Mathematical Medicine and Biology: A Journal of the IMA

1.Partial Rank Correlation Coefficient (PRCC), usually performed following Latin Hyper-cube Sampling (LHS), is a global sensitivity analysis that quantifies the monotonic relationship between model parameters and the desired output. To carry out this analysis, a range of acceptable parameter values must be known or estimated. However, within a biological context, approximating these values may be difficult. Parameter values and ranges can be taken from different organisms or systems or be estimated to produce qualitative phenomena in the model. Using a mathematical model of the epithelial mesenchymal transition (EMT) as a test case, this work examines how the parameter ranges chosen prior to analysis can influence LHS-PRCC results and shape subsequent analysis interpretations. Previous LHS-PRCC analysis of this model restricted parameters to {+/-}10% of their original value, which limits the scope and interpretability of parameter influence. Such a small range assumes, in the biological sense, that parameters are well-measured with little variability. Here, this work extends the previous analysis and explores several parameter ranges ({+/-}25%, {+/-}50% of the original value). This work also tests whether, within the {+/-}10%, {+/-}25% and {+/-}50% parameter ranges, the bistable switch present in the original model are maintained. Ultimately, this work showcases how a choice made prior to analysis, such as the accepted parameter ranges for biological rates and values in complex dynamical systems can influence sensitivity analysis results and interpretability. Additionally, these choices can have hidden consequences, such as the loss of phenomenological behavior. Thus, explicit prior knowledge about the appropriate parameter values is needed before using analysis to guide future experiments and model development.

Compartmental models of infectious disease transmission make assumptions about human behaviors. Specifically, they parameterize interactions across population groups, assumed to have distinct epidemiologically-relevant behavioral patterns, primarily through contact matrices stratified by demographic variables such as age, gender, or socioeconomic status. Although such demographic characteristics are readily measurable, they may inadequately capture the social and psychological forces that govern protective behaviors. Drawing on 20 waves of a national survey conducted throughout the COVID-19 pandemic in the United States, we show that institutional trust - particularly trust in public health agencies, physicians, and hospitals - is a dominant predictor of protective behavior adoption. For mask wearing during periods of strongest pandemic activity, for example, institutional trust explains more behavioral variance across population groups than age, income, education, and partisan affiliation combined. In unadjusted analyses, the difference in protective behavior adoption between individuals with the highest and lowest trust in the CDC was four- to six-fold larger than the corresponding differences by age, income, or educational attainment, and exceeded the difference between Democratic and Republican respondents. This association was institutionally specific (e.g., the relationship attenuates for trust in banks), and behaviorally specific (e.g., trust in the CDC is associated with protective behaviors but not visiting a doctor). The latter suggests that trust modifies voluntary compliance with public health recommendations rather than access to or use of healthcare. We conclude that compartmental models of disease transmission would be substantially improved by incorporating institutional trust as a stratifying variable. We additionally offer a trust-integrated mathematical modeling framework and recommendations for the data infrastructure needed for its implementation.

The osteocyte network in bone is believed to play an important role for how bone tissues sense and respond to mechanical stimulation. Yet, bone adaptation to mechanical loads is often conceptualised as a simple response to mechanical stimuli, such as Wolffs law, which is based on mechanical variables only and takes no account of the cellular basis of mechanosensation. Wolffs law presumes the existence of a reference mechanical stimulus, the mechanical setpoint, above which bone is consolidated, and under which bone is removed. In this paper, we develop a theory of bone tissue sensing and adaptation based on osteocytes to provide new understanding of the role played by osteocyte signals in mechanical adaptation. In this theory, the mechanical setpoint of Frosts mechanostat is explicitly embodied as osteocyte properties involved in mechanotransduction. The mechanical setpoint is allowed to adapt due to the replacement of osteocytes during remodelling, making the setpoint space and time dependent. We propose a mathematical model to implement this new theory of bone adapation and present numerical simulations of this model to explore how mechanobiological response curves (effective Wolffs laws) are modulated by setpoint adaptation during remodelling. By accounting for varying osteocyte populations within bone tissue, we explore bone adaptation under osteocyte disruptions, which is particularly relevant to age-related bone loss. Our model suggests that biological disruptions of remodelling balance cannot always be compensated by mechanical feedback, and that setpoint adaptation during remodelling may have significant observable consequences, such as hysteresis in bone response signatures that resemble lazy zones.

