Digital Commons Network^™

Outcomes Of A Penicillin Allergy De-Labelling Implementation Intervention In A Uk Hospital: A Prospective, Single Centre, Type 2 Hybrid Effectiveness-Implementation Study Evaluated Using Mixed Methods, Neil Powell, Daniel Hearsey, Robert West, Mathew Upton, Bridie Kent, Sarah Tonkin-Crine, Jonathan Sandoe

School of Biomedical Sciences

Background: Non-allergy specialist healthcare workers removing low-risk penicillin allergy (penA) records, enabling patients to receive penicillin antibiotics, is safe but not common practice. We developed a behavioural change implementation intervention to support non-allergist healthcare workers to remove incorrect penA records from adult inpatients (penicillin allergy de-labelling; PADL). This study aimed to evaluate the effectiveness of the implementation intervention strategy and its impact on delabelling and antibiotic prescribing. Methods: The implementation intervention was launched 10^th June 2024. This prospective, single centre, type 2 hybrid effectiveness-implementation study was evaluated using mixed methods: process evaluation, qualitative and quantitative study designs. The proportion …

Identifying Social Determinants Of Health Subgroups And Their Associations With Health Outcomes In A Prospective Us Adult Covid-19 Cohort: An Analysis Of The Inspire Registry, Yohali Burrola-Mendez, Eugene Lin, Canada Parrish, Chialing Hsu, Mandy J. Hill, Michael Gottlieb, Kristin L. Rising, Lauren E. Wisk, Nicole L. Gentile, Rachel E. Geyer, Robert A. Weinstein, Michelle Santangelo, Kristyn Gatling, Jonathan W. Dyal, Joann G. Elmore, Robert M. Rodriguez, Phillip Watts, Ji Chen, Zihan Diao, Erica S. Spatz, Kwun Cg Chan, K A. Stephens, Kelli N. O'Laughlin, Inspire Group

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To identify subgroups with similar social determinants of health (SDOH) characteristics using latent class analysis (LCA) and examine their associations with physical and mental health, cognitive function and missed workdays at 3 and 6 months post-SARS-CoV-2 infection. We hypothesised that intersecting SDOH factors would differentially influence COVID-19-related health outcomes across subgroups.

DESIGN: Prospective cohort study from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), with longitudinal data collection and cross-sectional analyses at baseline, 3-month and 6-month follow-ups.

SETTING: Multicentre registry across eight US academic medical centres (Chicago, Dallas, Houston, Los Angeles, New Haven, Philadelphia, San Francisco and …

Targeted Next-Generation Sequencing Implementation In Eswatini Identifies Rifampicin And Bedaquiline Resistance Undetected By Routine Diagnostic Testing, Debrah Vambe, Alexander Kay, Mangaliso Ziyane, Mdigo Thunzini, Sein Sein Thi, Leonardo De Araujo, Viola Dreyer, Tanja Niemann, Busizwe Sibandze, Sijabu Masina, Andrea Maurizio Cabibbe, Jennifer Furin, Tafadzwa Mazuruse, Lindokuhle Dlamini, Thulani Jele, Bheki Mamba, Gugu Maphalala, Makhosazana Dlamini, Mbongeni Dube, Nomthandazo Lukhele, Daniela Maria Cirillo, Anna Mandalakas, Christoph Lange, Sphiwe Ngwenya, Christian Utpatel, Sindisiwe Dlamini, Stefan Niemann

Faculty, Staff and Students Publications

In Eswatini, multidrug-resistant (MDR) Mycobacterium tuberculosis (Mtb) strains harbouring the rifampicin-resistance (RR) rpoB I491F mutation are missed by routine diagnostics, including GeneXpert MTB/RIF Ultra (Xpert Ultra), line probe assays (LPA), and mycobacterium growth indicator tube (MGIT) phenotypic drug susceptibility testing (pDST). To address this diagnostic gap, Eswatini introduced targeted next-generation sequencing (tNGS) in 2019. We analysed 234 patient samples enrolled from June 2021 to December 2024 with isoniazid and/or rifampicin resistance detected by routine diagnostics, or suspected treatment failure, and obtained detailed clinical and outcome data from 59 patients. tNGS detected RR in 159 strains, of which 101 (64%) carried …

