TASK DEFINITION: Given a paragraph and a claim, classify it this way: If the claim contradicts the evidence present in the paragraph, classify the claim as '0'. If the claim has multiple supporting *AND* contradicting evidences, classify the claim as '1'. If the claim has supporting evidence and the paragraph is in overall favor of the claim, then classify the claim as '2'.
PROBLEM: Paragraph: There is no mention of costs for the surgical implants or any of the other treatment methods. Whether insurers are likely to cover such treatments and whether they cover current treatment approaches would have been helpful information as well. The cost of medical devices needs to be considered for a host of reasons. A similar technology (vagal nerve stimulation) costs about $20,000 and could have been used as a useful example. No data on benefits are given for the “undisputed best treatment, called CPAP. ” Regarding the new devices, because they are in early studies, any suggestion of benefit must be made carefully. While a number of provisos were included in the story, the single patient anecdote and the “What we’re looking for is actually cure” quote from one of the investigators provide the reader with an imbalanced perspective. There is no mention of potential harms. This is troubling because the devices described would require a surgery. To be eligible for one of the devices, a person would need to undergo some fairly extensive testing, much of which is rather unpleasant, including having “a tube snaked down the airway” to see whether their sleep apnea  is being caused by a qualifying condition. The device is surgically implanted in the chest with wires run up the neck and into the base of the tongue. Once implanted the device now needs to be programmed to deliver the stimulation at the right time. There is a potential for nerve damage with long term use and the devices (as we have learned from the recent recall of heart defibrillator leads) are not infallible. There is no attempt to evaluate the quality of the evidence. We are given one anecdote of a man presumably enrolled in a clinical trial, but we don’t learn how much research has been done – only that a “key study” of 100 people is planned. There is also no evaluation of the evidence for “today’s undisputed best treatment, called CPAP” – only estimates of how many people won’t or can’t use it. This lead made us stop in our tracks. “Loud snoring may do more than irritate your spouse: It can signal sleep apnea, depriving you of enough zzzz’s to trigger a car crash, even a heart attack.” Car crashes and heart attacks? This sounds like a national emergency. The story goes on to say, “More than 12 million Americans have obstructive sleep apnea, according to the National Institutes of Health….Yet going untreated is more dangerous than just feeling tired. Sleep apnea stresses the body in ways that increase the risk of high blood pressure, heart attack, stroke and diabetes. More immediately, severe apnea increases the chance of a car crash sevenfold. Last year, the National Transportation Safety Board recommended that pilots, truck drivers and other commercial transportation operators start being screened for apnea, saying it has been a factor in incidents involving every mode of transit.” How many incidents? Is sleep apnea more dangerous than, say, texting while driving? Without any context, these facts serve only to scare, not to inform. There are many quotes in this story but none comes from an independent source. Meir Kryger, a sleep medicine specialist at Gaylord Hospital in Connecticut, is the most quoted and is receiving money from Inspire Medical Systems, a device maker, for clinical trials. Rik Krohn, a 67-year-old from suburban Minneapolis (where the company is based – how was he chosen?) is quoted as a sleep apnea sufferer who may have been helped by the Inspire device. We’re not told what connection Dr. Rick Odland, Krohn’s surgeon at Minneapolis’ Hennepin County Medical Center, may have with the company. He is the co-founder of his own medical device company, Twin Star. There is apparently one independent perspective – a voice of caution relegated to the very end in a two sentence paraphrase. “These experiments are only now beginning, with a handful of implants performed so far—and while it’s an interesting concept, frustrated patients should try some proven steps first, cautions, Dr. Amy Atkeson of Columbia University Medical Center in New York. Her advice: Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” The imbalance in the quotes provided, and the absence of any conflict of interest disclosure leads us to give an unsatisfactory score. The story does not do an adequate job comparing these devices to other treatments or to weight loss. The story ends with this brief statement:  “Don’t give up on CPAP without first seeing an experienced sleep technician to adjust humidity levels and take other steps that not every CPAP prescriber knows to try—and if you’re overweight or obese, apnea greatly improves with weight loss.” But, as noted, no data is given on CPAP’s benefits – only discussion of what doesn’t work with CPAP. And no data were given – only this one line – about the role of overweight, obesity, and weight loss in sleep apnea. The story provides a very good overview of the ongoing trials of the various companies’ devices and notes an upcoming clinical trial. The story makes it clear that there are several devices in competition to be the dominant sleep apnea device. “By the end of January, Minneapolis-based Inspire Medical Systems plans to begin enrolling 100 apnea patients in a key study in the U.S. and Europe to see if so-called hypoglossal nerve stimulation really could work. Two competitors are developing similar implants: ImThera Medical of San Diego says it hopes to begin U.S. studies later next year, and Apnex Medical of St. Paul, Minn., has announced some small-scale testing.” The story does not rely on a news release. Claim: Experiments test if implant can block sleep apnea