Infectious disease time series often show signs of epidemic transitions, such as the peaks and troughs of the time series. In these time series, key system parameters can lead to catastrophic changes in the dynamical system behaviour (often called critical transitions). Modellers have increasingly shown that early warning signals can anticipate these transitions, both critical and non-critical, in infectious disease time series. Existing methods, however, generally focus on univariate time series data, or ignore spatiotemporal patterns that may be present as a disease spreads through a population. Recent ecological literature developments expand existing temporal and spatial methods to consider the covariance matrix of multiple, related time series. However, many of these proposed signals still make an assumption of stationary time series/system equilibrium. Whilst often true in ecological modelling, disease systems are seldom at equilibrium. In this paper, we propose the usage of the eigendecomposition of the non-stationary covariance matrix as a more suitable early warning signal for epidemiological data. We first analyse the expected trends in the eigenvalues and eigenbasis of the covariance matrix on approach to a transition. Next we apply these methods to a spatially-structured susceptible-infectious-recovered model to explore how the eigenbasis may provide extra information to modellers. Finally, we test these methods on SARS-CoV-2 case data during the 2020-2021 pandemic period in England.

Sex work is diverse and includes a broad range of people and settings. Over the last thirty years, a large proportion of public health emergencies of international concern (PHEIC) have involved infections transmitted through sexual or close contact and in sexual networks (WHO 2024). Sex workers can face increased disadvantage in relation to these public health emergencies. Given the significant health inequalities sex workers can face, they should be eligible to receive targeted and tailored health support to reduce health protection risks (Hester 2019; Jeal and Salisbury 2004a). However, they are often not explicitly eligible for targeted and tailored support due to a lack of information on incidence, prevalence of disease, and even more basic data such as reliable estimates of the number of sex workers in the UK. Accordingly, the aim of this paper is to determine a population size estimate, with uncertainty, that is more robust than those currently available. In this study, we apply Bayesian Evidence Synthesis to bring together historic estimation efforts with recent ONS National Population Estimates and Genito-Urinary Medicine Clinics Attendance Data (GUMCAD) from the UK Health Security Agency (UKHSA). A key feature of our model is the embedding of uncertainty from each input study in model priors, hence propagating it through to our final estimate. The Bayesian evidence synthesis model estimated a total of 84,000 sex workers in the United Kingdom (95% credible interval: 49,000-130,000), representing 0.121% of the current UK population.

Coinfection of COVID-19 and malaria in endemic regions may generate complex epidemiological interactions that influence susceptibility patterns, disease burden, and outbreak risk. Although malaria-acquired immunity has been hypothesized to modulate host responses to other infections, its population-level implications for COVID-19 transmission under uncertainty remain insufficiently understood. In this study, we develop a deterministic-stochastic compartmental model for the coupled dynamics of COVID-19, malaria, and their co-infection. Malaria-acquired partial immunity is incorporated through a relative susceptibility parameter that reduces the risk of COVID-19 infection among malaria-recovered individuals. For the deterministic system, we establish positivity, boundedness, an invariant feasible region, and basic reproduction numbers for the COVID-19-only and malaria-only subsystems. We then use numerical simulations to examine how immunity-mediated reductions in susceptibility may influence COVID-19 incidence, peak burden, hospitalization, and cumulative mortality. To account for environmental and transmission variability, we extend the deterministic model to an Ito stochastic differential equation framework and use repeated realizations to characterize uncertainty in epidemic trajectories, peak distributions, and outbreak risk. In addition, global sensitivity analysis based on partial rank correlation coefficients (PRCCs) is performed to identify the parameters with the greatest influence on COVID-19 outcomes. Our results suggest that, under the assumed modeling framework, malaria-acquired partial immunity may reduce the peak infectious burden and cumulative mortality associated with COVID-19. The stochastic simulations further show substantial variability around deterministic trajectories and indicate a non-negligible probability of large outbreak events that are not fully captured by mean-field predictions alone. Overall, the proposed framework provides an uncertainty-aware, mechanistic basis for studying COVID-19-malaria co-dynamics and for assessing how interacting disease processes may shape epidemic outcomes in endemic settings.

