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Co-Production Of A Mobile Application For Parents Of Acutely Ill Children Under Five: ‘Ipoorly Child Symptom Checker’, Sarah Neill, Amy Rathbone, John Downey, Monica Lakhanpaul, Damian Roland, Matt Carey Jul 2026

Co-Production Of A Mobile Application For Parents Of Acutely Ill Children Under Five: ‘Ipoorly Child Symptom Checker’, Sarah Neill, Amy Rathbone, John Downey, Monica Lakhanpaul, Damian Roland, Matt Carey

School of Nursing and Midwifery

Acutely-ill children under five years are increasing users of urgent and emergency care with no increase in acuity of presenting illnesses. This raises concerns about parents' knowledge and confidence in assessing the severity ofsymptoms of acute illness, despite the abundance of digital information available.Method:Weco-designedtheiPoorlychildsymptomcheckerappusingexperience-basedco-designmethodology with seven parents and seven health professional patient and public involvement representatives. The prototype was iteratively developed on a no-code platform, then released for testing on android and iOS app stores for six weeks. The app was downloaded 603 times and 60% of users completed the embedded evaluation form. Results: System usability scale items were all …

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Autonomous Stress Testing In A Network Digital Twin For Predictive Remediation, Mohit Chandra, Amrita Mukherjee Jun 2026

Autonomous Stress Testing In A Network Digital Twin For Predictive Remediation, Mohit Chandra, Amrita Mukherjee

Defensive Publications Series

The management of complex telecommunications networks can be challenged by difficulties in predicting the impact of component failures and the risks of testing automations on a live system. Systems and methods are described that can address these challenges by creating and maintaining a graph-based digital representation, such as a digital twin, of an operational network that can be synchronized with real-time data. Within this digital twin, for example, an autonomous agent can perform synthetic fault injections to simulate a wide range of potential failures and stressors. The system can analyze the effects of these simulated faults to predict potential service-level …

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Speculative Data Prefetching Based On Predicted Agent Intent In Machine Learning Systems, Anonymous Jun 2026

Speculative Data Prefetching Based On Predicted Agent Intent In Machine Learning Systems, Anonymous

Defensive Publications Series

Techniques are described for speculative data prefetching in systems in which an LLM agent dynamically invokes retrieval backends whose candidates require embedding lookups from SSD-backed embedding tables. A user memory state with tiered memory data is obtained and converted into features. An intent prediction model produces, for each backend, a probability that the agent will invoke the backend. A prefetch controller computes a backend-specific prefetch decision using a value metric that combines probability, expected embedding lookups, SSD latency, and prefetch cost, and selects backends subject to a bandwidth budget based on SSD throughput and a Phase 1 time window. Speculative …

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Hierarchical Multi-Level Knowledge Graph With Compositional Contracts For Ai Agent Navigation Of Distributed Software Systems, Anonymous Jun 2026

Hierarchical Multi-Level Knowledge Graph With Compositional Contracts For Ai Agent Navigation Of Distributed Software Systems, Anonymous

Defensive Publications Series

Systems and methods store a hierarchical knowledge graph for navigating and changing distributed software systems. A product layer defines product identity, system bindings, and an end-to-end dataflow across system domains. A system knowledge graph includes a four-level specification hierarchy: domain specifications with intent phrases and ownership metadata; feature specifications with typed accepts/produces compositional contracts; behavior specifications with given/when/then invariants; and technical specifications with implementation anchors and referenced skills. An agent follows a six-phase change protocol: understand a request via semantic discovery over intent phrases, plan by traversing bindings and dataflow to identify impacted specs and code locations for approval, execute …

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Regional Shrink Testing For Empirical Capacity Validation In Distributed Computing Infrastructure, Anonymous Jun 2026

Regional Shrink Testing For Empirical Capacity Validation In Distributed Computing Infrastructure, Anonymous

Defensive Publications Series

Regional Shrink Testing is disclosed for empirical capacity validation in distributed computing infrastructure. A controller configures a production region by applying safeguards such as disabling autoscaling and isolating load balancing behavior, captures baseline metrics, and iteratively reduces active service instances while maintaining substantially constant production traffic. Shrink targets may be computed proportionally per hardware type class (LSST) using resource weights, with instance selection based on priority and/or random sampling. A monitoring layer evaluates stopper metrics at a percentile across active hosts and classifies health into multiple levels to control shrinking, backoff, and peak detection based on sustained threshold durations. The …

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Partitioned User Profile Architecture With Differentiated Access Control For Recommendation Systems, Anonymous Jun 2026

Partitioned User Profile Architecture With Differentiated Access Control For Recommendation Systems, Anonymous

Defensive Publications Series

Techniques are described for partitioning user profiles in agentic recommendation systems into a preference partition and a behavioral vulnerability partition with differentiated access control. A ranking agent retrieves only the preference partition to rank candidate content items, while a separate well-being monitoring system retrieves only the behavioral partition to compute a vulnerability-related measure and determine interventions. The well-being monitoring system transmits serving constraints to the ranking agent via a one-way constraint interface that excludes behavioral vulnerability indicators, such that delivery behavior may be adjusted (e.g., pacing, breaks, item limits, resource surfacing) without exposing behavioral vulnerability data to the ranking objective. …