Statewide Multi-Year Wastewater Sequencing Reveals Dual Origins Of Hiv-1 Signal, Justin R Clark, Dylan Chirman, Harihara Prakash, Austen Terwilliger, Marlene Mcneese, Matt Ross, Mike Tisza, Sara J Javornik Cregeen, Loren Hopkins, Jennifer Deegan, Catherine L Troisi, Eric Boerwinkle, Kristina Mena, Fuqing Wu, Jason T Kimata, Marc Johnson, Devon Gregory, Faith E Fletcher, Thomas P Giordano, Anthony W Maresso

Faculty, Staff and Students Publications

Human immunodeficiency virus 1 (HIV-1) is a retrovirus which has infected 90 million people and resulted in over 40 million deaths. Despite advances in diagnostics, treatment, and prophylaxis, HIV-1 continues to spread due to undiagnosed and untreated infections. Traditional monitoring methods are ineffective when access to testing is limited or people do not seek care, particularly given the long period between infection and symptom onset, allowing undetected transmission to continue. Here, we use a hybrid-capture sequencing approach to track HIV-1 signal in municipal wastewater in 15 different cities over nearly 3 years. We obtain near-complete genomic coverage of HIV-1, enabling …

Immune Suppression And Metabolic Reprogramming In Bactrocera Dorsalis Parasitized By Fopius Arisanus, Rehemah Gwokyalya, Jeremy Herren, Thomas Ogao Onchuru, Sahadatou Mama Sambo, Cassandra Purity Ronnie, Ndlela Shepard, Sunday Ekesi, Samira A. Mohamed

All Peer-Reviewed Publications

Abstract – Bactrocera dorsalis is a major horticultural pest. Biocontrol using parasitoids, such as Fopius arisanus, is a sustainable tool for managing this pest. However, the mechanisms enabling the successful parasitism of B. dorsalis are poorly understood. Using transcriptomic profiling, cellular bioassays, and targeted metabolite analyses, we investigated how F. arisanus modulates the immunity and metabolic activity of B. dorsalis to achieve a high parasitism rate. Our results revealed a weak and late encapsulation response of B. dorsalis towards F. arisanus. Additionally, parasitism reduced the number of circulating haemocytes by 35%, lowered constitutive granulocyte counts and inhibited phenoloxidase activity in …

A Predictive Model For Cytomegalovirus Infection Using Routine Hematological And Biochemical Parameters: A Pilot Study, Ahmad A. Shaikh, Mofareh H. Alabdaly, Nabil A. Ageeli, Sultan Z. Alasmari, Adel M. Abo Mansour, Mohammed H. Makkawi

Saudi Medical Journal

Objective: To examine whether hematological and biochemical parameters assist in diagnosing cytomegalovirus (CMV) infections and differentiating between CMV-G and CMV-M. Cytomegalovirus causes distinct hematological changes that can serve as markers for diagnosis.

Methods: A retrospective analysis was conducted on 54 patients infected with CMV (25 CMV-G and 29 CMV-M) and 82 healthy controls. Age, gender, and routine hematological and biochemical parameters were evaluated. Receiver operating characteristics (ROC) analysis and logistic regression were used for data analysis.

Results: In comparison to controls, laboratory findings of patients with CMV-G revealed characteristic decreases in red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), and …

Immunoinformatic Based Development Of A Multi-Epitope Precision Vaccine Targeting Glycoprotein And Rdrp Of Oropouche Virus: An Innovative Approach To Counter Emerging Public Health Threats, Mohammed Alissa, Muhammad Suleman

Saudi Medical Journal

Objectives: To design high immunogenic vaccine against the Oropouche virus (OROV). The OROV is a neglected arbovirus endemic to Central and South America, causes oropouche fever, which can progress to severe complications such as meningitis and hemorrhagic symptoms.

