters, and other public places would be closed to prevent the spread of ""Spanish Influenza."" "
[EX A]: During the 1918-19 H1N1 "Spanish" influenza pandemic, which infected a fifth to a third of the world population, and during which 50 million people have died worldwide, including an estimated 675,000 Americans, the United States has adopted a range of nonpharmaceutical (public health) interventions. These measures, which were similar to those currently adopted, included closure of schools and churches, banning of mass gatherings, mandated mask wearing, case isolation, and disinfection/hygiene measures. However, these measures were not implemented at the same time or for the same duration in different cities, nor were they uniformly followed. A recent analysis concluded that in some cities (San Francisco, St. Louis, Milwaukee, and Kansas City), where the measures were implemented early, they reduced transmission rates by up to 3050%. Cities that implemented such measures earlier had greater delays in reaching peak mortality, and had lower peak mortality rates and lower total mortality. The duration that these "social distancing" measures were kept in place correlated with a reduced total mortality burden. Although we still have no known effective therapy or vaccine prevention for this coronavirus, and the world is a quite different place than it was 100 years ago, the efficacy of the measures instituted during the 1918-19 pandemic gives us hope that the current measures will also limit the impact of the COVID-19 pandemic.

[EX Q]: Paragraph: Clearly, the costs involved in cancer treatment already are high. By removing a layer of treatment from an estimated 40,000 patients, those costs would have to drop, but it is unclear from the story by how much. Also, it would have been worth mentioning whether this is likely to affect how insurance companies handle lymph node removals. The story did a good job providing some numbers on benefits, but we wish it had provided more and explained some things a bit more. It says, for example, "In 27 percent of the women who had additional nodes removed, those nodes were cancerous." How many women had additional nodes removed and, of those, how many had cancerous nodes? A figure like 27% means 1 out of every 4 women had nodes that were, indeed, cancerous, which seems to conflict with other statements in the story about chemotherapy and radiation wiping out the cancer. The story discusses several harms from lymph node removal, and shows that the difference in survival for women who had nodes removed and those who did not was not significant. "Indeed, women in the study who had the nodes taken out were far more likely (70 percent versus 25 percent) to have complications like infections, abnormal sensations and fluid collecting in the armpit. They were also more likely to have lymphedema." This is where the story really outperformed some of the competition covering the same news. It placed the study into the broader context of a movement in cancer care away from surgeries that don't provide a clear benefit, and it also explained the study design and the limitations of the study in several ways. "The study, at 115 medical centers, included 891 patients. Their median age was in the mid-50s, and they were followed for a median of 6.3 years. One potential weakness in the study is that there was not complete follow-up information on 166 women, about equal numbers from each group. The researchers said that did not affect the results. A statistician who was not part of the study said the missing information should have been discussed further, but probably did not have an important impact. It is not known whether the findings also apply to women who do not have radiation and chemotherapy, or to those who have only part of the breast irradiated. Nor is it known whether the findings could be applied to other types of cancer." It was too bad that it did not mention limitations in terms of lack of enrollment. The targeted enrollment was 1900. There also was an imbalance in the randomization that should have been mentioned. The story is careful to explain to readers that the research findings only apply to a subset of women with breast cancer. "Now, researchers report that for women who meet certain criteria about 20 percent of patients, or 40,000 women a year in the United States taking out cancerous nodes has no advantage. It does not change the treatment plan, improve survival or make the cancer less likely to recur. And it can cause complications like infection and lymphedema, a chronic swelling in the arm that ranges from mild to disabling." The Q&A that ran with the story provided more detail about the different types of cancers and cancer patients, noting, for example, "First of all, 20 percent (the estimate of the study's lead author, Dr. Armando E. Giuliano) refers to 20 percent of all the newly diagnosed cases of invasive breast cancer each year. This does not include noninvasive breast cancer, or DCIS, ductal carcinoma in situ. The total is about 207,000, so 20 percent is roughly 40,000 women. That is about how many women would match those in the study, in terms of tumor status, affected lymph nodes and course of treatment."The story also says, "The results mean that women like those in the study will still have to have at least one lymph node removed, to look for cancer and decide whether they will need more treatment. But taking out just one or a few nodes should be enough." Good quotes including from Dr. Monica Morrow, chief of the breast service at Sloan-Kettering and an author of the study, but also a few fromindependent experts toward the end. Dr. Grant W. Carlson, a professor of surgery at the Winship Cancer Institute at Emory University, and the author of an editorial accompanying the study, provides some soul-searching context by saying that, in taking out so many lymph nodes, "I have a feeling we've been doing a lot of harm."Dr. Elisa R. Port, the chief of breast surgery at Mount Sinai Medical Center in Manhattan, said, "It's definitely practice-changing." AndDr. Alison Estabrook, the chief of the comprehensive breast center at St. Luke's-Roosevelt hospital in New York said, "In the past, surgeons thought our role was to get out all the cancer. Now he's saying we don't really have to do that." The story does a great job explaining the history of this form of treatment and how it has evolved over time. "But doctors have continued to think that even microscopic disease in the lymph nodes should be cut out to improve the odds of survival. And until recently, they counted cancerous lymph nodes to gauge the severity of the disease and choose chemotherapy. But now the number is not so often used to determine drug treatment, doctors say. What matters more is whether the disease has reached any nodes at all. If any are positive, the disease could become deadly. Chemotherapy is recommended, and the drugs are the same, no matter how many nodes are involved." The story goes on to do something that stories like this rarely do, it compares compares the harms from different forms of treatment, saying "After armpit surgery, 20 percent to 30 percent of women develop lymphedema, Dr. Port said, and radiation may increase the rate to 40 percent to 50 percent. Physical therapy can help, but there is no cure." The story makes it clear that removing all under-arm lymph nodes is the standard of care for women with breast cancer and that feelings about that standard are entrenched. The story establishes that a change in treatment protocol away from removing all the lymph nodes under the arms of women with breast cancer would be novel. There is some nuance, here, though that could be missed by a casual reader. Women who have one to two positive lymph nodes would avoid having additional lymph node surgery. The overall tone of the story may make it appear to some readers that women get to avoid lymph node surgery altogether, but they don't. The story goes well beyond any news release. Claim: Lymph Node Study Shakes Pillar of Breast Cancer Care
[EX A]:
We do wish that the story had provided a few more hard numbers, especially in regard to cost. And the story could have made it clear higher up that this study does not mean that lymph nodes should never be removed. But, overall, this story earns a top five-star score. The story says it all: "The discovery turns standard medical practice on its head. Surgeons have been removing lymph nodes from under the arms of breast cancer patients for 100 years, believing it would prolong women's lives by keeping the cancer from spreading or coming back." Patients who receive a cancer diagnosis are often thinking about one thing; metastisis. It has been drilled into our brains that cancer spreads and often can spread quickly. This study shows that, because doctors already are providing patients with chemotherapy and radiation, those treatments may wipe out the cancer in the lymph nodes and negate the need for surgery. This will be tough for some patients, and doctors, to accept, though. As the story notes, "Doctors and patients alike find it easy to accept more cancer treatment on the basis of a study, Dr. Morrow said, but get scared when the data favor less treatment."