• Número (calificador) - descendientes solamente
  • Conceptos existentes actualizados (n ≈ 20)
  • Nuevos conceptos creados (n ≈ 625)
    
    
• Unidad de presentación (unidad de presentación) - concepto raíz y descendientes
  • Nuevos conceptos creados (n ≈ 50)

• Jerarquía |Calificador (calificador)|:
  • unidad de presentación
    
    
• Jerarquía |Producto farmacéutico/biológico (producto)|:
  • producto medicinal
  • forma farmacéutica de producto medicinal
  • medicamento clínico

• tiene base de sustancia de la potencia
• tiene valor de numerador para la potencia de presentación 
• tiene unidad de numerador para la potencia de presentación 
• tiene valor de denominador para la potencia de presentación
• tiene unidad de denominador para la potencia de presentación

• |tiene forma farmacéutica|
  • La descripción completa y el término preferido existentes se inactivaron y reemplazaron por |tiene forma farmacéutica de elaboración|

• Las descripciones para ≈ 10 conceptos existentes que representan agrupadores basados en formas farmacéuticas por sitio para el cual el medicamento fue preparado se actualizaron de acuerdo con los nuevos lineamientos de denominación.
• Los conceptos se definieron completamente utilizando el patrón de modelado del supertipo primitivo proximal.

• Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "producto medicinal" 
  
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos |tiene componente activo| faltantes; se corrigieron errores en el contenido existente a medida que fueron identificados

• Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "forma farmacéutica de producto medicinal"
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|; se corrigieron errores en el contenido existente a medida que fueron identificados

• Se actualizaron las descripciones de ≈ 3000 conceptos existentes que representan comprimidos y cápsulas para administración oral capsules de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "medicamento clínico"
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|
• Se agregaron los nuevos atributos |tiene base de sustancia de la potencia|, |tiene valor de numerador para la potencia de presentación|, |tiene unidad de numerador para la potencia de presentación|, |tiene valor de denominador para la potencia de presentación| y |tiene unidad de denominador para la potencia de presentación|

• Número (calificador) - descendientes solamente
  • Conceptos existentes actualizados (n ≈ 20)
  • Nuevos conceptos creados (n ≈ 625)
    
    
• Unidad de presentación (unidad de presentación) - concepto raíz y descendientes
  • Nuevos conceptos creados (n ≈ 50)

• Jerarquía |Calificador (calificador)|:
  • unidad de presentación
    
    
• Jerarquía |Producto farmacéutico/biológico (producto)|:
  • producto medicinal
  • forma farmacéutica de producto medicinal
  • medicamento clínico

• tiene base de sustancia de la potencia
• tiene valor de numerador para la potencia de presentación 
• tiene unidad de numerador para la potencia de presentación 
• tiene valor de denominador para la potencia de presentación
• tiene unidad de denominador para la potencia de presentación

• |tiene forma farmacéutica|
  • La descripción completa y el término preferido existentes se inactivaron y reemplazaron por |tiene forma farmacéutica de elaboración|

• Las descripciones para ≈ 10 conceptos existentes que representan agrupadores basados en formas farmacéuticas por sitio para el cual el medicamento fue preparado se actualizaron de acuerdo con los nuevos lineamientos de denominación.
• Los conceptos se definieron completamente utilizando el patrón de modelado del supertipo primitivo proximal.

• Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "producto medicinal" 
  
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos |tiene componente activo| faltantes; se corrigieron errores en el contenido existente a medida que fueron identificados

• Se actualizaron las descripciones de ≈ 1300 conceptos existentes de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "forma farmacéutica de producto medicinal"
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|; se corrigieron errores en el contenido existente a medida que fueron identificados

• Se actualizaron las descripciones de ≈ 3000 conceptos existentes que representan comprimidos y cápsulas para administración oral capsules de acuerdo con los nuevos lineamientos de denominación, con inclusión del nuevo identificador semántico "medicamento clínico"
• Se conservaron los identificadores, los padres definidos y el estado de definición de conceptos existentes
• Se agregaron atributos faltantes |tiene componente activo| y |tiene forma farmacéutica de elaboración|
• Se agregaron los nuevos atributos |tiene base de sustancia de la potencia|, |tiene valor de numerador para la potencia de presentación|, |tiene unidad de numerador para la potencia de presentación|, |tiene valor de denominador para la potencia de presentación| y |tiene unidad de denominador para la potencia de presentación|

Ten RF1 descriptions for active concepts are status 10 (MOVED_TO), alongside descriptions with active status:
473038012: Hyperprolinemia type II
473040019: Hyperprolinemia, type II
357693015: Lichen planus pigmentosus
377070012: Joubert syndrome
378213010: Irapa type spondyloepimetaphyseal dysplasia
1787720010: Frontal fibrosing alopecia
473039016: Hyperprolinaemia type II
473043017: Hyperprolinaemia, type II
113698011: Warkany syndrome
187742012: Caroli's disease

RESOLUTION: SNOMED International Content team have inactivated all of the descriptions in question with reason "moved elsewhere"

The following failures occurred after we added new RVF assertions in to cover issues found during the Alpha/Beta feedback period.

0cc708af-6816-4370-91be-dba8da99d227 "Description: id=60213011 is in the delta file, but no actual changes made since the previous release."

4478a896-2724-4417-8bce-8986ecc53c4e "Concept: id=10082001 is in the delta file, but no actual changes made since the previous release."

35680574-3ac6-4b68-9efe-de88b677eb35 "Association refset id=0e23f0c4-3dfa-5278-b35f-03e2cda41a7e is in the delta file, but no actual changes made since the previous release."

cab60a2f-4239-4933-91d6-dc910a8ac08b "Stated relationship: id=3862464027 is in the delta file, but no actual changes made since the previous release."

