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.
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Question: Context: Environmental conditions (eg, latitude) play a critical role in the susceptibility and severity of many autoimmune disorders, including multiple sclerosis (MS). Here, we investigated the mechanisms underlying the beneficial effects of immune regulatory processes induced in the skin by moderate ultraviolet B (UVB) radiation on central nervous system (CNS) autoimmunity.', 'Effects of UVB light were analyzed in a murine model of CNS autoimmunity (experimental autoimmune encephalomyelitis). Additionally, patients with relapsing-remitting MS were treated with narrowband UVB phototherapy. Immunomodulatory effects were examined in skin biopsies, serum samples, and immune cells of the peripheral blood.', 'Regulatory T cells (Tregs), which are induced locally in the skin-draining lymph nodes in response to UVB exposure, connect the cutaneous immune response to CNS immunity by migration to the sites of inflammation (blood, spleen, CNS). Here, they attenuate the inflammatory response and ameliorate disease symptoms. Treg-inducing tolerogenic dendritic cells (DCs) were further necessary for induction of this systemic immune regulation by UVB radiation, because ablation of Langerhans cells abolished the UVB-induced phenotype. MS patients treated with UVB phototherapy showed an increase in induced Tregs and tolerogenic DCs accompanied by the downregulation of the T-cell effector cytokine interleukin 21. The treatment further induced elevated serum levels of vitamin D.
Answer: Local UVB radiation of the skin influences systemic immune reactions and attenuates systemic autoimmunity via the induction of skin-derived tolerogenic DCs and Tregs. Our data could have implications for the understanding or therapeutic modulation of environmental factors that influence immune tolerance.

Answer: Does ultraviolet B light attenuate the systemic immune response in central nervous system autoimmunity?


Question: Context: Anemia is an established adverse risk factor in cardiovascular disease. However, the effect of preoperative anemia is not well defined in heart surgery. This study evaluates the effect of preoperative anemia on early clinical outcomes in patients undergoing cardiac surgery.', 'A retrospective, observational, cohort study of prospectively collected data was undertaken on 7,738 consecutive patients undergoing heart surgery between April 2003 and February 2009. Of these, 1,856 patients with preoperative anemia were compared to 5,882 patients without anemia (control group). According to the World Health Organization, anemia was defined as hemoglobin level\u2009<\u200913 g/dl for men and <12 g/dl for women. Selection bias not controlled by multivariable methods was assessed with propensity-adjustment method.', 'Overall mortality was 2.1%. Preoperative anemia was associated with tripling in the risk of death (4.6% vs 1.5%, p\u2009<\u20090.0001) and postoperative renal dysfunction (18.5% vs 6.5%, p\u2009<\u20090.0001). There was also a significant difference between the anemic and non-anemic group in the risk of postoperative stroke (1.9% vs 1.1%, p\u2009=\u20090.008), atrial fibrillation (36.7% vs 33%, p\u2009=\u20090.003) and length of hospital stay\u2009>\u20097 days (54% vs 36.7%, p\u2009<\u20090.0001). In propensity-adjusted, multivariable logistic regression, preoperative anemia was an independent predictor of mortality (odds ratio [OR] 1.44, 95% confidence interval [CI] 1.02 to 2.03), postoperative renal dysfunction (OR 1.73, 95% CI 1.43 to 2.1) and length of hospital stay\u2009>\u20097 days (OR 1.3, 95% CI 1.15 to 1.47).
Answer: In patients undergoing heart surgery, preoperative anemia is associated with an increased risk of mortality and postoperative morbidity.

Answer: Does preoperative anemia increase mortality and postoperative morbidity after cardiac surgery?


Question: Context: Middle third clavicular fracture is effectively treated by conservative means. Previous studies showed that comminution and displacement of clavicular fractures might affect fracture healing. However, the clavicle horizontally aligns in the shoulder girdle and has different biomechanics from vertical weight-bearing bones. Therefore, this study was conducted with the hypothesis that comminution has no effect in worsening fracture healing and union configurations in conservatively treated middle third clavicular fractures.', 'One hundred ninety-eight middle third clavicular fractures treated by conservative means were reviewed and divided into 2 groups. Group 1, simple fractures, included 97 patients. Group 2, comminuted fractures, included 101 patients. Patient demographic data, initial fracture deformities, and union configurations such as angulation, overlying, and displacement were measured. Union rate and union complications such as delayed nonunion were evaluated. Data were analyzed for statistically significant differences (p<0.05).', 'Initial deformities of Group 1 and Group 2 were 11.94°±9.59° and 9.40°±8.57° angulation, 12.24±12.96 and 11.76±10.06 mm of overlying, and 13.31±8.63 and 13.72±7.42 mm of displacement, respectively, and exhibited no significant differences (p>0.05). Union rate and union complications of Group 1 were 74/97 (76.29%) and 23/97 (23.71%), respectively. For Group 2, the rates were 82/101 (81.19%) and 19/101 (18.81%), respectively. Union configuration of Group 1 and Group 2 were 13.76°±10.63° and 12.80°±8.65° angulation, 11.93±10.75 and 11.52±9.38 mm of overlying, and 9.79±8.33 and 10.74±6.68 mm of displacement, respectively, and showed no significant differences between the groups.
Answer: Comminution plays no role in worsening fracture healing of conservatively treated middle third clavicular fractures in terms of healing rate, union complications, and union configurations.

Answer:
Does comminution play no role in worsening fracture healing of conservatively treated middle third clavicular fractures?