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.

Ex 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.

Ex Output:
Is there no difference in the disease severity of gastro-oesophageal reflux disease between patients infected and not infected with Helicobacter pylori?


Ex Input:
Context: Surfactant protein (SP) D shares target cells with the proinflammatory cytokine TNF-alpha, an important autocrine stimulator of dendritic cells and macrophages in the airways.', 'We sought to study the mechanisms by which TNF-alpha and SP-D can affect cellular components of the pulmonary innate immune system.', 'Cytokine and SP-D protein and mRNA expression was assessed by means of ELISA, Western blotting, and real-time PCR, respectively, by using in vivo models of allergic airway sensitization. Macrophage and dendritic cell phenotypes were analyzed by means of FACS analysis. Maturation of bone marrow-derived dendritic cells was investigated in vitro.', 'TNF-alpha, elicited either by allergen exposure or pulmonary overexpression, induced SP-D, IL-13, and mononuclear cell influx in the lung. Recombinant IL-13 by itself was also capable of enhancing SP-D in vivo and in vitro, and the SP-D response to allergen challenge was impaired in IL-13-deficient mice. Allergen-induced increase of SP-D in the airways coincided with resolution of TNF-alpha release and cell influx. SP-D-deficient mice had constitutively high numbers of alveolar mononuclear cells expressing TNF-alpha, MHC class II, CD86, and CD11b, characteristics of proinflammatory, myeloid dendritic cells. Recombinant SP-D significantly suppressed all of these molecules in bone marrow-derived dendritic cell cultures.
Answer: TNF-alpha can contribute to enhanced SP-D production in the lung indirectly through inducing IL-13. SP-D, on the other hand, can antagonize the proinflammatory effects of TNF-alpha on macrophages and dendritic cells, at least partly, by inhibiting production of this cytokine.

Ex Output:
Does surfactant protein D inhibit TNF-alpha production by macrophages and dendritic cells in mice?


Ex Input:
Context: Contrast therapy has a long history of use in sports medicine. Edema and ecchymosis reduction, vasodilation and vasoconstriction of blood vessels, blood flow changes, and influences on the inflammatory response are physiologic effects attributed to the ability of this modality to evoke tissue temperature fluctuations. Our purpose was to measure the change in human gastrocnemius intramuscular tissue temperature during a typical contrast therapy treatment.', 'A randomized-group design was used to examine differences between 2 groups of subjects following a 31-minute warm whirlpool (control) and a 31-minute contrast therapy (experimental) treatment. A hydrotherapy room in a small- college sports medicine facility served as the test environment.', 'Twenty (7 females and 13 males) healthy college students (age = 20.9 +/- 1.2 years; ht = 178.5 +/- 11.1 cm; wt = 79.2 +/- 21.7 kg) volunteered to participate in this study. Subjects were randomly assigned to either a control or a treatment group.', 'Intramuscular tissue temperatures in the gastrocnemius were recorded every 30 seconds.', 'There was a significant difference in mean overall temperature change between the experimental group (0.85 degrees C +/- 0.60 degrees C) and the control group (2.10 degrees C +/- 1.50 degrees C). In addition, there were significant differences between the 2 groups at 10, 15, 16, 20, 21, 25, 26, 30, and 31 minutes. At each recording point, the control group temperature change was significantly higher than that of the experimental group. There was no difference in absolute temperatures at the 11-minute recording point between the groups.
Answer: Contrast therapy did not lead to significant fluctuations in muscle tissue temperature at 4 cm below the skin's surface. Therefore, it seems unlikely that the physiologic effects attributed to these fluctuations occur. A 1-minute exposure to a cold whirlpool during a typical contrast treatment does not appear to be long enough to significantly decrease tissue temperature after exposure to the warm hydrotherapy environment.

Ex Output:

Does contrast therapy cause fluctuations in human gastrocnemius intramuscular temperature?