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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Question: 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.

Answer: Brazil’s health minister resigns after one month on the job.


Question: Thirteen search warrants involving marijuana cultivation were served Monday by Riverside County sheriff’s deputies and state Department of Fish and Wildlife personnel in the unincorporated Aguanga area. In addition to the eradicated plants, 2,356 pounds of processed marijuana and 14 firearms were seized, the Sheriff″s Department said. One of the grows was using an extremely toxic pesticide that is banned in the United States, the department noted. “Marijuana cultivation negatively impacts the environment in many ways including diminishing and poisoning the water table and pesticides adversely affecting the health of neighboring residents,” the department said. Aguanga is about 55 miles (88.5 kilometers) north of San Diego.

Answer: Search warrants target illegal Southern California pot grows.


Question: The story does not say how much this new procedure costs or compare it with existing treatments for patients who don’t respond to medication. Deep brain stimulation, the current treatment standard, can run anywhere from $30,000 to $70,000, according to various online cost estimates. There also may be additional costs incurred by those patients who have adverse effects. The story is long on description but short on numbers. Saying the treatment “has had an immense impact on patients’ lives,” the story devotes quite a bit of print along with video footage to show rapid functional and quality-of-life improvements experienced by patients, focusing on one women who said her tremor “has almost disappeared” since she had the procedure in June. Video showing this patient before and after treatment–including her attempts to write her name, trace a spiral and pour water from one cup to another–do a great job of conveying the improvements. This is terrific news for this woman, but we’re not told how representative her experience is of overall outcomes. Is she a best-case scenario? Middle of the road? There are also inspiring quotes from a researcher, including a description of the “remarkable moment” patients experience when they realized the tremor has subsided. “They can write their names again, they can feed themselves, they are not embarrassed about being in public. So it really is extraordinarily helpful for people,” he says. In terms of study data, the story says researchers “found that the severity of essential tremor reduced significantly” in patients who underwent the treatment as well as reported improvements in quality of life. But there are no figures. In fact, according to the study, patients experienced a 47 percent improvement in tremor scores, dropping from 18.1 points on a 32-point scale at baseline to 9.6 points three months after the procedure. That data should have been included. Also, the story should have spelled out that 56 patients received the treatment, versus 20 who experienced a fake procedure. Also worth pointing out: We don’t know the meaning or clinical significance of a reduction of this magnitude in the total score. The story addresses adverse effects, and that’s sufficient for a Satisfactory rating. We do wish the story had quantified the harms that were measured in the study. The fourth paragraph says the procedure “brings lasting side effects in some patients” and later the story quotes a physician who is not involved in the research as saying, “It’s a pretty high incidence of side effects.” But nowhere do exact numbers appear. Rather than citing data from the study, the story quotes the physician as saying that “over a third of patients actually experienced either gait disturbance or paresthesia,” or numbness. This information isn’t very useful because the story does not explain when these rates were measured. According to the study, three months after the procedure 36% of patients had gait disturbance and 38% had numbness. After 12 months, the numbers dropped, to 9 percent and 14 percent respectively. Also worth mentioning is that one patient was reported to have permanent diminished sensation of the dominant thumb and index figure, which was categorized as a serious adverse event. That did not appear in the story. The story clearly spells out that there isn’t data on the long-term efficacy of this procedure, and that more study is needed, so we’ll give this a barely passing Satisfactory. Several important study limitations were not included in the story, such as the fact that the treatment did not provide significant improvement for some types of tremors, and the treatment is not appropriate for people who are unwilling or unable to undergo an MRI. We’re also not told that the sham group was only followed for 3 months, while the experimental group was followed for a year. This is not usually recommended in clinical trials and both groups should be followed for the same length of time. The story cites a figure from the International Essential Tremor Foundation, an advocacy group, that an estimated 10 million people in the United States suffer from the condition. However, a 2014 analysis of existing research put the number of cases at around 7 million as of 2012, or about 2.2% of the U.S. population. While this may not qualify as disease mongering, the story could have pointed out that the exact number of cases isn’t clear. Also, the story should have noted that not all people with essential tremor have symptoms severe enough to require treatment. The story only fulfills part of our criteria. It does use one independent source, a physician who was not involved in the study. It also accurately reports the trial’s funding sources: InSightec, which developed the device; along with Focused Ultrasound Foundation, which is funded by device makers and philanthropic organizations; and the Binational Industrial Research and Development Foundation, an Israel-U.S. government partnership that receives corporate support. However, the story falls short because it does not report the fact that nine of the study authors reported conflicts of interest, with most receiving financial compensation of some sort from device makers in the field. Lead researcher G. Rees Cosgrove, M.D. who is quoted in the story, reported receiving consulting fees from InSightec. The story states, “Doctors usually treat essential tremor with medication, but the drugs don’t work well for all patients.” That’s true, and so we’ll give this a Satisfactory rating for at least mentioning alternatives. But it should be noted that other procedural treatment options were not compared or even mentioned in the story and received only a brief mention in one of the videos. The current standard for tremor patients who don’t respond to medication is deep-brain stimulation, in which a probe connected to a pacemaker is implanted in the thalamus to suppress the tremors. Gamma Knife thalamotomy, which delivers precise doses of radiation to the thalamus, is also considered to be a safe and effective therapy for patients who don’t respond to medication. Also, some patients have mild symptoms that can be treated with relaxation techniques and the avoidance of triggers such as caffeine. The story states that the device was approved by the FDA in July. The story could have done readers a service by giving a sense of how many medical centers around the country are geared up to perform the procedure, or will be soon. This is indeed a new treatment option for essential tremor, though the story may leave readers with the false impression that the concept of killing off neurons in the thalamus is new. Rather, it’s the use of focused ultrasound to destroy brain tissue, rather than a probe inserted in the brain, that constitutes an advance. The story does not appear to rely solely on the news release, which we also reviewed.

Answer:
New treatment offers some hope for an unshakable tremor