Primer upate

I've checked in all the files from Chime, fixed the RDFa transform from
Fabien, and the latest SPARQL queries from Brian Suda in the primer, as
well as shortening the intro ala the comments from the microformat list
to make the primer shorter and snappier.

However, I haven't linked all the files from Chime because I'm not
entirely sure precisely how to do it.
Chime - could you stay on the phone for a little bit after our next
telecon to help me sort it out? Then we can get John Madden to give us a
review...

Chimezie Ogbuji wrote:
> So, I finally got the chunk of time to do the HL7 primer usecase
> justice. I suffered some data loss on my latop and had to redo alot of
> earlier work. No worries, I got several things done which I wanted to
> address to finish this off:
>
> - Move the documentation of the medical record target ontology off ESW
> to a permanent namespace document
> - A namespace document which has as GRDDL result the OWL ontology itself
> - Better references to literature and supporting ontologies
> - Compliance with the community of Ontology of Biomedical Ontologies
> (OBO) [1] as well as DOLCE [2]
> - Go through a second review of the target ontology (added
> annotations, ..)
> - Flesh out the GRDDL transform to cover as much of the input HL7
> document as possible
>
> The human/machine readable documentation of the medical record
> ontology is available from the namespace URL
>
> http://purl.org/cpr/0.5#
>
> This only documents the cpr:* terms and a handful of dependent terms.
> The *full* documentation is available from
>
> http://purl.org/cpr/html/full
>
> So, we can either host the ontology (also attached) in the primer
> webspace or just point to the permanent PURL.
>
> The attached snippets were generated by *running* the instance through
> a 4Suite / RDFLib pipeline (via Bash and pipes) so it would be a shock
> if they weren't both well-formed and reproducable by any other
> XML-compliant processor.
>
> References to SNOMED-CT are hard to come by as it is a proprietary
> (but widely used) clinical terminology. At best their web site (linked
> from the current draft) is the most consistent URL. Hopefully, this
> changes some day soon =)
>
> Attached:
>
> - hl7-sample.xml The source HL7 CDA [4] sample document
> - hl7-sample.rdf RDF/XML GRDDL result
> - hl7-sample.turtle (human-readable) Turtle GRDDL result
> - hl7-rim-to-pomr.xslt (The GRDDL transform itself)
> - problem-oriented-medical-record.owl (the ontology itself)
>
> Perhaps of interest to the WG, the HTML namespace document for the
> ontology was generated with a program [4] which can do this for any
> other OWL document. It makes for a quick and dirty way to generate
> highly accessible ontology namespace documents.
>
> The Turtle snippets need to be changed to reflect the changes:
>
> [ a cpr:patient-record;
> dc:date "2000-04-07";
> edns:about [ a galen:Patient;
> foaf:family_name "Levin";
> foaf:firstName "Henry"];
> foaf:maker [ a foaf:Person;
> foaf:family_name "Dolin";
> foaf:firstName "Robert"]]
>
>
> [ a cpr:clinical-description;
> cpr:description-of [ a cpr:screening-act;
> edns:realizes [ a cpr:medical-sign;
> cpr:interpretant-of [
> a foaf:Image;
> skos:prefLabel "Chest-X-ray"];
> skos:prefLabel "Chest hyperinflated"];
> skos:prefLabel "Imaging interpretation"]],
>
>
> [ a cpr:clinical-description;
> cpr:description-of [ a cpr:therapeutic-act;
> dc:date "2000-04-07T14:30:00";
> galen:hasSpecificLocation "Left forearm";
> skos:prefLabel "Suture removal"]]
>
> Namespace definitions (at the top of the namespace document for the
> medical record ontology):
>
> - cpr-> http://purl.org/cpr/0.5#
> - edns-> http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#
> - dc-> http://purl.org/dc/elements/1.1/
> - galen-> http://www.co-ode.org/ontologies/galen#
>
> [1] http://obo.sourceforge.net/
> [2] http://www.loa-cnr.it/DOLCE.html
> [3]
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16221939&query_hl=1
>
> [4] http://code.google.com/p/python-dlp/wiki/SemanticWebOntologyPublisher
>
> Chimezie Ogbuji
> Lead Systems Analyst
> Thoracic and Cardiovascular Surgery
> Cleveland Clinic Foundation
> 9500 Euclid Avenue/ W26
> Cleveland, Ohio 44195
> Office: (216)444-8593
> ogbujic@ccf.org
> ------------------------------------------------------------------------
>
> <?xml version="1.0" encoding="utf-8"?>
> <rdf:RDF xmlns:foaf="http://xmlns.com/foaf/0.1/" xmlns:obo="http://www.geneontology.org/owl#" xmlns:dol="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#" xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:cpr="http://purl.org/cpr/0.5#" xmlns:rim="urn:hl7-org:v3" xmlns:galen="http://www.co-ode.org/ontologies/galen#" xmlns:ex="http://example.com/" xmlns="urn:hl7-org:v3" xmlns:inf="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#" xmlns:skos="http://www.w3.org/2004/02/skos/core#" xmlns:edns="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#">
>   <rdfs:Description rdf:about="">
>     <rdfs:isDefinedBy rdf:resource="http://purl.org/cpr"/>
>   </rdfs:Description>
>   <cpr:patient-record>
>     <dc:date>2000-04-07</dc:date>
>     <edns:about>
>       <galen:Patient>
>         <foaf:firstName>Henry</foaf:firstName>
>         <foaf:family_name>Levin</foaf:family_name>
>       </galen:Patient>
>     </edns:about>
>     <foaf:maker>
>       <foaf:Person>
>         <foaf:firstName>Robert</foaf:firstName>
>         <foaf:family_name>Dolin</foaf:family_name>
>       </foaf:Person>
>     </foaf:maker>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>1950</dc:date>
>             <skos:prefLabel>clinical diagnosis</skos:prefLabel>
>             <dc:date>1950</dc:date>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>Asthma</skos:prefLabel>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>clinical diagnosis</skos:prefLabel>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>HTN</skos:prefLabel>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>clinical diagnosis</skos:prefLabel>
>             <galen:hasSpecificLocation>Knee joint</galen:hasSpecificLocation>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>Osteoarthritis</skos:prefLabel>
>                 <galen:hasSpecificLocation>Knee joint</galen:hasSpecificLocation>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>Theodur 200mg BID</skos:prefLabel>
>             <effectiveTime>
>               <rim:period>
>                 <rdf:value>12</rdf:value>
>                 <ex:unit>h</ex:unit>
>               </rim:period>
>             </effectiveTime>
>             <doseQuantity>
>               <rdf:Description>
>                 <ex:unit>mg</ex:unit>
>                 <rdf:value>200</rdf:value>
>               </rdf:Description>
>             </doseQuantity>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>Proventil inhaler 2puffs QID PRN</skos:prefLabel>
>             <effectiveTime>
>               <rim:period>
>                 <rdf:value>6</rdf:value>
>                 <ex:unit>h</ex:unit>
>               </rim:period>
>             </effectiveTime>
>             <doseQuantity>
>               <rdf:Description>
>                 <rdf:value>2</rdf:value>
>               </rdf:Description>
>             </doseQuantity>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>Prednisone 20mg qd</skos:prefLabel>
>             <effectiveTime>
>               <rim:period>
>                 <rdf:value>24</rdf:value>
>                 <ex:unit>h</ex:unit>
>               </rim:period>
>             </effectiveTime>
>             <doseQuantity>
>               <rdf:Description>
>                 <ex:unit>mg</ex:unit>
>                 <rdf:value>20</rdf:value>
>               </rdf:Description>
>             </doseQuantity>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>HCTZ 25mg qd</skos:prefLabel>
>             <effectiveTime>
>               <rim:period>
>                 <rdf:value>24</rdf:value>
>                 <ex:unit>h</ex:unit>
>               </rim:period>
>             </effectiveTime>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#medical-history-screening-act"/>
>                 <inf:realizes>
>                   <cpr:medical-sign>
>                     <skos:prefLabel>Allergy to penicillin</skos:prefLabel>
>                     <cpr:interpretant-of>
>                       <cpr:symptom>
>                         <skos:prefLabel>Hives</skos:prefLabel>
>                       </cpr:symptom>
>                     </cpr:interpretant-of>
>                   </cpr:medical-sign>
>                 </inf:realizes>
>                 <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#medical-history-screening-act"/>
>                 <inf:realizes>
>                   <cpr:medical-sign>
>                     <skos:prefLabel>Allergy to aspirin</skos:prefLabel>
>                     <cpr:interpretant-of>
>                       <cpr:symptom>
>                         <skos:prefLabel>Wheezing</skos:prefLabel>
>                       </cpr:symptom>
>                     </cpr:interpretant-of>
>                   </cpr:medical-sign>
>                 </inf:realizes>
>                 <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#medical-history-screening-act"/>
>                 <inf:realizes>
>                   <cpr:medical-sign>
>                     <skos:prefLabel>Adverse reaction to drug</skos:prefLabel>
>                     <cpr:interpretant-of>
>                       <cpr:symptom>
>                         <skos:prefLabel>Pruritis</skos:prefLabel>
>                       </cpr:symptom>
>                     </cpr:interpretant-of>
>                   </cpr:medical-sign>
>                 </inf:realizes>
>                 <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#medical-history-screening-act"/>
>                 <inf:realizes>
>                   <cpr:medical-sign>
>                     <cpr:interpretant-of>
>                       <cpr:symptom>
>                         <skos:prefLabel>Nausea</skos:prefLabel>
>                       </cpr:symptom>
>                     </cpr:interpretant-of>
>                   </cpr:medical-sign>
>                 </inf:realizes>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <dc:date>1970</dc:date>
>             <obo:OBO_REL_has_improper_part>
>               <cpr:medical-history-screening-act>
>                 <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>                 <inf:realizes>
>                   <rdf:Description>
>                     <dc:date>1970</dc:date>
>                     <skos:prefLabel>MI</skos:prefLabel>
>                   </rdf:Description>
>                 </inf:realizes>
>               </cpr:medical-history-screening-act>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>             <obo:OBO_REL_has_improper_part>
>               <cpr:medical-history-screening-act>
>                 <skos:prefLabel>history taking (procedure)</skos:prefLabel>
>                 <inf:realizes>
>                   <rdf:Description>
>                     <skos:prefLabel>No family history of diabetes</skos:prefLabel>
>                   </rdf:Description>
>                 </inf:realizes>
>               </cpr:medical-history-screening-act>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Tobacco use and exposure</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>ex-heavy cigarette smoker (20-39/day)</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Date ceased smoking</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Alcohol intake</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Trivial drinker -  less than 1/day</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Body height measure</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>m</ex:unit>
>                 <rdf:value>1.77</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>[in_I]</ex:unit>
>                 <rdf:value>69.7</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Body weight measure</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>[lb_ap]</ex:unit>
>                 <rdf:value>194.0</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>kg</ex:unit>
>                 <rdf:value>88.0</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Body mass index</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Body surface area</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>ar</ex:unit>
>                 <rdf:value>2.05</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Body temperature</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>Cel</ex:unit>
>                 <rdf:value>36.9</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>             <inf:realizes>
>               <rdf:Description>
>                 <ex:unit>[degF]</ex:unit>
>                 <rdf:value>98.5</rdf:value>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Heart rate</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Heart rate</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Regularity of heart rhythm</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Heart regular</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Regularity of heart rhythm</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Heart regular</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Respiratory rate</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Respiratory pattern</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Breathing easily</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Respiratory rate</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <skos:prefLabel>Cuff blood pressure</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <galen:hasSpecificLocation>Left arm</galen:hasSpecificLocation>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#clinical-examination"/>
>                 <inf:realizes>
>                   <galen:AbsoluteMeasurement>
>                     <skos:prefLabel>Systolic BP</skos:prefLabel>
>                     <ex:unit>mm[Hg]</ex:unit>
>                     <rdf:value>132</rdf:value>
>                   </galen:AbsoluteMeasurement>
>                 </inf:realizes>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#clinical-examination"/>
>                 <inf:realizes>
>                   <galen:AbsoluteMeasurement>
>                     <skos:prefLabel>Diastolic BP</skos:prefLabel>
>                     <ex:unit>mm[Hg]</ex:unit>
>                     <rdf:value>86</rdf:value>
>                   </galen:AbsoluteMeasurement>
>                 </inf:realizes>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Cuff blood pressure</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <galen:hasSpecificLocation>Left arm</galen:hasSpecificLocation>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#clinical-examination"/>
>                 <inf:realizes>
>                   <galen:AbsoluteMeasurement>
>                     <skos:prefLabel>Systolic BP</skos:prefLabel>
>                     <ex:unit>mm[Hg]</ex:unit>
>                     <rdf:value>135</rdf:value>
>                   </galen:AbsoluteMeasurement>
>                 </inf:realizes>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>             <obo:OBO_REL_has_improper_part>
>               <rdf:Description>
>                 <rdf:type rdf:resource="http://purl.org/cpr/0.5#clinical-examination"/>
>                 <inf:realizes>
>                   <galen:AbsoluteMeasurement>
