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.

[Q]: A University of Iowa study shows the state’s contribution to the Gulf dead zone spiked 47 percent to 618 million pounds in 2016, based on five-year running annual averages. “Just based on water quality data, I think we can say we’ve not made much progress over the past 20 years in terms of nitrogen,” said Chris Jones, a research engineer at the UI’s IIHR-Hydroscience & Engineering. Environmentalists say the study raises new questions about the effectiveness of Iowa’s approach to improving water quality and its reliance on voluntary ag compliance. “We’ve been pouring state and federal money into cutting nutrient pollution for decades, and this highlights the fact that the voluntary approach is not working,” said Jennifer Terry, executive director of the Iowa Environmental Council. “We’re not headed in the right direction. ... We need to follow the lead of other states and pass some environmental laws that will actually reduce loads and result in cleaner water,” Terry said. The Des Moines Register reports that the news comes as Iowa marks the five-year anniversary of the Iowa Nutrient Reduction Strategy, a plan designed to cut by 45 percent the nitrogen and phosphorus levels that leave Iowa and feed Gulf hypoxia — or the dead zone. Oxygen levels within the zone are so low that marine life can no longer survive, threatening the Gulf’s seafood industry. Most of the nutrient losses come from farming, although the strategy also targets losses from urban wastewater and industrial operations. Last year, Iowa invested $420 million in those water quality improvements, including helping farmers plant cover crops, build terraces and tackle other conservation practices that hold nutrients in place. But farmers expanding their drainage tile systems — along with increasing hog, cattle and chicken feeding operations, which provide manure to fertilize crops — likely outweigh those conservation efforts, UI scientists say. The nutrient reduction practices “being implemented are a tiny, tiny portion of what needs to be done, and it’s occurring in a system that’s changing,” Jones said. “We appreciate all that is being done with nutrient management and conservation farming. Unfortunately, we’re just impacting too few acres with too few practices,” added Larry Weber, executive associate dean for UI’s College of Engineering. Jones wrote the study with Weber and Keith Schilling, another UI research engineer. Increased nutrient pollution in water creates problems for people and animals beyond the dead zone. High phosphorus levels can lead to toxic algae blooms that can befoul lakes, rivers and streams, potentially killing pets and making people ill. And the federal government limits the amount of nitrates in drinking water to 10 milligrams per liter. Higher levels can be fatal to babies under 6 months old. Increased levels translate to higher costs for utilities for nitrate removal. “We need a dramatic increase, a rapidly-scaled up increase in conservation practices and more funding,” said Cindy Lane, the Iowa Environmental Council’s water program director. Schilling said the study shows that targeting nutrient reduction investment in Iowa can have a significant impact downstream. “Iowa has a dominant role in this Gulf hypoxia issue,” Schilling said. “Let’s invest the resources here, where we really need it. “If we solve Iowa, we solve the Gulf,” he said. The UI study gives Iowans new information in the fight to reduce the nitrogen levels that flow from the state into the Mississippi and Missouri rivers, which make their way to the Gulf of Mexico. Looking at Iowa Department of Natural Resources data from 23 monitoring stations, the study shows Iowa on average over the past 18 years contributed 29 percent of the total nitrogen headed to the Gulf from the Mississippi-Atchafalaya river basin. The river basin is a massive watershed that includes all or part of 31 states. Iowa’s nitrogen impact was even greater in other watersheds. The state averaged 45 percent of the nitrogen levels going into the Upper Mississippi River basin, and 55 percent of the nitrogen going into to the Missouri River basin. “When you look at the entire Missouri (River) watershed, our land comprises 3.3 percent of the total area ... and Iowa contributes nearly 12 percent of the water,” Jones said. But “we contribute 55 percent of the nitrate,” he said. “The way that pencils out is that the amount of water coming from Iowa has seven times more nitrates than the rest of the Missouri River watershed,” Jones said. If Iowa’s contributions were removed, the Missouri River would have little nitrogen contributions in some years. “We really need to take seriously the Missouri River’s contribution as a driver for Gulf hypoxia,” Jones said. The growing concentration of livestock feeding operations in western Iowa might account for Iowa’s large contribution to the Missouri River nitrate levels, the scientists said. “People tend to dismiss livestock influences, but maybe there’s more to it than people give credit it for,” Schilling said, adding that it would require more study to determine the impact. Iowa’s nitrogen levels, based on running five-year annual averages, have been above the 2003 value for 10 consecutive years, the study says. The scientists say 2003 was the first year the five-year rolling average could be calculated, with data that starts in 1999. The goal of the Gulf Hypoxia Task Force, made up of federal, state and tribal leaders, “will be very difficult to achieve if nitrate retention cannot be improved in Iowa,” the report said. The task force, with Iowa Agriculture Secretary Mike Naig as chairman, seeks to reduce the dead zone to 1,900 square miles by 2035. The deadline was extended from 2015. Last year, the dead zone set a record, which, at 8,776 square miles, was more than four times the goal size. The report says about 90 percent of Iowa’s nitrogen levels “can be sourced to the 72 percent of the state’s land area that is in crop cultivation.” Iowa, an agriculture powerhouse, is a national leader in corn, soybean, pork, egg and beef production. “This