These failures can be safely ignored for this release, as they are simply highlighting the results of the manual fixes that we had to implement as part of the Alpha/Beta feedback period, in order to resolve some teething issues with the SCA.

They therefore simply need to be verified after the final release has been deployed, in order to ensure that, as expected, they have not re-occurred.

RESOLUTION: Remaining failures were resolved as planned.

There are 2 concepts that after new type of validation have been shown to not have any equivalent ICD-10 maps:

ID Preferred Name

722302009 Glycogen storage disease type II infantile onset (disorder)

722343009 Glycogen storage disease type II late onset (disorder)

This was not reported until very late in the January 2017 release cycle. It was therefore discussed with the relevant Stakeholders, and the potential risk of impact involved in implementing a change to the content at this late stage in the release cycle was decided to be far greater than the perceived benefit of adding in just two map records. This will therefore be resolved in the July 2017 editing cycle, in order to preserve the quality of the January 2017 International edition.

RESOLUTION: SNOMED International Mapping Team have now mapped both concepts in the July 2017 editing cycle, and so these will be included in the July 2017 International Edition release.

As per the planned deprecation of antecedent SNOMED works (https://confluence.ihtsdotools.org/download/attachments/12779613/Antecedent%20SNOMED%20versions_External%20Newsletter%20Q1_v1.0.docx?version=1&modificationDate=1438866649000&api=v2), the SNOMED CT Identifier refset will be removed from the International Edition package as of the July 2017 International Edition.

RESOLUTION:  SNOMED CT Identifier refset removed from the July 2017 International Edition as planned.

The resolution for -ISRS-117- was completed for the January 2017 International Edition.

This now needs to be further refined in order to ensure that the historical audit trail remains intact.

RESOLUTION:  The 64 cases found in the current release with these issues have now been resolved in the July 2017 International Edition.

The following issue was reported during the July 2017 International edition editing cycle:

For concept 722183007 | Embolization of hepatic artery using selective internal radiation therapy (procedure) |, two descriptions were created, one for en-GB and one for en-US, due to the difference in spelling.

3331000018 is the en-GB textDefinition, and has been assigned a descriptionType of "preferred synonym", instead of "preferred definition".

RESOLUTION: The SNOMED International content team have updated the descriptionType in question, as part of the current cycle of content changes. It will therefore be published as part of the July 2017 International Edition. The Release Validation Framework will also be updated to include a validation check to capture any similar issues going forward.

The following Historical Associations have had invalid inactive records added in the previous release cycle:

https://docs.google.com/spreadsheets/d/1X_T8t2d5SFqBICorUORYhJbl9L8pWHMeKRJBjq0bMds/edit#gid=1682849169

RESOLUTION:  Historical Association records fixed in time for the July 2017 International Edition.

Born inactive stated relationships need to be deleted before alpha release.

https://docs.google.com/a/ihtsdo.org/spreadsheets/d/1_tcm-qiyJ29zXbIzXjkyp8teSBIRnfySrcghwVrwH54/edit?usp=sharing

https://rvf.ihtsdotools.org/api/v1/result/1494474563274?storageLocation=international/snomed_ct_ts_release/2017-05-11T03:15:01

RESOLUTION:  Born inactive Stated Relationship records were removed accordingly.

The following 2 records appears to contravene the Domain constraint, as follows:

42752001=Due to (attribute) applied to 268460000=Contraceptive device (physical object)

Relationship_snapshot records: 
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
7008666020 20170731 1 900000000000207008 733528009 268460000 0 42752001 900000000000011006 900000000000451002
7008672020 20170731 1 900000000000207008 733529001 268460000 0 42752001 900000000000011006 900000000000451002

RESOLUTION:  The relevant Relationships have been removed accordingly.

"assertionUuid": "c3249e80-84f0-11e1-b0c4-0800200c9a66",
"assertionText": "Calling procedure testing that terms that contain EN-US language-specific words are in the same US language refset.",
"queryInMilliSeconds": 8862,
"failureCount": 481,
"firstNInstances": [

,

,

,

,

,

,

,

,

,

,

,

,

RESOLUTION: This is just a warning and not an error and so no action is required.

"assertionUuid": "cc9c5340-84f0-11e1-b0c4-0800200c9a66",
"assertionText": "Calling procedure testing that terms that contain EN-GB language-specific words are in the same GB language refset.",
"queryInMilliSeconds": 46787,
"failureCount": 2036,
"firstNInstances": [

,

,

,

,

,

,

,

RESOLUTION: This is just a warning and not an error and so no action is required.

"assertionUuid": "d9f8a8d6-2c02-11e7-b0e7-3c15c2c6e32e",
"assertionText": "The FSN term should be unique in active content when case sensitivity is ignored.",
"queryInMilliSeconds": 2049276,
"failureCount": 15,
"firstNInstances": [

,

,

,

,

,

,

,

,

,

,

,

,

,

,

RESOLUTION: These have been confirmed by the SNOMED International Content Team to be false positives, which can therefore be safely ignored.

"assertionUuid": "dd0d0406-7481-444a-9f04-b6fc7db49039",
"assertionText": "The first letter of the FSN should be capitalized.",
"queryInMilliSeconds": 2060,
"failureCount": 58,
"firstNInstances": [

{ "conceptId": "198030008", "detail": "DESC: id=582480013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228961005", "detail": "DESC: id=616608018:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228969007", "detail": "DESC: id=616618011:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "228979009", "detail": "DESC: id=616629010:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "258259005", "detail": "DESC: id=649653011:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "258889007", "detail": "DESC: id=650356013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259011007", "detail": "DESC: id=650492013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259047008", "detail": "DESC: id=650532013:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259048003", "detail": "DESC: id=650533015:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259049006", "detail": "DESC: id=650534014:First letter of the active FSN of active concept not capitalized." }

,

{ "conceptId": "259060002", "detail": "DESC: id=650546013:First letter of the active FSN of active concept not capitalized." }

RESOLUTION:  Invalid descriptions inactivated, and valid descriptions added in for July 2017 with capitalised first words.