>                     <skos:prefLabel>Diastolic BP</skos:prefLabel>
>                     <ex:unit>mm[Hg]</ex:unit>
>                     <rdf:value>88</rdf:value>
>                   </galen:AbsoluteMeasurement>
>                 </inf:realizes>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>                 <dc:date>2000-04-07T15:30:00</dc:date>
>               </rdf:Description>
>             </obo:OBO_REL_has_improper_part>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Skin finding</skos:prefLabel>
>             <galen:hasSpecificLocation>Skin of palmer surface of index finger</galen:hasSpecificLocation>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Rash</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Respiratory sounds</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Chest clear</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Auscultation</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Normal heart rate</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Auscultation</skos:prefLabel>
>             <inf:realizes>
>               <rdf:Description>
>                 <skos:prefLabel>Fourth heart sound inaudible</skos:prefLabel>
>               </rdf:Description>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Imaging interpretation</skos:prefLabel>
>             <inf:realizes>
>               <cpr:medical-sign>
>                 <skos:prefLabel>Chest hyperinflated</skos:prefLabel>
>                 <cpr:interpretant-of>
>                   <foaf:Image>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                   </foaf:Image>
>                 </cpr:interpretant-of>
>               </cpr:medical-sign>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <skos:prefLabel>Imaging interpretation</skos:prefLabel>
>             <inf:realizes>
>               <cpr:medical-sign>
>                 <cpr:interpretant-of>
>                   <foaf:Image>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                     <skos:prefLabel>Chest-X-ray</skos:prefLabel>
>                   </foaf:Image>
>                 </cpr:interpretant-of>
>               </cpr:medical-sign>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07</dc:date>
>             <skos:prefLabel>Peak flow</skos:prefLabel>
>             <dc:date>2000-04-07</dc:date>
>             <inf:realizes>
>               <rdf:Description/>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:therapeutic-act>
>             <skos:prefLabel>Suture removal</skos:prefLabel>
>             <dc:date>2000-04-07T14:30:00</dc:date>
>             <galen:hasSpecificLocation>Left forearm</galen:hasSpecificLocation>
>           </cpr:therapeutic-act>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Established diagnosis</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>Asthma</skos:prefLabel>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Established diagnosis</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>Essential hypertension</skos:prefLabel>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <rdf:Description>
>             <rdf:type rdf:resource="http://purl.org/cpr/0.5#screening-act"/>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <skos:prefLabel>Established diagnosis</skos:prefLabel>
>             <dc:date>2000-04-07T15:30:00</dc:date>
>             <galen:hasSpecificLocation>Skin of palmer surface of index finger</galen:hasSpecificLocation>
>             <inf:realizes>
>               <cpr:diagnosis>
>                 <skos:prefLabel>Contact dermatitis</skos:prefLabel>
>                 <galen:hasSpecificLocation>Skin of palmer surface of index finger</galen:hasSpecificLocation>
>               </cpr:diagnosis>
>             </inf:realizes>
>           </rdf:Description>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of/>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>prednisone 20qOD alternating with 18qOD.</skos:prefLabel>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>     <obo:OBO_REL_has_proper_part>
>       <cpr:clinical-description>
>         <cpr:description-of>
>           <cpr:substance-administration>
>             <skos:prefLabel>Hydrocortisone cream to finger BID.</skos:prefLabel>
>             <effectiveTime>
>               <rim:period>
>                 <rdf:value>12</rdf:value>
>                 <ex:unit>h</ex:unit>
>               </rim:period>
>             </effectiveTime>
>           </cpr:substance-administration>
>         </cpr:description-of>
>       </cpr:clinical-description>
>     </obo:OBO_REL_has_proper_part>
>   </cpr:patient-record>
> </rdf:RDF>
>   
> ------------------------------------------------------------------------
>
> <?xml version="1.0" encoding="UTF-8"?>
>
> <!DOCTYPE rdf:RDF [
>
>     <!ENTITY owl "http://www.w3.org/2002/07/owl#" >
>
>     <!ENTITY xsd "http://www.w3.org/2001/XMLSchema#" >
>
>     <!ENTITY rdfs "http://www.w3.org/2000/01/rdf-schema#" >
>
>     <!ENTITY rdf "http://www.w3.org/1999/02/22-rdf-syntax-ns#" >
>
>     <!ENTITY cpr "http://purl.org/cpr/0.5#" >
>
> ]>
>
> <xsl:stylesheet 
>
>   xmlns:xsl  ="http://www.w3.org/1999/XSL/Transform" 
>
>   version    ="1.0"
>
>   xmlns:ex   ="http://example.com/"
>
>   xmlns      ="urn:hl7-org:v3"
>
>   xmlns:rim  ="urn:hl7-org:v3"
>
>   xmlns:dc   ="http://purl.org/dc/elements/1.1/"
>
>   xmlns:rdfs ="http://www.w3.org/2000/01/rdf-schema#" 
>
>   xmlns:rdf  ="http://www.w3.org/1999/02/22-rdf-syntax-ns#"
>
>   xmlns:cpr  ="&cpr;"
>
>   xmlns:edns ="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#"
>
>   xmlns:skos ="http://www.w3.org/2004/02/skos/core#"
>
>   xmlns:dol  ="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#"
>
>   xmlns:inf  ="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#"
>
>   xmlns:galen="http://www.co-ode.org/ontologies/galen#"
>
>   xmlns:obo  ="http://www.geneontology.org/owl#"
>
>   xmlns:foaf ="http://xmlns.com/foaf/0.1/"
>
>  >
>
>   <xsl:output method="xml"/>
>
>   <xsl:template match="text()"/>
>
>   <xsl:template match="node()">
>
>     <xsl:apply-templates select="*"/>
>
>   </xsl:template>
>
>   <xsl:template match="/">
>
>     <rdf:RDF>
>
>       <rdfs:Description rdf:about=''>
>         <rdfs:isDefinedBy rdf:resource="http://purl.org/cpr"/>
>       </rdfs:Description>      
>       <xsl:apply-templates select="rim:ClinicalDocument"/>  
>     </rdf:RDF>    
>
>   </xsl:template>  
>
>   <xsl:template match="rim:ClinicalDocument[rim:recordTarget/rim:patientRole/rim:patientPatient]">
>
>     <cpr:patient-record>
>
>       <xsl:apply-templates select="rim:effectiveTime"/>          
>
>       <xsl:apply-templates select="rim:recordTarget/rim:patientRole/rim:patientPatient"/>      
>       <xsl:for-each select="rim:author/rim:assignedAuthor/rim:assignedPerson">
>
>         <foaf:maker>
>
>           <foaf:Person>
>
>             <xsl:apply-templates select="rim:name"/>          
>
>           </foaf:Person>
>
>         </foaf:maker>        
>
>       </xsl:for-each>      
>
>       <xsl:apply-templates select="rim:component"/>
>
>     </cpr:patient-record>
>
>   </xsl:template>
>
>   <xsl:template match="rim:methodCode | rim:code[@displayName] | rim:value[@displayName]">
>
>     <skos:prefLabel>
>
>       <xsl:value-of select="@displayName"/>
>
>     </skos:prefLabel>    
>
>   </xsl:template>
>
>   <xsl:template match="rim:translation[@value and @code]">
>
>     <xsl:if test="@code">
>
>       <ex:unit><xsl:value-of select="@code"/></ex:unit>
>
>     </xsl:if>        
>
>     <rdf:value><xsl:value-of select="@value"/></rdf:value>    
>
>   </xsl:template>
>
>   <xsl:template match="rim:value[@unit]">
>
>     <xsl:if test="@unit">
>
>       <ex:unit><xsl:value-of select="@unit"/></ex:unit>
>
>     </xsl:if>        
>
>     <rdf:value><xsl:value-of select="@value"/></rdf:value>    
>
>   </xsl:template>  
>
>   <xsl:template match="node()[rim:text]" mode="human-readable-label">
>
>     <skos:prefLabel>
>
>       <xsl:value-of select="rim:text"/>
>
>     </skos:prefLabel>    
>
>   </xsl:template>
>
>   <xsl:template match="@value" mode="date-or-time">
>
>     <xsl:choose>
>
>       <xsl:when test="string-length(.) = 4">
>
>         <xsl:value-of select="."/>
>
>       </xsl:when>
>
>       <xsl:when test="string-length(.) = 8">
>
>         <xsl:value-of select="concat(substring(.,1,4),'-',substring(.,5,2),'-',substring(.,7,2))"/>
>
>       </xsl:when>
>
>       <xsl:otherwise>
>
>         <!--xsl:attribute name="rdf:datatype" 
>
>           namespace="http://www.w3.org/1999/02/22-rdf-syntax-ns#">http://www.w3.org/2001/XMLSchema#dateTime</xsl:attribute-->
>
>         <xsl:value-of select="concat(substring(.,1,4),'-',substring(.,5,2),'-',substring(.,7,2),'T',substring(.,9,2),':',substring(.,11,2),':00')"/>        
>
>       </xsl:otherwise>
>
>     </xsl:choose>
>
>   </xsl:template>
>
>   <xsl:template match="rim:effectiveTime[not(rim:high)]">    
>
>     <xsl:choose>
>       <xsl:when test="@value">
>
>         <xsl:element name="dc:date" namespace="http://purl.org/dc/elements/1.1/">          
>           <xsl:apply-templates select="@value" mode="date-or-time"/>
>
>         </xsl:element>
>       </xsl:when>
>       <xsl:when test="rim:period">
>
>         <xsl:copy>
>           <rim:period>
>             <rdf:value><xsl:value-of select="rim:period/@value"/></rdf:value>
>             <ex:unit><xsl:value-of select="rim:period/@unit"/></ex:unit>            
>           </rim:period>
>
>         </xsl:copy>
>       </xsl:when>
>       <xsl:otherwise>
>         <!-- This can be described as an open ended interval using OWL time: http://www.w3.org/TR/owl-time -->
>
>         <xsl:copy>
>           <xsl:value-of select="rim:high/@value"/>
>
>         </xsl:copy>
>       </xsl:otherwise>
>     </xsl:choose>
>
>   </xsl:template>
>
>   <xsl:template match="rim:doseQuantity">
>
>     <xsl:copy>
>
>       <rdf:Description>
>
>         <xsl:if test="rim:center/@unit">
>           <ex:unit><xsl:value-of select="rim:center/@unit"/></ex:unit>
>         </xsl:if>        
>
>         <rdf:value><xsl:value-of select="rim:center/@value"/></rdf:value>
>
>       </rdf:Description>
>
>     </xsl:copy>
>
>   </xsl:template>
>
>   <xsl:template match="rim:SubstanceAdministration">
>
>     <cpr:substance-administration>
>       <xsl:apply-templates mode="human-readable-label" select="."/>
>       <xsl:apply-templates select="rim:effectiveTime | rim:doseQuantity"/>
>     </cpr:substance-administration>
>
>   </xsl:template>
>
>   <xsl:template match="rim:approachSiteCode">
>
>     <xsl:copy>
>
>         <xsl:if test="@displayName"><xsl:value-of select="@displayName"/></xsl:if>
>
>     </xsl:copy>            
>
>   </xsl:template>
>
>   <xsl:template match="rim:routeCode">
>
>     <xsl:copy>
>
>       <xsl:choose>
>
>         <xsl:when test="@code = 'PO'">Swallow, oral</xsl:when>
>
>         <xsl:when test="@displayName"><xsl:value-of select="@displayName"/></xsl:when>
>
>         <xsl:otherwise><xsl:value-of select="@code"/></xsl:otherwise>
>
>       </xsl:choose>
>
>     </xsl:copy>
>
>   </xsl:template>
>
>   <xsl:template match="rim:entryRelationship">
>
>     <xsl:choose>
>       <xsl:when test="@typeCode='COMP'">
>         <obo:OBO_REL_has_improper_part>
>
>           <xsl:apply-templates select="*"/> 
>
>         </obo:OBO_REL_has_improper_part>        
>       </xsl:when>
>
>       <xsl:otherwise/>      
>     </xsl:choose>
>
>   </xsl:template>  
>
>   <xsl:template match="rim:Procedure">
>
>     <cpr:therapeutic-act>
>       <xsl:apply-templates select="rim:code | rim:effectiveTime | rim:targetSiteCode"/>  
>     </cpr:therapeutic-act>    
>
>   </xsl:template>      
>
>   <xsl:template match="rim:entry">
>
>     <xsl:for-each select="rim:Procedure[rim:code] | rim:Observation | rim:SubstanceAdministration">
>
>       <obo:OBO_REL_has_proper_part>
>
>         <cpr:clinical-description>
>
>           <cpr:description-of>
>
>             <xsl:apply-templates select="."/>
>
>           </cpr:description-of>
>
>         </cpr:clinical-description>      
>
>       </obo:OBO_REL_has_proper_part>      
>
>     </xsl:for-each>    
>   </xsl:template>
>
>   <xsl:template match="rim:Observation">
>
>     <xsl:param name="medical-history-taking" select="false"/>
>
>     <xsl:choose>
>       <xsl:when test="@negationInd = 'true' or @moodCode='INT'">
>       </xsl:when>
>       <xsl:otherwise>
>
>         <rdf:Description>
>           <xsl:choose>
>             <xsl:when test="$medical-history-taking">
>               <rdf:type rdf:resource="&cpr;medical-history-screening-act"/>
>
>               <inf:realizes>
>
>                 <xsl:choose>
>
>                   <xsl:when test="../../../rim:Observation[rim:value]">
>                     <!-- A manefestation / interpetation of a phenomenon? (cpr:medical-sign) -->
>
>                     <cpr:medical-sign>
>
>                       <xsl:apply-templates select="rim:value"/>
>                       <cpr:interpretant-of>
>                         <cpr:symptom>
>                           <xsl:apply-templates select="../../../rim:Observation/rim:value"/>
>                         </cpr:symptom>
>                       </cpr:interpretant-of>
>                     </cpr:medical-sign>                      
>                   </xsl:when>
>
>                   <xsl:otherwise>
>                   </xsl:otherwise>
>                 </xsl:choose>
>
>               </inf:realizes>                  
>             </xsl:when>
>
>             <xsl:when test="../../rim:entryRelationship[@typeCode='COMP']">
>
>               <!-- A measurement.  GALEN models the notion of a measurement well  -->
>
>               <rdf:type rdf:resource="&cpr;clinical-examination"/>
>
>               <inf:realizes>
>                 <galen:AbsoluteMeasurement>
>                   <xsl:apply-templates select="rim:code | rim:value"/>
>                 </galen:AbsoluteMeasurement>
>               </inf:realizes>
>
>             </xsl:when>            
>
>             <xsl:otherwise>
>               <rdf:type rdf:resource="&cpr;screening-act"/>
>             </xsl:otherwise>
>           </xsl:choose> 
>
>           <xsl:if test="not(rim:code[@code = '84100007' and @codeSystemName = 'SNOMED CT'])">
>             <xsl:apply-templates select="rim:effectiveTime"/>  
>           </xsl:if>
>
>           <xsl:choose>
>             <xsl:when test="rim:methodCode">
>               <xsl:apply-templates select="rim:methodCode"/>
>             </xsl:when>
>
>             <xsl:when test="not(../../rim:entryRelationship[@typeCode='COMP'])">
>               <xsl:apply-templates select="rim:code"/>
>             </xsl:when>
>
>           </xsl:choose>
>
>           <xsl:apply-templates select="rim:entryRelationship | rim:targetSiteCode | rim:effectiveTime"/>            
>
>           <xsl:choose>
>
>             <xsl:when test="@classCode = 'COND'">
>
>               <!--                
>
>                 From: http://www.hl7.org/library/data-model/RIM/C30202/ActClass.htm#C-0-D11527-cpt
>
>                 An observable finding or state that persists over time and tends to 
>
>                 require intervention or management, and, therefore, distinguished from an 
>
>                 Observation made at a point in time; may exist before an Observation of 
>
>                 the Condition is made or after interventions to manage the Condition are undertaken.
