--- a
+++ b/processing/MACCROBAT/24957905.ann
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+T1	Age 2 13	56-year-old
+T2	Personal_background 14 30	African American
+T3	Sex 31 34	man
+T4	Clinical_event 49 58	presented
+E1	Clinical_event:T4 
+T5	Sign_symptom 64 72	diarrhea
+E2	Sign_symptom:T5 
+T6	Sign_symptom 74 85	weight loss
+E3	Sign_symptom:T6 
+T7	Sign_symptom 99 107	jaundice
+E4	Sign_symptom:T7 
+T8	Detailed_description 90 98	painless
+R1	MODIFY Arg1:T8 Arg2:E4	
+T9	Disease_disorder 140 154	adenocarcinoma
+E5	Disease_disorder:T9 
+T10	Biological_structure 162 178	head of pancreas
+R2	MODIFY Arg1:T10 Arg2:E5	
+T11	Disease_disorder 217 223	cancer
+E6	Disease_disorder:T11 
+T12	Detailed_description 207 216	localized
+R3	MODIFY Arg1:T12 Arg2:E6	
+T13	Disease_disorder 252 262	metastases
+E7	Disease_disorder:T13 
+A1	POLARITY E7 NEG
+T14	Detailed_description 244 251	distant
+R4	MODIFY Arg1:T14 Arg2:E7	
+T15	Diagnostic_procedure 183 197	initial workup
+E8	Diagnostic_procedure:T15 
+T16	Therapeutic_procedure 282 305	pancreaticoduodenectomy
+E9	Therapeutic_procedure:T16 
+T17	Therapeutic_procedure 320 338	surgical resection
+E10	Therapeutic_procedure:T17 
+T18	Detailed_description 311 319	complete
+R5	MODIFY Arg1:T18 Arg2:E10	
+T19	Disease_disorder 385 399	adenocarcinoma
+E11	Disease_disorder:T19 
+T20	Biological_structure 374 384	pancreatic
+R6	MODIFY Arg1:T20 Arg2:E11	
+T21	Detailed_description 348 373	moderately differentiated
+R7	MODIFY Arg1:T21 Arg2:E11	
+T22	Distance 344 347	5cm
+R8	MODIFY Arg1:T22 Arg2:E11	
+T23	Therapeutic_procedure 3448 3463	palliative care
+E12	Therapeutic_procedure:T23 
+T24	Therapeutic_procedure 441 459	surgical resection
+E13	Therapeutic_procedure:T24 
+T25	Detailed_description 432 440	complete
+R9	MODIFY Arg1:T25 Arg2:E13	
+T26	Diagnostic_procedure 463 487	pathological examination
+E14	Diagnostic_procedure:T26 
+T27	Sign_symptom 499 518	neoplastic invasion
+E15	Sign_symptom:T27 
+T28	Biological_structure 535 550	adjacent organs
+R10	MODIFY Arg1:T28 Arg2:E15	
+T29	Sign_symptom 608 614	cancer
+E16	Sign_symptom:T29 
+T30	Lab_value 616 622	T3N1M0
+E17	Lab_value:T30 
+R11	MODIFY Arg1:E17 Arg2:E16	
+T31	Biological_structure 586 597	lymph nodes
+T32	Quantitative_concept 556 576	one out of the seven
+R12	MODIFY Arg1:T32 Arg2:T31	
+R13	MODIFY Arg1:T31 Arg2:E16	
+T33	Nonbiological_location 644 663	oncology department
+T34	Clinical_event 664 675	recommended
+E18	Clinical_event:T34 
+R14	MODIFY Arg1:T33 Arg2:E18	
+T35	Medication 701 713	chemotherapy
+E19	Medication:T35 
