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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.
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After hearing about a few more episodes Breckenridge had, Berger suggested she get a gate for the top of the stairs, in case Breckenridge were to fall. She then asked Breckenridge if she had set up Alexa, the virtual assistant developed by Amazon, which she had. They then discussed different exercises they had gone over in the past. Berger asked the patient about her arm mobility asking her to lift her arm and stability, prompting her to stand up without holding on to anything. After about a 30-minute session, they said their goodbyes and logged off their computers. Berger, a physical therapist, certified dementia specialist and owner of Rehab Smarter, conducted the entire session online. Rehab Smarter is a local telehealth business that provides comprehensive rehabilitation services to patients over the internet. "This has been a saving grace for me," Breckenridge said. "It's not because I don't want to go to the doctor's office. It's because I can't get to them. If I could, I would be there." The Brunswick resident turned to telehealth services due to her decreased mobility. She is, for the most part, homebound due to having multiple seizures a day. While she has online sessions with doctors, they still recommend that she come into the office at times to run certain tests and other functions that physicians are not yet capable of completing online. She works with Berger through online sessions about twice a week. Working with her is "completely the same" as if she were sitting with Berger face to-face. "Just because you're stuck at home doesn't mean that you can't get the help that you need," she said. "People just need to find the help that they need, and sometimes it's on the internet." Berger started Rehab Smarter about 18 months ago. She conducts sessions with her patients through an online portal where she can email with them directly, upload videos and add notes for their benefit. Everything is Health Insurance Portability and Accountability Act, or HIPAA, compliant. She typically doesn't do a face-to-face assessment with the patient, but she has gone in-home to see the setup and suggested any modifications to help the patient with mobility. She may also do an initial assessment and meet with the caregiver, if there is one, and ask what the patient's goals are. "Most of what clinicians do is educate and teach the client how to take care of themselves," she said. She demonstrates different exercises with her patients online and, with her expertise, can detect muscle strength and functionality by just observing them perform simple tasks. "You can test cognition over the internet, you can test sensation," she said. "You can't listen to the heart without special equipment, but that exists." Her average client has COPD, heart failure, diabetes, kidney disease, arthritis, high blood pressure and other conditions, all at once. They turn to telehealth because it's difficult for them to get out of the home and go to a doctor's office, although they sometimes do so. "It's not really home care," she said. "It's not really outpatient. It's a platform for clients that either have maxed out their benefits through traditional means or have prevention and wellness issues that will not be covered. It's another opportunity for people." Telehealth can be beneficial to the healthcare provider as well. When Berger provides home care through a company she works for, she can see up to six clients a day and then has hours of paperwork to complete, for insurance purposes. Through virtual care, she can see up to 12 patients with minimal paperwork. Her telehealth service is not covered under insurance, which cuts out a lot of the paperwork. A session can range from $80 to $200. With telehealth, a patient is not limited to one doctor. If Berger finds that a patient needs care in an area in which she's not an expert, she can consult with a doctor across the country to get the patient the care they need. "So you can now get care by anybody who's appropriate, wherever you are, at least to a point that you could not have gotten before," she said. But even with the internet playing such a vital role in the future of medicine, there are still many limitations to telehealth. "You can't touch a patient," Berger said. "If you have an abdominal problem and your physician is palpitating your stomach to feel for tension and different things, you can't do that (over the internet). Blood tests and physical surgeries also can't be done, at this point in time at least." Frederick Memorial Hospital is also making headway in telehealth services. The Chronic Care Management Program gives patients tablets, blood pressure monitors, a pulse oximeter and a scale to detect their vitals in the comfort of their own home. They consult with a nurse on the team once a week by phone. By the end of the summer, they plan to have video conferencing, according to Lisa Hogan, a nurse at FMH and the team lead for both the Chronic Care Management and telemonitoring programs. The program took off in 2017 and started with 30 monitors for in-home patients. Today it has 203 in the community. Up to 200 more monitors will be added in 2020. There is already a waiting list to be a part of the program. This past winter, the hospital also launched a separate Virtual Visit Program through Monocacy Health Partners, the hospital's own physician group. The program is for employees and primary care patients of MHP, according to Alex Nason, director of IT innovation at FMH. Through a series of questions, primary care providers can assess ailments such as upper respiratory infections, flu, cold, rash and pink eye. Although physicians can make diagnoses and write prescriptions after conducting a telehealth session, about 20 percent of the time the provider decides that they would like to see the patient in person. Through these efforts, FMH saw an 84 percent reduction in readmission rates and a 56 percent reduction in emergency room visits in 2018, according to Hogan. "Telehealth as technology has become easier to use, less expensive and more accepted. And the clinical validation is there as more and more parts of health care are embracing it," Nason said. "I think as the technology advances, the research continues to accrue validation and the economics of healthcare continue to evolve, we're seeing more and more movement, acceptance and options of telehealth because the stars are starting to align." ___ Information from: The Frederick (Md.) News-Post, http://www.fredericknewspost.com
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Telehealth rises as medium increases in validity.

