Note 1 : Recommended statistics for this type of classification highlighted in aqua
Note 2 : The recommender system assumes that the input is the result of classification over the whole data rather than just a part of it. If the confusion matrix is the result of test data classification, the recommendation is not valid.
| Actual | Predict
|
| Class | Crohn's_disease | Healthy | Ulcerative_Colitis | Description |
| ACC | 0.70968 | 0.95699 | 0.75269 | Accuracy |
| AGF | 0.64782 | 0.92945 | 0.7543 | Adjusted F-score |
| AGM | 0.71048 | 0.95961 | 0.75442 | Adjusted geometric mean |
| AM | -4 | -6 | 10 | Difference between automatic and manual classification |
| AUC | 0.66532 | 0.93952 | 0.74194 | Area under the ROC curve |
| AUCI | Fair | Excellent | Good | AUC value interpretation |
| AUPR | 0.55061 | 0.93462 | 0.66039 | Area under the PR curve |
| BCD | 0.01075 | 0.01613 | 0.02688 | Bray-Curtis dissimilarity |
| BM | 0.33065 | 0.87903 | 0.48387 | Informedness or bookmaker informedness |
| CEN | 0.59857 | 0.15004 | 0.43051 | Confusion entropy |
| DOR | 4.50621 | 966.42857 | 8.38095 | Diagnostic odds ratio |
| DP | 0.36046 | 1.64581 | 0.50904 | Discriminant power |
| DPI | Poor | Limited | Poor | Discriminant power interpretation |
| ERR | 0.29032 | 0.04301 | 0.24731 | Error rate |
| F0.5 | 0.56122 | 0.96154 | 0.62857 | F0.5 score |
| F1 | 0.55 | 0.9322 | 0.65672 | F1 score - harmonic mean of precision and sensitivity |
| F2 | 0.53922 | 0.90461 | 0.6875 | F2 score |
| FDR | 0.43103 | 0.01786 | 0.38889 | False discovery rate |
| FN | 29 | 7 | 18 | False negative/miss/type 2 error |
| FNR | 0.46774 | 0.1129 | 0.29032 | Miss rate or false negative rate |
| FOR | 0.22656 | 0.05385 | 0.15789 | False omission rate |
| FP | 25 | 1 | 28 | False positive/type 1 error/false alarm |
| FPR | 0.20161 | 0.00806 | 0.22581 | Fall-out or false positive rate |
| G | 0.55031 | 0.93341 | 0.65855 | G-measure geometric mean of precision and sensitivity |
| GI | 0.33065 | 0.87903 | 0.48387 | Gini index |
| GM | 0.65188 | 0.93805 | 0.74123 | G-mean geometric mean of specificity and sensitivity |
| IBA | 0.31186 | 0.78769 | 0.51398 | Index of balanced accuracy |
| IS | 0.77138 | 1.55897 | 0.87447 | Information score |
| J | 0.37931 | 0.87302 | 0.48889 | Jaccard index |
| LS | 1.7069 | 2.94643 | 1.83333 | Lift score |
| MCC | 0.33647 | 0.90333 | 0.46829 | Matthews correlation coefficient |
| MCCI | Weak | Very Strong | Weak | Matthews correlation coefficient interpretation |
| MCEN | 0.68163 | 0.22355 | 0.49423 | Modified confusion entropy |
| MK | 0.3424 | 0.9283 | 0.45322 | Markedness |
| N | 124 | 124 | 124 | Condition negative |
| NLR | 0.58586 | 0.11382 | 0.375 | Negative likelihood ratio |
| NLRI | Negligible | Fair | Poor | Negative likelihood ratio interpretation |
| NPV | 0.77344 | 0.94615 | 0.84211 | Negative predictive value |
| OC | 0.56897 | 0.98214 | 0.70968 | Overlap coefficient |
| OOC | 0.55031 | 0.93341 | 0.65855 | Otsuka-Ochiai coefficient |
| OP | 0.50968 | 0.9012 | 0.70921 | Optimized precision |
| P | 62 | 62 | 62 | Condition positive or support |
| PLR | 2.64 | 110.0 | 3.14286 | Positive likelihood ratio |
| PLRI | Poor | Good | Poor | Positive likelihood ratio interpretation |
| POP | 186 | 186 | 186 | Population |
| PPV | 0.56897 | 0.98214 | 0.61111 | Precision or positive predictive value |
| PRE | 0.33333 | 0.33333 | 0.33333 | Prevalence |
| Q | 0.63677 | 0.99793 | 0.7868 | Yule Q - coefficient of colligation |
| RACC | 0.10394 | 0.10036 | 0.12903 | Random accuracy |
| RACCU | 0.10406 | 0.10062 | 0.12975 | Random accuracy unbiased |
| TN | 99 | 123 | 96 | True negative/correct rejection |
| TNR | 0.79839 | 0.99194 | 0.77419 | Specificity or true negative rate |
| TON | 128 | 130 | 114 | Test outcome negative |
| TOP | 58 | 56 | 72 | Test outcome positive |
| TP | 33 | 55 | 44 | True positive/hit |
| TPR | 0.53226 | 0.8871 | 0.70968 | Sensitivity, recall, hit rate, or true positive rate |
| Y | 0.33065 | 0.87903 | 0.48387 | Youden index |
| dInd | 0.50934 | 0.11319 | 0.3678 | Distance index |
| sInd | 0.63984 | 0.91996 | 0.73993 | Similarity index |
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[%settitle Clinical Reasoning%]
[%file newheader%] [%file newnavbar%]For the purposes of the Clinical Reasoning module, a Knowledge Artifact is a structured, computable, and shareable representation of clinical knowledge. A comprehensive definition of clinical knowledge is beyond the scope of this module, but we effectively mean any knowledge relevant to improving patient care. For example, "Patients with diabetes should have regular comprehensive foot examinations to identify risk factors predictive of ulcers and amputations" is a statement of clinical knowledge. A knowledge artifact would then be some representation that can be used to integrate that knowledge into existing healthcare delivery systems.
There are any number of ways to accomplish this integration of clinical knowledge, ranging from direct implementation within an existing EHR system to the use of high-level representation and reasoning systems that can adapt clinical workflow to provide cognitive support to clinicians. Within this module, we aim to provide a representation that is both flexible enough to represent a broad range of knowledge artifacts, but simple and specific enough to enable automated integration of the content.
To achieve these goals, we define several components that are present in a broad variety of knowledge artifacts:
| Component | Description |
|---|---|
| Artifact Identity | Information used to uniquely identify an artifact. |
| Metadata | Information about the knowledge artifact such as lifecycle status, publisher, documentation, and supporting evidence. |
| Action Definitions | Descriptions of actions to be taken as part of the implementation of knowledge |
| Trigger Definitions | Information about what events should trigger the use of the artifact |
| Expression Logic | Expressions used to represent reasoning such as whether or not some criteria is satisfied, or calculation of new values from existing ones. |
As with any FHIR resource, the instance identity is specified by the id element. In addition, artifacts may have logical identifiers based on the content or behavior they provide, such as the CMS or NQF identifiers for measure content. These logical identifiers can be provided in the identifier
element defined on each resource.
In addition to identity, the version
element can be used to specify a content version for the artifact. In general, version numbers are required for published, non-experimental artifacts, and optional otherwise.
The following fragment shows the use of the logical identifier and version elements:
<identifier>
<use value="official"/>
<system value="http://motivemi.com/artifacts"/>
<value value="mmi:low-suicide-risk-order-set"/>
</identifier>
<version value="1.0.0"/>
When using the identifier
element to provide the Entity Identifier for a service module consistent with the Decision Support Service (DSS) specification, the following mappings apply:
| DSS Model Element | FHIR Element | Example |
|---|---|---|
| businessId | Identifier.value | hemoglobin-control-rule |
| scopingEntityId | Identifier.system | com.clinica |
| version | Artifact.version | 1.0.0 |
Each of the various knowledge artifact resources defines a set of elements that provide consistent representation of metadata such as title, description, and usage, repository indexing and publication information, as well as additional supporting documentation and evidence:
| Element | Description |
|---|---|
| name | A machine-friendly name for the artifact example |
| title | A user-friendly title for the artifact example |
| status | The lifecycle status for the artifact (draft, active, or inactive) example |
| experimental | Whether the artifact is for testing purposes, rather than production usage example |
| description | A natural language description of the artifact example |
| purpose | Describes the purpose of the artifact example |
| usage | Describes the clinical usage of the artifact example |
| approvalDate | The date when this artifact was approved by the publisher example |
| lastReviewDate | The date this version of the artifact was last reviewed example |
| effectivePeriod | The effective date range for the artifact example |
| useContext | Describes the context of use for this artifact example |
| topic | Descriptional topics for the artifact example |
| contributor | A content contributor example |
| publisher | The name of the publisher (either an organization or an individual) example |
| contact | Contact details for the publisher example |
| copyright | Legal copyright description for the artifact example |
| relatedArtifact | Related resources for the artifact, including additional documentation, supporting evidence, or knowledge management dependencies example |
General documentation elements, including description, purpose, and usage, provide immediately available documentation as part of the artifact. Additional documentation can be provided using the relatedArtifact
element to link to more detailed information, supporting evidence, and to additional required artifacts as appropriate.
<title value="Appropriate Testing for Children with Pharyngitis"/>
<status value="active"/>
<experimental value="true"/>
<description value="Percentage of children 2-18 years of age who were diagnosed with pharyngitis, ordered an antibiotic and
received a group A streptococcus (strep) test for the episode."/>
<purpose value="The Infectious Diseases Society of America (IDSA) "recommends swabbing the throat and testing for GAS
pharyngitis by rapid antigen detection test (RADT) and/or culture because the clinical features alone do not reliably discriminate
between GAS and viral pharyngitis except when overt viral features like rhinorrhea, cough, oral ulcers, and/or hoarseness are present""/>
<topic>
<coding>
<system value="http://hl7.org/fhir/c80-doc-typecodes" />

