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clinical phenomenon; nor are the responses obtained via offline questionnaire capable of revealing the discrepancy of awareness observed from their online task performance. The discrepancy is noticed when patients showed no awareness of their deficits from the offline responses to the questionnaire but demonstrated reluctance or verbal circumlocution when asked to perform an online task. For example, patients with anosognosia for hemiplegia may find excuses not to perform a bimanual task even though they do not admit it is because of their paralyzed arms.
355:
anticipatory awareness). It can also occur among patients with dementia and anosognosia for memory deficit when prompted with dementia-related words, showing possible pre-attentive processing and implicit knowledge of their memory problems. Patients with anosognosia may also overestimate their performance when asked in first-person formed questions but not from a third-person perspective when the questions referring to others.
296:
anosognosia for hemiplegia may occur with or without intact awareness of visuo-spatial unilateral neglect. This phenomenon of double dissociation can be an indicator of domain-specific disorders of awareness modules, meaning that in anosognosia, brain damage can selectively impact the self-monitoring process of one specific physical or cognitive function rather than a spatial location of the body.
320:, believed to contain representations of word sounds. With those representations significantly distorted, patients with receptive aphasia are unable to monitor their mistakes. Other patients with receptive aphasia are fully aware of their condition and speech inhibitions, but cannot monitor their condition, which is not the same as anosognosia and therefore cannot explain the occurrence of
387:
or focus caused by the intense stimulation of the vestibular system temporarily influences awareness. Most cases of anosognosia appear to simply disappear over time, while other cases can last indefinitely. Normally, long-term cases are treated with cognitive therapy to train patients to adjust for
303:
could temporarily improve both the syndrome of spatial unilateral neglect and of anosognosia for left hemiplegia. Combining the findings of hemispheric asymmetry to the right, association with spatial unilateral neglect, and the temporal improvement on both syndromes, it is suggested there can be a
358:
When assessing the causes of anosognosia within stroke patients, CT scans have been used to assess where the greatest amount of damage is found within the various areas of the brain. Stroke patients with mild and severe levels of anosognosia (determined by response to an anosognosia questionnaire)
350:
Clinically, anosognosia is often assessed by giving patients an anosognosia questionnaire in order to assess their metacognitive knowledge of deficits. However, neither of the existing questionnaires applied in the clinics are designed thoroughly for evaluating the multidimensional nature of this
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A similar situation can happen to patients with anosognosia for cognitive deficits after traumatic brain injury when monitoring their errors during the tasks regarding their memory and attention (online emergent awareness) and when predicting their performance right before the same tasks (online
232:
Relatively little has been discovered about the cause of the condition since its initial identification. Recent empirical studies tend to consider anosognosia a multi-componential syndrome or multi-faceted phenomenon. That is, it can be manifested by failure to be aware of a number of specific
295:
Anosognosia can be selective in that an affected person with multiple impairments may seem unaware of only one handicap, while appearing to be fully aware of any others. This is consistent with the idea that the source of the problem relates to spatial representation of the body. For example,
304:
spatial component underlying the mechanism of anosognosia for motor weakness and that neural processes could be modulated similarly. There were some cases of anosognosia for right hemiplegia after left hemisphere damage, but the frequency of this type of anosognosia has not been estimated.
268:
is estimated at between 10% and 18%. However, it can appear to occur in conjunction with virtually any neurological impairment. It is more frequent in the acute than in the chronic phase and more prominent for assessment in the cases with right hemispheric lesions than with the left.
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their inoperable limbs (though it is believed that these patients still are not "aware" of their disability). Another commonly used method is the use of feedback — comparing clients' self-predicted performance with their actual performance on a task in an attempt to improve insight.
1261:
Martyr A, Clare L, Nelis SM, Roberts JL, Robinson JU, Roth I, et al. (January 2011). "Dissociation between implicit and explicit manifestations of awareness in early stage dementia: evidence from the emotional Stroop effect for dementia-related words".
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is difficult because, as anosognosia impairs the patient's desire to seek medical aid, it may also impair their ability to seek rehabilitation. A lack of awareness of the deficit makes cooperative, mindful work with a therapist difficult. In the
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1726:
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O'Keeffe F, Dockree P, Moloney P, Carton S, Robertson IH (January 2007). "Awareness of deficits in traumatic brain injury: a multidimensional approach to assessing metacognitive knowledge and online-awareness".
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Spinazzola L, Pia L, Folegatti A, Marchetti C, Berti A (February 2008). "Modular structure of awareness for sensorimotor disorders: evidence from anosognosia for hemiplegia and anosognosia for hemianaesthesia".
