Commit graph

366 commits

Author SHA1 Message Date
Daniel
33ca4e65d9 fix: harden clinical assistant MCP connectivity 2026-05-06 07:42:03 +02:00
Daniel
c8e911cb64 chore: sync package lock 2026-05-06 07:34:10 +02:00
Daniel
96c4565b9c feat: add clinical assistant MCP search
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2026-05-06 07:31:32 +02:00
Daniel
0710c4de8e rebrand to Pediatric Clinical Tools, add diagrams tab, simplify litellm transcribe/tts 2026-05-02 18:23:06 +02:00
Daniel
cf1d88f36b Release v7.0.0 2026-04-28 03:11:55 +02:00
Daniel
b82db99ebc feat(mobile): biometric sign-in (Face ID / Touch ID / fingerprint)
Adds opt-in biometric login to the Capacitor app. Replaces the password
step on subsequent sign-ins; the 2FA step (if any) still applies — by
design, defense in depth.

How it works:
- After a successful password sign-in on a Capacitor build, prompt the
  user to enroll. If they accept, capacitor-native-biometric.setCredentials
  stores the (email, password) pair in the iOS Keychain / Android Keystore
  with biometric-protected access. The local flag ped_bio_enabled=1 is
  set so the next launch knows to probe.
- On the login form, if isNativeApp() + bioStored() + bioAvailable.ok,
  reveal the "Sign in with Face ID / Touch ID / fingerprint" button at
  the top. Label is set from the actual biometryType returned by the
  plugin so users see what their device supports.
- Tap → verifyIdentity (OS prompt) → getCredentials → fill the email +
  password fields → fire the existing form submit so all the regular
  flow runs (turnstile, 2FA prompt, error handling, session storage).
- Explicit logout deletes credentials AND clears the local flag,
  hiding the button on the next visit. Auto-logout (token expiry,
  network) does NOT come through that path, so biometric persists
  across silent session resets.

Storage choice — password not JWT:
- JWTs expire and the storage would constantly need refresh.
- Storing the password lets the standard /api/auth/login flow run,
  which already handles password-rotation (a stale stored password
  just fails 401 → user falls back to typing the new one → re-enrolls).
- The password sits in OS-level secure storage, accessible only after
  successful biometric verification — same security posture as a
  password manager autofill.

Files:
- mobile/package.json: add capacitor-native-biometric@^5.0.0 (Capacitor 6
  compat)
- mobile/android/app/src/main/AndroidManifest.xml: add USE_BIOMETRIC
  uses-permission
- mobile/ios/App/App/Info.plist: add NSFaceIDUsageDescription string
- public/js/auth.js: bioPlugin/bioAvailable/bioStored/bioEnroll/
  bioRetrieve/bioForget helpers; window.PedBio surface; reveal-on-load;
  click handler; post-login enrollment prompt; logout cleanup
- public/index.html: hidden #btn-bio-login + #bio-divider above the
  email field on the login form
- public/css/styles.css: themed gradient button + hover lift
- mobile/README.md: feature list updated

Build steps for Daniel:
  cd mobile && npm install        # picks up capacitor-native-biometric
  npx cap sync                    # ports the plugin into android/ + ios/
  # then build APK / IPA as usual
2026-04-28 03:09:38 +02:00
Daniel
b53aa34248 feat: ED multi-stage UX, extensions polish, docs viewer + application-logic docs
Three concurrent themes from this session:

═══════════════════════════════════════════════════════════════════
ED ENCOUNTERS — per-stage cards + consolidate→MDM finalize
═══════════════════════════════════════════════════════════════════

UX redesign per Daniel's feedback ("every stage note should be shown,
if AI is told to modify that particular note then the modified version
is used in final mdm"):

- Each generated stage stays on screen as its own editable card with
  its own embedded "Don't Miss" panel. No more single rolling note
  element that gets replaced on each generation.
- gatherCurrentNotes() reads contenteditable text from each stage card
  before any operation (advance, finalize, persist) so inline edits
  flow into the next AI call and the final consolidate.
- Stage badge is now state-accurate. "Stage N (recording)" with yellow
  background after Add-more before generation; "Stage N" with gray
  after generation. Fixes the bug where the badge flipped to Stage 2
  the moment Add-more was clicked.
- Save & Done now runs TWO server-side AI calls in /finalize:
  1. edConsolidate (new prompt) → polished single final note that
     integrates every stage chronologically (HPI / ROS / PE / ED Course /
     A&P with disposition).
  2. edFinalize (rewritten with full inline 2023 AMA E/M element
     rubric — problems / data / risk definitions, level mapping with
     concrete examples) → MDM JSON.
- Two new cards render after finalize: blue-bordered Final Consolidated
  Note + green-bordered MDM. Stage cards become read-only.
- partial_data on the saved row now stores {stages, finalNote, mdm,
  finalized} so resume re-renders the full state.

Why two-call finalize: a single combined prompt makes the model cut
corners on one task. Two focused calls cost ~2× latency at the very end
of an encounter — acceptable since finalize is a one-time terminal
action, not a per-stage hot path.

Files: public/components/ed-encounter.html, public/js/ed-encounters.js,
src/routes/edEncounters.js, src/utils/prompts.js (edConsolidate added,
edFinalize rewritten).

═══════════════════════════════════════════════════════════════════
EXTENSIONS / PAGERS — visual polish
═══════════════════════════════════════════════════════════════════

Multiple iterations based on Daniel's feedback:

- Layout: align-items:flex-start so action buttons stay pinned top-right
  when long numbers wrap (was align-items:center → buttons drifted into
  the text area, causing visible overlap).
- Number: word-break:break-all + min-width:0 + font-feature-settings:tnum
  so long numbers wrap within their column instead of pushing under the
  buttons. Click-to-copy with a 0.55s green flash + ✓ copied badge.
- Phone/pager Font Awesome icon next to the number in the type color —
  at-a-glance type signal (replacing an earlier 3px left stripe that
  Daniel found visually bulky).
- Name: font-weight 700, font-size 14.5px, color g900, letter-spacing
  -0.012em — scan-target headline typography for long lists.
- Alternating subtle backgrounds by index (white vs #fafbfc) so a long
  list reads as distinct rows.
- Hover: card lifts 1px with a soft shadow; action buttons fade from
  55% to 100% opacity. Cubic-bezier transition on transform.
- Entrance: staggered fade-up animation per card (35ms × index, capped
  at 12). prefers-reduced-motion media query disables motion.
- Empty state: 48px FA icon + heading instead of plain gray text.

Files: public/js/extensions.js, public/css/styles.css.

═══════════════════════════════════════════════════════════════════
DOCS REORGANIZATION + APPLICATION-LOGIC DOCS + ADMIN VIEWER
═══════════════════════════════════════════════════════════════════

Document moves (preserving git history via git mv):
  BROWSER_WHISPER_SETUP.md          → docs/browser-whisper-setup.md
  BROWSER_WHISPER_TROUBLESHOOTING.md → docs/browser-whisper-troubleshooting.md
  DEVELOPER_GUIDE.md                → docs/developer-guide-extended.md
  EMBEDDINGS_SETUP.md               → docs/embeddings-setup.md
  FEATURES_EXPLAINED.md             → docs/features-explained.md
  IMPROVEMENTS.md                   → docs/improvements.md
  OPENID_SETUP.md                   → docs/openid-setup.md
  TRANSCRIPTION_OPTIONS.md          → docs/transcription-options.md
README.md updated with the new paths + a Documentation section that
links to docs/logic/ at the top.