Type 2 diabetes is characterized by progressive aggregation of islet amyloid polypeptide (IAPP) within the islets of Langerhans, a process strongly implicated in beta-cell dysfunction and loss. Although oligomeric IAPP intermediates are widely considered the principal cytotoxic species, the relative contributions of the many biological and kinetic processes governing their formation, clearance, and conversion into fibrils remain poorly quantified. Here, a mathematical model of IAPP aggregation is developed that incorporates the physiology of beta-cell secretion and the microanatomy of the islet, including capillary-mediated clearance, enzymatic degradation, and the kinetics of oligomer and fibril formation within a well-mixed control volume. Building on the hypothesis that oligomers are the major cytotoxic species, the concept of accumulated cytotoxicity is introduced, defined as the time integral of the oligomer concentration, and a systematic sensitivity analysis of this quantity with respect to all model parameters is performed. The results reveal a striking hierarchy: only two parameters, the basal rate of IAPP monomer secretion and the rate constant for spontaneous oligomer dissociation, exert a first-order influence on long-term accumulated cytotoxicity, with dimensionless sensitivities approaching +1 and -1, respectively, while the effect of all other parameters remains subordinate and decays at long times. The model further shows that capillary clearance, owing to the physical exclusion of oligomers from fenestrated capillaries, selectively reduces fibril accumulation and amyloid deposition without affecting oligomer-mediated cytotoxicity, indicating that amyloid area fraction, the standard histological metric of disease severity, may not be a reliable surrogate for cytotoxic burden. The model predicts that approximately 48% of the islet area is replaced by amyloid after 30 years, broadly consistent with histological observations of advanced disease. These findings identify monomer secretion and oligomer dissociation as the most promising therapeutic targets to limit cytotoxic damage in type 2 diabetes and provide a quantitative framework for evaluating candidate intervention strategies.

Patients with primary immunodeficiency (PID) often face prolonged diagnostic delays and may increasingly turn to large language models (LLMs) to interpret their symptoms during this period. We evaluated whether an LLM could recognize PID from symptom descriptions derived from interviews with 21 PID patients. In a prior study, we showed that GPT-4o identified PID in 96% of cases when prompted with physician-written patient histories (Rider et al., JACI, 2024). Here, when prompted with symptom descriptions in patients' own words, GPT-5 identified PID in only 7 cases (33%), although it more broadly suggested immune system issues in 18 cases (81%). The gap between these findings indicates that LLMs are sensitive to the language and framing of symptom descriptions, performing substantially worse when patients describe their own symptoms in everyday language than when clinicians summarize patient histories in structured medical terms. This study underscores the need to carefully evaluate how LLMs are used in patient-facing applications.

Cell shape and mechanics are intricately connected and tightly regulated by mechanochemical events including biochemical signaling, cytoskeletal remodeling, and plasma membrane mechanics. While experimental advances in microscopy have shed light on the intricate coordination involved in cell shape change in response to different cues, the ability to conduct three-dimensional simulations in realistic geometries remains an open computational challenge. In this work, we develop a finite-element framework that incorporates advection-diffusion-reaction equations coupled with equations governing the kinematics of a deformable interface representing the cell membrane. We applied this framework to three distinct coupled mechanochemical systems, each governed by geometric partial differential equations, resulting in large deformations of the interface. In all three examples, our simulations revealed the emergence of feedback between cellular signaling, cytoskeletal organization, and cell shape. In our first two sets of simulations, we observed that cell migration and neutrophil protrusion were regulated by membrane tension-mediated feedback. In our final application, we predicted shape changes of a dendritic spine starting from a realistic geometry, and found that the complex shape of the spine gives rise to localized regimes of actin cytoskeleton remodeling not previously observed with idealized geometries. Thus, our finite-element framework allows us to generate new mechanistic insights for biophysical problems.

Microbes exhibit complex dynamic behavior as the result of a large number of biochemical processes, spatial and temporal interactions, environmental variations, and evolutionary pressure. Although significant progress has been achieved in understanding microbial ecological dynamics, multiple open questions remain, including the microscopic mechanisms of growth and the roles of nutrients and stochasticity. In this work, we present a minimal theoretical approach to clarify the link between consumption of resources by microbes and their growth. A stochastic model that accounts for a single microbial species consuming a single type of resource while growing via cell division is studied analytically and via Monte Carlo computer simulations. We identify three distinct dynamical regimes of microbial growth determined by the relative magnitudes of resource uptake and division rates and initial conditions. We also show that stochasticity influences the dynamic behavior when the amounts of microbes or resources are low. The model recovers Monod growth kinetics and provides a mechanistic interpretation of the Monod constant and maximal growth rate. The theoretical framework presented captures a wide spectrum of dynamic behaviors in microbial systems, providing a clearer microscopic picture to explain their underlying complex mechanisms.