+T36	Detailed_description 692 700	adjuvant
+R15	MODIFY Arg1:T36 Arg2:E19	
+T37	Medication 719 730	gemcitabine
+E20	Medication:T37 
+T38	Dosage 732 741	1000mg/m2
+T39	Administration 742 744	IV
+R16	SUB_PROCEDURE Arg1:E20 Arg2:E19	
+R17	MODIFY Arg1:T38 Arg2:E20	
+R18	MODIFY Arg1:T39 Arg2:E20	
+T40	Frequency 748 794	days 1, 8, 15 on a 28-day cycle for six cycles
+R19	MODIFY Arg1:T40 Arg2:E20	
+T41	Sign_symptom 831 841	recurrence
+E21	Sign_symptom:T41 
+A2	POLARITY E21 UNCERTAIN
+T42	Medication 906 918	chemotherapy
+E22	Medication:T42 
+T43	Clinical_event 923 932	presented
+E23	Clinical_event:T43 
+T44	Quantitative_concept 869 879	two cycles
+R20	MODIFY Arg1:T44 Arg2:E22	
+T45	Quantitative_concept 892 901	six doses
+R21	MODIFY Arg1:T45 Arg2:E22	
+T46	Nonbiological_location 940 960	emergency department
+R22	MODIFY Arg1:T46 Arg2:E23	
+T47	Sign_symptom 987 994	dyspnea
+E24	Sign_symptom:T47 
+A3	TREND E24 INC
+T48	Detailed_description 976 986	exertional
+R23	MODIFY Arg1:T48 Arg2:E24	
+T49	Sign_symptom 1009 1018	orthopnea
+E25	Sign_symptom:T49 
+T50	Detailed_description 996 1008	three-pillow
+R24	MODIFY Arg1:T50 Arg2:E25	
+#1	AnnotatorNotes T50	technically a severity, but specific to orthopnea
+T51	Sign_symptom 1041 1048	dyspnea
+E26	Sign_symptom:T51 
+T52	Detailed_description 1020 1030	paroxysmal
+T53	Detailed_description 1031 1040	nocturnal
+R25	MODIFY Arg1:T53 Arg2:E26	
+R26	MODIFY Arg1:T52 Arg2:E26	
+T54	Sign_symptom 1053 1060	fatigue
+E27	Sign_symptom:T54 
+T55	Diagnostic_procedure 1066 1086	physical examination
+E28	Diagnostic_procedure:T55 
+T56	Diagnostic_procedure 1108 1131	jugular venous pressure
+E29	Diagnostic_procedure:T56 
+T57	Diagnostic_procedure 1133 1136	JVP
+E30	Diagnostic_procedure:T57 
+R27	IDENTICAL Arg1:E30 Arg2:E29	
+T58	Lab_value 1099 1107	elevated
+E31	Lab_value:T58 
+R28	MODIFY Arg1:E31 Arg2:E29	
+T59	Lab_value 1139 1167	10cm above the sternal angle
+E32	Lab_value:T59 
+R29	MODIFY Arg1:E32 Arg2:E29	
+T60	Sign_symptom 1180 1185	rales
+E33	Sign_symptom:T60 
+T61	Detailed_description 1170 1179	bibasilar
+R30	MODIFY Arg1:T61 Arg2:E33	
+T62	Sign_symptom 1201 1206	edema
+E34	Sign_symptom:T62 
+T63	Detailed_description 1193 1200	pitting
+T64	Lab_value 1190 1192	+2
+E35	Lab_value:T64 
+R31	MODIFY Arg1:T63 Arg2:E34	
+R32	MODIFY Arg1:E35 Arg2:E34	
+T65	Biological_structure 1210 1232	both lower extremities
+R33	MODIFY Arg1:T65 Arg2:E34	
+T66	Diagnostic_procedure 1242 1254	auscultation
+E36	Diagnostic_procedure:T66 
+T67	Biological_structure 1234 1241	Cardiac
+R34	MODIFY Arg1:T67 Arg2:E36	
+T68	Sign_symptom 1266 1279	gallop rhythm