New application-logic doc series (~8,300 lines total) at docs/logic/.
Built with 5 parallel doc-writing agents per Daniel's "use multiple
agents" directive. Each doc explains how a part of the app actually
works — application logic, data flow, design decisions, sacred zones,
how-to-extend recipes — at a depth that lets a new dev (or an AI
assistant) modify the code confidently.

  docs/logic/README.md                — index + recommended reading order
  docs/logic/architecture.md (2166 L) — frontend IIFE pattern, lazy tab
                                         load, backend route convention,
                                         schema, encryption, deployment
  docs/logic/clinical-notes.md (1546L) — every note tab + helper trio
  docs/logic/bedside-and-calculators.md (1373L) — bedside ES module
                                         pocket + calculators + PE Guide
                                         + suture selector
  docs/logic/auth-admin-learning.md (1281L) — auth (local+OIDC+2FA) +
                                         admin panel + Learning Hub
                                         (Quiz engine logic at sub-detail
                                         only — TODO follow-up)
  docs/logic/ai-and-voice.md (1128 L) — callAI 5-provider routing,
                                         prompts, voice/STT, helper trio
  docs/logic/ed-encounters.md (821 L) — multi-stage ED + MDM (this
                                         session's worked example)

Admin-only docs viewer:
- New route /api/admin/docs/{tree,file}: recursively walks docs/, returns
  the tree as JSON; /file?path=X validates path stays inside docs/ and
  renders markdown via marked. Both gated by req.user.role==='admin'.
- New tab "Docs" (book icon) in the sidebar, hidden by default and
  revealed in auth.js when user.role==='admin' (same pattern as the
  existing Admin and CMS tabs).
- New component public/components/admin-docs.html: split-pane layout
  with a tree sidebar + filter input + a markdown reader pane.
- New module public/js/admin-docs.js: lazy-loads the tree on first tab
  activation, renders collapsible folders, persists expanded state and
  last-opened path via UIState. Server-rendered HTML so no client
  markdown parser needed.
- CSS for the viewer (responsive split-pane, code-block styling, table
  scrolling, etc.).
- Mounted at /api/admin/docs (NOT /api) — important: mounting a router
  with router.use(authMiddleware) at /api accidentally 401s every other
  /api/* path (caught and fixed during testing — /api/health was 401'ing).

Files: docs/* (moved + new), README.md, public/components/admin-docs.html
(new), public/js/admin-docs.js (new), src/routes/adminDocs.js (new),
public/index.html (tab + section + script), public/js/auth.js (admin
gate + logout cleanup), public/css/styles.css (viewer styles), server.js
(mount).

═══════════════════════════════════════════════════════════════════
KNOWN GAPS (TODO follow-ups)
═══════════════════════════════════════════════════════════════════

- Learning Hub quiz engine (MCQ / multi-select / T-F scoring + attempt
  tracking + progress dashboard) is covered at the architectural level
  in docs/logic/auth-admin-learning.md but not drilled into the quiz
  data model and scoring flow. Worth a focused follow-up doc.
- ED finalize: if MDM step JSON parse fails, server returns 502 with
  the consolidated finalNote in the error payload, but client doesn't
  surface the partial result. Add a "MDM failed, retry" affordance.
- No e2e Playwright coverage for ED encounters or the new docs viewer.
2026-04-28 03:09:38 +02:00
Daniel
4f129b24e1 feat: don't-miss tooltip after notes + bedside suture selector
#2 — Don't-miss tooltip (encounters HPI + sick visit, max 5)
- New POST /api/dont-miss returning {points: [{point, why}]} capped at 5
  (cap defended both in the prompt and server-side .slice(0,5))
- New dontMissTooltip prompt in prompts.js
- New suggestDontMiss() helper in app.js mirroring suggestBillingCodes;
  inserts an orange-bordered card next to the note output, silent on empty
- Wired into liveEncounter.js (encounter HPI) and sickVisit.js. Not added
  to wellvisit/soap/hospital/chart per spec.

#1 — Bedside suture selector
- New ES module public/js/bedside/sutures.js (~300L) following the
  burns.js pattern: site × age × tension × cosmetic × contamination ×
  hours-since-injury → material, size, technique, removal day range,
  glue/Steri-strip alternative, warnings, tetanus reminder.
- 15 anatomic sites covered (face, eyelid, lip vermilion, intraoral,
  ear, scalp, neck, trunk, upper/lower ext, hand, foot, joint surface,
  genitalia, fingertip).
- Bites: cat/human → don't-close-primarily warning; dog bite to hand →
  loose-approximation note. Heavy contamination → delayed primary
  closure. >12h non-face/scalp → judgment call note.
- Removal days shown as ranges (3–5, 7–10, 10–14) per source norms,
  not single midpoints.
- Subungual hematoma trephination guidance corrected: any painful
  hematoma with intact nail and no displaced fracture (especially if
  25–50% or more), per current UpToDate guidance.
- Inline citation: Roberts & Hedges 7e (2019), Fleisher & Ludwig 8e,
  AAP Section on EM, UpToDate (Pope JV).
- Pill registered in sub-nav SECTIONS + bedside/index.js. Persists
  active state via existing UIState helper.

All 46 tests pass.
2026-04-28 03:09:38 +02:00
Daniel
67b7667e04 feat: ED encounters + notes model selector; remove AI corrections; fix notes framing
Four changes batched:

1. ED Encounters tab (new) — multi-stage emergency note with don't-miss
   tooltips and 2023 E/M MDM finalize. New route /api/ed-encounters
   (generate per-stage + finalize MDM), new ed-encounters.js owning all
   client logic, new ed-encounter.html component, new template_ed memory
   category. Persists draft to localStorage every keystroke and to
   saved_encounters on stage advance. encounters.js touched only to
   register the new tab in sessionStorage restore + tabMap (save and
   idempotency code untouched).

2. Notes model selector — /notes/from-voice now accepts a client-supplied
   model (validated by the existing callAI allow-list); falls back to the
   admin default. Added <select class="tab-model-select"> to notes.html
   so the existing app.js populator handles options + default.

3. Remove AI-learning-from-corrections — deleted correctionTracker.js,
   POST /memories/correction, the corrections branch in
   /memories/context, the settings UI section, the FAQ entry, and all
   dead trackAIOutput/saveCorrection guards in callers. Legacy
   correction_* DB rows are filtered (NOT LIKE) rather than dropped, so
   no destructive migration.

4. Fix notes AI framing — /notes/from-voice prompt no longer assumes
   "physician dictation". Plain notes (shopping lists, reminders,
   ideas) now match the dictation tone instead of being forced into
   clinical structure.