Neutrophils move through narrow pores, convoluted channels, and tight spaces in tissue to find infection sites. Their ability to sense weak chemical gradients, undergo directed motion, and solve such path-finding problems rests on internal GTPase signaling circuits that control the front protrusion and rear retraction of the cell. Here we explore several variants of known core polarity circuits, with local and long-ranged negative feedback, including inhibitor downstream of Rac, Rac-Rho antagonism, and effects of membrane tension. The resulting reaction-diffusion (RD) equations for Rac and Rho are then used to simulate protrusion-retractions along the edge of a simulated motile cell. We visualize how cells navigate through narrow tracks with sharp corners and weak chemical gradients in 2D. Our metrics for cell performance include polarity initiation, wall-collision intensity, and track completion. In this way, we expose how Rac and Rho, together with their immediate down and upstream components can fine-tune neutrophil motility through complex environments. Author SummaryWhite blood cells, attracted to sites of infection, migrate through complex tissues to find their target. Such movement requires a balance between robust polarity in one direction versus flexibility in response to spatial cues such as obstacles and sharp turns. Here we use mathematical modeling to explore known intracellular circuits that regulate front protrusion and rear retraction in directed cell migration. We test several such circuits in simulations of cells moving along zigzag tracks with sharp turns. We demonstrate that a basic cell polarity circuit, on its own, has limited success, since cells tend to get trapped in sharp corners. Known modulators of this core, which add local negative feedback, mutual front-back antagonism, and long-range feedback from membrane tension, improve cell performance. A cell with the full front-back-membrane tension regulatory circuit avoids delays due to traps and obstacle collisions, and moves swiftly through a convoluted passage to its target site.

Canine rabies persists in NDjamena (Chad) despite vaccination campaigns exceeding 70% coverage, suggesting a role for dog mobility and spatial heterogeneity. We propose a metapopulation SEIR model incorporating distance-modulated dog movements and an explicit vaccinated class. Analysis of the isolated patch establishes global stability of the disease-free equilibrium via a Lyapunov function. For the metapopulation, a composite Lyapunov function shows that elimination is governed by a reproduction number [R]v. Calibrated with field data (2012-2022), simulations reveal that uniform vaccination of both patches reduces [R]v by 46% (from 2.84 to 1.52) but does not achieve elimination, while targeted strategies are less effective. These results demonstrate that exhaustive vaccination coverage across the entire urban network and increased vaccination intensity are necessary to eliminate canine rabies in NDjamena. Our model provides a quantitative framework for planning effective control strategies.

The Hajj is an annual pilgrimage made by millions of Muslims to Mecca in the Kingdom of Saudi Arabia (KSA). The large number of international attendees at the Hajj increases the risk of global infectious disease spread. However, we know very little about the benefits, costs, and cost-effectiveness of testing and quarantining strategies to contain epidemic spread during mass gathering events. In this work we developed a stochastic discrete-time compartmental metapopulation model to simulate international epidemics of infectious pathogens and their potential importation into KSA during the Hajj. We used the model and an epidemic simulation study to evaluate the impact and cost-effectiveness of three testing and quarantining strategies for arriving pilgrims: randomly testing 99% of pilgrims, 80% of pilgrims, or using a symptom-based screening strategy. The simulations lasted 100 days, covering the 30 days before the Hajj and 65 days after the Hajj. Under the conditions assumed in our simulation study, there was strong evidence that testing and quarantining strategies are cost-effective measures for controlling epidemic threats at the Hajj. The median net monetary benefits of intervention strategies ranged from Intl$-41.89M [95% quantile range Intl$-42.37M to Intl$3.18B] to Intl$12.68B [Intl$-8.70B to Intl$13.82B] across scenarios with different pathogen characteristics (based on the natural histories of SARS-CoV-2 and H1N1 Influenza) and epidemic seed locations. Our results were sensitive to the data sources that were used to estimate the number of pilgrims travelling to KSA by origin country, with flight passenger statistics providing biased estimates of pilgrim numbers. Our work provides an adaptable tool to inform infectious disease risk assessments and evaluate the cost-effectiveness of possible disease control measures for the Hajj, and could be extended to other mass gathering events.