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errors and shows "anger and disappointment with the person with whom s/he is speaking because that person fails to understand her/him". This may be a result of brain damage to the posterior portion of the
383:(squirting ice cold water into the left ear) is known to temporarily ameliorate unawareness of impairment. It is not entirely clear how this works, although it is thought that the unconscious shift of
476:
Moro V, Pernigo S, Zapparoli P, Cordioli Z, Aglioti SM (November 2011). "Phenomenology and neural correlates of implicit and emergent motor awareness in patients with anosognosia for hemiplegia".
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regions, when compared to those who experience moderate anosognosia, or none at all. In contrast, after a stroke, people with moderate anosognosia have a higher frequency of lesions involving the
338:
Although largely used to describe unawareness of impairment after brain injury or stroke, the term "anosognosia" is occasionally used to describe the lack of insight shown by some people with
311:, a language disorder that causes poor comprehension of speech and the production of fluent but incomprehensible sentences. A patient with receptive aphasia cannot correct his own
664:
869:
Breier JI, Adair JC, Gold M, Fennell EB, Gilmore RL, Heilman KM (January 1995). "Dissociation of anosognosia for hemiplegia and aphasia during left-hemisphere anesthesia".
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field and reducing their frustration and confusion. Since severity changes over time, no single method of treatment or rehabilitation has emerged or will likely emerge.
342:. They do not seem to recognize that they have a mental illness. There is evidence that anosognosia related to schizophrenia may be the result of frontal lobe damage.
164:
is cognitively unaware of having it due to an underlying physical condition. Anosognosia results from physiological damage to brain structures, typically to the
902:
1493:
Berti A, Bottini G, Gandola M, Pia L, Smania N, Stracciari A, et al. (July 2005). "Shared cortical anatomy for motor awareness and motor control".
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Marcel AJ, Tegnér R, Nimmo-Smith I (February 2004). "Anosognosia for plegia: specificity, extension, partiality and disunity of bodily unawareness".
527:
1787:
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processes that are involved in integrating sensory information with processes that support spatial or bodily representations (including the
1050:
Ellis AW, Miller D, Sin G (December 1983). "Wernicke's aphasia and normal language processing: a case study in cognitive neuropsychology".
1557:
Lysaker P, Bell M, Milstein R, Bryson G, Beam-Goulet J (November 1994). "Insight and psychosocial treatment compliance in schizophrenia".
1421:
Prigatano GP (2005). "Disturbances of self-awareness and rehabilitation of patients with traumatic brain injury: a 20-year perspective".
216:('knowledge'). It is considered a disorder that makes the treatment of the patient more difficult, since it may affect negatively the
1474:
I am not sick, I don't need help! Helping the seriously mentally ill accept treatment. A practical guide for families and therapists
292:
in which people seem unable to attend to, or sometimes comprehend, anything on a certain side of their body (usually the left).
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phase, very little can be done to improve their awareness, but during this time, it is important for the therapist to build a
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Pia L, Neppi-Modona M, Ricci R, Berti A (April 2004). "The anatomy of anosognosia for hemiplegia: a meta-analysis".
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Pia L, Tamietto M (October 2006). "Unawareness in schizophrenia: neuropsychological and neuroanatomical findings".
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Evans, Amanda. “Anorexia
Nervosa: Illusion in the Sense of Agency.” Mind & Language, 13 Feb. 2022,
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Kletenik, Isaiah; Gaudet, Kyla; Prasad, Sashank; Cohen, Alexander L.; Fox, Michael D. (2023-06-08).
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288:, a condition often found after damage to the non-dominant (usually the right) hemisphere of the
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Anosognosia is relatively common following different causes of brain injury, such as stroke and
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or a diffuse lesion on the fronto-temporal-parietal area in the right hemisphere, and is thus a
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In regard to anosognosia for neurological patients, no long-term treatments exist. As with
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Chapman S, Colvin LE, Vuorre M, Cocchini G, Metcalfe J, Huey ED, Cosentino S (April 2018).
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Vuilleumier P (February 2004). "Anosognosia: the neurology of beliefs and uncertainties".
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Vuilleumier P (February 2004). "Anosognosia: the neurology of beliefs and uncertainties".
8:
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224:, a form of neglect in which patients deny ownership of body parts such as their limbs.
