Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

[EX Q]: 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.
[EX A]: Lymph Node Study Shakes Pillar of Breast Cancer Care

[EX Q]: Dr. Nelson Teich, an oncologist and health care consultant, took the job April 17 faced with the task of aligning the ministry's actions with the president's view that Brazil's economy must not be destroyed by restrictions to control spread of the virus. Teich's predecessor, Luiz Henrique Mandetta, also had rejected the use of chloroquine, which also had been touted by U.S. President Donald Trump as a treatment. Four government ministers who spoke after Teich's resignation defended the idea of patients being allowed to use the drug if they want to, including Economy Minister Paulo Guedes and the Cabinet chief of staff, Gen. Walter Braga Netto. Officials say almost 15,000 people have died in Brazil from COVID-19, the disease caused by the coronavirus, though some experts say the figure is significantly higher due to insufficient testing. The peak of the crisis has yet to hit Latin America's largest nation, experts say. Gen. Eduardo Pazuello, who had no health experience until he became the Health Ministry's No. 2 official in April, will be the interim minister until Bolsonaro chooses a replacement. Brazilian media have said that Teich's ability to do his job had been weakened by the appointment of dozens of military personnel to jobs in the ministry. "Life is made up of choices and today I decided to leave," Teich told journalists in capital Brasilia. He did not explain why he left the job and refused to answer questions. Braga Netto, the Cabinet chief, said Teich left the job "for personal reasons." Bolsonaro did not comment. Teich's resignation came one day after Bolsonaro told business leaders in a videoconference he would ease rules for using chloroquine to treat people infected with the coronavirus. Teich has frequently called use of the drug "an uncertainty," and this week warned of its side effects. The Health Ministry previously allowed chloroquine to be used in coronavirus cases only for patients hospitalized in serious condition. At Bolsonaro's urging, the country's Army Chemical and Pharmaceutical Laboratory boosted chloroquine production in late March. Researchers last month reported no benefit in a large analysis of the drug or a related substance, hydroxychloroquine, in U.S. hospitals for veterans. Last month, scientists in Brazil stopped part of a study of chloroquine after heart rhythm problems developed in one quarter of people given the higher of two doses being tested. Governors who have recommended quarantine measures and refrained from touting the drug's unproven potential said Teich's resignation reflects Bolsonaro's failure to manage the pandemic. Rio de Janeiro Gov. Wilson Witzel, a former ally of Bolsonaro, said "no one can do serious work with interference in ministries." "That is why governors and mayors need to lead the pandemic crisis, and not you, Mr. President," Witzel said on Twitter. The governor of Ceara, one of Brazil's most hard-hit states, said Teich's exit "brings enormous insecurity and concern." "It is unacceptable that in the face of this serious health crisis, the focus of the government is still on political and ideological discussions. That is an affront to the nation," Camilo Santana said. On April 16, Bolsonaro fired Teich's predecessor, Mandetta, who had become the embodiment of challenges to the president's opposition to governors' quarantine recommendations and restrictions on businesses. Bolsonaro was eager to resume economic activity and warned failure to do so would cause Brazil to descend into "chaos". Teich took office pledging to balance health care concerns and the president's economic worries. He did not openly challenge the president's views, but did defend stay-at-home measures. Miguel Lago, executive director of Brazil's non-profit Institute for Health Policy Studies, which advises public health officials, said Teich wasn't able to build his own team, didn't have Mandetta's political strength and wasn't willing to violate the scientific recommendations. "He clearly had limitations," Lago said. "He would not challenge what has been consensus among the scientific community. He would never accept the chloroquine thing that Bolsonaro wanted him to do, to recommend publicly that chloroquine was a remedy to be used in the public health system." Hours after Teich left the job, the Health Ministry began listing figures on chloroquine distribution as part of its main charts about government initiatives against the pandemic, alongside intensive care unit beds, personal protection equipment, tests and flu vaccines. Risk consultancy Eurasia Group analyst Filipe Gruppelli Carvalho said that the Health Ministry's capacity for "an effective coordinating role looks to have dropped with Mandetta's exit," . "Ultimately, Teich's dismissal reinforces our view of increasing risks from the government's poor response to the pandemic, which could contribute to a weaker presidency and decline in support for Bolsonaro in the post-pandemic phase," he said. The newspaper Folha de S.Paulo published an editorial after Teich's exit saying Bolsonaro is trying to "put his own survival above state policies and national interest." "The resignation of another health minister in less than a month and during the most serious sanitary emergency of contemporary history exposes the downfall of a president that doesnt't even pretend to govern the country," the newspaper said. "As if the economic and sanitary calamities were not enough, he turned himself into a crisis to be faced." After Teich's resignation was announced, pot-banging protests were heard in different regions of Sao Paulo and Rio de Janeiro. _____ Associated Press writers David Biller and Diane Jeantet in Rio de Janeiro contributed to this report.
[EX A]: Brazil's health minister resigns after one month on the job.