>
>                 Examples: equipment repair status, device recall status, a health risk, 
>
>                 a financial risk, public health risk, pregnancy, health maintenance, chronic illness 
>
>               -->
>
>               <inf:realizes>
>
>                 <cpr:diagnosis>
>
>                   <xsl:apply-templates select="rim:value"/>
>
>                   <xsl:apply-templates select="rim:targetSiteCode"/>
>
>                 </cpr:diagnosis>
>
>               </inf:realizes>                
>
>             </xsl:when>
>
>             <xsl:when test="rim:code[@code = '84100007' and @codeSystemName = 'SNOMED CT']">
>
>               <xsl:choose>
>                 <xsl:when test="rim:entryRelationship[@typeCode='MFST'] and rim:value and not($medical-history-taking)">
>                   <!--                
>
>                     History taking act (cpr:medical-history-screening-act) - a manefestation of a problem determined from a case history
>
>                   -->
>
>                   <obo:OBO_REL_has_improper_part>
>
>                     <xsl:apply-templates select="rim:entryRelationship[@typeCode='MFST']/rim:Observation">
>                       <xsl:with-param name="medical-history-taking" select="true()"/>
>                     </xsl:apply-templates>
>
>                   </obo:OBO_REL_has_improper_part>                  
>                 </xsl:when>
>
>                 <xsl:when test="not($medical-history-taking)">
>                   <obo:OBO_REL_has_improper_part>
>
>                     <!-- Generic history taking act - Be sure to associate the date with the findings -->
>
>                     <cpr:medical-history-screening-act>
>
>                       <xsl:apply-templates select="rim:code"/>
>
>                       <xsl:for-each select="rim:value[@displayName]">
>
>                         <inf:realizes>
>
>                           <rdf:Description>
>
>                             <xsl:apply-templates select="../rim:effectiveTime"/>
>                             <xsl:apply-templates select="."/>
>                           </rdf:Description>
>
>                         </inf:realizes>
>
>                       </xsl:for-each>                      
>
>                     </cpr:medical-history-screening-act>
>
>                   </obo:OBO_REL_has_improper_part>                  
>                 </xsl:when>
>
>               </xsl:choose>
>
>             </xsl:when>    
>
>             <xsl:when test="rim:code[@code = '282290005' and @codeSystemName = 'SNOMED CT']">
>
>               <!--                
>
>                 Image interpretation - use foaf:Image to describe the image
>
>               -->
>
>               <inf:realizes>
>
>                 <cpr:medical-sign>
>
>                   <xsl:apply-templates select="rim:value"/>
>
>                   <cpr:interpretant-of>
>
>                     <foaf:Image>
>                       <xsl:apply-templates select="//rim:ExternalObservation[@classCode='DGIMG']/rim:code"/>  
>                     </foaf:Image>
>
>                   </cpr:interpretant-of>
>
>                   <xsl:apply-templates select="rim:targetSiteCode"/>
>
>                 </cpr:medical-sign>
>
>               </inf:realizes>                
>
>             </xsl:when>    
>
>             <xsl:when test="rim:value and not(../../rim:entryRelationship[@typeCode='COMP'])">
>
>               <inf:realizes>
>
>                 <rdf:Description>
>                   <xsl:apply-templates select="rim:value"/>                  
>                 </rdf:Description>
>
>               </inf:realizes>
>
>               <xsl:if test="rim:value/rim:translation[@value and @code]">
>                 <inf:realizes>
>
>                   <rdf:Description>
>
>                     <xsl:apply-templates select="rim:value/rim:translation"/>                  
>
>                   </rdf:Description>
>
>                 </inf:realizes>                
>               </xsl:if>                
>
>             </xsl:when>
>
>           </xsl:choose>          
>         </rdf:Description>
>       </xsl:otherwise>      
>     </xsl:choose>    
>   </xsl:template>
>
>   <xsl:template match="rim:reference[@typeCode='SPRT']/rim:ExternalObservation[@classCode='DGIMG']">
>
>     <xsl:element name="foaf:Image">
>       <!--xsl:if test="rim:id">
>         <xsl:attribute name="rdf:about" namespace="http://www.w3.org/1999/02/22-rdf-syntax-ns#">urn:tag:<xsl:value-of select="rim:id/@root"/></xsl:attribute>
>       </xsl:if-->
>
>       <xsl:apply-templates select="rim:code"/>
>     </xsl:element> 
>   </xsl:template>
>
>   <xsl:template match="rim:targetSiteCode[@displayName]">
>
>     <galen:hasSpecificLocation>
>
>         <xsl:value-of select="@displayName"/>
>
>     </galen:hasSpecificLocation>
>
>   </xsl:template>
>
>   <xsl:template match="rim:name/rim:family">
>
>     <foaf:family_name><xsl:value-of select="."/></foaf:family_name>
>
>   </xsl:template>
>
>   <xsl:template match="rim:name/rim:given">
>
>     <foaf:firstName><xsl:value-of select="."/></foaf:firstName>
>
>   </xsl:template>
>
>   <xsl:template match="rim:patientPatient">
>
>     <edns:about>
>
>       <galen:Patient>
>
>         <xsl:apply-templates select="rim:name"/>
>
>       </galen:Patient>
>
>     </edns:about>
>
>   </xsl:template>
>
>   <xsl:template match="rim:*">
>
>     <xsl:apply-templates select="*"/> 
>
>   </xsl:template>  
>
> </xsl:stylesheet>
> ------------------------------------------------------------------------
>
> <?xml version="1.0"?>
> <ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" templateId="2.16.840.1.113883.3.27.1776">
> 	<!-- 
> ********************************************************
>   CDA Header
> ********************************************************
> -->
> 	<id extension="c266" root="2.16.840.1.113883.3.933"/>
> 	<code code="11488-4" codeSystem="2.16.840.1.113883.6.1" displayName="Consultation note"/>
> 	<title>Good Health Clinic Consultation Note</title>
> 	<effectiveTime value="20000407"/>
> 	<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
> 	<setId extension="BB35" root="2.16.840.1.113883.3.933"/>
> 	<versionNumber value="2"/>
> 	<legalAuthenticator>
> 		<time value="20000408"/>
> 		<signatureCode code="S"/>
> 		<assignedEntity>
> 			<id extension="KP00017" root="2.16.840.1.113883.3.933"/>
> 			<assignedPerson>
> 				<name>
> 					<given>Robert</given>
> 					<family>Dolin</family>
> 					<suffix>MD</suffix>
> 				</name>
> 			</assignedPerson>
> 			<representedOrganization>
> 				<id extension="M345" root="2.16.840.1.113883.3.933"/>
> 			</representedOrganization>
> 		</assignedEntity>
> 	</legalAuthenticator>
> 	<author>
> 		<time value="20000407"/>
> 		<assignedAuthor>
> 			<id extension="KP00017" root="2.16.840.1.113883.3.933"/>
> 			<assignedPerson>
> 				<name>
> 					<given>Robert</given>
> 					<family>Dolin</family>
> 					<suffix>MD</suffix>
> 				</name>
> 			</assignedPerson>
> 			<representedOrganization>
> 				<id extension="M345" root="2.16.840.1.113883.3.933"/>
> 			</representedOrganization>
> 		</assignedAuthor>
> 	</author>
> 	<custodian>
> 		<assignedCustodian>
> 			<representedCustodianOrganization>
> 				<id extension="M345" root="2.16.840.1.113883.3.933"/>
> 				<name>Good Health Clinic</name>
> 			</representedCustodianOrganization>
> 		</assignedCustodian>
> 	</custodian>
> 	<recordTarget>
> 		<patientRole>
> 			<id extension="12345" root="2.16.840.1.113883.3.933"/>
> 			<patientPatient>
> 				<name>
> 					<given>Henry</given>
> 					<family>Levin</family>
> 					<suffix>the 7th</suffix>
> 				</name>
> 				<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
> 				<birthTime value="19320924"/>
> 			</patientPatient>
> 			<providerOrganization>
> 				<id extension="M345" root="2.16.840.1.113883.3.933"/>
> 			</providerOrganization>
> 		</patientRole>
> 	</recordTarget>
> 	<relatedDocument typeCode="RPLC">
> 		<parentDocument>
> 			<id extension="a123" root="2.16.840.1.113883.3.933"/>
> 			<setId extension="BB35" root="2.16.840.1.113883.3.933"/>
> 			<versionNumber value="1"/>
> 		</parentDocument>
> 	</relatedDocument>
> 	<componentOf>
> 		<currentEncounter>
> 			<id extension="KPENC1332" root="2.16.840.1.113883.3.933"/>
> 			<effectiveTime value="20000407"/>
> 			<location>
> 				<healthCareFacility classCode="DSDLOC">
> 					<code code="GIM" codeSystem="2.16.840.1.113883.5.10588" displayName="General internal medicine clinic"/>
> 				</healthCareFacility>
> 			</location>
> 			<encounterPerformer typeCode="CON">
> 				<time value="20000407"/>
> 				<assignedEntity>
> 					<id extension="KP00017" root="2.16.840.1.113883.3.933"/>
> 					<assignedPerson>
> 						<name>
> 							<given>Robert</given>
> 							<family>Dolin</family>
> 							<suffix>MD</suffix>
> 						</name>
> 					</assignedPerson>
> 					<representedOrganization>
> 						<id extension="M345" root="2.16.840.1.113883.3.933"/>
> 					</representedOrganization>
> 				</assignedEntity>
> 			</encounterPerformer>
> 		</currentEncounter>
> 	</componentOf>
> 	<!-- 
> ********************************************************
>   CDA Body
> ********************************************************
> -->
> 	<component>
> 		<StructuredBody>
> 			<!-- 
> ********************************************************
>   History of Present Illness section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="10164-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>History of Present Illness</title>
> 					<text>Henry Levin, the 7th is a 67 year old male referred for further asthma management. Onset of asthma in his <content revised="delete">twenties</content><content revised="insert">teens</content>. He was hospitalized twice last year, and already twice this year. He has not been able to be weaned off steroids for the past several months. 
