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: In a study in the medical journal The Lancet, they said the patients, with strains of TB known as extensively-drug resistant (XDR) and totally drug resistant (TDR) TB, have exhausted all available treatment options and are sent home. “These patients can survive for months or even years and are contributing to the community-based spread of XDR-TB,” said Keertan Dheda, who led the study at the University of Cape Town’s department of medicine. Tuberculosis infects the lungs and can spread through coughing and sneezing. In recent years, drug-resistant strains have spread around the world, batting off standard antibiotics and posing an increasingly urgent public health threat. The World Health Organization (WHO) estimates that in Eastern Europe, Asia and South Africa, 450,000 people have MDR-TB, and around half of these will fail to respond to existing treatments. Dheda’s team followed 107 patients with XDR-TB from three provinces in South Africa between March 2008 and August 2012 to establish their fate. They also took samples from 56 patients and tested them to find out which and how many of 10 first- and second-line anti-TB drugs they were susceptible to. Despite being treated intensively with an average of eight anti-tuberculosis drugs, many of the patients fared poorly, with high rates of treatment failure and death. Five years after treatment initiation, only 12 of the patients had favorable outcomes and 74 percent had died. The researchers found that almost two-thirds of the tested patients had resistance to at least eight drugs, and there was one case of totally drug-resistant TB that was not susceptible to any of the 10 drugs tested. More worrisome, Dheda said, was that of the XDR-TB patients discharged into the general community, some 42 percent had failed to get better on treatment and were testing positive for active TB, and of these almost a third were at high risk of transmitting the disease. The patients also survived in the community for an average of 20 months - plenty of time to infect others. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. Another person needs to inhale only a few of these germs to become infected. “Alarmingly, we have shown for the first time that... treatment failure and discharge of such patients into the wider community is occurring systematically on a country-wide level in South Africa,” Dheda said in a statement about the findings. In one case where the researchers followed a genetic trail of transmission, they found that a patient with XDR-TB who was discharged after failing treatment went on to infect his brother, who also eventually died. Dheda said the reason many TB patients are being sent away from hospitals appeared to be lack of bed space in designated tuberculosis hospitals. “And alternative long-term residential and palliative care facilities are scarce.”  Commenting on the findings in The Lancet, Max O’Donnell from New York’s Albert Einstein College of Medicine in the United States said they should serve as an “urgent alarm”. “MDR-TB (multi-drug-resistant TB) in all its forms is an out-of-control problem with potentially vast and devastating consequences for global public health,” he wrote. “The situation regarding MDR and XDR-TB is bleak.”

A: South Africa risks spreading totally drug-resistant TB: study.
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Q: Democrats on a subcommittee of the House of Representatives Committee on Oversight and Reform released a cache of internal Juul emails and other documents that committee staff described as early attempts to “enter schools and convey its messaging directly to teenage children.”   Juul’s use of social media influencers to promote its vaping devices in the years after it launched in 2015 also came under scrutiny. James Monsees, Juul’s co-founder and chief product officer, told the committee that the company’s target audience from the beginning has been adult cigarette smokers. Among efforts cited in the Juul documents released were a $134,000 payment to set up a five-week “holistic health education” summer camp at a Maryland charter school, recruiting children from third through 12th grades, and offering $10,000 to schools using the company’s “youth prevention and education” programs for students, including those caught using e-cigarette products. “You don’t think that sounds strange at all?” Representative Katie Hill, a Democrat, asked Juul’s chief administrative officer, Ashley Gould. “All of these educational efforts were intended to keep youth from using the product,” Gould responded. When Juul realized how the school involvement could be perceived as negative, “we stopped the program,” she said. In a statement after the hearing, Juul said the $134,000 donation was to “facilitate already-existing community outreach and youth-prevention programs,” and said the company “did not have any direct interaction with the students.”  Several committee members said Juul’s initiatives appeared similar to past efforts by the tobacco industry to reach young people under the guise of smoking prevention programs. Gould said Juul, which is 35 percent owned by Marlboro maker Altria Group Inc (MO.N), halted its program last year once it became aware of the tobacco industry’s past moves. Caleb Mintz, 17, a New York city high school student, testified at a separate hearing on Wednesday that a Juul representative came to his school as part of an educational program on mental health and addiction last year. He said in an interview Thursday that students received “mixed messages” about the product, being told it was safe but not to buy it. Mintz said after the hearing that the Juul presentation seemed to be “playing to the side of teens as rebellious. When a teen is told not to do something, they’re more likely to do it.”    Members of the committee also quizzed Gould and Monsees over the use of social media influencers to promote Juul’s vaping devices. Company executives early on agreed that “younger consumers age 25 to 34 was going to be the target of our initial campaign,” Monsees said. “They would be more receptive to new technology solutions,” such as the Juul device. Amid an enormous uptick in teenage use of e-cigarettes in 2018 — a 78% increase among high school students from 2017 to 2018, according to federal data — Juul said it ended all social media advertising last fall. Juul also pulled many flavored nicotine pods, except mint, menthol and tobacco, from retail stores, which Monsees said represented more than half of the company’s sales at that time.

