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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Major U.S. indexes fell about 2 percent and the Dow Jones Industrial Average dropped as much as 563 points. On the benchmark S&P 500 index, health care and technology companies absorbed the worst losses. Johnson & Johnson plunged by the most in 16 years after Reuters reported that the company has known since the 1970s that its talc Baby Powder sometimes contained carcinogenic asbestos. The company denied the report. China said industrial output and retail sales both slowed in November. That could be another sign that China’s trade dispute with the U.S. and tighter lending conditions are chilling its economy, which is the second-largest in the world. Meanwhile, purchasing managers in Europe signaled that economic growth was slipping. Sameer Samana, senior global market strategist for Wells Fargo Investment Institute, said investors are concerned that weakness will make it way to the U.S. They’re wondering if the U.S. economy is likely to run out of steam sooner than they had thought. “Market consensus has been that the next recession is probably in 2020 or beyond,” he said. Now, he said, the market is “really testing that assumption and trying to figure out whether it’s sooner.” Rising interest rates and tighter credit conditions are adding to investors’ nervousness because they both tend to slow down economic growth. This week the European Central Bank said it is ending a bond-buying program that has pumped trillions into Europe’s economy. The Federal Reserve is expected to increase U.S. rates again on Wednesday, as it’s been doing for the last three years. It may also shed light on whether it plans to raise rates further in 2019. For more than 20 years, China has been one of the biggest contributors to growth in the global economy, and when investors see signs the Chinese economy is weakening, they expect it will affect other countries like the U.S. that sell things to China. In Europe, the index of purchase managers fell in France, which is racked by protests, to a level that points toward economic contraction. Germany’s reading still pointed to growth, but it fell to its lowest level in four years. Those reports canceled out some potential good news on trade: the Chinese government announced a 90-day suspension of tariff increases on U.S. cars, trucks and auto imports. It’s part of a cease-fire that China and the U.S. announced earlier this month to give them time to work on other issues. December is typically the best month of the year for stocks as a “Santa Claus rally” often adds to the year’s gains. With 10 trading days left this month, however, the S&P 500 is down 5.8 percent. That followed a small gain in November and a steep 6.9 percent drop in October. The S&P 500 index lost 50.59 points, or 1.9 percent, to 2,599.95, its lowest close since April 2. The Dow retreated 496.87 points, or 2 percent, to 24,100.51. The Dow has fallen 10 percent from its record high in early October, reaching a mark known on Wall Street as a “correction.” The other major U.S. indexes were already in “corrections.” The Nasdaq composite slid 159.67 points, or 2.3 percent, to 6,910.66. The Russell 2000 index of smaller-company stocks fell 21.89 points, or 1.5 percent, to 1,410.81. Johnson & Johnson dropped 10 percent to $133 in very heavy trading. Its market value fell by $40 billion. Reuters reported that court documents and test results show Johnson & Johnson has known for decades that its raw talc and finished Baby Powder sometimes contained asbestos, but that the company didn’t inform regulators or the public. The company called the story “false and inflammatory.” In July the company lost a lawsuit from plaintiffs who argued that its products were linked to cases of ovarian cancer and mesothelioma. A St. Louis jury awarded plaintiffs $4.7 billion. Johnson & Johnson faces thousands of other lawsuits. Among technology companies, Apple dipped 3.2 percent to $165.48. Adobe skidded 7.3 percent to $230 after its fourth-quarter profit disappointed investors and it also forecast lower-than-expected earnings in the current fiscal year. Industrial companies sank as well. Boeing lost 2.1 percent to $318.75. Oil prices again turned lower, as a slower global economy would weaken demand for oil and other fuels. Benchmark U.S. crude fell 2.6 percent to $51.20 a barrel in New York. Brent crude, used to price international oils, dropped 1.9 percent to settle at $60.28 a barrel in London. European Union leaders rejected British Prime Minister Theresa May’s request to make changes to their deal covering Britain’s departure from the EU on March 29. British legislators aren’t satisfied with the terms May negotiated, and she canceled a scheduled vote earlier this week because it was clear Parliament wouldn’t approve it. Britain’s economy and financial markets across Europe face severe disruption without an agreement. In other trading: —European bond prices rose and yields fell. Both the British pound and the euro weakened. The pound slipped to $1.2579 from $1.2660 and the euro fell to $1.1303 from $1.1367. —Germany’s DAX declined 0.5 percent and the CAC 40 in France declined 0.8 percent. Britain’s FTSE 100 fell 0.5 percent. —Japan’s Nikkei 225 index slid 2 percent and the Kospi in South Korea lost 1.3 percent. Hong Kong’s Hang Seng was down 1.6 percent. —Bond prices edged higher. The yield on the 10-year Treasury note fell to 2.89 percent 2.90 percent. —In other commodities trading, wholesale gasoline lost 3 percent to $1.43 a gallon. Heating oil fell 1.7 percent to $1.85 a gallon and natural gas dropped 7.2 percent to $3.83 per 1,000 cubic feet. —Gold fell 0.5 percent to $1,241.40 an ounce. Silver dipped 1.5 percent to $14.64 an ounce. Copper was little changed at $2.77 a pound. —The dollar fell to 113.29 yen from 113.60 yen. ____ Associated Press Writer Josh Boak contributed to this report from Washington. ___ AP Markets Writer Marley Jay can be reached at http://twitter.com/MarleyJayAP
answer:
Stocks plunge to 8-month lows on growth fears; J&J nosedives.


