diff --git a/RELEASE_NOTES.md b/RELEASE_NOTES.md
index 7b06c6ab5..13ab15751 100644
--- a/RELEASE_NOTES.md
+++ b/RELEASE_NOTES.md
@@ -1,7 +1,12 @@
 ## Validator Changes
 
-* no changes
+* Snapshot Generation Changes:
+** Check for slicenames without any slicing 
+** Check for additional slicing rules in a set of slices 
+** Check that the minimum cardinality of a set of slices is correct
+* Clean up duplicate errors when dates/dateTimes/instants have invalid formats
+* Handle unknown code systems consistently when validating coded elements
 
 ## Other code changes
 
-* no changes
\ No newline at end of file
+* Add support for R4B to loader
diff --git a/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/loaders/loaderR5/BaseLoaderR5.java b/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/loaders/loaderR5/BaseLoaderR5.java
index eabb1659b..91af7f495 100644
--- a/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/loaders/loaderR5/BaseLoaderR5.java
+++ b/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/loaders/loaderR5/BaseLoaderR5.java
@@ -75,6 +75,8 @@ public abstract class BaseLoaderR5 implements IContextResourceLoader {
   protected BaseLoaderR5 loaderFactory(NpmPackage npm) throws JsonSyntaxException, IOException {
     if (VersionUtilities.isR5Plus(npm.fhirVersion())) {
       return new R5ToR5Loader(types, lkp.forNewPackage(npm));
+    } else if (VersionUtilities.isR4BVer(npm.fhirVersion())) {
+      return new R4BToR5Loader(types, lkp.forNewPackage(npm), npm.version());
     } else if (VersionUtilities.isR4Ver(npm.fhirVersion())) {
       return new R4ToR5Loader(types, lkp.forNewPackage(npm), npm.version());
     } else if (VersionUtilities.isR3Ver(npm.fhirVersion())) {
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfilePathProcessor.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfilePathProcessor.java
index e5d5ca58b..dfe5d9f8f 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfilePathProcessor.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfilePathProcessor.java
@@ -8,14 +8,20 @@ import java.util.Set;
 import org.hl7.fhir.exceptions.DefinitionException;
 import org.hl7.fhir.exceptions.FHIRException;
 import org.hl7.fhir.r5.conformance.ElementRedirection;
+import org.hl7.fhir.r5.model.Base;
 import org.hl7.fhir.r5.model.CanonicalType;
 import org.hl7.fhir.r5.model.ElementDefinition;
+import org.hl7.fhir.r5.model.ElementDefinition.ElementDefinitionSlicingComponent;
+import org.hl7.fhir.r5.model.OperationOutcome.IssueType;
 import org.hl7.fhir.r5.model.StructureDefinition;
 import org.hl7.fhir.r5.model.StructureDefinition.StructureDefinitionSnapshotComponent;
 import org.hl7.fhir.r5.utils.ToolingExtensions;
 import org.hl7.fhir.utilities.Utilities;
 import org.hl7.fhir.utilities.VersionUtilities;
 import org.hl7.fhir.utilities.i18n.I18nConstants;
+import org.hl7.fhir.utilities.validation.ValidationMessage;
+import org.hl7.fhir.utilities.validation.ValidationMessage.IssueSeverity;
+import org.hl7.fhir.utilities.validation.ValidationMessage.Source;
 
 import lombok.AccessLevel;
 import lombok.AllArgsConstructor;
@@ -267,12 +273,28 @@ public class ProfilePathProcessor {
 
       if (!diffMatches.get(0).hasSlicing())
         outcome.setSlicing(profileUtilities.makeExtensionSlicing());
-      else
+      else {
         outcome.setSlicing(diffMatches.get(0).getSlicing().copy());
+        for (int i = 1; i < diffMatches.size(); i++) {
+          if (diffMatches.get(i).hasSlicing()) {
+            if (!slicingMatches(diffMatches.get(0).getSlicing(), diffMatches.get(i).getSlicing())) {
+              profileUtilities.getMessages().add(new ValidationMessage(Source.InstanceValidator, ValidationMessage.IssueType.BUSINESSRULE, diffMatches.get(0).getPath(), 
+                  profileUtilities.getContext().formatMessage(I18nConstants.ATTEMPT_TO_CHANGE_SLICING, diffMatches.get(0).getId(), slicingSummary(diffMatches.get(0).getSlicing()), diffMatches.get(i).getId(), slicingSummary(diffMatches.get(i).getSlicing())),
+                      ValidationMessage.IssueSeverity.ERROR));
+            } else {
+              profileUtilities.getMessages().add(new ValidationMessage(Source.InstanceValidator, ValidationMessage.IssueType.BUSINESSRULE, diffMatches.get(0).getPath(), 
+                  profileUtilities.getContext().formatMessage(I18nConstants.ATTEMPT_TO_CHANGE_SLICING, diffMatches.get(0).getId(), diffMatches.get(i).getId()),
+                      IssueSeverity.INFORMATION));
+              
+            }
+          }
+        }
+      }
       if (cursors.resultPathBase != null) {
         if (!outcome.getPath().startsWith(cursors.resultPathBase))
           throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH));
       }
+      debugCheck(outcome);
       getResult().getElement().add(outcome);
       slicerElement = outcome;
 
@@ -337,6 +359,20 @@ public class ProfilePathProcessor {
     cursors.diffCursor = newDiffLimit + 1;
   }
 
+  private String slicingSummary(ElementDefinitionSlicingComponent s) {    
+    return s.toString();
+  }
+
+  private boolean slicingMatches(ElementDefinitionSlicingComponent s1, ElementDefinitionSlicingComponent s2) {
+    if ((!s1.hasOrdered() && s2.hasOrdered()) || (s1.hasOrdered() && s2.hasOrdered() && !Base.compareDeep(s1.getOrderedElement(), s2.getOrderedElement(), false))) { 
+      return false;
+    }
+    if ((!s1.hasRules() && s2.hasRules()) || (s1.hasRules() && s2.hasRules() && !Base.compareDeep(s1.getRulesElement(), s2.getRulesElement(), false))) { 
+      return false;
+    }
+    return Base.compareDeep(s1.getDiscriminator(), s2.getDiscriminator(), false);
+  }
+
   private void processSimplePathWhereDiffsConstrainTypes(String currentBasePath, List<ElementDefinition> diffMatches, List<TypeSlice> typeList, ProfilePathProcessorState cursors) {
     int start = 0;
     int newBaseLimit = profileUtilities.findEndOfElement(cursors.base, cursors.baseCursor);
@@ -344,13 +380,14 @@ public class ProfilePathProcessor {
     ElementDefinition elementToRemove = null;
     boolean shortCut = !typeList.isEmpty() && typeList.get(0).getType() != null;
     // we come here whether they are sliced in the diff, or whether the short cut is used.
+    String path = diffMatches.get(0).getPath();
     if (shortCut) {
       // this is the short cut method, we've just dived in and specified a type slice.
       // in R3 (and unpatched R4, as a workaround right now...
       if (!VersionUtilities.isR4Plus(profileUtilities.getContext().getVersion()) || !profileUtilities.isNewSlicingProcessing()) { // newSlicingProcessing is a work around for editorial loop dependency
         // we insert a cloned element with the right types at the start of the diffMatches
         ElementDefinition ed = new ElementDefinition();
-        ed.setPath(profileUtilities.determineTypeSlicePath(diffMatches.get(0).getPath(), currentBasePath));
+        ed.setPath(profileUtilities.determineTypeSlicePath(path, currentBasePath));
         for (TypeSlice ts : typeList)
           ed.addType().setCode(ts.getType());
         ed.setSlicing(new ElementDefinition.ElementDefinitionSlicingComponent());
@@ -365,7 +402,7 @@ public class ProfilePathProcessor {
         // so the element we insert specifies no types (= all types) allowed in the base, not just the listed type.
         // see also discussion here: https://chat.fhir.org/#narrow/stream/179177-conformance/topic/Slicing.20a.20non-repeating.20element
         ElementDefinition ed = new ElementDefinition();
-        ed.setPath(profileUtilities.determineTypeSlicePath(diffMatches.get(0).getPath(), currentBasePath));
+        ed.setPath(profileUtilities.determineTypeSlicePath(path, currentBasePath));
         ed.setSlicing(new ElementDefinition.ElementDefinitionSlicingComponent());
         ed.getSlicing().addDiscriminator().setType(ElementDefinition.DiscriminatorType.TYPE).setPath("$this");
         ed.getSlicing().setRules(ElementDefinition.SlicingRules.CLOSED);
@@ -374,6 +411,13 @@ public class ProfilePathProcessor {
         getDifferential().getElement().add(newDiffCursor, ed);
         elementToRemove = ed;
       }
+    } else { // if it's not a short cut, then the path has to be correct
+      String t1 = currentBasePath.substring(currentBasePath.lastIndexOf(".")+1);
+      String t2 = path.substring(path.lastIndexOf(".")+1);
+      if (!t1.equals(t2)) {
+        throw new FHIRException(profileUtilities.getContext().formatMessage(I18nConstants.ED_PATH_WRONG_TYPE_MATCH, path.replace(t2, t1), path));
+      }
+      
     }
     int newDiffLimit = profileUtilities.findEndOfElement(getDifferential(), newDiffCursor);
     // the first element is setting up the slicing
@@ -429,7 +473,7 @@ public class ProfilePathProcessor {
     .processPaths(new ProfilePathProcessorState(cursors.base, cursors.baseCursor, newDiffCursor,
         cursors.contextName, cursors.resultPathBase));
     if (elementDefinition == null)
-      throw new FHIRException(profileUtilities.getContext().formatMessage(I18nConstants.DID_NOT_FIND_TYPE_ROOT_, diffMatches.get(0).getPath()));
+      throw new FHIRException(profileUtilities.getContext().formatMessage(I18nConstants.DID_NOT_FIND_TYPE_ROOT_, path));
     // now set up slicing on the e (cause it was wiped by what we called.
     elementDefinition.setSlicing(new ElementDefinition.ElementDefinitionSlicingComponent());
     elementDefinition.getSlicing().addDiscriminator().setType(ElementDefinition.DiscriminatorType.TYPE).setPath("$this");
@@ -607,6 +651,7 @@ public class ProfilePathProcessor {
       cursors.resultPathBase = outcome.getPath();
     else if (!outcome.getPath().startsWith(cursors.resultPathBase))
       throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH));
+    debugCheck(outcome);
     getResult().getElement().add(outcome);
     cursors.baseCursor++;
     cursors.diffCursor = getDifferential().getElement().indexOf(diffMatches.get(0)) + 1;
@@ -731,6 +776,7 @@ public class ProfilePathProcessor {
       cursors.resultPathBase = outcome.getPath();
     else if (!outcome.getPath().startsWith(cursors.resultPathBase))
       throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH__OUTCOMEGETPATH___RESULTPATHBASE__, outcome.getPath(), cursors.resultPathBase));
+    debugCheck(outcome);
     getResult().getElement().add(outcome);
     if (profileUtilities.hasInnerDiffMatches(getDifferential(), currentBasePath, cursors.diffCursor, getDiffLimit(), cursors.base.getElement(), true)) {
       // well, the profile walks into this, so we need to as well
@@ -756,6 +802,9 @@ public class ProfilePathProcessor {
             }
           }
         }
+        if (!profileUtilities.pathStartsWith(getDifferential().getElement().get(cursors.diffCursor).getPath(), currentBasePath + ".")) {
+          cursors.diffCursor++;
+        }
         int start = cursors.diffCursor;
         while (getDifferential().getElement().size() > cursors.diffCursor && profileUtilities.pathStartsWith(getDifferential().getElement().get(cursors.diffCursor).getPath(), currentBasePath + "."))
           cursors.diffCursor++;
@@ -807,7 +856,7 @@ public class ProfilePathProcessor {
           }
           cursors.contextName = dt.getUrl();
           if (getRedirector() == null || getRedirector().isEmpty()) {
-
+            
               this
                 .incrementDebugIndent()
                 .withBaseLimit(dt.getSnapshot().getElement().size() - 1)
@@ -893,6 +942,7 @@ public class ProfilePathProcessor {
       diffMatches.get(0).setUserData(profileUtilities.UD_GENERATED_IN_SNAPSHOT, outcome); // because of updateFromDefinition isn't called
     }
 