SOLUTION: 0

PROBLEM: Paragraph: "Native American tribes have been among the hardest hit by the coronavirus pandemic, and Joe Biden claims that President Donald Trump has not done enough to help. ""Donald Trump has failed to live up to our trust and treaty obligations to Native Americans,"" Biden told The Arizona Republic May 21. ""He took more than a month to allocate Congress’ emergency funding to tribes — and only did so after tribes sued. He has failed to provide tribes with adequate protective personal equipment and medical supplies. It’s unacceptable."" Indian treaty rights recognized and established rights, benefits, and conditions for tribes who agreed to cede millions of acres of land to the United States and to accept the United States’ protection. Under a ""trust responsibility"" legal principle, the United States federal government is obligated to ensure the survival and welfare of Indian tribes. Is Biden, the presumptive Democratic presidential nominee, right that it took more than a month for tribes to get funding allocated by Congress, and that it happened only after suing the Trump administration? The chronology lines up, but omits important context. The Treasury Department has argued that payments were delayed because it is required to consult with tribes and the Interior Department regarding how much money to allocate to tribes. That consultation process started before the lawsuit over the delay in payments. A separate lawsuit filed by tribes to prevent corporations in Alaska from receiving aid has also affected the process. Congress passed the Coronavirus Aid, Relief, and Economic Security Act, or CARES Act, and Trump signed it into law March 27. The $2.2 trillion measure included a $150 billion Coronavirus Relief Fund for states, local governments, and tribal governments. The law set aside $8 billion for tribal governments. The law said the Treasury secretary had to make the payments within 30 days; so by April 26, all entities were supposed to have received funds. It wasn’t until May 5 that the Treasury Department said it would begin making funds available to tribal governments. So that part of Biden’s claim adds up. By May 5, the Trump administration was facing several lawsuits by multiple tribes: for delay of payment. The lawsuits also challenged the administration for intending to direct some of the funds to the Alaska Native Corporations, which are regional and village corporations recognized under Alaska law and created by Congress as part of the Alaska Native Claims Settlement Act of 1971. In the lawsuit to stop the corporations from getting a share of the $8 billion, tribes argued that corporations do not meet the statutory definition of ""tribal government,"" or ""Indian tribe"" and therefore did not qualify for the relief. A federal district judge on April 27 issued a preliminary injunction to prevent the Treasury from giving money to the corporations. Pending a final determination, the judge did not direct the Treasury secretary to immediately disburse the entire $8 billion to the tribes. In its May 5 announcement, the Trump administration said it would begin paying tribes 60% of the $8 billion, or $4.8 billion, based on population data. The remaining 40% would be paid at ""a later date"" based on employment data and tribe expenses related to COVID-19. Amounts calculated for corporations would be held back ""until pending litigation relating to their eligibility is resolved."" The Navajo Nation, which joined tribes in the lawsuit, on May 5 said the judge’s April 27 ruling ""led to the (Treasury) Department’s announcement to begin distributing funds to federally-recognized tribes."" In a separate lawsuit over the delay in the disbursement of funds, lawyers for the Trump administration argued that providing funds to tribal governments required a more involved and difficult process than the one for states and local governments. While the CARES Act imposed a 30-day deadline for funds disbursement, it also called for a consultation process among tribes and the Treasury and Interior departments. According to the Trump administration, Treasury staff spent about 2,200 hours on efforts to get tribes the appropriated money. The same federal district judge from the corporations case said that those hours of labor ""arguably should have produced better results,"" but a court intervention was not warranted. ""‘Egregious’ delay is the governing standard, and the Secretary is not there quite yet, even in the midst of a public health crisis,"" U.S. District Court Judge Amit P. Mehta wrote in a May 11 opinion. Mehta did not find that the Treasury secretary was ""lagging unreasonably"" behind in delivering the funds. ""The Secretary has not been ‘twiddling his thumbs’,"" he said, citing language from a precedent. Mehta said he would not give the Treasury department a deadline for disbursing the rest of the funds, but if it took the department double the amount of time Congress directed for the disbursement, ""then the question of egregiousness becomes a closer one than it is today."" Biden said Trump ""took more than a month to allocate Congress’ emergency funding to tribes — and only did so after tribes sued."" It did take more than a month for tribes to begin receiving funds appropriated by Congress, and they began to flow after lawsuits were filed against the Trump administration. But a consultation process for disbursing the funds began before the administration was sued." Claim: Joe Biden Says President Donald Trump “took more than a month to allocate Congress’ emergency funding to tribes — and only did so after tribes sued.”