+E37	Sign_symptom:T68 
+T69	Sign_symptom 1318 1324	murmur
+E38	Sign_symptom:T69 
+T70	Biological_structure 1330 1340	precordium
+R35	MODIFY Arg1:T70 Arg2:E38	
+T71	Detailed_description 1305 1317	holosystolic
+T72	Detailed_description 1288 1290	S3
+R36	MODIFY Arg1:T72 Arg2:E37	
+T73	Lab_value 1297 1304	grade 3
+E39	Lab_value:T73 
+R37	MODIFY Arg1:T71 Arg2:E38	
+R38	MODIFY Arg1:E39 Arg2:E38	
+T74	Diagnostic_procedure 1350 1355	X-ray
+E40	Diagnostic_procedure:T74 
+T75	Biological_structure 1344 1349	chest
+R39	MODIFY Arg1:T75 Arg2:E40	
+T76	Sign_symptom 1363 1375	cardiomegaly
+E41	Sign_symptom:T76 
+T77	Disease_disorder 1416 1432	pleural effusion
+E42	Disease_disorder:T77 
+T78	Severity 1381 1385	mild
+T79	Severity 1389 1403	moderate-sized
+T80	Detailed_description 1404 1415	right-sided
+R40	MODIFY Arg1:T80 Arg2:E42	
+R41	MODIFY Arg1:T79 Arg2:E42	
+R42	MODIFY Arg1:T78 Arg2:E42	
+T81	Disease_disorder 1519 1543	congestive heart failure
+E43	Disease_disorder:T81 
+T82	Disease_disorder 1545 1548	CHF
+E44	Disease_disorder:T82 
+R43	IDENTICAL Arg1:E44 Arg2:E43	
+T83	Sign_symptom 1491 1505	fluid overload
+E45	Sign_symptom:T83 
+R44	CAUSE Arg1:E43 Arg2:E45	
+A4	POLARITY E43 MAYBE_POS
+A5	POLARITY E45 MAYBE_POS
+T84	Medication 1589 1599	furosemide
+E46	Medication:T84 
+T85	Administration 1572 1583	intravenous
+T86	Administration 1585 1587	IV
+R45	IDENTICAL Arg1:T86 Arg2:T85	
+R46	MODIFY Arg1:T85 Arg2:E46	
+T87	Sign_symptom 1632 1640	symptoms
+E47	Sign_symptom:T87 
+A6	POLARITY E47 MAYBE_NEG
+T88	Diagnostic_procedure 1658 1690	two-dimensional echocardiography
+E48	Diagnostic_procedure:T88 
+T89	Diagnostic_procedure 1692 1699	2D Echo
+E49	Diagnostic_procedure:T89 
+R47	IDENTICAL Arg1:E49 Arg2:E48	
+T90	Diagnostic_procedure 1729 1763	left ventricular ejection fraction
+E50	Diagnostic_procedure:T90 
+T91	Diagnostic_procedure 1765 1769	LVEF
+E51	Diagnostic_procedure:T91 
+R48	IDENTICAL Arg1:E51 Arg2:E50	
+T92	Lab_value 1774 1790	15 to 20 percent
+E52	Lab_value:T92 
+R49	MODIFY Arg1:E52 Arg2:E50	
+T93	Sign_symptom 1803 1814	hypokinesia
+E53	Sign_symptom:T93 
+T94	Detailed_description 1796 1802	global
+R50	MODIFY Arg1:T94 Arg2:E53	
+T95	Sign_symptom 1835 1855	mitral regurgitation
+E54	Sign_symptom:T95 
+T96	Severity 1826 1834	moderate
+R51	MODIFY Arg1:T96 Arg2:E54	
+T97	Diagnostic_procedure 1879 1886	2D Echo
+E55	Diagnostic_procedure:T97 
+T98	Sign_symptom 1918 1958	risk factors for coronary artery disease
+E56	Sign_symptom:T98 
+A7	POLARITY E56 NEG
+T99	Disease_disorder 1935 1958	coronary artery disease
