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doi: 10.1097/MPA.0b013e3182a85c21 130 ZhengYSWuZSZhangLYKeLLiWQLiNet al
Additionally, respiratory insufficiency is signaled by dyspnea and increased work of breathing, retractions, orthopnea, and cyanosis
In the NYPLs digitized George Arents collection, I found an illustration called The Great Spirit, pasted on cardstock alongside a page from E

Its also linked to conditions such as chronic obstructive pulmonary disease (COPD)

