<?php

declare(strict_types=1);

require dirname(__DIR__) . '/vendor/autoload.php';
require __DIR__ . '/fixtures/CompleteTcmCase.php';

use app\adminapi\service\AiRequiredSource;
use app\adminapi\service\TcmClinicalFactStateGuard;
use app\adminapi\service\TcmEvidenceGuard;
use app\adminapi\service\TcmClinicalReportStream;
use app\adminapi\logic\tcm\PatientAiReportLogic;

$failures = [];
$assertions = 0;
function factStateExpect(bool $condition, string $message): void
{
    ++$GLOBALS['assertions'];
    if (!$condition) $GLOBALS['failures'][] = $message;
}
function factStateCode(array $result, string $code): bool
{
    return in_array($code, array_column($result['issues'], 'code'), true);
}
function factStateCheck(array $ledger, string $text, bool $valid, string $label, string $code = ''): void
{
    $result = TcmClinicalFactStateGuard::validate($ledger, $text);
    factStateExpect($result['valid'] === $valid, $label . ': ' . json_encode($result, JSON_UNESCAPED_UNICODE));
    if ($code !== '') factStateExpect(factStateCode($result, $code), $label . ': expected ' . $code);
}
function factStateStreamCheck(array $ledger, string $text, bool $valid, string $label, string $code = '', string $forbidden = ''): void
{
    factStateCheck($ledger, $text, $valid, $label, $code);
    $visible = '';
    $stream = new TcmClinicalReportStream($ledger, static function (string $delta) use (&$visible): bool {
        $visible .= $delta;
        return true;
    });
    foreach (mb_str_split($text . "\n\n", 2, 'UTF-8') as $chunk) {
        if (!$stream->push($chunk)) break;
    }
    $finished = $stream->finish();
    factStateExpect($finished === $valid && $stream->rejected() === !$valid, $label . ': stream result matches validation');
    if ($valid) factStateExpect($visible === $text . "\n\n", $label . ': accepted source bytes are preserved');
    else factStateExpect(!str_contains($visible, $forbidden !== '' ? $forbidden : $text), $label . ': rejected observation never reaches the callback');
}

$current = ['id' => 51, 'diagnosis_date' => '2026-10-23', 'chief_complaint' => '气短', 'present_illness' => '活动后气短，无胸痛；未记录固定刺痛或耳鸣。',
    'tongue' => '舌淡红，苔少；无黄腻苔、紫暗或瘀斑。', 'pulse' => '脉细弱，按之无力；不浮、不滑。'];
$ledger = TcmClinicalFactStateGuard::build($current);
factStateExpect(count(array_filter($ledger['assertions'], static fn (array $row): bool => $row['state'] === 'unknown')) === 2,
    'unknown list items are individually indexed without losing source text');
factStateExpect(in_array('positive', array_column($ledger['assertions'], 'state'), true)
    && in_array('negative', array_column($ledger['assertions'], 'state'), true), 'all three explicit source states coexist');
factStateCheck($ledger, '活动后气短。已记录“无胸痛”；固定刺痛或耳鸣未记录。', true, 'positive, explicit negative and unknown remain distinct');
factStateCheck($ledger, '无固定刺痛。', false, 'unknown is not an observed negative', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($ledger, '无耳鸣。', false, 'enumerated unknown is not an observed negative', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($ledger, '患者存在固定刺痛。', false, 'unknown is not a positive observation', 'UNKNOWN_TO_POSITIVE');
factStateCheck($ledger, '未见活动后气短。', false, 'recorded positive is not negative', 'POSITIVE_TO_NEGATIVE');
factStateCheck($ledger, '患者有胸痛。', false, 'recorded negative is not positive', 'NEGATIVE_TO_POSITIVE');
factStateCheck($ledger, '舌苔少而非腻。', false, 'a narrower negated compound cannot exclude the whole attribute', 'NEGATION_SCOPE_WIDENED');
factStateCheck($ledger, '无黄腻苔，舌无紫暗或瘀斑。', true, 'exact qualified source negation remains usable');
factStateCheck($ledger, '无黄腻。', true, 'omitting only the repeated object noun keeps its adjective scope');
factStateCheck($ledger, '皮肤未见异常皮疹。', false, 'an explicitly claimed physical negative needs a source even without an unknown label', 'NEGATIVE_NOT_IN_SOURCE');
factStateCheck($ledger, '肢体无颤抖或拘挛。', false, 'generic unsupported observed negatives are not invented to fill examination headings', 'NEGATIVE_NOT_IN_SOURCE');
factStateCheck($ledger, '若出现固定刺痛，应重新评估。', true, 'hypothetical future symptom is not asserted to exist');
factStateCheck($ledger, '请补问固定刺痛或耳鸣，不能把未记录视为无。', true, 'collection advice is not an observed negative');
factStateCheck($ledger, '当前无足够证据支持血瘀。', true, 'absence of evidence is not absence of a patient symptom');
factStateCheck($ledger, '因寒热属性不显，不宜把大苦寒清热、辛温助阳作为当前主方向。', true,
    'qualitative interpretation does not turn a treatment list into observed negative findings');
factStateCheck($ledger, '脉细弱，按之无力；不浮、不滑。', true, 'lexical force adjective is not a separate clinical absence');
factStateCheck($ledger, '脉弦滑有力。', false, 'a new explicit pulse feature cannot be invented', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE');
factStateCheck($ledger, '舌质红绛，苔黄腻。', false, 'new or polarity-reversed tongue features are rejected', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE');
factStateCheck($ledger, '脉弦、数尚未记录。', true, 'new pulse feature names can remain explicitly unknown');
factStateCheck($ledger, '结合语声低微、脉细弱按之无力，说明现有依据。', true, 'ordinary 结合 and voice 低微 do not invent pulse 结 or 微');
factStateCheck($ledger, '若后续脉弦滑、舌红绛，应重新辨证。', true, 'conditional future examinations are not current findings');
factStateCheck($ledger, '患者有轻微胸痛。', false, 'a qualified positive still conflicts with broad explicit source absence', 'NEGATIVE_TO_POSITIVE');
factStateStreamCheck($ledger, '本次无固定刺痛，若后续不适应复诊。', false,
    'a conditional tail cannot exempt an actual earlier patient assertion', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($ledger, '无固定刺痛，可作为鉴别依据。', false,
    'an evidence tail cannot exempt an actual earlier patient assertion', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($ledger, '无固定刺痛是鉴别依据。', false,
    'an evidence word inside the same part cannot exempt a patient assertion', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($ledger, '无固定刺痛，无专门描述。', false,
    'a later missing-description phrase cannot exempt the earlier patient negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($ledger, '固定刺痛须补问。', true, 'a postfix collection requirement is not a positive observation');
factStateStreamCheck($ledger, '本次不单凭病名选方。', true, 'a reasoning policy is not a physical negative');
factStateStreamCheck($ledger, '不移作闻诊所见。', true, 'an attribution policy is not a physical negative');
factStateStreamCheck($ledger, '若出现固定刺痛，应重新评估。', true, 'a true hypothetical is still not a patient observation');
factStateStreamCheck($ledger, '当前无足够证据支持血瘀。', true, 'pure absence of evidence remains a valid uncertainty statement');
$allergyUnknown = TcmClinicalFactStateGuard::build($current + ['allergy_history_text' => '未记录']);
factStateStreamCheck($allergyUnknown, '过敏史：无药物过敏史。', false, 'Chinese allergy labels retain field-level unknown', 'UNKNOWN_TO_NEGATIVE', '无药物过敏史');
factStateStreamCheck($allergyUnknown, '过敏史：无。', false, 'a standalone absent value cannot erase a field unknown', 'UNKNOWN_TO_NEGATIVE', '无');
factStateStreamCheck($allergyUnknown, "过敏史：\n\n无。", false, 'a paragraph break cannot separate an unknown field from its false absent value', 'UNKNOWN_TO_NEGATIVE', '无');
factStateStreamCheck($ledger, '无药物过敏史。', false, 'a missing allergy field is unknown rather than a negative', 'UNKNOWN_TO_NEGATIVE', '无药物过敏史');
$examUnknown = TcmClinicalFactStateGuard::build(array_replace($current, ['tongue' => '未记录', 'pulse' => '不详']));
factStateStreamCheck($examUnknown, '舌正常。', false, 'a short tongue alias cannot turn unknown into normal', 'UNKNOWN_TO_POSITIVE', '正常');
factStateStreamCheck($examUnknown, '脉正常。', false, 'a short pulse alias cannot turn unknown into normal', 'UNKNOWN_TO_POSITIVE', '正常');
factStateStreamCheck($examUnknown, "舌：\n\n正常。", false, 'a tongue title and a value across paragraphs remain bound', 'UNKNOWN_TO_POSITIVE', '正常');
factStateStreamCheck($examUnknown, "### 脉象\n\n正常。", false, 'a Markdown field title also retains its value state', 'UNKNOWN_TO_POSITIVE', '正常');
factStateStreamCheck($allergyUnknown, '过敏史：未记录。', true, 'a truthful unknown field is accepted');
factStateStreamCheck($allergyUnknown, '无药物过敏史记录。', true, 'absence of an allergy record is not an observed absence of allergy');
factStateStreamCheck($allergyUnknown, '过敏史：没有记录。', true, 'a field may explicitly state that its record is unavailable');
factStateStreamCheck($allergyUnknown, '无论药物过敏史如何，均需核实。', true, 'regardless-of wording is not an observed negative');
factStateStreamCheck($examUnknown, "舌：\n\n未记录。", true, 'a truthful unknown remains accepted across paragraphs');
$allergyDenied = TcmClinicalFactStateGuard::build($current + ['allergy_history_text' => '本次询问无已知药物过敏史']);
factStateStreamCheck($allergyDenied, '本次询问无已知药物过敏史。', true, 'an explicitly recorded denial is not recast as missing');
factStateStreamCheck($allergyDenied, "过敏史：\n\n无。", true, 'an explicitly denied history can retain its original field meaning');
$fieldDenied = TcmClinicalFactStateGuard::build($current + ['allergy_history_text' => '否认']);
factStateStreamCheck($fieldDenied, '过敏史：无。', true, 'an explicit denial retains the context of its history field');
$fieldUnknownWithAdvice = TcmClinicalFactStateGuard::build($current + ['allergy_history_text' => '本次过敏史未记录，已告知复诊核实。']);
factStateStreamCheck($fieldUnknownWithAdvice, '过敏史：无。', false,
    'an administrative instruction does not turn an unknown history field into a recorded finding', 'UNKNOWN_TO_NEGATIVE', '无');
factStateStreamCheck($ledger, '家族史：无。', false, 'a missing family history is also unknown', 'UNKNOWN_TO_NEGATIVE', '无');
factStateStreamCheck($ledger, '手术史：无。', false, 'a missing surgery history is also unknown', 'UNKNOWN_TO_NEGATIVE', '无');
$familyDenied = TcmClinicalFactStateGuard::build($current + ['family_history_text' => '否认']);
factStateStreamCheck($familyDenied, '家族史：无。', true, 'a clear text denial alias is preserved without interpreting a numeric code');
$emptyAliasDenied = TcmClinicalFactStateGuard::build($current + ['allergy_history' => '否认', 'allergy_history_text' => '']);
factStateStreamCheck($emptyAliasDenied, '过敏史：无。', true, 'an empty display alias cannot hide an explicit raw field denial');
$surgeryUnknown = TcmClinicalFactStateGuard::build($current + ['surgery_history_text' => '未记录']);
factStateStreamCheck($surgeryUnknown, "手术史\n\n无。", false, 'a text alias preserves unknown across a field heading', 'UNKNOWN_TO_NEGATIVE', '无');

$qualified = TcmClinicalFactStateGuard::build(['present_illness' => '无明显腹胀；未记录皮疹或手麻。']);
factStateCheck($qualified, '无腹胀。', false, 'removing a degree qualifier widens the negative', 'NEGATION_SCOPE_WIDENED');
factStateCheck($qualified, '无明显腹胀。', true, 'preserved degree qualifier is accepted');
factStateCheck($qualified, '没有皮疹。', false, 'different symptoms and negation wording use the same generic rule', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($qualified, '不伴手麻。', false, 'generic alternative negation wording is checked', 'UNKNOWN_TO_NEGATIVE');

$history = AiRequiredSource::submission(['diagnoses' => [
    ['id' => 51, 'diagnosis_date' => '2026-10-23', 'present_illness' => '未记录头晕。'],
    ['id' => 9, 'diagnosis_date' => '2020-05-02', 'present_illness' => '无头晕。'],
]]);
$temporal = TcmClinicalFactStateGuard::build(['id' => 51, 'diagnosis_date' => '2026-10-23', 'present_illness' => '未记录头晕。'], $history);
factStateCheck($temporal, '本次无头晕。', false, 'historical negative cannot fill current unknown', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($temporal, '既往2020-05-02无头晕，本次未记录头晕。', true, 'a dated historical quotation remains historical');
factStateCheck($temporal, '头晕本次未记录。', true, 'postfix unknown is preserved');
factStateCheck($temporal, '2020-05-02无头晕。', true, 'an explicit historical date is not silently applied to the current visit');
factStateCheck($temporal, "头晕未记录。\n\n无头晕。", false, 'correct uncertainty in one paragraph cannot excuse a later contradiction', 'UNKNOWN_TO_NEGATIVE');
$datedCurrent = ['id' => 61, 'diagnosis_date' => '2026-10-23', 'present_illness' => '无胸痛心悸；未记录耳鸣。'];
$datedSubmission = ['required_content' => [['key' => 'daily_tracking', 'value' => ['exercise' => [
    ['record_date' => '2026-10-22', 'note' => '活动后乏力、汗出较明显，无胸痛或晕厥；无耳鸣。'],
]]]]];
$dated = TcmClinicalFactStateGuard::build($datedCurrent, $datedSubmission);
factStateCheck($dated, '2026-10-22活动记录见“活动后乏力、汗出较明显，无胸痛或晕厥”。', true,
    'a full historical calendar date excludes the incompatible current compound on the next day');
factStateCheck($dated, '2026年10月22日活动记录见“活动后乏力、汗出较明显，无胸痛或晕厥”。', true,
    'Chinese calendar notation has the same exact-day scope');
factStateCheck($dated, '2026-10-23无胸痛。', false, 'same-year historical support cannot widen a different current negative', 'NEGATION_SCOPE_WIDENED');
factStateCheck($dated, '2026-10-23本次“无耳鸣”。', false, 'a mismatched-date old quote cannot erase current uncertainty', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($dated, '本次“无耳鸣”。', false, 'an undated historical quote cannot erase current uncertainty', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($dated, '2026-10-22活动记录“无耳鸣”。', true, 'a correctly dated historical negative remains usable as history');
$sameDay = TcmClinicalFactStateGuard::build(['id' => 62, 'diagnosis_date' => '2026-10-23', 'present_illness' => '无明显腹胀。'],
    ['required_content' => [['key' => 'daily_tracking', 'value' => ['exercise' => [
        ['record_date' => '2026-10-23', 'note' => '活动后无腹胀或头痛。'],
    ]]]]]);
factStateCheck($sameDay, '2026-10-23活动记录“活动后无腹胀或头痛”。', true,
    'a complete verified dated source quote is compared with its own scope rather than another context on that day');
factStateCheck($sameDay, '2026-10-23活动记录“无腹胀”。', false,
    'a truncated source quote cannot authorize widened negation', 'NEGATION_SCOPE_WIDENED');
factStateCheck($sameDay, '2026-10-23活动记录“活动后无腹胀或头痛”；本次无腹胀。', false,
    'source quote attribution never leaks to an unquoted current assertion', 'NEGATION_SCOPE_WIDENED');
$mixed = TcmClinicalFactStateGuard::build(['present_illness' => '偶有头晕，胸痛未记录，未提供手麻情况。']);
factStateCheck($mixed, '无胸痛。', false, 'postfix unknown after a positive clause is indexed independently', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($mixed, '有胸痛。', false, 'postfix unknown cannot become positive either', 'UNKNOWN_TO_POSITIVE');
factStateCheck($mixed, '患者有头晕，胸痛未记录。', true, 'adjacent mixed clauses preserve their own states');
$medications = TcmClinicalFactStateGuard::build(['current_medications' => '使用二甲双胍；未使用胰岛素或中药。']);
factStateCheck($medications, '当前使用胰岛素。', false, 'explicit non-use is not silently rewritten as active therapy', 'NEGATIVE_TO_POSITIVE');
factStateCheck($medications, '使用二甲双胍，未使用胰岛素或中药。', true, 'recorded current treatment and non-use survive together');

