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: "The article states that the costs are “generally … close to $45,000.” The news story notes in a sentence that hip replacement has a success rate of more than 90%, and defines “success” as “relatively pain-free mobility.” The article also clearly states why this new device was developed — to provide longer lifetime use prior to device failure. It quantifies this benefit vaguely, saying the device is ""much more durable"" and lasts ""much longer."" The news story focuses on one main harm—squeaking in hip implants made of ceramic—and provides estimates of its prevalence. A spokesperson for the hip maker points out that hip replacement has other potential risks as well, including infection, dislocation, and leg-length discrepancy. The news story makes it fairly clear that the research it is citing is from cohort studies. The first mention of the prevalence of squeaking in ceramic hip implants appears to cite the highest known estimate—7% of ceramic implants in one study of 143 patients. Only later do readers discover that other studies suggest the prevalence of the problem may be much smaller, from 3% (in a study of 1500 people) to less than 1%. This is not disease mongering, but it could cause some people to fear ceramic hip implants more than may be justified. In addition, the Times article says no squeaking occurred in patients with metal and plastic implants. But a recent 2007 review in the Journal of Bone & Joint Surgery (JBJS) reported that squeaking in similar implants made out of metal and plastic occurred in 4% of patients. (JBJS 2007;89:1874-85) If the JBJS review is accurate, the news story would be misleading. Unfortunately, the JBJS failed to support its own contention with a complete reference. The story cites 4 patients, 4 surgeons, a spokesperson for implant maker Stryker, and a lawyer representing aggrieved patients. All in all, they provide a balance of viewpoints. The story mentions a conflict of interest for one surgeon. It appears that 2 of the patients are clients of the lawyer. The story points out that the alternatives to a ceramic total hip replacement include hip replacements with implants made from metal and plastic. It doesn’t mention whether there are nonsurgical alternatives to hip replacement, but this is beyond the scope of the story. The story does not explicitly state that ceramic hip replacements are approved by the FDA, but with “tens of thousands” implanted, it’s clear that surgeons’ adoption of the devices is widespread. The FDA’s warning to implant maker Stryker about squeaking suggests the devices may not be perfect, but are approved. The story notes that Stryker introduced ceramic hip implants into the U.S. in 2003. The story cites several sources and does not appear to rely solely or largely on a news release."

Answer: That Must Be Bob. I Hear His New Hip Squeaking.


Question: Hookah smoking among Californians jumped more than 40 percent between 2005 and 2008, said Dr. Ron Chapman, the state director of public health, citing a 2011 state tobacco survey published in the American Journal of Public Health. He said the trend was particularly pronounced among college-age adults, with nearly a quarter of men 18 to 24 years old reporting they had used a hookah at least once, according to the same study. Experts say the growing popularity of hookahs has been fueled in part by a perception that the water pipes are more socially acceptable than cigarettes and the erroneous belief that inhaling tobacco smoke drawn through the water filters out some of its toxins. But smoke from hookah tobacco — which comes in such flavors as apple, strawberry, honey and mint — retains all the carcinogens of cigarette smoke while adding more carbon monoxide and extra carcinogens from the use of burning coals that are used to keep the nicotine flowing, health officials say. During a typical hour-long session, a hookah user inhales 100 to 200 times the volume of smoke inhaled from a single cigarette, according to the U.S. Centers for Disease Control and Prevention. “There is a very, very concerning misperception about the use of hookahs among youth, thinking it’s somehow safer. In fact, it puts you at the same risk,” Chapman said. The warning came as Chapman announced an anti-smoking advertising campaign aimed at those most likely to light up - low-income, minority youth, especially African-Americans. While California has in many ways led the nation in discouraging smoking, “tobacco use is still the No. 1 cause of death and disease in California,” he said. Tobacco kills nearly 34,000 Californians a year and leads to annual healthcare costs of $6.5 billion, or $400 for each state taxpayer, he said. Although pubs and restaurants in California have banned smoking since 1998, hookah bars and cafes are permitted under exemptions for owner-operated tobacco shops or other businesses where no food or beverages are sold without employees or staff, said Corey Egel, a state public health department spokesman. The growing popularity of hookahs among young adults in California mirrors a broader trend nationwide. A study in May by the University of Pittsburgh School of Medicine of 152 universities nationwide found that over 30 percent of students had smoked tobacco from a hookah during the previous month. Hookah smoking, which originated in Persia and India, has seen a resurgence in Middle Eastern countries and elsewhere, too, with water pipes referred to as narguila in Syria, Lebanon and Turkey and as sheesha in Egypt.