All 46 tests pass.
2026-04-28 03:09:38 +02:00
github-actions[bot]
2872f1d063 Release v6.53.2 2026-04-24 23:44:32 +00:00
Daniel
dccb3b4bcb fix(notes): Stop button never transcribed — silent-cancel branch was always taken
Root cause for "note recording, not working nor going into textbox / no
progress etc". The click handler was wired with:

  recStop.addEventListener('click', stopRecording);

addEventListener invokes the handler with the click Event as the first
argument. My stopRecording(silent) signature uses that first arg as a
boolean — and a non-null Event is truthy, so every Stop click hit the
silent-cancel branch (mic off, stream closed, UI back to idle, but no
.then-chain fires, no transcribeAudio, no /api/notes/from-voice).

Symptom matched exactly: click Dictate → record → click Stop → mic
indicator vanishes → editor stays empty → no Network activity for
/api/notes/from-voice. Server logs from earlier transcribes were all
from the Encounter / Dictation tabs (untouched flows), never Notes.

Fix: wrap all three voice-button handlers so the Event isn't passed
through. Only stopRecording cared about the first arg, but wrap all
three for symmetry and so future signature changes don't reintroduce
the same class of bug.

  recStart → function() { startRecording(); }
  recPause → function() { togglePauseRecording(); }
  recStop  → function() { stopRecording(false); }

SW cache bumped to pedscribe-v12-notes7.

About the model: /api/notes/from-voice already reads `models.default`
from app_settings (whatever you picked in Admin Panel → Models →
Default Model). Confirmed in your DB it's set to
"openrouter-vendor-model-sonnet-4.6". No new admin UI added.
2026-04-25 01:44:23 +02:00
Daniel
7ed8a2365b chore: ignore .codex workspace marker (accidentally committed in 66d4f1f) 2026-04-25 01:35:27 +02:00
github-actions[bot]
9106d85f98 Release v6.53.1 2026-04-24 23:35:20 +00:00
Daniel
df1a6613dd fix(notes): voice → AI note now produces HTML the editor can render
Symptom Daniel reported: "note recording, not working nor going into
textbox". Root cause was on the server side — /api/notes/from-voice
asked the AI for HTML in its prompt, but real-world models return
markdown ~25% of the time. Tiptap's setContent only renders HTML;
markdown comes through as literal text or a partial render, looking
like the textbox didn't fill.

Server (src/routes/notes.js):
  • New toHtmlBody() helper. If the AI returned real HTML (any
    block tag), pass through. Otherwise run through `marked` so
    markdown becomes <p>/<h*>/<strong>/etc.
  • Strips ```json / ```html code fences before JSON parsing.
  • Stricter JSON-recovery: only accepts {title|body} parsed shape;
    falls back to wrapping the AI's full reply via toHtmlBody().
  • Final guard: if body would be empty after sanitisation, wrap
    the raw transcript so the user can at least edit it manually.

Client (public/js/notes.js):
  • applyGeneratedNote prefers _editor.commands.setContent over a
    full remount — avoids the toolbar-reattach flicker + the brief
    window where the body looked empty.
  • Logs to console when the editor target is missing or Tiptap
    setContent throws, so a future regression is greppable.

Plus the two infra fixes Daniel approved earlier in the same
session — keeping them in this commit since they're already
deployed and tested:

  • src/db/database.js: cleanup interval handle exposed; server
    shutdown now clearInterval()s it before pool.end(). Removes
    the SIGTERM → 9-second-hang → Docker SIGKILL race.
  • src/routes/audioBackups.js: switch multer.memoryStorage() to
    diskStorage with cleanup. 10 concurrent 25 MB uploads no
    longer pin 250 MB of RAM. Identical user-visible perf since
    upload is wire-bound.

New dep: marked@latest (used server-side only in toHtmlBody).
2026-04-25 01:35:10 +02:00
github-actions[bot]
fd5108e7b3 Release v6.53.0 2026-04-24 23:02:58 +00:00
Daniel
9961688bfa feat(notes): trash + restore + DOMPurify sanitizer + 9 contract tests
Soft-delete for notes — Daniel asked for "deleted notes go to trash"
so a slip of the finger doesn't lose work.

Schema: migrations/1777090000000_notes-trash.js adds a deleted_at
timestamptz column to personal_notes (NULL = active) plus an index
on (user_id, deleted_at).

Server (src/routes/notes.js):
  GET    /api/notes              now filters deleted_at IS NULL
  GET    /api/notes/trash        new — list trashed items, newest-
                                  deleted first
  DELETE /api/notes/:id          now soft-deletes (sets deleted_at)
  DELETE /api/notes/:id?hard=1   hard-delete, only allowed on items
                                  already in trash (UI bug can't
                                  erase an active note)
  POST   /api/notes/:id/restore  pull a note out of trash
  POST   /api/notes/trash/empty  hard-delete every trashed note for
                                  the user

Frontend (public/components/notes.html + public/js/notes.js +
public/css/styles.css):
  • Sidebar gets two tabs — "Notes" / "Trash (n)" with live count
  • Trash tab shows deleted-at timestamps, Restore + delete-forever
    per row, Empty-trash button at the bottom
  • Active list and trash count refresh in parallel after every
    save / delete / restore
  • Delete button in the editor now says "Move to trash" and uses
    the showConfirm helper (no native dialogs)

Sanitizer swap (public/js/notes.js):
  Replaced the homegrown allowlist walker with DOMPurify (already
  loaded from cdnjs in index.html, used by learningHub.js too).
  Custom HTML sanitizers historically have bypasses; DOMPurify is
  the right primitive.

Tests (test/notes-sanitize.test.js — node:test + jsdom + dompurify
       as new dev deps):
  9 contract tests covering script-tag stripping, inline event
  handlers, img onerror, iframe/object, style attributes, every
  preserved tag in the allowlist, javascript: URI rejection,
  null/undefined input, and nested-script-inside-paragraph. Total
  test count: 37 → 46 passing.

SW cache bumped to pedscribe-v12-notes5.
2026-04-25 01:02:49 +02:00
github-actions[bot]
8c9c03c656 Release v6.52.1 2026-04-24 11:22:36 +00:00
Daniel
2a4269d496 fix(notes): 5 bugs found in post-commit review
1. flushAutosave dropped brand-new unsaved notes.
   The guard was `if (_dirty && _activeId != null)` but _activeId is
   null until the first POST succeeds. So tap-New-Note → type → tap-
   Back went through flushAutosave → skipped → closeToList → lost
   the typed content. saveNote() already handles isNew via POST;
   the guard only needs to check _dirty.

2. beforeunload sendBeacon used wrong HTTP method.
   navigator.sendBeacon is POST-only by spec, but my code used it to
   target PUT /api/notes/:id. Beacons silently hit a 404 route and
   the note didn't save. For brand-new notes the URL resolved to
   /api/notes/undefined. Replaced with fetch({ keepalive: true })
   which browsers queue + ship even across unload, supports PUT,
   and handles POST for new notes correctly.

3. Mobile: empty-state card stacked below the sidebar in list view.
   The mobile media-query hid .notes-reader + .notes-editor when
   data-view="list" but didn't include .notes-empty-state, so the
   big "new note" card appeared below the list on phones. Added
   the missing selector.

