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: The idea that the domestic dog descended from the grey wolf was originally established in 1993 using comparisons of wolf and dog mitochondrial DNA. This investigation showed that no other living animal was more closely related to the domestic dog than the grey wolf: “The domestic dog is an extremely close relative of the grey wolf, differing from it by at most 0.2% of [mitochondrial DNA].” Mitochondrial DNA is passed down by the mother (without any genetic contribution from the father) and changes only through random mutations that occur from generation to generation. Scientists use this much smaller and separate DNA sequence to estimate when populations of animals first diverged and to estimate the evolutionary relationships between organisms. By the mid-2000s, new technology allowed scientists to map the much longer DNA sequence found on the chromosomes of wolves and dogs — the genes that actually code for physical traits and behaviors. These studies demonstrated a 99.9% similarity (technically 99.96%) between dog and grey wolf, as covered in a 2007 review paper on the topic: In general, the domestic dog is an extremely close relative of the grey wolf, from which it differs by only ~0.04% in nuclear coding-DNA sequence, and no dog [mitochondrial DNA] sequences have been found that show closer kinship to other canid species. This similarity is so profound that hybridization often occurs between dogs and wolves. By the biological definition of species, this would mean that the domestic dog is a subspecies of the grey wolf (canis lupus familiaris). There remains some debate, however, as to what the appropriate classification for the domestic dog would be, with some arguing that the domestic dog should be its own distinct species (canis familiaris). Claim: Dogs and wolves are genetically 99.9% identical.
[EX A]: These advances in genetic analysis have allowed scientists as well to pin down the probable timing of the split between these two canid lineages. A study published in 2015, which compared the whole genome sequence of dogs to a 35,000 year old Siberian wolf specimen, suggested the split likely occurred between 27,000 and 40,000 years ago, and that domestic dogs are likely themselves the descendants of a now extinct descendant of grey wolves.

[EX Q]: Paragraph: The story focused on costs, including information about the relative cost comparison between what are called “open” surgeries and those done laparoscopically (with a thin flexible tube.) The release summarized how minimally invasive techniques reduced the length of hospital stay and complication rates for patients. “Researchers also found that, on average, the minimally invasive approach reduced length of hospital stay by approximately two days, and open operations were more than $9,000 more expensive than minimally invasive procedures. The researchers also found that laparoscopic procedures were better for patients in terms of fewer complications. Laparoscopic anti-reflux operations were less likely to result in postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” We rate this, but just barely, for citing cost differences between the two types of surgery and the average reduction in the number of days a patient must remain hospitalized. We do wish the release had delved more into the specifics of reduced complications. How common were the surgical complications in each surgical method? The release names complications associated with both types of surgery for GERD, while stating that patients undergoing laparoscopic procedures encountered fewer of them: “postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” The news release gave details about how the study examined records of about 75,000 patients from 1,000 hospitals to compare outcomes in the records for open vs. the minimally invasive laparoscopic surgeries. That’s all to the good. However, the news release didn’t mention any of the study’s limitations. The key one is that this is a retrospective, observational review of records that isn’t capable of supporting cause and effect statements such as the minimally invasive approach “reduced length of hospital stay by approximately two days.” Nor should this kind of evidence be used as the basis for statements such as laparoscopic procedures “were better for patients” and “should be the standard of care.” Patients receiving open vs. laparascopic procedures could differ in unknown ways, which is why the superiority of one approach over the other should ideally be established by a prospective, randomized controlled trial. There were other limitations outlined in the journal article that were not mentioned in the release. Because the NIS database doesn’t link to hospital records, researchers weren’t able to track and measure outcomes “including complications, readmission, and mortality, occurring after the initial hospital discharge.” The researchers were also unable to determine which open surgeries were “re-dos” of previous surgeries. The potential for errors in coding which procedures were used was also cited as a possible limitation. There was no disease mongering. The release also provided useful context on the prevalence of GERD and further specified that smaller group of patients, from the many heartburn suffers, might be candidates for the surgery. Well done. The release does not list any funding source for the research and the published study notes that authors had “nothing to disclose.”  