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.

Q: Context: Adipocytes express inflammatory mediators that contribute to the low-level, chronic inflammation found in obese subjects and have been linked to the onset of cardiovascular disorders and insulin resistance associated with type 2 diabetes mellitus. A reduction in inflammatory gene expression in adipocytes would be expected to reverse this low-level, inflammatory state and improve cardiovascular function and insulin sensitivity. The natural products, curcumin and resveratrol, are established anti-inflammatory compounds that mediate their effects by inhibiting activation of NF-kappaB signaling. In the present study, we examined if these natural products can inhibit NF-kappaB activation in adipocytes and in doing so reduce cytokine expression.', 'Cytokine (TNF-alpha, IL-1beta, IL-6) and COX-2 gene expression in 3T3-L1-derived adipocytes was measured by quantitative real-time PCR (qRT-PCR) with or without TNFalpha-stimulation. Cytokine protein and prostaglandin E2 (PGE2) expression were measured by ELISA. Effects of curcumin and resveratrol were evaluated by treating TNFalpha-stimulated adipocytes with each compound and 1) assessing the activation state of the NF-kappaB signaling pathway and 2) measuring inflammatory gene expression by qRT-PCR and ELISA.', 'Both preadipocytes and differentiated adipocytes express the genes for TNF-alpha, IL-6, and COX-2, key mediators of the inflammatory response. Preadipocytes were also found to express IL-1beta; however, IL-1beta expression was absent in differentiated adipocytes. TNF-alpha treatment activated NF-kappaB signaling in differentiated adipocytes by inducing IkappaB degradation and NF-kappaB translocation to the nucleus, and as a result increased IL-6 (6-fold) and COX-2 (2.5-fold) mRNA levels. TNF-alpha also activated IL-1beta gene expression in differentiated adipocytes, but had no effect on endogenous TNF-alpha mRNA levels. No detectable TNFalpha or IL-1beta was secreted by adipocytes. Curcumin and resveratrol treatment inhibited NF-kappaB activation and resulted in a reduction of TNF-alpha, IL-1beta, IL-6, and COX-2 gene expression (IC50 = 2 muM) and a reduction of secreted IL-6 and PGE2 (IC50 ~ 20 muM).
Answer: Curcumin and resveratrol are able to inhibit TNFalpha-activated NF-kappaB signaling in adipocytes and as a result significantly reduce cytokine expression. These data suggest that curcumin and resveratrol may provide a novel and safe approach to reduce or inhibit the chronic inflammatory properties of adipose tissue.

A: Do curcumin and resveratrol inhibit nuclear factor-kappaB-mediated cytokine expression in adipocytes?
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Q: Context: To assess the accuracy of the clinically estimated blood loss (EBL) when compared with the actual blood loss (ABL) in replacement surgeries.', "This prospective study was done in Sri Ramachandra Medical Centre from April 2011 to April 2013. Altogether 140 patients undergoing total hip replacement or total knee replacement were included with the inclusion criteria being patients with haemoglobin higher than 100 g/ml and coagulation profile within normal limits. Exclusion criteria were intake of anti-platelet drug or anti-coagulant, bleeding disorders, thrombotic episode, and haematological disorders. There were 65 men and 75 women. In this study, the consultants were free to use any clinical method to estimate the blood loss, including counting the blood-soaked mops and gauze pieces (estimating the volume of blood carried in all the mops and gauzes), measuring blood lost to suction bottles and blood in and around the operative field. The ABL was calculated based on a modification of the Gross's formula using haematocrit values.", 'In 42 of the 140 cases, the EBL exceeded the ABL. These cases had a negative difference in blood loss (or DIFF-BL<0) and were included in the overestimation group, which accounted for 30% of the study population. Of the remaining 98 cases (70%), the ABL exceeded the EBL. Therefore they were put into the underestimation group who had a positive difference in blood loss (DIFF-BL>0). We found that when the average blood loss was small, the accuracy of estimation was high. But when the average blood loss exceeded 500 ml, the accuracy rate decreased significantly. This suggested that clinical estimation is inaccurate with the increase of blood loss.
Answer: This study has shown that using clinical estimation alone to guide blood transfusion is inadequate. In this study, 70% of patients had their blood loss underestimated, proving that surgeons often underestimate blood loss in replacement surgeries.

A: Do surgeons often underestimate the amount of blood loss in replacement surgeries?
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Q: Context: The activation of Ras signaling and vascular endothelial growth factor (VEGF) expression in mesangial cells is a pathogenic consequence of diabetic nephropathy. We examined the role of simvastatin in modulating Ras signaling and the expression of VEGF in mesangial cells stressed with high doses of glucose in vitro and in vivo.', 'For the in vitro studies, we cultured mesangial cells, with or without simvastatin or manumycin A pretreatment, in 35 mM glucose and assayed VEGF activity. For the in vivo studies, we administered simvastatin or manumycin A to streptozocin-induced diabetic rats for 28 days and dissected renal tissues for an immunohistological assessment of Ras and VEGF expression in glomerular cells.', "We showed that high glucose significantly increased VEGF gene expression and Ras activation. The pretreatment with 10 microM simvastatin and inhibition of Ras activity by manumycin A significantly reversed high glucose promotion of VEGF mRNA expression. Pretreatment with simvastatin and manumycin A clearly affected the activation of Ras promoted by high glucose. Tube-like formations were abundant in high glucose-treated mesangial cells co-cultured with HUVEC. However, the simvastatin and manumycin A treatment group's down-regulated tube formation was comparable to the mesangial cells treated only with high glucose. Exogenous simvastatin and manumycin A treatment alleviated urinary albumin secretion and attenuated Ras activation and VEGF protein expression in the kidneys of diabetic rats.
Answer: Ras protein activation is a key mediator of VEGF-induced diabetic nephropathy. By inhibiting Ras activation, simvastatin modulates the high glucose-induced VEGF-mediated signaling pathway in vitro and in vivo.

A:
Does simvastatin alleviate diabetes-induced VEGF-mediated nephropathy via the modulation of Ras signaling pathway?
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