+E57	Disease_disorder:T99 
+T100	Disease_disorder 1960 1963	CAD
+E58	Disease_disorder:T100 
+R52	IDENTICAL Arg1:E58 Arg2:E57	
+T101	Disease_disorder 1978 1992	cardiomyopathy
+E59	Disease_disorder:T101 
+A8	POLARITY E57 NEG
+A9	POLARITY E59 NEG
+T102	Disease_disorder 1994 1997	CMP
+E60	Disease_disorder:T102 
+R53	IDENTICAL Arg1:E60 Arg2:E59	
+T103	Detailed_description 1969 1977	ischemic
+R54	MODIFY Arg1:T103 Arg2:E59	
+T104	Disease_disorder 2036 2039	CMP
+E61	Disease_disorder:T104 
+T105	Medication 2073 2084	gemcitabine
+E62	Medication:T105 
+R55	CAUSE Arg1:E62 Arg2:E61	
+T106	Medication 2118 2128	carvedilol
+E63	Medication:T106 
+T107	Medication 2136 2175	angiotensin-converting enzyme inhibitor
+E64	Medication:T107 
+T108	Medication 2191 2200	diuretics
+E65	Medication:T108 
+T109	Clinical_event 2212 2222	discharged
+E66	Clinical_event:T109 
+T110	Nonbiological_location 2232 2240	hospital
+R56	MODIFY Arg1:T110 Arg2:E66	
+T111	Date 2241 2255	two days later
+E67	Date:T111 
+T112	Nonbiological_location 2297 2318	cardiology department
+T113	Clinical_event 2319 2330	recommended
+E68	Clinical_event:T113 
+T114	Medication 2348 2360	chemotherapy
+E69	Medication:T114 
+A10	POLARITY E69 NEG
+T115	Medication 2366 2377	gemcitabine
+E70	Medication:T115 
+A11	POLARITY E70 NEG
+R57	SUB_PROCEDURE Arg1:E70 Arg2:E69	
+T116	Sign_symptom 2261 2270	euvolemic
+E71	Sign_symptom:T116 
+T117	Clinical_event 2403 2410	advised
+E72	Clinical_event:T117 
+R58	MODIFY Arg1:T112 Arg2:E68	
+T118	Nonbiological_location 2383 2402	oncology department
+R59	MODIFY Arg1:T118 Arg2:E72	
+T119	Diagnostic_procedure 2419 2426	testing
+E73	Diagnostic_procedure:T119 
+T120	Sign_symptom 2439 2447	ischemia
+E74	Sign_symptom:T120 
+A12	POLARITY E74 UNCERTAIN
+T121	Disease_disorder 2462 2465	CMP
+E75	Disease_disorder:T121 
+R60	CAUSE Arg1:E74 Arg2:E75	
+T122	Medication 2488 2500	chemotherapy
+E76	Medication:T122 
+T123	Medication 2506 2517	gemcitabine
+E77	Medication:T123 
+A13	POLARITY E76 UNCERTAIN
+A14	POLARITY E77 UNCERTAIN
+R61	SUB_PROCEDURE Arg1:E77 Arg2:E76	
+T124	Sign_symptom 2560 2570	recurrence
+E78	Sign_symptom:T124 
+A15	POLARITY E78 UNCERTAIN
+T125	Date 2588 2603	Two weeks later
+E79	Date:T125 
+T126	Diagnostic_procedure 2627 2655	myocardial perfusion imaging
+E80	Diagnostic_procedure:T126 
+T127	Diagnostic_procedure 2657 2660	MPI
+E81	Diagnostic_procedure:T127 
+R62	IDENTICAL Arg1:E81 Arg2:E80	
+T128	Sign_symptom 2723 2729	defect
+E82	Sign_symptom:T128 
+T129	Biological_structure 2709 2722	inferior wall
+R63	MODIFY Arg1:T129 Arg2:E82	
+T130	Sign_symptom 2761 2769	ischemia
