Audit: QRS - Thymogen for Health & Longevity

Audit conducted on 01/09/2026 02:01 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	85
Failed	0
N/A	8
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢	Protocol doses (25 µg intranasal, 100 µg IM, 0.05% cream), tier items, gate items, all 9 marker targets and the cadence trace to ER lines 316–320, 136–188, 204–240, 256–292 and 405–415.
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	“Theoretical autoimmune activation” (line 588), “conflicted antitumour activity” (532) and “Unblinded reports; no effect estimates published” (506) carry the ER’s own hedging.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Pregnancy/breastfeeding and transplant immunosuppression remain in the Contraindications gate, not the Key Interactions gate; the Kaposi progression signal stays at Medium risk.
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢	Gate content comes only from ER Key Interactions & Contraindications; nothing from Benefit-Modifying Factors or Risk-Modifying Factors appears in any gate or tier.
1.5	PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact.	🟢	No PMIDs, NCT identifiers, author names or trial names anywhere in the QRS; all named agents (ciclosporin, pembrolizumab, oxymetazoline, benzalkonium chloride, …) are ER-sourced.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind are introduced.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Matches the ER’s sober, sponsor-sceptical register.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Evidence-led throughout; tier labels and marker targets give the reader actionable structure without cheerleading.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Content is stated as evidence and observed practice, not instruction.
2.4	The QRS avoids language that implies medical or clinical advice	🟢	All gate, tier, marker and qualitative entries are noun phrases; no imperatives.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No “should”, “recommended” or “advised” appears in the document’s own voice.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the file.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms are confined to biomarker names in the Monitoring table, where they are the marker’s name; tier items spell out “vascular endothelial growth factor” and “blood-forming stem cells”.
2.8	Information is presented in a concise and very compact manner	🟢	Every gate and tier entry is a stripped noun phrase; the ER’s magnitude paragraphs are omitted entirely.
2.9	It DOES NOT address the reader directly	🟢	Confirmed — no direct address.
2.10	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢	Framing assumes a reader weighing a course of an unapproved peptide, including sourcing-grade concerns.
2.11	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢	A nine-marker baseline panel and repeat lymphocyte subsets are presented without hedging on effort or cost.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	Content depth (CD4:CD8 ratio, OLGA staging, plasma VEGF) is not general-population material.
2.13	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢	The At-A-Glance names both the single positive controlled result and the largest negative one, plus the sponsor-origin caveat.
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	“anti-aging” does not appear; the benefits tier uses “Delayed aging rate”.
2.15	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “injection” not “shot”; “adverse event” not “bad reaction”). Direct quotes from sources are exempt.	🟢	Formal register throughout; the plain-language wording in At-A-Glance is required by item 7.4 and does not use consumer-grade substitutes elsewhere.

3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment”; Gate headings: “Contraindications”, “Key Interactions”; Tier labels: “High”, “Medium”, “Low”, “Speculative”; Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢	All fixed strings match the template byte-for-byte (lines 446, 483, 525, 543, 557, 579, 598, 602–604, 717).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variable names are present; marker_#_* is expanded to 9 rows and qualitative_item_# to 5 items, giving 66 distinct span names.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	The three website= spans, the CSS block, the override stylesheet link and the footer disclaimer are byte-identical to the template.

4. Formatting

#	Description	Result	Comments
4.1	When the source ER section is empty, the QRS uses the ER’s own empty-state phrasing verbatim. Typical phrasings are “None documented in human trials to date” and “Not formally studied”	N/A	No source ER section is empty; the one absent tier (High benefits) is governed by item 12.5, which requires hiding rather than empty-state phrasing.
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢	Protocol cell labels “Intranasal course”, “Intramuscular course”, “Topical presentation” are the ER’s bold labels verbatim (ER 316–320); Monitoring row names reproduce the ER table’s biomarker column verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Marker names such as “Gastric histology, OLGA stage” and “Immunoglobulins IgG, IgA, IgM” match the ER table exactly.
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji characters in the file; tiering is carried by <strong> labels and the card palettes.
4.5	The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page.	🟢	Every section is condensed rather than transcribed: the ER’s 54-line Benefits section becomes three list items, the magnitude paragraphs are dropped, and the Monitoring “Why” column is reduced to single clauses.

