instruction:
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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The St. Louis Post-Dispatch reports that the Missouri Department of Health and Senior Services awarded a no-bid contract to the Missouri Primary Care Association. The agreement will pay the organization $125,000 a year to focus on getting more adolescents to receive at least five vaccines, including influenza, hepatitis A and HPV. Contract talks began before health officials warned last week that a hepatitis A outbreak in the state could grow worse if it spreads to urban areas. Health officials say the state has recorded 414 cases of the virus since September 2017. In previous years, only about 10 cases were reported annually.
answer:
State awards contract to boost hepatitis A vaccination rate.


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According to the story, brand-name aromatase inhibitors cost between $340 and $420 a month, but the story also points out that lower-costing, generic versions are available in the U.S. It would have been useful had the story also provided cost information for the other preventive drug options, tamoxifen and raloxifene. A particular strength of this story is its presentation of data. Dr. Winer, an independent source included in the story, translates a 65% risk reduction to mean that exemestane may reduce a woman’s risk of developing breast cancer from 3% to 1%. Not only does the story provide absolute risk, but it also presents the number needed to treat. According to the study authors, 26 women would need to take exemestane for five years to prevent a single case of breast cancer. It should be noted, however, that few women in the study completed five years of therapy. Since this is being used as a preventive measure in healthy women, side effects are very important and data should have been provided. The story indicates that “slightly” more women taking exemastane experienced hot flashes, fatigue, sweating, insomnia, and joint pain, compared to those taking placebo pills. It would have been helpful to note, for example, that 40% in the exemestane group experienced a hot flash versus 32% in the placebo group. Citing older research, the story indicates that that joint pain, muscle aches, problems having sex, and vaginal dryness may be more evident with a longer duration of use. The story makes it clear that the study was a large-scale, placebo-controlled, randomized trial, which enrolled over 4500 women in North America and Europe. The women included had at least one risk factor for breast cancer. It also notes that given the significant risk reduction associated with exemestane, the study was stopped after 3 years to give women in the control arm the option of taking exemestane to prevent possible breast cancers. More information regarding participants’ characteristics, including age and race would have been helpful. This story did not engage in disease-mongering. In addition to including experts not affiliated with the exemestane study, the story also notes that the it was funded by the Canadian Cancer Society, the Avon Foundation, and Pfizer. In addition, the writer points out that the study lead and a few other authors have received speaking fees from Pfizer and other pharmaceutical companies that make cancer drugs. This story compares the benefits and harms of exemestane with tamoxifen; however, a mention of how these compare with raloxifene, would have been useful. The availability of aromatase inhibitors is not in question. It’s clear from the story that aromatase inhibitors are currently used to prevent breast cancer recurrences. It’s also clear that this is the first study evaluating its utility for preventing the first instance of breast cancer in healthy women with a higher risk of developing the disease. The story does not appear to be based on the press release.
answer:
Hormone-blocking drug reduces breast cancer risk


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Scientists made an impassioned appeal to governments and businesses worldwide to confront “vested interests” they said were blocking reforms in farming, energy and mining needed to save the Earth’s ecosystems. “If we want to leave a world for our children and grandchildren that has not been destroyed by human activity, we need to act now,” said Robert Watson, who chaired the study, produced by the Intergovernmental Panel on Biodiversity and Ecosystem Services (IPBES), which groups 130 countries, including the United States, Russia and China. “If we do not act now, many of the million threatened species will become as extinct as the dodo on this tie,” Watson told a news conference in Paris, gesturing to his tie, which bore a design of the flightless bird. Known as the Global Assessment, the report found that up to one million of Earth’s estimated eight million plant, insect and animal species is at risk of extinction, many within decades. It identified industrial farming and fishing as major drivers of the crisis, with the current rate of species extinction tens to hundreds of times higher than the average over the last 10 million years. Climate change caused by burning the coal, oil and gas produced by the fossil fuel industry is exacerbating the losses, the report found. “We are facing a human extinction crisis,” said Hoda Baraka of 350.org, a climate change campaign group based in the United States. “We must work together to push back against the fossil fuel industry fuelling the climate crisis and for long-lasting and meaningful change.”  The largest, most comprehensive study ever undertaken of the conjoined fates of human wellbeing and the natural world, the report was finalised in Paris after intense negotiations between IPBES members that concluded at 0300 a.m. on Saturday. The report represents a cornerstone of an emerging body of research that suggests the world may need to embrace a new “post-growth” form of economics if it is to avert the existential risks posed by the cascading effects of pollution, habitat destruction and climate change. Compiled over three years and based on 15,000 scientific papers, the report identified a range of risks, from the disappearance of insects vital for pollinating food crops, to the destruction of coral reefs that support fish populations and the loss of medicinal plants. The threatened list includes more than 40 percent of amphibian species, almost 33 percent of reef-forming corals, sharks and shark relatives, and more than a third of all marine mammals. The picture was less clear for insect species, but a tentative estimate suggests 10 per cent could become extinct. Publication of the report has coincided with an upsurge in environmental activism by groups including Extinction Rebellion, whose civil disobedience campaign forced the British parliament this month to declare a climate emergency. The report’s blunt language echoed the United Nations’ Intergovernmental Panel on Climate Change, which said in October that profound economic and social changes would be needed to curb greenhouse gases quickly enough to avert the most devastating consequences of a warming world. The findings will also add to pressure for countries to agree bold action to protect wildlife at a major conference on biodiversity due to take place in China towards the end of next year, reinforcing a growing recognition among policy-makers that the extinction and climate crises are deeply interconnected. “We have reconfigured dramatically the life of the planet,” said Eduardo Brondizio, a professor of anthropology at Indiana University in the United States who co-chaired the report. “The key message: business as usual has to end.”
answer:

Scientists warn a million species at risk of extinction.