F/abaird hem validation vcom

projects/biogears/libBiogears/src/cdm/substance/SESubstanceClearance.cpp

@@ -293,9 +293,10 @@ bool SESubstanceClearance::HasCellBirthRate() const
 //-----------------------------------------------------------------------------
 SEScalarFrequency& SESubstanceClearance::GetCellBirthRate()
 {
-  if (m_CellBirthRate == nullptr)
+  if (m_CellBirthRate == nullptr) {
     m_hasCellular = true;
     m_CellBirthRate = new SEScalarFrequency();
+  }
   return *m_CellBirthRate;
 }
 //-----------------------------------------------------------------------------
@@ -314,9 +315,10 @@ bool SESubstanceClearance::HasCellDeathRate() const
 //-----------------------------------------------------------------------------
 SEScalarFrequency& SESubstanceClearance::GetCellDeathRate()
 {
-  if (m_CellDeathRate == nullptr)
+  if (m_CellDeathRate == nullptr) {
     m_hasCellular = true;
     m_CellDeathRate = new SEScalarFrequency();
+  }
   return *m_CellDeathRate;
 }
 //-----------------------------------------------------------------------------

projects/biogears/libBiogears/src/cdm/system/physiology/SECardiovascularSystem.cpp

@@ -34,10 +34,10 @@ constexpr char idCentralVenousPressure[] = "CentralVenousPressure";
 constexpr char idCerebralBloodFlow[] = "CerebralBloodFlow";
 constexpr char idCerebralPerfusionPressure[] = "CerebralPerfusionPressure";
 constexpr char idDiastolicArterialPressure[] = "DiastolicArterialPressure";
-constexpr char idExtremityPressureLeftArm[] = "ExtremityPressure-LeftArm";
-constexpr char idExtremityPressureLeftLeg[] = "ExtremityPressure-LeftLeg";
-constexpr char idExtremityPressureRightArm[] = "ExtremityPressure-RightArm";
-constexpr char idExtremityPressureRightLeg[] = "ExtremityPressure-RightLeg";
+constexpr char idExtremityPressureLeftArm[] = "ExtremityPressureLeftArm";
+constexpr char idExtremityPressureLeftLeg[] = "ExtremityPressureLeftLeg";
+constexpr char idExtremityPressureRightArm[] = "ExtremityPressureRightArm";
+constexpr char idExtremityPressureRightLeg[] = "ExtremityPressureRightLeg";
 constexpr char idHeartEjectionFraction[] = "HeartEjectionFraction";
 constexpr char idHeartRate[] = "HeartRate";
 constexpr char idHeartStrokeVolume[] = "HeartStrokeVolume";
@@ -1068,6 +1068,10 @@ Tree<const char*> SECardiovascularSystem::GetPhysiologyRequestGraph() const
     .emplace_back(idCerebralBloodFlow)
     .emplace_back(idCerebralPerfusionPressure)
     .emplace_back(idDiastolicArterialPressure)
+    .emplace_back(idExtremityPressureLeftArm)
+    .emplace_back(idExtremityPressureLeftLeg)
+    .emplace_back(idExtremityPressureRightArm)
+    .emplace_back(idExtremityPressureRightLeg)
     .emplace_back(idHeartEjectionFraction)
     .emplace_back(idHeartRate)
     .emplace_back(idHeartStrokeVolume)

projects/biogears/libBiogears/src/engine/Controller/BioGears.cpp

@@ -276,7 +276,7 @@ bool BioGears::SetupPatient()
   //AGE ---------------------------------------------------------------
   double age_yr;
   double ageMin_yr = 18.0;
-  double ageMax_yr = 65.0;
+  double ageMax_yr = 105.0;
   double ageStandard_yr = 44.0;
   if (!m_Patient->HasAge()) {
     m_Patient->GetAge().SetValue(ageStandard_yr, TimeUnit::yr);
@@ -607,7 +607,7 @@ bool BioGears::SetupPatient()
   double respirationRate_bpm;
   double respirationRateStandard_bpm = 14.0;
   double respirationRateMax_bpm = 20.0;
-  double respirationRateMin_bpm = 12.0;
+  double respirationRateMin_bpm = 10.0;
   if (!m_Patient->HasRespirationRateBaseline()) {
     respirationRate_bpm = respirationRateStandard_bpm;
     m_Patient->GetRespirationRateBaseline().SetValue(respirationRate_bpm, FrequencyUnit::Per_min);

projects/biogears/libBiogears/src/engine/Controller/BioGearsEngine.cpp

@@ -653,6 +653,9 @@ bool BioGearsEngine::InitializeEngine(const std::vector<const SECondition*>* con
   }
   AtSteadyState(EngineState::AtInitialStableState);
 