</coding>
</topic>
For information on the useContext
and topic
elements, refer to the Knowledge Artifact Distribution section.
The status
element describes the lifecycle status of the artifact, indicating whether it is a draft, active, or retired artifact. This representation is consistent with the states described by the Quality Metadata Conceptual Model. The following table provides a mapping from the states defined here, to the states as defined in the Clinical Decision Support Knowledge Artifact Specification (CDS KAS), as well as the Decision Support Service (DSS) standard:
| Experimental? | Status | CDS KAS Mapping | DSS Mapping |
|---|---|---|---|
| true | draft | Draft, InTest | DRAFT, DEFINED |
| true | active | InTest | DEFINED |
| true | retired | Inactive | REJECTED |
| false | draft | Draft | DRAFT |
| false | active | Active | APPROVED, PROMOTED |
| false | retired | Inactive | REJECTED, RETIRED |
Note that the experimental
element can be used independent of the lifecycle status, allowing the full lifecycle of an artifact to be tested.
Actions describe the "output" actions of the knowledge artifact. These actions may be in the form of messages (such as reminders), structured clinical acts (e.g., a laboratory test order) that can be implemented via clinical systems such as a computerized provider entry system or a documentation system, or they may create new events (e.g., declaration of a patient state such as failure of a treatment). Each action definition contains the following basic information:
| Description | Descriptive information such as identifier, label, title, and textEquivalent. |
| Documentation | Supporting documentation, citations, or evidence in support of the action. |
| Related Action Definitions | Each action definition can specify relationships to other actions, allowing timings and offsets to be expressed. |
| Trigger Definition | Triggering events for the action. See the section on trigger definitions below for more information. |
| Condition | An optional condition specifying whether the action definition applies. |
| Timing | A description of when the action definition should occur. |
| Behavior | Various behaviors that communicate the intended semantics of groups and actions (e.g. selection behavior, grouping behavior, etc.) |
| Type | The type of action to be performed (e.g. create, update, delete, etc.) |
| Activity Definition | A description of what activity is to be performed. To enable reuse and modularity, ActivityDefinition resources may be reusesd by multiple action definitions. |
| Dynamic Values | Expressions that can be used to specify dynamic values for the resulting activity. |
| Child Actions | Each action may contain any number of child actions, allowing a hierarchy of actions to be described (for example, sections in an order set). |
The following fragment shows a simple referral creation action from an example order set for suicide risk assessment and management:
<actionDefinition>

<textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health conditions now"/>
<activityDefinition>
<reference value="#referralToMentalHealthCare"/>
</activityDefinition>
<dynamicValue>
<path value="timing.event"/>
<expression value="Now()"/>
</dynamicValue>
<dynamicValue>
<path value="specialty"/>
<expression value="Code '261QM0850X' from "urn:oid:2.16.840.1.113883.11.19462""/>
</dynamicValue>
<dynamicValue>
<path value="fulfillmentTime"/>
<expression value="ReferralRequestFulfillmentTime"/>
</dynamicValue>
<dynamicValue>
<path value="patient"/>
<expression value="Patient"/>
</dynamicValue>
<dynamicValue>
<path value="requester"/>
<expression value="Practitioner"/>
</dynamicValue>
<dynamicValue>
<path value="reason"/>
<expression value="RiskAssessmentScore"/>
</dynamicValue>
<dynamicValue>
<path value="supportingInformation"/>
<expression value="RiskAssessment"/>
</dynamicValue>
</actionDefinition>
The example describes how to create a ReferralRequest
resource using information available from the context in which the order set is applied. The definition includes expressions for retrieving contextual information using the dynamicValue
element of the ActivityDefinition
resource. For more information on using expressions to provide dynamic values as part of a definition, refer to the Using Expressions topic in this module.
Each action may specify the type of action to perform:
The Create, Update, and Remove actions indicate that particular resources should be created, updated, or removed, and the Fire Event action indicates that a particular named event should be triggered.
Note that this element is optional, and is used to indicate what type of action is to be taken with the associated activity definition. For example, an action that indicates create
with an activity definition that defines a referral request means that the referral request should be realized and the resulting resource created (i.e. applied to the patient's record). An action that indicates update
with an activity definition would indicate that an existing resource on the patient's record should be updated based on the new resource content.
Each action may have any number of triggers associated to indicate what events should trigger the action to be taken. The following types of triggers may be defined:
A named event is an event identified by the implementation environment. This type of event allows Event-Condition-Action (ECA) rules to be triggered by any event generated within the implementation environment. A scheduled event occurs on a fixed or periodic schedule. And finally, a data event occurs in response to some data-related event in the integrated environment such as a record being added or updated.
As examples, the following fragments illustrate the use of a named event, a scheduled event, and a data event as part of an ECA rule definition:
<triggerDefinition>
<type value="named-event"/>
<eventName value="Admission"/>
</triggerDefinition>
<triggerDefinition>
<type value="scheduled-event"/>
<eventTimingDate>10/12/2015</eventTimingDate>
</triggerDefinition>
<triggerDefinition>
<type value="data-added"/>
<eventData>
<dataRequirement>
<type value="Condition"/>
<codeFilter>
<path value="code"/>
<valueSetString value="Other Female Reproductive Conditions"/>
</codeFilter>
</dataRequirement>
</eventData>
</triggerDefinition>
Each action may have associated conditions that specify whether the action is applicable, or when it should be started and stopped. The $apply operation is used to render a plan definition, and the parameters to the apply are available as context to expressions within the plan definition, including the applicable condition and the dynamic value expressions.
For example, the following fragment shows the condition element of an action definition used in an ECA rule. The condition references the named expression "NoScreening":
<condition>
<expression value="NoScreening"/>
</condition>
The Clinical Reasoning module defines several resources, including Library, PlanDefinition, and Measure to represent each of the components described above. By combining these components in different ways, several different types of knowledge artifacts can be represented:
| Artifact Type | Description | Example |
|---|---|---|
| Library | A general purpose container for clinical knowledge, potentially defined in non-FHIR structures. For example, a sharable package of clinical logic expressed in Clinical Quality Language. | Expressions that define the criteria that must be met to determine whether or not a patient has diabetes. |
| Event-Condition-Action (ECA) Rule | A decision support rule of the form [on Event] if Condition then Action , defining actions that shoud be taken whenever some condition is met in response to a particular event. | On a patient checking in to a clinic appointment, if the patient has diabetes and has not had a recent foot examination, place an unsigned order for a comprehensive foot exam. |
| Order Set | A pre-defined and approved group of orders related to a particular clinical condition (e.g., hypertension treatment and monitoring) or stage of care (e.g., hospital admission to Coronary Care Unit). Order sets are used within electronic health record systems as a checklist for physicians when treating a patient with a specific condition or in a specific context. An order set is a structured collection of orders presented to the physician in a computerized physician order entry system (CPOE). | The specific orders to be placed when a patient presents with diabetic ketoacidosis. |
| Protocol | A pre-defined procedural method for standardizing a set of activities. As examples, protocols can be used within laboratory settings to standardize handling of specimens for specific tests; standardize the treatment steps for a particular condition; or standardize the steps to be taken in a particular research trial. | The specific tasks that should be performed to provide effective treatment for a new diagnosis of diabetes. |
| Documentation Template | A structured form for recording information on a patient into a set of predefined data slots. | A form describing the information that should be gathered during a comprehensive diabetic foot exam. |
| Measure | A quantitative tool to assess the performance of an individual or organization with respect to a specified process or outcome via the measurement of actions, processes, or outcomes of clinical care. Quality measures are often derived from clinical quidelines and are designed to determine whether the appropriate care has been provided given a set of clinical criteria and an evidence base. | Percentage of patients aged 18-75 years of age with diabetes who had a foot exam during the measurement period. |
The Library resource is a general purpose container for clinical knowledge that may be defined in non-FHIR representations. For example, a Clinical Quality Language expression library can be represented as a Library resource so that it can be referenced as part of other knowledge artifacts.
For example, the following fragment shows a Library that contains the CQL logic for Chlamydia Screening decision support:
<Library>
<id value="example"/>
<identifier>
<use value="official"/>
<value value="ChalmydiaScreening_Common"/>
</identifier>
<version value="2.0.0"/>
<title value="Chlamydia Screening Common Library"/>
<type>
<coding>