4. Delete fallback used window.confirm.
   The `else if (window.confirm(...))` branch in deleteActive was
   a rule violation even as a fallback — feedback_no_native_dialogs
   says no native dialogs anywhere in frontend. Dropped it;
   showConfirm is loaded by app.js before any tab activates so the
   fallback path is unreachable in practice. Also upgraded the
   confirm call to use the danger + confirmText options so the
   modal renders red "Delete" button instead of neutral "Confirm".

5. Recorder kept running after switching tabs or notes.
   Dictating, then tapping another clinical-tools tab (or opening
   another note) left the MediaRecorder active and the mic stream
   open — wasted battery, privacy surprise. Added stopRecording
   (silent=true) to the non-notes branch of tabChanged, to
   startCreate, and to openReader so any in-flight recording
   cancels cleanly when the user moves on.

Minor:
  • Dead "'Saving…' : 'Saving…'" ternary in saveNote simplified.

SW cache bumped to pedscribe-v12-notes4.
2026-04-24 13:22:26 +02:00
github-actions[bot]
a25c36c875 Release v6.52.0 2026-04-24 10:49:31 +00:00
Daniel
2d89f295dd feat(notes): strip explanatory UI copy
Removed the "your note saves as you type" / "encrypted at rest" /
tip-list filler that telegraphs AI-generated code. UI now reads
the way a real app reads — names where names go, no paragraphs
explaining what a button does.

  • Module header: "Notes" — removed the paragraph tagline.
  • Empty state: icon + "New note" button only — removed the
    "Hello 👋" heading, the description, and the three-tip list.
  • Placeholders: "Title" / "Search" — removed the "…" ellipses
    and the "Note title" / "Search notes" verbosity.
  • Status + meta: emptied the "New note — will save automatically
    once you type" meta string and the "This note is empty. Tap
    Edit to add content" reader placeholder.
  • Empty-list copy trimmed to just "No matches" when the search
    filter is active.

SW cache bumped to pedscribe-v12-notes3.
2026-04-24 12:49:22 +02:00
github-actions[bot]
fd658739c3 Release v6.51.0 2026-04-24 10:45:40 +00:00
Daniel
9bb4879be1 feat(notes): read-mode default + Edit toggle + autosave + mobile layout
Four changes landing together so the UX flows properly.

1. Fix voice-generation model error.
   /api/notes/from-voice was passing `req.body.model` (undefined)
   through to callAI, which resolved to LITELLM_DEFAULT_MODEL (empty
   for LiteLLM deployments with no explicit default) → `model=""` →
   LiteLLM 400 "Invalid model name". Server now reads the admin-
   configured `models.default` setting, falls back to the
   LITELLM_DEFAULT_MODEL env var, and only passes a model if one
   resolved. Empty string never reaches the provider.

2. Read mode as the default post-save.
   Opening an existing note or saving a new one now lands on a
   clean, read-only rendering of the body (sanitized HTML with an
   allowlist — p/h2/h3/strong/em/u/s/a/ul/ol/li/blockquote/code/pre).
   Click the "Edit" button to switch to the Tiptap editor. Matches
   the mental model of "notes are documents I review, not drafts I'm
   always editing."

3. Autosave during edit.
   Title-input + Tiptap onUpdate trigger a 1.2-second-debounced save.
   In-flight saves coalesce: if the user types more while a save is
   in progress, a follow-up fires right after it lands so the last
   keystroke never gets stranded. beforeunload uses navigator.
   sendBeacon to best-effort flush on tab close. The manual Save
   button is kept as a "save + switch to reader" shortcut. Ctrl/
   Cmd+S still works in the editor.

4. Mobile layout.
   The two-pane layout collapses to a single-pane view below 900px,
   driven by a data-view attribute on .notes-layout. Back buttons
   appear in the reader + editor heads on mobile to return to the
   list. Desktop layout unchanged (sidebar + right pane always
   visible).

Also:
  • CSS specificity fix — .hidden{display:none} was losing to
    .notes-rec-indicator{display:inline-flex} on source order, so
    the "Recording" indicator was showing when idle. Added explicit
    .notes-rec-indicator.hidden + .notes-voice-bar .btn-sm.hidden
    overrides at higher specificity.
  • Reader-body sanitizer — allowlist of safe tags + attributes;
    <a> links get target=_blank + rel=noopener.
  • SW cache bumped to pedscribe-v12-notes2 so clients pick up the
    new module / component / CSS.
2026-04-24 12:45:30 +02:00
github-actions[bot]
415f67d432 Release v6.50.0 2026-04-24 04:18:56 +00:00
Daniel
3c0de624fc feat(notes): personal notes with rich-text editor + voice dictation
New "Notes" tab under Clinical Tools — a per-user scratchpad that's
explicitly NOT fed into AI prompts (distinct from user_memories).
Two-pane layout: searchable list on the left, rich-text editor with
title + save/edit/delete on the right.

Backend:
  migrations/…_add-personal-notes.js  — personal_notes table
    (id, user_id → users ON DELETE CASCADE, title, body, created_at,
    updated_at) with indexes on user_id + (user_id, updated_at).
  src/routes/notes.js — CRUD + one AI endpoint:
    GET    /api/notes           list, newest-updated first
    GET    /api/notes/:id       fetch one
    POST   /api/notes           create (title + body required)
    PUT    /api/notes/:id       update
    DELETE /api/notes/:id       remove
    POST   /api/notes/from-voice  transcript → { title, body }
                                   via callAI (admin-controlled
                                   provider — never selectable by
                                   the clinician).
    Body + title encrypted at rest via the same cryptoUtil used for
    user_memories; 500-note per-user cap; 200-char title / 50 KB
    body limits.

Frontend:
  public/components/notes.html — empty-state card ("Hello 👋"),
    sidebar list with search, editor head with voice-bar (Dictate /
    Pause / Resume / Stop + live timer + pulse indicator), Tiptap
    body, metadata footer. Uses existing .tp-* toolbar classes.
  public/js/notes.js — lazy-init on first tab activation; Tiptap
    editor built from window.Tiptap (same bundle the Content
    Manager uses); delegated list clicks; Ctrl/Cmd+S to save;
    uses app.js's AudioRecorder + transcribeAudio so the STT
    pipeline is shared. On stop → transcribe → /api/notes/from-
    voice → drop the AI-structured title + body into the editor;
    clinician reviews then saves.
  public/css/styles.css — 70 lines of .notes-* styles (card
    layout, warm empty-state with gradient icon + tips, pulse
    animation for the recording indicator, focus states, hover
    nudges).
  public/sw.js — bump cache from pedscribe-v12 → pedscribe-v12-
    notes1 so clients pick up the new module/component.