+  //for debugging, if you change the blood/gases then uncomment this line and update the biogeassubstances file
+  //m_Substances->WriteBloodGases();
+
   m_State = EngineState::SecondaryStabilization;
   // Apply conditions and anything else to the physiology
   // now that it's steady with provided patient, environment, and feedback

projects/biogears/libBiogears/src/engine/Systems/BloodChemistry.cpp

@@ -132,7 +132,10 @@ void BloodChemistry::Initialize()
   GetVolumeFractionNeutralLipidInPlasma().SetValue(0.0023);
   GetVolumeFractionNeutralPhospholipidInPlasma().SetValue(0.0013);
   GetPhosphate().SetValue(1.1, AmountPerVolumeUnit::mmol_Per_L);
-  GetStrongIonDifference().SetValue(40.5, AmountPerVolumeUnit::mmol_Per_L);
+  double otherIons_mmol_Per_L = 0.0;
+  double strongIonDifference_mmol_Per_L = m_venaCavaSodium->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) + m_venaCavaPotassium->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) - (m_venaCavaChloride->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) + (m_venaCavaLactate->GetMolarity(AmountPerVolumeUnit::mmol_Per_L))) + otherIons_mmol_Per_L;
+  //strongIonDifference_mmol_Per_L = 40.5;
+  GetStrongIonDifference().SetValue(strongIonDifference_mmol_Per_L, AmountPerVolumeUnit::mmol_Per_L);
   GetTotalBilirubin().SetValue(0.70, MassPerVolumeUnit::mg_Per_dL); //Reference range is 0.2-1.0
   GetLymphocyteCellCount().SetValue(1.9e9, AmountPerVolumeUnit::ct_Per_L); //Reference range is 1.3-3.5e9 per liter
   GetNeutrophilCellCount().SetValue(3.0e9, AmountPerVolumeUnit::ct_Per_L);  //Reference range is 1.5-3.8e9 per liter
@@ -455,9 +458,9 @@ void BloodChemistry::Process()
   m_data.GetSubstances().GetTriacylglycerol().GetBloodConcentration().Set(m_venaCavaTriacylglycerol->GetConcentration());
   m_data.GetSubstances().GetUrea().GetBloodConcentration().Set(m_venaCavaUrea->GetConcentration());
 
-  double otherIons_mmol_Per_L = -5.4; //Na, K, and Cl baseline concentrations give SID = 45.83, we assume baseline SID = 40.5, thus "other ions" (i.e. Mg, Ca, Ketones) make up -5.3 mmol_Per_L equivalent of charge
+  double otherIons_mmol_Per_L = 0.0; //Na, K, and Cl baseline concentrations give SID = 45.83, we assume baseline SID = 40.5, thus "other ions" (i.e. Mg, Ca, Ketones) make up -5.3 mmol_Per_L equivalent of charge
   double strongIonDifference_mmol_Per_L = m_venaCavaSodium->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) + m_venaCavaPotassium->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) - (m_venaCavaChloride->GetMolarity(AmountPerVolumeUnit::mmol_Per_L) + (m_venaCavaLactate->GetMolarity(AmountPerVolumeUnit::mmol_Per_L))) + otherIons_mmol_Per_L;
-  //GetStrongIonDifference().SetValue(strongIonDifference_mmol_Per_L, AmountPerVolumeUnit::mmol_Per_L);
+  GetStrongIonDifference().SetValue(strongIonDifference_mmol_Per_L, AmountPerVolumeUnit::mmol_Per_L);
 
   // Calculate pH
   GetArterialBloodPH().Set(m_aorta->GetPH());

projects/biogears/libBiogears/src/engine/Systems/Cardiovascular.cpp

@@ -905,8 +905,8 @@ void Cardiovascular::CalculateVitalSigns()
 