"assertionUuid": "f7117eb0-7cd6-11e1-b0c4-0800200c9a66",
"assertionText": "Active historical association refset members have inactive concepts as reference components.",
"queryInMilliSeconds": 1663,
"failureCount": 14379,
"firstNInstances": [

,

,

,

,

,

,

,

,

,

RESOLUTION: The RVF assertion needs to be updated in order to allow for the new SEP refsets in the Association Reference set. These failures can therefore safely be ignored for now.

In the SimpleMap Delta we exported from the mapping file, it contained 95 new activations for ICD-0.

However, in the final SimpleMap files in the release package, we're getting 105 records referencing ICD-0, including the following 10 inactivations that we've traced back to the simpleMap file exported from the termServer:

> 20170731 0 900000000000207008 446608001 128507001 C49.2
> 20170731 0 900000000000207008 446608001 128507001 C49.9
> 20170731 0 900000000000207008 446608001 244256001 C49.3
> 20170731 0 900000000000207008 446608001 245484003 C54.9
> 20170731 0 900000000000207008 446608001 303982006 C44.6
> 20170731 0 900000000000207008 446608001 361904009 C49.2
> 20170731 0 900000000000207008 446608001 367612008 C54.9
> 20170731 0 900000000000207008 446608001 56322004 C49.3
> 20170731 0 900000000000207008 446608001 76083001 C71.7
> 20170731 0 900000000000207008 446608001 84732004 C49.2

The mapping team are unaware of why these should have ben updated, and so we need to prove whether or not they are valid changes.

RESOLUTION: SNOMED International Content Team confirmed that these were expected changes, and Mapping Team confirmed everything as expected, therefore no action required.

"assertionUuid": "89ceaf00-79b9-11e1-b0c4-0800200c9a66",
"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.",
"queryInMilliSeconds": 24173,
"failureCount": 2,
"firstNInstances": [

{ "conceptId": "733529001", "detail": "Stated relationship: id=7002472022 is inactive in the current release but no active state found in the previous snapshot." }

,

{ "conceptId": "733528009", "detail": "Stated relationship: id=7002479029 is inactive in the current release but no active state found in the previous snapshot." }

],

RESOLUTION:  Relevant born inactive Stated Relationships removed accordingly.

"assertionUuid": "eff30fb0-7856-11e1-b0c4-0800200c9a66",
"assertionText": "All language refset members inactivated in current snapshot must have been active in the previous release.",
"queryInMilliSeconds": 64307,
"failureCount": 8,
"firstNInstances": [

,

,

,

,

,

,

,

],

RESOLUTION: This is just a warning and not an error and so no action is required.

"assertionUuid": "2b193a88-8dab-4d19-b995-b556ed59398d",
"assertionText": "New inactive states follow active states in the DESCRIPTION snapshot.",
"queryInMilliSeconds": 15019,
"failureCount": 4,
"firstNInstances": [

,

,

,

],

RESOLUTION: These warnings are due to a system defect - WRP-3146 ticket has been raised to resolve. These can therefore be safely ignored for this release.

The following concepts are reported by the MRCM validation to have inappropriate attributes:

• 429062005
• 448396008
• 710285001
• 428563002
• 428565009
• 448603000

Inferred view:
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
7001611029 20170731 1 900000000000207008 428563002 261449002 2 424876005 900000000000011006 900000000000451002
7001616023 20170731 1 900000000000207008 428565009 261449002 2 424876005 900000000000011006 900000000000451002
7001621021 20170731 1 900000000000207008 429062005 261449002 2 424876005 900000000000011006 900000000000451002
7001627020 20170731 1 900000000000207008 448396008 103387006 2 424876005 900000000000011006 900000000000451002
7001630029 20170731 1 900000000000207008 448603000 103387006 2 424876005 900000000000011006 900000000000451002
7001638020 20170731 1 900000000000207008 710285001 103387006 1 424876005 900000000000011006 900000000000451002

Stated view:
id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6994054029 20170731 1 900000000000207008 429062005 261449002 1 424876005 900000000000010007 900000000000451002
6994436023 20170731 1 900000000000207008 448396008 103387006 1 424876005 900000000000010007 900000000000451002

Note: MRCM rule states that 424876005(Surgical approach) applies to Domain 387713003 (Surgical procedure)

RESOLUTION:  Concepts re-modelled accordingly in time for the July 2017 International Edition.

The RF2 to RF1 conversion is failing and it appears to be data related - attached log file gives details but it looks like there is an issue calculating the value of a description status in RF1. Whatever is in RF2 is not giving enough information to calculate the RF1 value and it is coming back as null, which fails the query.

There are two possible causes from the information in the log file:

1. An un-attached description, i.e. where we had a reference to a concept ID in the descriptions file that was no in the concepts file. Checked this and all is good...

2. Alternative was a value (or values) in the Attribute Value reference set that was not being handled by the conversion code when associated with an inactive description ID. Bingo, we have our culprits, there are two concept IDs used in the valueId field of the Attribute Value reference set that have not been used before. Next checked the actual source code on Github for the RF2 to RF1 conversion routine and found the hard coded list of maps between the valueId and RF1 description status does not have these two values in it. This is the list referenced by the getMagicNumber method. The values at issue are 723277005 ‘Nonconformance to editorial policy component (foundation metadata concept)’ and 723278000 ‘Not semantically equivalent component (foundation metadata concept)’ occurring in reference set 900000000000490003.

