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: Small studies suggest exogenous estrogen may improve vitamin D status, but the etiology is unclear because women who use hormones may make lifestyle choices that differentially affect vitamin D status.', 'Our objective was to investigate the association between use of hormonal contraception and 25-hydroxy-vitamin D (25(OH)D).', 'We used linear regression modeling of cross-sectional data to estimate percent change in season-adjusted serum 25(OH)D with estrogen use after adjustment for other factors.', 'At the enrollment clinic visit (2010-2012) into a cohort study of uterine fibroids, each subject provided a blood sample, had anthropomorphic variables and skin reflectance measured, and answered questionnaires on demographics, dietary and supplement intake, contraceptive use, reproductive and medical history, and behaviors.', 'A total of 1662 African American women, community volunteers, 23-34 years old, living in the Detroit, Michigan, area were included.', 'None.', 'Serum 25(OH)D was measured.', 'Serum 25(OH)D concentrations were low (70% <20 ng/ml). Current use of an estrogen-containing contraceptive was associated with a 20% (95% confidence interval: 14-27) increase in 25(OH)D after adjustment. There was no increase in 25(OH)D among participants who had used estrogen in the past, but were not current users, indicating that results were unlikely to be due to unmeasured confounding by factors related to contraceptive choice.
Answer: The increase in 25(OH)D with use of estrogen-containing contraceptives raise mechanistic questions regarding the biological pathways involved, and highlights the need for studies that examine possible endogenous estrogen effects on vitamin D.
Example Output: Does use of Estrogen-Containing Contraception be Associated With Increased Concentrations of 25-Hydroxy Vitamin D?

Example Input: Context: Ametop gel (4% amethocaine) is a relatively new topical anesthetic that produces anesthesia within 30 to 45 minutes and therefore may be appropriate for use in busy outpatient settings. The objective of this study was to assess the efficacy and safety of 4% amethocaine in reducing the pain of subcutaneous measles-mumps-rubella vaccination in 1-year-old infants.', 'A double-blind, randomized, placebo-controlled trial was conducted in pediatric outpatient clinics.', 'A total of 120 infants participated in the study; 60 were followed up for assessment of antibody titers after 1 month. Either 1 g of amethocaine or placebo was applied for 30 minutes before vaccination. The Modified Behavioral Pain Scale was used to assess pain; the mean (standard deviation) pain scores for the amethocaine group (n = 61) was 1.5 (1.6) versus 2.3 (2.2) for the placebo group (n = 59). The rate of vaccination success (88% and 87%) was not different between treatment groups.
Answer: 4% Amethocaine significantly reduces the pain of measles-mumps-rubella vaccination in infants when compared with placebo and does not seem to interfere with subsequent development of protective antibody levels. Because of its relatively short application time (30 minutes), 4% amethocaine may be suitable for busy clinics and emergency departments.
Example Output: Does topical 4 % amethocaine gel reduce the pain of subcutaneous measles-mumps-rubella vaccination?

Example Input: Context: In the presented study the effect of age and cytogenetics on clinical outcome in acute myeloid leukemia (AML) was evaluated. The 1225 patients with de novo AML were separated according to age as follows: A1: 16 to 49 years (n=442), A2: 50 to 59 years (n=246), A3: 60-69 years (n=333), A4: 70 years and older (n=204).', 'Patients were categorized with respect to cytogenetics into 5 groups: C1: t(15;17) (n=107), C2: CBF-AML/inv(16)/t(8;21) (n=171), C3: 11q23/MLL (n=42), C4: complex aberrant karyotype (n=130), C5: other: normal, other abnormalities, 5q-/-5, 7q-/-7, inv(3)/t(3;3), other 3q abnormalities (n=746). For each age category univariate cox regression analysis was performed using age as a continuous variable and C1 to C5 as dichotomous variables.', 'In cohort A1 all parameters were significantly associated with overall survival (OS). However, in multivariate analysis all cytogenetic parameters were independently correlated with OS, while age was not. In cohort A2 only CBF and complex aberrant karyotype were significantly correlated with OS. In A3 t(15;17), complex karyotype and age, and in A4 only complex karyotype and age were significantly associated with OS in univariate and multivariate analyses. Within all cytogenetic subgroups except AML 11q23/MLL there were significant associations between age and OS.
Answer: (i) Both age and cytogenetics are independent prognostic parameters in AML;(ii) up to the age of 49 years age has no major impact on prognosis while the karyotype has; (iii) in patients 50 years and older the influence of age on outcome increases, and (iv) cytogenetics show an independent effect on survival also in patients over 60 years old.
Example Output:
Does the influence of age on prognosis of de novo acute myeloid leukemia differ according to cytogenetic subgroups?