       /// \event Patient: blood loss below 60%, irreversible state enacted
       // @cite champion2003profile
-      if (GetBloodVolume().GetValue(VolumeUnit::mL) <= 0.5 * m_patient->GetBloodVolumeBaseline(VolumeUnit::mL)) {
-        m_ss << "50% of the patient's blood volume has been lost. The patient is now in an irreversible state.";
+      if (GetBloodVolume().GetValue(VolumeUnit::mL) <= 0.4 * m_patient->GetBloodVolumeBaseline(VolumeUnit::mL)) {
+        m_ss << "40% of the patient's blood volume has been lost. The patient is now in an irreversible state.";
         Warning(m_ss);
         /// \irreversible Over half the patients blood volume has been lost.
         if (!m_PatientActions->HasOverride()) {

projects/biogears/libBiogears/src/engine/Systems/Energy.cpp

@@ -479,7 +479,7 @@ void Energy::CalculateVitalSigns()
   // The hydrogen ion concentration is a property of the blood
   // The events related to blood concentrations should be detected and set in blood chemistry.
   double highPh = 8.5;
-  double lowPh = 6.5; // \cite Edge2006AcidosisConscious
+  double lowPh = 6.3; // \cite Edge2006AcidosisConscious
   m_BloodpH.Sample(m_data.GetBloodChemistry().GetArterialBloodPH().GetValue());
   m_BicarbonateMolarity_mmol_Per_L.Sample(m_AortaHCO3->GetMolarity(AmountPerVolumeUnit::mmol_Per_L));
   //Only check these at the end of a cardiac cycle and reset at start of cardiac cycle

projects/biogears/libBiogears/src/engine/Systems/Nervous.cpp

@@ -149,7 +149,8 @@ void Nervous::Initialize()
   //m_data.GetDataTrack().Probe("m_PeripheralPressureDelta_cmH2O ", m_PeripheralPressureDelta_cmH2O);
   //m_data.GetDataTrack().Probe("m_OxygenAutoregulatorHeart ", m_OxygenAutoregulatorHeart);
   //m_data.GetDataTrack().Probe("m_OxygenAutoregulatorMuscle ", m_OxygenAutoregulatorMuscle);
-
+  //m_data.GetDataTrack().Probe("m_AfferentBaroreceptorAortic_Hz ", m_AfferentBaroreceptorAortic_Hz);
+  //m_data.GetDataTrack().Probe("m_AfferentBaroreceptorCarotid_Hz ", m_AfferentBaroreceptorCarotid_Hz);
 }
 
 bool Nervous::Load(const CDM::BioGearsNervousSystemData& in)
@@ -710,7 +711,9 @@ void Nervous::BaroreceptorFeedback()
   m_AfferentBaroreceptorCarotid_Hz = (fBaroMin + fBaroMax * carotidExponent) / (1.0 + carotidExponent);
   const double aorticExponent = std::exp((aorticStrainSignal - baselineStrainSignal) / kBaro);
   m_AfferentBaroreceptorAortic_Hz = (fBaroMin + fBaroMax * aorticExponent) / (1.0 + aorticExponent);
-
+  //m_data.GetDataTrack().Probe("m_AfferentBaroreceptorAortic_Hz ", m_AfferentBaroreceptorAortic_Hz);
+  //m_data.GetDataTrack().Probe("m_AfferentBaroreceptorCarotid_Hz ", m_AfferentBaroreceptorCarotid_Hz);
+  // 
   //Cardiopulmonary (or low pressure) receptors are sensitive to the volume of blood being return to heart
   //Since they are located by the heart, they are also effected by changes in transmural pressure.
   //This model for cardiopulmonary receptors is based on Lim2013Cardiovascular

projects/biogears/libBiogears/src/engine/Systems/Renal.cpp

@@ -871,6 +871,11 @@ void Renal::CalculateGlomerularTransport(SESubstance& sub)
 
     double massToMove_mg = concentration_mg_Per_mL * flow_mL_Per_s * m_dt * filterability * fractionUnbound;
 