RESOLUTION: RF2 to RF1 conversion utility has been updated accordingly.

Seven Concept ID's were found to be unexpectedly using partition ID's appropriate for Description ID's:

· 3446012016
· 3446013014
· 3446014015
· 3446015019
· 3446016018
· 3446017010
· 3446018017

This was found to be a result of these concepts having been loaded in manually through the CRS, which by-passed the standard validation and therefore allowed them to be created in the wrong format in the termServer.

RESOLUTION:  Offending concepts were removed accordingly.

Relationship 6923064024 (sourceId= 724482006) should have a typeId of 363714003|Interprets|

This is a result of the Concept having two attributes, one of which should be "363714003|Interprets|"

Amended in https://authoring.ihtsdotools.org/#/tasks/task/RFBINTJULA/RFBINTJULA-11/

RESOLUTION:  Concept re-modelled accordingly for the July 2017 International Edition.

The following descriptions look like text definitions:
92105015 55402005 Hospital admission, for laboratory work-up, radiography, etc. - Suggest CRS request: old concept since 2002 could be inactivated as it is ambiguous but not touched in this release. 
2988848017 32456001 Medulloblastoma with extensive nodularity and advanced neuronal differentiation. - looks like definition incorrectly marked as syn.
3042799019 710025005 Hamular notch is well defined to establish the posterior extension of the denture base.
3311128017 718089001 Post extubation acute respiratory failure requiring reintubation.
638911000124112 435801000124108 Alter the consistency of foods to optimize chewing and swallowing. (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648331000124115 439021000124105 Liquids included in the diet are provided at a viscosity of 51--350 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648361000124112 439031000124108 Liquids included in the diet are provided at a viscosity of 351-1750 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648391000124116 439041000124103 Liquids included in the diet are provided at a viscosity of > 1750 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648501000124118 439081000124109 Liquids included in the diet are provided at a viscosity of 1-50 centipoise (cP). (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).
648571000124112 439101000124101 Replace very hard, sticky or crunchy foods with those that are soft and moist. Treatment for dental problems and mouth soreness. (Source: Nutrition Care Manual, Academy of Nutrition and Dietetics 2013).

RESOLUTION:  Synonyms changed to TextDefinitions, or inactivated as ambiguous as appropriate.

Several inactive descriptions have never been published, and so don’t need to be in the release files:

3499616017 2017-07-31 00:00:00.0 0 900000000000207008 733528009 en 900000000000013009 Morphological change in endometrium due to intrauterine contraceptive device 900000000000448009
3499617014 2017-07-31 00:00:00.0 0 900000000000207008 733528009 en 900000000000003001 Morphological change in endometrium due to intrauterine contraceptive device (finding) 900000000000448009
3499618016 2017-07-31 00:00:00.0 0 900000000000207008 733529001 en 900000000000013009 Reactive cellular changes due to intrauterine contraceptive device 900000000000448009
3499619012 2017-07-31 00:00:00.0 0 900000000000207008 733529001 en 900000000000003001 Reactive cellular changes due to intrauterine contraceptive device (finding) 900000000000448009

RESOLVED: Ticket closed as already resolved in ISRS-180 and ISRS-181

Several inactive language reference set records have been published as inactive, but never been published before:

85d31301-45a6-4344-a28e-1c357975dd62 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499616017 900000000000548007
c1e2364a-9413-4e70-aaa1-9abe62165a2b 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499616017 900000000000548007
e97fc6fd-68de-451b-b7c2-fdab05db4d00 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499619012 900000000000548007
f3814870-ee80-459d-bdb6-310688626fa5 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499617014 900000000000548007
fd8a80da-a79a-4f9f-bf93-378657935e85 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499617014 900000000000548007
1575a4c0-b70f-4267-81cf-47f44dfad066 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 900000000000548007
2168b9f2-6ab3-4911-b14d-01d20c08e3d7 2017-07-31 00:00:00.0 0 900000000000207008 900000000000508004 3499618016 900000000000548007
65ae52bb-ed7f-4df1-8d5a-55388ffb223b 2017-07-31 00:00:00.0 0 900000000000207008 900000000000509007 3499619012 900000000000548007

RESOLUTION:  Born inactive members already removed in TPFIX-16

There’s a whole bunch of stuff in the Descriptor refset that I’m not sure about, from a content perspective… (not necessarily defects).

· looks like descriptor entries have been created for all the “refset patterns”? 
447250001|Complex map type reference set (foundation metadata concept)|, 
446609009|Simple type reference set (foundation metadata concept)|,
447258008|Ordered type reference set (foundation metadata concept)|
and more. I don’t think actual reference sets even exist for some? Though perhaps this is a technical decisision. Just not something I was expecting.
· I can guess at the intent here, just not something I was expecting.

RESOLUTION: Reporter happy with the level of information provided in the Release Notes to explain all of this, therefore ticket closed accordingly.

Several attributes using the attribute 371881003|During| - I’ve found some working documents and ECE stuff, but nothing official? Though I saw it mentioned in the MRCM refsets, so I assume it’s now permissible and updated editorial rules will come out in July? (Once confirmed I’ll update our checks)

