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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On 5 December 2018, the Seattle Times published an article whose terrifying headline ensured its own virality: “Rare brain-eating amoebas killed Seattle woman who rinsed her sinuses with tap water. Doctor warns this could happen again.” Sadly for those who visited this page hoping to find that the reporting was exaggerated or made-up, this really happened. Though her anonymity was maintained, the story of a 69-year-old Seattle woman who used tap water in her Neti pot for over a year and then died from a Balamuthia mandrillaris brain infection was documented in a 20 September 2018 case study published in the International Journal of Infectious Diseases: We report the case of a 69-year-old female who presented with a chronic nasal skin rash, new onset focal seizure, and a cerebral ring-enhancing lesion after a year of improper nasal irrigation. Despite aggressive and novel anti-amoebic treatment, she died as a result of a Balamuthia mandrillaris brain infection. One year before developing the brain infection, the authors reported, the woman developed a chronic sinus infection whose symptoms were not relieved by medication. She turned to using a Neti pot to rinse her sinuses, but instead of using sterile or saline water as directed, she used tap water filtered with a Brita system. After a month of this practice, and without any relief of her sinus symptoms, “she developed a quarter-sized, red raised rash on the right side of the bridge of her nose and raw red skin at the nasal opening.” Though several misdiagnoses followed, no doctor correctly recognized the rash as a symptom of an amoebic infection. The report stated that a year after that initial rash developed, the woman developed a seizure that required hospitalization. At that time, the doctors identified a lesion on the right side of the brain which they decided to biopsy. Some 19 days later, after a continued decline in the patient’s health, scientists from Johns Hopkins University suggested the possibility that the cause of her malady was an amoebic infection, and the Centers for Disease Control rushed a novel drug for her treatment. Unfortunately, they were unable to halt the progression of the disease, and the patient’s family made the decision to remove her from life support. An autopsy determined the cause of death to be Granulomatous Amebic Encephalitis (GAE), which the CDC defines as “a serious infection of the brain and spinal cord that typically occurs in persons with a compromised immune system.” In this case, the causative agent was an extremely rare amoeba named Balamuthia mandrillaris, one of three forms of amoeba known to be capable of infecting and consuming the human brain. Amoebas are a broad group of taxonomically mixed unicellular organisms that consume surrounding cellular material through absorption, and that express an ability to take on a variety of shapes. Several different species are associated with disease, most notably Naegleria fowleri, commonly known as the “brain-eating amoeba” that can cause a different kind of brain infection called primary amebic meningoencephalitis (PAM). Balamuthia mandrillaris was discovered in 1986 in the brain of a mandrill monkey during an autopsy at the San Diego Zoo and is now recognized to be a cause of GAE in both humans, several primates, and other animals, with an estimated 200 cases of human infection ever documented. The amoebae are ubiquitous in soil and groundwater although their presence is not expected in city-treated water, according to Liz Coleman, a spokeswoman for the Environmental Public Health division of Washington State’s Department of Health, quoted in the Seattle Times’ reporting. Merely ingesting the thing will not lead to health problems, but in rare cases (usually instances involving people with weakened immune systems, or those who are young or old), the organisms can infect a host through skin breakage or via the respiratory system. If they infect the central nervous system, they “ingest bits and pieces of host tissue [and produce] enzymes that degrade the tissue.” Nasal irrigation involves rinsing one’s sinus cavity with distilled or sterile water (or water that has been filtered to remove potentially infectious organisms), and one such method of water delivery is a Neti pot. The need for sterility is explicitly stated due to the (extremely small) risk posed by another amoeba, Naegleria fowleri, and it is the reason the FDA requires (in the absence of sterile water) a specific kind of filter capable of removing the amoeba and similarly-sized organisms from water before it is pushed through fragile sinus tissue. While the authors of this case report could not state with absolute certainty that the Neti pot was to blame, it is far and away the most likely explanation given the fact that the patient had been rinsing her sinuses with tap water regularly for an extended period of time: While it is recommended that only sterile water or saline be used … the patient used tap water that was filtered with a Brita Water Purifier … Improper nasal irrigation has been reported as a method of infection for the comparably insidious amoeba, N. fowleri. This precedent led us to suspect the same route of entry for the Balamuthia amoeba in our case. Although this hypothesis is consistent with the patient’s history and ultimate diagnosis, the water supply to the patient’s home was not tested, hence our ability to definitively trace the patient’s infection to improper nasal lavage is limited. Other routes of exposure are possible, according to a 2013 review of amoebic infections: Epidemiology of Balamuthia GAE is not well understood. However, based on several case reports it can be hypothesized that gardening, playing with dirt, or exposure to dust while motorcycling may play significant roles in the acquisition of Balamuthia infection. It has been shown that Balamuthia is found in the soil and dust in air and the route of infection is probably via inhalation of Balamuthia either present in soil or carried by the wind or the amebae entering the body through a cut or puncture. Once it gains entry into the body it is likely to spread hematogenously to the brain. Additionally, there is some indication that water may serve as a vehicle for acquiring the infection. Although the water used in the Neti pot likely caused this infection, Dr. Cynthia Maree, a co-author of the report and a member of the team that treated the woman in question, told the Seattle Times that “the risk of infection to the brain is extremely low,” adding that “people who use neti pots or other nasal-irrigation devices can nearly eliminate [that risk] by following directions printed on the devices, including using only saline or sterilized water.”