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Philosophical
Transactions of the Royal Society of London. Series B, Biological Sciences
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Delusion and Self-Deception: Affective and
Motivational Influences on Belief Formation
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1351:"Cross domain self-monitoring in anosognosia for memory loss in Alzheimer's disease"
1310:"Anosognosia in patients with cerebrovascular lesions. A study of causative factors"
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528:"Anosognosia for motor and sensory deficits after unilateral brain damage: a review"
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Starkstein SE, Fedoroff JP, Price TR, Leiguarda R, Robinson RG (October 1992).
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Cortex; A Journal
Devoted to the Study of the Nervous System and Behavior
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Cortex; A Journal
Devoted to the Study of the Nervous System and Behavior
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Cortex; A Journal
Devoted to the Study of the Nervous System and Behavior
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Cortex; A Journal
Devoted to the Study of the Nervous System and Behavior
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Cortex; A Journal
Devoted to the Study of the Nervous System and Behavior
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261:
253:) due to impairment of anatomo-functionally discrete monitoring systems.
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Awareness of deficit after brain injury: clinical and theoretical issues
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Awareness of deficit after brain injury: clinical and theoretical issues
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Pathologies of
Awareness: Bridging the Gap between Theory and Practice
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384:
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662:
719:"Network Localization of Awareness in Visual and Motor Anosognosia"
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246:
1538:
778:"Incidence and diagnosis of anosognosia for hemiparesis revisited"
172:. A deficit of self-awareness, the term was first coined by the
1307:
1206:
924:"Possible mechanisms of anosognosia: a defect in self-awareness"
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273:
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Phantoms in the brain: probing the mysteries of the human mind
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Phantoms in the Brain: Probing the Mysteries of the Human Mind
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Brain fiction: self-deception and the riddle of confabulation
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have been linked to lesions within the temporoparietal and
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loss but is thought to be caused by damage to higher level
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1650:. New York: W.W. Norton & Company. pp. 111–122.
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Unawareness of one's own illness, symptoms or impairments
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Journal of the International Neuropsychological Society
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264:(weakness of one side of the body) with onset of acute
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The condition does not seem to be directly related to
367:, compared to those with mild or severe anosognosia.
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71:
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47:
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612:. Oxford : Oxford University Press. pp. 53–55.
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There are also studies showing that the maneuver of
197:; attempts have been made at a unified explanation.
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112:
62:
1624:
1471:
1398:Prigatano, George P.; Schacter, Daniel L. (1991).
922:Heilman KM, Barrett AM, Adair JC (November 1998).
830:"The evaluation of anosognosia in stroke patients"
782:Journal of Neurology, Neurosurgery, and Psychiatry
555:
553:
1645:
1200:
606:Prigatano, George P.; Schacter, Daniel L (1991).
284:system). Anosognosia is thought to be related to
179:in 1914, in order to describe the unawareness of
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1623:Ramachandran, V. S.; Blakeslee, Sandra (1999).
1402:. New York, New York: Oxford University Press.
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663:Ramachandran, V. S.; Blakeslee, Sandra (1999).
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1264:International Journal of Geriatric Psychiatry
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1542:. Taylor & Francis(Psychology Press).
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220:. Anosognosia is sometimes accompanied by
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160:is a condition in which a person with a
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1021:10.1016/j.neuropsychologia.2007.12.015
532:Restorative Neurology and Neuroscience
1108:Psychiatry and Clinical Neurosciences
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631:
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334:Insight in psychology and psychiatry
449:(also known as hemispatial neglect)
13:
1461:
1094:https://doi.org/10.1111/mila.12385
776:Baier B, Karnath HO (March 2005).
189:, anosognosia has similarities to
14:
1799:
1704:
1470:Amador, Xavier Francisco (2000).
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307:Anosognosia may occur as part of
1435:10.1097/00001199-200501000-00004
1120:10.1111/j.1440-1819.2006.01576.x
706:from the original on 2020-04-17.
694:Castillero O (21 October 2016).
403:with patients by entering their
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260:; for example, anosognosia for
1571:10.1080/00332747.1994.11024695
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1:
1679:10.1016/S0010-9452(08)70918-3
1600:10.1016/S0010-9452(08)70131-X
1178:10.1016/s0010-9452(08)70919-5
574:10.1016/S0010-9452(08)70918-3
453:
327:
237:), sensory (hemianaesthesia,
1367:10.1016/j.cortex.2018.01.019
1064:10.1016/0010-0277(83)90036-7
669:. New York: Quill. pp.
370:
345:
7:
526:Vallar G, Ronchi R (2006).