$sourceOnly = TcmEvidenceGuard::assess($current);
$menu = json_encode($sourceOnly['facts'], JSON_UNESCAPED_UNICODE);
factStateExpect(str_contains($menu, '活动后气短，无胸痛；未记录固定刺痛或耳鸣。'),
    'source menu no longer drops mixed positive/negative/unknown fields');
factStateExpect($sourceOnly['restricted'] === false && isset($sourceOnly['fact_state_ledger']),
    'ledger presence does not change established examination completeness');
$unknownExams = TcmEvidenceGuard::assess(['chief_complaint' => '乏力', 'tongue' => '未记录', 'pulse' => '不详']);
factStateExpect($unknownExams['restricted'] === true, 'retaining unknown quotations does not make an examination complete');
factStateCheck($unknownExams['fact_state_ledger'], '舌象无异常。', false, 'unknown examination is not normal', 'UNKNOWN_TO_NEGATIVE');
factStateCheck($unknownExams['fact_state_ledger'], '舌淡红，脉细。', false, 'missing examination text cannot produce observed tongue or pulse features', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE');
factStateCheck($unknownExams['fact_state_ledger'], '舌象未记录，脉象不详。', true, 'missing examination text remains unknown');

$fixture = CompleteTcmCase::current();
$fixtureLedger = TcmClinicalFactStateGuard::build($fixture, AiRequiredSource::submission(CompleteTcmCase::rows()));
$artifactRoot = dirname(__DIR__, 2) . '/app/artifacts/ai_concurrency/';
$replayLocalArtifacts = getenv('TCM_TEST_LOCAL_REPLAYS') !== '0';
$samples = [
    'tcm_complete_v13_single_1_openai.md' => true,
    'tcm_complete_v13_concurrent4_2_openai.md' => false,
    'tcm_complete_v13_concurrent4_3_openai.md' => false,
];
if (!$replayLocalArtifacts) $samples = [];
foreach ($samples as $file => $valid) {
    $path = $artifactRoot . $file;
    if (!is_file($path)) continue;
    $report = (string) file_get_contents($path);
    $result = TcmClinicalFactStateGuard::validate($fixtureLedger, $report);
    factStateExpect($result['valid'] === $valid, 'prior full report lexical state gate: ' . $file . ' ' . json_encode($result));
    if (str_contains($file, 'concurrent4_2')) factStateExpect(factStateCode($result, 'UNKNOWN_TO_NEGATIVE'), 'prior unknown drift is explicitly rejected');
    if (str_contains($file, 'concurrent4_3')) factStateExpect(factStateCode($result, 'NEGATION_SCOPE_WIDENED'), 'prior partial-negation drift is explicitly rejected');
    foreach ($result['issues'] as $issue) factStateExpect(array_keys($issue) === ['code', 'source_id']
        && preg_match('/^[A-Z_]+$/D', $issue['code']) === 1 && preg_match('/^(?:s[1-9][0-9]*|report)$/D', $issue['source_id']) === 1,
        'issue metadata carries static codes and local IDs only');
}

// Reproduce the private pilot's pure canonical source construction. These two
// methods project/redact the supplied fixture only; they do not load records.
$snapshotMethod = new ReflectionMethod(PatientAiReportLogic::class, 'buildSourceSnapshotFromRows');
$redactMethod = new ReflectionMethod(PatientAiReportLogic::class, 'sanitizeSnapshotForUpstream');
$pilotSubmission = $redactMethod->invoke(null, AiRequiredSource::submission($snapshotMethod->invoke(null, CompleteTcmCase::rows())));
$pilotLedger = TcmClinicalFactStateGuard::build($fixture, $pilotSubmission);
// Required regressions are self-contained synthetic literals. Local artifacts
// below are optional additional replays, never a clean-checkout dependency.
factStateStreamCheck($pilotLedger, '本次舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑。脉细弱，按之无力；不浮、不滑、不紧。未记录腰酸耳鸣或固定刺痛。', true,
    'independent literal preserves positive, negative and unknown source states');
factStateStreamCheck($pilotLedger, '血分辨析：未记录腰酸耳鸣或固定刺痛。现无固定刺痛。', false,
    'independent prior drift literal still rejects unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '食欲一般、苔少而非腻。', false,
    'independent prior drift literal still rejects widened negation', 'NEGATION_SCOPE_WIDENED', '非腻');
factStateStreamCheck($pilotLedger, '闻诊方面，语声低微，无喘促及异常气味。听其呼吸，平稳但气息不足，未见痰鸣音。', false,
    'independent unsupported-observation literal is still rejected', 'NEGATIVE_NOT_IN_SOURCE', '未见痰鸣音');
factStateStreamCheck($pilotLedger, '**闻诊：**原文记“语声低微，无喘促及异常气味”。其他声音、气味未记录；“无咳嗽咯痰”为问诊原文，不移作闻诊所见。', true,
    'independent attribution-policy literal no longer rejects faithful source quotations');
// v16: independent synthetic regressions; no local replay artifact is required.
$instructionLedger = TcmClinicalFactStateGuard::build([
    'id' => 71, 'diagnosis_date' => '2026-10-23',
    'chief_complaint' => '乏力', 'present_illness' => '无恶寒发热；未记录固定刺痛。',
    'tongue' => '舌淡红，苔少；无黄腻苔。', 'pulse' => '脉细弱，不浮。',
    'remark' => '无附件，不从图片或心率推断舌脉；未记录眼痛；无明显腹胀。',
]);
$ruleSourceIds = array_keys(array_filter($instructionLedger['sources'],
    static fn (array $source): bool => $source['path'] === 'current.remark'));
factStateExpect(!array_filter($instructionLedger['assertions'], static fn (array $assertion): bool =>
    in_array($assertion['source_id'], $ruleSourceIds, true)
    && preg_match('/图片|心率|推断/u', $assertion['topic']) === 1),
    'an inference rule in a source note never becomes a clinical polarity assertion');
factStateStreamCheck($instructionLedger, '本次“无恶寒发热”，脉“不浮”。', true,
    'a pulse label starts its own assertion rather than inheriting the preceding absent marker');
factStateStreamCheck($instructionLedger, '本次“无恶寒发热”，脉细弱。', true,
    'a positive pulse phrase also starts its own assertion');
factStateStreamCheck($instructionLedger, '当前无眼痛。', false,
    'removing a source rule never removes adjacent unknown clinical notes', 'UNKNOWN_TO_NEGATIVE', '无眼痛');
factStateStreamCheck($instructionLedger, '绝无腹胀。', false,
    'an actual widened degree negation in the same source note remains rejected', 'NEGATION_SCOPE_WIDENED', '绝无腹胀');
factStateStreamCheck($instructionLedger, '舌苔少而非腻。', false,
    'an actual widened coating negation remains rejected', 'NEGATION_SCOPE_WIDENED', '非腻');
foreach (['后续若', '今后若', '此后若', '后续如果'] as $futurePrefix) {
    factStateStreamCheck($instructionLedger, '本次无恶寒发热，' . $futurePrefix . '新出现恶寒、发热或咽痛，应重新评估。', true,
        'a localized future condition does not invent present findings: ' . $futurePrefix);
    factStateStreamCheck($instructionLedger, '本次无固定刺痛，' . $futurePrefix . '新出现咽痛，应重新评估。', false,
        'a future tail cannot exempt a preceding current unknown-to-negative: ' . $futurePrefix,
        'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
    factStateStreamCheck($instructionLedger, '本次出现恶寒发热，' . $futurePrefix . '出现咽痛，应重新评估。', false,
        'a future tail cannot exempt a preceding actual current positive: ' . $futurePrefix,
        'NEGATIVE_TO_POSITIVE', '出现恶寒发热');
}
factStateStreamCheck($pilotLedger, '**表里：偏里证。**症状已持续3个月并逐渐出现，以“神疲乏力”“轻微活动后气短”“白天自汗”为主；本次又记录“无恶寒发热”，脉“不浮”，现有证据更支持内在功能失调，而非急性表证。但这只反映本次接诊状态，后续若新出现恶寒、发热、咽痛等，仍须重新判断。', true,
    'independent full synthetic paragraph retains its source facts and future qualification');

// v17: source attribution regressions use only the committed synthetic case.
factStateStreamCheck($pilotLedger, '访谈另记“没有最近高热、恶寒、腹泻”。', true,
    'a complete interview quote binds to chat rather than a different current compound');
factStateStreamCheck($pilotLedger, '运动记录为“无胸痛或晕厥”。', true,
    'a complete exercise quote binds to its exercise record');
factStateStreamCheck($pilotLedger, '运动记录另载“无胸痛或晕厥”。', true,
    'an explicitly attributed exercise quote retains its original scope');
factStateStreamCheck($pilotLedger, '2026-10-22运动记录为“无胸痛或晕厥”。', true,
    'an exact record date retains the exercise-source binding');
factStateStreamCheck($pilotLedger, '2026年10月22日运动记录另载“无胸痛或晕厥”。', true,
    'the existing full-date syntax retains the same exercise-source binding');
factStateStreamCheck($pilotLedger, '腰酸耳鸣、固定刺痛为“未记录”，不能视为明确无，待补采。', true,
    'the unknown-status explanation is not the source of the quotation conflict');
factStateStreamCheck($pilotLedger, '本次已记录阴性包括：“无恶寒发热”“无高热烦渴、汗出淋漓或意识异常”“无明显五心烦热、潮热盗汗”“无畏寒肢冷”“无咳嗽咯痰、胸痛心悸、浮肿或腹泻”。', true,
    'unchanged compound current-source quotations retain their original negation scope');
factStateStreamCheck($pilotLedger, '运动记录为“无胸痛”。', false,
    'a truncated exercise quote cannot widen the original compound', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '无胸痛');
factStateStreamCheck($pilotLedger, '运动记录为“无胸痛或呼吸困难”。', false,
    'a modified exercise quote is rejected instead of gaining attribution', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '呼吸困难');
factStateStreamCheck($pilotLedger, '运动记录为“无胸痛或晕厥或手麻”。', false,
    'an expanded exercise quote is rejected instead of gaining attribution', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '手麻');
factStateStreamCheck($pilotLedger, '运动记录为“没有最近高热、恶寒、腹泻”。', false,
    'a chat quote cannot be relabeled as an exercise record', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '没有最近高热');
factStateStreamCheck($pilotLedger, '访谈另记“没有最近高热”。', false,
    'a truncated interview scope is not a complete source-bound negative', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '没有最近高热');
factStateStreamCheck($pilotLedger, '当前运动记录为“无胸痛或晕厥”。', false,
    'an explicit current claim cannot borrow a historical-source exception', 'NEGATION_SCOPE_WIDENED', '无胸痛');
factStateStreamCheck($pilotLedger, '运动记录为“无胸痛或晕厥”，当前无胸痛。', false,
    'historical quote attribution cannot extend to the following current claim', 'NEGATION_SCOPE_WIDENED', '当前无胸痛');
factStateStreamCheck($pilotLedger, '访谈另记“没有最近高热、恶寒、腹泻”，当前无固定刺痛。', false,
    'a faithful interview quote cannot exempt a current unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '当前无固定刺痛');
factStateStreamCheck($pilotLedger, '2026-10-21运动记录为“无胸痛或晕厥”。', false,
    'an incorrect explicit record date cannot acquire a source binding', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '无胸痛');
factStateStreamCheck($qualified, '绝无腹胀。', false,
    'degree qualifier broadening remains rejected', 'NEGATION_SCOPE_WIDENED', '绝无腹胀');
factStateStreamCheck($ledger, '舌苔少而非腻。', false,
    'coating qualifier broadening remains rejected', 'NEGATION_SCOPE_WIDENED', '非腻');


// v18: a bounded conceptual comparison does not assert its right-hand tongue feature.
factStateStreamCheck($pilotLedger, '舌淡红不等同于舌淡白。', true,
    'only the explicit conceptual comparison target is excluded from observations');
factStateStreamCheck($pilotLedger, '舌淡红不等同于舌质淡白，不能据此确立血虚或阳虚。', true,
    'a named tongue-quality comparison has the same local boundary');
factStateStreamCheck($pilotLedger, '**舌象：**本次面诊为“舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑”。少津、苔少支持津液不足倾向；舌淡红不等同于舌淡白，不能据此确立血虚或阳虚。', true,
    'independent full synthetic comparison paragraph preserves grounded observations');
factStateStreamCheck($pilotLedger, '本例舌淡白。', false,
    'an actual unrecorded pale-white tongue remains rejected', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌淡白');
factStateStreamCheck($pilotLedger, '本例舌淡白不等同于舌淡红。', false,
    'an unsupported left-hand observation cannot borrow the target exception', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌淡白');
factStateStreamCheck($pilotLedger, '舌淡红不等同于舌淡白，但本例舌淡白。', false,
    'the same feature asserted later is still checked', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '本例舌淡白');
factStateStreamCheck($pilotLedger, '舌淡红不等同于舌淡白；当前舌质红绛。', false,
    'a later current feature across a clause boundary remains checked', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '当前舌质红绛');
factStateStreamCheck($pilotLedger, '本例舌淡白，不能据此确立血虚或阳虚。', false,
    'an arbitrary cannot-conclude tail never exempts an actual observation', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌淡白');
factStateStreamCheck($pilotLedger, '舌淡红不等同于舌淡白红绛。', false,
    'an unbounded target cannot consume additional feature tokens', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
factStateStreamCheck($pilotLedger, '舌质淡红而非红绛。', false,
    'a newly asserted negative tongue feature remains ungrounded', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非红绛');
factStateStreamCheck($pilotLedger, '舌质淡红而非明确红绛。', false,
    'an explicit degree word does not turn a new negative into a conceptual comparison', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
factStateStreamCheck($examUnknown, '舌淡红不等同于舌淡白。', false,
    'a conceptual target cannot invent its unknown left-hand observation', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌淡红');
factStateStreamCheck($examUnknown, '舌淡红不等同于舌淡白；当前脉细。', false,
    'unknown tongue and pulse still reject actual observations', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '当前脉细');
factStateStreamCheck($pilotLedger, '本次无五心烦热、潮热盗汗。', false,
    'the genuine removal of an observed-negative degree qualifier stays rejected', 'NEGATION_SCOPE_WIDENED', '无五心烦热');
factStateStreamCheck($pilotLedger, '望诊：活动后乏力、汗出较明显，无胸痛或晕厥。', false,
    'unattributed historical exercise negatives cannot be moved into current inspection', 'NEGATION_SCOPE_WIDENED', '无胸痛');

// Bounded advice cannot inherit an earlier observed negative or become an exam.
factStateStreamCheck($pilotLedger, '本次舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑。无舌像附件，不能补充裂纹、齿痕等未记录内容。', true,
    'a strict data-invention prohibition is not an observed tongue feature');
factStateStreamCheck($pilotLedger, '此处“无喘促”指面诊当时闻诊表现，不能替代活动后呼吸困难程度或心肺功能评价。', true,
    'an assessment limit never inherits the quoted absent marker');
factStateStreamCheck($pilotLedger, '不能补充裂纹等未记录内容，但本例舌裂纹。', false,
    'a following actual finding is not exempt', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌裂纹');
factStateStreamCheck($pilotLedger, '本例舌裂纹，不能补充其他未记录内容。', false,
    'a preceding actual finding is not exempt', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌裂纹');
factStateStreamCheck($examUnknown, '不能补充舌裂纹等未记录内容；当前脉滑。', false,
    'unknown pulse stays unknown after an advisory', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '当前脉滑');
factStateStreamCheck($pilotLedger, '当前无固定刺痛，不能替代后续检查。', false,
    'an advisory cannot exempt a current unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '当前无固定刺痛');
factStateStreamCheck($pilotLedger, '不能补充裂纹等未记录内容且本例舌裂纹。', false,
    'only a full bounded advisory can be exempt', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌裂纹');

factStateStreamCheck($pilotLedger, '望诊：未提供皮肤润燥资料，无舌照片或其他附件。', true,
    'missing attachment metadata is not a patient negative finding');
factStateStreamCheck($pilotLedger, '望诊：无舌照片，当前舌质淡白。', false,
    'attachment absence cannot exempt a following actual tongue claim', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质淡白');
factStateStreamCheck($pilotLedger, '闻诊：无其他附件，未见痰鸣音。', false,
    'attachment absence cannot exempt an unsupported clinical negative', 'NEGATIVE_NOT_IN_SOURCE', '未见痰鸣音');
factStateStreamCheck($pilotLedger, '当前无固定刺痛，无其他附件。', false,
    'attachment metadata cannot change the unknown clinical state', 'UNKNOWN_TO_NEGATIVE', '当前无固定刺痛');

foreach (['聊天记录另载', '聊天内容记载', '访谈记载'] as $label) {
    factStateStreamCheck($pilotLedger, $label . '“没有最近高热、恶寒、腹泻”。', true,
        'standard chat attribution aliases bind only complete original quotations');
}
factStateStreamCheck($pilotLedger, '运动时“无胸痛或晕厥”。', true,
    'an explicitly attributed exercise-event quotation binds only its complete original source');
factStateStreamCheck($pilotLedger, '聊天记录另载“没有最近高热”。', false,
    'chat aliases cannot exempt a truncated source quote', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '没有最近高热');
factStateStreamCheck($pilotLedger, '运动时“无胸痛或晕厥”，当前无固定刺痛。', false,
    'an event quote cannot exempt a following current unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '当前无固定刺痛');
factStateStreamCheck($pilotLedger, '当前运动时“无胸痛或晕厥”。', false,
    'a historical event quote cannot establish a current absence', 'NEGATION_SCOPE_WIDENED', '无胸痛');