+E83	Sign_symptom:T130 
+A16	POLARITY E83 NEG
+T131	Severity 2684 2708	small- to moderate-sized
+R64	MODIFY Arg1:T131 Arg2:E82	
+T132	Detailed_description 2678 2683	fixed
+R65	MODIFY Arg1:T132 Arg2:E82	
+T133	Diagnostic_procedure 2775 2792	ejection fraction
+E84	Diagnostic_procedure:T133 
+T134	Diagnostic_procedure 2794 2796	EF
+E85	Diagnostic_procedure:T134 
+R66	IDENTICAL Arg1:E85 Arg2:E84	
+T135	Diagnostic_procedure 2801 2804	MPI
+E86	Diagnostic_procedure:T135 
+T136	Lab_value 2833 2849	17 to 20 percent
+E87	Lab_value:T136 
+R67	MODIFY Arg1:E87 Arg2:E84	
+T137	Sign_symptom 2869 2880	hypokinesia
+E88	Sign_symptom:T137 
+T138	Detailed_description 2862 2868	global
+T139	Severity 2855 2861	severe
+R68	MODIFY Arg1:T139 Arg2:E88	
+R69	MODIFY Arg1:T138 Arg2:E88	
+T140	Therapeutic_procedure 2920 2941	heart failure therapy
+E89	Therapeutic_procedure:T140 
+T141	Clinical_event 2956 2965	admission
+E90	Clinical_event:T141 
+T142	Nonbiological_location 2973 2981	hospital
+R70	MODIFY Arg1:T142 Arg2:E90	
+T143	Disease_disorder 2986 2989	CHF
+E91	Disease_disorder:T143 
+T144	Detailed_description 2990 3002	exacerbation
+R71	MODIFY Arg1:T144 Arg2:E91	
+T145	Date 3009 3025	two months later
+E92	Date:T145 
+T146	Medication 3051 3061	furosemide
+E93	Medication:T146 
+T147	Therapeutic_procedure 3080 3101	heart failure therapy
+E94	Therapeutic_procedure:T147 
+T148	Detailed_description 3066 3076	adjustment
+R72	MODIFY Arg1:T148 Arg2:E94	
+T149	Administration 3048 3050	IV
+R73	MODIFY Arg1:T149 Arg2:E93	
+T150	Diagnostic_procedure 3105 3112	2D Echo
+E95	Diagnostic_procedure:T150 
+T151	Diagnostic_procedure 3174 3191	systolic function
+E96	Diagnostic_procedure:T151 
+T152	Lab_value 3159 3170	improvement
+E97	Lab_value:T152 
+R74	MODIFY Arg1:E97 Arg2:E96	
+T153	Date 3126 3144	a few months later
+E98	Date:T153 
+T154	Diagnostic_procedure 3200 3204	LVEF
+E99	Diagnostic_procedure:T154 
+T155	Lab_value 3208 3218	40 percent
+E100	Lab_value:T155 
+R75	MODIFY Arg1:E100 Arg2:E99	
+T156	Diagnostic_procedure 3236 3253	functional status
+E101	Diagnostic_procedure:T156 
+T157	Lab_value 3231 3235	poor
+E102	Lab_value:T157 
+R76	MODIFY Arg1:E102 Arg2:E101	
+T158	Disease_disorder 3269 3272	CMP
+E103	Disease_disorder:T158 
+T159	Medication 3282 3293	gemcitabine
+E104	Medication:T159 
+A17	POLARITY E104 NEG
+T160	Medication 3294 3306	chemotherapy
+E105	Medication:T160 
+A18	POLARITY E105 NEG
+R77	SUB_PROCEDURE Arg1:E104 Arg2:E105	
+T161	Medication 3407 3419	chemotherapy
+E106	Medication:T161 
+A19	POLARITY E106 NEG