6967032028 2017-07-31 00:00:00.0 1 900000000000207008 10561000087108 387713003 0 371881003 900000000000011006 900000000000451002
6967036025 2017-07-31 00:00:00.0 1 900000000000207008 10581000087102 387713003 0 371881003 900000000000011006 900000000000451002
6967040023 2017-07-31 00:00:00.0 1 900000000000207008 10661000087107 387713003 0 371881003 900000000000011006 900000000000451002
6967045029 2017-07-31 00:00:00.0 1 900000000000207008 10701000087104 387713003 0 371881003 900000000000011006 900000000000451002
6967048027 2017-07-31 00:00:00.0 1 900000000000207008 10901000087102 387713003 0 371881003 900000000000011006 900000000000451002
6967050024 2017-07-31 00:00:00.0 1 900000000000207008 11051000087106 387713003 0 371881003 900000000000011006 900000000000451002
6993353020 2017-07-31 00:00:00.0 1 900000000000207008 242991000 71388002 0 371881003 900000000000011006 900000000000451002
6993354025 2017-07-31 00:00:00.0 1 900000000000207008 242992007 71388002 0 371881003 900000000000011006 900000000000451002
6993356028 2017-07-31 00:00:00.0 1 900000000000207008 242993002 71388002 0 371881003 900000000000011006 900000000000451002
6993368021 2017-07-31 00:00:00.0 1 900000000000207008 269769006 71388002 0 371881003 900000000000011006 900000000000451002
6993551023 2017-07-31 00:00:00.0 1 900000000000207008 714381001 71388002 0 371881003 900000000000011006 900000000000451002
6993552027 2017-07-31 00:00:00.0 1 900000000000207008 714386006 71388002 0 371881003 900000000000011006 900000000000451002
6994092028 2017-07-31 00:00:00.0 1 900000000000207008 733041001 71388002 0 371881003 900000000000011006 900000000000451002]

RESOLUTION: Explanation of new attribute added to the Release Notes (section 2.3.5) to ensure those not reading the Editorial Guide updates are made aware of the changes.

There are 17,000 relationships for product concepts that use attributes, not in the documented model. Again, these seem to be in the MRCM – so might be fine.
However, as far as I was aware, none of these had actually been approved? Though that could be a misunderstanding on my side… However, the draft circulated has been changed since the April meeting, so still seems like a work in progress?

RESOLVED: Requester agreed that the level of information in the Release Notes covered the required updates to NRC systems, and so this ticket was closed without any action required.

There’s 6 concepts that use the surgical approach attribute, are not permitted to. They are not “surgical procedures”.
From the EG - 6.2.2.13 SURGICAL APPROACH - "The domain for | SURGICAL APPROACH | is descendants of | Surgical procedure (procedure) | 387713003".
The MRCM refset supports this too.

These are all embolization procedures, for which we encountered the exact same problem. Part of the problem is that “What is a surgical procedure”.
The EG (6.2.5.1) gives a definition “A surgical procedure is defined as a procedure that involves intentional non-transient alteration of structures of the body, and/or a procedure that necessarily involves cutting into the body.” – Not entirely sure what that means.
The next sentence says "From a practical standpoint, this definition is implemented to include all procedures defined by the METHOD attribute with a value of any action that is listed under surgical action."
Our solution was to add 129335008|Embolization - action (qualifier value)| as a sub type 129284003|Surgical action (qualifier value)|.
We considered a new action "surgical embolisation", but that seems odd "chemoembolisation". And just about every reference described these procedures as (minimally invasive) surgical.
It worked and we didn't violate the concept model. (though did change the stated relationship for a core concept...)

428563002 Stent assisted embolization of aneurysm using transluminal coil (procedure) - no new changes this release, existing issue, needs review and remodelling - CRS
428565009 Balloon assisted embolization of aneurysm using transluminal coil (procedure) - no new changes this release, existing issue, needs review and remodelling - CRS
429062005 Embolization of aneurysm using transluminal coil (procedure) - this is new this release and I believe could be remodelled under surgical procedure so the attribute would be allowed. - MRCM rule?
448396008 Transarterial embolization (procedure)
448603000 Transarterial embolization of abdominal artery (procedure)
710285001 Transarterial chemoembolization using fluoroscopic guidance (procedure)

RESOLUTION:  Already resolved as part of the fix for ISRS-182 - this ticket therefore closed with no action required.

There’s a redundant entry in the descriptor for the lateralisable refset.

bbdcc9fc-5bc6-415a-a5ee-c5adfc569bd5 2017-01-31 00:00:00 1 900000000000207008 900000000000456007 723264001 449608002 900000000000461009 0
31919d48-e54b-4993-abe1-9c2fa9568d78 2017-07-31 00:00:00 1 900000000000207008 900000000000456007 723264001 449608002 900000000000461009 0

RESOLUTION:  Redundant record (31919d48-e54b-4993-abe1-9c2fa9568d78) removed accordingly.

The CTV3 map includes 7 invalid entries (same 7 description Ids described before).

id refsetId referencedComponentId
9f652ba8-c4ca-49f1-90f8-8138e27beded 900000000000497000 3446016018
a105309b-06da-44e6-9884-7aa86992f511 900000000000497000 3446018017
a1f400d0-bca7-454d-a37d-b503927b0078 900000000000497000 3446013014
a86b5b16-cd16-448e-8cf1-54d7bd0e8ac2 900000000000497000 3446015019
d82ce717-b99d-4586-bc59-e15c7fc4d5dd 900000000000497000 3446017010
53c15d4f-e988-434a-baa5-e785b7ca5305 900000000000497000 3446012016
74d45743-767e-4bb7-9036-570a08b04b10 900000000000497000 3446014015

RESOLUTION:  Seven invalid records removed accordingly.

Attribute description not found within correct hierarchy. Attribute descriptions are expected to be subtypes of 900000000000457003 ("Reference set attribute"). The following two records contain values outside this hierarchy:-

de0f4894-9aff-4d5c-8702-60eeb33b7a96|410662002|Concept model attribute (attribute)
2d1ccbbf-bf08-4740-a80e-44fe774c5a2d|900000000000444006|Definition status (core metadata concept)

RESOLUTION:  Offending refsetDescriptor records removed accordingly.

Record 662b1db8-4b23-4dd1-8bf6-3964f99fe77e contains an inactive referenced component (447564002).