A: U.S. lawmakers grill e-cigarette maker Juul over efforts targeted at schoolchildren.
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Q: Invoking provisions of the state Riot Control Act, New Mexico Gov. Michelle Lujan Grisham ordered residents of Gallup to remain home except for emergencies and blocked roads leading in and out of town to nonessential travel and any vehicles carrying more than two people. The restrictions were welcomed by local and state officials who have watched COVID-19 infections spread to nursing homes and homeless populations as well as overwhelm hospital intensive care units, leading coronavirus patients to be transferred to Albuquerque. Some visitors were caught off guard as they traveled from the Navajo Nation to stack up on supplies, only to find entire sections of the Gallup Walmart cordoned off as sales were restricted to food and other essential commodities. “They didn’t tell us on the radio or anything,” said Patrick Sandoval of Ganado, Arizona, who came in search of food, games, baby wipes and other items for his family and neighbors. “You don’t find out until you get in there that it’s just essential items.” Despite restrictions, lines of shoppers outside Walmart stretched for hundreds of yards (meters) on Friday afternoon. Stores have been ordered to close under emergency provisions that expire at noon Monday and can be extended by order of the governor. Gallup is a hub for basic household supplies, liquor sales and water-container refills for people living in remote stretches of the Navajo Nation — often without full indoor plumbing — and indigenous Zuni Pueblo. The Navajo Nation has imposed evening and weekend curfews on the reservation spanning parts of New Mexico, Arizona and Utah. State Sen. George Munoz, D-Gallup, said the flow of visitors had gotten out of hand with little regard to state social distancing mandates, as federal stimulus checks arrived in March. He believes the crackdown had strong public support in Gallup. COVID-19 infections in Gallup and surrounding McKinley County surpassed 1,110 confirmed cases as of Saturday account for 30% of cases stateside, surpassing infections in much larger communities such as Albuquerque. In all, more than 3,730 cases have been reported in New Mexico as of Saturday, with at least 139 deaths. Federal health officials have linked the severity of the problem in Gallup to an early outbreak at a detox center that was followed by infections among homeless people and nursing homes. Homeless residents who contracted COVID-19 were being offered temporary shelter at four motels at the expense of the state to isolate them and slow the spread of the virus. Lujan Grisham is holding fast to business restrictions and social distancing mandates until at least May 15 in the northwest of the state, including large portions of the Navajo Nation, where infections are surging. She eased some restrictions Friday on nonessential businesses that can provide curbside service and allowed the reopening of gun shops and veterinary offices. Elective surgeries and procedures were reinstated at hospitals that resorted to furloughs and staff reductions as income from traditional sources plummeted. City officials in Gallup requested the new state of emergency under the riot act that can prohibit people from walking the streets and using certain roads. Violations are punishable as misdemeanors on a first offense and as a felony on the second offense. Emergency declarations under the act expire after three days and can be renewed. Gallup officials were correct to ask the governor to lock down the city because the influx of shoppers from the surrounding region makes it difficult to enforce social distancing, said David Conejo, CEO of Rehoboth McKinley Christian Health Care Services, which operates a Gallup hospital. Gallup’s hospitals send COVID-19 patients to Albuquerque hospitals to keep beds available locally for new patients, Conejo said. “We’re transferring and coordinating with them daily,” he said. “There’s a very structured system to address the COVID epidemic.” In addition to the Rehoboth McKinley’s hospital, the Indian Health Service has a hospital in Gallup where the Army Corps of Engineers recently set up a hospital in a closed Gallup high school. To the east, a pawn shop in Grants has been notified of a possible $60,000 fine for remaining open in defiance of a statewide public health order that restricted nonessential business operations. That city of 9,000 has become a flashpoint of political conflict after Mayor Martin Hicks urged all businesses to reopen against the governor’s orders and advice from nearby Acoma Pueblo. ___ Fonseca contributed from Flagstaff, Arizona. Associated Press reporter Paul Davenport contributed from Phoenix.

A:
New Mexico takes more drastic measures against virus hotspot.
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