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5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢	Lines 2–14; the comment opens immediately after the doctype on line 1.
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢	Opening --- at line 3, closing --- at line 13; the descriptive text on line 2 precedes the opening delimiter.
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢	Enclosed in an HTML comment; no metadata value is repeated in the header, footer or body.
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Only duration: "00:03" is quoted, correctly so because the value contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4: er_filename: thymogen_2026-0831-2216_Opus_ER.md.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	Line 5: 26.7.02, matching the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	Line 6: 2026-0901-0140, correct format.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7: Opus.
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢	Single word, no version or qualifier.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8: Opus 5.
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢	“Opus 5” — nickname plus version, no context-window or edition qualifier.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Line 9 matches the file’s actual name on disk.
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Confirmed for all nine keys, including git_user and git_issue.

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢	Line 22: “Thymogen for Health & Longevity - Quick Reference Sheet”, matching ER canonical_topic with the ampersand encoded.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	Line 417: “Thymogen for Health & Longevity”.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	Line 421: 09/01/2026, correct reformatting of 2026-0901-0140.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	Line 425: Opus 5.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	The header block is structurally identical to the template; the ER’s “Also known as” line was not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Compresses all four Conclusion paragraphs (ER 451–457) into what it is, how it is used, what the two controlled trials showed, tolerability and evidence provenance.
7.2	[at_a_glance] is no longer than 60 words	🟢	59 words.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Calf-thymus origin and Russian route/course pattern → ER 451; gastritis repair and the largest negative trial → ER 453; mild side effects from short courses → ER 455; developer/manufacturer origin of the evidence → ER 457.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “atrophic gastritis” is rendered as “stomach-lining thinning” and “immunodeficiency” as “weakened immune defences”.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	Trials are referred to only as “one placebo-controlled trial” and “the largest controlled trial”.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No numbers other than “three decades”; the ER’s 26.1%, p-values and confidence intervals are all omitted.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All seven items map to ER 258 and 282–292.
8.2	[stop_items] represent the Contraindications from the ER	🟢	The six “Populations who should avoid Thymogen” bullets plus the systemic-immunosuppressant bullet the ER labels an “Absolute contraindication”.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	Seven <li> elements inside the stop_items span (lines 546–552).
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	The ER’s trailing clauses (“Direct pharmacodynamic opposition…”, “when regression is still ongoing”, “on the basis that no reproductive toxicology…”) are all stripped; no dash-led clause remains.
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	“any time post-transplant”, “requiring systemic therapy”, “within 6 months of antiretroviral therapy” and “under 1 year” are all retained.
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER uses no ranking notation inside parentheses in this section.
8.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no population, condition, or scenario for which the intervention should be avoided, deferred, or used only under specialist supervision.	🟢	The ER names six such populations plus an absolute contraindication, and the section is correctly populated.
8.8	If the section is left empty, an HTML comment inside the [stop_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g.	N/A	The section is not empty.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All ten items map to ER bullets 260–278.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Ten of the ER’s eleven interaction bullets appear; the systemic-immunosuppressant bullet is correctly excluded because it sits in the Contraindications gate.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	Ten <li> elements inside the caution_items span (lines 560–569).
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	The ER’s “Caution”, “Monitor”, mechanism sentences and mitigation sentences are all stripped, as is the “Other interventions —” prefix on the vaccine bullet.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Every ER drug list is retained in shortened form (e.g. “(pembrolizumab, nivolumab)”, “(oxymetazoline, xylometazoline)”), and the “nasal spray only” scope qualifier is preserved.
9.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER uses no ranking notation inside parentheses in this section.
9.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used.	🟢	The ER names eleven such interactions, and the section is correctly populated.
9.8	If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g.	N/A	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells come from ER Therapeutic Protocol bullets 316–320.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The three registered routes — intranasal, intramuscular and topical — are the only dose-bearing bullets in the ER protocol.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER supplies three distinct actionable aspects, so no set is unused.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	All nine cells carry ER-derived content, including course lengths and the reservation of the intramuscular route to documented secondary immunodeficiency.

11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢	The ER’s Practical Considerations “Time to effect” bullet (line 373) names exactly two aspects, and both are covered.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Atrophic gastritis (Medium tier) precedes acute respiratory infections (Low tier).
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	🟢	The third pcell carries style="display: none" with all three spans empty (lines 509–519).
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	“Weeks to months” / re-biopsy timing and “Within a single 3–10 day course” / unblinded-report caveat both trace to ER 373 and 156.
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	The ER does provide time-to-effect information, so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	Every item is an ER benefit sub-heading from lines 146–188.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present at lines 527–536.
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	The ER’s Magnitude paragraphs (26.1% gland density, p-values, 36% response, confidence intervals) are entirely omitted.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain in any benefits item; the ER’s glosses on CDX-2 and VEGF are dropped.
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	🟢	The ER states “No benefit reaches High” (line 142) and benefits_high carries style="display: none" with empty content (line 527).