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A woman who rinsed her nasal passages using a neti pot filled with tap water contracted a fatal “brain-eating” amoeba infection.


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The Wildlife Department in eastern Sabah state on Borneo island said the rhino, named Iman, died of natural causes Saturday due to shock in her system. She had uterine tumors since her capture in March 2014. Department director Augustine Tuuga said in a statement that Iman, who reportedly was 25 years old, was suffering significant pain from growing pressure of the tumors to her bladder but that her death came sooner than expected. It came six months after the death of the country’s only male rhino in Sabah. Another female rhino also died in captivity in 2017 in the state. Efforts to breed them have been futile but Sabah authorities have harvested their cells for possible reproduction. “Despite us knowing that this would happen sooner rather than later, we are so very saddened by this news,” said Sabah Deputy Chief Minister Christina Liew, who is also environment minister. Liew said that Iman had escaped death several times over the past few years due to sudden massive blood loss, but that wildlife officials managed to nurse her back to health and obtained her egg cells for a possible collaboration with Indonesia to reproduce the critically endangered species through artificial insemination. The Sumatran rhino, the smallest of five rhinoceros species, once roamed across Asia as far as India, but its numbers have shrunk drastically due to deforestation and poaching. The WWF conservation group estimates that there are only about 80 left, mostly living in the wild in Sumatra and Borneo in Indonesia. The International Union for the Conservation of Nature identifies the Sumatran as well as the Black and Javan rhinoceros as being critically endangered. Both African and Sumatran rhinoceros have two horns, while the others have a single horn. Only about 24,500 rhinos survive in the wild with another 1,250 in captivity worldwide, the IUCN says. Of these, more than two-thirds are white rhinos. Rhinos are killed for their horns, which consist of keratin similar to human hair and nails and are used in traditional medicines in parts of Asia.
answer:
Sumatran rhino is extinct in Malaysia as lone survivor dies.


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At some point, costs must enter into this discussion. But this story never got there. The story states: “The data that we have suggests that 1 in a thousand will benefit from mammograms in the 40-49 age,” (the USPSTF chair) said. “There are whole lots of assumptions that are not supported by the data they presented.” We wouid have like to have seen more discussion of the potential harms in 85% of biopsies being non-cancerous. But since the story did actually quantify the number of false positives, we’ll give it the benefit of the doubt on this criterion. Better than the competing Denver Post story if only because CNN allows the US Preventive Services Task Force chair to explain their recommendations – something the Denver story didn’t do. But there could have been more scrutiny of the studies reported on. There was not much focus on whether we can really learn much from the single site retrospective study of their biopsies (did they compare to biopsies from patients who did not have screening mammograms? on what basis were they claiming that they were more treatable? and that being more treatable leads to longer life?). No overt disease-mongering. Good sourcing, including – unlike the competing Denver Post story – input from the chair of the US Preventive Services Task Force. There was a far more balanced discussion of harms and benefits in this story, although the use of personal opinion and recommendations, and the ending resulted in an imbalance in the piece. Excerpts that demonstrate this imbalance: Wouldn’t a more balanced way to end the piece – focusing on the shared decision-making element so important in this issue – have been to end with this: Nonethless, all of this was in the piece, so we’ll give it the benefit of the doubt. Not applicable. The availability of mammograms is not in question. Adequate job putting the new studies in context of past research and recommendations. It’s clear the story didn’t rely solely on a news release.
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Fewer mammograms being done, studies show