+    //scale the mass to move of the lactate during acidosis: 
+    if (sub.GetName() == "Lactate") {
+      massToMove_mg *= (10.0 / (1 + 24.5 * exp(100 * (m_data.GetBloodChemistry().GetArterialBloodPH().GetValue() - 7.35)))) + 1.0;
+    }
+
     //Make sure we don't try to move too much
     massToMove_mg = std::min(massToMove_mg, glomerularSubQ->GetMass().GetValue(MassUnit::mg));
 
@@ -1070,6 +1075,11 @@ void Renal::CalculateReabsorptionTransport(SESubstance& sub)
   SELiquidSubstanceQuantity* peritubularSubQ = nullptr;
   SEFluidCircuitPath* reabsorptionResistancePath = nullptr;
 
+  //we want to adjust the reabsorption in response to ph in the blood
+  if (sub.GetName() == "Lactate" && m_data.GetBloodChemistry().GetArterialBloodPH().GetValue() < 7.32) {
+    sub.GetClearance().GetRenalReabsorptionRatio().SetValue(0.000001);
+  }
+
   double totalReabsorptionRate_mg_Per_s = 0.0;
   //We'll apply the factor to the effectively make the FiltrationFraction change by the same amount
   //This is determined in Osmoreceptor Feedback

projects/biogears/libBiogears/src/engine/Systems/Saturation.cpp

@@ -112,7 +112,7 @@ struct error_functor : Functor<double> {
     double totalCO2_mM = CO2_mM + HCO3_mM + 4.0 * HbCO2_mM + 4.0 * HbO2CO2_mM;
     double totalO2_mM = O2_mM + 4.0 * HbO2_mM + 4.0 * HbO2CO2_mM;
 
-    double f0 = m_SatCalc.m_StrongIonDifference_mmol_Per_L - bicarb_mM - m_SatCalc.m_albumin_g_per_L * (0.123 * pH - 0.631) - m_SatCalc.m_Phosphate_mmol_Per_L * (0.309 * pH - 0.469);
+    double f0 = m_SatCalc.m_StrongIonDifference_mmol_Per_L - bicarb_mM - (m_SatCalc.m_albumin_g_per_L * (0.123 * pH - 0.631)) - m_SatCalc.m_Phosphate_mmol_Per_L * (0.309 * pH - 0.469);
     double f1 = totalCO2_mM - co2_mM - bicarb_mM - 4.0 * CarbonDioxideSaturation * totalHemoglobin_mM;
     double f2 = totalO2_mM - o2_mM - 4.0 * OxygenSaturation * totalHemoglobin_mM;
 

projects/biogears/libBiogears/src/engine/Systems/Tissue.cpp

@@ -926,7 +926,7 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
   const double biologicalDebt = m_data.GetNervous().GetBiologicalDebt().GetValue();
   const double exerciseEnergyRequested_kcal = m_data.GetEnergy().GetExerciseEnergyDemand(PowerUnit::kcal_Per_s) * time_s; //Will get added to muscle in tissue loop below
   const double otherEnergyDemandAboveBasal_kcal = std::max((TMR_kcal_Per_s - BMR_kcal_Per_s) * time_s * (1.0 - biologicalDebt) - exerciseEnergyRequested_kcal, 0.0); //Due to other factors like shivering -- will get split between muscles and fat stores in tissue loop below
-  const double hypoperfusionDeficit_kcal = m_data.GetEnergy().GetEnergyDeficit(PowerUnit::kcal_Per_s) * time_s; //Hypoperfusion deficit is "faux" energy value -- it makes system perceive an energy deficit and enter anaerobic production earlier during hemorrhage and sepsis
+  const double hypoperfusionDeficit_kcal = 1000.0*m_data.GetEnergy().GetEnergyDeficit(PowerUnit::kcal_Per_s) * time_s; //Hypoperfusion deficit is "faux" energy value -- it makes system perceive an energy deficit and enter anaerobic production earlier during hemorrhage and sepsis
   double brainNeededEnergy_kcal = .2 * baseEnergyRequested_kcal; //brain requires a roughly constant 20% of basal energy regardless of exercise \cite raichle2002appraising
   double nonbrainNeededEnergy_kcal = 0.8 * baseEnergyRequested_kcal + hypoperfusionDeficit_kcal;
   double totalEnergyRequested_kcal = brainNeededEnergy_kcal + nonbrainNeededEnergy_kcal + exerciseEnergyRequested_kcal + otherEnergyDemandAboveBasal_kcal; //Use to check math below
@@ -973,6 +973,9 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
   double mandatoryMuscleAnaerobicFraction = 0.028; //There is always some anaerobic consumption in the body, particularly in muscle fibers with few mitochondria \cite boron2012medical
   double kcal_Per_day_Per_Watt = 20.6362855;
   double maxWorkRate_W = m_Patient->GetMaxWorkRate().GetValue(PowerUnit::W);
+  double lactateScale = 1.0;
+  double currentBloodVolume_mL = m_data.GetCardiovascular().GetBloodVolume().GetValue(VolumeUnit::mL);
+  double bloodVolumeBaseline_mL = m_data.GetPatient().GetBloodVolumeBaseline().GetValue(VolumeUnit::mL);
 