The Poisson-Nernst-Planck (PNP) system is an accurate model of electrodiffusion of ionic species. It is commonly used in situations where nanoscale resolution is required, for instance close to ion channels in the membranes of biological cells. The inherent stiffness of the equations has made them challenging to solve and has limited the applicability of the system. In particular, the time step required for stable solutions has typically needed to be very short (nanoseconds), which makes simulations on the time scale of an action potential (milliseconds) difficult. Recently, it has been observed that avoiding operator splitting and instead solving the concentration equations and the electrostatic equation in a coupled manner relaxes the time-step limitation considerably. However, no theoretical explanation of this observation has been provided. Here, we aim to explain why the coupled scheme allows much larger time steps. We illustrate the mechanism by considering special cases that define necessary, but not sufficient, conditions for stability. We also show that these conditions remain relevant for the fully coupled PNP model in 3D.

Cancer progression following treatment failure is an evolutionary process in which therapy acts as a selection pressure driving Darwinian selection on heritable variation to favor resistant clones. This ability to generate variation, i.e., the cancers evolvability, is a key determinant of how rapidly tumors adapt to therapy. Here, we present an evolutionary game-theoretic model to evaluate how evolvability shapes resistance dynamics under two treatment modalities: targeted therapy and chemotherapy. We first compare cancer populations with fixed evolvabilities: low or high. Targeted therapy imposes a steep selection gradient, enabling rapid resistance evolution, while chemotherapy exerts a flatter gradient but drives tumors toward more extreme resistance strategies. We show that targeted therapy works better in low-evolvability cancers, whereas chemotherapy better controls high-evolvability populations. We then extend the model to incorporate facultative evolvability in which cancer cells dynamically adjust their evolvability in response to therapy-induced stress in which cells fine-tune the trade-off between acquiring higher resistance and limiting the costs of resistance and evolvability. The latter strategy sustains a higher tumor burden than fixed-evolvability populations. To address the challenges of facultative evolvability for therapy efficacy, we develop and simulate an evolutionary double bind using sequential cycles of chemotherapy and targeted therapy. With an appropriate sequence and timing, this strategy can drive cancer cells with facultative evolvability to extinction. Our results highlight the importance of evolvability in shaping treatment response and underscore the need to incorporate evolutionary principles into therapy design.

Natural selection acting on cancer cells within their tumor microenvironment should favor cells with fast or efficient nutrient uptake strategies. Here, we develop and analyze a game-theoretic model focusing on the coadaptation between two foraging traits: vascular endothelial growth factor (VEGF) and glucose transporter 1 (GLUT1). Studies show that VEGF and GLUT1 are often co-expressed and are associated with more aggressive tumor phenotypes and poor clinical prognosis. VEGF is a diffusible paracrine factor that recruits blood vessels towards neighborhoods of cancer cells (angiogenesis). GLUT1 is a cell-surface transporter that enables the uptake of nutrients, especially glucose. We model these strategies operating at different scales: VEGF influences resource availability at the neighborhood level, while GLUT1 determines resource uptake at the cellular level. For VEGF, we introduce a resource-sharing continuum. With no resource sharing, cells access resources in proportion to their VEGF contribution. With uniform sharing, cells have equal access to resources, regardless of their VEGF contribution. The former leads to a tragedy of the commons and overproduction of VEGF. The latter yields a public goods game with moderate VEGF expression matching a group optimum. GLUT1 expression mediates uptake of resources recruited by VEGF and is largely independent of the degree of resource sharing. Therapeutically, both VEGF and GLUT1 inhibitors are more effective in high resource-sharing neighborhoods and less so as resource sharing declines. Overall, inhibition of GLUT1-mediated uptake emerges as more effective. The model, perhaps the first to consider VEGF and GLUT1 as coadaptations, emphasizes the need to consider cancer cell traits jointly.

