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.

[EX Q]: Abstract: The records of 165 patients with diaphragmatic injuries seen at Detroit Receiving Hospital from July 1980 through June 1985 were reviewed. Causes included gunshot wounds in 89 patients, stab wounds in 65, and blunt trauma in 11. Mortality rates were 18%, 5%, and 27%, respectively, deaths being caused primarily by bleeding from associated injuries. Operations on these patients included laparotomy in 123 (75%), thoracotomy in four (2%), and both in 38 (23%). The mortality rates for these operations were 0%, 50%, and 53%, respectively. A presumptive preoperative diagnosis of diaphragmatic injury from chest x-ray findings was possible in only 24 (15%) patients. Of 42 thoracotomies, five were performed in the emergency department for cardiac arrest, with three (60%) deaths. Of 37 thoracotomies performed in the operating room, 17 were for thoracic injuries with six (35%) deaths and 20 were for resuscitation for abdominal injuries with 13 (65%) deaths. In most patients, the diaphragmatic injury was critical only in warning the surgeon that severe injuries might be present in both the chest and abdomen. Of 43 patients admitted with a blood pressure of less than 70 mm Hg or four or more associated injuries, 22 died. However, even in these high-risk patients, if resuscitation raised the initial operating room blood pressure to more than 70 mm Hg, reduced the shock time to less than 30 minutes, and kept blood loss below 10 units, the mortality was only 8% (1/12). In contrast, if none of these conditions could be met, the mortality in this high-risk group was 100% (16/16). Thus more aggressive resuscitative efforts and earlier control of bleeding seem to provide the best chance for improved survival.
[EX A]: Adolescence

[EX Q]: Abstract: The total cobalt and nickel concentration of 11 brands of Asian cement ranged from 8.1 to 14.2 micrograms/g and 14.9 to 28.5 micrograms/g, respectively. These metals exist mainly as insoluble salts; the water-soluble concentration of cobalt and nickel in the cements ranged from 0.39 to 0.65 micrograms/g and from 0-1.2 micrograms/g, respectively. 1.5% (4/272) of construction workers in a prefabrication construction factory had cobalt sensitivity. All had allergic contact dermatitis from chromate in cement. No worker had isolated cobalt sensitivity and cement dermatitis. It appeared that sensitization to cobalt in cement occurs only secondarily to an existing cement dermatitis. 1.8% (5/272) workers had nickel sensitivity: 2 with allergic contact dermatitis to nickel in their watches, 2 were asymptomatic and 1 had allergic contact dermatitis to chromate and cobalt in cement. The low prevalence of cobalt and nickel sensitivity from cement was probably related to the low concentration of soluble cobalt and nickel salts in the cement. However, these insoluble salts can form soluble complexes with body fluids on eczematous skin and sensitize the skin.
[EX A]: Asia

[EX Q]: Abstract: Multivariate analysis on an unselected patient population consisting of all 253 children treated for neuroblastoma in Denmark during 1943 to 1980 shows that stage, age, and treatment given are independent prognostic variables. Calendar year of diagnosis, sex of the patient, and site of primary tumor were not significant prognostic factors. Further analysis shows that multimodal treatment with surgery, irradiation, and chemotherapy, especially in patients older than 1 year of age with Stage II disease, has influenced the survival significantly. The fact that age at diagnosis and the administration of chemotherapy have independent prognostic significance can be explained by the theory that all neuroblastomas are virtually congenital; therefore, the difference in age at diagnosis largely reflects the difference in growth rates of the tumor. Thus, according to this theory, age may be a measure of the probability of micrometastases in addition to the clinical extent or stage of the disease, as it represents the duration of the disease. Additional chemotherapy may thus have eradicated these micrometastases in the older children, since the age influence on Stage II disease disappeared when multimodal treatment was given in this study. The implications for treatment policy are discussed in view of this theory.
[EX A]:
Age Factors