</coding>
</type>
<status value="draft"/>
<description value="Common Logic for adherence to Chlamydia Screening guidelines"/>
<publicationDate value="2015-07-22"/>
<topic>
<text value="Chlamydia Screening"/>
</topic>
<relatedArtifact>
<type value="depends-on"/>
<resource>
<reference value="Library/library-quick-model-definition"/>
</resource>
</relatedArtifact>
<dataRequirement>
<type value="Condition"/>
<codeFilter>
<path value="code"/>
<valueSetString value="Other Female Reproductive Conditions"/>
</codeFilter>
</dataRequirement>
<content>
<contentType value="text/cql"/>
<url value="http://cqlrepository.org/ChlamydiaScreening_Common.cql"/>
</content>
</Library>
An Event-Condition-Action (ECA) rule is an artifact with the general syntax "on event, if condition is true, then do action." The event triggers the invocation of the rule; the condition is a logical test that, if satisfied or evaluates "true", causes an action; while the action describes a set of activities to be performed. These actions may in turn cause further events to occur, which may in turn cause other ECA rules to fire.
Note that the "activity" to be performed may be to document a patient-specific assessment performed by a clinical decision support service (e.g. patient has a 37% chance of a heart attack in the next 5 years), not just recommendations/recommended actions. In this case, the action would be to "create" a RiskAssessment.
The PlanDefinition resource can be used to represent an ECA rule using the action
element. A single, top-level action
represents the overall rule, with the triggerDefinition
element used to specify the triggering event(s), the condition
element used to specify the applicable condition for the rule, and the action
element describing the action to be performed.
For example, the following fragment illustrates a simple use of PlanDefinition to expose a Chlamydia Screening ECA rule:
<PlanDefinition>
<id value="chlamydia-screening-intervention"/>
<identifier>
<use value="official"/>
<value value="ChlamydiaScreening_CDS_UsingCommon"/>
</identifier>
<version value="2.0.0"/>
<title value="Chalmydia Screening CDS Example Using Common"/>
<status value="draft"/>
<description value="Chlamydia Screening CDS Example Using Common"/>
<publicationDate value="2015-07-22"/>
<topic>
<text value="Chlamydia Screening"/>
</topic>
<library>
<reference value="Library/ChlamydiaScreening_CDS_UsingCommon"/>
</library>
<action>
<title value="Patient has not had chlamydia screening within the recommended timeframe..."/>
<triggerDefinition>
<type value="scheduled-event"/>
<eventTimingDate>10/12/2015</eventTimingDate>
</triggerDefinition>
<condition>
<expression value="NoScreening"/>
</condition>
<dynamicValue>
<path value="~"/>
<expression value="ChlamydiaScreeningRequest"/>
</dynamicValue>
</action>
</PlanDefinition>
Note that the use of the tilde (~
) in the path
element here indicates that the result of the expression is the entire result for the action, rather than providing the value for a specific element of the result. In other words, the ChlamydiaScreeningRequest
expression will result in an entire ProcedureRequest resource, which is the action to be performed.
An order set is a pre-defined and approved group of orders related to a particular clinical context (e.g., hypertension treatment and monitoring) or stage of care (e.g., hospital admission to Coronary Care Unit) or a particular grouping (e.g. pediatrics, adult, males over 50, etc.). An order set is typically used as a checklist for clinicians when managing a patient with a specific context. It is a structured collection of orders relevant to that condition or context and presented to the clinician in a computerized provider order entry system (CPOE).
The PlanDefinition resource can represent an Order Set using action definitions to define the orderable items in the order set. The items in an order set are typically organized hierarchically, as a set of sections, sub-sections, etc., with the actions themselves at the very bottom of the structure. In the PlanDefinition resource, each section, and sub-section, as well as the individual items are all represented as action definitions. Each group and/or subgroup may have behavior indicators associated with it, e.g., the number of actions that can/should/must be selected from the group of actions.
For example, the following fragment illustrates the items in a suicide risk order set:
Note that this example is a fragment of a larger example for the PlanDefinition resource, available here.
<actionDefinition>
<title value="Suicide Risk Assessment and Outpatient Management"/>

<action>
<title value="Consults and Referrals"/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="any"/>
<action>

<textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health conditions now"/>
<definition>
<reference value="#referralToMentalHealthCare"/>
</definition>
<dynamicValue>...</dynamicValue>
</action>
</action>

<action>
<title value="Medications"/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>

<title value="First-Line Antidepressants"/>
<documentation>
<type value="justification"/>
<document>
<contentType value="text/html"/>
<url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
<title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
</document>
</documentation>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>

<title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)"/>
<documentation>
<type value="justification"/>
<document>
<contentType value="text/html"/>
<url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/>
<title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."/>
</document>
</documentation>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>

<textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)"/>
<definition>
<reference value="#citalopramPrescription"/>
</definition>
<dynamicValue>...</dynamicValue>
</action>
<action>

<textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>

</action>
<action>

<textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/>

</action>
<action>

<textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>

</action>
<action>

<textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>

</action>
</action>
<action>

<textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"/>

</action>
<action>

<textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"/>

</action>
<action>

<textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/>

</action>
</action>
</action>
</action>
In this example, the order set structure consists of:

Each group defines the selection and grouping behavior for the items in the group, as well as providing links to supporting documentation for the particular items in the order set.
A protocol is a pre-defined procedural method for standardizing a set of activities. As examples, protocols can be used within laboratory settings to standardize handling of specimens for specific tests; standardize the treatment steps for a particular condition; or standardize the steps to be taken in a particular research trial.
The PlanDefinition resource can be used to represent a Protocol, using the action definitions to define the steps of the protocol and the relationships between them. Triggering events for each action, as well as applicable conditions can all be specified using the appropriate action elements within the PlanDefinition.
As a simple example, the following fragment shows a portion of a BMI Assessment protocol:
<action>

<title value="Measure, Weight, Height, Waist, Circumference; Calculate BMI"/>

<description value="Weight must be measured so that the BMI can be calculated. Most charts are based on weights obtained with the patient wearing undergarments and no shoes. BMI can be manually calculated (kg/[height in meters]2), but is more easily obtained from a nomogram. Waist circumference is important because evidence suggests that abdominal fat is a particularly strong determinant of cardiovascular risk in those with a BMI of 25 to 34.9 kg/m2. Increased waist circumference can also be a marker of increased risk even in persons of normal weight. The technique for measuring waist circumference is described in the text. A nutrition assessment will also help to assess the diet and physical activity habits of overweight patients"/>

<condition>
<description value="The practitioner must seek to determine whether the patient has ever been overweight. While a technical definition is provided, a simple question such as 'Have you ever been overweight?' will accomplish the same goal. Questions directed towards weight history, dietary habits, physical activities, and medications may provide useful information about the origins of obesity in particular patients.
For those who have not been overweight, a 2 year interval is appropriate for the reassessment of BMI. While this time span is not evidence-based, it is believed to be a reasonable compromise between the need to identify weight gain at an early stage and the need to limit the time, effort, and cost of repeated measurements."/>
<expression value="Observation of Obesity or BMI Measured in Past 2 Years"/>

</condition>

<definition>
<reference value="#procedure"/>
</definition>
</action>
A documentation template is a structured form for recording information on a patient into a set of pre-defined data slots. These templates are used to guide structured data entry within an EHR or other clinical information system. Some types of clinical documents that can be represented via the documentation template artifacts are encounter summaries, procedure notes, patient-reported outcomes, and flowsheets.
The Questionnaire resource provides a basis for representing the structure of a documentation template. Using the expression extensions, the resource can be extended to provide dynamic behavior such as calculating values, showing/hiding content based on answers to questions, and other interactive functionality.
Documentation Templates often include not only a description of the data to be collected, but the behavior of the template during evaluation. For example, whether or not to display a particular question or group of questions based on answers to previously asked questions, or calculating the value of an answer based on other answers. The Questionnaire resource by itself does not provide this functionality, so this module introduces a CQIF-Questionnaire profile of the Questionnaire resource to allow this behavior to be modeled.
As an example, the PHQ-9 Health Questionnaire contains a question that is answered by totaling the weights from the answers of each of the previous questions. The CQIF Questionnaire example illustrates the representation of this questionnaire with the required logic for computation.
The following fragment taken from that example illustrates the use of the cqlExpression extension to calculate the TotalScore answer for a PHQ-9 Depression Assessment instrument:
<item>
<extension url="http://hl7.org/fhir/StructureDefinition/cqif-basic-cqlExpression">
<valueString value="CalculateTotalScore"/>
</extension>
<linkId value="TotalScore"/>
<concept>
<system value="http://loinc.org"/>