[EX Q]: "It is less surprising that neither story discussed costs, given that so few stories do. But sample costs could have been obtained by calling any of the numerous medical marijuana outlets in states where it is legal. Both stories did a decent job of quantifying the benefits.This story provided more details, though, including the differences in patient experiences between the three different concentrations of marijuana. It also repeated this important bit of information:""There was also no difference in the quality of life or mood scores that participants reported when they were on any of the four treatments."" The story also does a great job of pointing out that the treatment duration of five days in each dosage phase is too short to judge utility for chronic pain, which isa long-term affliction. Neither story actually quantified the harms, but they both noted there were side effects. This story did a better job, though, by noting that the only dose that seemed to work also seemed to produce the most side effects and by raising the issue of long-term safety concerns. It also was the only story to answer the question that readers surely would have when reading about an illegal narcotic being used as medicine. Did these patients feel high as a result? This story says that most did not. Because of the additional information and context, the rating here is satisfactory. This story, unlike the competing WebMD piece, establishes in the first sentence even in the first three words that this was ""a small study."" It then discusses the limitations of the study at several points. The second sentence says, ""The pain reduction was ""modest"" less than 1 point on an 11-point scale for the strongest marijuana and patients reported no overall difference in their quality of life based on what they smoked."" The writer elegantly and succinctly described the study design a complex randomized cross-over trial with double blinding and delved into an important feature of the study, that the subjects in retrospect may have been able to detect during which phase of their experience they inhaled placebo versus the most potent drug. This story avoids disease mongering, and, in fact, goes beyond that to note how few people actually suffer from the type of chronic pain that was the subject of the study:""About 1 to 2 percent of adults in the U.S."" The story quotes two outside experts, one of whom is completely independent from the study and the journal, Dr Andrea Hohmann. Beyond that, we would bet that the reporter spent more time interviewing Dr. Mark Ware, the lead researcher, or at least asked tougher questions. Because Ware is more measured in this story than in the WebMD story. He even goes so far as to say, ""What about long-term safety issues?"" he asked. ""These need to be considered before the drug becomes prescribable."" As with the WebMD story, it would have been nice to see who funded the research. Unlike the WebMD story, this one did not point out the conflicts of interest of Dr. Henry McQuay. This story talks about a range of treatment options and even has the study's lead author suggesting, that ""these patients should also be getting behavioral and physical therapy."" Strangely, neither story we reviewed pointed out that marijuana is illegal in most states and in Canada, where the study took place. The story could have, at a minimum, mentioned which states have medical marijuana laws or talked about whether any other countries currently allow cannabis to be sold in pill form the way it was used in this study. The story alludes to the fact that this study ""supports a limited number of trials that have suggested marijuana may be helpful for people suffering from chronic pain,"" indicating that the treatmentis not very novel at all. It would have been nice to see more context around that. The WebMD story provides a little more information in this regard. If the news release is to be believed, ""This is the first trial to be conducted where patients have been allowed to smoke cannabis at home and to monitor their responses, daily"". That could have been made clear. The story goes well beyond the release. Here's the release."
[EX A]:
Pot may provide some chronic pain relief: study