// v23: provenance/capability text does not become a clinical observation.
$hearingSource = array_values(array_filter($pilotLedger['sources'], static fn (array $row): bool => $row['path'] === 'current.symptoms'))[0];
foreach (['现病史', 'symptoms', 'current.symptoms', $hearingSource['id']] as $sourceLabel) {
    factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味（来源：' . $sourceLabel . '）。', true,
        'a complete annotation names an existing group, field, path or source ID: ' . $sourceLabel);
}
factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味(来源：现病史)。', true,
    'ASCII parentheses use the same bounded metadata grammar');
factStateStreamCheck($pilotLedger, '闻诊：无皮疹（来源：现病史）。', false,
    'valid provenance never supplies an unrecorded clinical absence', 'NEGATIVE_NOT_IN_SOURCE', '无皮疹');
factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味（来源：不存在分组）。', false,
    'an unknown source label is not silently stripped', 'NEGATIVE_NOT_IN_SOURCE', '无喘促');
factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味（来源：现病史）（患者无固定刺痛）。', false,
    'clinical content in a second parenthesis is still checked', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味（来源：现病史，患者无固定刺痛）。', false,
    'a source prefix cannot turn a mixed clinical parenthesis into metadata', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '一、四诊
望诊：神疲乏力，面色少华（来源：现病史）。
闻诊：语声低微，无喘促及异常气味（来源：现病史）。
问诊：主诉乏力、动则气短、自汗、口干3个月。现病史见轻微活动后气短，白天自汗、活动后加重，口干欲饮、少量频饮。食欲一般，大便稍干、每日1次，小便量较以往略多、夜尿1次。睡眠一般。
明确阴性：无恶寒发热，无高热烦渴、汗出淋漓或意识异常。无明显五心烦热、潮热盗汗，无畏寒肢冷。无咳嗽咯痰、胸痛心悸、浮肿或腹泻。未记录腰酸耳鸣或固定刺痛（来源：现病史）。
舌象：舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑（来源：诊断信息）。
脉象：脉细弱，按之无力；不浮、不滑、不紧（来源：诊断信息）。', true,
    'portable full synthetic four-diagnosis paragraph preserves all stated source scopes');
factStateStreamCheck($pilotLedger, '**舌象：**本次文字记录为“舌质淡红，舌面少津，苔少”；已记录阴性为“无黄腻苔、紫暗或瘀斑”。因无舌照，不能复核舌体胖瘦、齿痕、裂纹及舌下络脉。', true,
    'portable full synthetic tongue paragraph distinguishes observations from a review limit');
factStateStreamCheck($examUnknown, '因无舌照，不能复核舌体胖瘦、齿痕、裂纹及舌下络脉。', true,
    'a strict review limit neither fabricates nor fills an unknown examination');
factStateStreamCheck($examUnknown, '因无舌照，不能复核齿痕，当前舌质淡红。', false,
    'a review limit cannot fill an unknown tongue with a later observation', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质淡红');
factStateStreamCheck($pilotLedger, '因无舌照，不能复核齿痕，当前舌无裂纹。', false,
    'actual absence after a bounded review limit remains unsupported', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌无裂纹');
factStateStreamCheck($pilotLedger, '因无舌照，不能复核齿痕，当前舌有齿痕。', false,
    'actual presence after a bounded review limit remains unsupported', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌有齿痕');
factStateStreamCheck($pilotLedger, '本例舌无裂纹，因无舌照，不能复核齿痕。', false,
    'a preceding actual absence cannot borrow a later review limit', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌无裂纹');
factStateStreamCheck($pilotLedger, '不能复核齿痕且本例舌裂纹。', false,
    'the review-limit grammar cannot consume an asserted feature tail', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌裂纹');
$recordedReview = TcmClinicalFactStateGuard::build(['tongue' => '舌质淡红，有齿痕，无裂纹。']);
factStateStreamCheck($recordedReview, '舌质淡红，有齿痕；无裂纹。因无舌照，不能复核齿痕、裂纹。', true,
    'inability to recheck does not relabel known positive or negative features as unknown');
factStateStreamCheck($pilotLedger, '四诊所示阴虚热象不突出，舌质淡红。', true,
    'a new tongue subject does not inherit a reasoning predicate');
factStateStreamCheck($pilotLedger, '四诊所示阴虚热象不突出，舌质并非淡红。', false,
    'an actual new tongue negation still contradicts the recorded positive', 'POSITIVE_TO_NEGATIVE', '并非淡红');
factStateStreamCheck($pilotLedger, '四诊所示阴虚热象不突出，舌质淡红而非明显红绛。', false,
    'fixing a preceding reasoning scope does not approve a new red-crimson negative', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明显红绛');
factStateStreamCheck($pilotLedger, '乏力、气短和出汗也可能存在贫血、甲状腺、心肺或自主神经等非中医证候原因，中药不能替代必要排查。', true,
    'a different-subject safety sentence is not current herbal use');
factStateStreamCheck($pilotLedger, '当前使用中药，中药不能替代必要排查。', false,
    'actual herbal use preceding a safety statement remains a contradiction', 'NEGATIVE_TO_POSITIVE', '使用中药');
factStateStreamCheck($pilotLedger, '可能存在贫血，中药不能替代必要排查，当前使用中药。', false,
    'actual herbal use following a safety statement remains a contradiction', 'NEGATIVE_TO_POSITIVE', '使用中药');
factStateStreamCheck($pilotLedger, '患者未记录心悸等其他常见相关表现，但这不否定现有主方向。', false,
    'an explicitly denied named symptom cannot be recast as unknown', 'NEGATIVE_TO_UNKNOWN', '未记录心悸');
factStateStreamCheck($pilotLedger, '其他声音、心悸未记录。', false,
    'a general other-findings prefix cannot exempt a named known symptom', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '胸痛心悸未记录。', false,
    'an entire known negative compound cannot be erased', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '口干未记录。', false,
    'a known positive symptom cannot be recast as unknown', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '舌象未记录。', false,
    'an exactly named known examination field cannot become unknown', 'RECORDED_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '固定刺痛未记录；脉亦未记录数象。', true,
    'genuine missing symptoms and pulse features retain unknown state');
factStateStreamCheck($pilotLedger, '本次无固定刺痛。', false,
    'reverse-state checks do not weaken unknown-to-negative rejection', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '舌质并非鲜红，现有舌象不足以确定明显阴虚内热。', false,
    'the reproduced fresh-red negative is not silently outside the vocabulary', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '并非鲜红');
$freshRedRecorded = TcmClinicalFactStateGuard::build(['tongue' => '舌质鲜红。']);
factStateStreamCheck($freshRedRecorded, '舌质鲜红。', true,
    'the new surface term remains usable when explicitly recorded');
factStateStreamCheck($freshRedRecorded, '鲜红未记录。', false,
    'a known fresh-red positive also retains its recorded state', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($freshRedRecorded, '舌质并非鲜红。', false,
    'a new surface term also retains source polarity', 'POSITIVE_TO_NEGATIVE', '并非鲜红');
$freshRedDenied = TcmClinicalFactStateGuard::build(['tongue' => '舌质淡红；无鲜红。']);
factStateStreamCheck($freshRedDenied, '舌质淡红；无鲜红。', true,
    'an explicit fresh-red negative is allowed when the source actually records it');
factStateStreamCheck($pilotLedger, '**反证与局限：**四诊所示阴虚热象不突出，舌质淡红而非明显红绛，脉亦未记录数象，因此不应将本方解释为治疗阴虚火旺。患者未记录心悸等其他常见相关表现，但这不否定现有主方向。乏力、气短和出汗也可能存在贫血、甲状腺、心肺或自主神经等非中医证候原因，中药不能替代必要排查。', false,
    'the portable full v21-like paragraph remains invalid after removing its parser false positives', 'NEGATIVE_TO_UNKNOWN', '未记录心悸');


// v24: attachment nouns, image capability limits and a genuine bare 待补.
factStateStreamCheck($pilotLedger, '**望诊：**本次面诊见“神疲、面色少华”。生命体征：体温36.5℃，血压124/76mmHg，心率78次/分；身高170cm、体重65kg、BMI 22.5kg/m²。无舌照或其他图像附件，不能据图片补充面色、形体及局部体征。', true,
    'portable full synthetic observation paragraph keeps the attachment capability limit local');
factStateStreamCheck($pilotLedger, '**舌象：**本次医师记录“舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑”。无图像可供复核，舌体胖瘦、齿痕、裂纹及舌下络脉待补。', true,
    'portable full synthetic tongue paragraph uses bare postfix missing-data state');
factStateStreamCheck($examUnknown, '无舌照或其他图像附件，不能据图片补充面色、形体及局部体征。', true,
    'file absence and a capability limit do not fabricate unknown examinations');
factStateStreamCheck($pilotLedger, '无图像可供复核，齿痕、裂纹待补。', true,
    'a preceding file absence does not turn missing features into observed negatives');
factStateStreamCheck($pilotLedger, '无舌照或其他图像附件，不能据图片补充面色、形体及局部体征，当前舌无裂纹。', false,
    'a following actual negative is outside the bounded capability limit', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌无裂纹');
factStateStreamCheck($pilotLedger, '本例舌有裂纹，无舌照或其他图像附件，不能据图片补充面色。', false,
    'a preceding actual positive is outside the file metadata exemption', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌有裂纹');
factStateStreamCheck($pilotLedger, '不能据图片补充面色且本例舌裂纹。', false,
    'an appended actual clause cannot masquerade as a capability list', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌裂纹');
factStateStreamCheck($pilotLedger, '望诊：无其他图像附件，患者无固定刺痛。', false,
    'attachment noun suffixes do not exempt a subsequent unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '望诊：无其他图像附件及皮疹。', false,
    'a metadata list cannot consume a clinical negative item', 'NEGATIVE_NOT_IN_SOURCE', '皮疹');
factStateStreamCheck($pilotLedger, '无图像可供复核，齿痕、裂纹待补，舌有裂纹。', false,
    'postfix missing-data scope ends before a later actual feature', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌有裂纹');
factStateStreamCheck($pilotLedger, '无图像可供复核，齿痕待补，患者有心悸。', false,
    'postfix missing-data scope cannot conceal a known-negative symptom becoming positive', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '齿痕待补，患者无固定刺痛。', false,
    'postfix missing-data scope cannot conceal an unknown symptom becoming negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '心悸待补。', false,
    'bare postfix missing state cannot overwrite an explicitly denied symptom', 'NEGATIVE_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, '口干待补。', false,
    'bare postfix missing state cannot overwrite a positive symptom', 'POSITIVE_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, '舌象待补。', false,
    'a recorded tongue field cannot become bare missing data', 'RECORDED_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, '脉待补。', false,
    'a recorded short pulse alias cannot become bare missing data', 'RECORDED_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, '舌象：待补。', false,
    'a field label does not turn missing-data wording into blanket collection advice', 'RECORDED_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, '待补脉象。', false,
    'a prefix bare missing marker also retains the known field state', 'RECORDED_TO_UNKNOWN', '待补');
factStateStreamCheck($pilotLedger, "舌象：" . chr(10) . chr(10) . "待补。", false,
    'a known field title remains bound across a paragraph break', 'RECORDED_TO_UNKNOWN', '待补');
factStateStreamCheck($examUnknown, "舌象：" . chr(10) . chr(10) . "待补。", true,
    'a genuinely unknown field can retain bare missing state across paragraphs');
factStateStreamCheck($pilotLedger, '固定刺痛待补；待补齿痕。', true,
    'genuine missing source items retain unknown state in either word order');
factStateStreamCheck($recordedReview, '齿痕、裂纹待补。', false,
    'bare missing state does not erase explicitly recorded positive or negative features', 'POSITIVE_TO_UNKNOWN', '待补');
factStateExpect(factStateCode(TcmClinicalFactStateGuard::validate($recordedReview, '齿痕、裂纹待补。'), 'NEGATIVE_TO_UNKNOWN'),
    'a known negative feature in the same list also retains its recorded state');
factStateStreamCheck($pilotLedger, '舌质淡红非青紫。', false,
    'a new color negative remains rejected after attachment fixes', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非青紫');
factStateStreamCheck($pilotLedger, '本例无痰多。', false,
    'a new patient sputum negative remains rejected after attachment fixes', 'NEGATIVE_NOT_IN_SOURCE', '无痰多');
factStateStreamCheck($pilotLedger, '舌质淡红而非明确红绛。', false,
    'a new explicit red-crimson negative remains rejected', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');