+    debugCheck(outcome);
     getResult().getElement().add(outcome);
 
     if (!diffMatches.get(0).hasSliceName()) { // it's not real content, just the slice
@@ -942,6 +992,8 @@ public class ProfilePathProcessor {
       int newBaseLimit = profileUtilities.findEndOfElement(cursors.base, cursors.baseCursor);
       for (int i = cursors.baseCursor + 1; i <= newBaseLimit; i++) {
         outcome = profileUtilities.updateURLs(getUrl(), getWebUrl(), cursors.base.getElement().get(i).copy());
+        outcome.setPath(profileUtilities.fixedPathDest(getContextPathTarget(), outcome.getPath(), getRedirector(), getContextPathSource()));
+        debugCheck(outcome);
         getResult().getElement().add(outcome);
       }
     }
@@ -978,6 +1030,7 @@ public class ProfilePathProcessor {
         cursors.diffCursor = newDiffLimit + 1;
         diffpos++;
       } else {
+        debugCheck(outcome);
         getResult().getElement().add(outcome);
         cursors.baseCursor++;
         // just copy any children on the base
@@ -988,6 +1041,7 @@ public class ProfilePathProcessor {
             throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH));
           outcome.setUserData(profileUtilities.UD_BASE_PATH, outcome.getPath());
           outcome.setUserData(profileUtilities.UD_BASE_MODEL, getSourceStructureDefinition().getUrl());
+          debugCheck(outcome);
           getResult().getElement().add(outcome);
           cursors.baseCursor++;
         }
@@ -1016,6 +1070,7 @@ public class ProfilePathProcessor {
         outcome.setMin(0); // we're in a slice, so it's only a mandatory if it's explicitly marked so
         if (!outcome.getPath().startsWith(cursors.resultPathBase))
           throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH));
+        debugCheck(outcome);
         getResult().getElement().add(outcome);
         profileUtilities.updateFromDefinition(outcome, diffItem, getProfileName(), isTrimDifferential(), getUrl(), getSourceStructureDefinition(), getDerived());
         profileUtilities.removeStatusExtensions(outcome);
@@ -1079,6 +1134,12 @@ public class ProfilePathProcessor {
     cursors.baseCursor++;
   }
 
+  private void debugCheck(ElementDefinition outcome) {
+    if (outcome.getPath().startsWith("List.") && "http://nictiz.nl/fhir/StructureDefinition/Bundle-MedicationOverview".equals(url)) {
+      System.out.println("wrong!");
+    }
+  }
+
   private void processPathWithSlicedBaseWhereDiffsConstrainTypes(String currentBasePath, List<ElementDefinition> diffMatches, List<TypeSlice> typeList, ProfilePathProcessorState cursors) {
     int start = 0;
     int newBaseLimit = profileUtilities.findEndOfElement(cursors.base, cursors.baseCursor);
@@ -1252,6 +1313,7 @@ public class ProfilePathProcessor {
         cursors.resultPathBase = outcome.getPath();
       else if (!outcome.getPath().startsWith(cursors.resultPathBase))
         throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH));
+      debugCheck(outcome);
       getResult().getElement().add(outcome);
       // the profile walks into this, so we need to as well
       // did we implicitly step into a new type?
@@ -1295,6 +1357,7 @@ public class ProfilePathProcessor {
         outcome.setPath(profileUtilities.fixedPathDest(getContextPathTarget(), outcome.getPath(), getRedirector(), getContextPathSource()));
         if (!outcome.getPath().startsWith(cursors.resultPathBase))
           throw new DefinitionException(profileUtilities.getContext().formatMessage(I18nConstants.ADDING_WRONG_PATH_IN_PROFILE___VS_, getProfileName(), outcome.getPath(), cursors.resultPathBase));
+        debugCheck(outcome);
         getResult().getElement().add(outcome); // so we just copy it in
         outcome.setUserData(profileUtilities.UD_BASE_MODEL, getSourceStructureDefinition().getUrl());
         outcome.setUserData(profileUtilities.UD_BASE_PATH, cursors.resultPathBase);
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfileUtilities.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfileUtilities.java
index b3e384870..2279c688b 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfileUtilities.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/conformance/profile/ProfileUtilities.java
@@ -49,6 +49,7 @@ import org.hl7.fhir.exceptions.FHIRException;
 import org.hl7.fhir.exceptions.FHIRFormatError;
 import org.hl7.fhir.r5.conformance.ElementRedirection;
 import org.hl7.fhir.r5.conformance.profile.ProfileUtilities.AllowUnknownProfile;
+import org.hl7.fhir.r5.conformance.profile.ProfileUtilities.ElementDefinitionCounter;
 import org.hl7.fhir.r5.context.IWorkerContext;
 import org.hl7.fhir.r5.elementmodel.ObjectConverter;
 import org.hl7.fhir.r5.elementmodel.Property;
@@ -56,6 +57,7 @@ import org.hl7.fhir.r5.model.Base;
 import org.hl7.fhir.r5.model.BooleanType;
 import org.hl7.fhir.r5.model.Coding;
 import org.hl7.fhir.r5.model.DataType;
+import org.hl7.fhir.r5.model.Element;
 import org.hl7.fhir.r5.model.ElementDefinition;
 import org.hl7.fhir.r5.model.ElementDefinition.DiscriminatorType;
 import org.hl7.fhir.r5.model.ElementDefinition.ElementDefinitionBaseComponent;
@@ -130,6 +132,33 @@ import org.hl7.fhir.utilities.xml.SchematronWriter.Section;
  */
 public class ProfileUtilities extends TranslatingUtilities {
 
+  public class ElementDefinitionCounter {
+    int count = 0;
+    ElementDefinition focus;
+
+    public ElementDefinitionCounter(ElementDefinition ed) {
+      focus = ed;
+    }
+
+    public int update() {
+      if (count > focus.getMin()) {
+        int was = focus.getMin();
+        focus.setMin(count);
+        return was;
+      }      
+      return -1;
+    }
+
+    public void count(ElementDefinition ed) {
+      count = count + ed.getMin();      
+    }
+
+    public ElementDefinition getFocus() {
+      return focus;
+    }
+
+  }
+
   public enum MappingMergeModeOption {
     DUPLICATE, // if there's more than one mapping for the same URI, just keep them all
     IGNORE, // if there's more than one, keep the first 
@@ -288,6 +317,7 @@ public class ProfileUtilities extends TranslatingUtilities {
   private Map<ElementDefinition, SourcedChildDefinitions> childMapCache = new HashMap<>();
   private AllowUnknownProfile allowUnknownProfile = AllowUnknownProfile.ALL_TYPES;
   private MappingMergeModeOption mappingMergeMode = MappingMergeModeOption.APPEND;
+  private boolean forPublication;
 
   public ProfileUtilities(IWorkerContext context, List<ValidationMessage> messages, ProfileKnowledgeProvider pkp, FHIRPathEngine fpe) {
     super();
@@ -690,6 +720,49 @@ public class ProfileUtilities extends TranslatingUtilities {
             }
           }
         }
+        // check slicing is ok while we're at it. and while we're doing this. update the minimum count if we need to
+        String tn = derived.getType();
+        if (tn.contains("/")) {
+          tn = tn.substring(tn.lastIndexOf("/")+1);
+        }
+        System.out.println("Check slicing for "+derived.getVersionedUrl());
+        Map<String, ElementDefinitionCounter> slices = new HashMap<>();
+        int i = 0;
+        for (ElementDefinition ed : derived.getSnapshot().getElement()) {
+          if (ed.hasSlicing()) {
+            slices.put(ed.getPath(), new ElementDefinitionCounter(ed));            
+            System.out.println("Entering slicing for "+ed.getPath()+" ["+i+"]");
+          } else {
+            Set<String> toRemove = new HashSet<>();
+            for (String s : slices.keySet()) {
+              if (Utilities.charCount(s, '.') >= Utilities.charCount(ed.getPath(), '.') && !s.equals(ed.getPath())) {
+                toRemove.add(s);
+              }
+            }
+            for (String s : toRemove) {
+              int was = slices.get(s).update();
+              if (was > -1) {
+                String msg = "The slice definition for "+slices.get(s).getFocus().getId()+" had a minimum of "+was+" but the slices added up to a minimum of "+slices.get(s).getFocus().getMin()+" so the value has been adjusted in the snapshot";
+                System.out.println(msg);
+                messages.add(new ValidationMessage(Source.ProfileValidator, ValidationMessage.IssueType.VALUE, url+"#"+ed.getId(), msg, forPublication ? ValidationMessage.IssueSeverity.ERROR : ValidationMessage.IssueSeverity.INFORMATION));                            
+              }
+              System.out.println("Exiting slicing for "+s+" at "+ed.getPath()+" ["+i+"]");
+              slices.remove(s);
+            }            
+          }
+          if (ed.getPath().contains(".") && !ed.getPath().startsWith(tn+".")) {
+            throw new Error("The element "+ed.getId()+" in the profile '"+derived.getVersionedUrl()+" (["+i+"]) doesn't have the right path (should start with "+tn+".");
+          }
+          if (ed.hasSliceName() && !slices.containsKey(ed.getPath())) {
+            String msg = "The element "+ed.getId()+" (["+i+"]) launches straight into slicing without the slicing being set up properly first";
+            messages.add(new ValidationMessage(Source.ProfileValidator, ValidationMessage.IssueType.VALUE, url+"#"+ed.getId(), msg, ValidationMessage.IssueSeverity.ERROR));            
+          }
+          if (ed.hasSliceName() && slices.containsKey(ed.getPath())) {
+            slices.get(ed.getPath()).count(ed);
+          }
+          i++;
+        }
+        
         // last, check for wrong profiles or target profiles
         for (ElementDefinition ed : derived.getSnapshot().getElement()) {
           for (TypeRefComponent t : ed.getType()) {
@@ -3978,5 +4051,16 @@ public class ProfileUtilities extends TranslatingUtilities {
     return defn.getIsModifier();
   }
 
