Given an abstract, generate a keyword (a noun phrase) that best describes the focus or contribution of the paper. Such keywords can be directly from the given abstract or outside it.
Example: Abstract: Some patients converted from ventricular fibrillation to organized rhythms by defibrillation - trained ambulance technicians(EMT - Ds) will refibrillate before hospital arrival.The authors analyzed 271 cases of ventricular fibrillation managed by EMT - Ds working without paramedic back - up.Of 111 patients initially converted to organized rhythms, 19(17 % ) refibrillated, 11(58 % ) of whom were reconverted to perfusing rhythms, including nine of 11(82 % ) who had spontaneous pulses prior to refibrillation.Among patients initially converted to organized rhythms, hospital admission rates were lower for patients who refibrillated than for patients who did not(53 % versus 76 % , P = NS), although discharge rates were virtually identical(37 % and 35 % , respectively).Scene - to - hospital transport times were not predictively associated with either the frequency of refibrillation or patient outcome.Defibrillation - trained EMTs can effectively manage refibrillation with additional shocks and are not at a significant disadvantage when paramedic back - up is not available.
Example solution: Ventricular Fibrillation
Example explanation: This term is directly present in the abstract and it is one of the main topic in it. So can be chosen as the medical subject heading.

Problem: Abstract: TSH is a glycoprotein hormone whose carbohydrate content varies among different species. Although recent studies suggest that variants of TSH deficient in carbohydrate occur naturally, the significance of the carbohydrate moiety of TSH in respect to its thyrotropic function is unclear. The present studies were undertaken, therefore, to examine this question. A highly purified preparation of bovine TSH (bTSH) was deglycosylated by treatment with anhydrous hydrogen fluoride. Amino acid and carbohydrate analyses of the original and deglycosylated preparations indicated that approximately 85% of the carbohydrate originally present had been removed and that the protein moiety was unaltered. As judged from TSH radioreceptor assays, bTSH and deglycosylated bTSH (dg-bTSH) bound to human thyroid membranes with equal affinity, since both caused a half-maximal inhibition of [125I]bTSH binding at approximately equal concentrations. Nonetheless, dg-bTSH at optimal concentration displayed only about one third the activity of intact TSH in stimulating adenylate cyclase activity in human thyroid membranes. dg-bTSH also antagonized the adenylate cyclase-stimulating activity of intact bTSH in this system, but only weakly, since abolition of the bTSH effect required an approximately 40-fold higher concentration of dg-bTSH. In cultures of FRTL5 cells, a cloned line of follicular cells derived from normal rat thyroid, both intact and dg-bTSH enhanced cell growth, as measured by [3H]thymidine incorporation and stimulated cAMP release in the medium, but the response elicited by dg-bTSH was much less than that caused by equal concentrations of the intact hormone. In accord with the findings in the in vitro assays, dg-bTSH evoked a much smaller response than bTSH did in the in vivo mouse assay. It is concluded that although not required for receptor recognition, the carbohydrate moiety of bTSH is essential for the full expression of its biological activity.
Solution: Adenosine Cyclic Monophosphate