// v25: strict bare citations, copular unknowns and a closed hearing reference.
foreach (['（s3）', '（s2, s3）', '(s2, s3)', '（2026-10-23，[s3]）', '（s3，2026年10月23日）', '（2026-10-23）'] as $citation) {
    factStateStreamCheck($pilotLedger, '闻诊：“无喘促及异常气味”' . $citation . '。', true,
        'a complete source annotation contains only existing IDs and a verified date: ' . $citation);
}
foreach (['（s999）', '（s3，s999）', '（2026-10-22，[s3]）', '（2026-13-99，s3）', '（2026-10-23，2026-10-22，s3）', '（2026-10-22）'] as $citation) {
    factStateStreamCheck($pilotLedger, '闻诊：“无喘促及异常气味”' . $citation . '。', false,
        'unknown IDs or inconsistent dates cannot be removed as trusted metadata: ' . $citation,
        'SOURCE_ANNOTATION_INVALID', '无喘促');
}
factStateStreamCheck($pilotLedger, '闻诊：无喘促及异常气味（s3，患者无固定刺痛）。', false,
    'a mixed citation cannot strip a patient unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '闻诊：无喘促及异常气味（s3，患者有心悸）。', false,
    'a mixed citation cannot strip an actual positive assertion', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '闻诊：无喘促及异常气味（[s3，患者有心悸]）。', false,
    'nested citation brackets do not erase clinical content inside a mixed parenthesis', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '闻诊：无喘促及异常气味（[s3，患者无固定刺痛]）。', false,
    'nested brackets do not erase an unknown-to-negative inside a mixed parenthesis', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '闻诊：语声低微，无喘促及异常气味（s2, s3）。本次舌质淡红，舌面少津，苔少（s9）；无黄腻苔、紫暗或瘀斑（s9）。未记录腰酸耳鸣或固定刺痛（s2）。', true,
    'portable synthetic negative list retains its source states beside bare existing IDs');
$historicalSource = array_values(array_filter($dated['sources'], static fn (array $row): bool => str_starts_with($row['path'], 'daily_tracking.exercise.')))[0];
factStateStreamCheck($dated, '运动记录为“无胸痛或晕厥”（2026-10-22，' . $historicalSource['id'] . '）。', true,
    'a correct historical citation retains its event date and original compound scope');
factStateStreamCheck($dated, '运动记录为“无胸痛或晕厥”（2026-10-23，' . $historicalSource['id'] . '）。', false,
    'a historical source cannot be assigned the current date', 'SOURCE_ANNOTATION_INVALID', '无胸痛');
factStateStreamCheck($dated, '本次无耳鸣（2026-10-22，' . $historicalSource['id'] . '）。', false,
    'a valid historical citation cannot wash an explicitly current patient absence', 'NEGATIVE_NOT_IN_SOURCE', '无耳鸣');
factStateStreamCheck($dated, '运动记录为“无胸痛”（2026-10-22，' . $historicalSource['id'] . '）。', false,
    'valid metadata does not approve a truncated historical negative quote', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '无胸痛');
foreach (['属', '为', '属于'] as $copula) {
    factStateStreamCheck($pilotLedger, '腰酸耳鸣、固定刺痛' . $copula . '“未记录腰酸耳鸣或固定刺痛”（s2），属于未知，不能作为肯定或否定依据。', true,
        'a copular explanation binds exactly the same named unknown subjects: ' . $copula);
}
factStateStreamCheck($pilotLedger, '腰酸耳鸣、固定刺痛属“未记录腰酸耳鸣或固定刺痛”，是未知而非否认。', true,
    'the alternate closed unknown explanation keeps its full tail');
factStateStreamCheck($pilotLedger, '腰酸耳鸣、固定刺痛为未记录腰酸耳鸣或固定刺痛，属于未知。', true,
    'unknown-state binding does not depend on decorative quotation marks');
factStateStreamCheck($pilotLedger, '患者有腰酸耳鸣、固定刺痛为“未记录腰酸耳鸣或固定刺痛”。', false,
    'a copula cannot erase an original explicit positive predicate', 'UNKNOWN_TO_POSITIVE', '有腰酸耳鸣');
factStateStreamCheck($pilotLedger, '患者出现固定刺痛属“未记录固定刺痛”。', false,
    'an occurrence predicate remains an actual assertion before the copula', 'UNKNOWN_TO_POSITIVE', '出现固定刺痛');
factStateStreamCheck($pilotLedger, '固定刺痛属“未记录固定刺痛”，患者有固定刺痛。', false,
    'a following explicit positive cannot borrow the unknown explanation', 'UNKNOWN_TO_POSITIVE', '有固定刺痛');
factStateStreamCheck($pilotLedger, '固定刺痛属“未记录固定刺痛”，本例舌质淡白。', false,
    'an implicit actual examination after the comma stays outside unknown scope', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质淡白');
factStateStreamCheck($pilotLedger, '腰酸耳鸣为“未记录固定刺痛”。', false,
    'different subject and unknown payload cannot acquire the copular binding', 'UNKNOWN_TO_POSITIVE', '腰酸耳鸣');
factStateStreamCheck($pilotLedger, '心悸为“未记录心悸”，属于未知。', false,
    'same-subject binding still checks a known negative recast as unknown', 'NEGATIVE_TO_UNKNOWN', '未记录心悸');
factStateStreamCheck($pilotLedger, '口干为“未记录口干”。', false,
    'same-subject binding also preserves known positives', 'POSITIVE_TO_UNKNOWN', '未记录口干');
$hearingReference = '此处仅表示闻诊当时未见上述表现';
factStateStreamCheck($pilotLedger, '**闻诊：**本次记载语声低微，可作为气虚倾向的支持。“无喘促及异常气味”（2026-10-23，[s3]）；' . $hearingReference . '，不能替代活动状态下呼吸评估。', true,
    'portable full hearing paragraph binds a closed reference to the adjacent verified negative');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $hearingReference . '。', true,
    'an adjacent exact current-source negative supports the closed reference');
factStateStreamCheck($pilotLedger, $hearingReference . '。', false,
    'the closed reference cannot appear without an antecedent', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“语声低微”（s3）；' . $hearingReference . '。', false,
    'a positive quoted antecedent cannot become a negative by reference', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“未记录固定刺痛”（s2）；' . $hearingReference . '。', false,
    'an unknown quoted antecedent cannot become a negative by reference', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s2）；' . $hearingReference . '。', false,
    'a known but wrong source ID cannot verify the hearing antecedent', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（2026-10-22，s3）；' . $hearingReference . '。', false,
    'a mismatched date never gets washed away before reference validation', 'SOURCE_ANNOTATION_INVALID', '无喘促');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $hearingReference . '（2026-10-22，s3）。', false,
    'the referring clause cannot switch the supported source date', 'SOURCE_ANNOTATION_INVALID', '未见上述表现');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $hearingReference . '（s2）。', false,
    'the referring clause cannot switch to a different existing source', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；食欲一般；' . $hearingReference . '。', false,
    'an intervening statement clears the closed antecedent', 'UNSUPPORTED_NEGATIVE_REFERENCE', '未见上述表现');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $hearingReference . '，患者有心悸。', false,
    'the reference cannot exempt a later actual positive assertion', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $hearingReference . '，患者无固定刺痛。', false,
    'the reference cannot exempt a later actual unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');

// v26: the three parser fixes remain portable without retained live artifacts.
$dyspneaReference = '该记录支持气短尚未表现为闻诊可见的喘促';
$dyspneaParagraph = '**闻诊：**语声低微。四诊已记录阴性：“无喘促及异常气味”（s3，2026-10-23）。'
    . $dyspneaReference . '，但不能替代活动时呼吸频率、语句连续性及肺部听诊。';
factStateStreamCheck($pilotLedger, $dyspneaParagraph, true,
    'portable full hearing paragraph keeps a bounded non-occurrence interpretation tied to its source');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（2026-10-23，s3）；' . $dyspneaReference . '。', true,
    'a verified hearing negative supports only the closed dyspnea interpretation');
foreach (['', '“语声低微”（s3）；', '“未记录固定刺痛”（s2）；', '“无喘促及异常气味”（s2）；', '“无喘促及异常气味”（s3）；食欲一般；'] as $antecedent) {
    factStateStreamCheck($pilotLedger, $antecedent . $dyspneaReference . '。', false,
        'a closed dyspnea interpretation requires an adjacent exact hearing negative: ' . $antecedent,
        'UNSUPPORTED_NEGATIVE_REFERENCE', '尚未表现为');
}
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（2026-10-22，s3）；' . $dyspneaReference . '。', false,
    'an incorrect antecedent date is not discarded before dyspnea reference binding', 'SOURCE_ANNOTATION_INVALID', '无喘促');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '（s2）。', false,
    'the dyspnea interpretation cannot change its hearing source', 'UNSUPPORTED_NEGATIVE_REFERENCE', '尚未表现为');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '（2026-10-22，s3）。', false,
    'the dyspnea interpretation cannot change its source date', 'SOURCE_ANNOTATION_INVALID', '尚未表现为');
$qualifiedHearing = TcmClinicalFactStateGuard::build(['chief_complaint' => '气短', 'symptoms' => '闻诊无明显喘促及异常气味。']);
factStateStreamCheck($qualifiedHearing, '“无明显喘促及异常气味”；' . $dyspneaReference . '。', false,
    'the reference cannot delete the hearing source degree qualifier', 'UNSUPPORTED_NEGATIVE_REFERENCE', '尚未表现为');
$otherHearing = TcmClinicalFactStateGuard::build(['chief_complaint' => '气短', 'symptoms' => '闻诊无异常气味。']);
factStateStreamCheck($otherHearing, '“无异常气味”；' . $dyspneaReference . '。', false,
    'a different hearing absence cannot supply an absent dyspnea target', 'UNSUPPORTED_NEGATIVE_REFERENCE', '尚未表现为');
$hearingWithoutDyspnea = TcmClinicalFactStateGuard::build(['symptoms' => '闻诊无喘促及异常气味。']);
factStateStreamCheck($hearingWithoutDyspnea, '“无喘促及异常气味”；' . $dyspneaReference . '。', false,
    'a closed interpretation cannot invent its positive gas-shortness subject', 'UNSUPPORTED_NEGATIVE_REFERENCE', '尚未表现为');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '，患者有心悸。', false,
    'a following patient positive cannot borrow the dyspnea reference', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '，患者无固定刺痛。', false,
    'a following patient negative cannot borrow the dyspnea reference', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '，但不能替代后续检查，患者有心悸。', false,
    'an advisory tail after the closed reference does not hide a later actual patient positive', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '“无喘促及异常气味”（s3）；' . $dyspneaReference . '且患者有喘促。', false,
    'an asserted tail does not fit the closed reference grammar', 'NEGATIVE_TO_POSITIVE', '有喘促');

factStateStreamCheck($pilotLedger, '**切诊：**汗出及四肢温度的触诊、腹诊、按诊未记录，待补。', true,
    'a portable complete palpation paragraph names missing examination records rather than absent sweat symptoms');
factStateStreamCheck($pilotLedger, '汗出的触诊未记录。', true,
    'an explicit method noun does not relabel the recorded symptom itself');
factStateStreamCheck($pilotLedger, '口干及心悸的触诊、腹诊未记录。', true,
    'a coordinated method subject retains its own record scope');
factStateStreamCheck($pilotLedger, '汗出未记录。', false,
    'without a method noun an explicit source symptom still cannot be recast as unknown', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '汗出及四肢温度未记录。', false,
    'a coordinated symptom list without a method noun retains source state checks', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '汗出及四肢温度的触诊、心悸未记录。', false,
    'a method noun cannot absorb a later known negative symptom', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '口干、汗出及四肢温度的触诊未记录。', false,
    'a method noun cannot absorb an earlier known positive symptom', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '心悸的触诊及口干未记录。', false,
    'a symptom after the method noun is not hidden in its coordinated subject', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '汗出及四肢温度的触诊未记录，患者无固定刺痛。', false,
    'a missing method record never authorizes an actual negative tail', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '患者有心悸，汗出及四肢温度的触诊未记录。', false,
    'an actual positive before the method record is checked independently', 'NEGATIVE_TO_POSITIVE', '有心悸');
$knownMethod = TcmClinicalFactStateGuard::build(['present_illness' => '记录汗出的触诊。']);
factStateStreamCheck($knownMethod, '汗出的触诊未记录。', false,
    'a method record explicitly present in the source also cannot be recast as unknown', 'POSITIVE_TO_UNKNOWN', '未记录');

$sameDayUnknownParagraph = '**问诊：**主症持续3个月，为神疲乏力、轻微活动后气短、白天自汗且活动后加重，并有口干欲饮、少量频饮。'
    . '食欲一般，大便稍干、每日1次，小便量较以往略多、夜尿1次，睡眠一般。四诊已记录阴性：“无恶寒发热，”（2026-10-23，s2）；'
    . '“无高热烦渴、汗出淋漓或意识异常”（同日，s2）；“无明显五心烦热、潮热盗汗，”（同日，s2）；“无畏寒肢冷”（同日，s2）；'
    . '“无咳嗽咯痰、胸痛心悸、浮肿或腹泻”（同日，s2）；“无明显急性感染诱因”（同日，s2）。'
    . '腰酸耳鸣、固定刺痛为“未记录腰酸耳鸣或固定刺痛”（同日，s2），属于未知，不能作为阴性。';
factStateStreamCheck($pilotLedger, $sameDayUnknownParagraph, true,
    'portable full question paragraph binds relative-date metadata before normalizing the identical unknown subject');
$portableWire = $dyspneaParagraph . "\r\n\r\n" . '**切诊：**汗出及四肢温度的触诊、腹诊、按诊未记录，待补。'
    . "\r\n\r\n" . $sameDayUnknownParagraph;
$portableVisible = '';
$portableStream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$portableVisible): bool {
    $portableVisible .= $delta;
    return true;
});
$portablePushed = true;
// Byte chunks deliberately split UTF-8 characters and annotation/CRLF tokens.
foreach (str_split($portableWire, 7) as $chunk) {
    if (!$portableStream->push($chunk)) { $portablePushed = false; break; }
}
factStateExpect($portablePushed && $portableStream->finish() && !$portableStream->rejected(),
    'all three portable paragraphs stream through split UTF-8 and CRLF byte boundaries');
factStateExpect($portableVisible === $portableWire,
    'normalization cannot alter any accepted original byte including CRLF and a final undelimited paragraph');
foreach (['（同日，s2）', '(同日, s2)', '（同日，[s2]）'] as $annotation) {
    factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；固定刺痛为“未记录固定刺痛”' . $annotation . '，属于未知。', true,
        'a same-day citation inherits only the preceding verified calendar date: ' . $annotation);
}
factStateStreamCheck($pilotLedger, '“无恶寒发热”（s2）；固定刺痛为“未记录固定刺痛”（同日，s2）。', false,
    'same-day metadata without a preceding full calendar date is rejected', 'SOURCE_ANNOTATION_INVALID', '未记录固定刺痛');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；固定刺痛为“未记录固定刺痛”（同日，s999）。', false,
    'a relative date cannot make an unknown source ID trusted', 'SOURCE_ANNOTATION_INVALID', '未记录固定刺痛');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；固定刺痛为“未记录固定刺痛”（同日，患者有心悸）。', false,
    'clinical text inside a same-day parenthesis remains a patient assertion', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；固定刺痛为“未记录固定刺痛”（同日，[s2，患者无固定刺痛]）。', false,
    'nested brackets in relative-date metadata cannot strip a clinical negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；心悸为“未记录心悸”（同日，s2），属于未知。', false,
    'valid relative-date metadata does not erase a known negative', 'NEGATIVE_TO_UNKNOWN', '未记录心悸');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；口干为“未记录口干”（同日，s2）。', false,
    'valid relative-date metadata does not erase a known positive', 'POSITIVE_TO_UNKNOWN', '未记录口干');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；患者有固定刺痛为“未记录固定刺痛”（同日，s2）。', false,
    'valid relative-date metadata does not exempt a positive copular subject', 'UNKNOWN_TO_POSITIVE', '有固定刺痛');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；腰酸耳鸣为“未记录固定刺痛”（同日，s2）。', false,
    'relative-date parsing does not bind different unknown subjects', 'UNKNOWN_TO_POSITIVE', '腰酸耳鸣');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）；固定刺痛为“未记录固定刺痛”（同日，s2），患者无固定刺痛。', false,
    'a later actual absence stays outside the same-day unknown explanation', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '“无恶寒发热”（2026-10-23，s2）。' . "\n\n" . '固定刺痛为“未记录固定刺痛”（同日，s2）。', false,
    'an ambiguous same-day antecedent cannot carry across paragraph boundaries', 'SOURCE_ANNOTATION_INVALID', '未记录固定刺痛');
factStateStreamCheck($dated, '运动记录为“无胸痛或晕厥”（2026-10-22，' . $historicalSource['id'] . '）；运动记录为“无胸痛或晕厥”（同日，' . $historicalSource['id'] . '）。', true,
    'a relative historical date remains attached to the correctly dated event');
factStateStreamCheck($dated, '运动记录为“无胸痛或晕厥”（2026-10-22，' . $historicalSource['id'] . '）；本次耳鸣未记录（同日，s1）。', false,
    'a same-day annotation cannot move a historical event onto a current source date', 'SOURCE_ANNOTATION_INVALID', '未记录');
factStateStreamCheck($dated, '“无胸痛心悸”（2026-10-23，s1）；运动记录为“无胸痛或晕厥”（同日，' . $historicalSource['id'] . '）。', false,
    'a same-day annotation cannot move a historical source onto the current day', 'SOURCE_ANNOTATION_INVALID', '无胸痛或晕厥');
factStateStreamCheck($dated, '运动记录为“无胸痛或晕厥”（2026-10-22，' . $historicalSource['id'] . '）；运动记录为“无胸痛”（同日，' . $historicalSource['id'] . '）。', false,
    'a valid relative historical date still requires a complete original negative scope', 'ATTRIBUTED_SOURCE_QUOTE_INVALID', '无胸痛');
foreach (['无急性感染诱因。', '无五心烦热、潮热盗汗。', '无烦渴。'] as $broadened) {
    factStateStreamCheck($pilotLedger, $broadened, false,
        'the real v25 degree or compound-scope deletion remains rejected: ' . $broadened,
        'NEGATION_SCOPE_WIDENED', $broadened);
}

