Given a passage with a context and an answer, construct a question on the basis of the information present in the passage. Construct the question in such a way that (i) it is unambiguous, (ii) it is answerable from the passage, (iii) its answer is unique (iv) it answer uses text phrases from the passage. Avoid creating questions that (i) can't be answered correctly without actually understanding the passage and (ii) uses the same words or phrases given in the passage.

Example Input: Context: Parkinsonian signs, especially gait impairment, are common and associated with morbidity and mortality in older persons. Our objective was to test the hypothesis that substantia nigra neurofibrillary tangles (NFTs) are related to parkinsonian signs in older persons with and without dementia.', "We studied 86 deceased older Catholic clergy without idiopathic Parkinson's disease from the Religious Order Study, a longitudinal clinical-pathological study. Mean age at death was 85.3 years. Signs of gait disturbance, bradykinesia, rigidity, and tremor were assessed proximate to death using a modified Unified Parkinson's Disease Rating Scale. Forty-micrometer paraffin-embedded sections of substantia nigra were bleached before tau immunohistochemistry and the optical disector was used to count NFTs. We used multivariable linear regression to examine parkinsonian signs as a function of nigra NFTs, controlling for age, sex, education, and cortical NFTs.", 'Substantia nigra NFTs were present in 67 of 86 persons (77.9%). After controlling for age, sex, education, and cortical NFTs, nigra NFTs were related to gait impairment (p < 0.001), but not bradykinesia, rigidity, or tremor. Results were not confounded by dementia, Braak score, neuroleptic medication, cerebral infarcts, or Lewy bodies.
Answer: NFTs in the substantia nigra are associated with gait impairment in older persons with and without dementia.
Example Output: Are substantia nigra tangles related to gait impairment in older persons?

Example Input: Context: The role of Helicobacter pylori in gastro-oesophageal reflux disease (GERD) is controversial.', 'To compare the severity of GERD in infected vs. non-infected patients, as part of an ongoing randomized controlled trial that examines the impact of H. pylori eradication on GERD-related outcomes.', 'Consecutive GERD patients underwent urea breath testing and completed validated GERD symptom severity, and quality of life questionnaires as well as, 24-h pH-metry. These parameters, as well as demographics and endoscopic findings were assessed in double-blinded fashion and compared between H. pylori-infected and non-infected subjects.', "Helicobacter pylori-infected GERD patients (n=50) were significantly older and less educated than non-infected patients (n=51). They also used proton pump inhibitors less often but had no difference in symptoms (as measured with both the Spechler's Activity Index and the Gastrointestinal Symptom Rating Scale), quality of life, endoscopic findings or 24-h pH-metry findings.
Answer: This prospective, double-blind study demonstrates, using excellent GERD quantifying measures including validated symptom severity scores, endoscopy, and 24-h pH-metry, that there exist no clinically significant differences in clinical or laboratory-related GERD manifestations between H. pylori-infected and non-infected GERD patients.
Example Output: Is there no difference in the disease severity of gastro-oesophageal reflux disease between patients infected and not infected with Helicobacter pylori?

Example Input: Context: To identify risk factors for hearing impairment among patients with type 2 diabetes mellitus.', 'A total of 68 patients with type 2 diabetes were enrolled between March and September of 2011. Pure-tone auditory tests were carried out for each patient at the following speech frequencies: 250; 500; 1,000; 2,000; 4,000 and 8,000\xa0Hz. Participants were classified as having hearing impairment if the average of the pure-tone thresholds measured at 500, 1000 and 2000\xa0Hz in either ear exceeded 25\xa0dBHL. Demographic, anthropometric, clinical, and laboratory parameters and diabetes-associated complications were analyzed.', 'Patients were divided into those with (n\xa0=\xa032) and without (n\xa0=\xa036) hearing impairment. Hearing impaired participants had a higher urine albumin-to-creatinine ratio than those without (223.1 vs 56.5\xa0mg/g, respectively). After adjustment for age, sex and other risk factors, the urine albumin-to-creatinine ratio remained significantly associated with hearing impairment (odds ratio 9.07, 95% confidence interval 1.73-47.43, P\xa0=\xa00.009). There were no significant differences in oxidative stress between the two groups.
Answer: The present study showed increased albuminuria was positively associated with the severity of hearing impairment among patients with type 2 diabetes. Screening for hearing impairment in diabetic patients who develop albuminuria might provide early detection of hearing impairment.
Example Output:
Is severity of hearing impairment positively associated with urine albumin excretion rate in patients with type 2 diabetes?