RESOLUTION:  The refsetDescriptor record for the reference set 447564002 has now been inactivated accordingly.

Concept 411116001 is a member of module 900000000000012004 ("SNOMED CT model component module"), while its only active FSN, 3495166019, is in module 900000000000207008 ("SNOMED CT core module").

RESOLUTION:  FSN (3495166019) and synonym (3495165015) have both been moved to 900000000000012004 ("SNOMED CT model component module") accordingly.

These four concepts lack any active synonyms:

326342007
377389001
377416002
377417006

Note that all four of these concepts are inactive.

RESOLUTION: SNOMED International Content Team confirmed that these are inactive concepts so therefore adding new synonyms is not the correct approach. Therefore no action is required in this case.

Descriptions which have had their case significance ids altered to 900000000000448009 ("Entire term case insensitive") for this release.

RESOLUTION: UKTC confirmed that this issue was with the QA test rather than the content - this is therefore not a valid issue and so has been closed down without action required.

New namespace added for upcoming October 2017 Spanish Edition release, resolved in TPFIX-25

RESOLUTION:  New namespace (734535006) created as planned.

"assertionUuid": "eff30fb0-7856-11e1-b0c4-0800200c9a66",
"assertionText": "All language refset members inactivated in current snapshot must have been active in the previous release.",
"queryInMilliSeconds": 60635,
"failureCount": 12,
"firstNInstances": [

,

,

,

,

,

,

,

,

,

,

,

],

RESOLUTION: This is just a warning and not an error and so no action is required.

"assertionUuid": "2b193a88-8dab-4d19-b995-b556ed59398d",
"assertionText": "New inactive states follow active states in the DESCRIPTION snapshot.",
"queryInMilliSeconds": 33619,
"failureCount": 6,
"firstNInstances": [

{ "conceptId": "435801000124108", "detail": "DESCRIPTION: id=638911000124112 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439021000124105", "detail": "DESCRIPTION: id=648331000124115 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439031000124108", "detail": "DESCRIPTION: id=648361000124112 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439041000124103", "detail": "DESCRIPTION: id=648391000124116 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439081000124109", "detail": "DESCRIPTION: id=648501000124118 is inactive but no active state found in the previous snapshot." }

,

{ "conceptId": "439101000124101", "detail": "DESCRIPTION: id=648571000124112 is inactive but no active state found in the previous snapshot." }

RESOLUTION:  The six born inactive Descriptions above have been removed accordingly.

"assertionUuid": "4478a896-2724-4417-8bce-8986ecc53c4e",
"assertionText": "There must be actual changes made to previously published concepts in order for them to appear in the current delta.",
"queryInMilliSeconds": 6660,
"failureCount": 1,
"firstNInstances": [

{ "conceptId": "448396008", "detail": "Concept: id=448396008 is in the detla file, but no actual changes made since the previous release." }

RESOLUTION:  Concept removed from the Delta file accordingly.

Concept 448396008 experienced issues with the branch problem during the Alpha feedback period - when it was fixed in the Alpha the termServer believed it to be new an so added another active record to the delta, thus corrupting the Full and Snapshot files.

RESOLUTION:  Resolved as part of ISRS-204

There’s still one description that might be text definition? Though it’s the presence of a period/full stop at the end of the description (which is unusual) is what’s causing the fail.

718089001 3311128017 2017-07-31 00:00:00 Post extubation acute respiratory failure requiring reintubation.

RESOLUTION:  Description inactivated, as turned out to be a duplicate.

Possibly inconsequential. Members of refset 900000000000490003 ("Description inactivation indicator attribute value reference set") for which a more recent record in the Full release expresses the same relationship (but with a different id). Note that the members in question are inactive: the QA is objecting to the same relationship appearing with two different ids.

RESOLUTION:  Four invalid AttributeValue records removed, plus four valid records re-activated for July 2017:

Removed:

6937d3ce-9b92-46a5-915c-105ef53a85a3 20170731 1 900000000000207008 900000000000490003 350608017 900000000000495008
2b1419fb-6396-4d96-b67a-bf3404e4e24f 20170731 1 900000000000207008 900000000000490003 377741012 900000000000495008
55c7c001-05d3-4476-b0c2-29205a0387d8 20170731 1 900000000000207008 900000000000490003 2737731017 900000000000495008
78e492ae-9b4f-4da5-9ebb-a37f8eb70ee1 20170731 1 900000000000207008 900000000000490003 622260016 900000000000495008

Re-activated:

ff7de500-472d-5380-930e-b5ddfb184d98 1 900000000000207008 900000000000490003 377741012 900000000000495008
7f442764-3b09-5827-9629-81c0407c828b 1 900000000000207008 900000000000490003 350608017 900000000000495008
12a081ef-baf8-5a46-b93d-a4c9de998790 1 900000000000207008 900000000000490003 622260016 900000000000495008
66e03cc0-51fd-535c-907a-5761cd1d2e36 1 900000000000207008 900000000000490003 2737731017 900000000000495008

The 363714003 |Interprets| attribute has a mandatory 'attributeInGroupCardinality' of 0..1. However, the concept 724758000 |Manic symptoms co-occurrent and due to primary psychotic disorder (disorder)| - with an effectiveTime of 20170731 - has 3 x 363714003 |Interprets| relationships in the same relationship group (Role group 3). This therefore breaks the concept model rule.

RESOLUTION:  Three extraneous Stated relationships removed and re-classified to resolve the errors.

The concept model states that all NEW precoordinated content must have at most 1 x 363698007 |Finding site| relationship in any relationship group (where relationshipGroup > 0). However, several concepts break this rule. 