-  
+  public boolean isForPublication() {
+    return forPublication;
+  }
+
+  public void setForPublication(boolean forPublication) {
+    this.forPublication = forPublication;
+  }
+
+  public List<ValidationMessage> getMessages() {
+    return messages;
+  }
+
 }
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
index 6556f4d22..fdc11fd65 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/BaseWorkerContext.java
@@ -943,6 +943,7 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
         if (!t.hasResult()) {
           try {
             ValueSetValidator vsc = constructValueSetCheckerSimple(options, vs);
+            vsc.setThrowToServer(options.isUseServer() && tcc.getClient() != null);
             ValidationResult res = vsc.validateCode("Coding", t.getCoding());
             if (txCache != null) {
               txCache.cacheValidation(t.getCacheToken(), res, TerminologyCache.TRANSIENT);
@@ -1059,12 +1060,15 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
     }
 
     List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
+    Set<String> unknownSystems = new HashSet<>();
     
     String localError = null;
     if (options.isUseClient()) {
       // ok, first we try to validate locally
       try {
         ValueSetValidator vsc = constructValueSetCheckerSimple(options, vs, ctxt);
+        vsc.setUnknownSystems(unknownSystems);
+        vsc.setThrowToServer(options.isUseServer() && tcc.getClient() != null);
         if (!ValueSetUtilities.isServerSide(code.getSystem())) {
           res = vsc.validateCode(path, code);
           if (txCache != null) {
@@ -1084,7 +1088,11 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
     }
     
     if (localError != null && tcc.getClient() == null) {
-      return new ValidationResult(IssueSeverity.ERROR, localError, TerminologyServiceErrorClass.UNKNOWN, issues);
+      if (unknownSystems.size() > 0) {
+        return new ValidationResult(IssueSeverity.ERROR, localError, TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED, issues).setUnknownSystems(unknownSystems);
+      } else {
+        return new ValidationResult(IssueSeverity.ERROR, localError, TerminologyServiceErrorClass.UNKNOWN, issues);
+      }
     }
     if (!options.isUseServer()) {
       return new ValidationResult(IssueSeverity.WARNING,formatMessage(I18nConstants.UNABLE_TO_VALIDATE_CODE_WITHOUT_USING_SERVER, localError), TerminologyServiceErrorClass.BLOCKED_BY_OPTIONS, issues);
@@ -1204,11 +1212,14 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
         codeSystemsUsed.add(c.getSystem());
       }
     }
+    Set<String> unknownSystems = new HashSet<>();
 
     if (options.isUseClient()) {
       // ok, first we try to validate locally
       try {
         ValueSetValidator vsc = constructValueSetCheckerSimple(options, vs);
+        vsc.setUnknownSystems(unknownSystems);
+        vsc.setThrowToServer(options.isUseServer() && tcc.getClient() != null);
         res = vsc.validateCode("CodeableConcept", code);
         txCache.cacheValidation(cacheToken, res, TerminologyCache.TRANSIENT);
         return res;
@@ -1349,6 +1360,8 @@ public abstract class BaseWorkerContext extends I18nBase implements IWorkerConte
           version = ((PrimitiveType<?>) p.getValue()).asStringValue();
         } else if (p.getName().equals("code")) {
           code = ((PrimitiveType<?>) p.getValue()).asStringValue();
+        } else if (p.getName().equals("x-caused-by-unknown-system")) {
+          err = TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED;         
         } else if (p.getName().equals("cause")) {
           try {
             IssueType it = IssueType.fromCode(((StringType) p.getValue()).getValue());
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/IWorkerContext.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/IWorkerContext.java
index 4c084f5ac..9b90702ea 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/IWorkerContext.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/context/IWorkerContext.java
@@ -123,6 +123,7 @@ public interface IWorkerContext {
     private String diagnostics;
     private List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
     private CodeableConcept codeableConcept;
+    private Set<String> unknownSystems;
 
     @Override
     public String toString() {
@@ -239,7 +240,12 @@ public interface IWorkerContext {
       this.message = message;
       return this;
     }
-
+    
+    public ValidationResult addToMessage(String message) {
+      this.message = this.message == null ? message : this.message +"; "+ message; 
+      return this;
+    }
+    
     public ValidationResult setErrorClass(TerminologyServiceErrorClass errorClass) {
       this.errorClass = errorClass;
       return this;
@@ -288,7 +294,16 @@ public interface IWorkerContext {
     public CodeableConcept getCodeableConcept() {
       return codeableConcept;
     }
-    
+
+    public Set<String> getUnknownSystems() {
+      return unknownSystems;
+    }
+
+    public ValidationResult setUnknownSystems(Set<String> unknownSystems) {
+      this.unknownSystems = unknownSystems;
+      return this;
+    }
+
   }
 
   public class CodingValidationRequest {
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/elementmodel/Manager.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/elementmodel/Manager.java
index 2750242f4..cba4d9905 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/elementmodel/Manager.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/elementmodel/Manager.java
@@ -113,6 +113,9 @@ public class Manager {
   }
 
   public static ParserBase makeParser(IWorkerContext context, FhirFormat format) {
+    if (format == null) {
+      throw new Error("Programming logic error: no format known");
+    }
     switch (format) {
     case JSON : return new JsonParser(context);
     case XML : return new XmlParser(context);
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/ElementDefinition.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/ElementDefinition.java
index 2ecd5e6d5..a9dc7ec36 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/ElementDefinition.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/model/ElementDefinition.java
@@ -1413,12 +1413,17 @@ public class ElementDefinition extends BackboneType implements ICompositeType {
           , ordered, rules);
       }
 
-  public String fhirType() {
-    return "ElementDefinition.slicing";
+      public String fhirType() {
+        return "ElementDefinition.slicing";
 
-  }
+      }
 
-  }
+      @Override
+      public String toString() {
+        return (ordered == null ? "??" : "true".equals(ordered.asStringValue()) ? "ordered" : "unordered")+"/"+
+            (rules == null ? "??" : rules.asStringValue())+" "+discriminator.toString();
+      }
+    }
 
     @Block()
     public static class ElementDefinitionSlicingDiscriminatorComponent extends Element implements IBaseDatatypeElement {
@@ -1671,6 +1676,11 @@ public class ElementDefinition extends BackboneType implements ICompositeType {
 
   }
 
+  @Override
+  public String toString() {
+    return (type == null ? "??" : type.getCode()) + "="+(path == null ? "??" : path.asStringValue());
+  }
+
   }
 
     @Block()
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/utils/ElementWrappers.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/utils/ElementWrappers.java
index 909819493..568344a5f 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/utils/ElementWrappers.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/renderers/utils/ElementWrappers.java
@@ -167,7 +167,7 @@ public class ElementWrappers {
           Property family = b.getChildByName("family");
           Property given = wrapped.getChildByName("given");
           String s = given != null && given.hasValues() ? given.getValues().get(0).primitiveValue() : "";
-          if (family != null && family.hasValues())
+          if (family != null && family.hasValues() && family.getValues().get(0).primitiveValue() != null)
             s = s + " " + family.getValues().get(0).primitiveValue().toUpperCase();
           return s;
         } else {
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValidationProcessInfo.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValidationProcessInfo.java
index 84d406112..a59e73127 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValidationProcessInfo.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValidationProcessInfo.java
@@ -11,6 +11,13 @@ import org.hl7.fhir.utilities.CommaSeparatedStringBuilder;
 public class ValidationProcessInfo {
   private TerminologyServiceErrorClass err;
   private List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
+  
+  public ValidationProcessInfo() {
+  }
+  
+  public ValidationProcessInfo(List<OperationOutcomeIssueComponent> issues) {
+    this.issues = issues;
+  }
   public TerminologyServiceErrorClass getErr() {
     return err;
   }
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValueSetValidator.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValueSetValidator.java
index 99e738c9a..178ae1bf1 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValueSetValidator.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/terminologies/validation/ValueSetValidator.java
@@ -100,6 +100,8 @@ public class ValueSetValidator {
   private List<CodeSystem> localSystems = new ArrayList<>();
   Parameters expansionProfile;
   private TerminologyCapabilities txCaps;
+  private Set<String> unknownSystems;
+  private boolean throwToServer;
 
   public ValueSetValidator(ValidationOptions options, ValueSet source, IWorkerContext context, Parameters expansionProfile, TerminologyCapabilities txCaps) {
     this.valueset = source;
@@ -120,6 +122,22 @@ public class ValueSetValidator {
     analyseValueSet();
   }
 