Immune cell engagers (ICE) such as bispecific antibodies (bsAbs), within an immunological synapse, bind and link CD3 on a T cell to a target antigen (TAA) on a cancer cell, forming a trimer (CD3:bsAb:TAA complex). With sufficient trimer numbers within the synapse, the T cell can become activated and promote cancer cell killing. Elranatamab, a CD3-bispecific antibody for multiple myeloma, has received FDA and EMA filing acceptance (August 2023 and December 2023, respectively) adding to a growing list of bsAbs that are treating patients. In the drug development stages of ICE bsAbs, mechanistic modeling approaches are often used to attain a greater quantitative understanding of the modality, preclinically, and provide human pharmacokinetic and efficacious dose predictions to aide in Phase 1 trial design. To date, the majority of ordinary differential equation (ODE) trimer models treat the tumor compartment as well-mixed and trimer formation is governed by a bulk population reaction not accounting for individual synapses. This lack of discrimination can lead to imprecise analysis when analyzing results across E:T ratios using metrics like trimers per T cell or trimers per target cell. To this end we developed an ODE trimer model based on single-synapse complexes (one target cell/one immune cell) with 2D cross-linking trimer formation. We show computationally that the number of trimers per synapse is invariant to the value of the E:T ratio for a given free bsAb concentration, a property that cannot be captured by non-synapse models. A simple demonstration of this discrepancy using the well-known Betts trimer model is presented. We then apply the Betts trimer model coupled to a tumor growth inhibition (TGI) module to show that our synapse-based trimer model is easy to substitute in to model TGI, including the addition of a trimer-per-synapse activation threshold function for cell killing. Overall, our model attempts to balance mechanistic fidelity while limiting the complexity of the model.

This work focuses on the global and partial identification problem for fractional differential equations. We provide a general numerical procedure based on global and local optimization algorithms with two refinements for biological systems that ensure solution positivity and homogeneous parameter units. The method is applied to a new fractional model of Dengue outbreak called the Fractional Homogeneous Nishiura (FHN) model, calibrated using data of newly infected people in Cape Verde. We show that our identification method yields a better fit between data and model solutions than previous approaches and that our FHN model captures the dynamics of Dengue more closely than existing systems.

Cells communicate via extracellular ligands, such as hormones, which bind to plasma membrane receptors and trigger intracellular signaling cascades. G Protein-Coupled Receptors (GPCRs) exemplify this mechanism by initiating signaling both at the cell surface and, from intracellular compartments such as endosomes. The kinetics and spatial localization of these signals are critical determinants of cellular responses, yet receptor trafficking-including internalization, endosomal sorting, and recycling-remains a pivotal but often overlooked component of theoretical GPCR models. In this study, we present a mathematical framework that integrates receptor trafficking and signaling compartmentalization into generic GPCR dynamic models. Using a compartmentalized approach based on systems of ordinary differential equations (Chemical Reaction Networks), we analyze how receptor internalization and recycling modulate ligand-induced responses. Our results show that the balance between plasma membrane and endosomal signaling can significantly enhance or diminish ligand efficacy. Calibrated with high-throughput kinetic data, our model offers a refined tool for ligand pharmacological characterization and advances the understanding of GPCR signaling spatial organization.

Small molecule modifiers whence bound, allosterically, will alter the binding of a macromolecule to one- or more-cognate substrates/partners via conformational and non-conformational changes. Although allostery is inferred directly from empirical data, the mathematical basis of these models, constraints deployed and choice of parameter(s) are not clear. Here, we present and characterize a discrete-to-continuous mathematical model for ensemble distributions of a ligand-interacting macromolecular species across milieux-dependent conformational states and examine its role in the genesis and progression of cooperative binding. The premise, of our model, is a set of occupancy matrices (sparse, binary, strictly delocalized) which can be partitioned by a probability-based hyperparameter into mutually exclusive proper subsets of occupancy matrices with identical multinomial probabilities. Since each subset is canonical with a constituent occupancy matrix, it is characterized by a unique multinomial probability. The inner product of combinatorial pairs of all mutually exclusive subsets of occupancy matrices, with an expression for the summed transitional probabilities (finite differences between unique multinomial probabilities), is the differentiable matrix of strictly positive real-valued numbers for the system of ensemble distributions. Whilst the harmonic mean is presented as a generic solution for a system of ensemble distributions, the row-wise definite integral for each column is the finite union of open intervals (contiguous, strictly monotone) which in tandem with a set of interval-specific and bounded transitional probabilities constitutes a piecewise smooth curve (path-connected-, closed- and compact-set). Our discrete-to-continuous model is phenomenological and able to recapitulate the basic tenets of cooperative binding whilst offering insights into the genesis and progression of the same.