410:
233:deficits, including motor (
193:, which is a psychological
10:
1804:
1646:Torrey, E. Fuller (2012).
975:. MIT Press. p. 148.
478:Behavioural Brain Research
331:
1712:
1327:10.1161/01.STR.23.10.1446
1222:10.1017/S1355617707070075
490:10.1016/j.bbr.2011.07.010
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170:neuropsychiatric disorder
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29:
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834:Cerebrovascular Diseases
794:10.1136/jnnp.2004.036731
218:therapeutic relationship
212:'disease'), and γνῶσις,
1783:Complications of stroke
1515:10.1126/science.1110625
1096:. Accessed 5 Mar. 2022.
422:Anton–Babinski syndrome
318:superior temporal gyrus
940:10.1098/rstb.1998.0342
432:Body transfer illusion
381:caloric reflex testing
301:vestibular stimulation
258:traumatic brain injury
200:The name derives from
1648:The Insanity Offense
642:. Psychology Press.
401:therapeutic alliance
208:('without'), νόσος,
1631:. New York: Quill.
1507:2005Sci...309..488B
971:Hirstein W (2005).
934:(1377): 1903–1909.
883:10.1212/WNL.45.1.65
723:Annals of Neurology
392:Neurorehabilitation
700:Psicología y Mente
447:Unilateral neglect
377:unilateral neglect
322:neologistic jargon
286:unilateral neglect
243:unilateral neglect
187:Phenomenologically
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1657:978-0-393-34137-9
1638:978-0-688-17217-6
1549:978-1-84169-810-6
1501:(5733): 488–491.
1485:978-0-9677189-0-3
1320:(10): 1446–1453.
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847:10.1159/000199466
736:10.1002/ana.26709
680:978-0-688-17217-6
649:978-1-136-87486-4
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309:receptive aphasia
251:receptive aphasia
249:), and language (
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696:"Anosognosia"
690:
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621:
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365:basal ganglia
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222:asomatognosia
219:
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202:Ancient Greek
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167:
166:parietal lobe
163:
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1209:
1202:
1172:(1): 19–40.
1169:
1165:
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231:
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427:Body schema
262:hemiparesis
245:), memory (
174:neurologist
158:Anosognosia
25:Anosognosia
1767:Categories
1559:Psychiatry
1231:2262/35786
454:References
332:See also:
328:Psychiatry
239:hemianopia
235:hemiplegia
181:hemiplegia
162:disability
146:Psychiatry
1408:496306119
1129:2318/8242
1052:Cognition
1007:CiteSeerX
871:Neurology
745:1531-8249
385:attention
371:Treatment
346:Diagnosis
313:phonetics
150:Neurology
141:Specialty
1778:Dementia
1687:15070000
1608:15156794
1523:16020740
1451:27815630
1443:15668568
1385:29518705
1292:34463285
1284:21157854
1240:17166302
1186:15070001
1146:42043399
1138:16958934
1080:29284758
1029:18281065
899:46383489
856:19202333
812:15716526
763:37289520
754:10524951
704:Archived
582:15070000
544:17119302
498:21777624
411:See also
361:thalamic
247:dementia
1773:Agnosia
1695:4482597
1616:4479704
1579:7899525
1531:8423262
1503:Bibcode
1495:Science
1376:5877321
1336:1412582
1248:8466337
1194:4484058
1072:6686505
1037:2436977
958:9854262
949:1692420
909:3452304
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671:113–157
590:4482597
506:8389272
274:sensory
210:nosos (
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266:stroke
228:Causes
214:gnōsis
204:: ἀ-,
191:denial
132:
1751:780.9
1736:R41.8
1691:S2CID
1612:S2CID
1527:S2CID
1447:S2CID
1288:S2CID
1244:S2CID
1190:S2CID
1142:S2CID
1076:S2CID
1033:S2CID
903:INIST
895:S2CID
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502:S2CID
397:acute
1746:9-CM
1683:PMID
1652:ISBN
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1480:ISBN
1439:PMID
1404:OCLC
1381:PMID
1332:PMID
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741:ISSN
675:ISBN
644:ISBN
614:ISBN
578:PMID
540:PMID
494:PMID
1742:ICD
1727:ICD
1675:doi
1596:doi
1567:doi
1511:doi
1499:309
1431:doi
1371:PMC
1363:doi
1359:101
1322:doi
1272:doi
1226:hdl
1218:doi
1174:doi
1124:hdl
1116:doi
1060:doi
1017:doi
944:PMC
936:doi
932:353
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798:PMC
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