TASK DEFINITION: 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.
PROBLEM: 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.

SOLUTION: Are substantia nigra tangles related to gait impairment in older persons?

PROBLEM: Context: A computerized physician order entry (CPOE) system with embedded clinical decision support can reduce medication errors in hospitals, but might increase the time taken to generate orders.', 'We aimed to quantify the effects of temporal (month, day of week, hour of shift) and other factors (grade of doctor, prior experience with the system, alert characteristics, and shift type) on the time taken to generate a prescription order.', 'A large university teaching hospital using a locally developed CPOE system with an extensive audit database.', 'We retrospectively analyzed prescription orders from the audit database between August 2011 and July 2012.', 'The geometric mean time taken to generate a prescription order within the CPOE system was 11.75\u2005s (95% CI 11.72 to 11.78). Time to prescribe was most affected by the display of high-level (24.59\u2005s (24.43 to 24.76); p<0.001) or previously unseen (18.87\u2005s (18.78 to 18.96); p<0.001) alerts. Prescribers took significantly less time at weekends (11.29\u2005s (11.23 to 11.35)) than on weekdays (11.88\u2005s (11.84 to 11.91); p<0.001), in the first (11.25\u2005s (11.16 to 11.34); p<0.001) and final (11.56\u2005s (11.47 to 11.66); p<0.001) hour of their shifts, and after the first month of using the system.
Answer: The display of alerts, prescribing experience, system familiarity, and environment all affect the time taken to generate a prescription order. Our study reinforces the need for appropriate alerts to be presented to individuals at an appropriate place in the workflow, in order to improve prescribing efficiency.

SOLUTION: Do temporal and other factors that influence the time doctors take to prescribe using an electronic prescribing system?

PROBLEM: Context: Back pain is among the most prevalent pain disorders causing chronic disability among adults, and insomnia is a common co-morbidity. However, whether insomnia precedes back pain or vice versa remains unclear. The current study tested the temporal association between insomnia and back pain.', 'A longitudinal design was used to investigate whether changes in insomnia over time predict the onset of back pain and vice versa. The study was conducted on a cohort of active healthy working adults (N = 2,131, 34% women) at three time points (T1, T2, and T3) over a period of 3.7 years (range = 2.2-5.12) years. Logistic regression analysis was used to test whether increased insomnia symptoms from T1 to T2 predicted the onset of new back pain. Ordinary least squares regression was used to test whether the existence of back pain at T2 predicted an increase in insomnia from T2 to T3.', 'The results indicated that after controlling for socioeconomic variables, self-reported health, lifestyle behaviors, and anthropometrics, a T1-T2 increase in insomnia symptoms was associated with a 1.40-fold increased risk of back pain at T3 (OR = 1.40; 95% CI = 1.10-1.71). No support was found for reverse causation; i.e., that back pain predicts subsequent increase in insomnia.
Answer: Insomnia appears to be a risk factor in the development of back pain in healthy individuals. However, no evidence of reverse causation was found.

SOLUTION:
Do increased insomnia symptoms predict the onset of back pain among employed adults?