TASK DEFINITION: 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.
PROBLEM: Context: Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED).', 'This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December 31st, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death.', 'During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47).\Question: Do cancer Patients Are at High Risk of Mortality if Presenting with Sepsis at an Emergency Department?

SOLUTION: Cancer patients have double the risk of mortality if presenting with sepsis at the ED.

PROBLEM: Context: Transport across the blood-brain barrier (BBB) is an important mediator of beta-amyloid (A) accumulation in the brain and a contributing factor in the pathogenesis of Alzheimer's disease (AD). One of the receptors responsible for the transport of A in the BBB is the low density lipoprotein receptor-related protein 1 (LRP1). LRP1 is susceptible to proteolytic shedding at the cell surface, which prevents endocytic transport of ligands. Previously, we reported a strong inverse correlation between LRP1 shedding in the brain and A transit across the BBB. Several proteases contribute to the ectodomain shedding of LRP1 including the -secretase, a desintegrin and metalloproteinase domain containing protein 10 (ADAM10).", 'The role of ADAM10 in the shedding of LRP1 and A BBB clearance was assessed through pharmacological inhibition of ADAM10 in an in vitro model of the BBB and through the use of ADAM10 endothelial specific knock-out mice. In addition, an acute treatment paradigm with an ADAM10 inhibitor was also tested in an AD mouse model to assess the effect of ADAM10 inhibition on LRP1 shedding and Abrain accumulation.', 'In the current studies, inhibition of ADAM10 reduced LRP1 shedding in brain endothelial cultures and increased A42 transit across an in vitro model of the BBB. Similarly, transgenic ADAM10 endothelial knockout mice displayed lower LRP1 shedding in the brain and significantly enhanced A clearance across the BBB compared to wild-type animals. Acute treatment with the ADAM10-selective inhibitor GI254023X in an AD mouse model substantially reduced brain LRP1 shedding and increased A40 levels in the plasma, indicating enhanced A transit from the brain to the periphery. Furthermore, both soluble and insoluble A40 and A42 brain levels were decreased following GI254023X treatment, but these effects lacked statistical significance.\Question: Does inhibition of ADAM10 promote the clearance of A across the BBB by reducing LRP1 ectodomain shedding?

SOLUTION: These studies demonstrate a role for ADAM10 in the ectodomain shedding of LRP1 in the brain and the clearance of A across the BBB, which may provide a novel strategy for attenuating A accumulation in the AD brain.

PROBLEM: Context: Carrot allergy is caused by primary sensitization to birch pollen. Continuous carrot exposure results in additional Dau c 1-specific allergic responses. Thus, immunotherapy with birch pollen may not improve the food allergy.', 'Evaluation of mutation and oligomerization of the major carrot allergen, Dau c 1, in regard to alteration of antibody binding capacities, structure, and the ability to induce blocking IgG antibodies.', 'Measurement of IgE reactivities to monomers, dimers of wild-type and mutant Dau c 1.0104 and Dau c 1.0201, and Dau c 1.0104 trimer, their ability to induce blocking antibodies in mice, and their allergenic potency by histamine release.', 'The reactivity of human IgE to the mutant dimer was reduced on average by 81%. Sera of immunized Balb/c mice showed specific IgG similar to the human IgE antibody response; Dau c 1.01 was more antigenic than Dau c 1.02. Both wild-type and mutant Dau c 1 variants induced cross-reacting IgG, which blocked binding of human IgE. The mutants were more antigenic than the wild-type forms, and the dimers induced higher IgG responses in mice than the monomers. The results of the histamine release experiments corroborated the findings of the antibody binding studies.\Question: Is allergenicity and antigenicity of wild-type and mutant , monomeric , and dimeric carrot major allergen Dau c 1 : destruction of conformation , not oligomerization , the roadmap to save allergen vaccines?

SOLUTION:
Destruction of native conformation rather than oligomerization is the appropriate strategy to reduce the allergenicity of Bet v 1-homologous food allergens.