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They found several creams caused skin cancer in the specially bred mice, which had been pre-treated with ultraviolet radiation. The cancers are not melanoma, the deadliest kind of skin cancer, they stressed in their report in the Journal of Investigative Dermatology, but another type called squamous cell carcinoma. Such tumours are slow growing, highly treatable and only fatal if patients fail to have them removed. Allan Conney and colleagues at Rutgers University in New Jersey said they discovered the risk while testing a theory that caffeine could prevent skin cancer. "We sort of got into this by accident," Conney said in a telephone interview. "We wanted a safe cream that we could put the caffeine into." They were testing specially bred albino mice, which are prone to develop skin cancer. The mice are pre-treated with ultraviolet radiation to simulate the effects of a human who has had heavy sun exposure in the past but then stopped something that may be happening in the population as people realize the risks of getting a tan. Conney's team decided to test the creams first and found that all four they tested caused tumours to grow on the mice. He said he does not know why, but suspects two ingredients mineral oil and sodium laurel sulphate. "We'd like to understand the mechanism. What is most important is to see whether these moisturizing creams are tumorigenic in people," Conney said. He said his lab is not equipped to do this but someone should. But he added, "I don't think that people should be scared because this is a mouse study and we don't know whether or not it applies to humans." Other experts were sceptical about the study. "This is a pretty artificial situation with the mouse skin primed by a lot of UV light to develop cancer," Karol Sikora, Medical Director of Cancer Partners U.K. in Britain, said in a statement. Dr. Jonathan Rees, an expert in dermatology at the University of Edinburgh in Scotland, said squamous cell carcinoma was not a big health worry. "Non-melanoma skin cancer in man is very, very common and is almost 100 percent curable with an operation usually simpler than a tooth filling," Rees said in a statement. Conney said the mouse was a commonly used model in skin cancer but said he agreed that it does not perfectly replicate human skin and human behaviour. He said his team approached Johnson & Johnson to create a cream without the suspect products and they developed one using other readily available ingredients. "They are things that are commonly used in many moisturizing creams," he said. This cream did not cause the tumours in the mice, they said. He said Rutgers and Johnson & Johnson had patented the new cream jointly but did not know whether it would be commercially developed. A spokesman at the company was not immediately available for comment.
answer:
Skin creams seen to cause tumours on mice.

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In Wuhan, the epicenter of the disease, one person has died for every 23 infections reported. That number drops to one on 50 nationally, and outside mainland China, one death has been recorded per 114 confirmed cases. Get our full coverage on the coronavirus: here Experts say the discrepancy is mainly due to under-reporting of milder virus cases in Wuhan and other parts of Hubei province that are grappling with shortages in testing equipment and beds. "In an outbreak your really have to interpret fatality rates with a very skeptical eye, because often it's only the very severe cases that are coming to people's attention," said Amesh Adalja, an expert in pandemic preparedness at the Johns Hopkins Center for Health Security in Baltimore. "It's very hard to say those numbers represent anything like the true burden of infection" said Adalja, who estimates current fatality rates are likely below 1%. As of Tuesday, 24,551 cases have been confirmed globally. A 1% fatality rate would put total cases at over 49,000, based on the current death toll of 492. Gauden Galea, the World Health Organisation (WHO) representative for China, told Reuters on Sunday that a "crude calculation" done by dividing total cases by deaths put the rate at 2% and said the rate was generally falling. "Trying to really demystify those fatality numbers by including mildly symptomatic cases will help people to better understand the risk," said Adalja. In Wuhan, some patients with milder symptoms have been turned away from hospitals in recent weeks because of the strain on resources, several people in the city told Reuters. Others have opted to self-isolate. Wuhan resident Meiping Wang said she and her sister both believe they have mild cases of the virus after their mother tested positive, but have not been tested. "There is no use going to the hospital because there is no treatment," Wang, 31, said in a telephone interview. Under-reporting mild cases - which increases fatality rates - could have a negative social and economic impact as global health authorities race to contain the disease. "It's good to remember that when H1N1 influenza came out in 2009, estimates of case fatality were 10 percent," said David Fisman, an epidemiologist at the University of Toronto, who was working in public health at the time. "That turned out to be incredibly wrong." "As the denominator is growing in terms of case numbers, and case fatality goes down and down... you start to realize it's everywhere," he said. The global response to the coronavirus epidemic has been swift and fierce. Several countries have implemented partial or full travel bans on Chinese travelers. "There are many actions going on all over the world that really are premised on the idea that this is a very severe illness," said Johns Hopkins' Adalja. WHO chief Tedros Adhanom Ghebreyesus said on Monday that the bans were an unnecessary interruption to travel and trade.
answer:
Data suggests virus infections under-reported, exaggerating fatality rate.