Methods: We utilized immunoinformatic and molecular dynamic simulation approaches to design highly immunogenic vaccines against OROV. This observational study, carried out between January and August 2024 in Saudi Arabia. As it involves an in-silico method, ethical consent was not required.

Results: Docking analysis confirmed the stable interaction of the designed vaccines with human toll-like receptors (TLR)-3, producing binding scores of –300.78, –306.19, …

Acute And Inpatient Occupational Therapy Practice For People With Chronic Conditions Who Are Experiencing Homelessness, Emily K. Simpson, Anne K. Mokate, Elizabeth A. Gibbs, Nina K. Duric

Internet Journal of Allied Health Sciences and Practice

Purpose: Despite having high rates of chronic illness, people experiencing homelessness (PEH) in the United States face barriers to healthcare access that result in unmet health needs and poor health outcomes.  The objective of the study was to identify the barriers to service experienced by occupational therapy practitioners (OTPs) in acute and inpatient settings in providing services to PEH and to describe education strategies to reduce those barriers. Methods: Researchers employed a cross-sectional design with OTPs (n=292) with experience treating PEH. Results: Barriers to treatment for OTP included lack of education, need to prioritize acute concerns, and inadequate institutional resources. …

Note From The Editors: On Misinformation, Robert Rozema

Ought: The Journal of Autistic Culture

No abstract provided.

Front Matter

Ought: The Journal of Autistic Culture

No abstract provided.

Mapping How Design Engages With Systems Thinking In Complex Healthcare Systems: A Scoping Review, Yuanrong Guo, Zixuan Wang, Sarah Kettley, Autumn Roesch-Marsh

DRS Biennial Conference Series

Integrating systems thinking and design thinking offers a promising approach to address systemic challenges in healthcare. However, existing studies apply diverse systems thinking theories and methods across different healthcare contexts, and design also shows methodological pluralism. Such diversity has created conceptual fragmentation and uncertainty about how designers can meaningfully apply systems thinking. This paper presents a scoping review of 44 empirical studies that apply both design approaches and systems thinking theories or methods in healthcare service systems. The analysis examines where systems thinking is positioned within studies and identifies four relationship types: (1) design as systemic practice, (2) systems thinking …

Participatory Visual Mapping As A Systemic Data Collection Method In Complex, High-Pressure Context, Wenbo Ai, Alison Prendiville

DRS Biennial Conference Series

This paper introduces design ethnographic methods—participatory observation and visual mapping activities—used in the discovery phase of a co-design project aimed at optimising blood culture pathways for potentially infectious patients across three NHS trust emergency departments in the UK. By integrating participatory systemic design with ethnographic approaches, the study enabled clinical staff to share their insights and shape service workflows. Their engagement reshapes systemic thinking for blood culture pathways used by clinical staff, enabling researchers to frame co-design workshops and later systemic interventions for the next stage of the research project. This paper emphasises the significance of systemic visual mapping activities …

Bio-Inspired Design For Preventive Healthcare: Translating Living Systems Into Design Knowledge, Xiuyuan Tu, Wei Liu

DRS Biennial Conference Series

This paper investigates how bio-inspired design can contribute to preventive healthcare by learning from the adaptive intelligence of living systems. Through a Critical Interpretive Synthesis of 356 studies, it explores the translation of concepts like adaptation, cooperation, and self-repair from biology to design practice. The Design Knowledge Translation Model (DKTM) is introduced to illustrate the process by which biological insights are interpreted, abstracted, and applied to inform design knowledge. The findings indicate that leveraging nature-inspired reasoning can shift healthcare from a reactive to an anticipatory approach, fostering systems that enhance wellbeing and collective care. Furthermore, this work provides a guideline …

