In this task, you are given a passage which has a question and the context. You have to generate an answer to the question based on the information present in the context.

Input: Consider Input: Context: Population-based studies of associations between subclinical hypercortisolism and risk for disease states, such as type 2 diabetes mellitus, have been difficult to assess because of imprecise measures of glucocorticoid exposure. Alternative measures (salivary cortisol and adrenal gland volume) have not been systematically compared with 24-h urine free cortisol (UFC) in a healthy population.', 'Our objectives were: 1) to determine whether 24-h UFC and total daily salivary cortisol correlated with each other, adrenal gland volume, and salivary cortisol after dexamethasone suppression and 2) to evaluate the association of adrenal gland volume with salivary cortisol after dexamethasone suppression.', 'This was a cross-sectional study of 20 healthy, premenopausal African-American women aged 18-45 yr.', 'Salivary cortisol was assessed at six time points throughout the day simultaneous with 24-h UFC collection. Adrenal gland volume was measured by computed tomography scan. Dexamethasone-suppressed salivary cortisol was measured at 0800 h after administration of 0.5 mg dexamethasone at 2300 h the prior evening.', 'Dexamethasone-suppressed salivary cortisol levels correlated strongly with individual, timed salivary cortisol measurements, total daily salivary cortisol (rs=0.75; P=0.0001; n=20), and adrenal gland volume (rs=0.66; P=0.004; n=17). Total daily salivary cortisol and adrenal gland volume also correlated (rs=0.46; P=0.04; n=19). In contrast, 24-h UFC levels did not correlate with any of the other hypothalamic-pituitary-adrenal axis measures.\Question: Do adrenal gland volume and dexamethasone-suppressed cortisol correlate with total daily salivary cortisol in African-American women?

Output: A dexamethasone suppression test or adrenal gland volume may be alternative measures for characterizing subtle subclinical hypercortisolism in healthy adults.


Input: Consider Input: Context: Exosomes are 30-100 nm membrane vesicles of endocytic origin, mediating diverse biological functions including tumor cell invasion, cell-cell communication and antigen presentation through transfer of proteins, mRNAs and microRNAs. Recent evidence suggests that microRNAs can be released through ceramide-dependent secretory machinery regulated by neutral sphingomyelinase 2 (nSMase2) enzyme encoded by the smpd3 gene that triggers exosome secretion. However, whether exosome-mediated microRNA transfer plays any role in cell invasion remains poorly understood. Thus, the aim of this study was to identify the exosomal microRNAs involved in breast cancer invasion.', 'The expression level of endogenous and exosomal miRNAs were examined by real time PCR and the expression level of target proteins were detected by western blot. Scanning electron and confocal microscopy were used to characterize exosomes and to study its uptake and transfer. Luciferase reporter plasmids and its mutant were used to confirm direct targeting. Furthermore, the functional significance of exosomal miR-10b was estimated by invasion assay.', 'In this study, we demonstrate that microRNA carrying exosomes can be transferred among different cell lines through direct uptake. miR-10b is highly expressed in metastatic breast cancer MDA-MB-231 cells as compared to non-metastatic breast cancer cells or non-malignant breast cells; it is actively secreted into medium via exosomes. In particular, nSMase2 or ceramide promotes the exosome-mediated miR-10b secretion whereas ceramide inhibitor suppresses this secretion. Moreover, upon uptake, miR-10b can suppress the protein level of its target genes such as HOXD10 and KLF4, indicating its functional significance. Finally, treatment with exosomes derived from MDA-MB-231 cells could induce the invasion ability of non-malignant HMLE cells.\Question: Does exosome-mediated transfer of miR-10b promote cell invasion in breast cancer?

Output: Together, our results suggest that a set of specific microRNAs may play an important role in modulating tumor microenvironment through exosomes. Thus, a better understanding of this process may aid in the development of novel therapeutic agents.


Input: Consider Input: Context: Serum prostate-specific antigen (PSA) level is a widely used serum marker for diagnosis and management of prostate cancer. Although not well-defined, liver appears to be the most likely site of PSA metabolism. However, general anaesthesia usually changes hepatic blood flow, therefore it may affect the metabolism of PSA. In this study we investigated the affect of general anaesthesia on the serum total PSA, free PSA and free to total PSA levels.', '30 male patients who were hospitalised in the internal medicine clinic (non-surgery group) and 30 male patients who would undergo operation under general anaesthesia (15 for cholecystectomy and 15 for inguinal hernia repair) enrolled into the study. PSA measurement was done on the day of the hospitalisation (which was also the day of operation for surgery group), on the 24th hour following the first measurement and on the 21st day. Anaesthesia was standardized for all patients.', 'There was no statistically significant difference in serum total PSA (p >0.05), free PSA levels (p >0.05) and free to total PSA ratio (p >0.05) between the surgery and non-surgery groups. There were statistically significant decreases in the 24th hour total PSA levels (13.8% in surgery group, p <0.05, and 13.1% in non-surgery group, p <0.05) and in the free PSA levels (4.0% in surgery group, p <0.05, and 8.2% in non-surgery group, p <0.05). There was no statistically significant difference in the free to total PSA ratios (p >0.05 and p >0.05, respectively).\Question: Does general anesthesia affect the serum complexed and free prostate specific antigen levels?


Output: Anaesthesia does not affect PSA levels alone. However, hospitalisation decreases total and free PSA levels, although it does not have an affect on free to total PSA ratio.