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.

Input: Consider Input: Context: Noninvasive pacemaker stress echocardiography is a newly introduced method for the diagnosis of coronary artery disease in patients with a permanent pacemaker. The prognostic value of pacemaker stress echocardiography has not been studied.', 'We studied 136 patients (mean age 64+/-12 years) with a permanent pacemaker who underwent pacemaker stress echocardiography for evaluation of coronary artery disease. All patients underwent pacemaker stress echocardiography by external programming (pacing heart rate up to ischemia or target heart rate).', 'Thirty-one patients (23%) had normal study results. Ischemia was detected in 75 patients (55%). During a mean follow-up of 3.5+/-2.4 years, 35 deaths (26%) (20 the result of cardiac causes) and 2 nonfatal myocardial infarctions (1%) occurred. The annual cardiac death rate was 1.3% in patients without ischemia and 4.6% in patients with ischemia (P=.01). The annual all-cause mortality rate was 3.1% in patients without ischemia and 7% in patients with ischemia (P=.004). The presence of ischemia during pacemaker stress echocardiography was the strongest independent predictor of cardiac death (hazard ratio 4.1, confidence interval 1.2-14.5) and all-cause mortality (hazard ratio 2.7, confidence interval 1.2-6.0) in a multivariable model.
Answer: Myocardial ischemia during pacemaker stress echocardiography is an independent predictor of cardiac death and all-cause mortality in patients with a permanent pacemaker.

Output: Does pacemaker stress echocardiography predict cardiac events in patients with permanent pacemaker?

Input: Consider Input: Context: Women with antiphospholipid syndrome (APS) are at increased risk of recurrent pregnancy loss (RPL) and preeclampsia. Antiphospholipid antibodies (aPL) directly alter trophoblast function. Treatment with low molecular weight heparin (LMWH) reduces the risk of RPL but not preeclampsia. Moreover, LMWH stimulates trophoblast sFlt-1 release, an anti-angiogenic factor associated with preeclampsia. Since vitamin D deficiency is associated with APS and preeclampsia, this study sought to determine the effect of vitamin D on trophoblast function in the setting of aPL and LMWH.', 'A human first trimester trophoblast cell line (HTR8) and primary trophoblast cultures were treated with or without aPL in the presence and absence of vitamin D, LMWH or both. Trophoblast secretion of inflammatory cytokines and angiogenic factors were measured by ELISA.', 'Vitamin D alone or in combination with LMWH attenuated the aPL-induced trophoblast inflammatory response in the HTR8 cells and primary cultures. While vitamin D did not have any impact on aPL-mediated modulation of angiogenic factors in the primary trophoblast, it significantly inhibited LMWH-induced sFlt-1 release.
Answer: LMWH in combination with vitamin D may be more beneficial than single-agent therapy by preventing aPL-induced trophoblast inflammation and reversing LMWH-induced sFlt-1 secretion.

Output: Does vitamin D reverse aPL-induced inflammation and LMWH-induced sFlt-1 release by human trophoblast?

Input: Consider Input: Context: Food supplements are known to affect the development of gastric adenocarcinoma. In this study, an animal model of gastric resection was used to investigate the effects of calcium carbonate on spontaneous development of gastric adenocarcinoma.', 'Ninety-two Wistar rats with gastric resections (performed to induce spontaneous gastric cancer) and 60 without resections (controls) were used to analyse the carcinogenic potential of different ion supplements in food.', 'Among the resected rats, cancer developed in 3 out of 18 (17%, NS) given NaCl but in 11 out of 18 (61%, p<0.01) exposed to calcium carbonate. No tumours were found in the unresected (unoperated) animals. These findings were further analysed by separately investigating the effects of calcium and carbonate ions on tumorigenesis in the gastric stump model. Cancer developed in one of 26 (4%) resected animals given a diet supplemented with CaHPO(4), which was lower than the rate observed in the resected control group fed a normal diet, although this difference was not statistically significant. However, tumour development increased significantly in the resected animals given a diet supplemented with NaHCO(3) (tumours in 13 out of 24 rats, 54%; p<0.01).
Answer: The present results reveal a significant role for carbonate in the induction of gastric carcinoma in the rat. The relevance of this finding is underlined by the fact that carbonate is a major constituent of intestinal reflux into the stomach, and that such reflux is considered to be one of the major causes of gastric cancer.
Output: Does dietary supplementation of carbonate promote spontaneous tumorigenesis in a rat gastric stump model?