Answer: California health officials sound alarm over hookah smoking.


Question: Despite a 25-year-old international ban on most international elephant ivory trade, poachers are illegally slaughtering elephants by the thousands for their tusks and wildlife advocates blame the remaining ivory trade. In the United States, regulations against trading in ivory are tightening. The state of New York has adopted a near total ban and the Obama administration is tightening federal rules. This is unfair, say people like Defrin, whose gallery sells costly figurines, vases and other ivory curios. Such antiques contain ivory taken from elephants in the distant past, sometimes centuries ago, and should not be subject to sales restrictions, they say. Defrin said regulations already in place have damaged his business, drying up European demand for his goods and restricting import of ivory. “They’ve basically ruined the collective antique trade,” he said. “Is this really something that will stop poor African people from killing elephants?”  Yes, say wildlife advocates and regulators. They say an “antique loophole” in existing rules sometimes allows new ivory to be disguised as old, fueling global demand for tusks and keeping illegal poaching profitable. “This poaching crisis in Africa is being driven by demand for ivory,” said Laura Noguchi, a biologist with the U.S. Fish and Wildlife Service. With the U.S. Congress back this month after a summer break, a fight over ivory trade regulation is taking shape. It will not be a top priority for lawmakers faced with other urgent decisions. But it may get attention due to the involvement of the National Rifle Association. One of Washington’s most powerful special interest groups, the NRA is advocating for the interests of gun enthusiasts with ivory-decorated weapons. Alaska’s Don Young and California’s Ken Calvert, both Republican representatives, are offering legislation to soften  Obama administration restrictions issued over the last year. “The administration’s ivory rule is well-intentioned, but was not crafted carefully enough to account for law-abiding Americans who may possess legally obtained products containing ivory,” Calvert told Reuters in a statement. Ivory has been used for hundreds of years in manufacturing items such as the tips of bows for stringed instruments, piano keys, decorative items for the home, and importantly, for ornamental inlays in rifle and shotgun stocks and handgun grips. Even though the ivory trade is largely curbed globally under the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), an estimated 100,000 African elephants were killed by poachers between 2010 and 2012, according to a study last year by the National Academy of Sciences. Much of the demand for ivory comes from Asia. In China, a growing affluent class has increasingly sought ivory as an ornamental item. Some experts have reported that speculators in eastern Asia are stockpiling raw ivory, hoping it will fetch higher prices in the future. The U.S. Fish and Wildlife Service, which regulates ivory sales on a federal level, said the United States is a “significant market” for ivory, though it had no detailed estimates for ivory trading in the country. The agency issued a director’s order last year prohibiting commercial import of all ivory, without exception, and clarified other limits on ivory exports. The agency followed up that order with a proposal in July that would further limit exports of ivory to legally qualified antiques. The proposal would offer an exemption allowing the sale of certain manufactured items that contain less than 200 grams (7 ounces) of ivory, a move the service said should include most firearms and musical instruments. New York state outlawed the sale of ivory last year, offering exceptions only for items proven to be antique and containing only a small amount of ivory. Earlier this month, California’s legislature approved a similar measure. Just how much new illegal ivory may be “laundered” as antique is unclear. A study of ivory for sale in Los Angeles in 2014 commissioned by the Natural Resources Defense Council, an environmental group, found that up to 90 percent of the ivory surveyed may have been illegal under California law, and as much as 60 percent may have been prohibited under federal law. The study’s author, Daniel Stiles, cautioned that determining the age of ivory by visual examination is subjective. The only way to firmly date ivory is based on carbon dating and DNA tests, which are costly and require cutting into the ivory. Wildlife groups have applauded the Obama administration’s actions and are seeking more bans at the state level on even the sale of antique ivory similar to New York’s statute. “The more we can eliminate legal markets in ivory, the more difficult it becomes to sell ivory illegally,” said Andrew Wetzler, director of the wildlife program for the Natural Resources Defense Council.

Answer:
Push to save African elephants stirs U.S. clash over antique ivory trade.