question:
Tuberculosis is North Korea’s biggest public health problem. With this American-made machine, his lab would be able to complete a TB test in just two hours, instead of two months. It took years, but Dr. O got the machines, only to discover that GeneXpert needs cartridges he can’t replace. It’s not entirely clear what about the cartridges would violate international sanctions. For a long time, the producer refused to disclose what agents were inside because that was patented information. But it doesn’t really matter. No one, it seems, is willing to help him procure them from abroad and run the risk of angering Washington. Despite a budding mood of detente on the Korean Peninsula since the summit between President Donald Trump and North Korean leader Kim Jong Un last month in Singapore, ongoing sanctions championed by the U.S. and Trump’s “maximum pressure” policy continue to generate an atmosphere of hesitation and the fear of even unintentional violations. And that is keeping lifesaving medicines and supplies from thousands of North Korean tuberculosis patients. Dr. O’s laboratory, built with help from Stanford University and Christian Friends of Korea aid group, has essentially been running on empty since April. But the idle GeneXperts may soon be the least of his troubles. ___ Tuberculosis kills more than 1.6 million people a year. When left untreated it will be fatal in half of those it infects. It’s the world’s most deadly infectious disease and is so contagious that each case can be expected to lead to 10 to 20 more. In developed countries, it has largely been brought under control. There’s a vaccine that prevents it and a cocktail of drugs that can be used to treat, and often cure, it in a matter of months. But it’s a major scourge in less affluent places, including North Korea and sub-Saharan Africa. To help North Korea control its tuberculosis problem, a Geneva-based international aid organization called the Global Fund to Fight AIDS, Tuberculosis and Malaria has dispersed more than $100 million in grants since 2010. Last year it supported the treatment of about 190,000 North Korean TB patients. But, two weeks ago, Global Fund ended all of its North Korea-related grants, saying it could no longer accept the North’s “unique operating conditions.” Spokesman Seth Faison said the fund informed Pyongyang in February so it would have time to look for alternative funding sources. He said Global Fund is providing buffer stocks of medicines and health products to help support the treatment of tuberculosis patients through June next year. Faison said Global Fund welcomes the “positive diplomatic efforts underway” between Pyongyang and its neighbors. But the fund’s position stands. The decision shocked the doctors at the Pyongyang tuberculosis lab, who praised Global Fund for the work it had done but accused it of bowing to political pressure from the United States and Trump’s vow to keep the pressure on and not ease sanctions until the North makes major steps toward denuclearization. The United States government, which has pledged $1.4 billion this year, is one of Global Fund’s biggest donors. The fund’s retreat sparked outrage outside of North Korea as well. In an open letter published in the medical journal Lancet, Harvard physician Kee Park, director of North Korea programs for the Korean American Association, warned the fund’s withdrawal could create a “humanitarian and public health crisis” and called the move “a cataclysmic betrayal of the people of the DPRK.” Whatever the reason, its departure is valid cause for concern. When tuberculosis patients reduce or go off their medications prematurely, or begin taking lower quality ones, the bacteria that causes their disease can develop a resistance to the two most powerful anti-TB drugs, making the condition harder and much more expensive to treat. This kind of multi-drug resistant TB is most often found in China, India and Russia. And it’s a big problem in North Korea. ___ North Korea’s health system is fragile and strapped for resources. But in keeping with Kim’s directives to lift the nation’s standard of living, officials are looking for ways to improve. “We have been waging a vigorous struggle with a highly ambitious plan to increase the average life expectancy of the population and bring other health indices in line with those of the world’s most advanced countries,” explained Ri Jong Chang, who is the director of the Central Tuberculosis Prevention Institute and has worked with TB patients for the past 25 years. Ri explained that at the most basic level, the country maintains a network of about 7,000 clinics and a system initiated decades ago that focuses on “household doctors.” Each doctor is responsible for the care of 150 households within their administrative area. Along with primary care, they keep their patients informed and educated about health issues and conduct activities to prevent diseases. If a suspected case of tuberculosis is found, the patient is sent to a county-level hospital for testing. Aware of its needs and vulnerabilities, North Korea, which is generally secretive and deeply suspicious of anything that smacks of foreign “meddling,” has demonstrated a surprising willingness to accept help, allow access and share information with United Nations’ agencies and foreign aid organizations. Along with Global Fund, the most established group treating TB patients in the North is the Eugene Bell Foundation, which supports the treatment of more than 1,000 patients at 12 centers across the country. Unlike Global Fund, since 2008 the Eugene Bell Foundation has been solely focused on fighting multi drug-resistant tuberculosis, which typically takes about 18 months to treat and costs nearly $5,000 per patient. Stephen Linton, who founded the group in 1995, has a grim assessment of the situation. “We are probably only covering about one-tenth of the MDR-TB patients in the country right now,” he told The Associated Press. He said about half of his patients are in Pyongyang, a city of 3 million and the place where most of the North’s elites reside. The reason is straightforward — MDR-TB develops after exposure to medications that failed. In rural areas, fewer people have access to those medicines to begin with. “If you are living in the countryside in North Korea, you are much less likely to get MDR-TB than if you live in Pyongyang. It’s horrendous,” he said. “We can’t get to the bottom of it, even though we focus a lot of resources there.” What really worries him, and the North Korean government, is what will happen if the patients who relied on Global Fund support run out of medications, stop getting help or turn to cheaper, less effective treatments. Many will die. But not before infecting many others. “This is an airborne infection,” he said. “Every time you are in a closed space with a TB patient, you are at risk. So for all the people that travel to North Korea, all the tourists, all the diplomats — they are a risk to everyone who comes near them.” ___ This was supposed to be the year Eugene Bell began to really up its game in North Korea, tripling to 3,000 the number of patients it treats. Many of the sanatoria where TB patients are treated in the North were built 30 or 40 years ago. They have poor insulation, are overcrowded and are often fire hazards. To address those problems and the sort of transparency issues Global Fund was concerned about, Eugene Bell has developed pre-fabricated wards tailor-made to meet the North’s conditions. They are simple, single-story duplexes. Each can be put up quickly by three or four people, meaning the entire process can be monitored while Linton and other Eugene Bell people are in the country on their bi-annual medical team visits. The wards are already paid for when they are shipped from China, so the money isn’t going into the pockets of government officials or funding Kim Jong Un’s missile programs. The idea was to begin putting up 80-100 wards to create large centers in each of North Korea’s nine provinces. A pilot project with 10 wards is now operating on the outskirts of Pyongyang, not far from the airport. Linton said everything was going well until last December. “Then we ran into this sanctions problem,” he said. “It’s officially approved. The design is approved. And it’s not that we can’t send anything in. But these buildings have a metal roof — a panel that has metal in it, aluminum — and that’s the issue.” Linton said Eugene Bell has a quarter of a million dollars’ worth of them “rotting in monsoon weather” in a dockyard outside of Seoul. He believes that until Washington makes it clear it is not against humanitarian aid, other countries and aid organizations will be reluctant to act — or even approve the shipment of items like Dr. O’s GeneXpert cartridges or Eugene Bell’s patient wards that are clearly intended for humanitarian use. As an American, Linton says, he is concerned the U.S. will be held responsible for whatever bad happens with TB in North Korea since no country is as seen as “owning” the sanctions as much as America. “Unless something is done and done soon, this medical emergency will become known in Korea as the ‘Sanctions TB Epidemic,’” he said. “And it will haunt the peninsula for generations.” ___ Talmadge is the AP’s Pyongyang bureau chief. Follow him on Instagram and Twitter: @EricTalmadge
answer:
Despite detente, sanctions on North Korea fan TB epidemic.


question:
The story did not provide cost estimates for either approach; the story did mention that the through-the-wrist approach was associated with shorter hospital stays (and therefore reduced costs.) There was no discussion in the story about whether there are different costs associated with the procedure itself. The story explained that the through-the-wrist approach was associated with lower risk of bleeding and shorter hospitalizations but should have included a caveat explanation about the strength of research and that the results of the study reported on require follow-up investigation. The story mentioned risk of bleeding at the site of catheter insertion as a possible harm of treatment which was greater for those who had a the catheter inserted in the leg. To its credit, the story provided absolute risk information, i.e. pointing out the 60% reduction in bleeding was the difference between 2 and 1% of patients having this complication. The story did not mention whether there were any particular side effects or harms associated with catheter insertion at the wrist. The story explained that the study was an analysis of information contained within a national registry. But it should have explained that this is the weakest type of study from which to draw a clinical conclusion (such as this procedure is safer or as safe as the alternative). Thus the statement in the story ‘both methods were equally effective’ should have been more tentative. The underlying weakness of the study, that it is not a controlled trial, may mean that the patients who had the wrist approach had something else about them that helped to reduce risk and that the researchers may not have been able to take into consideration. The story did not engage in overt disease mongering. The story included interview material from one clinician who was not associated with the study reported on. The quality of the piece would have been improved if it had included input from physicians who might have explained some of the reasons why not all interventional cardiologists use the wrist approach. The story did an adequate job of reporting about a recent study comparing two approaches to angioplasty. The story indicated that the angioplasty using access through the wrist as opposed to a leg, was used much less frequently.vThe story explained that extra training is required in order to use this procedure and many doctors are not trained in this technique. This would contribute to the procedure’s limited availability. The story did a good job of explaining that neither of the two approaches compared were new and that the point of the study was to determine how the two sites compare in terms of their use. The story does not appear to rely exclusively on a press release.
answer:

Angioplasty through the wrist backed by new study