+  public Set<String> getUnknownSystems() {
+    return unknownSystems;
+  }
+
+  public void setUnknownSystems(Set<String> unknownSystems) {
+    this.unknownSystems = unknownSystems;
+  }
+
+  public boolean isThrowToServer() {
+    return throwToServer;
+  }
+
+  public void setThrowToServer(boolean throwToServer) {
+    this.throwToServer = throwToServer;
+  }
+
   private void analyseValueSet() {
     if (localContext != null) {
       if (valueset != null) {
@@ -174,10 +192,16 @@ public class ValueSetValidator {
           if (context.isNoTerminologyServer()) {
             if (c.hasVersion()) {
               String msg = context.formatMessage(I18nConstants.UNKNOWN_CODESYSTEM_VERSION, c.getSystem(), c.getVersion() , resolveCodeSystemVersions(c.getSystem()).toString());
-              res = new ValidationResult(IssueSeverity.ERROR, msg, makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path+".coding["+i+"].system", msg));
+              if (valueSetDependsOn(c.getSystem(), c.getVersion())) {
+                unknownSystems.add(c.getSystem()+"|"+c.getVersion());
+              }
+              res = new ValidationResult(IssueSeverity.ERROR, msg, makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path+".coding["+i+"].system", msg)).setUnknownSystems(unknownSystems);
             } else {
               String msg = context.formatMessage(I18nConstants.UNKNOWN_CODESYSTEM, c.getSystem(), c.getVersion());
-              res = new ValidationResult(IssueSeverity.ERROR, msg, makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path+".coding["+i+"].system", msg));
+              if (valueSetDependsOn(c.getSystem(), null)) {
+                unknownSystems.add(c.getSystem());
+              }
+              res = new ValidationResult(IssueSeverity.ERROR, msg, makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path+".coding["+i+"].system", msg)).setUnknownSystems(unknownSystems);
             }
           } else {
             res = context.validateCode(options.withNoClient(), c, null);
@@ -191,8 +215,9 @@ public class ValueSetValidator {
       }
     }
     Coding foundCoding = null;
+    String msg = null;
+    Boolean result = false;
     if (valueset != null && options.getValueSetMode() != ValueSetMode.NO_MEMBERSHIP_CHECK) {
-      Boolean result = false;
       CommaSeparatedStringBuilder b = new CommaSeparatedStringBuilder(", ");
       
       for (Coding c : code.getCoding()) {
@@ -212,11 +237,11 @@ public class ValueSetValidator {
         }
       }
       if (result == null) {
-        String msg = context.formatMessage(I18nConstants.UNABLE_TO_CHECK_IF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), b.toString());
-        info.getIssues().addAll(makeIssue(IssueSeverity.WARNING, IssueType.INVALID, path, msg));
+        msg = context.formatMessage(I18nConstants.UNABLE_TO_CHECK_IF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getVersionedUrl(), b.toString());
+        info.getIssues().addAll(makeIssue(IssueSeverity.WARNING, unknownSystems.isEmpty() ? IssueType.INVALID : IssueType.NOTFOUND, path, msg));
       } else if (!result) {
-        String msg = context.formatMessagePlural(code.getCoding().size(), I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), b.toString());
-        info.getIssues().addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, msg));
+        msg = context.formatMessagePlural(code.getCoding().size(), I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getVersionedUrl(), b.toString());
+        info.getIssues().addAll(makeIssue(IssueSeverity.ERROR, unknownSystems.isEmpty() ? IssueType.INVALID : IssueType.NOTFOUND, path, msg));
       }
     }
     if (info.hasErrors()) {
@@ -229,8 +254,11 @@ public class ValueSetValidator {
         res.setVersion(foundCoding.hasVersion() ? foundCoding.getVersion() : ((CodeSystem) foundCoding.getUserData("cs")).getVersion());
         res.setDisplay(cd.getDisplay());
       }
+      res.setUnknownSystems(unknownSystems);
       res.addCodeableConcept(vcc);
       return res;
+    } else if (result == null) {
+      return new ValidationResult(IssueSeverity.WARNING, info.summary(), info.getIssues());
     } else if (foundCoding == null) {
       return new ValidationResult(IssueSeverity.ERROR, "Internal Error that should not happen", makeIssue(IssueSeverity.FATAL, IssueType.EXCEPTION, path, "Internal Error that should not happen"));
     } else if (info.getIssues().size() > 0) {
@@ -245,6 +273,15 @@ public class ValueSetValidator {
     }
   }
 
+  private boolean valueSetDependsOn(String system, String version) {
+    for (ConceptSetComponent inc : valueset.getCompose().getInclude()) {
+      if (system.equals(inc.getSystem()) && (version == null || inc.getVersion() == null || version.equals(inc.getVersion()))) {
+        return true;
+      }
+    }
+    return false;
+  }
+
   private String getVersion(Coding c) {
     if (c.hasVersion()) {
       return c.getVersion();
@@ -329,6 +366,7 @@ public class ValueSetValidator {
     ValidationResult res = null;
     boolean inExpansion = false;
     boolean inInclude = false;
+    List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
     VersionInfo vi = new VersionInfo(this);
 
     String system = code.hasSystem() ? code.getSystem() : getValueSetSystemOrNull();
@@ -363,8 +401,10 @@ public class ValueSetValidator {
       if (cs == null) {
         if (wv == null) {
           warningMessage = context.formatMessage(I18nConstants.UNKNOWN_CODESYSTEM, system);
+          unknownSystems.add(system);
         } else {
           warningMessage = context.formatMessage(I18nConstants.UNKNOWN_CODESYSTEM_VERSION, system, wv, resolveCodeSystemVersions(system).toString());
+          unknownSystems.add(system+"|"+wv);
         }
         if (!inExpansion) {
           if (valueset != null && valueset.hasExpansion()) {
@@ -372,18 +412,18 @@ public class ValueSetValidator {
                 valueset.getUrl(), 
                 code.getSystem(), 
                 code.getCode().toString());
-            List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
             issues.addAll(makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path, msg));
             throw new VSCheckerException(msg, issues);
           } else {
-            List<OperationOutcomeIssueComponent> issues = new ArrayList<>();
             issues.addAll(makeIssue(IssueSeverity.ERROR, IssueType.NOTFOUND, path+".system", warningMessage));
+            res = new ValidationResult(IssueSeverity.WARNING, warningMessage, issues);              
             if (valueset == null) {
               throw new VSCheckerException(warningMessage, issues);
             } else {
-              String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), code.toString());
-              issues.addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, msg));
-              throw new VSCheckerException(warningMessage+"; "+msg, issues);
+//              String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), code.toString());
+//              issues.addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, msg));
+              // we don't do this yet
+              // throw new VSCheckerException(warningMessage, issues); 
             }
           }
         }
@@ -407,7 +447,7 @@ public class ValueSetValidator {
               // we'll take it on faith
               String disp = getPreferredDisplay(cc);
               res = new ValidationResult(system, cs.getVersion(), new ConceptDefinitionComponent().setCode(cc.getCode()).setDisplay(disp), disp);
-              res.setMessage("Resolved system "+system+", but the definition is not complete, so assuming value set include is correct");
+              res.addToMessage("Resolved system "+system+", but the definition is not complete, so assuming value set include is correct");
               return res;
             }
           }
@@ -419,12 +459,14 @@ public class ValueSetValidator {
         // we just take the value set as face value then
         res = new ValidationResult(system, wv, new ConceptDefinitionComponent().setCode(code.getCode()).setDisplay(code.getDisplay()), code.getDisplay());
         if (!preferServerSide(system)) {
-          res.setMessage("Code System unknown, so assuming value set expansion is correct ("+warningMessage+")");
+          res.addToMessage("Code System unknown, so assuming value set expansion is correct ("+warningMessage+")");
         }
       } else {
         // well, we didn't find a code system - try the expansion? 
         // disabled waiting for discussion
-        throw new FHIRException("No try the server");
+        if (throwToServer) {
+          throw new FHIRException("No; try the server");
+        }
       }
     } else {
       inExpansion = checkExpansion(code, vi);
@@ -432,7 +474,7 @@ public class ValueSetValidator {
     }
     String wv = vi.getVersion(system, code.getVersion());
 
-    ValidationProcessInfo info = new ValidationProcessInfo();
+    ValidationProcessInfo info = new ValidationProcessInfo(issues);
     
     // then, if we have a value set, we check it's in the value set
     if (valueset != null && options.getValueSetMode() != ValueSetMode.NO_MEMBERSHIP_CHECK) {
@@ -446,20 +488,24 @@ public class ValueSetValidator {
             res.setErrorClass(info.getErr());
           }
           if (ok == null) {
-            res.setMessage("Unable to check whether code is in value set "+valueset.getUrl()+": "+info.summary()).setSeverity(IssueSeverity.WARNING);
-            res.getIssues().addAll(makeIssue(IssueSeverity.WARNING, IssueType.EXCEPTION, path, res.getMessage()));
+            String m = "Unable to check whether the code is in the value set "+valueset.getVersionedUrl();
+            res.addToMessage(m);
+            res.getIssues().addAll(makeIssue(IssueSeverity.WARNING, IssueType.NOTFOUND, path, m));
+            res.setUnknownSystems(unknownSystems);
+            res.setSeverity(IssueSeverity.ERROR); // back patching for display logic issue
           } else if (!inExpansion && !inInclude) {
-            if (!info.getIssues().isEmpty()) {
-              res.setMessage("Not in value set "+valueset.getUrl()+": "+info.summary()).setSeverity(IssueSeverity.ERROR);              
-              res.getIssues().addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, res.getMessage()));
-            } else {
-              String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), code.toString());
-              res.setMessage(msg).setSeverity(IssueSeverity.ERROR);
+//            if (!info.getIssues().isEmpty()) {
+//              res.setMessage("Not in value set "+valueset.getUrl()+": "+info.summary()).setSeverity(IssueSeverity.ERROR);              
+//              res.getIssues().addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, res.getMessage()));
+//            } else
+//            {
+              String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getVersionedUrl(), code.toString());
+              res.addToMessage(msg).setSeverity(IssueSeverity.ERROR);
               res.getIssues().addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, msg));
               res.setDefinition(null);
               res.setSystem(null);
               res.setDisplay(null);
-            }
+//            }
           } else if (warningMessage!=null) {
             String msg = context.formatMessage(I18nConstants.CODE_FOUND_IN_EXPANSION_HOWEVER_, warningMessage);
             res = new ValidationResult(IssueSeverity.WARNING, msg, makeIssue(IssueSeverity.WARNING, IssueType.EXCEPTION, path, msg));
@@ -472,7 +518,7 @@ public class ValueSetValidator {
           }
         }
       } else if ((res != null && !res.isOk())) {
-        String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getUrl(), code.toString());
+        String msg = context.formatMessagePlural(1, I18nConstants.NONE_OF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_, valueset.getVersionedUrl(), code.toString());
         res.setMessage(res.getMessage()+"; "+msg);
         res.getIssues().addAll(makeIssue(IssueSeverity.ERROR, IssueType.INVALID, path, msg));
       }
@@ -483,7 +529,7 @@ public class ValueSetValidator {
     return res;
   }
 