+T162	Disease_disorder 3369 3386	pancreatic cancer
+E107	Disease_disorder:T162 
+T163	Sign_symptom 3351 3361	recurrence
+E108	Sign_symptom:T163 
+T164	Disease_disorder 3518 3532	cardiomyopathy
+E109	Disease_disorder:T164 
+T165	Detailed_description 3510 3517	dilated
+R78	MODIFY Arg1:T165 Arg2:E109	
+T166	Medication 3550 3561	gemcitabine
+E110	Medication:T166 
+R79	CAUSE Arg1:E110 Arg2:E109	
+T167	Medication 3658 3669	gemcitabine
+E111	Medication:T167 
+T168	Medication 3670 3682	chemotherapy
+E112	Medication:T168 
+R80	SUB_PROCEDURE Arg1:E111 Arg2:E112	
+T169	Sign_symptom 3696 3725	risk factors for ischemic CMP
+E113	Sign_symptom:T169 
+A20	POLARITY E113 NEG
+T170	Disease_disorder 3747 3750	CAD
+E114	Disease_disorder:T170 
+T171	History 3736 3750	history of CAD
+T172	Sign_symptom 3770 3781	hypokinesia
+E115	Sign_symptom:T172 
+T173	Detailed_description 3763 3769	global
+R81	MODIFY Arg1:T173 Arg2:E115	
+T174	Diagnostic_procedure 3785 3792	2D Echo
+E116	Diagnostic_procedure:T174 
+T175	Sign_symptom 3805 3813	ischemia
+E117	Sign_symptom:T175 
+A21	POLARITY E117 NEG
+T176	Diagnostic_procedure 3817 3820	MPI
+E118	Diagnostic_procedure:T176 
+T177	Diagnostic_procedure 3845 3862	systolic function
+E119	Diagnostic_procedure:T177 
+T178	Lab_value 3826 3837	improvement
+E120	Lab_value:T178 
+R82	MODIFY Arg1:E120 Arg2:E119	
+T179	Medication 3888 3899	gemcitabine
+E121	Medication:T179 
+A22	POLARITY E121 NEG
+T180	Medication 3925 3936	gemcitabine
+E122	Medication:T180 
+T181	Disease_disorder 3945 3959	cardiomyopathy
+E123	Disease_disorder:T181 
+R83	CAUSE Arg1:E122 Arg2:E123	
+*	OVERLAP E1 E2 E3 E4 E5 E8 E6 E7
+R84	BEFORE Arg1:E7 Arg2:E9	
+*	OVERLAP E9 E10 E11 E13
+R85	BEFORE Arg1:E13 Arg2:E14	
+*	OVERLAP E14 E15 E16
+R86	BEFORE Arg1:E16 Arg2:E18	
+*	OVERLAP E18 E19 E21
+R87	BEFORE Arg1:E21 Arg2:E22	
+R88	BEFORE Arg1:E22 Arg2:E23	
+*	OVERLAP E23 E24 E25 E26 E27 E28 E29 E33 E34 E36 E37 E38 E40 E41 E42 E45 E46 E47
+T182	Date 1646 1654	next day
+E124	Date:T182 
+R89	BEFORE Arg1:E47 Arg2:E124	
+*	OVERLAP E124 E48 E50 E53 E54 E55 E56 E57 E59 E61 E62
+R90	BEFORE Arg1:E62 Arg2:E63	
+*	OVERLAP E63 E64 E65
+R91	BEFORE Arg1:E65 Arg2:E66	
+*	OVERLAP E66 E67 E71 E68 E69 E72 E73 E74 E75 E76 E78
+A23	POLARITY E73 UNCERTAIN
+R92	BEFORE Arg1:E78 Arg2:E79	
+*	OVERLAP E79 E80 E82 E83 E84 E88
+R93	BEFORE Arg1:E88 Arg2:E89	
+R94	BEFORE Arg1:E89 Arg2:E90	
+*	OVERLAP E90 E91 E92
+R95	BEFORE Arg1:E92 Arg2:E93	
+*	OVERLAP E93 E94
+R96	BEFORE Arg1:E94 Arg2:E95	
+*	OVERLAP E95 E98 E96 E99 E101 E103 E104
+R97	BEFORE Arg1:E104 Arg2:E108	
+*	OVERLAP E108 E107 E106 E12