Describing Hidden Curriculum In An Undergraduate Computing Context, Joseph R. Teahen, Briana C. Bettin, Leo Ureel

Michigan Tech Publications

Hidden Curriculum (HC) is the set of essential knowledge, skills, and norms students are expected to know, but never explicitly taught. HC is disproportionately experienced across identities and communities. In computing education, most research addresses immediately identifiable HC within the researcher's context. While such work is important, without proper HC descriptive studies, we could miss more subtle HC that affects student success. This work presents results from interviews with undergraduate computing faculty, students, and peer mentors on their HC experiences. The results demonstrate several categories of HC including development tools, professional skills, institutional navigation, social well-being, and physical well-being. These …

Impact Of Dolutegravir-Based Regimens On Patient Satisfaction And Quality Of Life Among People Living With Hiv: A Systematic Review And Meta-Analysis, Mustapha Muhammed Abubakar, Christabel Ogechukwu Okoye, Ruth Jeminiwa, Ifeanyi Kanayo Ifeorah, Lotanna Ezeja, Yusuf Dauran, Sahabi Musa, Silas Usen Joel, Abdurrahman Murtala Bello, Amauche Pearl Ngige, Gabriel Ezenri, Abdulmuminu Isah, Ifunanya Ikhile, Blessing Onyinye Ukoha-Kalu

College of Pharmacy Faculty Papers

Background: Despite the global scale up of dolutegravir (DTG)-based regimens as the preferred first-line therapy for persons living with HIV (PLHIV), no comprehensive evidence exists on its effect on patient-reported outcomes such as Quality of Life (QoL) and patient satisfaction (PS). We conducted a systematic review and meta-analysis to provide the first comprehensive quantitative synthesis of the effect of DTG-based regimens on QoL and PS among PLHIV.

Method: We conducted literature search on PubMed, Scopus, Embase and Cochrane Library databases for peer-reviewed, primary studies published from January 2015 to January 2025. Studies using validated tools to evaluate QoL and PS …

Effect Of Implementing An Evidence-Based Clinical Practice Intra-Hospital Transport Guideline For Hospitalized Children: A Type Iii Hybrid Implementation-Effectiveness Study, Yang Li, Yuxia Yang, Jing Hu, Wenchao Wang, Yun Jin, Weijie Shen, Yanhong Zhang, Yingfeng Zhou, Ye Cheng, Jos M Latour, Ying Gu

School of Nursing and Midwifery

BACKGROUND: Intra-hospital transfers (IHT) of hospitalized children are unavoidable practices often performed with emergency patients and postoperative patients. Standardizing IHT processes to minimize adverse events might improve children's outcomes. We developed an evidence-based clinical practice IHT guideline for hospitalized children. The aim of this study was to evaluate the implementation process and the effectiveness of the implementation of this guideline on patient outcomes, healthcare professionals' knowledge and behavior, and hospital organizational context.

METHODS: A type III hybrid effectiveness-implementation design was adopted, using a pre-post intervention trial (January-December 2024). Data of patient demographics, transport-related outcomes, and healthcare providers' knowledge and compliance …

Multidomain Expert Evaluation Of Leading Large Language Models As Providers Of Vaccination And Preventive Medicine Information, Marcello Di Pumpo, Leonardo Villani, Vittorio Maio, Maria Rosaria Gualano, Eleonora Marziali, Lucia De Maio, Rossella Mancini, Stefania Boccia, Walter Ricciardi, Patrizia Laurenti

College of Population Health Faculty Papers

OBJECTIVES: Vaccination is one of the most effective public health interventions. Large language models (LLMs) show great capability for providing health information. This study compared the performance of ChatGPT 3.5 (G3E), ChatGPT 4o in English (G4E), Claude 3.0 (CDE), Gemini 1.5 (GME), and ChatGPT 4o in Italian (G4I) in delivering information on vaccination and preventive medicine.