Admin-controlled STT provider: the recorder posts its audio blob
to the existing /api/transcribe (Google / LiteLLM / ElevenLabs /
Browser Whisper — whatever admin wired up in Settings). Users
cannot pick the provider from this UI.
2026-04-24 06:18:41 +02:00
Daniel
d71714b65d test(lint): static reference linter — catches dead-code + orphan refs
You were right that Playwright has been catching the easy bugs while
the high-signal bugs (lightbox stranded after the Bedside reorg, PVC
clinically wrong, prod not rebuilt) all had to be caught by you as
the user. Adding a static linter so the class of bug that produced
the lightbox regression fails CI next time instead of the app.

scripts/lint-references.js walks public/js and validates every
getElementById('X') and querySelector('#X') resolves to an id that
is defined SOMEWHERE in the repo — either a static HTML attribute,
a .id = 'X' assignment, or an id="X" substring inside a JS template
string. It also walks HTML for asset references (data-img-src,
<img src>, <audio src>, <link href>) and verifies each root-absolute
path maps to a real file on disk.

Running it on the current tree surfaced two real problems:

1. shadess.js:917 reached for #wv-note-transcript when collecting
   refine source context. The actual id is #wv-transcript (no -note-
   infix — the transcript element is shared across well-visit sub-
   panels). The bug meant a generated well-visit note's Refine call
   silently missed the original transcript as source context; the AI
   still "worked" but with less signal and no error. Fixed.

2. public/js/adminMilestones.js (221 lines) referenced 17 ids that
   were removed a year+ ago in commit 3173ce6 ("Remove milestone
   admin UI, add CMS content refresh button"). That commit dropped
   the HTML but forgot the JS, which has been dead-loaded on every
   page view since. All its addEventListener calls are guarded with
   optional chaining, so nothing errored — just silent cruft.
   Deleted the file and dropped the <script defer> tag from
   index.html.

scripts/e2e.sh runs the linter as a preflight before the Playwright
container starts; a broken reference now fails the suite before any
test even boots.

Allowlist is kept small and prefix-based for the handful of id families
that are built dynamically by JS (bedside em-* sections, BP chart
elements, etc.). When a new component is added, its ids get picked up
automatically by the repo-wide collect() pass; the allowlist rarely
needs to grow.

Suite: 294 passed / 0 failed.
2026-04-23 18:58:38 +02:00
Daniel
abc1a64363 test(e2e): +44 tests — sick visit, hospital course, auth screen,
session persistence, per-tab model selector

Brings detailed coverage to sections that were previously only smoke-
tested:

- sickvisit-workflow.spec.js: generate → mocked note, refine bar
  round-trip, load popover, New button clears demographics + transcript.
- hospitalcourse-workflow.spec.js: fill H&P → generate → mocked
  narrative renders via /api/generate-hospital-course, refine updates
  text, load popover open/close.
- auth-screen.spec.js: unauthenticated landing visible, login form
  structure, forgot-password swap + return, register link is
  intentionally display:none on this instance (pinned), register form
  DOM still wired correctly if the link is manually unhidden, reg-
  password has minlength=8 + type=password.
- session-persistence.spec.js: clear cookie simulates logout (UI login
  is gated by Turnstile which can't be completed in the e2e container);
  re-login via loginAs restores the last tab + sub-pill via localStorage.
- model-selector.spec.js: tab-model-select dropdowns render with >0
  options across 7 tabs.

Fixture corrections:
- /api/sick-visit/note and /api/well-visit/note were not being mocked
  at all — the wrong /api/generate-sick-visit pattern was intercepting
  nothing, so tests fell through to the real AI backend. Both now have
  correct patterns and response shapes (sick-visit returns `note`,
  well-visit note returns `note`).
- /api/generate-hospital-course response key updated from `narrative`
  to `hospitalCourse` to match what the frontend actually reads.

wellvisit-workflow: the Visit Note test now asserts a concrete
waitForResponse on /api/well-visit/note + text render, instead of the
previous "hit either endpoint" fallback.

Suite: 294 passed / 0 failed in 5m30s.
2026-04-23 18:58:38 +02:00
Daniel
9c53e19d29 fix(pe-guide): remove PVC entry from cardiac sounds library
PVCs are an ECG / rhythm finding, not a routine auscultation sample —
what you actually hear on the stethoscope is an irregular rhythm with a
compensatory pause, which depends on the underlying rate and is not
teachable from a canned audio clip. The card was also backed by a
synthesized sound, not a real recording. Removing both the card and
the pvc.ogg asset.
2026-04-23 18:58:38 +02:00
Daniel
1b209b5eb7 fix(nav): move image lightbox to index.html so NRP + seizure pathways
open from the Bedside tab

The #img-lightbox overlay markup was sitting at the bottom of
calculators.html. Before the reorg it was fine — the calculators tab
was always the only home for bedside, so by the time a user clicked
the seizure or NRP pathway button the lightbox HTML was guaranteed to
be in the DOM. After promoting Bedside to its own tab, a user can
open Bedside -> Seizures without having visited Calculators first;
the lightbox JS's getElementById('img-lightbox') then returns null
and the click silently no-ops.

Moved the overlay markup to the bottom of index.html so it exists
from page load regardless of which tab has been lazy-loaded. The e2e
harness gets a duplicate copy so the existing lightbox smoke test
keeps working.

Added a regression test for NRP (bedside-smoke.spec.js:141) to catch
any future breakage — the prior seizure-only test didn't exercise the
second pathway button and so the neonatal/NRP path had never been
clicked in CI.

Suite: 252 passed / 0 failed.
2026-04-23 18:58:38 +02:00
Daniel
2e517a67a9 feat(ui-state): persist sub-pill selections across reload + sign-out
Tab-level choice (ped_last_tab) already survived sign-out/in via
localStorage, but sub-pill and sub-tab selections inside a loaded tab
lived only in memory — they reset to defaults after a reload or
browser restart. Now the following are persisted under the ped_ui/
namespace:

  - Calculators nav pill (BP / BMI / GCS / …)
  - Bedside sub-pill (neonatal / airway / …)
  - Well Visit sub-tab (byvisit / milestones / shadess / note)
  - Physical Exam Guide age group + system

Implementation:
- Added public/js/ui-state.js — a ~30-line window.UIState wrapper
  around localStorage with a ped_ui/ prefix and try/catch around both
  read and write (Safari private mode + quota errors silently no-op).
- Each tab's click handler now also calls UIState.set; each tab's
  init path calls UIState.get and replays the saved value through
  the same function a click would call — so there is exactly one
  code path for "show this selection", whether it came from the user
  or from a restore. For Bedside, the restore additionally listens
  for tabChanged so the lazy-loaded HTML is guaranteed to exist by
  the time we re-activate the pill.

Tests:
- e2e/tests/ui-state-persistence.spec.js — 5 specs × 2 viewports =
  10 tests. Each clicks the feature, reloads the page, and asserts
  the same pill / subtab / dropdown value is still active. Catches
  any future regression in the persistence wiring.
- e2e/tests/soap-hospital-workflow.spec.js — fills SOAP transcript,
  generates via mocked AI, clears, opens/closes load popovers; also
  smoke-tests the Hospital Course save-bar.

Suite: 250 passed / 0 failed (+ 20 over the last run).
2026-04-23 18:58:38 +02:00
Daniel
8d97b13bf7 feat(nav): promote Bedside to its own tab; reorganise sidebar sections
Bedside is now a top-level tab instead of a sub-pill inside Calculators —
it's the highest-traffic emergency reference in the app and deserves a
one-click entry. Same DOM structure and JS modules; only the container
moved.