intense production of carbohydrates and protein has resulted in the state being a leading contributor” to the nitrogen loads and Gulf hypoxia, the report said. Naig said farmers understand the important role they play in improving water quality and are scaling up efforts across the state “as we move from demonstration projects to larger, watershed-scale implementation projects. “We recognize that there is still a lot of work to be done, but we are on the right path,” said Naig, who adds farmers are working with more than 250 partners in 65 rural and urban demonstration projects. The UI scientists doubt that increased cropping is the reason for the increased nitrogen impact. Iowa’s cropped area has increased only 4 percent over the past 18 years, while other states’ farmed land has climbed 21 percent, particularly in Minnesota, North and South Dakota and Kansas. About 85 percent of Iowa’s acres are farmed, making it the fifth-highest in the nation, based on the 2012 U.S. Agriculture Census, so there are few acres left that can be brought into production compared with other states. “Iowa’s decline in the share of the region’s soybean area was especially pronounced, dropping from 18.6 percent in 1999 to 14.5 percent in 2016,” the report said. “One would expect our (nitrogen) contributions relative to the other areas would be diminished,” Jones said. “But the opposite has occurred.” Jones said it’s led the scientists to consider other factors. The scientists doubt that Iowa farmers are using significantly more fertilizer. “When we look at nitrogen sales data, it might change a little year over year. But on a per acre basis, that hasn’t changed a lot since 1990,” he said. And with little increase in corn and soybean acres, the scientists speculate that Iowa’s increased nitrogen levels could be coming from more drainage tiles. Or farmers could be using more manure as fertilizer from animal feeding operations. Without Iowa, the Gulf’s overall nitrate loads would have declined 43,400 tons over 18 years, based on five-year running annual averages, the scientists’ data show. Instead nitrate loads grew by 52,000 tons. “It’s pretty clear these loads from the Ohio basin have to be declining,” Jones said. “A lot that is coming from Indiana.” That state’s high level of cover crop adoption by farmers could be the reason, he said, and should be studied. Cover crops such as cereal rye slow the rate of water runoff, reduce erosion and improve soil fertility. Iowa also needs to honestly discuss the impact that drainage tiling has on nitrogen losses, Jones said. Iowa doesn’t collect data on how much underground drainage runs through the state, although officials estimate about 9 million acres are drained through tile. Environmentalists believe the number is much higher. Underground drainage tile helps improve yields by quickly removing excess water from fields. Iowa’s tiling system consists of a network of drainage lines that feed into large pipes. The massive network, first constructed in the 1920s, ’30s and ’40s, turned once swampy lands into some of the nation’s most productive farmland. But water quickly carried away by the tiling system misses cleansing that would naturally occur by filtering through soil or the roots of trees, shrubs and grasses in riparian buffers along streams. Des Moines Water Works unsuccessfully sued drainage districts in three north Iowa counties in 2015, claiming underground tiles funneled high levels of nitrates into the Raccoon River, a source of drinking water for 500,000 central Iowa residents. “We acknowledge that it’s important to track implemented conservation, and we encourage that,” Jones said. “But we also need to have the courage to talk about these things that drive the system in the other direction.” Terry said Iowa is “one of the most heavily tiled states in the nation,” and its 110-year-old law regulating the practice does little to protect water quality. ___ Information from: The Des Moines Register, http://www.desmoinesregister.com
[A]: Study: Iowa nitrogen pollution in the water is getting worse.


[Q]: On 5 December 2018, the Seattle Times published an article whose terrifying headline ensured its own virality: “Rare brain-eating amoebas killed Seattle woman who rinsed her sinuses with tap water. Doctor warns this could happen again.” Sadly for those who visited this page hoping to find that the reporting was exaggerated or made-up, this really happened. Though her anonymity was maintained, the story of a 69-year-old Seattle woman who used tap water in her Neti pot for over a year and then died from a Balamuthia mandrillaris brain infection was documented in a 20 September 2018 case study published in the International Journal of Infectious Diseases: We report the case of a 69-year-old female who presented with a chronic nasal skin rash, new onset focal seizure, and a cerebral ring-enhancing lesion after a year of improper nasal irrigation. Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection. One year before developing the brain infection, the authors reported, the woman developed a chronic sinus infection whose symptoms were not relieved by medication. She turned to using a Neti pot to rinse her sinuses, but instead of using sterile or saline water as directed, she used tap water filtered with a Brita system. After a month of this practice, and without any relief of her sinus symptoms, “she developed a quarter-sized, red raised rash on the right side of the bridge of her nose and raw red skin at the nasal opening.” Though several misdiagnoses followed, no doctor correctly recognized the rash as a symptom of an amoebic infection. The report stated that a year after that initial rash developed, the woman developed a seizure that required hospitalization. At that time, the doctors identified a lesion on the right side of the brain which they decided to biopsy. Some 19 days later, after a continued decline in the patient’s health, scientists from Johns Hopkins University suggested the possibility that the cause of her malady was an amoebic infection, and the Centers for Disease Control rushed a novel drug for her