STUDY DESIGN: Mixed-method analysis evaluating large language models.

METHODS: Twenty-six expert-designed healthcare scenarios were used to evaluate each model through an adapted DISCERN-based instrument. Four experts independently rated outputs across six domains: Information Reliability, Information Quality, Medical Appropriateness, Impact on Vaccine Hesitancy, Potential for …

Algal-Mediated Green Synthesis Of Silver Nanoparticles And Their Antibacterial Activity, Yahya B. Alyoubi, Hassan A. Ewais, Magda M. Aly, Walied M. Alarif

The Journal of King Abdulaziz University: Science

A green, low-cost, and straightforward method was implemented for the synthesis of silver nanoparticles (AgNPs) using Digenea simplex Algal Extract (D. simplex). The formation of AgNPs was initially indicated by a golden yellow color of the solution and UV-Vis λ_max at 410 nm. Key factors such as reaction time, temperature, pH, concentrations of Ag⁺ and algal extract was also investigated. FTIR analysis confirmed the presence of alga-derived biomolecules which assets the reduction of silver ions. TEM analysis revealed the successful synthesis of spherical AgNPs with an average size of 12.86 ± 4.84 nm. The biosynthesized AgNPs exhibited a …

Hypertensive Disorders Of Pregnancy, Covid And Readmission Status, Margaret Luebke, Ross Bindler, Trisha Saul, Linda Trinh

Publications 2026-present

No abstract provided.

Hypertension And Pneumonia: A Retrospective Analysis On The Length Of Stay, Cassandra Blau, Diana Hamdan, Peter Reisdorf, Brandon Shin, Jack T. Adcock, Nova Beyersdorfer, Kerry Johnson, John Paulson

Student Publications

Background: Pneumonia is a serious respiratory infection that affects patients across all age groups. While it typically responds to treatment, patients with pre-existing comorbidities are at increased risk of poor outcomes. Hypertension (HTN) is a common condition that may coexist in patients with pneumonia. Although pneumonia and HTN have been studied separately, there is limited evidence regarding their combined effect on clinical outcomes, including hospital length of stay (LOS), treatment duration, and recovery trajectory.

Objectives: Identifying factors that influence the length of hospital stay in patients with pneumonia is essential for addressing the burden of hospitalization on both patients and …

Global Burden Of Drug-Resistant Tuberculosis In Children: A Systematic Analysis For The Global Burden Of Disease Study, Xuhui Liu, Peierdun Mijiti, Lu Xia, Sylvia M Lacourse, Wulan Talafuhan, Alexander W Kay, Yang Yang, Huarui Liu, Dan Ye, Leonardo Martinez, Shuihua Lu, Adong Shen, Anna M Mandalakas, Feng Li, Christoph Lange, Zhen Huang

Faculty, Staff and Students Publications

Background: Paediatric tuberculosis (TB), particularly drug-resistant TB (DR-TB), is associated with significant mortality. However, the global burden of childhood TB remains poorly understood.

Methods: We analysed incident cases, deaths, and age-standardised incidence and mortality rates among children (0-14 years) with multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) and extensively drug-resistant tuberculosis (XDR-TB) using the Global Burden of Disease (GBD) 2021 database. Data were stratified by age, sex, region, country, and HIV/AIDS status. Annual and average annual percentage changes were assessed using joinpoint regression analysis. Secondary analyses compared adult and paediatric TB trends in the End TB era and evaluated the potential impact of the …

Biologically Informed Negative Samplingfor Antibody Chain Pairing Classification, Ishita Singh

Computer Science Senior Theses

Antibody heavy and light chain (H/L) pairing is fundamental to antigen recognition and stability. While single-cell sequencing preserves native pairing information, widely used bulk repertoire and spatial transcriptomics platforms do not, motivating the need for efficient ML methods to infer H/L pairing. Training a binary classifier for this task faces the methodological challenge of a lack of true biological negatives, since natural selection eliminates B cells with incompatible H/L pairs.

