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.
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Question: Context: Despite the potential benefits of total quality management (TQM), many healthcare organisations encountered difficulties in its implementation. The purpose of this paper is to explore the barriers to successful implementation of TQM in healthcare organisations of Iran.', 'This study involved a mixed research design. In-depth interviews were conducted with TQM practitioners to explore TQM implementation obstacles in Iranian healthcare organisations. In addition, this study involved survey-based research on the obstacles associated with successful TQM transformation.', "TQM implementation and its impact depend on the ability of managers to adopt and adapt its values and concepts in professional healthcare organisations. Unsuccessful TQM efforts in Iranian healthcare organisations can be attributed to the non-holistic approach adopted in its implementation, inadequate knowledge of managers' about TQM implementation, frequent top management turnover, poor planning, vague and short-termed improvement goals, lack of consistent managers' and employees' commitment to and involvement in TQM implementation, lack of a corporate quality culture, lack of team orientation, lack of continuous education and training and lack of customer focus. Human resource problems, cultural and strategic problems were the most important obstacles to TQM successful implementation, respectively.\Question: Does why TQM work in Iranian healthcare organisations?

Answer: Understanding the factors that are likely to obstruct TQM implementation would enable managers to develop more viable strategies for achieving business excellence.


Question: Context: Genetic haploinsufficiency of SYNGAP1/Syngap1 commonly occurs in developmental brain disorders, such as intellectual disability, epilepsy, schizophrenia, and autism spectrum disorder. Thus, studying mouse models of Syngap1 haploinsufficiency may uncover pathologic developmental processes common among distinct brain disorders.', 'A Syngap1 haploinsufficiency model was used to explore the relationship between critical period dendritic spine abnormalities, cortical circuit assembly, and the window for genetic rescue to understand how damaging mutations disrupt key substrates of mouse brain development.', 'Syngap1 mutations broadly disrupted a developmentally sensitive period that corresponded to the period of heightened postnatal cortical synaptogenesis. Pathogenic Syngap1 mutations caused a coordinated acceleration of dendrite elongation and spine morphogenesis and pruning of these structures in neonatal cortical pyramidal neurons. These mutations also prevented a form of developmental structural plasticity associated with experience-dependent reorganization of brain circuits. Consistent with these findings, Syngap1 mutant mice displayed an altered pattern of long-distance synaptic inputs into a cortical area important for cognition. Interestingly, the ability to genetically improve the behavioral endophenotype of Syngap1 mice decreased slowly over postnatal development and mapped onto the developmental period of coordinated dendritic insults.\Question: Does syngap1 haploinsufficiency damage a postnatal critical period of pyramidal cell structural maturation linked to cortical circuit assembly?

Answer: Pathogenic Syngap1 mutations have a profound impact on the dynamics and structural integrity of pyramidal cell postsynaptic structures known to guide the de novo wiring of nascent cortical circuits. These findings support the idea that disrupted critical periods of dendritic growth and spine plasticity may be a common pathologic process in developmental brain disorders.


Question: Context: To evaluate whether subjects with nonalcoholic hepatic steatosis (HS) differed in their circulating adiponectin levels compared with those in subjects without HS and, if so, to examine to what extent such differences are mediated by the adverse pattern of the metabolic syndrome variables, typically observed in these subjects.', 'In a cross-sectional study, we analysed 68 healthy, mildly obese individuals with a negative or negligible daily alcohol consumption.', 'HS (by ultrasonography), glucose tolerance status (by oral glucose load), insulin resistance [by homeostasis model assessment (HOMA)], and plasma adiponectin concentration [by enzyme-linked immunosorbent assay (ELISA)] were measured.', 'Subjects with nonalcoholic HS (n = 43) had markedly lower plasma adiponectin concentrations than those without HS (n = 25) (5.6 +/- 3 vs. 10.8 +/- 4 microg/ml; P < 0.001). In addition, the former had significantly higher values for body mass index (BMI), waist/hip ratio (WHR), HOMA-insulin resistance score, plasma insulin (at fasting and after glucose load), plasma triglyceride and liver enzyme concentrations [such as alanine aminotransferase (ALT) and gamma-glutamyltranspeptidase (GGT)], and tended to have lower high density lipoprotein (HDL) cholesterol concentration. The significant differences in plasma adiponectin levels that were observed between the groups were little affected by adjustment for potential confounding variables, such as age, sex, BMI, WHR, lipids and HOMA-insulin resistance score. Similarly, in multivariate regression analyses, hypoadiponectinaemia significantly predicted the presence of HS (P < 0.001) and the increased levels of GGT and ALT (P < 0.05), independently of potential confounders.\Question: Are decreased plasma adiponectin concentrations closely associated with nonalcoholic hepatic steatosis in obese individuals?

Answer:
These results show that decreased plasma adiponectin concentrations are closely correlated with nonalcoholic HS in healthy obese individuals.