SOLUTION: 2

PROBLEM: Paragraph: There is also the revival of the humble foam roller, which experts say, like old-time push-ups, squats and planks, has never been more popular. Anita Golden, fitness manager at a Crunch gym in New York City, said she’ll be giving clients a foam roller called the GRID. “We’ve always had foam rollers in the club but now more people are using them as a way to ease post-workout muscles, prevent injuries and exercise the core,” Golden said. When it comes to big-ticket items, Colleen Logan of Icon Health and Fitness, which manufactures a number of fitness brands, said the treadmill remains the most popular gift. “Treadmills continue to lead the industry in terms of home fitness purchases,” said Logan. They account for about 57 percent of fitness purchases, while elliptical trainers and stationary bicycles are a distant second and third place at about 8 percent each. The average home treadmill costs about $700, said Logan, but the technology revolution has transformed even this stalwart at the high end. The ultimate splurge, at $4,000, she said, is the Boston Marathon Treadmill, which allows users to adjust speed in 1/10 of a mile per hour increments without touching the console. It also lets users run a virtual Boston Marathon. For people on a smaller budget, there is the iFit app that lets the iPhone capture a favorite vacation run or bike ride in Hawaii, store it in data centers all over the world which collectively are referred to as the “cloud,” and download it to an iFit-enabled treadmill at home. “You’ll view the exact route and experience the same terrain again,” Logan explained. Devices, gadgets and apps proliferate as tech-savvy fitness becomes more accessible, according to Jessica Matthews of the American Council on Exercise (ACE). “There’s a lot of interest in on-body monitoring devices as ways to motivate and track progress,” she said. “They run the gamut from basic devices to track hours, steps, and caloric expenditure to full-body tracking.”  Nike+ Sportsband has a series of small lights on the wrist band that change from red to green as the runner nears his goal, while the BodyMedia FIT Armband tracks everything from the number of calories burned to the quality and quantity of sleep. ACE also studied fitness DVDs released for the holidays. “We evaluated them for quality of instruction, safety, effectiveness and design of workout,” Matthews said. Among the best were “Amy Dixon’s Breathless Body Vol.2: The Edge.” Matthews called it a challenging cardio workout best suited to those on your list with “an established base of fitness.”  “Jessica Smith’s 10 Pounds Down Better Body Blast” also got a thumbs up for its well-rounded routine and clarity of instruction. For people seeking a mind-body approach, Matthews praised “STOTT Pilates Intense Body Blast: Pilates Interval Training: Level I,” which she said is accessible for someone new to fitness. “They do a great job queuing movements and creating flow,” she said. Richard Cotton of the American College of Sports Medicine suggests giving the fitness novice the gift of a personal trainer. “The best is human assistance,” he said. “Another way is a beginner group exercise class.”  He also suggests a gift certificate for shoes at a running store equipped with a treadmill. “You need shoes that fit your gait,” he said. “People should always get their gait analyzed.”  Golden likes to cite the law of reciprocity to the personal trainers she manages. “I always tell them to get their clients something,” she said. And what does the personal trainer want for Christmas? “I like the roller, or a new jump rope,” she said. “Fitness people aren’t hard to please. Get me a new yoga mat and I’m happy.” Claim: Holiday fitness gifts trend from high-tech to basic.

SOLUTION:
2