</concept>
<text value="Total score"/>
<type value="choice"/>
<required value="true"/>
<options>
<reference value="ValueSet/http://loinc.org/vs/LL358-3"/>
<display value="Patient Health Questionnaire (PHQ-9) Not at all/Several days/More than half the days/Nearly every day"/>
</options>
</item>
A quantitative tool to assess the performance of an individual or organization with respect to a specified process or outcome via the measurement of actions, processes, or outcomes of clinical care. Note that the Measure itself does not contain any logic; rather a Library resource is referenced that contains the logic required by the measure, and the various expression elements, such as poulation criteria, reference named expressions within that library (or libraries).
For example, the following fragment defines how to calculate the controlling high blood pressure measure:
<Measure>
<id value="cbp"/>
<status value="active"/>
<experimental value="true"/>
<description value="Controlling High Blood Pressure Cohort Definition"/>
<topic>
<coding>
<system value="http://hl7.org/fhir/c80-doc-typecodes"/>

</coding>
</topic>
<library>
<reference value="Library/cbp-logic"/>
</library>
<group>
<identifier>
<value value="CBP-cohort"/>
</identifier>
<population>
<type value="initial-population"/>
<identifier>
<value value="cbp-cohort"/>
</identifier>
<criteria value="In Demographic"/>
</population>
</group>
<group>
<identifier>
<value value="BP-systolic"/>
</identifier>
<population>
<type value="initial-population"/>
<identifier>
<value value="bp-systolic"/>
</identifier>
<criteria value="BP: Systolic"/>
</population>
</group>
<group>
<identifier>
<value value="BP-diastolic"/>
</identifier>
<population>
<type value="initial-population"/>
<identifier>
<value value="bp-diastolic"/>
</identifier>
<criteria value="BP: Diastolic"/>
</population>
</group>
</Measure>


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In the articulation of consonants, there is always some kind of obstruction to the airflow. This obstruction may be thorough or partial. The ways obstructions occur are listed vertically along the first column. These are known as manners of articulation. Obstruction may occur in different regions, from the lips (labial), to the teeth (dental) to the alveolar, the palate, the velum, the pharynx and the glottal. These are known as places of articulation.
Please click on the chart to explore the consonant sounds. Please note that all consonantal sounds are put inside a carrier frame [a __a], i.e. the consonant sound is flanked by two vowels [a]. This is done so that the consonant may be heard most distinctly.
| Plosive |
Nasal |
| Trill |
Tap or Flap |
| Fricative |
Lateral Fricative |
| Approximant |
Lateral Approximant |
| Plosive |
| Bilabial | p | b |
| Dental | t | d |
| Alveolar | t | d |
| Postalveolar | t | d |
| Retroflex | ʈ | ɖ |
| Palatal | c | ɟ |
| Velar | k | ɡ |
| Uvular | q | ɢ |
| Glottal | ʔ |
| Nasal |
| Bilabial | m |
| Labiodental | ɱ |
| Dental | n |
| Alveolar | n |
| Postalveolar | n |
| Retroflex | ɳ |
| Palatal | ɲ |
| Velar | ŋ |
| Uvular | ɴ |
| Trill |
| Bilabial | ʙ |
| Dental | r |
| Alveolar | r |
| Postalveolar | r |
| Uvular | ʀ |
| Tap or Flap |
| Labiodental | ⱱ |
| Dental | ɾ |
| Alveolar | ɾ |
| Postalveolar | ɾ |
| Retroflex | ɽ |
| Fricative |
| Bilabial | ɸ | β |
| Labiodental | f | v |
| Dental | θ | ð |
| Alveolar | s | z |
| Postalveolar | ʃ | ʒ |
| Retroflex | ʂ | ʐ |
| Palatal | ç | ʝ |
| Velar | x | ɣ |
| Uvular | χ | ʁ |
| Pharyngeal | ħ | ʕ |
| Glottal | h | ɦ |
| Lateral fricative |
| Dental | ɬ | ɮ |
| Alveolar | ɬ | ɮ |
| Postalveolar | ɬ | ɮ |
| Approximant |
| Labiodental | ʋ |
| Dental | ɹ |
| Alveolar | ɹ |
| Postalveolar | ɹ |
| Retroflex | ɻ |
| Palatal | j |
| Velar | ɰ |
| Lateral approximant |
| Dental | l |
| Alveolar | l |
| Postalveolar | l |
| Retroflex | ɭ |
| Palatal | ʎ |
| Velar | ʟ |


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The pre version of this numbertheory package has been released!!!
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Bink and Mike Dean Trade Barbs Over Credits on Kanye's "Devil in a New Dress"
by VladTVProducers Bink and Mike Dean went at one another on Twitter after Dean claimed that he "made the whole section" of Kanye's "Devil in a New Dress" track on My Beautiful Dark Twisted Fantasy. This comes after Billboard named the project "Album of the Decade."
Bink disagreed with Dean, tweeting, "F**k you!  No excuse!! Plain disrespectful! @therealmikedean has never done anything like this in his career BY HIMSELF!" In a since-deleted tweet, Bink also wrote, "To all that know me know I don’t need no LAME ASS WHITE BOY to help me with sh*t! He’s putting on for the net rt now! @therealmikedean know f**king well he has never and will never be as soulful as me! Foh."
Dean shot back and told Bink that he "killed the beat," but added, "I did take it to another dimension with the switch up." You can read their full back and forth above.


TRIANGLES.
Equilateral Triangle-Has all sides equal.
Isosceles Triangle-Only two sides are equal to each other.
Scalene Triangle-No side is equal to the other.
"Checkout on the different angles of triangle and the method of calculation"...
Identify diffrent types of triangles;
Side A:
Side B:
Side C:
FINDOUT
RESET