treatment. Unfortunately, they were unable to halt the progression of the disease, and the patient’s family made the decision to remove her from life support. An autopsy determined the cause of death to be Granulomatous Amebic Encephalitis (GAE), which the CDC defines as “a serious infection of the brain and spinal cord that typically occurs in persons with a compromised immune system.” In this case, the causative agent was an extremely rare amoeba named Balamuthia mandrillaris, one of three forms of amoeba known to be capable of infecting and consuming the human brain. Amoebas are a broad group of taxonomically mixed unicellular organisms that consume surrounding cellular material through absorption, and that express an ability to take on a variety of shapes. Several different species are associated with disease, most notably Naegleria fowleri, commonly known as the “brain-eating amoeba” that can cause a different kind of brain infection called primary amebic meningoencephalitis (PAM). Balamuthia mandrillaris was discovered in 1986 in the brain of a mandrill monkey during an autopsy at the San Diego Zoo and is now recognized to be a cause of GAE in both humans, several primates, and other animals, with an estimated 200 cases of human infection ever documented. The amoebae are ubiquitous in soil and groundwater although their presence is not expected in city-treated water, according to Liz Coleman, a spokeswoman for the Environmental Public Health division of Washington State’s Department of Health, quoted in the Seattle Times’ reporting. Merely ingesting the thing will not lead to health problems, but in rare cases (usually instances involving people with weakened immune systems, or those who are young or old), the organisms can infect a host through skin breakage or via the respiratory system. If they infect the central nervous system, they “ingest bits and pieces of host tissue [and produce] enzymes that degrade the tissue.” Nasal irrigation involves rinsing one’s sinus cavity with distilled or sterile water (or water that has been filtered to remove potentially infectious organisms), and one such method of water delivery is a Neti pot. The need for sterility is explicitly stated due to the (extremely small) risk posed by another amoeba, Naegleria fowleri, and it is the reason the FDA requires (in the absence of sterile water) a specific kind of filter capable of removing the amoeba and similarly-sized organisms from water before it is pushed through fragile sinus tissue. While the authors of this case report could not state with absolute certainty that the Neti pot was to blame, it is far and away the most likely explanation given the fact that the patient had been rinsing her sinuses with tap water regularly for an extended period of time: While it is recommended that only sterile water or saline be used … the patient used tap water that was filtered with a Brita Water Purifier … Improper nasal irrigation has been reported as a method of infection for the comparably insidious amoeba, N. fowleri. This precedent led us to suspect the same route of entry for the Balamuthia amoeba in our case. Although this hypothesis is consistent with the patient’s history and ultimate diagnosis, the water supply to the patient’s home was not tested, hence our ability to definitively trace the patient’s infection to improper nasal lavage is limited. Other routes of exposure are possible, according to a 2013 review of amoebic infections: Epidemiology of Balamuthia GAE is not well understood. However, based on several case reports it can be hypothesized that gardening, playing with dirt, or exposure to dust while motorcycling may play significant roles in the acquisition of Balamuthia infection. It has been shown that Balamuthia is found in the soil and dust in air and the route of infection is probably via inhalation of Balamuthia either present in soil or carried by the wind or the amebae entering the body through a cut or puncture. Once it gains entry into the body it is likely to spread hematogenously to the brain. Additionally, there is some indication that water may serve as a vehicle for acquiring the infection. Although the water used in the Neti pot likely caused this infection, Dr. Cynthia Maree, a co-author of the report and a member of the team that treated the woman in question, told the Seattle Times that “the risk of infection to the brain is extremely low,” adding that “people who use neti pots or other nasal-irrigation devices can nearly eliminate [that risk] by following directions printed on the devices, including using only saline or sterilized water.”
[A]: A woman who rinsed her nasal passages using a neti pot filled with tap water contracted a fatal “brain-eating” amoeba infection.


[Q]: Three children who were in the airport that day tested positive for the highly contagious disease after traveling to a country where there was an outbreak, officials said. Health officials don’t consider this an outbreak because the children are related, the Tri-County Health Department said in a statement. But they are warning people who were in the airport between 1:15 p.m. and 5:45 p.m. on Dec. 11 that they may have been exposed. It’s unclear how many people came in contact with the children. About 179,000 people passed through the airport that day, spokeswoman Emily Williams told The Denver Post. Health officials are also notifying people who were at the Children’s Hospital Colorado’s Anschutz Emergency Department between 1 and 7:30 p.m. Dec. 12. “We’re doing this investigation for a reason, and that reason is precisely to prevent secondary spread — and having a non-ideal vaccination rate in Colorado isn’t helping matters,” said Dr. Bernadette Albanese, a medical epidemiologist. Colorado’s immunization rate for the measles, mumps and rubella vaccination was 87.4% last school year, which is below the threshold needed to protect a community from a measles outbreak. The three children who tested positive had not been vaccinated, officials said. There is no ongoing risk of exposure at the two locations.
[A]:
Health officials warn of measles exposure at Denver airport.