   double sleepTime_min = m_data.GetNervous().GetSleepTime().GetValue(TimeUnit::min); //update value from last computation
   double wakeTime_min = m_data.GetNervous().GetWakeTime().GetValue(TimeUnit::min); //update value from last computation
@@ -986,7 +989,10 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
   if (m_PatientActions->HasHemorrhage()) {
     double maxBleedingRate_mL_Per_min = 200.0;
     double bleedingRate_mL_Per_min = m_data.GetCompartments().GetLiquidCompartment(BGE::VascularCompartment::Ground)->GetInFlow(VolumePerTimeUnit::mL_Per_min);
-    mandatoryMuscleAnaerobicFraction = 0.5 * bleedingRate_mL_Per_min / maxBleedingRate_mL_Per_min;
+    mandatoryMuscleAnaerobicFraction = (bleedingRate_mL_Per_min / maxBleedingRate_mL_Per_min);
+    //also scale based on total blood loss in increase lactate scaling (this perturbes blood volume as a function of hypovolemia up to 8 times production)
+    lactateScale = 15.5 / (1 + 5.4 * exp(25.0 * ((currentBloodVolume_mL / bloodVolumeBaseline_mL) - 1.0))) + 1;
+    lactateScale += mandatoryMuscleAnaerobicFraction;
   }
 