// v27: report structure, location references and file-availability explanations
// retain their roles. These complete literals need no retained local artifacts.
$pulseLocationParagraph = '**切诊：**脉诊结果见下方独立脉象行；腹诊、肌肤温度及按诊资料未记录。';
$unknownIndexParagraph = '**显式未知/待补：**1.“未记录腰酸耳鸣或固定刺痛”（s2，2026-10-23），二者均保持未知；'
    . '还需补采体位性变化、汗出时冷热感、饮水总量、口渴昼夜规律及完整腹诊。'
    . '附件缺失只表示不能图像复核，不代表舌体不存在其他异常。';
$attachmentRoleParagraph = "**明确未知／待补：**  \n1. “未记录腰酸耳鸣或固定刺痛”（s2，2026-10-23），两项均保持未知。  \n"
    . '2. “无附件”（s11，2026-10-23），表示没有可复核图像或报告，并非患者无异常。'
    . '氧饱和度、腰围及部分系统查体亦未记录。';
foreach ([$pulseLocationParagraph, $unknownIndexParagraph, $attachmentRoleParagraph] as $index => $paragraph) {
    factStateStreamCheck($pilotLedger, $paragraph, true,
        'portable complete v26 rejected unit retains its report role: ' . $index);
}

foreach (['脉诊结果见下方独立脉象行。', '切诊：脉象结果见下文脉象行。'] as $reference) {
    factStateStreamCheck($pilotLedger, $reference, true,
        'a closed location reference does not invent pulse 结 from 结果');
    factStateStreamCheck($examUnknown, $reference, true,
        'a location reference supplies no observed value even when the pulse field is unknown');
}
factStateStreamCheck($pilotLedger, '脉诊结果见下方独立脉象行，脉细弱，按之无力。', true,
    'a location reference can precede a faithful actual pulse value');
foreach (['脉结。', '脉滑。', '脉诊结果见下方独立脉象行，患者脉滑。',
    '患者脉滑，脉诊结果见下方独立脉象行。', '脉诊结果见下方独立脉象行且患者脉滑。'] as $observation) {
    factStateStreamCheck($pilotLedger, $observation, false,
        'actual pulse findings remain visible beside or outside the closed reference',
        'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', str_contains($observation, '脉滑') ? '脉滑' : '脉结');
}
factStateStreamCheck($pilotLedger, '脉诊结果见下方独立脉象行，患者无固定刺痛。', false,
    'a reference cannot exempt an actual patient negative tail', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '患者有心悸，脉诊结果见下方独立脉象行。', false,
    'a reference cannot exempt an earlier actual patient positive', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '脉诊结果见下方独立脉象行，口干未记录。', false,
    'a reference cannot erase an already recorded positive', 'POSITIVE_TO_UNKNOWN', '未记录');

$numberedLedger = TcmClinicalFactStateGuard::build(['present_illness' => 'eGFR 96mL/min/1.73m²；口干；无胸痛；未记录耳鸣。']);
foreach (['显式未知/待补：1.未记录耳鸣。', '明确未知／待补：1. 未记录耳鸣。',
    "明确未知／待补：\n1. 未记录耳鸣。", '未知/待补：2、耳鸣未记录。'] as $heading) {
    factStateStreamCheck($numberedLedger, $heading, true,
        'structural heading and list number cannot become a fragment of a recorded lab value');
}
factStateStreamCheck($numberedLedger, '显式未知/待补：1.口干未记录。', false,
    'number removal retains an actual known positive to unknown', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($numberedLedger, '明确未知／待补：1.胸痛未记录。', false,
    'number removal retains an actual known negative to unknown', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($numberedLedger, '显式未知/待补：1.患者有耳鸣。', false,
    'an uncertainty heading cannot exempt a positive unknown symptom', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
factStateStreamCheck($numberedLedger, '1.73m²未记录。', false,
    'a real decimal topic is not consumed as a numbered-list marker', 'POSITIVE_TO_UNKNOWN', '未记录');

$attachmentExplanation = '无附件，表示没有可复核图像或报告，并非患者无异常';
$recheckExplanation = '附件缺失只表示不能图像复核，不代表舌体不存在其他异常';
foreach ([$attachmentExplanation, $recheckExplanation,
    '未提供舌照，仅表示没有可复核图片或报告，不代表本例没有其他异常'] as $metadata) {
    factStateStreamCheck($pilotLedger, $metadata . '。', true,
        'a bounded metadata role does not assert the nested patient absence');
    factStateStreamCheck($pilotLedger, $metadata . '，脉细弱。', true,
        'a metadata explanation can coexist with a faithful observed pulse');
    factStateStreamCheck($pilotLedger, $metadata . '，患者无固定刺痛。', false,
        'metadata roles do not hide a following actual unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
    factStateStreamCheck($pilotLedger, '患者有心悸，' . $metadata . '。', false,
        'metadata roles do not hide an earlier actual negative-to-positive', 'NEGATIVE_TO_POSITIVE', '有心悸');
    factStateStreamCheck($pilotLedger, $metadata . '，口干未记录。', false,
        'metadata roles do not erase a later known positive', 'POSITIVE_TO_UNKNOWN', '未记录');
    factStateStreamCheck($pilotLedger, '心悸未记录，' . $metadata . '。', false,
        'metadata roles do not erase an earlier known negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
    factStateStreamCheck($pilotLedger, $metadata . '，舌质红绛。', false,
        'metadata roles do not hide a new tongue feature', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质红绛');
    factStateStreamCheck($pilotLedger, $metadata . '，患者脉滑。', false,
        'metadata roles do not hide a new pulse feature', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
}
factStateStreamCheck($pilotLedger, '无附件，表示没有可复核图像或报告，患者无异常。', false,
    'an actual broad patient absence is not the closed logical limitation', 'NEGATION_SCOPE_WIDENED', '无异常');
factStateStreamCheck($pilotLedger, $attachmentExplanation . '且患者有心悸。', false,
    'an unbounded clinical suffix cannot fit the metadata explanation', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '无附件（s999），表示没有可复核图像或报告，并非患者无异常。', false,
    'metadata roles cannot make an invalid citation trusted', 'SOURCE_ANNOTATION_INVALID', '无附件');

$nullAliasCurrent = ['id' => 7301, 'diagnosis_date' => '2026-10-23', 'chief_complaint' => '乏力',
    'present_illness' => null, 'tongue' => null, 'pulse' => null, 'current_medications' => null,
    'allergy_history' => 0, 'allergy_history_text' => '未记录',
    'family_history' => 0, 'family_history_text' => '未记录',
    'surgery_history' => 0, 'surgery_history_text' => '未记录',
    'trauma_history' => 0, 'trauma_history_text' => '未记录',
    'pregnancy_history' => 0, 'pregnancy_history_text' => '未记录'];
$nullAliasSubmission = AiRequiredSource::submission(['diagnoses' => [$nullAliasCurrent]]);
$nullAliasLedger = TcmClinicalFactStateGuard::build($nullAliasCurrent, $nullAliasSubmission);
factStateExpect(!array_filter($nullAliasLedger['sources'], static fn (array $source): bool =>
    in_array($source['field'], ['present_illness', 'tongue', 'pulse', 'current_medications'], true)),
    'complete-source nested nulls do not fabricate source findings');
foreach (['allergy_history' => '过敏史', 'family_history' => '家族史', 'surgery_history' => '手术史',
    'trauma_history' => '外伤史', 'pregnancy_history' => '孕产史'] as $field => $label) {
    factStateExpect($nullAliasLedger['field_states'][$field]['state'] === 'unknown',
        'legacy zero and its explicit unknown alias retain an unknown field state: ' . $field);
    factStateStreamCheck($nullAliasLedger, $label . '：未记录。', true,
        'complete-source explicit unknown alias remains usable: ' . $field);
    factStateStreamCheck($nullAliasLedger, $label . '：无。', false,
        'complete-source zero/null representation cannot authorize a patient denial: ' . $field,
        'UNKNOWN_TO_NEGATIVE', '无');
}
factStateStreamCheck($nullAliasLedger, '舌象未记录，脉象未记录。', true,
    'null current examinations remain unknown after complete-source projection');
factStateStreamCheck($nullAliasLedger, '脉滑。', false,
    'a null current examination never supplies a new pulse feature', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
$explicitAliasCurrent = array_replace($nullAliasCurrent, ['allergy_history_text' => '本次询问否认药物过敏史']);
$explicitAliasLedger = TcmClinicalFactStateGuard::build($explicitAliasCurrent,
    AiRequiredSource::submission(['diagnoses' => [$explicitAliasCurrent]]));
factStateStreamCheck($explicitAliasLedger, '本次询问否认药物过敏史。', true,
    'an explicit source denial remains valid beside a raw legacy zero');
factStateStreamCheck($explicitAliasLedger, '过敏史未记录。', false,
    'an explicit text denial cannot be erased by the legacy representation', 'NEGATIVE_TO_UNKNOWN', '未记录');

$v27Wire = $pulseLocationParagraph . "\r\n\r\n" . $unknownIndexParagraph . "\r\n\r\n" . $attachmentRoleParagraph;
foreach ([1, 7, 19] as $byteSize) {
    $v27Visible = '';
    $v27Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v27Visible): bool {
        $v27Visible .= $delta;
        return true;
    });
    $v27Pushed = true;
    foreach (str_split($v27Wire, $byteSize) as $chunk) {
        if (!$v27Stream->push($chunk)) { $v27Pushed = false; break; }
    }
    factStateExpect($v27Pushed && $v27Stream->finish() && !$v27Stream->rejected(),
        'v27 complete portable units survive UTF-8/metadata/CRLF boundaries at byte size ' . $byteSize);
    factStateExpect($v27Visible === $v27Wire,
        'v27 role normalization preserves every accepted original byte at byte size ' . $byteSize);
}

// v29: a centralized date has only a closed, same-paragraph negative-list role.
$datedNegativeList = "已记录阴性（2026-10-23）：\n"
    . "1.“无恶寒发热，”（s2）\n2.“无高热烦渴、汗出淋漓或意识异常”（s2）\n"
    . "3.“无明显五心烦热、潮热盗汗，”（s2）\n4.“无畏寒肢冷”（s2）\n"
    . "5.“无咳嗽咯痰、胸痛心悸、浮肿或腹泻”（s2）\n6.“无明显急性感染诱因”（s2）\n"
    . "7.“无喘促及异常气味”（s3）\n8.“无已知冠心病、心衰或慢性肾病”（s4）\n"
    . "9.“无已知药物过敏史”（s5）\n10.“未使用胰岛素或中药”（s6）";
$bloodCombination = '血分方面，面色少华、脉细可供血虚鉴别，但缺乏头晕、唇甲色淡等记录，现有证据不足以确认血虚；'
    . '固定刺痛为未知，舌无紫暗瘀斑，故血瘀缺少阳性支持。';
factStateStreamCheck($pilotLedger, $datedNegativeList, true,
    'a portable complete centralized-date list validates each original quote and source date');
factStateStreamCheck($pilotLedger, $datedNegativeList . "\n另据2026-10-22运动记录：“无胸痛或晕厥。”（原资料未提供source_id）", true,
    'the list date stops before a separately dated historical observation');
foreach ([
    str_replace('2026-10-23', '2026-10-22', $datedNegativeList),
    str_replace('（s3）', '（s999）', $datedNegativeList),
    str_replace('7.“无喘促及异常气味”（s3）', '7.“无喘促”（s3）', $datedNegativeList),
    str_replace('7.“无喘促及异常气味”（s3）', '7.“无喘促及异常气味”', $datedNegativeList),
    str_replace('已记录阴性（2026-10-23）：', '已记录阴性（2026-10-23，患者无固定刺痛）：', $datedNegativeList),
    "已记录阴性（2026-10-23）：\n\n1.“无恶寒发热，”（s2）",
] as $invalidList) {
    factStateStreamCheck($pilotLedger, $invalidList, false,
        'a date header cannot bypass source IDs, dates, complete quotes, closed grammar or paragraph boundaries');
}
factStateStreamCheck($pilotLedger, $datedNegativeList . "\n患者无固定刺痛。", false,
    'a dated list cannot authorize a following current unknown-to-negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, $datedNegativeList . "\n心悸未记录。", false,
    'a dated list cannot erase a known source negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, $datedNegativeList . "\n口干未记录。", false,
    'a dated list cannot erase a known source positive', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, $datedNegativeList . "\n固定刺痛未记录（同日，s2）。", false,
    'a centralized heading never seeds same-day metadata outside its list', 'SOURCE_ANNOTATION_INVALID', '未记录');
$oldHeaderSource = array_values(array_filter($dated['sources'], static fn (array $row): bool => str_starts_with($row['path'], 'daily_tracking.exercise.')))[0];
$oldDateList = "已记录阴性（2026-10-22）：\n1.“无胸痛或晕厥”（" . $oldHeaderSource['id'] . '）';
factStateStreamCheck($dated, $oldDateList, true,
    'a valid dated historical list remains an explicitly dated historical quotation');
factStateStreamCheck($dated, str_replace('2026-10-22', '2026-10-23', $oldDateList), false,
    'a current header date cannot promote an older source', 'SOURCE_ANNOTATION_INVALID', '无胸痛');
factStateStreamCheck($dated, $oldDateList . "\n本次无耳鸣。", false,
    'a historical list date cannot leak to a later explicitly current assertion', 'UNKNOWN_TO_NEGATIVE', '无耳鸣');

factStateStreamCheck($pilotLedger, $bloodCombination, true,
    'the complete portable blood paragraph combines two exact negative features from one current tongue source');
factStateStreamCheck($pilotLedger, '舌无紫暗瘀斑。', true,
    'a negative tongue combination preserves 紫暗 and 瘀斑 without inventing broad 舌紫');
foreach ([
    TcmClinicalFactStateGuard::build(['tongue' => '无明显紫暗、瘀斑。']),
    TcmClinicalFactStateGuard::build(['tongue' => '无紫暗。', 'tongue_coating' => '无瘀斑。']),
    TcmClinicalFactStateGuard::build(['tongue' => '舌紫暗，无瘀斑。']),
] as $unsupportedCombination) {
    factStateStreamCheck($unsupportedCombination, '舌无紫暗瘀斑。', false,
        'the combination requires both complete unqualified negatives from the same current tongue source',
        'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌无紫暗瘀斑');
}
factStateStreamCheck($pilotLedger, '舌无紫暗瘀斑，患者有固定刺痛。', false,
    'a supported tongue combination cannot authorize a new positive tail', 'UNKNOWN_TO_POSITIVE', '有固定刺痛');
factStateStreamCheck($pilotLedger, '舌无紫暗瘀斑，舌质红绛。', false,
    'a supported tongue combination cannot hide a new tongue feature', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质红绛');
factStateStreamCheck($pilotLedger, '舌无紫暗瘀斑，脉滑。', false,
    'a supported tongue combination cannot hide a new pulse feature', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, '无急性感染诱因。', false,
    'the actual Qwen deletion of 明显 remains rejected', 'NEGATION_SCOPE_WIDENED', '无急性感染诱因');
$v29Wire = str_replace("\n", "\r\n", $datedNegativeList) . "\r\n\r\n" . $bloodCombination;
$v29Visible = '';
$v29Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v29Visible): bool {
    $v29Visible .= $delta;
    return true;
});
$v29Pushed = true;
foreach (str_split($v29Wire, 7) as $chunk) {
    if (!$v29Stream->push($chunk)) { $v29Pushed = false; break; }
}
factStateExpect($v29Pushed && $v29Stream->finish() && !$v29Stream->rejected(),
    'both portable v29 roles survive split UTF-8, source metadata and CRLF boundaries');
factStateExpect($v29Visible === $v29Wire,
    'v29 validation-only normalization preserves all original accepted bytes');

// v30: the closed “未知项：” label is report structure, including before item 1.
$unknownItemSingle = '未知项：1.“未记录腰酸耳鸣或固定刺痛”（s2，2026-10-23）；'
    . '2.腹诊、体位性血压、氧饱和度、近期体重变化及完整饮食饮水量未采集或未记录；相关空栏保持未知。';
$unknownItemConcurrent = '未知项：1.“未记录腰酸耳鸣或固定刺痛”（s2，2026-10-23）；'
    . '2.婚姻、地区、腰围、血氧及体重变化等为空栏，保持未知；'
    . '3.无舌图、图片备注、文件报告及视频附件，不能据此判断相应体征或检查结果。';
foreach ([$unknownItemSingle, $unknownItemConcurrent] as $paragraph) {
    factStateStreamCheck($pilotLedger, $paragraph, true,
        'the portable complete v29 unknown-items paragraph cannot turn item 1 into an eGFR data gap');
}
factStateStreamCheck($numberedLedger, '未知项：1.未记录耳鸣。', true,
    'a closed unknown-items heading binds only its following item structure');
foreach (['未知项：1.eGFR 96mL/min/1.73m²未记录。', '未知项：2.未记录eGFR 96mL/min/1.73m²。',
    '未知项：1.73m²未记录。'] as $erasedLab) {
    factStateStreamCheck($numberedLedger, $erasedLab, false,
        'Latin lab items and true decimal topics retain known-to-unknown checks', 'POSITIVE_TO_UNKNOWN', '未记录');
}
factStateStreamCheck($pilotLedger, '未知项：1.eGFR 96mL/min/1.73m²未记录（2026-10-23，s23）。', false,
    'the actual dated s23 lab cannot be erased by an unknown-items heading', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($numberedLedger, '未知项：1.口干未记录。', false,
    'an unknown-items heading cannot erase a recorded clinical positive', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($numberedLedger, '未知项：1.胸痛未记录。', false,
    'an unknown-items heading cannot erase a recorded clinical negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
foreach (['未知项：1.患者有耳鸣。', '未知项：1..患者有耳鸣。', '未知项1.患者有耳鸣。'] as $actualClinicalItem) {
    factStateStreamCheck($numberedLedger, $actualClinicalItem, false,
        'valid or malformed numeric/clinical list syntax never exempts an actual observation',
        'UNKNOWN_TO_POSITIVE', '有耳鸣');
}
factStateStreamCheck($numberedLedger, '未知项：1.无耳鸣。', false,
    'a closed unknown-items heading cannot authorize an actual negative', 'UNKNOWN_TO_NEGATIVE', '无耳鸣');
$v30Wire = $unknownItemSingle . "\r\n\r\n" . $unknownItemConcurrent;
$v30Visible = '';
$v30Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v30Visible): bool {
    $v30Visible .= $delta;
    return true;
});
$v30Pushed = true;
foreach (str_split($v30Wire, 7) as $chunk) {
    if (!$v30Stream->push($chunk)) { $v30Pushed = false; break; }
}
factStateExpect($v30Pushed && $v30Stream->finish() && !$v30Stream->rejected(),
    'both complete v30 portable units stream through split UTF-8 and CRLF boundaries');
factStateExpect($v30Visible === $v30Wire,
    'v30 heading normalization preserves every accepted original input byte');