Alice's Adventures in Wonderland
by Lewis Carroll
Chapter XI: Who Stole the Tarts?
Additional Information
- Year Published: 1865
- Language: English
- Country of Origin: England
- Source: Carroll, L. (1865). Alice's Adventures in Wonderland. London: MacMillan Publishing Co.
-
Readability:
- Flesch–Kincaid Level: 5.5
- Word Count: 1,997
- Genre: Fantasy
- Keywords: 19th century literature, british literature, children's literature
- ✎ Cite This
Downloads
The King and Queen of Hearts were seated on their throne when they arrived, with a great crowd assembled about them—all sorts of little birds and beasts, as well as the whole pack of cards: the Knave was standing before them, in chains, with a soldier on each side to guard him; and near the King was the White Rabbit, with a trumpet in one hand, and a scroll of parchment in the other. In the very middle of the court was a table, with a large dish of tarts upon it: they looked so good, that it made Alice quite hungry to look at them—'I wish they'd get the trial done,' she thought, 'and hand round the refreshments!' But there seemed to be no chance of this, so she began looking at everything about her, to pass away the time.
Alice had never been in a court of justice before, but she had read about them in books, and she was quite pleased to find that she knew the name of nearly everything there. 'That's the judge,' she said to herself, 'because of his great wig.'
The judge, by the way, was the King; and as he wore his crown over the wig, (look at the frontispiece if you want to see how he did it,) he did not look at all comfortable, and it was certainly not becoming.
'And that's the jury–box,' thought Alice, 'and those twelve creatures,' (she was obliged to say 'creatures,' you see, because some of them were animals, and some were birds,) 'I suppose they are the jurors.' She said this last word two or three times over to herself, being rather proud of it: for she thought, and rightly too, that very few little girls of her age knew the meaning of it at all. However, 'jury–men' would have done just as well.
The twelve jurors were all writing very busily on slates. 'What are they doing?' Alice whispered to the Gryphon. 'They can't have anything to put down yet, before the trial's begun.'
'They're putting down their names,' the Gryphon whispered in reply, 'for fear they should forget them before the end of the trial.'
'Stupid things!' Alice began in a loud, indignant voice, but she stopped hastily, for the White Rabbit cried out, 'Silence in the court!' and the King put on his spectacles and looked anxiously round, to make out who was talking.
Alice could see, as well as if she were looking over their shoulders, that all the jurors were writing down 'stupid things!' on their slates, and she could even make out that one of them didn't know how to spell 'stupid,' and that he had to ask his neighbour to tell him. 'A nice muddle their slates'll be in before the trial's over!' thought Alice.
One of the jurors had a pencil that squeaked. This of course, Alice could not stand, and she went round the court and got behind him, and very soon found an opportunity of taking it away. She did it so quickly that the poor little juror (it was Bill, the Lizard) could not make out at all what had become of it; so, after hunting all about for it, he was obliged to write with one finger for the rest of the day; and this was of very little use, as it left no mark on the slate.
'Herald, read the accusation!' said the King.
On this the White Rabbit blew three blasts on the trumpet, and then unrolled the parchment scroll, and read as follows:—
'The Queen of Hearts, she made some tarts,
All on a summer day:
The Knave of Hearts, he stole those tarts,
And took them quite away!'
'Consider your verdict,' the King said to the jury.
'Not yet, not yet!' the Rabbit hastily interrupted. 'There's a great deal to come before that!'
'Call the first witness,' said the King; and the White Rabbit blew three blasts on the trumpet, and called out, 'First witness!'
The first witness was the Hatter. He came in with a teacup in one hand and a piece of bread–and–butter in the other. 'I beg pardon, your Majesty,' he began, 'for bringing these in: but I hadn't quite finished my tea when I was sent for.'
'You ought to have finished,' said the King. 'When did you begin?'
The Hatter looked at the March Hare, who had followed him into the court, arm–in–arm with the Dormouse. 'Fourteenth of March, I think it was,' he said.
'Fifteenth,' said the March Hare.
'Sixteenth,' added the Dormouse.
'Write that down,' the King said to the jury, and the jury eagerly wrote down all three dates on their slates, and then added them up, and reduced the answer to shillings and pence.
'Take off your hat,' the King said to the Hatter.
'It isn't mine,' said the Hatter.
'Stolen!' the King exclaimed, turning to the jury, who instantly made a memorandum of the fact.
'I keep them to sell,' the Hatter added as an explanation; 'I've none of my own. I'm a hatter.'
Here the Queen put on her spectacles, and began staring at the Hatter, who turned pale and fidgeted.
'Give your evidence,' said the King; 'and don't be nervous, or I'll have you executed on the spot.'
This did not seem to encourage the witness at all: he kept shifting from one foot to the other, looking uneasily at the Queen, and in his confusion he bit a large piece out of his teacup instead of the bread–and–butter.
Just at this moment Alice felt a very curious sensation, which puzzled her a good deal until she made out what it was: she was beginning to grow larger again, and she thought at first she would get up and leave the court; but on second thoughts she decided to remain where she was as long as there was room for her.
'I wish you wouldn't squeeze so.' said the Dormouse, who was sitting next to her. 'I can hardly breathe.'
'I can't help it,' said Alice very meekly: 'I'm growing.'
'You've no right to grow here,' said the Dormouse.
'Don't talk nonsense,' said Alice more boldly: 'you know you're growing too.'
'Yes, but I grow at a reasonable pace,' said the Dormouse: 'not in that ridiculous fashion.' And he got up very sulkily and crossed over to the other side of the court.
All this time the Queen had never left off staring at the Hatter, and, just as the Dormouse crossed the court, she said to one of the officers of the court, 'Bring me the list of the singers in the last concert!' on which the wretched Hatter trembled so, that he shook both his shoes off.
'Give your evidence,' the King repeated angrily, 'or I'll have you executed, whether you're nervous or not.'
'I'm a poor man, your Majesty,' the Hatter began, in a trembling voice, '—and I hadn't begun my tea—not above a week or so—and what with the bread–and–butter getting so thin—and the twinkling of the tea—'
'The twinkling of the what?' said the King.
'It began with the tea,' the Hatter replied.
'Of course twinkling begins with a T!' said the King sharply. 'Do you take me for a dunce? Go on!'
'I'm a poor man,' the Hatter went on, 'and most things twinkled after that—only the March Hare said—'
'I didn't!' the March Hare interrupted in a great hurry.
'You did!' said the Hatter.
'I deny it!' said the March Hare.
'He denies it,' said the King: 'leave out that part.'
'Well, at any rate, the Dormouse said—' the Hatter went on, looking anxiously round to see if he would deny it too: but the Dormouse denied nothing, being fast asleep.
'After that,' continued the Hatter, 'I cut some more bread–and–butter—'
'But what did the Dormouse say?' one of the jury asked.
'That I can't remember,' said the Hatter.
'You MUST remember,' remarked the King, 'or I'll have you executed.'
The miserable Hatter dropped his teacup and bread–and–butter, and went down on one knee. 'I'm a poor man, your Majesty,' he began.
'You're a very poor speaker,' said the King.
Here one of the guinea–pigs cheered, and was immediately suppressed by the officers of the court. (As that is rather a hard word, I will just explain to you how it was done.  'I've so often read in the newspapers, at the end of trials, "There was some attempts at applause, which was immediately suppressed by the officers of the court," and I never understood what it meant till now.'
'If that's all you know about it, you may stand down,' continued the King.
'I can't go no lower,' said the Hatter: 'I'm on the floor, as it is.'
'Then you may SIT down,' the King replied.
Here the other guinea–pig cheered, and was suppressed.
'Come, that finished the guinea–pigs!' thought Alice. 'Now we shall get on better.'
'I'd rather finish my tea,' said the Hatter, with an anxious look at the Queen, who was reading the list of singers.
'You may go,' said the King, and the Hatter hurriedly left the court, without even waiting to put his shoes on.
'—and just take his head off outside,' the Queen added to one of the officers: but the Hatter was out of sight before the officer could get to the door.
'Call the next witness!' said the King.
The next witness was the Duchess's cook. She carried the pepper–box in her hand, and Alice guessed who it was, even before she got into the court, by the way the people near the door began sneezing all at once.
'Give your evidence,' said the King.
'Shan't,' said the cook.
The King looked anxiously at the White Rabbit, who said in a low voice, 'Your Majesty must cross–examine THIS witness.'
'Well, if I must, I must,' the King said, with a melancholy air, and, after folding his arms and frowning at the cook till his eyes were nearly out of sight, he said in a deep voice, 'What are tarts made of?'
'Pepper, mostly,' said the cook.
'Treacle,' said a sleepy voice behind her.
'Collar that Dormouse,' the Queen shrieked out. 'Behead that Dormouse! Turn that Dormouse out of court! Suppress him! Pinch him! Off with his whiskers!'
For some minutes the whole court was in confusion, getting the Dormouse turned out, and, by the time they had settled down again, the cook had disappeared.
'Never mind!' said the King, with an air of great relief. 'Call the next witness.' And he added in an undertone to the Queen, 'Really, my dear, YOU must cross–examine the next witness. It quite makes my forehead ache!'
Alice watched the White Rabbit as he fumbled over the list, feeling very curious to see what the next witness would be like, '—for they haven't got much evidence YET,' she said to herself. Imagine her surprise, when the White Rabbit read out, at the top of his shrill little voice, the name 'Alice!'


Calculating the scale value is also demonstrated within this demo. This project is essentially a combination of PLAYING WITH PATTERNS and TRIGONOMETRY to create an interesting interactive pattern.
Link to Full Codes
for (let j = 0; j < numOfSquares; j++) {
for (let i = 0; i < numOfSquares; i++) {
let transX = i * squareSize + squareSize / 2;
let transY = j * squareSize + squareSize / 2;
let distance = dist(transX, transY, mouseX, mouseY);
// let scaleVal = map(distance, 0, cWidth, 15, squareSize * 2);
let scaleVal = map(distance, 0, cWidth, squareSize, 15);
push();
translate(transX, transY);
let rotateVal = atan2(mouseY - transY, mouseX - transX);
rotate(rotateVal);
// noStroke();
fill(i, 0, numOfSquares - j);
ellipse(0, 0, scaleVal, scaleVal);
// noStroke();
stroke(180);
ellipse(10, 0, squareSize / 4, squareSize / 4);
pop();
}
}


Reports
protected
members in the
final
classes. Such members are better to be declared
private
or package-visible instead.