   //if a patient is sleep deprived scale back how much glucose the brain is using (7%)
@@ -1434,7 +1440,7 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
     if (tissueNeededEnergy_kcal > 0 && totalEnergyAsTissueIntracellularGlucose_kcal >= tissueNeededEnergy_kcal) {
       double glucoseToConsume_mol = tissueNeededEnergy_kcal / energyPerMolATP_kcal / anaerobic_ATP_Per_Glucose;
       TissueGlucose->GetMass().IncrementValue(-glucoseToConsume_mol * m_Glucose->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
-      TissueLactate->GetMass().IncrementValue(glucoseToConsume_mol * lactate_Per_Glucose * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
+      TissueLactate->GetMass().IncrementValue(lactateScale * glucoseToConsume_mol * lactate_Per_Glucose * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
       tissueNeededEnergy_kcal = 0;
       lactateProductionRate_mol_Per_s += glucoseToConsume_mol * lactate_Per_Glucose / time_s;
       if (m_AnaerobicTissues.find(tissue->GetName()) == std::string::npos) //for tracking only
@@ -1444,7 +1450,7 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
     else if (tissueNeededEnergy_kcal > 0) {
       double glucoseToConsume_mol = totalEnergyAsTissueIntracellularGlucose_kcal / energyPerMolATP_kcal / anaerobic_ATP_Per_Glucose;
       TissueGlucose->GetMass().SetValue(0, MassUnit::g);
-      TissueLactate->GetMass().IncrementValue(glucoseToConsume_mol * lactate_Per_Glucose * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
+      TissueLactate->GetMass().IncrementValue(lactateScale * glucoseToConsume_mol * lactate_Per_Glucose * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
       tissueNeededEnergy_kcal -= glucoseToConsume_mol * anaerobic_ATP_Per_Glucose * energyPerMolATP_kcal;
       lactateProductionRate_mol_Per_s += glucoseToConsume_mol * lactate_Per_Glucose / time_s;
       if (m_AnaerobicTissues.find(tissue->GetName()) == std::string::npos) //for tracking only
@@ -1461,7 +1467,7 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
         double glycogenConsumed_g = ((tissueNeededEnergy_kcal + muscleMandatoryAnaerobicNeededEnergy_kcal) / energyAsMuscleGlycogen_kcal) * GetMuscleGlycogen(MassUnit::g);
         double glycogenConsumed_mol = glycogenConsumed_g / m_Glucose->GetMolarMass(MassPerAmountUnit::g_Per_mol);
         GetMuscleGlycogen().IncrementValue(-glycogenConsumed_g, MassUnit::g);
-        TissueLactate->GetMass().IncrementValue(glycogenConsumed_mol * lactate_Per_Glycogen * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
+        TissueLactate->GetMass().IncrementValue(lactateScale * glycogenConsumed_mol * lactate_Per_Glycogen * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
         lactateProductionRate_mol_Per_s += glycogenConsumed_mol * lactate_Per_Glycogen / time_s;
         if (m_AnaerobicTissues.find(tissue->GetName()) == std::string::npos && tissueNeededEnergy_kcal != 0) //for tracking only
           m_AnaerobicTissues.append(std::string { tissue->GetName() } + " ");
@@ -1472,7 +1478,7 @@ void Tissue::CalculateMetabolicConsumptionAndProduction(double time_s)
       else {
         double glycogenConsumed_mol = GetMuscleGlycogen(MassUnit::g) / m_Glucose->GetMolarMass(MassPerAmountUnit::g_Per_mol);
         GetMuscleGlycogen().SetValue(0, MassUnit::g);
-        TissueLactate->GetMass().IncrementValue(glycogenConsumed_mol * lactate_Per_Glycogen * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
+        TissueLactate->GetMass().IncrementValue(lactateScale * glycogenConsumed_mol * lactate_Per_Glycogen * m_Lactate->GetMolarMass(MassPerAmountUnit::g_Per_mol), MassUnit::g);
         tissueNeededEnergy_kcal -= glycogenConsumed_mol * anaerobic_ATP_Per_Glycogen * energyPerMolATP_kcal;
         lactateProductionRate_mol_Per_s += glycogenConsumed_mol * lactate_Per_Glycogen / time_s;
         if (m_AnaerobicTissues.find(tissue->GetName()) == std::string::npos && tissueNeededEnergy_kcal != 0) //for tracking only

projects/cli/src/data/PatientGenerator.cpp

@@ -148,24 +148,24 @@ bool PatientGenerator::process(const std::string& name, const std::string& value
     } catch (std::exception e) {
       rValue = false;
     }
-  } else if ("RightLungFraction" == name) {
-    PatientData::RightLungRatio_type rlr_data;
-    try {
-      rlr_data.value(std::stod(value));
-      patient.RightLungRatio(rlr_data);
-    } catch (std::exception e) {
-      rValue = false;
-    }
-  } else if ("SkinSurfaceArea" == name) {
-    size_t pos;
-    PatientData::SkinSurfaceArea_type ssa_data;
-    try {
-      ssa_data.value(std::stod(value, &pos));
-      ssa_data.unit(biogears::trim(value.substr(pos)));
-      patient.SkinSurfaceArea(ssa_data);
-    } catch (std::exception e) {
-      rValue = false;
-    }
+  //} else if ("RightLungFraction" == name) {
+  //  PatientData::RightLungRatio_type rlr_data;
+  //  try {
+  //    rlr_data.value(std::stod(value));
+  //    patient.RightLungRatio(rlr_data);
+  //  } catch (std::exception e) {
+  //    rValue = false;
+  //  }
+  //} else if ("SkinSurfaceArea" == name) {
+  //  size_t pos;
+  //  PatientData::SkinSurfaceArea_type ssa_data;
+  //  try {
+  //    ssa_data.value(std::stod(value, &pos));
+  //    ssa_data.unit(biogears::trim(value.substr(pos)));
+  //    patient.SkinSurfaceArea(ssa_data);
+  //  } catch (std::exception e) {
+  //    rValue = false;
+  //  }
   } else if ("BasalMetabolicRate" == name) {
     size_t pos;
     PatientData::BasalMetabolicRate_type bmr_data;