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Cascading Proxy Drift Detection And Corrective Action System For Multi-Layer Optimization Pipelines, Anonymous Jun 2026

Cascading Proxy Drift Detection And Corrective Action System For Multi-Layer Optimization Pipelines, Anonymous

Defensive Publications Series

Systems and methods are described for detecting and correcting cascading proxy drift in multi-layer optimization pipelines. A directed acyclic graph represents proxy metrics across layers, including a ground-truth metric and downstream proxies. For each adjacent layer pair, a drift state is computed using sliding-window Spearman correlation, a trend estimate, and volatility, with adaptive window sizing via change-point detection. Cascade onset is detected based on a product of per-layer correlations and/or concurrent negative drift across multiple layers. Upon cascade detection, a drift source is localized using intervention-based tests including sequential freeze, counterfactual correlation estimation, and Shapley-value attribution (optionally via permutation sampling). …

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Psychological Reasoning Validation For Agentic Recommendation Systems, Anonymous Jun 2026

Psychological Reasoning Validation For Agentic Recommendation Systems, Anonymous

Defensive Publications Series

A validation layer for agentic recommendation systems validates psychological reasoning used by an LLM-based recommendation agent. A non-LLM behavioral ground truth estimator computes psychological-state estimates from behavioral signals with confidence values. A non-LLM reasoning extractor parses agent reasoning traces into structured psychological-state claims. Claims are compared to ground truth subject to confidence thresholds to compute per-state reasoning-quality metrics including precision, recall, and hallucination rate, optionally at granularities such as per topic, per user segment, and per prompt version. A hallucination detection pipeline may apply tiered responses including logging, soft override via ground truth injection, and hard override for safety-relevant actions. …

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Feedback Loop Intensity Monitoring And Automatic Intervention For Recommendation Systems, Anonymous Jun 2026

Feedback Loop Intensity Monitoring And Automatic Intervention For Recommendation Systems, Anonymous

Defensive Publications Series

Systems and methods are described for monitoring recommendation feedback loops and automatically intervening in live ranking. A feedback loop intensity (FLI) for a user and topic is computed as a ratio of a user-conditional topic serving proportion to a global topic serving proportion over a rolling window. An organic interest score is computed from non-recommendation-channel evidence including one or more of search, direct navigation, creator following, or external engagement. An adjusted FLI is generated by dampening the raw FLI as a function of organic interest. When adjusted FLI exceeds configurable thresholds, a controller applies topic-specific, tiered interventions in the ranking …

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Double Trouble: A Case Series Of Patients With Primary Lung And Esophageal Cancer, Srineil Vuthaluru Jun 2026

Double Trouble: A Case Series Of Patients With Primary Lung And Esophageal Cancer, Srineil Vuthaluru

Graduate Medical Education Research Journal

NA

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A Rhabdo Roller Coaster: Delayed Diagnosis Of Mcardle Disease In A Patient With Recurrent Non- Traumatic Rhabdomyolysis, Marilee Schaner Jun 2026

A Rhabdo Roller Coaster: Delayed Diagnosis Of Mcardle Disease In A Patient With Recurrent Non- Traumatic Rhabdomyolysis, Marilee Schaner

Graduate Medical Education Research Journal

NA

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A Severe Presentation Of Sickle Cell Crisis, Marilee Schaner Jun 2026

A Severe Presentation Of Sickle Cell Crisis, Marilee Schaner

Graduate Medical Education Research Journal

NA

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Vaccination Attitudes Of Migrant And Seasonal Farm Workers In Iowa: Analysis Of A Clinical Survery, Jenna Mccoy Jun 2026

Vaccination Attitudes Of Migrant And Seasonal Farm Workers In Iowa: Analysis Of A Clinical Survery, Jenna Mccoy

Graduate Medical Education Research Journal

NA

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Loss Of Cd44 On Immunohistochemistry Shows Increased Likelihood Of Early Recurrence In Non- Invasive Low-Grade Papillary Urothelial Carcinoma With A Minor (< 5%) High-Grade Component, Holly Mitzel Jun 2026

Loss Of Cd44 On Immunohistochemistry Shows Increased Likelihood Of Early Recurrence In Non- Invasive Low-Grade Papillary Urothelial Carcinoma With A Minor (< 5%) High-Grade Component, Holly Mitzel

Graduate Medical Education Research Journal

NA

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Technical Validation Of Insulin Immunoassay For Cross-Reactivity Of Veterinary Insulins, Kristina Sevcik Jun 2026

Technical Validation Of Insulin Immunoassay For Cross-Reactivity Of Veterinary Insulins, Kristina Sevcik

Graduate Medical Education Research Journal

NA

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Liberal Renal Sinus Sampling After Introduction Of Subspecialized Genitourinary Practice Leads To Upstaging And Optimal Management Of Renal Cell Carcinoma, Rory Li Jun 2026

