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.

Example Input: Context: Cytokeratin 19 is significant for indicating cancer cells, and Cyfra 21-1 is a fragment of cytokeratin 19. This retrospective study was designed to define the prognostic value of serum Cyfra 21-1 in epithelial ovarian cancers (EOC).', 'Serum Cyfra 21-1 concentration was obtained from 42 patients with EOC prior to treatment. Various prognostic aspects were examined using univariable and multivariable analyses. The standard serum marker cancer antigen 125 was measured simultaneously and compared in this analysis.', 'Serum levels of both Cyfra 21-1 and cancer antigen 125 were associated with positive retroperitoneal lymph nodes and platinum resistance; higher levels of Cyfra 21-1 (3.0\xa0ng/mL as the cut-off) were associated with shorter disease-free survival (16 months vs. 28 months, p\xa0=\xa00.001) and overall survival (29 months vs. 41 months, p\xa0=\xa00.007) than lower levels. Further univariable analysis showed that Cyfra 21-1, poor differentiation, and retroperitoneal lymph node metastasis were related to platinum resistance and mortality. Multivariable analysis indicated retroperitoneal lymph node metastasis and serum Cyfra 21-1 were independent risk factors for both disease-free survival and overall survival.\Question: Is serum cytokeratin-19 fragment ( Cyfra 21-1 ) a prognostic indicator for epithelial ovarian cancer?
Example Output: The pretreatment level of serum Cyfra 21-1 had remarkable prognostic significance for EOC, indicating poor survival when it was elevated above 3.0 ng/mL.

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

Example Input: Context: Rural primary health centers frequently treat patients with tick bites. This study compares everyday clinical practice at our primary healthcare center to practices recommended by current scientific evidence.', 'To describe the everyday management of tick bites by different healthcare professionals and to compare this management to evidence-based therapy guidelines.', 'Cross-sectional, descriptive observational study.', 'Data was collected through an anonymous self-completed questionnaire. The form was filled out by a consecutive sample of nurses, physicians and pediatricians of the clinical management unit of Medina-Sidonia (Cádiz).', 'Most nurses in the sample group use some type of product to facilitate the extraction of the tick (10 of the 11 surveyed nurses, 90.9%). The most frequently used products were chloroethyl and local anesthetic. In addition, nine nurses use gentle traction with tweezers (81.82%) to remove the tick. In the physician sample group, 3 out of 12 respondents (25%) prescribe antibiotics in all cases and nine stated that they knew which antibiotic should be used as first choice. In both cases, a high number of healthcare providers confirm giving post-extraction advice to patients: 11 in the medical community (91.66%) and nine nurses (81.82%).\Question: Does [ Descriptive study of healthcare professionals ' management of tick bite ]?
Example Output:
We conclude that the performance of the healthcare providers that integrate this study does not closely follow general recommendations for extraction, treatment and follow-up care in patients with tick bites. Therefore, there is a need to improve the level of knowledge to ensure quality care in these instances.