CCDA download problems and unstructured documents (#5870)

CCDA download problems and unstructured documents (#5870)

* CCDA download problems and unstructured documents
- fix issue where download export was generating the ccda twice
- fix issue where last gen'ed document was being echoed after zip already created.

* - add unstructured document for patient doc exports
- add an export flag Export Documents to export if user wants to add the unstrutured doc.
- export zip now includes all exported files in same directory
- fix corrupted zip build
- some restyles include radio selects using label

* - ccda service updated for unstructured doc.
- removed functionalStatusSelfCareObservation. needs to be reported differently.

* - turns out spec requires SHALL contain exactly one [1..1] Self-Care Activities as weird as it may be in doc placement!
- add document level unstructered template
- add UUID to patient identifier extension.
- add compression to exported files
- fix searchFiltered to honor import button

* - add longtext to ccda and audit_detail

* - imlements new reader class that implements the Laminas reader XML class
- cache unstructured files to audit table for import
- code cleanup

* - add global to turn off ccda validation
- database changes
- more ccda import additions
- spiff up zip imports

* - finish document imports