// v31: three proven discourse roles, with observed assertions kept outside them.
$evidenceNounParagraph = '气方面以气虚为主：乏力、动则气短、自汗、语声低微与无力脉相互印证，并见活动后加重，提示推动、固摄功能不足。'
    . '血方面仅有面色少华、脉细可作血虚鉴别线索，但未记录头晕、唇甲色泽等，现有证据不足以确认血虚；亦无本次阳性资料支持血瘀。';
$upperPulseParagraph = "望诊：神疲，面色少华。身高170cm，体重65kg，BMI 22.5kg/m²。体温36.5℃，血压124/76mmHg。  \n"
    . "闻诊：语声低微。  \n问诊：乏力、动则气短、自汗、口干3个月；轻微活动后气短，白天自汗且活动后加重，口干欲饮、少量频饮。"
    . "食欲一般，大便稍干、每日1次；小便量较以往略多，夜尿1次；睡眠一般。2026-10-22步行20分钟后乏力、汗出较明显。  \n"
    . "舌象：本次面诊记录：舌质淡红，舌面少津，苔少；无黄腻苔、紫暗或瘀斑。（s9）  \n"
    . "脉象：本次医师切诊：脉细弱，按之无力；不浮、不滑、不紧。（s10）  \n切诊：脉诊结果见上列脉象；其他切诊体征未记录。";
$reviewQuestionParagraph = '适用前须核实：复核自汗与气短是否持续呈活动后加重，有无新发感染、胸闷胸痛、心悸、晕厥或气促加剧；'
    . '补采完整饮水量、尿量、体重变化、腹诊及腰膝耳鸣等资料。若出现急性发热、明显实热、痰湿壅盛或其他实邪表现，应重新辨证，不能机械沿用本方向。';
foreach ([$evidenceNounParagraph, $upperPulseParagraph, $reviewQuestionParagraph] as $paragraph) {
    factStateStreamCheck($pilotLedger, $paragraph, true,
        'a complete portable v30 rejected unit retains its evidence, reference or review-question role');
}
factStateStreamCheck($pilotLedger, '亦无本次阳性资料支持血瘀。', true,
    'a closed evidence noun is not an observed patient negative');
foreach (['亦无本次阳性资料支持血瘀，患者无固定刺痛。', '患者无固定刺痛，亦无本次阳性资料支持血瘀。'] as $mixedEvidence) {
    factStateStreamCheck($pilotLedger, $mixedEvidence, false,
        'an evidence noun cannot hide an actual negative before or after it', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
}
factStateStreamCheck($pilotLedger, '亦无本次阳性资料支持血瘀且患者有心悸。', false,
    'an evidence noun has no wildcard slot for an actual positive tail', 'NEGATIVE_TO_POSITIVE', '有心悸');
foreach (['切诊：脉诊结果见上列脉象。', '脉象结果见上述独立脉象行。', '脉诊结果见下列脉象。'] as $locationReference) {
    factStateStreamCheck($pilotLedger, $locationReference, true,
        'upper and lower location references contain no observed pulse value');
}
factStateStreamCheck($pilotLedger, '切诊：脉诊结果见上列脉象，脉结。', false,
    'a result reference does not exempt an actual pulse 结', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉结');
factStateStreamCheck($pilotLedger, '脉诊结果见上列脉象且脉滑。', false,
    'an unbounded assertion tail does not fit the pulse-reference role', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, '患者无固定刺痛，脉诊结果见上列脉象。', false,
    'an upper reference does not hide an earlier actual patient negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '脉诊结果见上列脉象，口干未记录。', false,
    'a result reference cannot erase a recorded positive', 'POSITIVE_TO_UNKNOWN', '未记录');
$reviewQuestion = '适用前须核实：复核自汗与气短是否持续呈活动后加重，有无新发感染、胸闷胸痛、心悸、晕厥或气促加剧';
factStateStreamCheck($pilotLedger, '适用前须核实：有无心悸或固定刺痛。', true,
    'an anchored yes/no inquiry does not assert either source polarity');
foreach ([$reviewQuestion . '，患者无固定刺痛。', '患者无固定刺痛，' . $reviewQuestion . '。',
    $reviewQuestion . '且患者无固定刺痛。', '适用前须核实：复核无固定刺痛。'] as $mixedQuestion) {
    factStateStreamCheck($pilotLedger, $mixedQuestion, false,
        'a review request cannot hide an actual negative prefix, suffix or non-question statement',
        'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
}
foreach ([$reviewQuestion . '，患者有心悸。', $reviewQuestion . '且患者有心悸。',
    '适用前须核实：患者有心悸，复核自汗是否持续。'] as $mixedQuestion) {
    factStateStreamCheck($pilotLedger, $mixedQuestion, false,
        'a request frame cannot lend its generic collection exemption to an actual positive',
        'NEGATIVE_TO_POSITIVE', '有心悸');
}
factStateStreamCheck($pilotLedger, $reviewQuestion . '，心悸未记录。', false,
    'a review question cannot erase a recorded negative tail', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '无固定刺痛。', false,
    'the actual Qwen unknown-to-negative error remains rejected', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '无五心烦热。', false,
    'the actual Qwen degree-qualifier deletion remains rejected', 'NEGATION_SCOPE_WIDENED', '无五心烦热');
$v31Wire = $evidenceNounParagraph . "\r\n\r\n" . str_replace("\n", "\r\n", $upperPulseParagraph)
    . "\r\n\r\n" . $reviewQuestionParagraph;
$v31Visible = '';
$v31Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v31Visible): bool {
    $v31Visible .= $delta;
    return true;
});
$v31Pushed = true;
foreach (str_split($v31Wire, 7) as $chunk) {
    if (!$v31Stream->push($chunk)) { $v31Pushed = false; break; }
}
factStateExpect($v31Pushed && $v31Stream->finish() && !$v31Stream->rejected(),
    'all three portable v31 roles survive split UTF-8, source annotation and CRLF boundaries');
factStateExpect($v31Visible === $v31Wire,
    'v31 discourse-role handling preserves every accepted original byte');

// v32: grammatical data objects, bounded quantity predicates and review actions.
// These complete units are synthetic literals, independent of retained artifacts.
$missingRecordParagraph = '血方面仅有面色少华、脉细可供鉴别，尚不足以确认血虚；缺乏固定刺痛资料，亦不能确认血瘀。待补依据：见第一节未知第1项（s2）。';
$quantityParagraph = '气分以气虚为主要判断：乏力、活动后气短和汗出加重，与语声低微、脉弱无力相互印证，并见卫外不固、腠理失摄倾向。'
    . '津液方面为津液偏少：口干欲饮而每次不多、大便稍干、舌面少津苔少；自汗及小便较前略多可能增加津液耗失，但不能仅据尿量变化确立肾阴虚或消渴下消。';
$safetyReviewParagraph = '禁忌与安全复核：虽第一节阴性第9项（s5）记录本次询问情况，新用药仍须逐味复核过敏、既往不良反应、肝肾功能、合并药物及制剂含糖辅料。'
    . '2026-10-20 ALT 22U/L、肌酐78μmol/L、eGFR 96mL/min/1.73m²、尿ACR 12mg/g可作当前安全基线，不代表后续无需监测。'
    . '若复核发现邪实未解、痰湿壅盛、中满纳差等不适用条件，不宜机械采用本方向。';
foreach ([$missingRecordParagraph, $quantityParagraph, $safetyReviewParagraph] as $paragraph) {
    factStateStreamCheck($pilotLedger, $paragraph, true,
        'a complete v32 portable unit keeps its missing-record, quantity or review-action role');
}
$gapLedger = TcmClinicalFactStateGuard::build([
    'diagnosis_date' => '2026-10-23', 'present_illness' => '口干；无心悸；未记录耳鸣、固定刺痛或胰岛素。',
    'tongue' => '舌质淡红，舌面少津，苔少。', 'pulse' => '脉细弱。',
]);
foreach (['缺乏固定刺痛资料。', '缺少耳鸣记录。', '无耳鸣资料。', '未见耳鸣记录。',
    '缺少固定刺痛及耳鸣的专门文字描述。', '缺少舌裂纹资料。'] as $gapText) {
    factStateStreamCheck($gapLedger, $gapText, true,
        'a closed missing-data object retains unknown rather than patient-positive or patient-negative state');
}
foreach (['缺乏口干资料。', '缺少口干记录。', '没有口干专门描述。', '缺少口干及耳鸣记录。'] as $erasedPositive) {
    factStateStreamCheck($gapLedger, $erasedPositive, false,
        'missing-record metadata cannot erase a known same-time positive', 'POSITIVE_TO_UNKNOWN', '口干');
}
foreach (['缺少心悸记录。', '无心悸资料。'] as $erasedNegative) {
    factStateStreamCheck($gapLedger, $erasedNegative, false,
        'missing-record metadata cannot erase a known same-time negative', 'NEGATIVE_TO_UNKNOWN', '心悸');
}
factStateStreamCheck($gapLedger, '舌象：缺少资料。', false,
    'a field label supplies the missing record subject', 'RECORDED_TO_UNKNOWN', '缺少资料');
factStateStreamCheck($gapLedger, "脉象：\n\n缺乏资料。", false,
    'a carried recorded field cannot become an empty data gap across paragraphs', 'RECORDED_TO_UNKNOWN', '缺乏资料');
factStateStreamCheck($examUnknown, '舌象：缺少资料。', true,
    'the same labeled data gap is faithful when the examination really is unknown');
factStateStreamCheck($examUnknown, '舌象：缺少资料，脉象未记录。', true,
    'a comma-delimited field gap cannot turn the next unknown examination into an observed value');
factStateStreamCheck($examUnknown, '舌象：缺少资料，脉滑。', false,
    'a comma-delimited field gap cannot authorize an actual pulse value', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($gapLedger, '舌象：缺少资料，脉细弱。', false,
    'a later grounded pulse cannot hide erasure of the recorded tongue field', 'RECORDED_TO_UNKNOWN', '缺少资料');
factStateStreamCheck($gapLedger, '缺少口干记录（2026-10-23，s1）。', false,
    'valid source metadata cannot authorize erasing its actual positive', 'POSITIVE_TO_UNKNOWN', '口干');
factStateStreamCheck($gapLedger, '缺少耳鸣记录（2026-10-22，s1）。', false,
    'a data-gap role cannot make an inconsistent source date valid', 'SOURCE_ANNOTATION_INVALID', '缺少耳鸣');
factStateStreamCheck($gapLedger, '缺乏胰岛素。', false,
    'a deficiency without a record head noun remains an actual clinical proposition', 'UNKNOWN_TO_POSITIVE', '缺乏胰岛素');
$sourceGapLedger = TcmClinicalFactStateGuard::build(['present_illness' => '缺少耳鸣记录；缺乏胰岛素。']);
factStateStreamCheck($sourceGapLedger, '无耳鸣。', false,
    'source-side data-gap grammar also preserves unknown', 'UNKNOWN_TO_NEGATIVE', '无耳鸣');
factStateStreamCheck($sourceGapLedger, '胰岛素未记录。', false,
    'source-side deficiency is not indexed as missing-record metadata', 'POSITIVE_TO_UNKNOWN', '未记录');
foreach (['缺少耳鸣记录，患者有耳鸣。', '缺少耳鸣资料且患者有耳鸣。'] as $mixedGap) {
    factStateStreamCheck($gapLedger, $mixedGap, false,
        'a record object cannot hide an adjacent actual positive', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
}
factStateStreamCheck($gapLedger, '患者无固定刺痛，缺少耳鸣记录。', false,
    'a record object cannot hide an earlier actual negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($gapLedger, '缺少患者无耳鸣记录。', false,
    'an observed negative cannot be embedded inside a neutral data object', 'UNKNOWN_TO_NEGATIVE', '无耳鸣');
factStateStreamCheck($gapLedger, '缺少耳鸣记录，患者有心悸。', false,
    'a missing-data clause cannot reverse a different recorded negative', 'NEGATIVE_TO_POSITIVE', '有心悸');

factStateStreamCheck($pilotLedger, '口干欲饮而每次不多、大便稍干、舌面少津苔少。', true,
    'a closed quantity predicate cannot carry its negation into later positive list items');
factStateStreamCheck($pilotLedger, '饮水量不多，舌面少津，苔少；脉细弱。', true,
    'an explicit measure subject has the same quantity boundary as an iteration subject');
factStateStreamCheck($pilotLedger, '每次不多、大便稍干、舌质红绛。', false,
    'quantity scoping does not exempt a later invented tongue feature', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '舌质红绛');
factStateStreamCheck($pilotLedger, '每次不多、脉滑。', false,
    'quantity scoping does not exempt a later invented pulse feature', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, '每餐不少，患者有心悸。', false,
    'a bounded quantity does not exempt a later explicit clinical positive', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '每次不多，患者无固定刺痛。', false,
    'a bounded quantity does not exempt a later explicit unknown-to-negative error', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '每次不多、无五心烦热。', false,
    'a bounded quantity does not permit deleting a source degree qualifier', 'NEGATION_SCOPE_WIDENED', '无五心烦热');
factStateStreamCheck($pilotLedger, '每次不多，口干未记录。', false,
    'a bounded quantity does not authorize a later known-to-unknown error', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($gapLedger, '耳鸣每次不多。', false,
    'a quantity predicate still leaves its own clinical subject visible', 'UNKNOWN_TO_POSITIVE', '耳鸣');
factStateStreamCheck($pilotLedger, '不多、大便稍干、舌面少津苔少。', false,
    'an unbound negative has no invented quantity subject', 'POSITIVE_TO_NEGATIVE', '大便');
factStateStreamCheck($pilotLedger, '每次不多舌质红绛。', false,
    'an unclosed quantity complement cannot absorb a new examination value', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
$quantityUnknownLedger = TcmClinicalFactStateGuard::build(['present_illness' => '饮水量未记录。']);
factStateStreamCheck($quantityUnknownLedger, '饮水量不多。', false,
    'a measured quantity cannot be invented from an unknown record', 'UNKNOWN_TO_POSITIVE', '饮水量');

$reviewAction = '新用药仍须逐味复核过敏、既往不良反应、肝肾功能';
factStateStreamCheck($pilotLedger, $reviewAction . '。', true,
    'a modal collection action governs a neutral noun list without asserting its contents');
foreach (['患者无固定刺痛，' . $reviewAction . '。', $reviewAction . '，患者无固定刺痛。',
    '新用药仍须逐味复核无固定刺痛。'] as $mixedReviewAction) {
    factStateStreamCheck($pilotLedger, $mixedReviewAction, false,
        'a review action cannot hide an actual negative prefix, suffix or object statement',
        'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
}
foreach (['患者有心悸，' . $reviewAction . '。', $reviewAction . '，患者有心悸。',
    $reviewAction . '且患者有心悸。', $reviewAction . '患者有心悸。',
    '新用药须复核患者有心悸。', '须复核患者有心悸。'] as $mixedReviewAction) {
    factStateStreamCheck($pilotLedger, $mixedReviewAction, false,
        'a review action cannot hide an actual positive prefix, suffix or conjunction',
        'NEGATIVE_TO_POSITIVE', '有心悸');
}
factStateStreamCheck($pilotLedger, $reviewAction . '，心悸未记录。', false,
    'a review action cannot erase a known negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, $reviewAction . '且舌质红绛。', false,
    'a request object list stops before an assertion conjunction', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
factStateStreamCheck($gapLedger, $reviewAction . '且患者有耳鸣。', false,
    'a historical noun inside a request cannot redate a new current patient assertion', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
factStateStreamCheck($pilotLedger, '患者无不良反应。', false,
    'an adverse-reaction noun does not exempt an actual unsupported patient absence', 'NEGATIVE_NOT_IN_SOURCE', '无不良反应');
factStateStreamCheck($pilotLedger, '患者无药物过敏史。', false,
    'the original known-allergy qualifier still cannot be deleted', 'NEGATION_SCOPE_WIDENED', '无药物过敏史');
$v32Wire = $missingRecordParagraph . "\r\n\r\n" . $quantityParagraph . "\r\n\r\n" . $safetyReviewParagraph;
$v32Visible = '';
$v32Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v32Visible): bool {
    $v32Visible .= $delta;
    return true;
});
$v32Pushed = true;
foreach (str_split($v32Wire, 7) as $chunk) {
    if (!$v32Stream->push($chunk)) { $v32Pushed = false; break; }
}
factStateExpect($v32Pushed && $v32Stream->finish() && !$v32Stream->rejected(),
    'all complete v32 roles survive split UTF-8, metadata and CRLF boundaries');
factStateExpect($v32Visible === $v32Wire,
    'v32 scope analysis preserves every accepted original input byte');