Sidebar reorg:
- Notes: Hospital Course, Chart Review, SOAP Note, Well Visit, Sick Visit
  (Well Visit + Sick Visit relocated from the old "Pediatric" group —
  they're clinical note workflows, not pure reference tools).
- Section rename: "Pediatric" → "Clinical Tools". The section now holds
  Vaccine Schedule, Catch-Up Schedule, Physical Exam Guide, Bedside,
  Calculators, Pagers & Extensions, Learning Hub, Content Manager — mix
  of reference tables + active calculators + utilities, none strictly
  pediatric. "Clinical Tools" reads naturally for the combined set.

Layout changes:
- calculators.html: dropped 480 lines of bedside panel + the Bedside
  nav-pill. The shared age→weight estimator moved with it.
- bedside.html: new component file, contains the full bedside card +
  the age→weight estimator prepended.
- index.html: added bedside-tab section, sidebar restructured.
- e2e-harness.html: renders calculators + bedside side-by-side (not the
  old calc-tab→bedside-pill dance) so the bedside smoke suite still
  works without auth. e2e-bootstrap fetches both with a cache-buster.
- bedside-smoke.spec.js: removed the now-obsolete calc-nav-pill click
  from each test.

Tab persistence is unchanged — ped_last_tab already survives sign-out,
and the lazy-load cache keeps sub-pill state across navigation within a
session. Persistence across browser restart for sub-pills is a separate
follow-up.
2026-04-23 18:58:38 +02:00
Daniel
3884bf673b test(e2e): +120 tests across 8 new specs; baseline fixes
8 new spec files covering sections previously only smoke-tested:
- ai-endpoints-contract.spec.js  — hits 8 real AI endpoints via request
  context and fails if the response leaks TypeError / ReferenceError /
  'Cannot read properties of undefined' / 'is not defined' / 'is not a
  function'. This is the class of bug that shipped the PE-narrative
  regression to prod because every page-level mock prevented the real
  handler from running.
- encounter-workflow.spec.js — generate HPI, refine, clear transcript.
- encounter-save-load.spec.js — save draft, load popover, repopulate.
- wellvisit-workflow.spec.js — byvisit, milestones, SSHADESS (12+
  reveal), visit note.
- vaxschedule-content.spec.js — schedule + catch-up panels populate
  beyond "Loading".
- chart-review-workflow.spec.js — generate + load popover.
- learning-tab.spec.js — search filter, category pills, feed.
- settings-faq-dictation.spec.js — voice/password/2FA/Nextcloud
  sections, FAQ expand/collapse, dictation generate flow.

Baseline fixes:
- Added CORS_ORIGINS + API_RATE_LIMIT_MAX env overrides so the e2e
  container accepts the browser's Origin header and can absorb the
  full suite's API traffic without tripping the 200/min guard.
- Server's /api/ rate limit is now configurable via
  API_RATE_LIMIT_MAX (default stays 200).
- extensions-crud: replaced native page.on('dialog') listeners with
  #confirm-modal-ok clicks (we moved off native confirm()).
- pe-guide-smoke + extensions-crud: mobile viewport opens the hamburger
  before clicking sidebar tabs.
- fixtures.js: /api/refine mock uses 'refined' (real API shape), not
  'content'. /api/chart-review replaced with /api/generate-chart-review.

Suite: 230 passed / 0 failed in 4m36s.
2026-04-23 18:58:38 +02:00
Daniel
015eaf9945 feat(pe-guide): real lung recordings for normal/rhonchi/pleural-rub;
drop grunting + dead synth module

Three lung sounds that were Web-Audio syntheses now play real clinical
recordings sourced from the HLS-CMDS manikin dataset (MIT license):

- normal-vesicular.ogg
- rhonchi.ogg
- pleural-rub.ogg

Dropped expiratory grunting from the library entirely — no
openly-licensed clinical recording located across Wikimedia, Freesound
CC0, SPRSound, Pixabay, Internet Archive, or Littmann/EasyAuscultation
(all proprietary). Card is honest by omission rather than hiding a
synth behind a Play-only UI.

All seven remaining entries now use the same native <audio controls>
player (pause, seek, volume). The synth fallback branch in
renderSoundCard, the stopAllExcept synth reset loop, the script tag,
and the entire public/js/respiratorySounds.js (332 lines of Web Audio)
are removed since nothing references them anymore.
2026-04-23 18:58:38 +02:00
Daniel
02e7281e52 fix(pe-guide): correct route imports (prod 500 regression)
The route destructured PROMPTS/INJECTION_GUARD/wrapUserText from
../utils/prompts, but PROMPTS is the module's default export and the
other two live in ../utils/promptSafe. All three resolved to undefined,
so every /api/generate-pe-narrative request crashed with
"Cannot read properties of undefined (reading 'peGuideNarrative')"
and the client surfaced "Request failed" for PE Guide narrative and
summary generation. Split the require into the two-line form that
every other AI route already uses.
2026-04-23 18:58:38 +02:00
github-actions[bot]
fda5b12143 Release v6.20.0 2026-04-22 20:57:21 +00:00
Daniel
8cfa07dcf5 feat(pe-guide): unified single-play + remove badges; fix(e2e): shared fixture + raised login limit
User-visible changes:
- Removed the REAL / SYNTH badge from each sound card. User feedback:
  "ridiculous". Cards now just show the sound title + description +
  player, no distinction beyond the player type (native <audio controls>
  for recordings, play/stop/progress bar for synth).
- Removed the "real recordings; synth labelled SYNTH" subtitle from
  the sounds library header.
- Single-playback policy across the whole PE Guide: when any sound
  starts (audio or synth), every other playing sound stops. Covers:
  audio → audio (pause the previous), audio → synth, synth → audio,
  synth → synth. Listeners attach on each .pe-audio 'play' event and
  on every synth play-button click.

E2E infrastructure fixes (for the test failures we hit):
- auth-gated-smoke.spec.js now imports test + loginAs from the shared
  fixtures.js so the token cache is unified across every spec. Without
  this, each spec file's module-scoped _tokenCache multiplied logins
  and hit the 10/15min rate limit.
- server.js: /api/auth/login rate limit is now configurable via
  LOGIN_RATE_LIMIT_MAX env var (default 10, prod unchanged).
- docker-compose.e2e.yml: LOGIN_RATE_LIMIT_MAX="500" so Playwright's
  two-project (chromium + mobile-chrome) multi-worker runs can do
  their logins without tripping the cap. Prod container unaffected.
- fixtures.js console.error allowlist expanded to suppress known
  non-bugs: Cross-Origin-Opener-Policy warnings on http:// e2e
  server, transient 401/403/404/503 resource loads, ERR_BLOCKED_BY_CLIENT.
2026-04-22 22:57:11 +02:00
github-actions[bot]
b80a91e40a Release v6.19.0 2026-04-22 19:51:04 +00:00
Daniel
2913b09abd feat(pe-guide): 7 cardiac sounds, APTM image full-width + tap-to-zoom, synth stop/progress
Three user-flagged fixes:

1. Cardiac sounds library expanded from 3 to 7 (from Wikimedia Commons
   heart-sounds + heart-murmurs subcategories). All real recordings:
   - Normal (61 bpm)                 [existing]
   - Infant heartbeat                [new — pediatric reference]
   - VSD                              [existing]
   - Mitral valve prolapse            [existing]
   - Still's murmur in a toddler      [new — classic innocent murmur]
   - Functional murmur (adult female) [new — benign flow murmur]
   - PVCs                             [new — arrhythmia]
   All with native <audio controls> (play/pause/seek/elapsed/total
   work on desktop AND mobile for free).