> 						</text>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Past Medical History section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="10153-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Past Medical History</title>
> 					<text>
> 						<list>
> 							<item>
> 								<content ID="a1">Asthma</content>
> 							</item>
> 							<item>
> 								<content ID="a2">Hypertension (see HTN.cda for details)</content>
> 							</item>
> 							<item>
> 								<content ID="a3">Osteoarthritis, 
> 									<content ID="a4">right knee</content>
> 								</content>
> 							</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="39154008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="clinical diagnosis"/>
> 							<effectiveTime value="1950"/>
> 							<value xsi:type="CD" code="195967001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Asthma">
> 								<originalText>
> 									<reference value="#a1"/>
> 								</originalText>
> 							</value>
> 							<reference typeCode="XCRPT">
> 								<!-- A reference of type "XCRPT" can be used to show that this problem list value is excerpted from the referenced external observation. -->
> 								<ExternalObservation>
> 									<id root="123.456.789.23.17"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="39154008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="clinical diagnosis"/>
> 							<value xsi:type="CD" code="59621000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="HTN">
> 								<originalText>
> 									<reference value="#a2"/>
> 								</originalText>
> 							</value>
> 							<reference typeCode="SPRT">
> 								<seperatableInd value="false"/>
> 								<ExternalDocument>
> 									<id root="123.456.789"/>
> 									<text mediaType="multipart/related">
> 										<reference value="HTN.cda"/>
> 									</text>
> 									<setId root="147.89.9001"/>
> 									<versionNumber value="1"/>
> 								</ExternalDocument>
> 							</reference>
> 							<reference typeCode="XCRPT">
> 								<ExternalObservation>
> 									<id root="123.456.789.23.18"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="39154008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="clinical diagnosis"/>
> 							<value xsi:type="CD" code="396275006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Osteoarthritis">
> 								<originalText>
> 									<reference value="#a3"/>
> 								</originalText>
> 							</value>
> 							<targetSiteCode code="49076000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Knee joint">
> 								<originalText>
> 									<reference value="#a4"/>
> 								</originalText>
> 								<qualifier>
> 									<name code="78615007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="with laterality"/>
> 									<value code="24028007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="right"/>
> 								</qualifier>
> 							</targetSiteCode>
> 							<reference typeCode="XCRPT">
> 								<ExternalObservation>
> 									<id root="123.456.789.23.18"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Medications section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="10160-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Medications</title>
> 					<text>
> 						<list>
> 							<item>Theodur 200mg BID</item>
> 							<item>Proventil inhaler 2puffs QID PRN</item>
> 							<item>Prednisone 20mg qd</item>
> 							<item>HCTZ 25mg qd</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<SubstanceAdministration>
> 							<text>Theodur 200mg BID</text>
> 							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
> 								<period value="12" unit="h"/>
> 							</effectiveTime>
> 							<routeCode code="PO" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration"/>
> 							<doseQuantity>
> 								<center value="200" unit="mg"/>
> 							</doseQuantity>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="66493003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Theophylline"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 					<entry>
> 						<SubstanceAdministration>
> 							<text>Proventil inhaler 2puffs QID PRN</text>
> 							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
> 								<period value="6" unit="h"/>
> 							</effectiveTime>
> 							<priorityCode code="PRN"/>
> 							<routeCode code="IPINHL" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration" displayName="Inhalation, oral"/>
> 							<doseQuantity>
> 								<center value="2"/>
> 							</doseQuantity>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="91143003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Albuterol"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 					<entry>
> 						<SubstanceAdministration>
> 							<id root="10.23.27.123"/>
> 							<text>Prednisone 20mg qd</text>
> 							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
> 								<period value="24" unit="h"/>
> 							</effectiveTime>
> 							<routeCode code="PO" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration"/>
> 							<doseQuantity>
> 								<center value="20" unit="mg"/>
> 							</doseQuantity>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="10312003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Prednisone preparation"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 					<entry>
> 						<SubstanceAdministration>
> 							<text>HCTZ 25mg qd</text>
> 							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
> 								<period value="24" unit="h"/>
> 							</effectiveTime>
> 							<routeCode code="PO" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration"/>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="376209006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Hydrochlorothiazide 25mg tablet"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Allergies & Adverse Reactions section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="10155-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Allergies and Adverse Reactions</title>
> 					<text>
> 						<list>
> 							<item>Penicillin - Hives</item>
> 							<item>Aspirin - Wheezing</item>
> 							<item>Codeine - Itching and nausea</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<value xsi:type="CD" code="247472004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Hives"/>
> 							<entryRelationship typeCode="MFST">
> 								<Observation>
> 									<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 									<value xsi:type="CD" code="91936005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Allergy to penicillin"/>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<value xsi:type="CD" code="56018004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Wheezing"/>
> 							<entryRelationship typeCode="MFST">
> 								<Observation>
> 									<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 									<value xsi:type="CD" code="293586001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Allergy to aspirin"/>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<value xsi:type="CD" code="32738000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Pruritis"/>
> 							<entryRelationship typeCode="MFST">
> 								<Observation>
> 									<id root="2.16.840.1.113883.3.933.25.47"/>
> 									<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 									<value xsi:type="CD" code="62014003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Adverse reaction to drug">
> 										<qualifier>
> 											<name code="246075003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="causative agent"/>
> 											<value code="1476002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="codeine"/>
> 										</qualifier>
> 									</value>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<value xsi:type="CD" code="73879007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Nausea"/>
> 							<entryRelationship typeCode="MFST">
> 								<Observation>
> 									<id root="2.16.840.1.113883.3.933.25.47"/>
> 									<code code="84100007" codeSystem="2.16.840.1.113883.6.96"/>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Family History section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="10157-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Family history</title>
> 					<text>
> 						<list>
> 							<item>Father had fatal MI in his early 50's.</item>
> 							<item>No cancer or diabetes.</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<effectiveTime value="1970"/>
> 							<value xsi:type="CD" code="22298006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="MI"/>
> 							<subject>
> 								<relatedSubject classCode="PRS">
> 									<code code="FTH"/>
> 								</relatedSubject>
> 							</subject>
> 							<entryRelationship typeCode="CAUS">
> 								<Observation>
> 									<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 									<effectiveTime value="1970"/>
> 									<value xsi:type="CD" code="399347008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="death"/>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation negationInd="true">
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<effectiveTime>
> 								<high value="20000407" inclusive="true"/>
> 							</effectiveTime>
> 							<value xsi:type="CD" code="275937001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Family history of cancer"/>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="84100007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="history taking (procedure)"/>
> 							<effectiveTime>
> 								<high value="20000407" inclusive="true"/>
> 							</effectiveTime>
> 							<value xsi:type="CD" code="160274005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="No family history of diabetes"/>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Social History section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="29762-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Social History</title>
> 					<text>
> 						<list>
> 							<item>Smoking :: 1 PPD between the ages of 20 and 55, and then he quit.</item>
> 							<item>Alcohol :: rare</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation>
> 							<code code="229819007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Tobacco use and exposure"/>
> 							<effectiveTime>
> 								<low value="1955"/>
> 								<high value="1990"/>
> 							</effectiveTime>
> 							<value xsi:type="CD" code="266924008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="ex-heavy cigarette smoker (20-39/day)"/>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="160625004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Date ceased smoking"/>
> 							<value xsi:type="TS" value="1990"/>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<code code="160573003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Alcohol intake"/>
> 							<value xsi:type="CD" code="266917007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Trivial drinker -  less than 1/day"/>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Physical Exam section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="11384-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Physical Examination</title>
> 					<!-- 
>           ********************************************************
>             Physical Exam  - Vital Signs
>           ********************************************************
>           -->
> 					<component>
> 						<section>
> 							<code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 							<title>Vital Signs</title>
> 							<text>
> 								<table>
> 									<tr>
> 										<th>Date / Time</th>
> 										<th>April 7, 2000 14:30</th>
> 										<th>April 7, 2000 15:30</th>
> 									</tr>
> 									<tr>
> 										<th>Height</th>
> 										<td>177 cm (69.7 in)</td>
> 									</tr>
> 									<tr>
> 										<th>Weight</th>
> 										<td>194.0 lbs (88.0 kg)</td>
> 									</tr>
> 									<tr>
> 										<th>BMI</th>
> 										<td>28.1 kg/m2</td>
> 									</tr>
> 									<tr>
> 										<th>BSA</th>
> 										<td>2.05 m2</td>
> 									</tr>
> 									<tr>
> 										<th>Temperature</th>
> 										<td>36.9 C (98.5 F)</td>
> 										<td>36.9 C (98.5 F)</td>
> 									</tr>
> 									<tr>
> 										<th>Pulse</th>
> 										<td>86 / minute</td>
> 										<td>84 / minute</td>
> 									</tr>
> 									<tr>
> 										<th>Rhythm</th>
> 										<td>Regular</td>
> 										<td>Regular</td>
> 									</tr>
> 									<tr>
> 										<th>Respirations</th>
> 										<td>16 / minute, unlabored</td>
> 										<td>14 / minute</td>
> 									</tr>
> 									<tr>
> 										<th>Systolic</th>
> 										<td>132 mmHg</td>
> 										<td>135 mmHg</td>
> 									</tr>
> 									<tr>
> 										<th>Diastolic</th>
> 										<td>86 mmHg</td>
> 										<td>88 mmHg</td>
> 									</tr>
> 									<tr>
> 										<th>Position / Cuff</th>
> 										<td>Left Arm</td>
> 										<td>Left Arm</td>
> 									</tr>
> 								</table>
> 							</text>
> 							<entry>
> 								<Observation>
> 									<code code="50373000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Body height measure"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="PQ" value="1.77" unit="m">
> 										<translation value="69.7" code="[in_I]" codeSystem="2.16.840.1.113883.6.8" codeSystemName="UCUM"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="363808001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Body weight measure"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="PQ" value="194.0" unit="[lb_ap]">
> 										<translation value="88.0" code="kg" codeSystem="2.16.840.1.113883.6.8" codeSystemName="UCUM"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="60621009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Body mass index"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="RTO_PQ_PQ">
> 										<numerator value="28.1" unit="kg"/>
> 										<denominator value="1" unit="ar"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="301898006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Body surface area"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="PQ" value="2.05" unit="ar"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="386725007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Body temperature"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="PQ" value="36.9" unit="Cel">
> 										<translation value="98.5" code="[degF]" codeSystem="2.16.840.1.113883.6.8" codeSystemName="UCUM"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="364075005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Heart rate"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="RTO_PQ_PQ">
> 										<numerator value="86"/>
> 										<denominator value="1" unit="min"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="364075005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Heart rate"/>
> 									<effectiveTime value="200004071530"/>
> 									<value xsi:type="RTO_PQ_PQ">
> 										<numerator value="84"/>
> 										<denominator value="1" unit="min"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="364074009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Regularity of heart rhythm"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="CD" code="248649006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Heart regular"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="364074009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Regularity of heart rhythm"/>
> 									<effectiveTime value="200004071530"/>
> 									<value xsi:type="CD" code="248649006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Heart regular"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="86290005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Respiratory rate"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="RTO_PQ_PQ">
> 										<numerator value="16"/>
> 										<denominator value="1" unit="min"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="278907009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Respiratory pattern"/>
> 									<effectiveTime value="200004071430"/>
> 									<value xsi:type="CD" code="276362002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Breathing easily"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="86290005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Respiratory rate"/>
> 									<effectiveTime value="200004071530"/>
> 									<value xsi:type="RTO_PQ_PQ">
> 										<numerator value="14"/>
> 										<denominator value="1" unit="min"/>
> 									</value>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="251076008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cuff blood pressure"/>
> 									<effectiveTime value="200004071430"/>
> 									<targetSiteCode code="368208006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Left arm"/>
> 									<entryRelationship typeCode="COMP">
> 										<Observation>
> 											<code code="271649006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Systolic BP"/>
> 											<effectiveTime value="200004071530"/>
> 											<value xsi:type="PQ" value="132" unit="mm[Hg]"/>
> 										</Observation>
> 									</entryRelationship>
> 									<entryRelationship typeCode="COMP">
> 										<Observation>
> 											<code code="271650006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diastolic BP"/>
> 											<effectiveTime value="200004071530"/>
> 											<value xsi:type="PQ" value="86" unit="mm[Hg]"/>
> 										</Observation>
> 									</entryRelationship>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="251076008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cuff blood pressure"/>
> 									<effectiveTime value="200004071530"/>
> 									<targetSiteCode code="368208006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Left arm"/>
> 									<entryRelationship typeCode="COMP">
> 										<Observation>
> 											<code code="271649006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Systolic BP"/>
> 											<effectiveTime value="200004071530"/>
> 											<value xsi:type="PQ" value="135" unit="mm[Hg]"/>
> 										</Observation>
> 									</entryRelationship>
> 									<entryRelationship typeCode="COMP">
> 										<Observation>
> 											<code code="271650006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Diastolic BP"/>
> 											<effectiveTime value="200004071530"/>
> 											<value xsi:type="PQ" value="88" unit="mm[Hg]"/>
> 										</Observation>
> 									</entryRelationship>
> 								</Observation>
> 							</entry>
> 						</section>
> 					</component>
> 					<!-- 
>           ********************************************************
>             Physical Exam  - Skin
>           ********************************************************
>           -->
> 					<component>
> 						<section>
> 							<code code="8709-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 							<title>Skin Exam</title>
> 							<text>Erythematous rash, palmar surface, left index finger.
> 								 <renderMultiMedia referencedObject="MM1"/>
> 							</text>
> 							<entry>
> 								<Observation>
> 									<code code="106076001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Skin finding"/>
> 									<value xsi:type="CD" code="271807003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Rash"/>
> 									<targetSiteCode code="48856004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Skin of palmer surface of index finger">
> 										<qualifier>
> 											<name code="78615007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="with laterality"/>
> 											<value code="7771000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="left"/>
> 										</qualifier>
> 									</targetSiteCode>
> 									<entryRelationship typeCode="SPRT">
> 										<RegionOfInterest MMID="MM1">
> 											<id root="10.23.4567.4489"/>
> 											<code code="ELLIPSE"/>
> 											<value>3 1 3 7 2 4 4 4</value>
> 											<entryRelationship typeCode="SUBJ">
> 												<ObservationMedia>
> 													<id root="10.23.4567.345"/>
> 													<value xsi:type="ED" mediaType="image/jpeg">
> 														<reference value="lefthand.jpeg"/>
> 													</value>
> 												</ObservationMedia>
> 											</entryRelationship>
> 										</RegionOfInterest>
> 									</entryRelationship>
> 								</Observation>
> 							</entry>
> 						</section>
> 					</component>
> 					<!-- 
>           ********************************************************
>             Physical Exam  - Lungs
>           ********************************************************
>           -->
> 					<component>
> 						<section>
> 							<code code="8710-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 							<title>Lungs</title>
> 							<text>Clear with no wheeze. Good air flow.</text>
> 							<entry>
> 								<Observation>
> 									<code code="301708006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Respiratory sounds"/>
> 									<value xsi:type="CD" code="48348007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chest clear"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation negationInd="true">
> 									<code code="52653008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Respiratory sounds"/>
> 									<value xsi:type="CD" code="56018004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Wheezing"/>
> 								</Observation>
> 							</entry>
> 						</section>
> 					</component>
> 					<!-- 
>           ********************************************************
>             Physical Exam  - Cardiac
>           ********************************************************
>           -->
> 					<component>
> 						<section>
> 							<code code="10223-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 							<title>Cardiac</title>
> 							<text>RRR with no murmur, no S3, no S4.</text>
> 							<entry>
> 								<Observation>
> 									<code code="364066008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cardiovascular observable"/>
> 									<value xsi:type="CD" code="76863003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Normal heart rate"/>
> 									<methodCode code="37931006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Auscultation"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation negationInd="true">
> 									<code code="364066008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cardiovascular observable"/>
> 									<value xsi:type="CD" code="88610006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="heart murmur"/>
> 									<methodCode code="37931006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Auscultation"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation negationInd="true">
> 									<code code="364066008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cardiovascular observable"/>
> 									<value xsi:type="CD" code="277455002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Third heart sound"/>
> 									<methodCode code="37931006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Auscultation"/>
> 								</Observation>
> 							</entry>
> 							<entry>
> 								<Observation>
> 									<code code="364066008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Cardiovascular observable"/>
> 									<value xsi:type="CD" code="60721002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Fourth heart sound inaudible"/>