// v33: a postfix gap modifies its closed record object, never a patient finding.
// This portable literal includes the full rejected paragraph, without artifacts.
$postfixRecordParagraph = '气方面，以气虚为主要病机：乏力、动则气短、自汗、语声低微及脉按之无力构成连续证据链，并提示气的推动、固摄功能不足。'
    . '血方面，面色少华、脉细可作为血分不足的鉴别线索，但缺少头晕、唇甲色淡等本例阳性记录，故血虚尚不能确证；'
    . '固定刺痛资料缺失，待补依据：见第一节未知第1项（s2）。';
factStateStreamCheck($pilotLedger, $postfixRecordParagraph, true,
    'the complete v32 OpenAI paragraph keeps its postfix missing-record role');
foreach (['固定刺痛资料缺失。', '耳鸣记录缺失。', '耳鸣信息缺失。', '耳鸣描述缺失。',
    '耳鸣的专门文字描述缺失。', '耳鸣资料仍缺失。', '本次耳鸣记录尚缺失。',
    '耳鸣、固定刺痛资料缺失。', '耳鸣及固定刺痛资料缺失。', '舌裂纹资料缺失。',
    '耳鸣资料缺失，口干。', '耳鸣资料缺失，舌质淡红；脉细弱。'] as $postfixGap) {
    factStateStreamCheck($gapLedger, $postfixGap, true,
        'a closed postfix record gap retains unknown and preserves adjoining grounded findings');
}
foreach (['口干资料缺失。', '口干记录缺失。', '口干信息缺失。', '口干描述缺失。',
    '口干及耳鸣记录缺失。', '口干的专门文字描述缺失。'] as $postfixErasure) {
    factStateStreamCheck($gapLedger, $postfixErasure, false,
        'a postfix record gap cannot erase a known positive', 'POSITIVE_TO_UNKNOWN', '口干');
}
foreach (['心悸记录缺失。', '心悸资料缺失。', '耳鸣及心悸信息缺失。'] as $postfixErasure) {
    factStateStreamCheck($gapLedger, $postfixErasure, false,
        'a postfix record gap cannot erase a known negative', 'NEGATIVE_TO_UNKNOWN', '心悸');
}
factStateStreamCheck($gapLedger, '舌象：资料缺失。', false,
    'a labeled postfix record gap still conflicts with a recorded examination', 'RECORDED_TO_UNKNOWN', '资料缺失');
factStateStreamCheck($gapLedger, "脉象：\n\n资料缺失。", false,
    'a carried recorded examination cannot become a postfix data gap', 'RECORDED_TO_UNKNOWN', '资料缺失');
factStateStreamCheck($examUnknown, '舌象：资料缺失。', true,
    'a labeled postfix record gap is faithful for an unknown examination');
factStateStreamCheck($examUnknown, '舌象：资料缺失，脉象未记录。', true,
    'a postfix record gap cannot supply a value for the next unknown examination');
factStateStreamCheck($examUnknown, '舌象：资料缺失，脉滑。', false,
    'a postfix record gap cannot authorize a new examination value', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
foreach (['耳鸣资料缺失，患者有耳鸣。', '患者有耳鸣，耳鸣资料缺失。',
    '耳鸣资料缺失且患者有耳鸣。', '耳鸣资料缺失而患者有耳鸣。',
    '患者有耳鸣资料缺失。', '耳鸣资料缺失、固定刺痛。', '耳鸣资料缺失及固定刺痛。',
    '耳鸣资料缺失患者有耳鸣。'] as $mixedPostfixGap) {
    factStateStreamCheck($gapLedger, $mixedPostfixGap, false,
        'a postfix record object cannot absorb an actual positive clause or list tail', 'UNKNOWN_TO_POSITIVE', '耳鸣');
}
foreach (['耳鸣资料缺失，患者无固定刺痛。', '患者无固定刺痛，耳鸣资料缺失。',
    '耳鸣资料缺失且患者无固定刺痛。', '无固定刺痛资料缺失。'] as $mixedPostfixGap) {
    factStateStreamCheck($gapLedger, $mixedPostfixGap, false,
        'a postfix record object cannot absorb an actual clinical negative', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
}
factStateStreamCheck($gapLedger, '耳鸣资料缺失，患者有心悸。', false,
    'a postfix data gap cannot reverse a different recorded negative', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, '固定刺痛资料缺失，口干未记录。', false,
    'a postfix gap cannot erase an adjoining known positive', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '固定刺痛资料缺失，心悸未记录。', false,
    'a postfix gap cannot erase an adjoining known negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, '固定刺痛资料缺失，无五心烦热。', false,
    'a postfix gap cannot authorize deleting a degree qualifier', 'NEGATION_SCOPE_WIDENED', '无五心烦热');
factStateStreamCheck($pilotLedger, '固定刺痛资料缺失，舌质红绛。', false,
    'a postfix gap cannot authorize an unsupported tongue feature', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
factStateStreamCheck($pilotLedger, '固定刺痛资料缺失且脉滑。', false,
    'a postfix gap cannot absorb a joined unsupported pulse feature', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($gapLedger, '胰岛素缺失。', false,
    'a deficiency without a record head noun stays a clinical proposition', 'UNKNOWN_TO_POSITIVE', '胰岛素');
factStateStreamCheck($gapLedger, '固定刺痛资料缺失（2026-10-22，s1）。', false,
    'a postfix data gap cannot validate inconsistent source metadata', 'SOURCE_ANNOTATION_INVALID', '资料缺失');
$postfixSourceLedger = TcmClinicalFactStateGuard::build(['present_illness' => '耳鸣资料缺失；胰岛素缺失。']);
factStateStreamCheck($postfixSourceLedger, '无耳鸣。', false,
    'source-side postfix record grammar also retains unknown', 'UNKNOWN_TO_NEGATIVE', '无耳鸣');
factStateStreamCheck($postfixSourceLedger, '患者有耳鸣。', false,
    'source-side postfix record grammar cannot become a positive', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
factStateStreamCheck($postfixSourceLedger, '胰岛素未记录。', false,
    'source-side clinical deficiency is not a postfix record gap', 'POSITIVE_TO_UNKNOWN', '未记录');
$v33Wire = str_replace('。', "。\r\n", $postfixRecordParagraph) . "\r\n";
$v33Visible = '';
$v33Stream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v33Visible): bool {
    $v33Visible .= $delta;
    return true;
});
$v33Pushed = true;
foreach (str_split($v33Wire, 7) as $chunk) {
    if (!$v33Stream->push($chunk)) { $v33Pushed = false; break; }
}
factStateExpect($v33Pushed && $v33Stream->finish() && !$v33Stream->rejected(),
    'the portable v33 paragraph survives split UTF-8, source annotations and CRLF boundaries');
factStateExpect($v33Visible === $v33Wire,
    'v33 role analysis preserves every accepted original byte');

// The exclusion predicate is inside a modal limit, not a patient denial.
$exclusionLimitParagraph = '表里：症状持续3个月、渐进出现，以乏力、动则气短、自汗、口干及二便改变为主，现有资料更支持里证倾向。'
    . '限制依据：见第一节阴性第①、⑥项（s2），只能降低本次急性表证可能，不能仅凭否认彻底排除所有表证。';
factStateStreamCheck($pilotLedger, $exclusionLimitParagraph, true,
    'the complete frozen B OpenAI paragraph limits exclusion rather than denying a patient finding');
$exclusionLedger = TcmClinicalFactStateGuard::build([
    'present_illness' => '口干；无心悸；未记录表证、耳鸣或固定刺痛。',
    'tongue' => '舌质淡红。', 'pulse' => '脉细弱。',
]);
$exclusionLimit = '不能仅凭否认彻底排除所有表证';
foreach ([$exclusionLimit . '。', '本次依据有限，' . $exclusionLimit . '。',
    '不能排除耳鸣。', '不能彻底排除表证。', '不能排除固定刺痛或耳鸣。',
    '不得单凭现有资料完全排除耳鸣。', '不应仅依据上述证据排除表证。',
    '不得单凭本次资料完全排除耳鸣。', '不能仅凭当前阴性记录排除表证。',
    '不能仅据阴性记录直接排除所有表证。', '不能只凭否认排除全部表证。',
    '不据此宣称表证已被排除。', '但不据此宣称表证已被排除。', '不代表表证已被排除。',
    '不能据此宣称表证已被排除。', '不说明耳鸣已经被完全排除。',
    $exclusionLimit . '，口干，脉细弱。'] as $modalLimit) {
    factStateStreamCheck($exclusionLedger, $modalLimit, true,
        'a closed modal exclusion limit contains a neutral source noun and neutral target object');
}
foreach ([$exclusionLimit . '，患者有耳鸣。', '患者有耳鸣，' . $exclusionLimit . '。',
    $exclusionLimit . '且患者有耳鸣。', $exclusionLimit . '患者有耳鸣。',
    '不能排除患者有耳鸣。'] as $mixedLimit) {
    factStateStreamCheck($exclusionLedger, $mixedLimit, false,
        'a modal exclusion limit cannot absorb an actual patient positive', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
}
foreach ([$exclusionLimit . '，患者无固定刺痛。', '患者无固定刺痛，' . $exclusionLimit . '。',
    $exclusionLimit . '且患者无固定刺痛。', $exclusionLimit . '患者无固定刺痛。',
    '不能排除患者无固定刺痛。', '不能仅凭患者无固定刺痛彻底排除表证。',
    '不能仅凭否认固定刺痛彻底排除表证。'] as $mixedLimit) {
    factStateStreamCheck($exclusionLedger, $mixedLimit, false,
        'a modal limit cannot turn an embedded or adjacent clinical denial into a neutral noun', 'UNKNOWN_TO_NEGATIVE', '固定刺痛');
}
foreach ([$exclusionLimit . '，患者有心悸。', $exclusionLimit . '且患者有心悸。'] as $mixedLimit) {
    factStateStreamCheck($exclusionLedger, $mixedLimit, false,
        'a modal exclusion limit cannot reverse a known negative', 'NEGATIVE_TO_POSITIVE', '有心悸');
}
foreach ([$exclusionLimit . '，口干未记录。', $exclusionLimit . '且口干未记录。'] as $mixedLimit) {
    factStateStreamCheck($exclusionLedger, $mixedLimit, false,
        'a modal exclusion limit cannot erase a known positive', 'POSITIVE_TO_UNKNOWN', '未记录');
}
factStateStreamCheck($exclusionLedger, $exclusionLimit . '，心悸未记录。', false,
    'a modal exclusion limit cannot erase a known negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
foreach (['本次彻底排除表证。', '本次已排除表证。', '表证已被排除。', '据此宣称表证已被排除。'] as $actualExclusion) {
    factStateStreamCheck($exclusionLedger, $actualExclusion, false,
        'an actual exclusion without modal scope receives no exemption', 'UNKNOWN_TO_POSITIVE', '表证');
}
$exclusionScopeMethod = new ReflectionMethod(TcmClinicalFactStateGuard::class, 'exclusionLimitProse');
$exclusionScopeMethod->setAccessible(true);
foreach (['排除表证', '本次彻底排除表证', '仅凭阴性记录彻底排除表证', '患者无固定刺痛',
    '表证已被排除', '据此宣称表证已被排除', '不能仅凭否认固定刺痛彻底排除表证', '舌质淡红而非明确红绛'] as $actualPredicate) {
    factStateExpect($exclusionScopeMethod->invoke(null, $actualPredicate) === $actualPredicate,
        'exclusion normalization preserves every byte of an actual or unbounded predicate');
}
factStateStreamCheck($exclusionLedger, '本次否认耳鸣。', false,
    'an actual patient denial without modal scope remains a clinical negative', 'UNKNOWN_TO_NEGATIVE', '否认耳鸣');
factStateStreamCheck($pilotLedger, $exclusionLimit . '，无五心烦热。', false,
    'a modal limit cannot authorize degree-qualifier loss', 'NEGATION_SCOPE_WIDENED', '无五心烦热');
factStateStreamCheck($pilotLedger, $exclusionLimit . '且脉滑。', false,
    'a joined actual pulse value cannot borrow modal exclusion scope', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, $exclusionLimit . '，舌质红绛。', false,
    'an actual tongue value cannot borrow modal exclusion scope', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
factStateStreamCheck($pilotLedger, $exclusionLimit . '，舌质淡红而非明确红绛。', false,
    'the frozen B tongue-color negation remains unsupported after modal scoping', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
factStateStreamCheck($pilotLedger, $exclusionLimit . '且舌质淡红而非明确红绛。', false,
    'a joined tongue-color negation remains unsupported after modal scoping', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
foreach (['不能排除脉滑。', $exclusionLimit . '脉滑。'] as $phenotypeLimit) {
    factStateStreamCheck($pilotLedger, $phenotypeLimit, false,
        'modal normalization leaves pulse phenotypes under the existing examination policy', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
}
foreach (['不能排除舌质红绛。', $exclusionLimit . '舌质红绛。'] as $phenotypeLimit) {
    factStateStreamCheck($pilotLedger, $phenotypeLimit, false,
        'modal normalization leaves tongue phenotypes under the existing examination policy', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
}
factStateStreamCheck($pilotLedger, $exclusionLimit . '（s999）。', false,
    'modal scope cannot validate an invalid source annotation', 'SOURCE_ANNOTATION_INVALID', '排除');
foreach (['不据此宣称相关证候已被排除', '不代表相关证候已被排除'] as $passiveLimit) {
    factStateStreamCheck($pilotLedger, $passiveLimit . '。', true,
        'a denial of an exclusion conclusion stays inside its modal scope');
    factStateStreamCheck($pilotLedger, $passiveLimit . '且患者无固定刺痛。', false,
        'a passive exclusion limit cannot absorb a joined patient absence', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
    factStateStreamCheck($pilotLedger, $passiveLimit . '，患者有心悸。', false,
        'a passive exclusion limit cannot reverse a known patient negative', 'NEGATIVE_TO_POSITIVE', '有心悸');
    factStateStreamCheck($pilotLedger, $passiveLimit . '且口干未记录。', false,
        'a passive exclusion limit cannot erase a known finding', 'POSITIVE_TO_UNKNOWN', '未记录');
    factStateStreamCheck($pilotLedger, $passiveLimit . '且舌质淡红而非明确红绛。', false,
        'a passive exclusion limit cannot reinterpret a tongue phenotype', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
}