-  private static final HashSet<String> SERVER_SIDE_LIST = new HashSet<>(Arrays.asList("http://fdasis.nlm.nih.gov", "http://hl7.org/fhir/sid/ndc", "http://loinc.org", "http://snomed.info/sct", "http://unitsofmeasure.org", 
+  private static final Set<String> SERVER_SIDE_LIST = new HashSet<>(Arrays.asList("http://fdasis.nlm.nih.gov", "http://hl7.org/fhir/sid/ndc", "http://loinc.org", "http://snomed.info/sct", "http://unitsofmeasure.org", 
       "http://unstats.un.org/unsd/methods/m49/m49.htm", "http://varnomen.hgvs.org", "http://www.nlm.nih.gov/research/umls/rxnorm", "https://www.usps.com/",
       "urn:ietf:bcp:13","urn:ietf:bcp:47","urn:ietf:rfc:3986", "urn:iso:std:iso:3166","urn:iso:std:iso:4217", "urn:oid:1.2.36.1.2001.1005.17"));
   
@@ -917,6 +963,7 @@ public class ValueSetValidator {
   public Boolean codeInValueSet(String system, String version, String code, ValidationProcessInfo info) throws FHIRException {
     return codeInValueSet("code", system, version, code, info);
   }
+  
   public Boolean codeInValueSet(String path, String system, String version, String code, ValidationProcessInfo info) throws FHIRException {
     if (valueset == null) {
       return false;
@@ -991,30 +1038,42 @@ public class ValueSetValidator {
     // ok, we need the code system
     CodeSystem cs = resolveCodeSystem(system, version);
     if (cs == null || (cs.getContent() != CodeSystemContentMode.COMPLETE && cs.getContent() != CodeSystemContentMode.FRAGMENT)) {
-      // make up a transient value set with
-      ValueSet vs = new ValueSet();
-      vs.setStatus(PublicationStatus.ACTIVE);
-      vs.setUrl(valueset.getUrl()+"--"+vsiIndex);
-      vs.setVersion(valueset.getVersion());
-      vs.getCompose().addInclude(vsi);
-      ValidationResult res = context.validateCode(options.withNoClient(), new Coding(system, code, null), vs);
-      if (res.getErrorClass() == TerminologyServiceErrorClass.UNKNOWN || res.getErrorClass() == TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED || res.getErrorClass() == TerminologyServiceErrorClass.VALUESET_UNSUPPORTED) {
-        if (info != null && res.getErrorClass() == TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED) {
-       // server didn't know the code system either - we'll take it face value
-          info.addIssue(makeIssue(IssueSeverity.WARNING, IssueType.UNKNOWN, path, context.formatMessage(I18nConstants.TERMINOLOGY_TX_SYSTEM_NOTKNOWN, system)));
-          for (ConceptReferenceComponent cc : vsi.getConcept()) {
-            if (cc.getCode().equals(code)) {
-              return true;
+      if (throwToServer) {
+        // make up a transient value set with
+        ValueSet vs = new ValueSet();
+        vs.setStatus(PublicationStatus.ACTIVE);
+        vs.setUrl(valueset.getUrl()+"--"+vsiIndex);
+        vs.setVersion(valueset.getVersion());
+        vs.getCompose().addInclude(vsi);
+        ValidationResult res = context.validateCode(options.withNoClient(), new Coding(system, code, null), vs);
+        if (res.getErrorClass() == TerminologyServiceErrorClass.UNKNOWN || res.getErrorClass() == TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED || res.getErrorClass() == TerminologyServiceErrorClass.VALUESET_UNSUPPORTED) {
+          if (info != null && res.getErrorClass() == TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED) {
+            // server didn't know the code system either - we'll take it face value
+            info.addIssue(makeIssue(IssueSeverity.WARNING, IssueType.UNKNOWN, path, context.formatMessage(I18nConstants.TERMINOLOGY_TX_SYSTEM_NOTKNOWN, system)));
+            for (ConceptReferenceComponent cc : vsi.getConcept()) {
+              if (cc.getCode().equals(code)) {
+                return true;
+              }
             }
+            info.setErr(TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED);
+            return null;
           }
-          info.setErr(TerminologyServiceErrorClass.CODESYSTEM_UNSUPPORTED);
+          return false;
         }
-        return false;
+        if (res.getErrorClass() == TerminologyServiceErrorClass.NOSERVICE) {
+          throw new NoTerminologyServiceException();
+        }
+        return res.isOk();
+      } else {
+        if (unknownSystems != null) {
+          if (version == null) {
+            unknownSystems.add(system);
+          } else {
+            unknownSystems.add(system+"|"+version);          
+          }
+        }
+        return null;
       }
-      if (res.getErrorClass() == TerminologyServiceErrorClass.NOSERVICE) {
-        throw new NoTerminologyServiceException();
-      }
-      return res.isOk();
     } else {
       if (vsi.hasFilter()) {
         ok = true;
diff --git a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IResourceValidator.java b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IResourceValidator.java
index f36db48be..7f26bb8f9 100644
--- a/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IResourceValidator.java
+++ b/org.hl7.fhir.r5/src/main/java/org/hl7/fhir/r5/utils/validation/IResourceValidator.java
@@ -100,7 +100,7 @@ public interface IResourceValidator {
   void setNoUnicodeBiDiControlChars(boolean noUnicodeBiDiControlChars);
   
   boolean isForPublication();
-  void setForPublication(boolean forPublication);
+  IResourceValidator setForPublication(boolean forPublication);
   
   /**
    * Whether being unable to resolve a profile in found in Resource.meta.profile or ElementDefinition.type.profile or targetProfile is an error or just a warning
diff --git a/org.hl7.fhir.r5/src/test/java/org/hl7/fhir/r5/test/SnapShotGenerationTests.java b/org.hl7.fhir.r5/src/test/java/org/hl7/fhir/r5/test/SnapShotGenerationTests.java
index 4b551d4c5..7429723a6 100644
--- a/org.hl7.fhir.r5/src/test/java/org/hl7/fhir/r5/test/SnapShotGenerationTests.java
+++ b/org.hl7.fhir.r5/src/test/java/org/hl7/fhir/r5/test/SnapShotGenerationTests.java
@@ -585,8 +585,8 @@ public class SnapShotGenerationTests {
 
       boolean structureDefinitionEquality = t1.equalsDeep(t2);
       if (!structureDefinitionEquality) {
-        System.out.println("Encountered unexpected diff in structure definition");
-        DiffUtils.testDiff(dst.getAbsolutePath(), actualFilePath);
+        System.out.println("Encountered unexpected change in diff in structure definition");
+//        DiffUtils.testDiff(dst.getAbsolutePath(), actualFilePath);
       }
       Assertions.assertTrue(structureDefinitionEquality, "Output does not match expected");
     }
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/Utilities.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/Utilities.java
index e6b735e45..47f3f7b6d 100644
--- a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/Utilities.java
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/Utilities.java
@@ -590,7 +590,7 @@ public class Utilities {
   public static boolean isPlural(String word) {
     word = word.toLowerCase();
     if ("restricts".equals(word) || "contains".equals(word) || "data".equals(word) || "specimen".equals(word) || "replaces".equals(word) || "addresses".equals(word)
-      || "supplementalData".equals(word) || "instantiates".equals(word) || "imports".equals(word))
+      || "supplementalData".equals(word) || "instantiates".equals(word) || "imports".equals(word) || "covers".equals(word))
       return false;
     Inflector inf = new Inflector();
     return !inf.singularize(word).equals(word);
@@ -1966,4 +1966,8 @@ public class Utilities {
     return Utilities.startsWithInList(s.replace("https://", "http://"), FhirSettings.getTxFhirProduction(), FhirSettings.getTxFhirDevelopment(), FhirSettings.getTxFhirLocal());
   }
 
+  public static String[] splitLines(String txt) {
+    return txt.split("\\r?\\n|\\r");
+  }
+
 }
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
index 1c3d65423..5b5dcf412 100644
--- a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
@@ -866,6 +866,9 @@ public class I18nConstants {
   public static final String SD_NO_CONTEXT_INV_WHEN_NOT_EXTENSION = "SD_NO_CONTEXT_INV_WHEN_NOT_EXTENSION";
   public static final String SM_TARGET_TRANSFORM_OP_UNKNOWN_SOURCE = "SM_TARGET_TRANSFORM_OP_UNKNOWN_SOURCE";
   public static final String SM_TARGET_TRANSFORM_OP_INVALID_TYPE = "SM_TARGET_TRANSFORM_OP_INVALID_TYPE";
+  public static final String ED_PATH_WRONG_TYPE_MATCH = "ED_PATH_WRONG_TYPE_MATCH";
+  public static final String ATTEMPT_TO_CHANGE_SLICING = "ATTEMPT_TO_CHANGE_SLICING";
+  public static final String REPEAT_SLICING_IGNORED = "REPEAT_SLICING_IGNORED";
 }
 
 
diff --git a/org.hl7.fhir.utilities/src/main/resources/Messages.properties b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
index 462016ece..c7d8d4fa5 100644
--- a/org.hl7.fhir.utilities/src/main/resources/Messages.properties
+++ b/org.hl7.fhir.utilities/src/main/resources/Messages.properties
@@ -672,7 +672,7 @@ RENDER_BUNDLE_DOCUMENT_CONTENT = Additional Document Content
 RENDER_BUNDLE_HEADER_DOC_ENTRY_URD = {0}. {1} ({2}/{3})
 RENDER_BUNDLE_HEADER_DOC_ENTRY_U = {0}. {1}
 RENDER_BUNDLE_HEADER_DOC_ENTRY_RD = {0}. {2}/{3}
-UNABLE_TO_CHECK_IF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_ = Unable to determine whether the provided codes {1} are in the value set {0} because the value set or a code system it depends on is not known to the validator
+UNABLE_TO_CHECK_IF_THE_PROVIDED_CODES_ARE_IN_THE_VALUE_SET_ = Unable to check whether the code is in the value set {0}
 TERMINOLOGY_TX_SYSTEM_WRONG_HTML = The code system reference {0} is wrong - the code system reference cannot be to an HTML page. This may be the correct reference: {1}
 TERMINOLOGY_TX_SYSTEM_WRONG_BUILD = The code system reference {0} is wrong - the code system reference cannot be a reference to build.fhir.org. This may be the correct reference: {1}
 FHIRPATH_BAD_DATE = Unable to parse Date {0}
@@ -920,6 +920,7 @@ NO_VALID_DISPLAY_FOUND_other = No valid Display Names found for {1}#{2} in the l
 SD_NO_CONTEXT_WHEN_NOT_EXTENSION = The type is {0} so an extension context should not be specified
 SD_NO_CONTEXT_INV_WHEN_NOT_EXTENSION = The type is {0} so an extension context invariants should not be specified
 SD_CONTEXT_SHOULD_NOT_BE_ELEMENT = Review the extension type: extensions should not have a context of {0} unless it''s really intended that they can be used anywhere
-
-
+ED_PATH_WRONG_TYPE_MATCH = The path must be ''{0}'' not ''{1}'' when the type list is not constrained
+ATTEMPT_TO_CHANGE_SLICING = The element at {0} defines the slicing {1} but then an element in the slicing {2} tries to redefine the slicing to {3}
+REPEAT_SLICING_IGNORED = The element at {0} defines the slicing but then an element in the slicing {2} repeats it, which is ignored
 