Programmatic solution written in Vanilla JavaScript at the request of Laura Lewis from Kx Labs.
Hope you find this solution presentation acceptable.
Best regards,
Vyacheslav Zlobin
1) Rotate an array of n elements to the right by k steps. For example, with n = 7 and k = 3, the array [1,2,3,4,5,6,7] is rotated to [5,6,7,1,2,3,4].
2) A Pythagorean triplet is a set of three natural numbers, a, b & c for which: a2 + b2 = c2 For example, 32 + 42 = 9 + 16 = 25 = 52.
There exists exactly one Pythagorean triplet for which a + b + c = 1000.
Find the product abc.
3) For positive n, factorial is n! = n*(n−1)! (e.g. 5! = 5 * 4 * 3 * 2 * 1) Create a recursive algorithm to calculate the factorial using every second number as shown in examples below:
5! = 5 * 3 * 1 = 15


Sylvie and Bruno Concluded
by Lewis Carroll
Chapter 24: “The Beggar’s Return”
Additional Information
- Year Published: 1893
- Language: English
- Country of Origin: England
- Source: Carroll, L. (1893). Sylvie and Bruno Concluded. London: Macmillan and Co.
-
Readability:
- Flesch–Kincaid Level: 6.5
- Word Count: 3,181
- Genre: Fantasy
- Keywords: chapter 24: “the beggar’s return”
- ✎ Cite This
Downloads
“Your Imperial Highnesses!” he began. “It’s the old Beggar again! Shall we set the dogs at him?”
“Bring him here!” said the Emperor.
The Chancellor could scarcely believe his ears. “Here your Imperial Highness? Did I rightly understand—”
Bring him here!” the Emperor thundered once more. The Chancellor tottered down the hall—and in another minute the crowd divided, and the poor old Beggar was seen entering the Banqueting-Hall.
He was indeed a pitiable object: the rags, that hung about him, were all splashed with mud: his white hair and his long beard were tossed about in wild disorder. Yet he walked upright, with a stately tread, as if used to command: and—strangest sight of all—Sylvie and Bruno came with him, clinging to his hands, and gazing at him with looks of silent love.
Men looked eagerly to see how the Emperor would receive the bold intruder. Would he hurl him from the steps of the dais? But no. To their utter astonishment the Emperor knelt as the beggar approached, and with bowed head murmured “Forgive us!”
“Forgive us!” the Empress, kneeling at her husband’s side, meekly repeated.
The Outcast smiled. “Rise up!” he said. “I forgive you!” And men saw with wonder that a change had passed over the old beggar, even as he spoke. What had seemed, but now, to be vile rags and splashes of mud, were seen to be in truth kingly trappings, broidered with gold, and sparkling with gems. All knew him now, and bent low before the Elder Brother, the true Warden.
“Brother mine, and Sister mine!” the Warden began, in a clear voice that was heard all through that vast hall. “I come not to disturb you. Rule on, as Emperor, and rule wisely. For I am chosen King of Elfland. To-morrow I return there, taking nought from thence, save only— save only—” his voice trembled, and with a look of ineffable tenderness, he laid his hands in silence on the heads of the two little ones who clung around him.
But he recovered himself in a moment, and beckoned to the Emperor to resume his place at the table. The company seated themselves again—room being found for the Elfin-King between his two children—and the Lord Chancellor rose once more, to propose the next toast.
“The next toast—the hero of the day—why, he isn’t here!” he broke off in wild confusion.
Good gracious! Everybody had forgotten Prince Uggug!
“He was told of the Banquet, of course?” said the Emperor.
“Undoubtedly!” replied the Chancellor. “That would be the duty of the Gold Stick in Waiting.”
“Let the Gold Stick come forwards!” the Emperor gravely said.
The Gold Stick came forwards. “I attended on His Imperial Fatness,” was the statement made by the trembling official. “I told him of the Lecture and the Banquet—.”
“What followed!” said the Emperor: for the unhappy man seemed almost too frightened to go on.
“His Imperial Fatness was graciously pleased to be sulky. His Imperial Fatness was graciously pleased to box my ears. His Imperial Fatness was graciously pleased to say ‘I don’t care!’”
“ ‘Don’t-care’ came to a bad end,” Sylvie whispered to Bruno. “I’m not sure, but I believe he was hanged.”
The Professor overheard her. “That result”, he blandly remarked, was merely a case of mistaken identity.”
Both children looked puzzled.
“Permit me to explain. ‘Don’t-care’ and ‘Care’ were twin-brothers.  And they caught Don’t-care’ by mistake, and hanged him instead. And so ‘Care’ is alive still. But he’s very unhappy without his brother. That’s why they say ‘Begone, dull Care!’ ”
“Thank you!” Sylvie said, heartily. “It’s very extremely interesting. Why, it seems to explain everything!”
“Well, not quite everything,” the Professor modestly rejoined. “There are two or three scientific difficulties—”
What was your general impression as to His Imperial Fatness?” the Emperor asked the Gold Stick.
“My impression was that His Imperial Fatness was getting more—”
“More what?”
All listened breathlessly for the next word.
“More PRICKLY!”
“He must be sent for at once!” the Emperor exclaimed. And the Gold Stick went off like a shot. The Elfin-King sadly shook his head. “No use, no use!” he murmured to himself. “Loveless, loveless!”
Pale, trembling, speechless, the Gold Stick came slowly back again.
“Well?” said the Emperor. “Why does not the Prince appear?”
“One can easily guess,” said the Professor. “His Imperial Fatness is, without doubt, a little preoccupied.”
Bruno turned a look of solemn enquiry on his old friend. “What do that word mean?”
But the Professor took no notice of the question. He was eagerly listening to the Gold Stick’s reply.
“Please your Highness! His Imperial Fatness is—” Not a word more could he utter.
The Empress rose in an agony of alarm. “Let us go to him!” she cried. And there was a general rush for the door.
Bruno slipped off his chair in a moment. “May we go too?” he eagerly asked. But the King did not hear the question, as the Professor was speaking to him. “Preoccupied, your Majesty!” he was saying. “That is what he is, no doubt!”
“May we go and see him?” Bruno repeated. The King nodded assent, and the children ran off. In a minute or two they returned, slowly and gravely. “Well?” said the King. “What’s the matter with the Prince?”
“He’s—what you said,” Bruno replied looking at the Professor. “That hard word.” And he looked to Sylvie for assistance.
“Porcupine,” said Sylvie.
“No, no!” the Professor corrected her. Pre-occupied, you mean.”
“No, it’s porcupine,” persisted Sylvie. “Not that other word at all. And please will you come? The house is all in an uproar.” (”And oo’d better bring an uproar-glass wiz oo!” added Bruno.)
We got up in great haste, and followed the children upstairs. No one took the least notice of me, but I wasn’t at all surprised at this, as I had long realized that I was quite invisible to them all—even to Sylvie and Bruno.
All along the gallery, that led to the Prince’s apartment, an excited crowd was surging to and fro, and the Babel of voices was deafening: against the door of the room three strong men were leaning, vainly trying to shut it—for some great animal inside was constantly bursting it half open, and we had a glimpse, before the men could push it back again, of the head of a furious wild beast, with great fiery eyes and gnashing teeth. Its voice was a sort of mixture—there was the roaring of a lion, and the bellowing of a bull, and now and then a scream like a gigantic parrot. “There is no judging by the voice!” the Professor cried in great excitement. “What is it?” he shouted to the men at the door. And a general chorus of voices answered him “Porcupine! Prince Uggug has turned into a Porcupine!”
“A new Specimen!” exclaimed the delighted Professor. “Pray let me go in. It should be labeled at once!”
But the strong men only pushed him back. “Label it, indeed! Do you want to be eaten up?” they cried.