RESOLUTION:  The MRCM validation rule was proven to require refinement, in order to restrict it to the Stated view rather than Inferred.  This has now been implemented and is now producing just 3 failures.  The SNOMED International Content Team have therefore re-modelled the following 3 concepts:

• 15665401000119102
• 15665361000119106
• 15665321000119101

The related born-inactive components created by this re-modelling after Versioning the content have also been removed.

The concept model states that all NEW precoordinated content must have at most 1 x 116676008 |Associated morphology| in any relationship group (where relationshipGroup > 0). However several concepts appeared to contravene this rule:

RESOLUTION:  The MRCM validation rule was proven to require refinement, in order to restrict it to the Stated view rather than Inferred.  This has now been implemented and is now producing no failures.  This ticket has therefore been closed down with no action required.

The domain of 405815000 |Procedure device| is << 71388002 |Procedure|. However, there are 3 concepts, which are << 363787002 |Observable entity|, which have an attribute that is a descendant of |Procedure device| (namely 424226004 |Using device|). This is valid, from a content perspective - however the MRCM rules are incorrect. The reason for this is that domain constraints are inherited by an attribute's children. And since 424226004 |Using device| has recently been added to the |Observable entity| domain, this should have also been added to the domain of the parent attribute (ie 405815000 |Procedure device|.

RESOLUTION: 1 new row (row 103) has been added to the 'Attribute domain' refset for the Member Release. This has also updated the 'attributeRule' value in row 57 of 'Attribute range' refset.

734059009 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia (morphologic abnormality)

3482536011 20170731 1 900000000000207008 734059009 en 900000000000003001 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia (morphologic abnormality) 900000000000448009
3482537019 20170731 1 900000000000207008 734059009 en 900000000000013009 Intraductal papillary neoplasm with high-grade intraepithelial neoplasia 900000000000448009

734133009 Intraductal papillary neoplasm with high grade intraepithelial neoplasia (morphologic abnormality)

3483018012 20170731 1 900000000000207008 734133009 en 900000000000003001 Intraductal papillary neoplasm with high grade intraepithelial neoplasia (morphologic abnormality) 900000000000448009
3483019016 20170731 1 900000000000207008 734133009 en 900000000000013009 Intraductal papillary neoplasm with high grade intraepithelial neoplasia 900000000000448009

RESOLUTION: SNOMED International Content team have resolved this for the July 2017 Member release, by removing duplicate Concept 734059009.

https://rvf.ihtsdotools.org/api/v1/result/1497864338295?storageLocation=international/snomed_ct_international_edition_july_2017_beta_release_package/2017-06-19T08:48:47

testCategory: "release-type-validation",
assertionUuid: "89ceaf00-79b9-11e1-b0c4-0800200c9a66",
assertionText: "All stated relationships inactivated in current release must have been active in the previous release.",

Delete the following 3 born inactive stated relationships:

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6905147028 20170731 0 900000000000207008 724758000 285854004 1 363714003 900000000000010007 900000000000451002
6905148022 20170731 0 900000000000207008 724758000 247774004 1 363714003 900000000000010007 900000000000451002
6905149025 20170731 0 900000000000207008 724758000 3850002 1 363714003 900000000000010007 900000000000451002

Note: This is the result of ISRS-210 fixes.

RESOLUTION:  3 Born inactive Stated Relationships removed for the July 2017 Member release.

A change in the mapping history of 121161000000105 | Chickenpox vaccination. Unsure of the main cause of this but looks like it needs to be reviewed by SNOMED International. It is marked as a duplicate to 68525005 | Varicella vaccination (procedure) this has now been made duplicate to 722215002 | Administration of herpes zoster vaccine. However, I think this is incorrect and should be mapped to one of its child concepts 571611000119101 | Administration of varicella live vaccine (procedure). Researching this, the herpes zoster vaccine is a slightly different vaccine to the varicella vaccine.

RESOLUTION: SNOMED International Content team have resolved this for the July 2017 Member release, by amending the mapping to 571611000119101

RVF failed several Stated Relationships which have been born inactive in July 2017:

"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.", 

"failureCount": 12,

"firstNInstances": 

[{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807693029 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807695020 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665361000119106","detail": "Stated relationship: id=6807696021 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807707026 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807709028 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665321000119101","detail": "Stated relationship: id=6807710022 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807712025 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807714029 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807715028 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807716027 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807718026 is inactive in the current release but no active state found in the previous snapshot."},{"conceptId": "15665401000119102","detail": "Stated relationship: id=6807719023 is inactive in the current release but no active state found in the previous snapshot."}

RESOLUTION:  All born inactive Stated relationships removed from the July 2017 International Edition accordingly.

Retired concepts must have a historical relationship of the appropriate type (unless their concept status is 1 or 3)

RESOLUTION:  The majority of these issues were proven by the SNOMED International Content team to be valid, with the root cause being invalid QA routines.  One historical association (for concept 192203002) was proven to be invalid, and has now been amended accordingly for the July 2017 Member release.

Concepts may not have more than one historical relationship (except MAY_BE_As, MOVED_TOs OR WAS_As). The following concepts have all come through RF2 to RF1 conversion with more than the expected number of historical relationships attached to them:

This may be another RF2 to RF1 conversion issue, rather than any problem with the RF2 source.

RESOLUTION:  All concepts changed to have AssociationReference refsetId equal to "POSSIBLY EQUIVALENT TO", and their AttributeValue valueId equal to "AMBIGUOUS"

Historical relationships must belong to concepts of appropriate status. Three active concepts have come through conversion with odd historical relationships attached: 

These may be odd entries in the RF2 reference sets or another group of RF2 to RF1 conversion issues.

RESOLUTION:  Concepts inactivated, plus historical associations corrected.

Children of concepts with the "Has active ingredient" attribute must also have that attribute. The following concepts are not inheriting the necessary attribute from the parent concept:

RESOLUTION:  UKTC confirmed that after further investigation this issue was specific to the UK extension, and therefore requires no action for the International Edition.  Issue therefore closed without action.