2. APTM diagram is now full-width on every device, no longer sharing
   row space with the legend on mobile:
   - Image always on its own row, max-width:420px, centered
   - Wrapped in an <a href target="_blank"> — tap/click opens the PNG
     full-size in a new tab where browser pinch-zoom works natively
   - "Tap to open full-size" hint line under the image
   - Legend below uses auto-fit minmax(min(100%,260px),1fr) so it stacks
     on narrow viewports without cramping

3. Synth sounds (rhonchi, pleural rub, grunting, normal vesicular — all
   Web-Audio-API generated, no native controls) now have:
   - Play button → kicks off playback and hides itself
   - Stop button appears, lets user terminate early
   - Progress bar animates over 3.2 s, resets at end
   - Only one synth sound plays at a time (clicking another stops the
     previous)
2026-04-22 21:50:54 +02:00
github-actions[bot]
bf62d15ad6 Release v6.18.0 2026-04-22 19:10:45 +00:00
Daniel
9bbfb4ce83 feat(pe-guide): native audio controls + cardiac sounds library + mobile layout
Three user-flagged issues fixed together:

1. Mixed real/synth audio was labelled only "synthesised samples" — misleading
   since wheeze, stridor, fine+coarse crackles are real Wikimedia recordings.
   Now each sound card has a REAL or SYNTH badge and the library header
   reads: "real recordings where available; synthesised approximations
   labelled SYNTH".

2. No murmur sounds in the CV section. Added a Cardiac sounds library
   between the APTM diagram and the innocent-murmur panel:
     - Normal heart sounds (S1, S2) — 61 bpm reference
     - Ventricular septal defect (VSD) — harsh holosystolic at LLSB
     - Mitral valve prolapse (MVP) — mid-systolic click + late systolic
   All 3 are real recordings from Wikimedia Commons.

3. No pause / stop / duration controls. Replaced the synth-only play
   button with a native <audio controls> element for every real
   recording — gives play, pause, seek, elapsed/total time, volume
   for free on desktop AND mobile (browser-native, accessibility-
   compliant, consistent with platform conventions). Synth sounds
   (rhonchi, pleural rub, grunting, normal vesicular) keep the one-
   shot play button since they\'re Web-Audio-API generated and don\'t
   support seeking.

Mobile layout:
- The APTM diagram + legend was hard-coded 2-col (minmax(280px,1fr) 1fr)
  which could overflow narrow screens. Switched to repeat(auto-fit,
  minmax(280px,1fr)) — stacks to 1-col below ~580 px viewport.
- Refactored sound-library + APTM render into helpers (renderSoundCard,
  renderSoundsLibrary, TWO_COL_GRID constant) to reduce duplication.
2026-04-22 21:10:36 +02:00
github-actions[bot]
7d860c5287 Release v6.17.1 2026-04-22 19:04:54 +00:00
Daniel
b7a2e15107 fix(entrypoint): docker-compose env overrides win over OpenBao-fetched values
The previous entrypoint unconditionally exported every key from
kv/ped-ai/prod. This broke the e2e container, which needs
TURNSTILE_SECRET_KEY="" and SMTP_HOST="" set via docker-compose
environment block so login works without bot challenge and register
auto-verifies. OpenBao's real values were overriding those empties,
re-enabling Turnstile and email on e2e.

Fix: before the OpenBao fetch, snapshot every env var name already
defined (env_file + environment: block). During the export loop,
skip any OpenBao key that's already in the snapshot. Docker-compose
wins, OpenBao fills in the rest.

Impact:
- Prod container: no change (env_file only has OPENBAO_* bootstrap
  vars, which aren't in the KV payload anyway)
- E2e container: TURNSTILE_SECRET_KEY="" and SMTP_HOST="" preserved
  even when the image is rebuilt from the current source tree
- Any future per-container override via docker-compose environment:
  block just works

Log line now reports counts: "applied N secrets; M already set by
docker (kept override)".
2026-04-22 21:04:46 +02:00
Daniel
abb67bd03a test(e2e): PE Guide smoke — 8 tests covering all systems + age-group coverage
Uses the shared fixture so pageerror + console.error fail the test —
would catch any regression of the bug-class that shipped the SSO
ReferenceError. All tests log in as the seeded e2e user and drive the
real UI.

Coverage:
- tab loads with empty-state before age selected
- MSK (default) renders with scales + steps
- switch to Neuro shows MRC scale + teaching pearl
- Respiratory shows 8-sound library with play buttons + RR scale
- Cardiovascular shows APTM image (naturalWidth > 0 — actual network
  fetch confirmed), all 5 landmark letters, innocent-murmur panel,
  7 "S" criteria footer
- parametrised: every age group × {resp, cv} must NOT show "no data",
  must have ≥ 1 step (catches the regression Daniel just flagged)
- step toggle cycles Normal → Abnormal → Skip with visual state change
  and note-field show/hide
- grading scales <details> is collapsible and expands on click
2026-04-22 21:03:13 +02:00
github-actions[bot]
8cabe7da4b Release v6.17.0 2026-04-22 19:00:54 +00:00
Daniel
8be268df6a feat(pe-guide): real audio, innocent-murmur panel, APTM image, all-ages resp+CV
Four changes rolled together:

1. REAL AUDIO from Wikimedia Commons (CC BY-SA 3.0, attribution to follow
   in privacy policy per Daniel). Embedded in /public/audio/ — synthesis
   stays as fallback for sounds not available from Wikimedia.
   respiratorySounds.js now tries the real OGG first; falls back to Web
   Audio synthesis if file missing.

2. REAL APTM IMAGE from Daniel's Nextcloud share, placed at
   /public/images/pe-guide/aptm.png (134 KB PNG). Replaces the inline SVG.
   Kept the side legend with A/P/E/T/M colour-coded points.

3. INNOCENT MURMUR REFERENCE PANEL below the APTM diagram with the 5
   classic innocent murmurs (Still's, pulmonary flow, venous hum, carotid
   bruit, PPS) — age, location, character, confirming maneuver — plus
   the 7 "S" criteria summary.