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/BaseValidator.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/BaseValidator.java
index 2d0be1a81..2c46c8566 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/BaseValidator.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/BaseValidator.java
@@ -156,6 +156,7 @@ public class BaseValidator implements IValidationContextResourceLoader {
   private ValidationLevel level = ValidationLevel.HINTS;
   protected Coding jurisdiction;
   protected boolean allowExamples;
+  protected boolean forPublication;
 
   public BaseValidator(IWorkerContext context, XVerExtensionManager xverManager) {
     super();
@@ -1242,7 +1243,16 @@ public class BaseValidator implements IValidationContextResourceLoader {
   }
 
   protected boolean isExampleUrl(String url) {
-    return Utilities.containsInList(url, "example.org", "acme.com", "acme.org");
-    
+    return Utilities.containsInList(url, "example.org", "acme.com", "acme.org");    
   }
+  
+  public boolean isForPublication() {
+    return forPublication;
+  }
+  
+  public BaseValidator setForPublication(boolean forPublication) {
+    this.forPublication = forPublication;
+    return this;
+  }
+
 }
\ No newline at end of file
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
index 1eb7997f9..093c6a696 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/InstanceValidator.java
@@ -505,7 +505,6 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
   private ValidationOptions baseOptions = new ValidationOptions();
   private Map<String, CanonicalResourceLookupResult> crLookups = new HashMap<>();
   private boolean logProgress;
-  private boolean forPublication;
 
   public InstanceValidator(IWorkerContext theContext, IEvaluationContext hostServices, XVerExtensionManager xverManager) {
     super(theContext, xverManager);
@@ -2394,18 +2393,21 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       }
     }
     if (type.equals("dateTime")) {
-      warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path,
-        e.primitiveValue()
-          .matches("([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))?)?)?)?"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_VALID, e.primitiveValue()) && ok;
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !hasTime(e.primitiveValue()) || hasTimeZone(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_TZ) && ok;
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !context.hasMaxLength() || context.getMaxLength() == 0 || e.primitiveValue().length() <= context.getMaxLength(), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_PRIMITIVE_LENGTH, context.getMaxLength()) && ok;
-      try {
-        DateTimeType dt = new DateTimeType(e.primitiveValue());
-      } catch (Exception ex) {
-        rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_VALID, ex.getMessage());
-        ok = false;
+      boolean dok = ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path,
+          e.primitiveValue()
+          .matches("([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1])(T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))?)?)?)?"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_VALID, "'"+e.primitiveValue()+"' doesn't meet format requirements for dateTime") && ok;
+      dok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !hasTime(e.primitiveValue()) || hasTimeZone(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_TZ) && dok;
+      dok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !context.hasMaxLength() || context.getMaxLength() == 0 || e.primitiveValue().length() <= context.getMaxLength(), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_PRIMITIVE_LENGTH, context.getMaxLength()) && dok;
+      if (dok) {
+        try {
+          DateTimeType dt = new DateTimeType(e.primitiveValue());
+          warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
+        } catch (Exception ex) {
+          rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_VALID, ex.getMessage());
+          dok = false;
+        }
       }
+      ok = ok && dok;
     }
     if (type.equals("time")) {
       ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path,
@@ -2419,15 +2421,18 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       }
     }
     if (type.equals("date")) {
-      warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, e.primitiveValue().matches("([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATE_VALID) && ok;
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !context.hasMaxLength() || context.getMaxLength() == 0 || e.primitiveValue().length() <= context.getMaxLength(), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_PRIMITIVE_LENGTH, context.getMaxLength()) && ok;
-      try {
-        DateType dt = new DateType(e.primitiveValue());
-      } catch (Exception ex) {
-        rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATE_VALID, ex.getMessage());
-        ok = false;
+      boolean dok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, e.primitiveValue().matches("([0-9]([0-9]([0-9][1-9]|[1-9]0)|[1-9]00)|[1-9]000)(-(0[1-9]|1[0-2])(-(0[1-9]|[1-2][0-9]|3[0-1]))?)?"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATE_VALID, "'"+e.primitiveValue()+"' doesn't meet format requirements for date");
+      dok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, !context.hasMaxLength() || context.getMaxLength() == 0 || e.primitiveValue().length() <= context.getMaxLength(), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_PRIMITIVE_LENGTH, context.getMaxLength()) && dok;
+      if (dok) {
+        try {
+          DateType dt = new DateType(e.primitiveValue());
+          warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
+        } catch (Exception ex) {
+          rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATE_VALID, ex.getMessage());
+          dok = false;
+        }
       }
+      ok = ok && dok;
     }
     if (type.equals("base64Binary")) {
       String encoded = e.primitiveValue();
@@ -2511,15 +2516,18 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
       }
     }
     if (type.equals("instant")) {
-      ok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path,
-        e.primitiveValue().matches("-?[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REGEX, e.primitiveValue()) && ok;
-      warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
-      try {
-        InstantType dt = new InstantType(e.primitiveValue());
-      } catch (Exception ex) {
-        rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_INSTANT_VALID, ex.getMessage());
-        ok = false;
+      boolean dok = rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path,
+          e.primitiveValue().matches("-?[0-9]{4}-(0[1-9]|1[0-2])-(0[1-9]|[1-2][0-9]|3[0-1])T([01][0-9]|2[0-3]):[0-5][0-9]:([0-5][0-9]|60)(\\.[0-9]+)?(Z|(\\+|-)((0[0-9]|1[0-3]):[0-5][0-9]|14:00))"), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REGEX, "'"+e.primitiveValue()+"' doesn't meet format requirements for instant)");
+      if (dok) {
+        try {
+          InstantType dt = new InstantType(e.primitiveValue());
+          warning(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, yearIsValid(e.primitiveValue()), I18nConstants.TYPE_SPECIFIC_CHECKS_DT_DATETIME_REASONABLE, e.primitiveValue());
+        } catch (Exception ex) {
+          rule(errors, NO_RULE_DATE, IssueType.INVALID, e.line(), e.col(), path, false, I18nConstants.TYPE_SPECIFIC_CHECKS_DT_INSTANT_VALID, ex.getMessage());
+          dok = false;
+        }
       }
+      ok = ok && dok;
     }
 
     if (type.equals("code") && e.primitiveValue() != null) {
@@ -5040,7 +5048,7 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     } else if (element.getType().equals("SearchParameter")) {
       return new SearchParameterValidator(context, timeTracker, fpe, xverManager, jurisdiction).validateSearchParameter(errors, element, stack);
     } else if (element.getType().equals("StructureDefinition")) {
-      return new StructureDefinitionValidator(context, timeTracker, fpe, wantCheckSnapshotUnchanged, xverManager, jurisdiction).validateStructureDefinition(errors, element, stack);
+      return new StructureDefinitionValidator(context, timeTracker, fpe, wantCheckSnapshotUnchanged, xverManager, jurisdiction, forPublication).validateStructureDefinition(errors, element, stack);
     } else if (element.getType().equals("StructureMap")) {
       return new StructureMapValidator(context, timeTracker, fpe, xverManager,profileUtilities, jurisdiction).validateStructureMap(errors, element, stack);
     } else if (element.getType().equals("ValueSet")) {
@@ -6527,14 +6535,6 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     this.logProgress = logProgress;
   }
 
-  public boolean isForPublication() {
-    return forPublication;
-  }
-  
-  public void setForPublication(boolean forPublication) {
-    this.forPublication = forPublication;
-  }
-
   public boolean isDisplayWarnings() {
     return baseOptions.isDisplayWarningMode();
   }
@@ -6543,4 +6543,9 @@ public class InstanceValidator extends BaseValidator implements IResourceValidat
     baseOptions.setDisplayWarningMode(displayWarnings);
   }
 
+
+  public InstanceValidator setForPublication(boolean forPublication) {
+    this.forPublication = forPublication;
+    return this;
+  }
 }
\ No newline at end of file
diff --git a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/StructureDefinitionValidator.java b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/StructureDefinitionValidator.java
index e7245bbcf..9cad656d9 100644
--- a/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/StructureDefinitionValidator.java
+++ b/org.hl7.fhir.validation/src/main/java/org/hl7/fhir/validation/instance/type/StructureDefinitionValidator.java
@@ -60,13 +60,14 @@ public class StructureDefinitionValidator extends BaseValidator {
   private FHIRPathEngine fpe;
   private boolean wantCheckSnapshotUnchanged;
 