Liberal Renal Sinus Sampling After Introduction Of Subspecialized Genitourinary Practice Leads To Upstaging And Optimal Management Of Renal Cell Carcinoma, Rory Li

Graduate Medical Education Research Journal

NA

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Primary Cutaneous Marginal Zone Lymphoma With Admixed Hodgkin Lymphoma: A First Of Its Kind Of Collision, Pauline Xu Jun 2026

Primary Cutaneous Marginal Zone Lymphoma With Admixed Hodgkin Lymphoma: A First Of Its Kind Of Collision, Pauline Xu

Graduate Medical Education Research Journal

NA

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Ebv-Negative T-Cell Post-Transplant Lymphoproliferative Disorder Of The Skin With Ebv-Positive Diffuse Large B-Cell Lymphoma Of The Intestine In A Multi-Organ Transplant Recipient Child, Pauline Xu Jun 2026

Ebv-Negative T-Cell Post-Transplant Lymphoproliferative Disorder Of The Skin With Ebv-Positive Diffuse Large B-Cell Lymphoma Of The Intestine In A Multi-Organ Transplant Recipient Child, Pauline Xu

Graduate Medical Education Research Journal

NA

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Primary Cutaneous High-Grade Extra-Skeletal Osteosarcoma: A Rare Case Report, Pauline Xu Jun 2026

Primary Cutaneous High-Grade Extra-Skeletal Osteosarcoma: A Rare Case Report, Pauline Xu

Graduate Medical Education Research Journal

NA

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Dupilumab-Associated Mycosis Fungoides: Unmasked, Direct Effect, Or A Lymphoid Reaction?, Pauline Xu Jun 2026

Dupilumab-Associated Mycosis Fungoides: Unmasked, Direct Effect, Or A Lymphoid Reaction?, Pauline Xu

Graduate Medical Education Research Journal

NA

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Beyond Pituitary Neuroendocrine Tumors: Spectrum Of 1101 Sellar/Suprasellar Region Masses In A Tertiary Referral Center In 36 Years, Lili Guo Jun 2026

Beyond Pituitary Neuroendocrine Tumors: Spectrum Of 1101 Sellar/Suprasellar Region Masses In A Tertiary Referral Center In 36 Years, Lili Guo

Graduate Medical Education Research Journal

NA

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Characterization Of Chronic Intestinal Pseudo-Obstruction With Abnormal Cd117 Staining: A Distinct Clinical Phenotype?, Holly Mitzel Jun 2026

Characterization Of Chronic Intestinal Pseudo-Obstruction With Abnormal Cd117 Staining: A Distinct Clinical Phenotype?, Holly Mitzel

Graduate Medical Education Research Journal

NA

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Calcific Emboli From Valvular Heart Disease: A Cause Of Retinal And Cerebral Ischemic Events – A Case Series, Praneeth Thadi Jun 2026

Calcific Emboli From Valvular Heart Disease: A Cause Of Retinal And Cerebral Ischemic Events – A Case Series, Praneeth Thadi

Graduate Medical Education Research Journal

NA

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Fatal Hemorrhagic Transformation In Acute Thalamic Ischemic Stroke Following Dual Antiplatelet Therapy And Prophylactic Enoxaparin, Praneeth Thadi Jun 2026

Fatal Hemorrhagic Transformation In Acute Thalamic Ischemic Stroke Following Dual Antiplatelet Therapy And Prophylactic Enoxaparin, Praneeth Thadi

Graduate Medical Education Research Journal

NA

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If It Quacks Like A Duck, Brendan Hurley Jun 2026

If It Quacks Like A Duck, Brendan Hurley

Graduate Medical Education Research Journal

NA

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A Purulent Surprise, Brendan Hurley Jun 2026

A Purulent Surprise, Brendan Hurley

Graduate Medical Education Research Journal

NA

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Cardio-Bariatrics In Advanced Heart Failure, Chukwuebuka Ubochi Jun 2026

Cardio-Bariatrics In Advanced Heart Failure, Chukwuebuka Ubochi

Graduate Medical Education Research Journal

NA

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Culture Negative Endocarditis Secondary To Neisseria Gonorrhoeae, Miranda Jangula Jun 2026

Culture Negative Endocarditis Secondary To Neisseria Gonorrhoeae, Miranda Jangula

Graduate Medical Education Research Journal

NA

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Practice Patterns Among Providers Regarding Amiodarone Use For Atrial Fibrillation In The Inpatient Setting, Kevan English Jun 2026

Practice Patterns Among Providers Regarding Amiodarone Use For Atrial Fibrillation In The Inpatient Setting, Kevan English

Graduate Medical Education Research Journal

NA

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Lead I Sign In Ecg: An Underrecognized Truth Or A Myth?, Anis Abobaker Jun 2026

Lead I Sign In Ecg: An Underrecognized Truth Or A Myth?, Anis Abobaker

Graduate Medical Education Research Journal

NA

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