Postfix metamodel rule: Only known FSN postfix values may occur as children of other FSN postfix values. The table below gives the issues from the International content.  In the details column the child is the first code and the parent the second.

RESOLUTION:  All relevant descriptions and Stated Relationship amended as per the noted in the table above.

RVF failure:

"assertionText": "New inactive states follow active states in the ASSOCIATION REFSET snapshot file.",

"failureCount": 9,

"firstNInstances": 

[{"conceptId": "157379003","detail": "ASSOC RS: id=a0e20ebe-a5dc-4cb6-a226-a3b4441b0dc8 is inactive but no active state found in the previous release."},{"conceptId": "157379003","detail": "ASSOC RS: id=c03e2672-3d0e-4e5a-b61e-d43021b90810 is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=d4f62913-bdbb-467c-811f-0f8250a7661d is inactive but no active state found in the previous release."},{"conceptId": "157379003","detail": "ASSOC RS: id=df96b92e-76b1-42f3-aa6f-01e3a9a8c0eb is inactive but no active state found in the previous release."},{"conceptId": "413138007","detail": "ASSOC RS: id=e806ed49-531d-41ed-bebf-2ec69995b0aa is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=fc1cc179-f30c-49f7-b1c2-954955c78c2c is inactive but no active state found in the previous release."},{"conceptId": "397967003","detail": "ASSOC RS: id=006bbe0f-3d34-4ca8-9b94-bf97d44ca4a1 is inactive but no active state found in the previous release."},{"conceptId": "397967003","detail": "ASSOC RS: id=58121ca7-6b7d-4c9a-916f-d6d70df9b7c5 is inactive but no active state found in the previous release."},{"conceptId": "287103000","detail": "ASSOC RS: id=65d450af-36ef-47e5-a29b-fd0c82a27a0b is inactive but no active state found in the previous release."}

RESOLUTION: The relevant Association refset components removed accordingly.

RVF failure:

"assertionText": "Previously published historical association components should not be modified.",

"failureCount": 1,

"firstNInstances": 

[

],

RESOLUTION:  Association Reference record fixed as folllows:

id effectiveTime active moduleId refsetId referencedComponentId targetComponentId
84eb1cc8-23b9-5112-8ad1-9a075becd413 0 900000000000207008 900000000000527005 413138007 68525005
2120b5b4-5a52-11e7-8261-3c15c2c6e32e 1 900000000000207008 900000000000527005 413138007 571611000119101

According to the attribute group rule there should not be more than one attribute per group as it is [0..1] group.  This one only exists in the stated relationship but not in the inferred view: 

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid

[4428858023|tel:(442)%20885-8023] 20090131 1 900000000000207008 438595008 417992006 1 118168003 900000000000010007 900000000000451002

7111885023 20170731 1 900000000000207008 438595008 367643001 1 118168003 900000000000010007 900000000000451002

RESOLUTION:  Stated Relationship inactivated as follows, to leave only 1 relationships in the group:

4428858023 20170731 0 900000000000207008 438595008 417992006 1 118168003 900000000000010007 900000000000451002

The following 3 born inactive Stated Relationship records have failed the MRCM tests:

id effectivetime active moduleid sourceid destinationid relationshipgroup typeid characteristictypeid modifierid
6937579029 20170731 1 900000000000207008 1542009 371520008 2 116676008 900000000000010007 900000000000451002 
6937585020 20170731 1 900000000000207008 18735004 371520008 2 116676008 900000000000010007 900000000000451002 
6937613027 20170731 1 900000000000207008 72951007 371520008 1 116676008 900000000000010007 900000000000451002

RESOLUTION:  The three Stated Relationship records in question were removed by the SNOMED International Content team.

SNOMED International’s continuous Content quality review identified a change within the terminology that requires wider consideration - namely the addition of the following Stated Relationship:

6842860029 20170731 1 900000000000207008 80400009 3898006 0 116680003 900000000000010007 900000000000451002

RESOLUTION:  This Stated relationship and the related Inferred relationships have therefore been removed pending further review, to ensure that the impact of this change within the hierarchy is fully communicated with appropriate consultation with the wider community of practice.

"assertionUuid": "89ceaf00-79b9-11e1-b0c4-0800200c9a66",

"assertionText": "All stated relationships inactivated in current release must have been active in the previous release.",

"failureCount": 1,

"firstNInstances": [{"conceptId": "80400009","detail": "Stated relationship: id=6842860029 is inactive in the current release but no active state found in the previous snapshot."}

RESOLUTION:  Born Inactive record was removed accordingly.

The following textDefinition records have been found to have unexpected control characters contained within the text (just before the number of degrees in each case):

3476134011 20170731 1 900000000000207008 733525007 en 900000000000550004 Left anterior fascicular block is characterized by all of the following: Left-axis deviation with frontal QRS axis between �45° and �90°; Q wave in lead aVL; rS in inferior leads; QRS duration is �120 ms. 900000000000017005
3476135012 20170731 1 900000000000207008 733525007 en 900000000000550004 Left anterior fascicular block is characterised by all of the following: Left-axis deviation with frontal QRS axis between �45° and �90°; Q wave in lead aVL ; rS in inferior leads; QRS duration is �120 ms. 900000000000017005
3476139018 20170731 1 900000000000207008 733524006 en 900000000000550004 Right-axis deviation with frontal QRS axis between �90° and �180° rS in leads I and aVL and qR in inferior leads (Q waves �40 ms).;QRS duration �120 ms; Exclude other causes of right-axis deviation. 900000000000017005

RESOLUTION:  The 3 textDefinition records have been updated accordingly, to remove the special characters.