4. ALL-AGE RESP + CV DATA. Before: only adolescent. Now every age group
   has age-appropriate resp + cv content (newborn through adolescent).
   Newborn: Silverman, pre/postductal sats, duct-dependent lesion screen.
   Infant: bronchiolitis, CHF diaphoresis, VSD, early CHD.
   Toddler: croup/FB/epiglottitis, innocent murmur peak age.
   Preschool + school-age: adult-pattern transition, sports screening.
2026-04-22 21:00:42 +02:00
github-actions[bot]
1aa785068b Release v6.16.0 2026-04-22 18:15:16 +00:00
Daniel
316a5e0338 feat(pe-guide): Cardiovascular system with APTM auscultation SVG
Fourth PE system added. Adolescent cardiovascular exam at the same
teaching-focused depth as respiratory/neuro: five components with
significance + pearls + detailed step methods + watch-for blocks.

APTM auscultation diagram (new, inline SVG, no image file):
- Stylised anterior chest with sternum, clavicles, ICS level lines,
  left mid-clavicular line
- Five colour-coded landmarks:
   A  Aortic    — 2nd ICS right sternal border
   P  Pulmonic  — 2nd ICS left sternal border
   E  Erb's pt  — 3rd ICS left sternal border
   T  Tricuspid — 4th ICS left sternal border
   M  Mitral    — 5th ICS mid-clavicular (apex)
- Side legend: location + what to listen for at each point
- Patient's-left / patient's-right labels to prevent mirror-image
  confusion

CV-specific grading scales (3 new entries in SCALES):
- Murmur grade Levine 1–6
- Pulse amplitude 0–4+
- Capillary refill time thresholds

CV components:
1. Inspection (general appearance, central/peripheral cyanosis,
   clubbing with Schamroth sign, precordial bulge, visible apex, JVP)
2. Palpation (apex position + character, parasternal heave, thrills
   at all 5 points, peripheral pulses upper + lower, radio-femoral
   delay for coarctation)
3. Auscultation — approach (positioning, diaphragm vs bell, systematic
   walk through all 5 points, left lateral decub for MS, leaning
   forward for AR)
4. Auscultation — heart sounds + murmurs (S1, S2 split, S3/S4 gallops,
   murmur characterisation by timing/location/radiation/character,
   Levine grading, dynamic maneuvers, innocent-murmur "7 S" pearl)
5. Peripheral vascular (four-limb BP for coarctation, radio-femoral
   delay, bounding pulse differential)

UI wiring:
- renderSystem() emits APTM diagram card at the top of cv system,
  before scales. Two-column layout: SVG on left, legend on right.
- accentMap/iconMap/labelMap extended with cv = rose accent,
  heart-pulse icon, "Cardiovascular" label
- New sub-tab pill in pe-guide.html
2026-04-22 20:15:08 +02:00
github-actions[bot]
8efc4e9a56 Release v6.15.0 2026-04-22 18:10:04 +00:00
Daniel
83a78fa8cd feat(pe-guide): Respiratory system with synthesized sounds library
Third PE system added. Adolescent respiratory fully fleshed out with
the same teaching-focused depth as neuro: overview, grading scales,
per-component significance + pearls, detailed step methods with HOW
and NORMAL labels, and a watch-for red-flag block.

New respiratorySounds.js uses the Web Audio API to synthesize 8 classic
breath sounds on demand — no network, no audio files, no licensing:
  - Normal vesicular
  - Wheeze (two-partial + vibrato, filtered sawtooth)
  - Stridor (inspiratory, bandpass-filtered sawtooth sweep)
  - Fine crackles (dense brief high-freq noise bursts, late inspiration)
  - Coarse crackles (sparser, longer, lower-freq bursts)
  - Rhonchi (low-pitched warbled sawtooth, expiratory)
  - Pleural friction rub (bandpass noise, biphasic)
  - Expiratory grunting (square-wave short grunts)

Sounds are synthesised approximations intended to teach the pattern
(what makes a wheeze a wheeze vs a stridor). Labelled as such in the UI.
Controls: one play at a time, auto-stop ~3s.

Respiratory-specific grading scales:
  - RR by age (WHO tachypnea cutoffs)
  - Pulse ox (SpO2) with hypoxemia thresholds
  - Silverman–Andersen (neonatal retractions, 0–10)
  - Westley croup severity score

Components in adolescent respiratory:
  1. Inspection (observation-first — RR, pattern, WOB, audible sounds,
     chest shape, colour, clubbing with Schamroth sign)
  2. Palpation (trachea, expansion symmetry, tactile fremitus,
     tenderness, subcutaneous emphysema)
  3. Percussion (technique + systematic zones + cardiac/hepatic
     dullness + diaphragmatic excursion)
  4. Auscultation — normal breath sounds (vesicular, bronchovesicular,
     bronchial) with systematic side-to-side comparison
  5. Auscultation — adventitious sounds with per-sound listen buttons
     linking directly to the sounds library
  6. Special maneuvers — bronchophony, egophony, whispered pectoriloquy

Older age groups (newborn through school-age) will get their own resp
blocks incrementally — v1 focused on adolescent for the quality bar.

UI: new sub-tab pill "Respiratory" with lung icon, sky-blue accent.
renderSystem refactored to use accent/icon maps instead of per-system
if/else — scales to future systems (cardiovascular coming next).
2026-04-22 20:09:54 +02:00
github-actions[bot]
4e1a870fe2 Release v6.14.0 2026-04-22 17:35:12 +00:00
Daniel
33bfc0bfbc feat(pe-guide): teaching-focused redesign — grading scales, pearls, significance
User feedback: the exam steps were too generic (e.g. "Shoulder abduction
— 5/5 bilaterally" never explained what 5/5 means or HOW to test it).
The guide needs to serve as a teaching tool, not just a checkbox list.

Three changes:

1. GRADING SCALES reference card (new). Collapsible panel at the top of
   each system showing the relevant scales:
   - Neuro: MRC strength (0-5), DTR (0-4+), Plantar response
   - MSK: Scoliometer ATR, Beighton hypermobility score
   Each scale shows the grade AND its clinical meaning in a compact
   table. No more orphan "5/5 bilaterally" without definition.

2. Per-component SIGNIFICANCE + PEARL fields (optional). Adolescent
   neuro components enriched with:
   - Significance: one-line clinical relevance (what this component is
     actually for — what pathologies it detects)
   - Teaching pearl: a Hutchison/Bates/Nelson-style tip that helps the
     learner see past the mechanics to the reasoning
   Visually distinct — pearl gets a warm amber accent, significance is
   a crosshair icon under the name.

3. Method strings REWRITTEN for every adolescent strength step. Before:
   "Shoulder abduction — 5/5 bilaterally". After: "Patient abducts both
   arms to 90°. Examiner pushes down on each arm just above the elbow
   while patient resists. Compare sides. — Holds against full resistance
   — MRC 5/5 bilaterally". Same treatment for all 14 strength steps,
   all 8 DTR steps, and tone/pronator-drift.

UI redesign:
- Accent bars on cards (cyan for MSK, purple for neuro) for visual
  anchor
- Numbered step circles instead of "1." prefix
- HOW / NORMAL label badges on each step
- Watch-for block with red left-border for red-flag grouping
- System-level header with icon (bone for MSK, brain for neuro)

Other age groups (newborn through school-age) keep the old data shape
(steps without pearls) — they still render correctly, just without the
pearl/significance blocks. Enriching them is an incremental follow-up.
2026-04-22 19:35:03 +02:00