-  public StructureDefinitionValidator(IWorkerContext context, TimeTracker timeTracker, FHIRPathEngine fpe, boolean wantCheckSnapshotUnchanged, XVerExtensionManager xverManager, Coding jurisdiction) {
+  public StructureDefinitionValidator(IWorkerContext context, TimeTracker timeTracker, FHIRPathEngine fpe, boolean wantCheckSnapshotUnchanged, XVerExtensionManager xverManager, Coding jurisdiction, boolean forPublication) {
     super(context, xverManager);
     source = Source.InstanceValidator;
     this.fpe = fpe;
     this.timeTracker = timeTracker;
     this.wantCheckSnapshotUnchanged = wantCheckSnapshotUnchanged;
     this.jurisdiction = jurisdiction;
+    this.forPublication = forPublication;
   }
   
   public boolean validateStructureDefinition(List<ValidationMessage> errors, Element src, NodeStack stack)  {
@@ -89,6 +90,7 @@ public class StructureDefinitionValidator extends BaseValidator {
             rule(errors, "2022-11-02", IssueType.NOTFOUND, stack.getLiteralPath(), sd.hasType() && sd.getType().equals(base.getType()), I18nConstants.SD_CONSTRAINED_TYPE_NO_MATCH, sd.getType(), base.getType());
             List<ValidationMessage> msgs = new ArrayList<>();
             ProfileUtilities pu = new ProfileUtilities(context, msgs, null);
+            pu.setForPublication(forPublication);
             pu.setXver(xverManager);
             pu.setNewSlicingProcessing(!sd.hasFhirVersion() || VersionUtilities.isR4Plus(sd.getFhirVersion().toCode()));
             pu.generateSnapshot(base, sd, sd.getUrl(), "http://hl7.org/fhir/R4/", sd.getName());
@@ -121,7 +123,7 @@ public class StructureDefinitionValidator extends BaseValidator {
               I18nConstants.SD_DERIVATION_KIND_MISMATCH, base.getKindElement().primitiveValue(), src.getChildValue("kind")) && ok;
         }
       }
-    } catch (FHIRException | IOException e) {
+    } catch (Exception e) {
       rule(errors, NO_RULE_DATE, IssueType.EXCEPTION, stack.getLiteralPath(), false, I18nConstants.ERROR_GENERATING_SNAPSHOT, e.getMessage());
       ok = false;
     }
diff --git a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/conversion/tests/SnapShotGenerationXTests.java b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/conversion/tests/SnapShotGenerationXTests.java
index b98ab090f..203d599c0 100644
--- a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/conversion/tests/SnapShotGenerationXTests.java
+++ b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/conversion/tests/SnapShotGenerationXTests.java
@@ -175,19 +175,19 @@ public class SnapShotGenerationXTests {
     }
 
     public void load(String version) throws FHIRFormatError, FileNotFoundException, IOException {
-      if (UtilitiesXTests.findTestResource("rX", "snapshot-generation", id + "-input.json"))
-        source = (StructureDefinition) XVersionLoader.loadJson(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", id + "-input.json"));
+      if (TestingUtilities.findTestResource("rX", "snapshot-generation", id + "-input.json"))
+        source = (StructureDefinition) XVersionLoader.loadJson(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", id + "-input.json"));
       else
-        source = (StructureDefinition) XVersionLoader.loadXml(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", id + "-input.xml"));
+        source = (StructureDefinition) XVersionLoader.loadXml(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", id + "-input.xml"));
       if (!fail)
-        expected = (StructureDefinition) XVersionLoader.loadXml(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", id + "-expected.xml"));
+        expected = (StructureDefinition) XVersionLoader.loadXml(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", id + "-expected.xml"));
       if (!Utilities.noString(include))
-        included = (StructureDefinition) XVersionLoader.loadXml(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", include + ".xml"));
+        included = (StructureDefinition) XVersionLoader.loadXml(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", include + ".xml"));
       if (!Utilities.noString(register)) {
-        if (UtilitiesXTests.findTestResource("rX", "snapshot-generation", register + ".xml")) {
-          included = (StructureDefinition)  XVersionLoader.loadXml(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", register + ".xml"));
+        if (TestingUtilities.findTestResource("rX", "snapshot-generation", register + ".xml")) {
+          included = (StructureDefinition)  XVersionLoader.loadXml(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", register + ".xml"));
         } else {
-          included = (StructureDefinition)  XVersionLoader.loadJson(version, UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", register + ".json"));
+          included = (StructureDefinition)  XVersionLoader.loadJson(version, TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", register + ".json"));
         }
       }
     }
@@ -404,7 +404,7 @@ public class SnapShotGenerationXTests {
   public static Iterable<Object[]> data() throws ParserConfigurationException, IOException, FHIRFormatError, SAXException {
 
     SnapShotGenerationTestsContext context = new SnapShotGenerationTestsContext();
-    Document tests = XMLUtil.parseToDom(UtilitiesXTests.loadTestResource("rX", "snapshot-generation", "manifest.xml"));
+    Document tests = XMLUtil.parseToDom(TestingUtilities.loadTestResource("rX", "snapshot-generation", "manifest.xml"));
     Element test = XMLUtil.getFirstChild(tests.getDocumentElement());
     List<Object[]> objects = new ArrayList<Object[]>();
     while (test != null && test.getNodeName().equals("test")) {
@@ -471,7 +471,7 @@ public class SnapShotGenerationXTests {
     pu.sortDifferential(base, test.getOutput(), test.getOutput().getUrl(), errors, false);
     if (!errors.isEmpty())
       throw new FHIRException(errors.get(0));
-    IOUtils.copy(UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", test.getId() + "-expected.xml"), new FileOutputStream(UtilitiesXTests.tempFile("snapshot", test.getId() + "-expected.xml")));
+    IOUtils.copy(TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", test.getId() + "-expected.xml"), new FileOutputStream(UtilitiesXTests.tempFile("snapshot", test.getId() + "-expected.xml")));
     new XmlParser().setOutputStyle(OutputStyle.PRETTY).compose(new FileOutputStream(UtilitiesXTests.tempFile("snapshot", test.getId() + "-actual.xml")), test.getOutput());
     Assertions.assertTrue(test.expected.equalsDeep(test.output), "Output does not match expected");
   }
@@ -545,7 +545,7 @@ public class SnapShotGenerationXTests {
       File dst = new File(UtilitiesXTests.tempFile("snapshot", test.getId() + "-expected.xml"));
       if (dst.exists())
         dst.delete();
-      IOUtils.copy(UtilitiesXTests.loadTestResourceStream("rX", "snapshot-generation", test.getId() + "-expected.xml"), new FileOutputStream(dst));
+      IOUtils.copy(TestingUtilities.loadTestResourceStream("rX", "snapshot-generation", test.getId() + "-expected.xml"), new FileOutputStream(dst));
       new XmlParser().setOutputStyle(OutputStyle.PRETTY).compose(new FileOutputStream(UtilitiesXTests.tempFile("snapshot", test.getId() + "-actual.xml")), output);
       StructureDefinition t1 = test.expected.copy();
       t1.setText(null);
diff --git a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
index dc2156dbd..6a7bb24ec 100644
--- a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
+++ b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/terminology/tests/TerminologyServiceTests.java
@@ -280,6 +280,11 @@ public class TerminologyServiceTests {
     if (vm.getCodeableConcept() != null) {
       res.addParameter("codeableConcept", vm.getCodeableConcept());
     }
+    if (vm.getUnknownSystems() != null) {
+      for (String s : vm.getUnknownSystems()) {
+        res.addParameter("x-caused-by-unknown-system", new UriType(s));
+      }
+    }
     if (vm.getIssues().size() > 0) {
       OperationOutcome oo = new OperationOutcome();
       oo.getIssue().addAll(vm.getIssues());
diff --git a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/validation/tests/ValidationTests.java b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/validation/tests/ValidationTests.java
index 6fefd8b33..0bca11e59 100644
--- a/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/validation/tests/ValidationTests.java
+++ b/org.hl7.fhir.validation/src/test/java/org/hl7/fhir/validation/tests/ValidationTests.java
@@ -202,6 +202,9 @@ public class ValidationTests implements IEvaluationContext, IValidatorResourceFe
     byte[] testCaseContent = TestingUtilities.loadTestResource("validator", JsonUtilities.str(content, "file")).getBytes(StandardCharsets.UTF_8);
     // load and process content    
     FhirFormat fmt = determineFormat(content, testCaseContent);
+    if (fmt == null) {
+      throw new FHIRException("Unknown format in source "+JsonUtilities.str(content, "file"));
+    }
     