> 									<methodCode code="37931006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Auscultation"/>
> 								</Observation>
> 							</entry>
> 						</section>
> 					</component>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Labs section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="11502-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Labs</title>
> 					<text>
> 						<list>
> 							<item>CXR 02/03/1999: Hyperinflated. Normal cardiac silhouette, clear lungs.</item>
> 							<item>Peak Flow today: 260 l/m</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation>
> 							<id root="10.23.4573.15877"/>
> 							<code code="282290005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Imaging interpretation"/>
> 							<value xsi:type="CD" code="249674001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chest hyperinflated"/>
> 							<reference typeCode="SPRT">
> 								<ExternalObservation classCode="DGIMG">
> 									<id root="123.456.2557"/>
> 									<code code="56350004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chest-X-ray"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<id root="10.23.4573.15878"/>
> 							<code code="282290005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Imaging interpretation"/>
> 							<value xsi:type="CD" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" nullFlavor="OTH">
> 								<originalText>normal cardiac silhouette</originalText>
> 							</value>
> 							<reference typeCode="SPRT">
> 								<ExternalObservation classCode="DGIMG">
> 									<id root="123.456.2557"/>
> 									<code code="56350004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chest-X-ray"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation negationInd="true">
> 							<id root="10.23.4573.15879"/>
> 							<code code="282290005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Imaging interpretation"/>
> 							<value xsi:type="CD" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" nullFlavor="OTH">
> 								<originalText>radiopacities</originalText>
> 							</value>
> 							<reference typeCode="SPRT">
> 								<ExternalObservation classCode="DGIMG">
> 									<id root="123.456.2557"/>
> 									<code code="56350004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chest-X-ray"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation>
> 							<id root="10.23.4573.15879"/>
> 							<code code="313193002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Peak flow"/>
> 							<effectiveTime value="20000407"/>
> 							<value xsi:type="RTO_PQ_PQ">
> 								<numerator value="260" unit="l"/>
> 								<denominator value="1" unit="min"/>
> 							</value>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   In-office Procedure section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" nullFlavor="OTH"/>
> 					<title>In-office Procedures</title>
> 					<text>
> 						<list>
> 							<item>Suture removal, left forearm.</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Procedure>
> 							<code code="30549001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Suture removal"/>
> 							<effectiveTime value="200004071430"/>
> 							<targetSiteCode code="66480008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Left forearm"/>
> 						</Procedure>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Assessment section
> ********************************************************
> -->
> 			<component>
> 				<section>
> 					<code code="11496-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
> 					<title>Assessment</title>
> 					<text>
> 						<list>
> 							<item>Asthma, with prior smoking history. Difficulty weaning off steroids. Will try gradual taper.</item>
> 							<item>Hypertension, well-controlled.</item>
> 							<item>Contact dermatitis on finger.</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="14657009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Established diagnosis"/>
> 							<effectiveTime value="200004071530"/>
> 							<value xsi:type="CD" code="195967001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Asthma">
> 								<translation code="49390" codeSystem="2.16.840.1.113883.6.2" codeSystemName="ICD9CM" displayName="ASTHMA W/O STATUS ASTHMATICUS"/>
> 							</value>
> 							<reference typeCode="ELNK">
> 								<ExternalObservation classCode="COND">
> 									<id root="10.23.27.111.17"/>
> 									<code code="14657009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Established diagnosis"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="14657009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Established diagnosis"/>
> 							<effectiveTime value="200004071530"/>
> 							<value xsi:type="CD" code="59621000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Essential hypertension">
> 								<translation code="4019" codeSystem="2.16.840.1.113883.6.2" codeSystemName="ICD9CM" displayName="HYPERTENSION NOS"/>
> 							</value>
> 							<reference typeCode="ELNK">
> 								<ExternalObservation classCode="COND">
> 									<id root="10.23.27.111.1732"/>
> 									<code code="14657009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Established diagnosis"/>
> 								</ExternalObservation>
> 							</reference>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation classCode="COND">
> 							<code code="14657009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Established diagnosis"/>
> 							<effectiveTime value="200004071530"/>
> 							<value xsi:type="CD" code="40275004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Contact dermatitis">
> 								<translation code="692.9" codeSystem="2.16.840.1.113883.6.2" codeSystemName="ICD9CM" displayName="Contact Dermatitis, NOS"/>
> 							</value>
> 							<targetSiteCode code="48856004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Skin of palmer surface of index finger">
> 								<qualifier>
> 									<name code="78615007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="with laterality"/>
> 									<value code="7771000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="left"/>
> 								</qualifier>
> 							</targetSiteCode>
> 						</Observation>
> 					</entry>
> 				</section>
> 			</component>
> 			<!-- 
> ********************************************************
>   Plan section
> ********************************************************
> -->
> 			<component>
> 				<section templateId="2.16.840.1.113883.3.27.354">
> 					<code code="1150x-y" codeSystem="2.16.840.1.113883.3.933.278.47" codeSystemName="MyLocalCodeSystem"/>
> 					<title>Plan</title>
> 					<text>
> 						<list>
> 							<item>Complete PFTs with lung volumes.</item>
> 							<item>Chem-7 tomorrow.</item>
> 							<item>Teach peak flow rate measurement.</item>
> 							<item>Decrease prednisone to 20qOD alternating with 18qOD.</item>
> 							<item>Hydrocortisone cream to finger BID.</item>
> 							<item>RTC 1 week.</item>
> 						</list>
> 					</text>
> 					<entry>
> 						<Observation moodCode="INT">
> 							<id/>
> 							<code code="23426006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Pulmonary function test"/>
> 							<text>Complete PFTs with lung volumes.</text>
> 							<entryRelationship typeCode="COMP">
> 								<Observation moodCode="INT">
> 									<code code="252472004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Lung volume test"/>
> 								</Observation>
> 							</entryRelationship>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Observation moodCode="INT">
> 							<code code="24320-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC">
> 								<originalText>Chem-7</originalText>
> 								<translation code="aYU7t6" codeSystem="2.16.840.1.113883.3.933.278.47" codeSystemName="MyLocalCodeSystem" displayName="Chem7"/>
> 							</code>
> 							<text>Chem-7 tomorrow</text>
> 							<effectiveTime value="20000408"/>
> 						</Observation>
> 					</entry>
> 					<entry>
> 						<Act moodCode="INT">
> 							<id/>
> 							<code code="223468009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Teaching of skills">
> 								<qualifier>
> 									<name code="363702006" displayName="has focus"/>
> 									<value code="29893006" displayName="Peak flow rate measurement"/>
> 								</qualifier>
> 							</code>
> 						</Act>
> 					</entry>
> 					<entry>
> 						<SubstanceAdministration moodCode="RQO">
> 							<text>prednisone 20qOD alternating with 18qOD.</text>
> 							<routeCode code="PO" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration"/>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="10312003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Prednisone preparation"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 					<entry>
> 						<SubstanceAdministration moodCode="RQO">
> 							<text>Hydrocortisone cream to finger BID.</text>
> 							<effectiveTime xsi:type="PIVL_TS" institutionSpecified="true">
> 								<period value="12" unit="h"/>
> 							</effectiveTime>
> 							<routeCode code="SKIN" codeSystem="2.16.840.1.113883.5.112" codeSystemName="RouteOfAdministration" displayName="Topical application, skin"/>
> 							<approachSiteCode code="48856004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Skin of palmer surface of index finger">
> 								<qualifier>
> 									<name code="78615007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="with laterality"/>
> 									<value code="7771000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="left"/>
> 								</qualifier>
> 							</approachSiteCode>
> 							<consumable>
> 								<manufacturedProduct>
> 									<manufacturedLabeledDrug>
> 										<code code="331646005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Hydrocortisone cream"/>
> 									</manufacturedLabeledDrug>
> 								</manufacturedProduct>
> 							</consumable>
> 						</SubstanceAdministration>
> 					</entry>
> 					<entry>
> 						<Encounter moodCode="RQO">
> 							<code code="185389009" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Follow-up visit"/>
> 							<effectiveTime>
> 								<low value="20000412"/>
> 								<high value="20000417"/>
> 							</effectiveTime>
> 						</Encounter>
> 					</entry>
> 				</section>
> 			</component>
> 		</StructuredBody>
> 	</component>
> </ClinicalDocument>
>   
> ------------------------------------------------------------------------
>
>
> @prefix _17: <<>.
> @prefix _18: <http://purl.org/>.
> @prefix cpr: <http://purl.org/cpr/0.5#>.
> @prefix dc: <http://purl.org/dc/elements/1.1/>.
> @prefix edns: <http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#>.
> @prefix ex: <http://example.com/>.
> @prefix foaf: <http://xmlns.com/foaf/0.1/>.
> @prefix galen: <http://www.co-ode.org/ontologies/galen#>.
> @prefix hl7: <urn:hl7-org:>.
> @prefix obo: <http://www.geneontology.org/owl#>.
> @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#>.
> @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#>.
> @prefix skos: <http://www.w3.org/2004/02/skos/core#>.
>
>  _17:stdin> a rdfs:Description;
>      rdfs:isDefinedBy _18:cpr. 
>
>  [ a cpr:patient-record;
>          dc:date "2000-04-07";
>          obo:OBO_REL_has_proper_part [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ a cpr:diagnosis;
>                                  skos:prefLabel "HTN"];
>                          skos:prefLabel "clinical diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ skos:prefLabel "Breathing easily"];
>                          skos:prefLabel "Respiratory pattern"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          edns:realizes [];
>                          skos:prefLabel "Respiratory rate"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          galen:hasSpecificLocation "Left arm";
>                          obo:OBO_REL_has_improper_part [ a cpr:clinical-examination;
>                                  dc:date "2000-04-07T15:30:00";
>                                  edns:realizes [ a galen:AbsoluteMeasurement;
>                                          ex:unit "mm[Hg]";
>                                          rdf:value "132";
>                                          skos:prefLabel "Systolic BP"]],
>                              [ a cpr:clinical-examination;
>                                  dc:date "2000-04-07T15:30:00";
>                                  edns:realizes [ a galen:AbsoluteMeasurement;
>                                          ex:unit "mm[Hg]";
>                                          rdf:value "86";
>                                          skos:prefLabel "Diastolic BP"]];
>                          skos:prefLabel "Cuff blood pressure"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          galen:hasSpecificLocation "Left arm";
>                          obo:OBO_REL_has_improper_part [ a cpr:clinical-examination;
>                                  dc:date "2000-04-07T15:30:00";
>                                  edns:realizes [ a galen:AbsoluteMeasurement;
>                                          ex:unit "mm[Hg]";
>                                          rdf:value "135";
>                                          skos:prefLabel "Systolic BP"]],
>                              [ a cpr:clinical-examination;
>                                  dc:date "2000-04-07T15:30:00";
>                                  edns:realizes [ a galen:AbsoluteMeasurement;
>                                          ex:unit "mm[Hg]";
>                                          rdf:value "88";
>                                          skos:prefLabel "Diastolic BP"]];
>                          skos:prefLabel "Cuff blood pressure"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          galen:hasSpecificLocation "Skin of palmer surface of index finger";
>                          edns:realizes [ skos:prefLabel "Rash"];
>                          skos:prefLabel "Skin finding"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ skos:prefLabel "Chest clear"];
>                          skos:prefLabel "Respiratory sounds"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ skos:prefLabel "Normal heart rate"];
>                          skos:prefLabel "Auscultation"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          galen:hasSpecificLocation "Knee joint";
>                          edns:realizes [ a cpr:diagnosis;
>                                  galen:hasSpecificLocation "Knee joint";
>                                  skos:prefLabel "Osteoarthritis"];
>                          skos:prefLabel "clinical diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ skos:prefLabel "Fourth heart sound inaudible"];
>                          skos:prefLabel "Auscultation"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ a cpr:medical-sign;
>                                  cpr:interpretant-of [ a foaf:Image;
>                                          skos:prefLabel "Chest-X-ray"];
>                                  skos:prefLabel "Chest hyperinflated"];
>                          skos:prefLabel "Imaging interpretation"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ a cpr:medical-sign;
>                                  cpr:interpretant-of [ a foaf:Image;
>                                          skos:prefLabel "Chest-X-ray"]];
>                          skos:prefLabel "Imaging interpretation"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07";
>                          edns:realizes [];
>                          skos:prefLabel "Peak flow"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:therapeutic-act;
>                          dc:date "2000-04-07T14:30:00";
>                          galen:hasSpecificLocation "Left forearm";
>                          skos:prefLabel "Suture removal"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          edns:realizes [ a cpr:diagnosis;
>                                  skos:prefLabel "Asthma"];
>                          skos:prefLabel "Established diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          edns:realizes [ a cpr:diagnosis;
>                                  skos:prefLabel "Essential hypertension"];
>                          skos:prefLabel "Established diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          galen:hasSpecificLocation "Skin of palmer surface of index finger";
>                          edns:realizes [ a cpr:diagnosis;
>                                  galen:hasSpecificLocation "Skin of palmer surface of index finger";
>                                  skos:prefLabel "Contact dermatitis"];
>                          skos:prefLabel "Established diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "Theodur 200mg BID";
>                          hl7:v3doseQuantity [ ex:unit "mg";
>                                  rdf:value "200"];
>                          hl7:v3effectiveTime [ a hl7:v3period;
>                                  ex:unit "h";
>                                  rdf:value "12"]]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "prednisone 20qOD alternating with 18qOD."]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "Hydrocortisone cream to finger BID.";
>                          hl7:v3effectiveTime [ a hl7:v3period;
>                                  ex:unit "h";
>                                  rdf:value "12"]]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "Proventil inhaler 2puffs QID PRN";
>                          hl7:v3doseQuantity [ rdf:value "2"];
>                          hl7:v3effectiveTime [ a hl7:v3period;
>                                  ex:unit "h";
>                                  rdf:value "6"]]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "Prednisone 20mg qd";
>                          hl7:v3doseQuantity [ ex:unit "mg";
>                                  rdf:value "20"];
>                          hl7:v3effectiveTime [ a hl7:v3period;
>                                  ex:unit "h";
>                                  rdf:value "24"]]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:substance-administration;
>                          skos:prefLabel "HCTZ 25mg qd";
>                          hl7:v3effectiveTime [ a hl7:v3period;
>                                  ex:unit "h";
>                                  rdf:value "24"]]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ a cpr:medical-sign;
>                                          cpr:interpretant-of [ a cpr:symptom;
>                                                  skos:prefLabel "Hives"];
>                                          skos:prefLabel "Allergy to penicillin"];
>                                  skos:prefLabel "history taking (procedure)"];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ a cpr:medical-sign;
>                                          cpr:interpretant-of [ a cpr:symptom;
>                                                  skos:prefLabel "Wheezing"];
>                                          skos:prefLabel "Allergy to aspirin"];
>                                  skos:prefLabel "history taking (procedure)"];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ a cpr:medical-sign;
>                                          cpr:interpretant-of [ a cpr:symptom;
>                                                  skos:prefLabel "Pruritis"];
>                                          skos:prefLabel "Adverse reaction to drug"];
>                                  skos:prefLabel "history taking (procedure)"];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ a cpr:medical-sign;
>                                          cpr:interpretant-of [ a cpr:symptom;
>                                                  skos:prefLabel "Nausea"]]];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "1970";
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ dc:date "1970";
>                                          skos:prefLabel "MI"];
>                                  skos:prefLabel "history taking (procedure)"];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of ""],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          obo:OBO_REL_has_improper_part [ a cpr:medical-history-screening-act;
>                                  edns:realizes [ skos:prefLabel "No family history of diabetes"];
>                                  skos:prefLabel "history taking (procedure)"];
>                          skos:prefLabel "history taking (procedure)"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ skos:prefLabel "ex-heavy cigarette smoker (20-39/day)"];
>                          skos:prefLabel "Tobacco use and exposure"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [];
>                          skos:prefLabel "Date ceased smoking"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          edns:realizes [ skos:prefLabel "Trivial drinker -  less than 1/day"];
>                          skos:prefLabel "Alcohol intake"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ ex:unit "m";
>                                  rdf:value "1.77"],
>                              [ ex:unit "[in_I]";
>                                  rdf:value "69.7"];
>                          skos:prefLabel "Body height measure"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "1950";
>                          edns:realizes [ a cpr:diagnosis;
>                                  skos:prefLabel "Asthma"];
>                          skos:prefLabel "clinical diagnosis"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ ex:unit "[lb_ap]";
>                                  rdf:value "194.0"],
>                              [ ex:unit "kg";
>                                  rdf:value "88.0"];
>                          skos:prefLabel "Body weight measure"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [];
>                          skos:prefLabel "Body mass index"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ ex:unit "ar";
>                                  rdf:value "2.05"];
>                          skos:prefLabel "Body surface area"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ ex:unit "Cel";
>                                  rdf:value "36.9"],
>                              [ ex:unit "[degF]";
>                                  rdf:value "98.5"];
>                          skos:prefLabel "Body temperature"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [];
>                          skos:prefLabel "Heart rate"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          edns:realizes [];
>                          skos:prefLabel "Heart rate"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [ skos:prefLabel "Heart regular"];
>                          skos:prefLabel "Regularity of heart rhythm"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T15:30:00";
>                          edns:realizes [ skos:prefLabel "Heart regular"];
>                          skos:prefLabel "Regularity of heart rhythm"]],
>              [ a cpr:clinical-description;
>                  cpr:description-of [ a cpr:screening-act;
>                          dc:date "2000-04-07T14:30:00";
>                          edns:realizes [];
>                          skos:prefLabel "Respiratory rate"]];
>          edns:about [ a galen:Patient;
>                  foaf:family_name "Levin";
>                  foaf:firstName "Henry"];
>          foaf:maker [ a foaf:Person;
>                  foaf:family_name "Dolin";
>                  foaf:firstName "Robert"]].