We’ll rate this not applicable since this is an examination of existing data, and there may have been no additional outside funding. The news release does a good job here. It compares different surgical methods and it also names alternatives for treating GERD such as medications and changes in the diet. It also states which group of patients the surgery is aimed at: “Anti-reflux surgery should be considered in patients who do not achieve complete control of their symptoms [regurgitation or cough] with medications; who do not want to take medications for the rest of their lives; or who experience complications of medical therapy.” It’s clear from the release that both methods of surgery have been widely available nationally and the outcomes of 75,000 surgeries were tracked by the National Inpatient Sample (NIS) database. The release also notes that “urban academic or teaching hospitals” perform laparoscopic anti-reflux surgery more often than “open” procedures, 54.4 percent versus 45.6 percent. And it recommends that anti-reflux surgery should be performed laparoscopically in specialized centers. The news release was not about a novel procedure and made no claim of novelty. However, this isn’t the first study to examine laparoscopic vs. open surgery. For example, the British Journal of Surgery published results of a randomized trial of the two methods and the Scandinavian Journal of Gastroenterology published research on long-term outcomes following laparoscopic and open procedures for GERD. We did not observe any unjustifiable language. Claim: Laparoscopic anti-reflux operation for GERD linked to fewer postoperative complications
[EX A]: A new study by the American College of Surgeons, a professional organization, compared records for 75,000 patients who underwent surgery for GERD, or gastrointestinal esophageal reflux disease. The study looked at two different surgical procedures and found the less invasive one seemed equally effective, but kept patients in the hospital a shorter time with fewer complications. The news release did a good job of discussing surgical alternatives and costs, which were estimated to be $9,000 lower for the less invasive laparoscopic procedure. The release would have been better had it spelled out some of the study limitations, the key one being that a retrospective, observational review of hospital records — as this study was — isn’t capable of supporting the cause and effect statements sprinkled throughout the release. Millions of Americans complain of occasional heartburn, sometimes called a burning sensation in the throat from food coming back up from the stomach. But some estimates are that about 20 percent of US adults fit the definition of GERD, which means they suffer symptoms at least every week. If patients consider a surgical fix, this study shows that a less-invasive procedure could reduce their complications and shorten their hospital stay. It’s hard to pin down stats on GERD prevalence. A 2014 review of 16 epidemiological studies of GERD prevalence published in the journal Gut suggest GERD prevalence ranges from “18.1%-27.8% in North America, 8.8%-25.9% in Europe, 2.5%-7.8% in East Asia, 8.7%-33.1% in the Middle East, 11.6% in Australia and 23.0% in South America.”

[EX Q]: Paragraph: The decision by Cleveland County District Judge Thad Balkman in Norman, Oklahoma, came in the first case to go to trial out of 2,700 nationally by states, counties and cities seeking to hold drug companies responsible for the deadly epidemic. Balkman reduced the amount he had awarded in August by $107 million after agreeing with New Brunswick, New Jersey-based J&J that he had made a math error. J&J said it will appeal, and that the award and finding of liability were “neither supported by the facts nor the law.”  A spokesman for Oklahoma Attorney General Mike Hunter said that office is reviewing the decision and will formally respond within the next few days. Opioids were involved in almost 400,000 overdose deaths from 1999 to 2017, according to the U.S. Centers for Disease Control and Prevention. Following a non-jury trial, Balkman ruled in August that Oklahoma had proven that J&J engaged in misleading marketing about the benefits of painkillers, and that their addictive risks caused a public nuisance in the form of the opioid crisis. Hunter had sought to have J&J pay $17 billion to help fund addiction treatment and other services to repair damage from the opioid epidemic over the next 30 years. Balkman, however, awarded only enough money for one year of programs, saying Oklahoma failed to support its claims regarding the need to abate the epidemic in future years. Following the August ruling, Oklahoma asked Balkman for permission to return to his courtroom annually to prove those costs, but Balkman on Friday maintained his prior ruling. J&J, meanwhile, argued that it deserved a $355 million credit, reflecting pre-trial settlements by the drugmakers Purdue Pharma LP and Teva Pharmaceutical Industries Ltd.  Balkman concluded on Friday that state law did not allow such credits. Last month, J&J and four other companies proposed a $48 billion settlement framework to resolve all of the opioid cases they face, with J&J paying $4 billion. Lawyers for the local governments have opposed the proposal. If approved, the settlement would let J&J resolve some of the thousands of product liability lawsuits it faces. The company also faces litigation over whether its baby powder causes cancer, a claim it denies. Claim: I helped win one of the biggest private lawsuits against Medicare fraud in history. The government declined to pursue the case, so my firm did, and we recovered $324 million for taxpayers.
[EX A]:
An Oklahoma judge on Friday said Johnson & Johnson must pay that state $465 million for fueling the opioid epidemic through the deceptive marketing of painkillers, down from his original award of $572 million.