“Never mind about Specimens, Professor!” said the Emperor, pushing his way through the crowd. “Tell us how to keep him safe!”
“A large cage!” the Professor promptly replied. “Bring a large cage,” he said to the people generally, “with strong bars of steel, and a portcullis made to go up and down like a mouse-trap! Does anyone happen to have such a thing about him?”
It didn’t sound a likely sort of thing for anyone to have about him; however, they brought him one directly: curiously enough, there happened to be one standing in the gallery.
“Put it facing the opening of the door, and draw up the portcullis!” This was done in a moment.
“Blankets now ” cried the Professor. “This is a most interesting Experiment!”
 The Professor rapidly arranged them in two rows, so as to make a dark passage, leading straight from the door to the mouth of the cage.
“Now fling the door open!” This did not need to be done: the three men had only to leap out of the way, and the fearful monster flung the door open for itself, and, with a yell like the whistle of a steam-engine, rushed into the cage.
“Down with the portcullis!” No sooner said than done: and all breathed freely once more, on seeing the Porcupine safely caged.
The Professor rubbed his hands in childish delight. “The Experiment has succeeded!” he proclaimed. “All that is needed now is to feed it three times a day, on chopped carrots and—”
“Never mind about its food, just now!” the Emperor interrupted. “Let us return to the Banquet. Brother, will you lead the way?” And the old man, attended by his children, headed the procession down stairs. “See the fate of a loveless life!” he said to Bruno, as they returned to their places. To which Bruno made reply, “I always loved Sylvie, so I’ll never get prickly like that!”
“He is prickly, certainly,” said the Professor, who had caught the last words, “but we must remember that, however porcupiny, he is royal still! After this feast is over, I’m going to take a little present to Prince Uggug—just to soothe him, you know: it isn’t pleasant living in a cage.”
“What’ll you give him for a birthday-present?” Bruno enquired.
“A small saucer of chopped carrots,” replied the Professor. “In giving birthday-presents, my motto is—cheapness! I should think I save forty pounds a year by giving —oh, what a twinge of pain!”
“What is it?” said Sylvie anxiously.
“My old enemy!” groaned the Professor. “Lumbago— rheumatism—that sort of thing. I think I’ll go and lie down a bit.” And he hobbled out of the Saloon, watched by the pitying eyes of the two children.
“He’ll be better soon!” the Elfin-King said cheerily “Brother!” turning to the Emperor, “I have some business to arrange with you to-night. The Empress will take care of the children.” And the two Brothers went away together, arm-in-arm.
The Empress found the children rather sad company. They could talk of nothing but “the dear Professor”, and “what a pity he’s so ill”, till at last she made the welcome proposal “Let’s go and see him!”
The children eagerly grasped the hands she offered them: and we went off to the Professor’s study, and found him lying on the sofa, covered up with blankets, and reading a little manuscript-book. “Notes on Vol. Three!” he murmured, looking up at us. And there, on a table near him, lay the book he was seeking when first I saw him.
“And how are you now, Professor?” the Empress asked bending over the invalid.
The Professor looked up, and smiled feebly. “As devoted to your Imperial Highness as ever!” he said in a weak voice. “All of me, that is not Lumbago, is Loyalty!”
“A sweet sentiment!” the Empress exclaimed with tears in her eyes. “You seldom hear anything so beautiful as that even in a Valentine!”
“We must take you to stay at the seaside,” Sylvie said tenderly. “It’ll do you ever so much good! And the Sea’s so grand!”
“But a Mountain’s grander!” said Bruno.
“What is there grand about the Sea?” said the Professor. “Why, you could put it all into a teacup!”
“Some of it,” Sylvie corrected him.
“Well, you’d only want a certain number of teacups to hold it all. And then where’s the grandeur? Then as to a Mountain—why, you could carry it all away in a wheelbarrow, in a certain number of years!”
“It wouldn’t look grand—the bits of it in the wheelbarrow,” Sylvie candidly admitted.
“But when oo put it together again—” Bruno began.
“When you’re older,” said the Professor, “you’ll know that you ca’n’t put Mountains together again so easily! One lives and one learns, you know!”
“But it needn’t be the same one, need it?” said Bruno “Wo’n’t it do, if I live, and if Sylvie learns?”
“I ca’n’t learn without living!” said Sylvie.
“But I can live without learning!” Bruno retorted. “Oo just try me!”
“What I meant, was—” the Professor began, looking much puzzled, “—was—that you don’t know everything, you know.”
“But I do know everything I know!” persisted the little fellow. “I know ever so many things! Everything, ‘cept the things I don’t know. And Sylvie knows all the rest.”
The Professor sighed, and gave it up.  “It’s the thing what wrenches people out of their boots!”
“He means ‘bootjack’,” Sylvie explained in a whisper.
“You ca’n’t wrench people out of boots,” the Professor mildly observed.
Bruno laughed saucily. “Oo can, though! Unless they’re welly tight in.”
“Once upon a time there was a Boojum—” the Professor began, but stopped suddenly. “I forget the rest of the Fable,” he said. “And there was a lesson to be learned from it. I’m afraid I forget that too.”
“I’ll tell oo a Fable!” Bruno began in a great hurry. “Once there were a Locust, and a Magpie, and a Engine-driver. And the Lesson is, to learn to get up early—”
“It isn’t a bit interesting!” Sylvie said contemptuously. “You shouldn’t put the Lesson so soon.”
“When did you invent that Fable?” said the Professor. “Last week?”
“No!” said Bruno. “A deal shorter ago than that, Guess again!”
“I ca’n’t guess,” said the Professor. “How long ago?”
“Why, it isn’t invented yet!” Bruno exclaimed triumphantly. “But I have invented a lovely one! Shall I say it?”
“If you’ve finished inventing it,” said Sylvie. “And let the Lesson be ‘to try again’!”
“No,” said Bruno with great decision. “The Lesson are ’not to try again’!” “Once there were a lovely china man, what stood on the chimbley-piece. And he stood, and he stood. And one day he tumbleded off, and he didn’t hurt his self one bit. Only he would try again. And the next time he tumbleded off, he hurted his self welly much, and breaked off ever so much varnish.”
“But how did he come back on the chimney-piece after his first tumble?” said the Empress. (It was the first sensible question she had asked in all her life.)
“I put him there!” cried Bruno.
“Then I’m afraid you know something about his tumbling,” said the Professor. “Perhaps you pushed him?”
To which Bruno replied, very seriously, “Didn’t pushed him much—he were a lovely china man,” he added hastily, evidently very anxious to change the subject.
“Come, my children!” said the Elfin-King, who had just entered the room.  And he was leading them away, but at the door they let go his hands, and ran back again to wish the Professor good night.
“Good night, Professor, good night!”
“Good night, little ones!” said the Professor. “You may leave me now—to ruminate. I’m as jolly as the day is long, except when it’s necessary to ruminate on some very difficult subject. All of me,” he murmured sleepily as we left the room, “all of me, that isn’t Bonhommie, is Rumination!”
“What did he say, Bruno?” Sylvie enquired, as soon as we were safely out of hearing.
“I think he said ‘All of me that isn’t Bone-disease is Rheumatism.’ Whatever are that knocking, Sylvie?”
Sylvie stopped, and listened anxiously. It sounded like some one kicking at a door, “I hope it isn’t that Porcupine breaking loose!” she exclaimed.
“Let’s go on!” Bruno said hastily. “There’s nuffin to wait for, oo know!”