>   
> ------------------------------------------------------------------------
>
> <?xml version="1.0"?>
> <rdf:RDF 
>     xmlns:bfo="http://www.ifomis.org/bfo/1.0/snap#"
>     xmlns:time="http://www.w3.org/2006/time#"
>     xmlns:temp="http://www.loa-cnr.it/ontologies/TemporalRelations.owl#" 
>     xmlns:foaf="http://xmlns.com/foaf/0.1/" 
>     xmlns:wn="http://xmlns.com/wordnet/1.6/"
>     xmlns:common="http://www.loa-cnr.it/ontologies/CommonSenseMapping.owl#"
>     xmlns:rdfs="http://www.w3.org/2000/01/rdf-schema#" 
>     xmlns:owl="http://www.w3.org/2002/07/owl#" 
>     xmlns:rim="http://wopeg.he.agfa.be/rules/RIMV3OWL#" 
>     xmlns:inf="http://www.loa-cnr.it/ontologies/InformationObjects.owl#" 
>     xmlns:galen="http://www.co-ode.org/ontologies/galen#" 
>     xmlns:dol="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#" 
>     xmlns="http://purl.org/cpr/owl/latest#" 
>     xmlns:edns="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#" 
>     xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" 
>     xmlns:xsd="http://www.w3.org/2001/XMLSchema#" 
>     xmlns:skos="http://www.w3.org/2004/02/skos/core#" 
>     xmlns:obi="http://obi.sourceforge.net/ontology/OBI.owl#"
>     xmlns:obo="http://www.geneontology.org/owl#"
>     xmlns:dc="http://purl.org/dc/elements/1.1/"
>     xmlns:cpr="http://purl.org/cpr/0.5#"
>     xml:base="http://purl.org/cpr/0.5#">
>   <owl:Ontology rdf:about="">
>     <dc:description>
>
> ## Accessibility ##
>
> This Semantic Web Ontology document (for self-hosted Medical Records) was written with a [faithful rendition](http://www.w3.org/2004/01/rdxh/spec#sec_rend) (GRDDL) in mind for consumption by  Semantic Web Agents, lay people, logicians,  *and* more ubiquitous markup user agents.
>
> It is generated by a Python software library which takes an OWL/XML document with the following additional (embedded) formats:
>
> * Markdown
> * RDF Vocabularies: [SKOS](http://www.w3.org/TR/swbp-skos-core-spec) / Ontology of Biomedical Investigation ([OBO](http://obi.sourceforge.net/)) vocabulary / Dublin Core ([DC](http://dublincore.org/documents/dces/))
>
> .. and generates a host XHTML document with the following (embeded) formats:
>
> * GRDDL (OWL RDF/XML)
> * Manchester OWL [Syntax](http://owl-workshop.man.ac.uk/acceptedLong/submission_9.pdf)
> * LaTex (eventually)
>
> </dc:description>
>     <dc:format>OWL-DL</dc:format>
>     <dc:format>Manchester OWL</dc:format>
>     <dc:format>Markdown</dc:format>
>     <dc:format>XHTML</dc:format>
>     <dc:format>RDF</dc:format>
>     <rdfs:comment>This Semantic Web Ontology document (for self-hosted Medical Records) was written with a faithful rendition (GRDDL) in mind for consumption by  Semantic Web Agents, lay people, logicians,  *and* more ubiquitous markup user agents.</rdfs:comment>
>     <dc:creator>Chimezie Ogbuji</dc:creator>
>     <foaf:maker>
>       <foaf:Person rdf:about="http://metacognition.info/profile/webwho.xrdf#chime">
>         <rdfs:seeAlso rdf:resource="http://metacognition.info/profile/webwho.xrdf"/>
>       </foaf:Person>
>     </foaf:maker>
>     <owl:versionInfo>0.5</owl:versionInfo>
>     <dc:title>Problem-oriented Medical Record Ontology</dc:title>
>     <dc:description>
>       <![CDATA[
> ## Definition ##
>
> The goal is to define a minimal set of terms that connect representations from well defined healthcare information &amp; process models 
> (such as [HL7 RIM](http://www.hl7.org/library/data-model/RIM/C30202/rim.htm)) with more expressive [foundational](http://ontology.buffalo.edu/bio/OBR.pdf) 
> ontologies of biology (both domain-agnostic and those specific to the domains of life sciences and healthcare) through the use of the criteria [outlined](http://www.pkc.com/papers/pomr.pdf) in 
>   the traditional Problem-oriented Medical Record structure.
>   
> ## Meeting CPR Requirements ##
>
> This is an attempt to demonstrate how a few best practices in ontology and software engineering can be applied to address the problem 
> of the lack of a unified vocabulary for Computer-based Patient Records (CPR)  
>   
> ## Problem-oriented Medical Record Methodology ##
>
>   
>> The fundamental motivation for the design and philosophy of the Problem-Oriented Medical Record (POMR) 
>> is the belief that the medical record is the central medium of communication and the first repository 
>> of knowledge in the practice of clinical medicine    
>>     
>
> ## KR Methodology ##
>
> Elisabeth Bayegan's methodology (outlined in full within her PhD [thesis](http://www.idi.ntnu.no/~bayegan/pub/ebthesis.pdf)) is followed as
>  a means for capturing clinical content in an RDF knowledge base with syntactic and semantic extensions for *DLP* (and RIF?) expressivity (RDFLib)
>       
> ## KR (Description Logic) Syntax ##
>
> Wherever possible, the Manchester OWL Syntax (@@TODO References) is adopted to capture axiomatic semantics of DL terminologies.            
>       
> ## GALEN' Role classes ##
>
> GALEN's role classes are used heavily to categorize (for instance):
>
> * Clinical social roles (physician, nurse, patient, etc..)
> * Other roles: DiagnosisRole, SignRole, SymptomRole, ..     
>
> ## OBO Links ##
>
> The dependent OBO ontologies can be [browsed](http://www.bioontology.org/ncbo/faces/pages/ontology_list.xhtml)
>
> ## Anatomical Ontology ##
>
> Foundational Model of Anatomy [FMA](http://www.bioontology.org/ncbo/faces/pages/ontology_details.xhtml?ontology_display_name=FMA) is adopted for describing anatomical constructs.
>
> ## Papers and References ##
>
>  * [A Problem Oriented Approach to the Computerized Patient Record](http://www.pkc.com/papers/pomr.pdf)
>  * [A Strategy for Improving and Integrating Biomedical Ontologies](http://ontology.buffalo.edu/bio/OBR.pdf) 
>  * [HL7 RIM: An Incoherent Standard](http://ontology.buffalo.edu/HL7/doublestandards.pdf)
>  * [DOLCE: Descriptive Ontology of Linguistics and Cognitive Engineering](http://www.loa-cnr.it/DOLCE.html)
>  * [Ontologies for Knowledge Representation in a Computer-Based Patient Record](http://www.idi.ntnu.no/~bayegan/pub/bayegan_ictai02.pdf)
>  * [Open Galen](http://www.co-ode.org/galen)
>  * [Laboratory for Applied Ontology- Medical Theories](http://www.loa-cnr.it/medicine)
>  * [http://www.hl7.org/library/data-model/RIM/C30202/rim.htm](HL7 Reference Information Model)
>  * [HL7 Clinical Document Architecture, Release 2.](http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=pubmed&amp;dopt=Abstract&amp;list_uids=16221939&amp;query_hl=1)
>  * [Towards a Reference Terminology for Ontology Research and Development in the Biomedical Domain](http://ontology.buffalo.edu/bfo/Terminology_for_Ontologies.pdf)
>  * [Time Ontology in OWL](http://www.w3.org/TR/owl-time/)
>
>            ]]>
>     </dc:description>
>     <owl:imports rdf:resource="http://protege.stanford.edu/plugins/owl/dc/protege-dc.owl"/>
>     <owl:imports rdf:resource="http://obi.svn.sourceforge.net/viewvc/*checkout*/obi/ontology/trunk/OBI.owl"/>
>     <owl:imports rdf:resource="http://obo.sourceforge.net/relationship/relationship.owl"/>
>     <!--owl:imports rdf:resource="http://www.w3.org/2004/02/skos/core"/>
>     <owl:imports rdf:resource="http://xmlns.com/foaf/0.1/index.rdf"/>
>     <owl:imports rdf:resource="http://www.cs.man.ac.uk/~horrocks/OWL/Ontologies/galen.owl"/-->
>     <owl:imports rdf:resource="http://www.loa-cnr.it/ontologies/InformationObjects.owl"/>
>     <owl:imports rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl"/>
>     <owl:imports rdf:resource="http://www.w3.org/2006/time"/>
>     <owl:imports rdf:resource="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl"/>
>   </owl:Ontology>
>   <owl:Class rdf:ID="patient-record">
>     <obi:definition></obi:definition>
>     <rdfs:label rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Patient Record</rdfs:label>
>     <skos:editorialNote
>     >No longer a subclass of foaf:Document and inf:linguistic-object.  Now is a sole subclass of edns:information-object</skos:editorialNote>
>     <obi:definition
>     >An information object (a obi:digital_entity?) which includes relevant healthcare content about (similar to foaf:primaryTopic) a patient  
>     </obi:definition>
>     <rdfs:subClassOf rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#information-object"/>
>     <owl:intersectionOf rdf:parseType="Collection">
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#about"/>        
>         <owl:allValuesFrom rdf:resource="http://www.co-ode.org/ontologies/galen#Patient"/>
>       </owl:Restriction>      
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.geneontology.org/owl#OBO_REL_has_proper_part"/>        
>         <owl:allValuesFrom rdf:resource="#clinical-description"/>
>       </owl:Restriction>      
>     </owl:intersectionOf>
>   </owl:Class>    
>     
>   <owl:Class rdf:about="#person">
>     <rdfs:label>person</rdfs:label>
>     <obi:definition
>       >(a human being) "there was too much for one person to do" - http://wordnet.princeton.edu/perl/webwn?s=person</obi:definition>
>     <rdfs:subClassOf rdf:resource="http://www.co-ode.org/ontologies/galen#Person"/>
>   </owl:Class>  
>     
>   <owl:Class rdf:ID="clinical-description">
>     <rdfs:label>clinical description</rdfs:label>
>     <dc:description
>     ><![CDATA[
>
> ### Reconciling HL7 RIM Inconsistencies
>
> The *cpr:clinical-description* class is an attempt to reconcile the ontological inconsistencies with the archetype of 
> a recording of an act and the thing the recording describes (which could be either a continuant / endurant or an occurrant / perdurant).            
>                   
> ### about
>
>   
>> The relation between information objects and entities they are about. The difference with 'expresses' is that the last 
>> requires a situation to be about something. E.g. Dante's Comedy is about facts like Dante's travel to the hereafter. 
>> The Comedy expresses a script as well as various related meanings, while the facts talked about are not 'expressed'.
>> Given that descriptions are expressed by at least one IO, and that interpretations of IOs requires conceiving a description, 
>> and the (plausible) claim that being about something can only be done in context, i.e. within a situation, we can propose 
>> that the conceived description is satisfied by the situation (the context) of the entity the IO is about.On this basis, 
>> about would result to be a mediated relation. This is still a proposal, then we keep about here as a primitive for some time.
>>     
>
> ### depiction
>
>   
>> An information realization consisting of depicted images/signs of any sort (e.g. graffiti, drawings, inscriptions, pictures, 
>> sculptures, etc.), which are inscripted on a medium that lasts longer than the depicting act. It also includes any early form 
>> of inscripted iconic expression, which can be considered as original bodily expressions.
>>     
>
> ### REPRESENTATIONAL ARTIFACT
>
>   
>> A representation that is fixed in some medium in such a way that it can serve to make the cognitive representations existing in the minds of separate
>> subjects publicly accessible in some enduring fashion. Examples are: a text, a diagram, a map legend, a list, a clinical record, or a controlled
>> vocabulary.
>>     
>
> ### Act (HL7 RIM)
>
>   
>> A record of something that is being done, has been done, can be done, or is intended or requested to be done.
>>     
>
> One of the goals of this ontology is to facilitate the use of owl-time constructs to express temporal qualities using foundational ontology terms such as:
>
> * has-quality
>   
> As such time:TemporalEntity serves as a syntactic proxy for temporal-quality
>           
>     ]]>      
>     </dc:description>
>     <obi:definition
>       >Corresponds (at least syntactically) with the HL7 RIM Act Class, insofar as it is the class of clinical recordings (a REPRESENTATIONAL ARTIFACT) of a natural phenomenon 
>       (cpr:medical-problem, cpr:clinical-act, and anything else of clinical relevance) by an individual.  Collections of such recordings, each of which is related to a person,
>       manifests as the patient record.</obi:definition>
>     <skos:editorialNote>The extension of this class does not include intent or requests ala HL7 RIM</skos:editorialNote>
>     <skos:editorialNote>With regards to temporal provenance, a clinical description can be associated with a date (of initial creation or last modification).