     InstanceValidator val = vCurr.getValidator(fmt);
     val.setWantCheckSnapshotUnchanged(true);
@@ -238,6 +241,7 @@ public class ValidationTests implements IEvaluationContext, IValidatorResourceFe
       val.setValidationLanguage(content.get("language").getAsString());
     else
       val.setValidationLanguage(null);
+    val.setForPublication(content.has("for-publication") && "true".equals(content.get("for-publication").getAsString()));
     if (content.has("default-version")) {
       val.setBaseOptions(val.getBaseOptions().withVersionFlexible(content.get("default-version").getAsBoolean()));
     } else {
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/all-systems.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/all-systems.cache
index c4953b917..ff532930b 100644
--- a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/all-systems.cache
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/all-systems.cache
@@ -1116,3 +1116,39 @@ v: {
   "class" : "UNKNOWN"
 }
 -------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "77176002",
+  "display" : "Smoker"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-bloodGroup", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Smoker",
+  "code" : "77176002",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "38341003",
+  "display" : "Hypertensive disorder, systemic arterial (disorder)"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-bloodGroup", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "High blood pressure",
+  "code" : "38341003",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/http___varnomen.hgvs.org.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/http___varnomen.hgvs.org.cache
index 1d26e3c7f..213ff2f24 100644
--- a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/http___varnomen.hgvs.org.cache
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/http___varnomen.hgvs.org.cache
@@ -63,3 +63,35 @@ v: {
   "class" : "SERVER_ERROR"
 }
 -------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://varnomen.hgvs.org",
+  "code" : "NC_000019.8:g.1171707G>A"
+}, "url": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-hgvs-vs", "version": "1.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Error from server: Error parsing HGVS response: Error parsing JSON source: Unexpected char \"<\" in json stream at Line 0 (path=[])",
+  "class" : "SERVER_ERROR"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://varnomen.hgvs.org",
+  "code" : "NC_000019.8:g.1171707G>AXXX"
+}, "url": "http://hl7.org/fhir/us/mcode/ValueSet/mcode-hgvs-vs", "version": "1.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Error from server: Error parsing HGVS response: Error parsing JSON source: Unexpected char \"<\" in json stream at Line 0 (path=[])",
+  "class" : "SERVER_ERROR"
+}
+-------------------------------------------------------------------------------------
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/loinc.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/loinc.cache
index 476aab8d3..db0a89521 100644
--- a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/loinc.cache
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/loinc.cache
@@ -3167,3 +3167,279 @@ v: {
   "version" : "2.74"
 }
 -------------------------------------------------------------------------------------
+{"code" : {
+  "coding" : [{
+    "system" : "http://loinc.org",
+    "code" : "59408-5",
+    "display" : "O2 % BldC Oximetry"
+  },
+  {
+    "system" : "http://loinc.org",
+    "code" : "2708-6",
+    "display" : "Oxygen saturation in Arterial blood"
+  }]
+}, "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs", "version": "4.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"CHECK_MEMERSHIP_ONLY", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Wrong Display Name 'O2 % BldC Oximetry' for http://loinc.org#59408-5 - should be one of 26 choices: 'Oxygen saturation in Arterial blood by Pulse oximetry, \"SaO2 % BldA PulseOx\", \"O2 SaO2\" (pl-PL), \"saturacja krwi tlenem\" (pl-PL), \"MFr O2\" (zh-CN), \"tO2\" (zh-CN), \"总氧\" (zh-CN), \"氧气 SaO2 动脉血 动脉血O2饱和度 可用数量表示的\" (zh-CN), \"定量性\" (zh-CN), \"数值型\" (zh-CN), \"数量型\" (zh-CN), \"连续数值型标尺 时刻\" (zh-CN), \"随机\" (zh-CN), \"随意\" (zh-CN), \"瞬间 肺部测量指标与呼吸机管理 脉搏血氧测定法\" (zh-CN), \"脉搏血氧定量\" (zh-CN), \"脉搏血氧测定\" (zh-CN), \"脉搏血氧仪 血氧测定法 饱和 饱和状态 饱和程度\" (zh-CN), \"O2-Sättigung\" (de-DE), \"Frazione di massa Gestione ventilazione polmonare Punto nel tempo (episodio) Sangue arterioso\" (it-IT), \"Oksijen doymuşluğu\" (tr-TR), \"Количественный Кровь артериальная Массовая доля Насыщение кислородом Оксигемометрия\" (ru-RU), \"Гемоксиметрия Точка во времени\" (ru-RU), \"Момент\" (ru-RU), \"zuurstofsaturatiemeting\" (nl-NL), \"O2 SatO2\" (fr-BE)' for the language(s) '--' (from Tx-Server)",
+  "class" : "UNKNOWN"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "coding" : [{
+    "system" : "http://loinc.org",
+    "code" : "3150-0",
+    "display" : "Inhaled Oxygen Concentration"
+  }]
+}, "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs", "version": "4.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"CHECK_MEMERSHIP_ONLY", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Inhaled oxygen concentration",
+  "code" : "3150-0",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "coding" : [{
+    "system" : "http://loinc.org",
+    "code" : "3151-8",
+    "display" : "Flow Rate"
+  }]
+}, "url": "http://hl7.org/fhir/us/core/ValueSet/us-core-vital-signs", "version": "4.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"CHECK_MEMERSHIP_ONLY", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Wrong Display Name 'Flow Rate' for http://loinc.org#3151-8 - should be one of 37 choices: 'Inhaled oxygen flow rate, \"Inhaled O2 flow rate\", \"O2\" (zh-CN), \"tO2\" (zh-CN), \"总氧\" (zh-CN), \"氧气 体积速率(单位时间)\" (zh-CN), \"单位时间内体积的变化速率\" (zh-CN), \"流量 可用数量表示的\" (zh-CN), \"定量性\" (zh-CN), \"数值型\" (zh-CN), \"数量型\" (zh-CN), \"连续数值型标尺 吸入气\" (zh-CN), \"吸入气体\" (zh-CN), \"吸入的空气 所吸入的氧\" (zh-CN), \"已吸入的氧气 时刻\" (zh-CN), \"随机\" (zh-CN), \"随意\" (zh-CN), \"瞬间 气 气体类 空气\" (zh-CN), \"Inhaled O2\" (pt-BR), \"vRate\" (pt-BR), \"Volume rate\" (pt-BR), \"Flow\" (pt-BR), \"Point in time\" (pt-BR), \"Random\" (pt-BR), \"IhG\" (pt-BR), \"Inhaled Gas\" (pt-BR), \"Inspired\" (pt-BR), \"Quantitative\" (pt-BR), \"QNT\" (pt-BR), \"Quant\" (pt-BR), \"Quan\" (pt-BR), \"Gases\" (pt-BR), \"Clinico Gas inalati Punto nel tempo (episodio) Tasso di Volume\" (it-IT), \"Количественный Объемная скорость Точка во времени\" (ru-RU), \"Момент\" (ru-RU), \"ingeademde O2\" (nl-NL), \"O2-Zufuhr\" (de-AT)' for the language(s) '--' (from Tx-Server)",
+  "class" : "UNKNOWN"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "883-9",
+  "display" : "ABO group [Type] in Blood"
+}, "url": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult", "version": "4.0.1", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "ABO group [Type] in Blood",
+  "code" : "883-9",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "883-9"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "ABO group [Type] in Blood",
+  "code" : "883-9",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "46418-0",
+  "display" : "INR in Capillary blood by Coagulation assay"
+}, "url": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult", "version": "4.0.1", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "INR in Capillary blood by Coagulation assay",
+  "code" : "46418-0",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "77140-2",
+  "display" : "Creatinine [Moles/volume] in Serum, Plasma or Blood"
+}, "url": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult", "version": "4.0.1", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Creatinine [Moles/volume] in Serum, Plasma or Blood",
+  "code" : "77140-2",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "4535-1",
+  "display" : "Cytotoxic percent reactive Ab [Presence] in Serum by Quick method"
+}, "url": "http://hl7.org/fhir/ValueSet/observation-vitalsignresult", "version": "4.0.1", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Cytotoxic percent reactive Ab [Presence] in Serum by Quick method",
+  "code" : "4535-1",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "29463-7",
+  "display" : "Body weight"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-laboratory", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Body weight",
+  "code" : "29463-7",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "8302-2",
+  "display" : "Body height"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-laboratory", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Body height",
+  "code" : "8302-2",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "39156-5",
+  "display" : "Body mass index (BMI) [Ratio]"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-laboratory", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Body mass index (BMI) [Ratio]",
+  "code" : "39156-5",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "85354-9",
+  "display" : "Blood pressure panel with all children optional"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-laboratory", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Blood pressure panel with all children optional",
+  "code" : "85354-9",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "883-9",
+  "display" : "ABO group [Type] in Blood"
+}, "url": "https://mednet.swiss/fhir/ValueSet/mni-obs-laboratory", "version": "0.5.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "ABO group [Type] in Blood",
+  "code" : "883-9",
+  "system" : "http://loinc.org",
+  "version" : "2.74"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "X-34133-9"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Unknown Code 'X-34133-9' in the system 'http://loinc.org'; The provided code http://loinc.org#X-34133-9 is not in the value set 'http://hl7.org/fhir/ValueSet/@all' (from Tx-Server)",
+  "class" : "UNKNOWN"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://loinc.org",
+  "code" : "5792-7"
+}, "valueSet" :{
+  "resourceType" : "ValueSet"
+}, "langs":"[]", "useServer":"true", "useClient":"false", "guessSystem":"false", "valueSetMode":"CHECK_MEMERSHIP_ONLY", "displayWarningMode":"false", "versionFlexible":"true", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "severity" : "error",
+  "error" : "Error from server: Unable to resolve value set \"http://hl7.org/fhir/ValueSet/birthDate\"",
+  "class" : "SERVER_ERROR"
+}
+-------------------------------------------------------------------------------------
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/snomed.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/snomed.cache
index c4b75d6e7..b51a4f158 100644
--- a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/snomed.cache
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/4.0.1/snomed.cache
@@ -2116,3 +2116,37 @@ v: {
   "class" : "UNKNOWN"
 }
 -------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "77176002"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Smoker",
+  "code" : "77176002",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "38341003"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "High blood pressure",
+  "code" : "38341003",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/dicom.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/dicom.cache
new file mode 100644
index 000000000..71885930b
--- /dev/null
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/dicom.cache
@@ -0,0 +1,19 @@
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://dicom.nema.org/resources/ontology/DCM",
+  "code" : "110122",
+  "display" : "Login"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Login",
+  "code" : "110122",
+  "system" : "http://dicom.nema.org/resources/ontology/DCM",
+  "version" : "2023.1.20230123"
+}
+-------------------------------------------------------------------------------------
diff --git a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/snomed.cache b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/snomed.cache
index cec561d38..4996fd9cc 100644
--- a/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/snomed.cache
+++ b/org.hl7.fhir.validation/src/test/resources/txCache/org.hl7.fhir.validation/5.0.0/snomed.cache
@@ -752,3 +752,73 @@ v: {
   "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
 }
 -------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "90655003",
+  "display" : "Geriatrics specialist"
+}, "url": "http://hl7.org/fhir/ValueSet/c80-practice-codes", "version": "5.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"true", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Geriatrics specialist",
+  "code" : "90655003",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "90655003"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"true", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Geriatrics specialist",
+  "code" : "90655003",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "106004",
+  "display" : "Posterior carpal region"
+}, "url": "http://hl7.org/fhir/ValueSet/clinical-findings", "version": "5.0.0", "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"NO_MEMBERSHIP_CHECK", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Posterior carpal region",
+  "code" : "106004",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
+{"code" : {
+  "system" : "http://snomed.info/sct",
+  "code" : "106004"
+}, "valueSet" :null, "langs":"[en]", "useServer":"true", "useClient":"true", "guessSystem":"false", "valueSetMode":"ALL_CHECKS", "displayWarningMode":"false", "versionFlexible":"false", "profile": {
+  "resourceType" : "Parameters",
+  "parameter" : [{
+    "name" : "profile-url",
+    "valueString" : "http://hl7.org/fhir/ExpansionProfile/dc8fd4bc-091a-424a-8a3b-6198ef146891"
+  }]
+}}####
+v: {
+  "display" : "Posterior carpal region",
+  "code" : "106004",
+  "system" : "http://snomed.info/sct",
+  "version" : "http://snomed.info/sct/900000000000207008/version/20230131"
+}
+-------------------------------------------------------------------------------------
diff --git a/pom.xml b/pom.xml
index d9af733e1..d185ac805 100644
--- a/pom.xml
+++ b/pom.xml
@@ -19,7 +19,7 @@
 
     <properties>
         <hapi_fhir_version>6.4.1</hapi_fhir_version>
-        <validator_test_case_version>1.3.6</validator_test_case_version>
+        <validator_test_case_version>1.3.7-SNAPSHOT</validator_test_case_version>
         <jackson_version>2.14.0</jackson_version>
         <junit_jupiter_version>5.9.2</junit_jupiter_version>
         <junit_platform_launcher_version>1.8.2</junit_platform_launcher_version>