{% extends "index.html" %} {% import "./lists/election-list.html" as electionList %} {% block mainContent %}


Karaoke Timing Tutorial
From Aegisub Manual
This tutorial will teach you how to load a song into Aegisub, how to enter the words for the song and how to add time-codes to the words to synchronise them with the song.
You don't need to have used Aegisub before to follow this tutorial.
Contents |
Before we begin
There's a few things you need to have ready before starting:
- The song itself. This can for example be as an MP3 file or inside a video. Aegisub can read the sound from video files, you don't need to create a separate sound file if the song is on a video.
- The words for the song. It's easiest if you have them in a plain text file (.txt file) broken into verses and stanzas already.
I am using an English song for demonstration here, but many of the more advanced functions in Aegisub are designed for use with songs in Japanese and other languages that often need transcription or transliteration into Latin script. I will show how to use those in a video tutorial.
Loading the song
We'll start by creating a new file. You already have that if you have just started Aegisub.
Now open your song. Select Open Audio from the Audio menu...
...then select your song file.
Aegisub will now spend a short while reading the audio file.
When it's done, you should have a waveform display (the audio display) at the top of the Aegisub window. If you've used Aegisub before things might look a little different, it might be easier to follow the rest of this tutorial if you set things to look like on this picture.
We'll look at how to use the audio display for timing in a moment, but first let's get the lyrics for the song loaded.
Tips
Loading audio directly from video files: You can select to choose from video files in the Open Audio file selector. This won't actually open the video in the file, it will just read the audio from the video file, the same as if it was just the audio in a separate file.
Instant loading of WAV files: If you have an uncompressed PCM WAV file, Aegisub can open it instantly without first loading it entirely into memory. This can be a great time-saver, but of course it requires a bit of extra disk space and probably also a bit of work beforehand to even create the WAV file. (Remember that this only works with uncompressed PCM files, things like ADPCM or MP3 in WAV files won't work and will still trigger the pre-loading.)
Entering the words
Now, to get the text in, we could just start typing it in...
But don't do that! You'll get much huger success if you have it all in a text file, copy it from there and paste it into Aegisub. (You can often also just copy-paste directly from your favourite lyrics website.)
I have the lyrics in a text file, so I open that, select the text and copy it to the clipboard.
Now things get a little complicated, but don't worry, it really isn't hard :-)
There are two different places you can paste into Aegisub: The subtitles grid and the subtitles edit box. When you paste into the subtitles grid, you create new lines in the subtitle file. When you paste into the subtitles edit box you change the currently selected subtitle line.
We want to make sure we paste into the subtitles grid, so click once inside the grid area (at the bottom of the window) to set the input focus to that.
And now we can paste in the lyrics.
They should appear immediately as lines in the grid. Notice that they all have start and end times set to zero. This makes it easier when we're going to time each line of the lyrics to the song.
It might be a good idea to save your file now, just so you can easily save it later on without having to give it a name.
Remember that Aegisub automatically saves a copy of your file every minute, even if you haven't given it a name yet, so you rarely lose much work if something goes wrong.
Now we're ready to time the individual lines in the lyrics.
Rough timing, the lines first
Before we start with timing, you should know that the way presented here is just one of many. There's several ways you can time to audio in Aegisub and this one might not be the best one for you. Try to also explore the program and see if you can find your own best way to do it. This is just the way I (jfs) usually do it.
First let's look at how to get around the audio display and play the audio. You might already have noticed that there's no less than 6 different "Play" buttons. Usually you'll just use one of them, though: The one with the blue outward-pointing brackets around. That one is Play Selection, and plays the part of the audio that's currently highlighted.
Try pressing the Play Selection button, you should hear the first 5 seconds of the song played. (Aegisub selects the first 5 seconds by default.)
Now try changing the selection: You can left-click and drag in the audio display to select the part you've dragged across. If you click and drag on the left or right edge of the selection you can change just the start or end. Finally, you can make a single left-click (without dragging!) anywhere to set the selection start right to that point, and you can make a single right-click to set the selection end.
Let's time the first line. Find the start and end of the first line of the song you're working on and make sure the audio selection matches it exactly. Notice that at first, the selection was gray but as soon as you started changing it, it became red and the word "Modified" appeared. This means that you have changed the selection but not saved (committed) the new timing.
To commit the timing and store it back to the subtitle line, just press the Commit button, the green check mark.
When you commit, you will also be sent to the next line automatically, so you can immediately continue timing that.
Just continue timing like that until you have covered all the lines of the song: Find start and end of line, set the selection and then commit.
When you're done, save the file.
Tips
Timing from audio isn't hard at all, but here's some tips to make it even easier and also a lot faster!
Hotkeys: There's a number of keyboard shortcuts that can make audio timing much faster to work with.
The most important ones are:
- S - Play Selection: Play back the currently selected audio.
- A and F - Scroll Left and Right: Change the potion of the audio visible.
- G - Commit: Copy the start and end times of the current audio selection into the line selected in the subtitles grid and move to the next line.
Play near start/end: There's four buttons (hotkeys Q, W, E and D) that play half a second just before or just after the start and end of the selection. You can use these to more accurately set the start and end to exactly where the singing starts/ends.
Change selection while playing: While audio is playing you can still change the selection. You won't see any difference if you change the selection start, but if you change the selection end, playback will now end when it hits the new selection end. This way you can quickly stop playback by setting the end close to the playback cursor (the white line that moves while Aegisub is playing) or extend the playback to go even further.
For example, when looking for the start of the first line, you can just start playback with the initial 5 second selection and continue extending it until you find the line. Then, while it's still playing, you can set the right start time and then the end time. When you have the line approximately down like that, you can do an extra check by playing the entire selection again, or by using the Q/W/E/D keys to play the parts right around the start and end times.
Spectrum mode: Usually the audio display is in waveform mode, this is what I've shown on all the screenshots so far. But actually Aegisub has a much cooler way of showing the audio: Spectrum mode.
The spectrum mode takes more CPU and RAM than waveform mode, but it gives a better picture of the audio and with a bit of training you can learn to tell singing from music and even how different sounds look. For example, S sounds are very easy to recognise.
Zooming and scaling: You can use the slider bars to the far right of the audio display to zoom in and out on the audio and to change the volume.
Fine timing, words and then syllables
Click Karaoke button.
Time words.
Click Split button. Place split markers. Click Accept Split button.
Time syllables.
Commit.
Repeat.
Styling


--- title: "Main Content Post Meta" type: typography scss: _assets/stylesheets/_page.scss usage: "Post meta data with tag page links and publication information." ---


Different implementations of the ProxyFactory interface.
Currently are two implementations supported. One based on the {@linkplain java.lang.reflect JDK's reflection API} and the other one on the CGLIB library.
The usage of a special {@linkplain com.thoughtworks.proxy.ProxyFactory} is simple and easy:
ProxyFactory factory = new StandardProxyFactory(); List<String> proxy = factory.createProxy(new SimpleInvoker(new ArrayList<String>()), List.class); proxy.add("Hello World"); System.out.println("Size of list: " + proxy.size()); System.out.println("First element of list: " + proxy.get(0));
The example creates a proxy that implements the {@linkplain java.util.List} interface. The proxy is backed up by a instance of an {@linkplain java.util.ArrayList}. The proxy ensures in this example, that the instance cannot just be casted to access the specific methods of the ArrayList like {@link java.util.ArrayList#ensureCapacity(int)}. Compare with the JDK's reflection API, there is not a real difference.


Happy Teacher's Day Rashmi ma'am!
You have been a wonderful teacher and a very dear friend. I will miss your classes but I have all that you taught me stored safely in my mind and my heart. Thank you for the inspiration and always believing in me, even when sometimes I didn't believe in myself.
You showed me the path to success: believe in yourself, be confident in your abilities and always strive to achieve your own personal best. Thank you Rashmi ma'am for being such an inspiration!
Made With


Morphology
Uralic languages exhibit rich morphology. The parts-of-speech used are mapped to UD following common linguistic practices. There is a number of language-specific features that arch over most of the Uralic languages but are not found in many others, e.g. IE languages.
This page is an overview to open questions and general guidelines.
Lemma field
Following the universal principle, lemma field should be filled with dictionary entry form, as is with existing Uralic treebanks. If no practice exists, singular nominatives for nominals and an infinitive for verbs is common. For lexeme sets with limited inflection, e.g. adpositions with three case series, it is common to use the inflected form as lemma, especially if the etyomological nominative is highly theoretical.
Parts-of-Speech
The common parts of speech are used as defined in Universal part of the standard without large changes. Verbs (VERB), nouns (NOUN), adjectives (ADJ) are quite straight forward in the common cases and exist for all Uralic languages. Also adverbs (ADV) and adpositions (ADP) should be used as separate classes. The classes for symbols (SYM) and punctuation (PUNCT) are both used as normal. Interjections (INTJ) are used. The uncategorisable (X) class should be used for foreign tokens and otherwise non-linguistic or broken tokens.
Determiners? (DET)
Most Uralic languages do not have determiners (DET) at least not in the sense of articles (apart Hungarians and…), however, there are open questions whether to use a certain sub-set of pronouns etc., that modify nouns in agreement. Most traditional grammars would not talk about determiners in Uralic languages.
Auxiliaries? (AUX)
Auxiliaries are not often used as a part-of-speech in Uralic grammars, however, they are used in existing Uralic treebanks. Generally an auxiliary can be used for verb that has verbal complement or forms verb chains.
Particles? (PART)
Various Uralic grammars have used particle (PART) category as a left-over class for hard-to-classify, in some grammars and traditions this class has been subsumed by adverbs, and partially by interjections.
Features
Uralic universal annotations make use of lexical, inflectional and layered features. Many of lexical and inflectional features follow Universal definitions closely, e.g. most sub-classes of parts of speech (lexical) and inflectional affixes mapping to features or layered features. Some inflectional affixes, such as discourse particle enclitics are hard to map to anything in Universal Dependencies scheme.
Most basic things like nominal cases and numbers follow Universal conventions. Tense and mood as well as aspect may require some language specific values not seen in other languages.
Possessive suffixes
Most Uralic languages use possessive suffix morphology to describe possession, rather than specific verbs. The feature to use with the possessive suffixes are:
- Number[psor] and Person[psor] for possessive suffixes marking possessor and
- Number[psed] and Person[psed] for possessive suffixes marking possessed quantities and references.
Values are same as with Number and Person in universal features.
Negation
Many uralic languages mark negation in verb forms with special suffixes and/or have a specific negation verb, that inflects like a regular verb.
Non-finite verb forms
Many Uralic languages exhibit large verbal paradigms with number of non-finite grammatical forms. There are no clear tendencies, languages should make use of language specific values for VerbForm feature?


Key: = Must support, = QICore-defined extension, = Is-Modifier
| Field | Card. | Type and Description |
|---|---|---|
| contact |
0..*
|
List<ContactPoint>
|
| expirationDate |
0..1
|
DateTime
|
| identifier |
0..*
|
List<Identifier>
|
| location |
0..1
|
Location
|
| lotNumber |
0..1
|
String
|
| manufactureDate |
0..1
|
DateTime
|
| manufacturer |
0..1
|
String
|
| model |
0..1
|
String
|
| note |
0..*
|
List<Annotation>
|
| owner |
0..1
|
Organization
|
| patient |
0..1
|
Patient
|
| status |
0..1
|
code
|
| type |
1..1
|
Concept
|
| udiCarrier |
0..1
|
Identifier
|
| url |
0..1
|
Uri
|
| version |
0..1
|
String
|
Key: = Must support, = QICore-defined extension, = Is-Modifier


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