>       This is not to be confused with the temporal qualities of the phenomenon it describes.</skos:editorialNote>
>     <skos:editorialNote>Should clinical-descriptions *only* be about people, problems, or acts?</skos:editorialNote>
>     <rdfs:subClassOf rdf:resource="http://www.loa-cnr.it/ontologies/InformationObjects.owl#depiction"/>
>     <rdfs:subClassOf>
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://purl.org/dc/elements/1.1/creator"/>
>         <owl:cardinality rdf:datatype="http://www.w3.org/2001/XMLSchema#int">1</owl:cardinality>
>       </owl:Restriction>
>     </rdfs:subClassOf>
>     <owl:intersectionOf rdf:parseType="Collection">
>       <!--  Is this redundant?  owl:Class rdf:about="http://www.loa-cnr.it/ontologies/InformationObjects.owl#depiction"/-->
>       <owl:Restriction>
>         <owl:someValuesFrom rdf:resource="http://www.w3.org/2006/time#TemporalEntity"/>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#has-quality"/>
>       </owl:Restriction>          
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#about"/>
>         <owl:minCardinality rdf:datatype="http://www.w3.org/2001/XMLSchema#int">1</owl:minCardinality>
>       </owl:Restriction>
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#about"/>
>         <owl:allValuesFrom>
>           <owl:Class>
>             <owl:unionOf rdf:parseType="Collection">
>               <owl:Class rdf:about="#clinical-act"/>
>               <owl:Class rdf:about="#person"/>
>               <owl:Class rdf:about="#medical-problem"/>
>             </owl:unionOf>
>           </owl:Class>
>         </owl:allValuesFrom>
>       </owl:Restriction>      
>     </owl:intersectionOf>
>   </owl:Class>
>     
>   <owl:Class rdf:ID="medical-problem">
>     <obi:definition>The class of entities or particulars which play a galen:SignOrSymptomRole or a galen:DiagnosisRole</obi:definition>
>     <dc:description
>   
>> <![CDATA[
>>     
> ### POMR Definition
>
> Consists mainly of problems that clearly require the intervention of a health care professional. These include acute problems requiring 
> hospitalization and chronic problems requiring long-term management. Such problems usually offer at least some risk of impairment
> or disability especially if diagnosis or management is not handled properly.      
>       
> ### Relation to GALEN's "Basic Template for Signs and Symptoms"
>
> This 'defined class' can be considered equivalent to GALEN's SignSymptomOrDiagnosis.  
>    ]]></dc:description>
>     <rdfs:label>medical problem</rdfs:label>
>     <skos:editorialNote>Does the POMR methodology require that all medical-problems are occurrents? Do they include endurants (continuants) and / or qualities? </skos:editorialNote>
>     <skos:editorialNote>Is galen:hasSeverity an appropriate relation to use to capture the severity of medical problems</skos:editorialNote>
>     <rdfs:seeAlso rdf:resource="http://www.pkc.com/papers/pomr.pdf"/>
>     <dc:references rdf:resource="http://www.pkc.com/papers/pomr.pdf"/>
>     <rdfs:subClassOf> 
>       <owl:Class>
>         <owl:intersectionOf rdf:parseType="Collection">
>           <owl:Restriction>
>             <owl:someValuesFrom rdf:resource="http://www.w3.org/2006/time#TemporalEntity"/>
>             <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#has-quality"/>
>           </owl:Restriction>                    
>           <owl:Restriction>
>             <owl:minCardinality rdf:datatype="http://www.w3.org/2001/XMLSchema#int">1</owl:minCardinality>
>             <owl:onProperty rdf:resource="http://www.co-ode.org/ontologies/galen#hasSeverity"/>
>           </owl:Restriction>
>         </owl:intersectionOf>
>       </owl:Class>
>     </rdfs:subClassOf>
>   </owl:Class>    
>
>   <owl:Class rdf:ID="medical-sign">
>     <rdfs:label>medical sign</rdfs:label>
>     <dc:description
>   
>> <![CDATA[
>>     
> ### Wordnet 
>       
> Wordnet definition of a medical sign:
>
>   
>> .. any objective evidence of the presence of a disorder or disease
>>     
>
> ### Wikipedia 
>
> Wikipedia [definition](http://en.wikipedia.org/wiki/Medical_sign)
>
>   
>> a medical sign is an objective indication of some medical fact or quality 
>> that is detected by a physician during a physical examination of a patientósuch 
>> as elevated blood pressure, or a clubbing of the fingers (which may be a sign 
>> of lung disease), or arcus senilis.  
>>     
>
> ### Representation Theory - Laboratory for Applied Ontology (LOA) : Medical Theories
>
>   
>> In principle, a theory of signs admits that anything can be used to describe anything else. 
>> In practice, there are severe limitations on the use of some entity as interpretant of another, 
>> and these limitations derive from the cultural and local context, from the symbolic system used, 
>> and from the cognitive and ontological underlying motivations. This is a theory which only 
>> describes the use of signs as a post-hoc issue, after some intentionality has decided what is an 
>> interpretant of what. Interpretant is a relation which holds between any two entities, where the 
>> first is used to describe or explain the second. There are background conditions for being an 
>> interpretant: an agent should be aware of both the interpretant and the reference, and a context 
>> should encompass the agent and the entities involved. Interpretant is reflexive, while symmetry 
>> and transitivity are debatable. Symmetry seems inappropriate, since usually some entity is USED 
>> as interpretant, and the process is not reverted (not an equivalence). Transitivity holds only 
>> if metaphor and metonymy are discarded as possible sense sources in the domain of interpretation.
>>     
>  ]]>                                                                                                                                               
> </dc:description>      
>     <dc:references rdf:resource="http://en.wikipedia.org/wiki/Medical_sign"/>
>     <obi:definition>An "objective" (determined by a clnician) indication of some medical fact or quality that is detected by a physician during a physical examination of a patient</obi:definition>
>     <rdfs:subClassOf rdf:resource="#medical-problem"/>
>     <skos:editorialNote>Are class axioms in conflict? *Any* interpretation by a doctor is a medical sign, but *all* medical signs must be medical problems?</skos:editorialNote>
>
>     <owl:intersectionOf rdf:parseType="Collection">
>       <owl:Restriction>
>         <owl:minCardinality rdf:datatype="http://www.w3.org/2001/XMLSchema#int">1</owl:minCardinality>
>         <owl:onProperty rdf:resource="#interpretant-of"/>
>       </owl:Restriction> 
>       <owl:Restriction>
>         <owl:allValuesFrom rdf:resource="http://www.co-ode.org/ontologies/galen#Doctor"/>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#interpreted-by"/>
>       </owl:Restriction>      
>     </owl:intersectionOf>
>   </owl:Class>
>
>   <owl:Class rdf:ID="symptom">
>     <rdfs:label>symptom</rdfs:label>
>     <obi:definition>A sensation or change in health function experienced by a patient</obi:definition>  
>     <dc:description>
> <![CDATA[
> ### Wordnet Definition
>
> See: [symptom](http://wordnet.princeton.edu/perl/webwn?s=symptom)
>
> ### Wikipedia Definition
>
> See: [Symptom](http://en.wikipedia.org/wiki/Symptom):
>
>   
>> Strict  ly, a symptom is a sensation or change in health function experienced by a patient. Thus, symptoms may be 
>> loosely classified as strong, mild or weak. In this, medically correct, sense of the word, it is a subjective 
>> report, as opposed to a sign, which is objective evidence of the presence of a disease or disorder. Examples of 
>> symptoms are fatigue/tiredness, pain, or nausea. In contrast, elevated blood pressure, or abnormal appearance of 
>> the retina, would be a medical sign indicating the nature of the disease.
>>     
>
> ### GALEN (GRAIL) Definition(s)
>
>     (Phenomenon whichG playsConsultationRole SymptomRole) name Symptom.
>     
> interpetant-of can be thought of as somewhat related to how isConsultationRolePlayedBy relates a SymptomRole with the phenomenon which 'plays' it            
>
> ]]></dc:description>    
>     <dc:references rdf:resource="http://en.wikipedia.org/wiki/Symptom"/>
>     <rdfs:subClassOf rdf:resource="#medical-problem"/>
>     <owl:equivalentClass rdf:resource="http://www.co-ode.org/ontologies/galen#Symptom"/>
>     <rdfs:subClassOf>
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#interpreted-by"/>
>         <owl:allValuesFrom rdf:resource="http://www.co-ode.org/ontologies/galen#Patient"/>
>       </owl:Restriction>
>    </rdfs:subClassOf>
>   </owl:Class>
>
>   <owl:Class rdf:about="#diagnosis">
>     <dc:description><![CDATA[
> ### Diagnosis Role 
>
> Both GALEN and OBI define diagnosis roles:
>
> ### GALEN Diagnosis
>
>     (Phenomenon whichG playsConsultationRole DiagnosisRole) name Diagnosis.
>
> ### OBI Diagnosis Role (OBI_159)
>
>   
>> A diagnostic role is a role which is assigned to an entity when it is used to identify the nature or cause of some phenomenon (i.e. a diagnosis). - http://wordnet.princeton.edu/perl/webwn?s=diagnosis
>>     
> ]]></dc:description>
>     <obi:definition>Identification of a disease from its symptoms</obi:definition>
>     <rdfs:label>diagnosis</rdfs:label>
>     <rdfs:subClassOf rdf:resource="#medical-problem"/>
>     <skos:editorialNote>This may eventually be aligned with obi:OBI_159</skos:editorialNote>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=diagnosis"/>
>     <owl:equivalentClass rdf:resource="http://www.co-ode.org/ontologies/galen#Diagnosis"/>
>   </owl:Class>
>
>   <owl:Class rdf:about="#disease">
>     <rdfs:label>disease</rdfs:label>
>     <dc:description>
> <![CDATA[
> ### Alignment with OBI
>
> **TODO** Align with OBI_155 once it settles
>       
> ### Ontology of Biomedical Reality
>
>   
>> Relying on the FMAs definition of anatomical structure, we distinguish anatomical (normal)
>> from pathological (abnormal) material entities; the latter resulting from processes other than those
>> governed by the organismís structural genes. We also extend the FMAs representation of material entities
>>     
>             
> ]]></dc:description>
>     <obi:definition>an impairment of health or a condition of abnormal functioning</obi:definition>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=disease"/>
>     <rdfs:seeAlso rdf:resource="http://ontology.buffalo.edu/bio/OBR.pdf"/>
>     <rdfs:subClassOf rdf:resource="http://www.ifomis.org/bfo/1.0/snap#Disposition"/>
>     <skos:editorialNote>This may eventually be aligned with obi:OBI_155</skos:editorialNote>
>     <rdfs:comment rdf:datatype="http://www.w3.org/2001/XMLSchema#string">Wordnet: </rdfs:comment>
>   </owl:Class>
>
>   <owl:Class rdf:about="#clinical-act">
>     <dc:description>
>       <![CDATA[
> ### GALEN Definition
>
>       NAMEDVolitionalAct newSub ClinicalAct.
>       
> ### Knowledge Representation for Relevance Ranking of Patient-Record Contents in Primary-Care Situations
>
> Elisabeth Bayegan follows the clinical headings set as a framework for a class of 'clinical acts':
>
>   
>> The NHS Clinical Headings Projectís main objective has been to identify a limited number of headings that will perform
>> the jobs that are needed for clinical communicationand navigation and that can be agreed upon by every participant
>> involved in clinical communication. The project produced a well-established framework of clinical headings
>> compatible with HL7 and CEN TC251ís standardization work on electronic patient records. Clinical Headings refer
>> to a set of words and phrases that clinicians use to name sections of their communications (e.g., symptoms, examination
>> findings, test results, diagnosis, etc.). Clinical headings have no formal syntax or definition, therefore, our content
>> ontology represents the formal data structures needed to strictly define concepts in the patient record.
>>     
>
> Her methodology (outlined in full within her PhD [thesis](http://www.idi.ntnu.no/~bayegan/pub/ebthesis.pdf)) is followed as
>  a means for capturing clinical content in an RDF knowledge base.  The support for a abstract clinical workflow is also an 
>  asset in possible combinations with the HCLS Advanced Clinical Protocols and Pathways ontology being developed in the W3C. 
>
> ### Care Acts and Agents - Modeling the Clinical Workflow
>
> Bayegan:
>
>   
>> We distinguish between the direct observations (the patient's problem statement and
>> physician's observations) and the interpretations that are done on these observations
>> (assessment, diagnostics, and treatment actions). This distinction between the input
>> to a process and the actions based on the input is also reflected in our CareActType
>> ontology (Figure 8.5). The CareActType ontology has four main classes that jut out
>> from the root concept THING (1) case history, (2) assessment, (3) diagnosis, and
>> (4) treatment. The former class represents the information input to the care process,
>> while the three latter classes represent the actions done in the care process (i.e., based
>> on interpretations).
>>     
>
> ### Connections to DOLCE's Plan Ontology ###
>
> See: [edns:activity][activity]
>                                     
> ]]></dc:description>
>     <rdfs:label>clinical-act</rdfs:label>    
>     <obi:definition>An activity associated with the clinical care process model</obi:definition>
>     <dc:references rdf:resource="http://www.idi.ntnu.no/~bayegan/pub/ebthesis.pdf"/>
>     <skos:editorialNote>Should this be a subclass of edns:activity (provide linkage to DOLCE's more generic workflow semantics)? The participant restriction becomes redundant if so</skos:editorialNote>
>     <rdfs:seeAlso rdf:resource="http://www.nhsia.nhs.uk/headings/pdf/hstan32.pdf"/>
>     <rdfs:subClassOf rdf:resource="http://www.co-ode.org/ontologies/galen#ClinicalAct"/>
>     <rdfs:subClassOf>
>       <owl:Restriction>
>         <owl:someValuesFrom rdf:resource="http://www.co-ode.org/ontologies/galen#Person"/>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/DOLCE-Lite.owl#participant"/>
>       </owl:Restriction>      
>     </rdfs:subClassOf>
>   </owl:Class>
>
>   <owl:Class rdf:ID="therapeutic-act">
>     <dc:description>
>       <![CDATA[
> ### Wordnet Definition
>
>   
>> ..care provided to improve a situation (especially medical procedures or applications that are intended to relieve illness or injury)
>>     
>
> ### GALEN Defintion
>
>     ClinicalAct newSub TreatmentAct.