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All items are ER risk sub-headings from lines 210–240.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present at lines 581–592.
13.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	The 16-vs-35-week time-to-progression figures and the concentration ranges from the ER Magnitude blocks are omitted.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses remain in any risks item.
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	The ER populates all four risk tiers, so no span needs hiding.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Rows reproduce the ER Monitoring Protocol & Defining Success table (lines 405–415).
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All nine ER table rows are present, in ER order, with matching functional ranges.
14.3	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from the ER Monitoring section. It is not left with placeholder text or empty.	🟢	Line 711 condenses ER line 403: baseline panel, 8–12 week recheck, 6–12 month intervals, symptom-triggered autoimmune serology.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	Items come from the ER’s “Qualitative markers worth tracking” list (lines 419–427).
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All five ER qualitative bullets are present, in ER order.

Issues 01/09/2026 02:01

Pass rate 100.00%. No issues found.

Issues 01/09/2026 01:53

1. 13.3 — Risks High tier over-elaborated: [risks_high] at line 582 reads “Mild transient adverse events: headache, fatigue, paraesthesia, nausea, and allergic rhinitis with the nasal spray”, adding an enumerated event list and a route qualifier to the ER heading “Mild Transient Adverse Events”; every other risk tier (lines 585, 588, 591) carries the ER heading alone.
2. 2.7 — Unexplained clinical jargon: “paraesthesia” appears bare in [risks_high] at line 582, whereas the ER always expands it as “paraesthesia (tingling or pins-and-needles)”.

Fixes 01/09/2026 01:53

1. 13.3 / 2.7 — Risks High condensed to ER heading: [risks_high] was reduced from “Mild transient adverse events: headache, fatigue, paraesthesia, nausea, and allergic rhinitis with the nasal spray” to “Mild transient adverse events”, matching the ER heading and the heading-only form used by the other three risk tiers. This also removed the unexplained term “paraesthesia” from the sheet.

Issues 01/09/2026 01:47

1. 2.8 / 4.5 — Content not condensed to page budget: Qualitative items (lines 720–732), monitoring_cadence (line 711), marker_8_target / marker_9_target (lines 690, 701), the Protocol and Time-to-Effect sub-lines (lines 456, 467, 478, 506) and several Key Interaction items (lines 560–569) are near-verbatim ER lifts carrying explanatory clauses, pushing the sheet well past one A4 page.

Fixes 01/09/2026 01:47

1. 2.8 / 4.5 — Protocol and Time sub-lines condensed: action_1_sub, action_2_sub, action_3_sub, time_1_sub and time_2_sub were stripped of ER carry-over prose (e.g. “reserved in Russian practice for documented secondary immunodeficiency rather than general use” → “reserved for documented secondary immunodeficiency”).
2. 2.8 / 4.5 — Key Interaction drug lists trimmed: Example drug lists in the caution gate were shortened to two representatives each per item 9.5 (e.g. “(fluorouracil, irinotecan, doxycycline)” → “(fluorouracil, doxycycline)”), and the unexpanded acronym “AHCC” was replaced with plain “colostrum, thymus extracts”.
3. 2.8 / 4.5 — Contraindication items tightened: Shortened the transplant, vascular-tumour and hypersensitivity items without dropping their qualifiers (e.g. “haematopoietic stem-cell” → “stem-cell”; “within the first 6 months of antiretroviral therapy” → “within 6 months of antiretroviral therapy”).
4. 2.8 / 4.5 — Monitoring cells condensed: The “why” column and the two open-ended targets were reduced to their key fact (e.g. marker_8_target “No established target; track the change from the individual’s own staged baseline” → “No target; track change from staged baseline”).
5. 2.8 / 4.5 — Monitoring cadence shortened: Removed the ER aside “which is after roughly two courses” and the duplicated “repeated” clauses, naming hs-CRP directly instead of “the inflammation marker”.
6. 2.8 / 4.5 — Qualitative items condensed: All five items were stripped of their trailing ER explanatory clauses (e.g. “Energy levels and post-exertional recovery, which decline early when immune load is high” → “Energy levels and post-exertional recovery”).