In this thesis, I introduce a biologically informed negative sampling strategy for H/L pairing classification, drawing on known V-gene biases in heavy and light chain pairing. Pseudo-negatives are constructed by …

Loss Of Mct1 Mediated Lactate Uptake Causes Delayed Endplate Maturation And Intervertebral Disc Degeneration, Maria Tsingas, Konstantinos Tsingas, Mei Smyers, Wujuan Zhang, Aaron R. Goldman, Eulisa Lawrence, John A. Collins, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

During skeletal growth, it is thought that the lactate secreted by the glycolytic nucleus pulposus (NP) cells exits the intervertebral disc into circulation via endplates. Our current studies challenge this long-held notion. Mice with early postnatal, endplate, and annulus fibrosus-specific deletion of lactate importer, MCT1, exhibited disc degeneration characterized by NP cell loss and pronounced endplate structural changes. Using metabolic and transcriptomic approaches, we demonstrate that MCT1 loss inhibits endplate chondrocyte differentiation and that lactate serves both as a crucial TCA metabolite and promotes protein and histone lactylation and gene expression. These findings suggest that during skeletal growth, NP-derived lactate …

Optimizing The Sensitivity Of Detection Of Respiratory Syncytial Virus Infections In Longitudinal Studies Using The Combination Of Weekly Sample Testing And Biannual Serology., Shannon C. Conrey, Daniel C. Payne, Maria Deza Leon, Monica Epperson, Melissa M. Coughlin, Allison R. Burrell, Claire P. Mattison, Rachel M. Burke, Julia M. Baker, Natalie J. Thornburg, Meredith L. Mcmorrow, Mary Allen Staat, Ardythe L. Morrow

Manuscripts, Articles, Book Chapters and Other Papers

Cohort studies are often challenged by incomplete adherence to sampling regimens, limiting the full capture of disease burden. We describe the detection of respiratory syncytial virus (RSV) infections achieved in a birth cohort using a combination of weekly nasal sample testing and serology. The Pediatric Respiratory and Enteric Viral Acquisition and Immunogenesis Longitudinal Cohort followed 245 maternal-child dyads from birth to age 18 to 24 months. Weekly mid-turbinate nasal swabs were tested for RSV using real-time polymerase chain reaction (RT-qPCR). Serum was tested for RSV pre-fusion F IgG and IgA antibody at age 6 weeks and biannually from 6 to …

Vitamin D–Amp Axis In Host Defense Against Fungal Infections, Nuraly S. Akimbekov, Ilya Digel, Svetlana K. Sakhanova, Kuanysh Tastambek, Dinara K. Sherelkhan, Mohammed S. Razzaque

School of Medicine Publications

Vitamin D–mediated regulation of antimicrobial peptides (AMPs) is an important focus in innate immunology and is aimed at elucidating the role of vitamin D in enhancing antimicrobial defense. AMPs are short protein chains that serve as a first line of defense against invading pathogens, including fungi, bacteria and viruses. Unlike conventional antibiotics, AMPs are produced endogenously and are less likely to induce antimicrobial resistance, making them promising candidates for treating infections caused by drug-resistant pathogens. Studies indicate that optimal vitamin D levels are essential for activating antimicrobial pathways and regulating AMPs that target multiple fungal pathogens. This article summarizes recent …

The Relationship Between Psychological Stress And Sars-Cov-2 Nucleocapsid-Antibody Response Following Natural Infection: Longitudinal Findings From The Aegis Study, Erika T Beidelman, Ashley Judge, David B Allison, Stephanie Dickinson, Lilian Golzarri Arroyo, Anna L M Macagno, Michael J Ricciardi, Jon Macy, Stanley Perlman, Christina Ludema, Kevin C Maki, Molly Rosenberg