>     
> ### NHS Clinical Headings
>
>   
>> Any activity which is undertaken to maintain or improve a patient/client's state of health and well-being, relieve distress or reduce risk  
>>     
>
> ### HL7 RIM Definition
>
>   
>> An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject.
>>     
>
> ### Laboratory for Applied Ontology (LOA)
>
>   
>> A procedure, method, or technique designed to prevent a disease or a disorder, or to improve physical function, or used in the process of treating a disease or injury.
>>     
>   
> ]]></dc:description>
>     <rdfs:label>therapeutic act</rdfs:label>    
>     <obi:definition>Any activity which is undertaken to maintain or improve a patient/client's state of health and well-being, relieve distress or reduce risk</obi:definition>
>     <dc:references rdf:resource="http://www.nhsia.nhs.uk/headings/pages/draftinfo.asp"/>
>     <rdfs:subClassOf rdf:resource="#clinical-act"/>
>   </owl:Class>
>
>   <owl:Class rdf:ID="surgical-procedure">
>     <dc:description>
>       <![CDATA[
> ### GALEN Definition
>
>       (Process whichG playsClinicalRole SurgicalRole) name SurgicalDeed.
>                         
> ]]></dc:description>
>     <rdfs:label>surgical procedure</rdfs:label>    
>     <obi:definition
>     >A medical procedure involving an incision with instruments; performed to repair damage or arrest disease in a living body)</obi:definition>    
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=surgical%20operation"/>
>     <rdfs:seeAlso rdf:resource="http://www.hl7.org/library/data-model/RIM/C30202/rim.htm#Procedure-cls"/>
>     <rdfs:seeAlso rdf:resource="http://www.loa-cnr.it/medicine/medical-procedures/class15.html"/>
>     <rdfs:subClassOf rdf:resource="#therapeutic-act"/>
>   </owl:Class>
>
>   <owl:Class rdf:ID="diagnostic-act">
>     <dc:description>
>       <![CDATA[
> ### GALEN Defnition(s)
>
>     (ClinicalAct whichG isToDetermine Phenomenon) name InvestigationAct.
>     (ClinicalAct whichG hasSubprocess ExaminingProcess) name ExaminationAct.
>     
> ### DOLCE's Definition of an information realization
>
>   
>> Any physical entity that realizes an information object.    
>>     
>             
> ]]></dc:description>
>     <rdfs:label>diagnostic act</rdfs:label>    
>     <obi:definition>Any activity which is undertaken to find out more information about a patient/client's state of health and social well-being</obi:definition>    
>     <dc:references rdf:resource="http://www.nhsia.nhs.uk/headings/pages/draftinfo.asp"/>
>     <rdfs:subClassOf rdf:resource="#clinical-act"/>
>     <rdfs:subClassOf rdf:resource="http://www.loa-cnr.it/ontologies/InformationObjects.owl#information-realization"/>
>   </owl:Class>
>   <owl:Class rdf:ID="screening-act">
>     <dc:description>
>       <![CDATA[
> ### Problem-oriented Medical Record Definition      
>       
>   
>> .. screening information can be subdivided into at least four major areas: (1) wellness
>> screening, (2) physical examination, (3) medical history, and (4) mental health screening.
>> Additional categories or sub-categories may be introduced for special needs (such as breast
>> cancer screening). For each of these areas we expect to record findings indicating the patient's
>> current status and condition, and recommended actions (in response to the findings) that may
>> require follow-up and monitoring.
>>     
>
> ### Laboratory for Applied Ontology (LOA) - Medical-procedures Theory
>
>   
>> A procedure, method, or technique used to determine the nature or identity of a disease or disorder. This excludes procedures which are primarily carried out on specimens in a laboratory. 
>>     
>
> ### HL7 RIM Observation Definition
>
>   
>> An Act of recognizing and noting information about the subject, and whose immediate and primary outcome (post-condition) is new data about a subject.
>>     
>
> ### GALEN Definition
>
>     ClinicalAct whichG isToDetermine (Existentiality which isExistenceOf PathologicalPhenomenon)) name ScreeningAct.
>
> OBO\_REL\_has\_improper\_part is used to relate a screening act with the acts that compose it (history taking and physical examination)
>
>       
> ]]></dc:description>
>     <rdfs:label>screening act</rdfs:label>    
>     <obi:definition>Process of data collection with pre-defined and standardized screening questionnaires in order to discover problems.</obi:definition>    
>     <rdfs:subClassOf rdf:resource="#diagnostic-act"/>
>     <dc:references rdf:resource="http://www.pkc.com/papers/pomr.pdf"/>
>     <dc:references rdf:resource="http://www.nhsia.nhs.uk/headings/pages/draftinfo.asp"/>
>     <rdfs:seeAlso rdf:resource="http://www.loa-cnr.it/medicine/medical-procedures/class2.html"/>
>     <owl:intersectionOf rdf:parseType="Collection">
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#realizes"/>
>         <owl:allValuesFrom rdf:resource="#medical-problem"/>
>       </owl:Restriction>
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.geneontology.org/owl#OBO_REL_has_improper_part"/>
>         <owl:allValuesFrom>
>           <owl:Class>
>             <owl:unionOf rdf:parseType="Collection">
>               <owl:Class rdf:about="#medical-history-screening-act"/>
>               <owl:Class rdf:about="#clinical-examination"/>
>             </owl:unionOf>
>           </owl:Class>
>         </owl:allValuesFrom>
>       </owl:Restriction>      
>     </owl:intersectionOf>
>     <rdfs:comment rdf:datatype="http://www.w3.org/2001/XMLSchema#string"></rdfs:comment>
>   </owl:Class>  
>   
>   <owl:Class rdf:ID="medical-history-screening-act">
>     <dc:description>
>       <![CDATA[
> ### WIkipedia Definition
>       
>   
>> The medical history or anamnesis[1] of a patient is information gained by a physician or other 
>> healthcare professional by asking specific questions, either of the patient or of other people 
>> who know the person and can give suitable information (in this case, it is sometimes called heteroanamnesis), 
>> with the aim of obtaining information useful in formulating a diagnosis and providing medical care 
>> to the patient. This kind of information is called the symptoms, in contrast with clinical signs, 
>> which are ascertained by direct examination.      
>>     
>       
> Rather than explicitely referring (within the patient record) to instances of a class called 'history' (which act as input to activities in the care process),
> information-objects realized by instances of this class are assumed to be considered a case history (relative - temporaly - to the screening acts)            
>       
> ]]></dc:description>
>     <rdfs:label>medical history screening act</rdfs:label>    
>     <obi:definition>Any diagnostic act which attempts to determine / realize anamnesis</obi:definition>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=anamnesis"/>    
>     <rdfs:seeAlso rdf:resource="http://en.wikipedia.org/wiki/Medical_history"/>
>     <rdfs:subClassOf rdf:resource="#diagnostic-act"/>
>   </owl:Class>  
>   <owl:Class rdf:ID="clinical-examination">
>     <dc:description>
>       <![CDATA[
> ### Wikipedia definition
>
>   
>> Physical examination or clinical examination is the process by which a health care provider investigates the body of a patient for signs 
>> of disease. It generally follows the taking of the medical history - an account of the symptoms 
>> as experienced by the patient. Together with the medical history, the physical examination aids 
>> in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.
>>     
>             
> ]]></dc:description>
>     <rdfs:label>clinical-examination</rdfs:label>    
>     <obi:definition>The process by which a health care provider investigates the body of a patient for signs of disease</obi:definition>
>     <dc:references rdf:resource="http://en.wikipedia.org/wiki/Clinical_examination"/>    
>     <rdfs:subClassOf rdf:resource="#diagnostic-act"/>
>     <owl:equivalentClass>
>       <owl:Restriction>
>         <owl:onProperty rdf:resource="http://www.loa-cnr.it/ontologies/ExtendedDnS.owl#realizes"/>
>         <owl:allValuesFrom rdf:resource="http://www.co-ode.org/ontologies/galen#ExaminationFinding"/>
>       </owl:Restriction>      
>     </owl:equivalentClass>
>   </owl:Class>  
>   <owl:Class rdf:ID="laboratory-test">
>     <dc:description>
>       <![CDATA[
> ### Wordnet Defnitions
>
> Assay: 
>
>   
>> A quantitative or qualitative test of a substance (especially an ore or a drug) to determine its components; 
>> frequently used to test for the presence or concentration of infectious agents or antibodies etc.)
>>     
>
> Diagnostic test:
>
>   
>> An assay conducted for diagnostic purposes.
>>     
>                   
> ]]></dc:description>
>     <rdfs:label>lab test</rdfs:label>    
>     <obi:definition>A quantitative or qualitative test of a substance (especially an ore or a drug) to determine its components;</obi:definition>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=assay"/>    
>     <rdfs:subClassOf rdf:resource="#diagnostic-act"/>
>   </owl:Class>  
>       
>   <owl:Class rdf:ID="physical-therapy">
>     <rdfs:label>physical therapy</rdfs:label>    
>     <obi:definition>Therapy that uses physical agents: exercise and massage and other modalities</obi:definition>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=physical%20therapy"/>    
>     <rdfs:subClassOf rdf:resource="#therapeutic-act"/>
>   </owl:Class>  
>   <owl:Class rdf:ID="psychological-therapy">
>     <rdfs:label>psychological therapy</rdfs:label>
>     <rdfs:subClassOf rdf:resource="#therapeutic-act"/>
>   </owl:Class>  
>   <owl:Class rdf:ID="medical-therapy">
>     <rdfs:label>medical therapy</rdfs:label>    
>     <rdfs:subClassOf rdf:resource="#therapeutic-act"/>
>   </owl:Class>  
>   
>   <owl:Class rdf:ID="substance-administration">
>     <rdfs:label>substance administration</rdfs:label>
>     <dc:description>
>       <![CDATA[
> ### GALEN Definition
>
>     (MechanicalPropulsion whichG <
>           actsSpecificallyOn Drug
>           hasUniqueAssociatedDisplacement (Displacement which isDisplacementTo BodyStructure)>
>     ) name DrugAdministration.
>                   
> ### HL7 RIM Defnition (SubstanceAdministration-cls)
>
>   
>> The act of introducing or otherwise applying a substance to the subject.
>>     
>
>   
>> Discussion: The effect of the substance is typically established on a biochemical basis, 
>> however, that is not a requirement. For example, radiotherapy can largely be described in 
>> the same way, especially if it is a systemic therapy such as radio-iodine. This class also 
>> includes the application of chemical treatments to an area.                                     
>>     
>                   
> ]]></dc:description>    
>     <rdfs:label>medical therapy</rdfs:label>
>     <rdfs:subClassOf rdf:resource="#medical-therapy"/>
>     <skos:editorialNote>How should this relate to the cpr:medication being administered?</skos:editorialNote>
>     <obi:definition>The act of introducing or otherwise applying a substance to the patient</obi:definition>
>     <dc:references rdf:resource="http://www.hl7.org/library/data-model/RIM/C30202/rim.htm#SubstanceAdministration-cls"/>
>     <rdfs:comment rdf:datatype="http://www.w3.org/2001/XMLSchema#string">The act of introducing or otherwise applying a substance to the subject.</rdfs:comment>
>   </owl:Class>
>   
>   <!--
>     cpr:medical-device is-a galen:Device
>     -->
>   <owl:Class rdf:ID="medical-device">
>     <rdfs:label>medical device</rdfs:label>
>     <rdfs:subClassOf rdf:resource="http://www.co-ode.org/ontologies/galen#Device"/>
>     <skos:editorialNote>Placeholder for medical devices ontology</skos:editorialNote>
>   </owl:Class>    
>   
>   <owl:Class rdf:ID="medication">
>     <rdfs:label>medication</rdfs:label>
>     <dc:description>
>       <![CDATA[
>
> ### Laboratory for Applied Ontology (LOA)
>
>   
>> A substance used in the treatment, diagnosis, prevention, or analysis of normal and abnormal body function. This includes substances that occur naturally in the body and are administered therapeutically.
>>     
>                   
> ]]></dc:description>    
>     <skos:editorialNote>Placeholder for drug ontology</skos:editorialNote>
>     <obi:definition>(medicine) something that treats or prevents or alleviates the symptoms of disease</obi:definition>
>     <dc:references rdf:resource="http://wordnet.princeton.edu/perl/webwn?s=medication"/>
>     <rdfs:seeAlso rdf:resource="http://www.loa-cnr.it/medicine/biologic-substances/class18.html"/>
>     <rdfs:subClassOf rdf:resource="http://www.co-ode.org/ontologies/galen#NAMEDDrug"/>
>   </owl:Class>
>   
>   
>   <!--
>     Properties / relations
>     -->
>   <owl:ObjectProperty rdf:about="#description-of">
>     <obi:defnition>Relation between a clinical-description and what it describes</obi:defnition>
>     <rdfs:label>description of</rdfs:label>
>     <rdfs:subPropertyOf rdf:resource="http://www.geneontology.org/owl#OBO_REL_has_agent"/>
>     <owl:inverseOf>
>       <owl:ObjectProperty rdf:ID="described-by"/>
>     </owl:inverseOf>
>     <rdfs:domain rdf:resource="#clinical-description"/>
>   </owl:ObjectProperty>
>   <owl:ObjectProperty rdf:about="#described-by">
>     <rdfs:label>described by</rdfs:label>
>     <obi:defnition>Relation between a phenomena and the clinical-description which records it in a patient record</obi:defnition>
>     <rdfs:subPropertyOf rdf:resource="http://www.geneontology.org/owl#OBO_REL_agent_in"/>
>     <rdfs:range rdf:resource="#clinical-description"/>
>     <owl:inverseOf rdf:resource="#description-of"/>
>   </owl:ObjectProperty>
>   <owl:ObjectProperty rdf:about="#interpretant-of">
>     <obi:defnition>Relation between a medical sign and the entity which causes the objective indication interpreted by a clinician</obi:defnition>
>     <dc:references rdf:resource="http://www.loa-cnr.it/medicine/representation/relation30.html"/>
>     <rdfs:domain rdf:resource="#medical-sign"/>
>   </owl:ObjectProperty>  
> </rdf:RDF>
>   


-- 
		-harry

Harry Halpin,  University of Edinburgh 
http://www.ibiblio.org/hhalpin 6B522426

Received on Wednesday, 14 March 2007 08:15:09 UTC