$attachmentRoleParagraph = '反证与限制：限制依据见第一节已记录阴性第2、3、4项（s2）；这些资料降低显著实热、虚热及阳虚寒象对本方向的支持，但不据此宣称相关证候已被排除。'
    . '限制依据另见第一节已记录阴性第5项（s2）和第7项（s3）；仅说明当前缺乏相应心肺急症伴随表现，不能替代心肺检查。'
    . '舌脉虽有本次医师记录，但无附件可供二次图像核验，仍应由复核医师结合现场所见确认。';
$denialReferenceParagraph = '反证与局限：限制依据见第一节已记录阴性第2、3、4项（s2），这仅提示典型热盛、虚热或阳虚寒象的支持不足，不代表相关证候已被排除；'
    . '见第5、7项（s2、s3），仅降低明显心肺伴随症状对当前判断的干扰，不能代替心肺评估。既往疾病否认见第8项（s4），亦不能替代本次检查。';
foreach ([$attachmentRoleParagraph, $denialReferenceParagraph] as $metadataParagraph) {
    factStateStreamCheck($pilotLedger, $metadataParagraph, true,
        'a complete retained A paragraph preserves bounded availability or source-verified history reference roles');
}
$attachmentRole = '无附件可供二次图像核验';
foreach ([$attachmentRole . '。', '未提供舌照可供二次复核。', '无图像可供图片核验。',
    '舌脉有本次医师记录，但' . $attachmentRole . '，仍应复核。'] as $availability) {
    factStateStreamCheck($pilotLedger, $availability, true,
        'a closed attachment availability object is metadata rather than a clinical absence');
}
foreach ([$attachmentRole . '，患者无固定刺痛。', '患者无固定刺痛，' . $attachmentRole . '。',
    $attachmentRole . '且患者无固定刺痛。', $attachmentRole . '患者无固定刺痛。',
    $attachmentRole . '、固定刺痛。'] as $mixedAvailability) {
    factStateStreamCheck($pilotLedger, $mixedAvailability, false,
        'attachment availability cannot absorb actual clinical absences or list items', 'UNKNOWN_TO_NEGATIVE', '固定刺痛');
}
factStateStreamCheck($pilotLedger, $attachmentRole . '且患者有心悸。', false,
    'attachment availability cannot reverse a known negative', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($pilotLedger, $attachmentRole . '且口干未记录。', false,
    'attachment availability cannot erase a known positive', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, $attachmentRole . '且脉滑。', false,
    'attachment availability cannot authorize a new pulse phenotype', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, '本次' . $attachmentRole . '及皮疹。', false,
    'a clinical list cannot be reclassified as one attachment object', 'NEGATIVE_NOT_IN_SOURCE', '皮疹');
factStateStreamCheck($pilotLedger, $attachmentRole . '（s999）。', false,
    'attachment metadata cannot validate a nonexistent citation', 'SOURCE_ANNOTATION_INVALID', '核验');

$referenceLedger = TcmClinicalFactStateGuard::build([
    'id' => 1, 'diagnosis_date' => '2026-10-23',
    'present_illness' => '口干；无心悸；未记录固定刺痛或耳鸣。',
    'past_history' => '无已知冠心病。', 'allergy_history' => '未记录', 'family_history' => '否认',
]);
$referenceIds = [];
foreach ($referenceLedger['sources'] as $source) $referenceIds[$source['field']] = $source['id'];
$denialReference = '既往疾病否认见第8项（' . $referenceIds['past_history'] . '）';
foreach ([$denialReference . '。', $denialReference . '，亦不能替代本次检查。',
    '既往史否认见第8项（2026-10-23，' . $referenceIds['past_history'] . '）。',
    '家族史否认见第⑧项（' . $referenceIds['family_history'] . '）。'] as $verifiedReference) {
    factStateStreamCheck($referenceLedger, $verifiedReference, true,
        'a neutral history locator cites a current negative source in the same history field');
}
foreach (['既往疾病否认见第8项。', '既往疾病否认见第8项（s999）。',
    '既往疾病否认见第8项（' . $referenceIds['present_illness'] . '）。',
    '过敏史否认见第8项（' . $referenceIds['allergy_history'] . '）。',
    '既往疾病否认见第8项（2026-10-22，' . $referenceIds['past_history'] . '）。'] as $invalidReference) {
    factStateStreamCheck($referenceLedger, $invalidReference, false,
        'a history locator needs a real same-time negative source in its own history field', 'SOURCE_ANNOTATION_INVALID', '否认见');
}
factStateStreamCheck($referenceLedger, $denialReference . '且患者无固定刺痛。', false,
    'a verified history locator cannot absorb a patient absence', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($referenceLedger, $denialReference . '，患者有心悸。', false,
    'a verified history locator cannot reverse another negative', 'NEGATIVE_TO_POSITIVE', '有心悸');
factStateStreamCheck($referenceLedger, $denialReference . '且口干未记录。', false,
    'a verified history locator cannot erase a known finding', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($referenceLedger, '固定刺痛否认见第8项（' . $referenceIds['past_history'] . '）。', false,
    'a named clinical symptom is not a neutral history-field locator', 'UNKNOWN_TO_POSITIVE', '固定刺痛');
factStateStreamCheck($referenceLedger, '既往疾病否认见第8项（' . $referenceIds['past_history'] . '，当前患者无固定刺痛）。', false,
    'a mixed clinical citation cannot borrow history-reference scope', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
factStateStreamCheck($pilotLedger, '既往疾病否认见第8项（s4），舌质淡红而非明确红绛。', false,
    'a valid history reference cannot authorize an unsupported tongue comparison', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
$historicalReferenceLedger = TcmClinicalFactStateGuard::build([
    'id' => 1, 'diagnosis_date' => '2026-10-23', 'past_history' => '未记录',
], ['required_content' => [['key' => 'past_history', 'value' => [[
    'id' => 2, 'diagnosis_date' => '2026-10-22', 'past_history' => '否认',
]]]]]);
$historicalReferenceSource = array_values(array_filter($historicalReferenceLedger['sources'],
    static fn (array $source): bool => $source['scope'] === 'historical'))[0];
factStateStreamCheck($historicalReferenceLedger, '既往疾病否认见第8项（' . $historicalReferenceSource['id'] . '）。', false,
    'a historical denial cannot supply a current history reference', 'SOURCE_ANNOTATION_INVALID', '否认见');
foreach (['糖尿病4年。', '既往否认冠心病。', '无附件。', '否认记录有误。'] as $unsupportedHistory) {
    $unsupportedReferenceLedger = TcmClinicalFactStateGuard::build([
        'diagnosis_date' => '2026-10-23', 'past_history' => $unsupportedHistory,
    ]);
    factStateStreamCheck($unsupportedReferenceLedger, '既往疾病否认见第8项（s1）。', false,
        'a positive, historical or metadata-only history source cannot authorize a current denial locator',
        'SOURCE_ANNOTATION_INVALID', '否认见');
}
$v33ScopeWire = implode("\r\n\r\n", [$postfixRecordParagraph, $exclusionLimitParagraph,
    $attachmentRoleParagraph, $denialReferenceParagraph]) . "\r\n\r\n";
$v33ScopeVisible = '';
$v33ScopeStream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$v33ScopeVisible): bool {
    $v33ScopeVisible .= $delta;
    return true;
});
$v33ScopePushed = true;
foreach (str_split($v33ScopeWire, 7) as $chunk) {
    if (!$v33ScopeStream->push($chunk)) { $v33ScopePushed = false; break; }
}
factStateExpect($v33ScopePushed && $v33ScopeStream->finish() && !$v33ScopeStream->rejected(),
    'all v33 scoped roles survive split UTF-8, source annotations and CRLF paragraph boundaries together');
factStateExpect($v33ScopeVisible === $v33ScopeWire,
    'all accepted v33 scoped roles preserve every original streamed byte');

// Follow-up: verification is a bounded review action, not an observed noun list.
$verifySafetyParagraph = '禁忌与安全：虽本次询问无已知药物过敏史，首次用药仍须核对人参、麦冬、五味子及制剂辅料的既往反应。'
    . '对药材质量、胃肠耐受、肝肾功能变化及潜在相互作用需复核；妊娠事项不适用于本例男性。'
    . '2026-10-20 ALT 22U/L、肌酐78μmol/L、eGFR 96mL/min/1.73m²、尿ACR 12mg/g，可作当前安全基线，但不能保证后续用药绝对安全。';
factStateStreamCheck($pilotLedger, $verifySafetyParagraph, true,
    'the complete retained v33 safety paragraph preserves its verification-action role');
$verifyAction = '首次用药仍须核对药材及制剂辅料的既往反应';
foreach ([$verifyAction . '。', '用药前需逐项核对既往反应及合并药物。',
    '复诊仍应核对过敏、肝肾功能。', '仍须核对既往不良反应。',
    '虽本次询问无已知药物过敏史，' . $verifyAction . '。'] as $neutralVerification) {
    factStateStreamCheck($pilotLedger, $neutralVerification, true,
        'a modal verification action governs only its neutral object list');
}
foreach (['患者无固定刺痛，' . $verifyAction . '。', $verifyAction . '，患者无固定刺痛。',
    $verifyAction . '且患者无固定刺痛。', $verifyAction . '患者无固定刺痛。',
    '首次用药须核对无固定刺痛。', '须核对患者无固定刺痛。'] as $mixedVerification) {
    factStateStreamCheck($pilotLedger, $mixedVerification, false,
        'verification cannot absorb an actual negative prefix, suffix or object assertion', 'UNKNOWN_TO_NEGATIVE', '无固定刺痛');
}
foreach (['患者有心悸，' . $verifyAction . '。', $verifyAction . '，患者有心悸。',
    $verifyAction . '且患者有心悸。', $verifyAction . '患者有心悸。',
    '首次用药须核对患者有心悸。', '须核对患者有心悸。', '需核对患者有心悸。',
    '首次用药仍须核对有心悸。'] as $mixedVerification) {
    factStateStreamCheck($pilotLedger, $mixedVerification, false,
        'verification cannot absorb an actual positive and cannot borrow a generic modal exemption', 'NEGATIVE_TO_POSITIVE', '有心悸');
}
factStateStreamCheck($pilotLedger, $verifyAction . '且口干未记录。', false,
    'a verification action cannot erase a known positive', 'POSITIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($pilotLedger, $verifyAction . '，心悸未记录。', false,
    'a verification action cannot erase a known negative', 'NEGATIVE_TO_UNKNOWN', '未记录');
factStateStreamCheck($gapLedger, $verifyAction . '且患者有耳鸣。', false,
    'a historical noun in a verification object cannot redate a new current assertion', 'UNKNOWN_TO_POSITIVE', '有耳鸣');
factStateStreamCheck($pilotLedger, $verifyAction . '且舌质红绛。', false,
    'a verification action cannot authorize a new tongue phenotype', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '红绛');
factStateStreamCheck($pilotLedger, $verifyAction . '且脉滑。', false,
    'a verification action cannot authorize a new pulse phenotype', 'PULSE_FEATURE_NOT_IN_CURRENT_SOURCE', '脉滑');
factStateStreamCheck($pilotLedger, $verifyAction . '，舌质淡红而非明确红绛。', false,
    'a verification action cannot reinterpret the unsupported tongue comparison', 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE', '非明确红绛');
factStateStreamCheck($pilotLedger, '虽本次询问无药物过敏史，' . $verifyAction . '。', false,
    'a verification action cannot authorize deleting the known-allergy qualifier', 'NEGATION_SCOPE_WIDENED', '无药物过敏史');
factStateStreamCheck($allergyUnknown, '虽本次询问无已知药物过敏史，' . $verifyAction . '。', false,
    'a verification action cannot make an unknown allergy history an observed negative', 'UNKNOWN_TO_NEGATIVE', '无已知药物过敏史');
factStateStreamCheck($pilotLedger, $verifyAction . '（s999）。', false,
    'verification cannot validate a nonexistent source citation', 'SOURCE_ANNOTATION_INVALID', '核对');
$verifyWire = $verifySafetyParagraph . "\r\n\r\n";
$verifyVisible = '';
$verifyStream = new TcmClinicalReportStream($pilotLedger, static function (string $delta) use (&$verifyVisible): bool {
    $verifyVisible .= $delta;
    return true;
});
$verifyPushed = true;
foreach (str_split($verifyWire, 7) as $chunk) {
    if (!$verifyStream->push($chunk)) { $verifyPushed = false; break; }
}
factStateExpect($verifyPushed && $verifyStream->finish() && !$verifyStream->rejected(),
    'the complete safety verification paragraph survives split UTF-8 and CRLF boundaries');
factStateExpect($verifyVisible === $verifyWire,
    'safety verification preserves every accepted original byte');

$retainedParagraphs = [
    'tcm_complete_v33_original_single_20261024_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v32_workflow_a_c4_20261024_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v32_workflow_a_c4_20261024_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v32_workflow_b_c4_20261024_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v32_workflow_b_c4_20261024_2_openai.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v32_workflow_a_single_20261024_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v32_workflow_a_single_20261024_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v31_isolated_single_20261023_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v31_isolated_c4_20261023_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v31_isolated_c4_20261023_3_openai.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v31_isolated_single_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v31_isolated_c4_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v31_isolated_c4_20261023_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v29_isolated_deadline_after_20261023_openai_next_full90_openai.rejected.json' => [true, ''],
    'tcm_complete_v30_isolated_single_20261023_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v30_isolated_c4_20261023_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v30_isolated_c4_20261023_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v30_isolated_single_20261023_0_qwen.rejected.json' => [false, 'UNKNOWN_TO_NEGATIVE'],
    'tcm_complete_v30_isolated_c4_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v30_isolated_c4_20261023_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v29_isolated_single_20261023_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v29_isolated_c4_20261023_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v29_isolated_single_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v29_isolated_c4_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v29_isolated_c4_20261023_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v28_isolated_single_20261023_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v28_isolated_c4_20261023_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v28_isolated_c4_20261023_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v28_isolated_single_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v28_isolated_c4_20261023_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v28_isolated_c4_20261023_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v26_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v26_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v26_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v26_single_fixed_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v26_c4_fixed_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v26_c4_fixed_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v25_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v25_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v25_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v25_single_fixed_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v25_c4_fixed_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v25_c4_fixed_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v24_single_fixed_0_qwen.rejected.json' => [true, ''],
    'tcm_complete_v24_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v24_c4_fixed_0_qwen.rejected.json' => [true, ''],
    'tcm_complete_v24_c4_fixed_1_qwen.rejected.json' => [true, ''],
    'tcm_complete_v24_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v24_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v23_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v23_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v23_single_fixed_0_qwen.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v23_c4_fixed_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v23_single_fixed_1_openai.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v22_qwen_single_fixed_0_qwen.rejected.json' => [true, ''],
    'tcm_complete_v22_openai_single_fixed_0_openai.rejected.json' => [true, ''],
    'tcm_complete_v21_mixed2_fixed_1_openai.rejected.json' => [false, 'NEGATIVE_TO_UNKNOWN'],
    'tcm_complete_v20_mixed2_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v19_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v18_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v18_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v14_staged_pilot3_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v14_staged_pilot2_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v14_staged_pilot4_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v14_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v15_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v17_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v17_c4_fixed_2_openai.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v17_c4_fixed_3_openai.rejected.json' => [false, 'TONGUE_FEATURE_NOT_IN_CURRENT_SOURCE'],
    'tcm_complete_v17_c4_fixed_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v17_c4_fixed_1_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
    'tcm_complete_v16_single_fixed_1_openai.rejected.json' => [true, ''],
    'tcm_complete_v16_c4_fixed_2_openai.rejected.json' => [true, ''],
    'tcm_complete_v16_c4_fixed_3_openai.rejected.json' => [true, ''],
    'tcm_complete_v14_staged_pilot3_0_qwen.rejected.json' => [false, 'NEGATIVE_NOT_IN_SOURCE'],
    'tcm_complete_v14_staged_pilot2_0_qwen.rejected.json' => [false, 'NEGATION_SCOPE_WIDENED'],
];
if (!$replayLocalArtifacts) $retainedParagraphs = [];
foreach ($retainedParagraphs as $file => [$valid, $code]) {
    $path = $artifactRoot . $file;
    if (!is_file($path)) continue;
    $saved = json_decode((string) file_get_contents($path), true);
    factStateExpect(is_array($saved['rejections'] ?? null) && $saved['rejections'] !== [], 'pilot artifact contains the complete rejected paragraph');
    foreach ($saved['rejections'] ?? [] as $rejection) {
        factStateCheck($pilotLedger, (string) $rejection['unit'], $valid, 'full retained pilot paragraph: ' . $file, $code);
    }
}
factStateCheck([], '无固定刺痛。', false, 'missing ledger cannot produce a successful validation', 'FACT_STATE_LEDGER_UNAVAILABLE');
factStateCheck($ledger, "\xC3\x28", false, 'malformed UTF-8 is not silently accepted', 'FACT_STATE_INVALID_UTF8');
factStateExpect(str_contains(TcmClinicalFactStateGuard::prompt($fixtureLedger), '固定刺痛')
    && mb_strlen(TcmClinicalFactStateGuard::prompt($fixtureLedger), 'UTF-8') < 700,
    'compact prompt points to explicit unknown topics without duplicating the case');

if ($failures !== []) {
    fwrite(STDERR, 'Clinical fact state: ' . count($failures) . ' failures / ' . $assertions . " assertions\n- " . implode("\n- ", $failures) . "\n");
    exit(1);
}
echo 'Clinical fact state: ' . $assertions . " assertions passed.\n";