Faculty, Staff and Students Publications

Psychological stress can cause diminished immune response to infectious challenges. The extent this holds true during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the modifying effect of vaccination status is untested. We explored these relationships in a non-random sample standardized to the US adult population. Across 2178 participants in the Aegis study (2021-2022), we identified 507 eligible laboratory-confirmed SARS-CoV-2 infections. We estimated the natural log of nucleocapsid-binding antibody absorbance (N-antibody) at study visits up to 225 days following a positive SARS-CoV-2 test. Linear mixed effects models were fit to estimate the association of baseline perceived stress and, separately, …

Napier Grass (Pennisetum Purpureum) Meal Modulates Growth Efficiency, Gut Morphology, And Systemic Health In Broiler Chickens, Eric Lim Teik Chung, Yee Lyn Ong, Nazri Nayan, Muhamad Faris Ab Aziz, Faez Firdaus Abdullah Jesse, Faizal Andri, Arissara Sopawong

The Thai Journal of Veterinary Medicine

Grass and leaf meals, which include vital phytocompounds, have the potential to be a natural and safe alternative to antibiotics in the poultry industry. Therefore, this study aims to assess Pennisetum purpureum leaf meal and its phytocompounds on the health performances of colored-broilers. A total of 216 unsexed Sasso chicks were assigned to six diet groups. The negative control (T1) received a commercial basal diet without antibiotics, while the positive control (T2) received the same diet with oxytetracycline (100 mg/kg). Groups T3 to T6 received no antibiotics and included P. purpureum meal at 1.25, 2.50, 3.75, or 5.00 grams per …

Caldwell Integrated Non-Invasive Health Resilience System (Cinhrs), Michael Victor Caldwell Mr.

Defensive Publications Series

The Caldwell Integrated Non-Invasive Health Resilience System (CINHRS) is a conceptual open-hardware framework intended to organize numerous previously disclosed Technical Disclosure Commons (TDC) medical inventions into a unified ecosystem.

The architecture focuses on non-invasive or minimally invasive approaches to monitoring, diagnostics, targeted delivery, physiological support, and long-term health resilience.

The system is not a medical device and is not intended for clinical use without extensive independent engineering, laboratory, regulatory, and clinical validation.

The purpose of this disclosure is to establish a conceptual framework showing how multiple previously disclosed inventions may interact within a larger health-support architecture.

IMPORTANT NOTE REGARDING PRIOR …

Mathematical Analysis Of Within-Host Models: Viral–Immune Dynamics, Bifurcations, And Disease Severity, Nazia Afrin

Doctoral Dissertations

My research develops and analyzes ODE-based within-host models at multiple scales. Using dynamical systems theory and numerical methods, I study host–pathogen interactions and immune responses, providing insights into disease dynamics and control. The first model describes the complex dynamics of Hepatitis B virus (HBV) infection and addresses the question: what mechanisms determine whether the infection is cleared during the acute phase or progresses to a chronic state? A key feature of this model is the assumption that all classes of liver cells (uninfected, infected, and protected from reinfection) proliferate at different rates. The findings provide insight into two important aspects …

The Evolutionary Response Of HawaiʻI ʻAmakihi (Chlorodrepanis Virens) To The Introduction Of Avian Malaria (Plasmodium Relictum), Gabrielle Atkinson

Doctoral Dissertations

The emergence of novel pathogens can impose intense selective pressures on natural populations, driving rapid evolutionary change or precipitating population collapse. In Hawaiʻi, the introduction of avian malaria (Plasmodium relictum) and its mosquito vector (Culex quinquefasciatus) have caused severe declines and extinctions among native forest birds. Yet some populations of Hawaiʻi ʻamakihi (Chlorodrepanis virens) persist across a broad elevational and disease gradient, providing a powerful natural system for examining the genomic basis of rapid adaptation, the role of gene flow in adaptive response, and the potential for parallel evolutionary responses. This dissertation integrates genomic, population genetic, and transcriptomic approaches to …