Digital Commons Network^™

Canary In The Carpal Tunnel: A Pilot Study Of The Value Of The Screening For Amyloidosis In Carpal Tunnel Syndrome, Trevor Ruesch, Nevil Khurana, Logan Hansen Md, Katiya Barkho, Julia Malewicz, Charles Day Md

Medical Student Research Symposium

Introduction/Purpose:

Transthyretin amyloidosis occurs in two forms, hereditary transthyretin amyloidosis (hATTR), and wild-type ATTR (wtATTR)². Amyloidosis can result in restrictive cardiomyopathy presenting as heart failure with preserved ejection fraction (HFpEF)⁴. A growing body of evidence demonstrates that amyloidosis may be underdiagnosed and can be caught earlier in the disease course⁵. The proteins causing amyloidosis can also deposit into various tissues including the carpal tunnel leading to carpal tunnel syndrome ².

In this pilot study, we propose that early detection of amyloid via a biopsy of the transverse carpal ligament or tenosynovium in the …

Stopping The Cirrhosis: An International Review Of Hep C Screening In Prisons And Jails From 2004-2023, Anastasia Sahu Bs, Jack Spurlock Ba, Mhs, Eliza Beal Md

Medical Student Research Symposium

Background: As of 2023, HCV prevalence in state prisons in the United States was 9 times higher than the general population¹. Without treatment, 20% of people with HCV will develop cirrhosis, and some estimate that 70% of hepatocellular carcinoma (HCC) cases arise from cirrhosis or advanced fibrosis². Despite the high prevalence in prisons, the US does not have nationally standardized Hep C screening in correctional facilities. The goal of this study is to investigate different models of existing programs in prisons internationally. Understanding these models will inform Hep C screening in US prisons on a state …

Characterizing Kmt2d In Endometrial Cancer, Katherine R. Davanzo

Medical Student Research Symposium

Endometrial cancer is rising in incidence in the United States, notably among premenopausal women. This increase and the trend of delayed childbearing warrant the need for further advancement in fertility-sparing treatment for endometrial cancer. A gene left widely unexplored in its possible clinical utility as a target for fertility-sparing treatment is KMT2D, a lysine-specific methyltransferase and tumor suppressor. Preliminary gene set enrichment analysis on a 12Z endometriotic epithelial cell line identified TIMP3 as a gene that is possibly regulated by KMT2D expression. TIMP3 encodes an irreversible inhibitor of matrix metalloproteinases (MMPs), a well-recognized class of proteins as contributing to the …

Sexual And Reproductive Healthcare Perceptions Among Arab-American Women: Implications For Gynecological Health Outcomes, Munna Hazime, Kaitlyn Zablock, Whitney Bowyer, Natalie Ahmad Mateju, Andrew Markowitz

Medical Student Research Symposium

This literature review analyzes the sexual and reproductive healthcare perceptions of Arab-American (AA) women living in the United States and how this impacts the prevalence of gynecological diseases. Sexual health is viewed promiscuously within the AA population and is generally reduced to the physical act of intercourse. It is considered either an agent of sexual desire or a means to reproduce. This dichotomy overlooks aspects of gynecological health within a broader framework. This attitude is evident in the minimal utilization of preventative screenings and increased rates of sexually transmitted infections (STIs) and gynecological cancers. Consequently, this narrow view of sexual …

Breaking The Synaptic Vesicle Cycle: Mechanistic Insights Into Presynaptic Dysfunctions In Epilepsy, Kevin Jiang, Lu-Tang Yang, Mingshan Xue

Duncan NRI Faculty and Staff Publications

Synaptic dysfunction is a hallmark of many neurological disorders including epilepsy. An increasing number of epilepsy-causing pathogenic variants are being identified in genes encoding presynaptic proteins that affect every step of the synaptic vesicle cycle, from vesicle loading, tethering, docking, priming, calcium sensing, fusing, to recycling. These different molecular dysfunctions result in converging impairment of presynaptic neurotransmitter release, yet lead to diverse epileptic disorders. This review focuses on representative monogenic epileptic disorders caused by pathogenic variants of key presynaptic proteins involved in different stages of the synaptic vesicle cycle: SYN1 (vesicle pool regulation), STXBP1 (vesicle docking, priming, and fusion), and …

Oral Hygiene And Cardiovascular Health, Md. S. Zaman, S. M. Golam Alam, Mohammed S. Razzaque

School of Medicine Publications

The human oral microbiome plays a vital role in maintaining oral and systemic health. This diverse microbial community includes over 700 bacterial species, some of which are implicated in developing systemic diseases, particularly cardiovascular diseases (CVDs). Research highlights a strong association between periodontal disease and increased cardiovascular risk, suggesting that good oral hygiene practices may reduce the incidence of CVDs. Porphyromonas gingivalis and Fusobacterium nucleatum drive chronic inflammation in periodontal disease; these bacteria can extend beyond the mouth and contribute to systemic inflammatory responses. The inflammatory factors, including C-reactive protein (CRP), interleukins (IL-1, IL-6), and tumor necrosis factor-alpha (TNF-α), damage …

The Role Of Non-Statin Lipid Lowering Therapies To Reduce Ascvd Events In Primary Prevention, Chukwuemezie Mamanu, Dean Karalis

Division of Cardiology Faculty Papers

PURPOSE OF REVIEW: Atherosclerotic cardiovascular disease (ASCVD) remains a leading global health challenge, with low-density lipoprotein (LDL) cholesterol a pivotal risk factor. While statins are cornerstone therapy for lowering LDL cholesterol, many high-risk primary prevention patients are unable to tolerate statin therapy and do not achieve their guideline directed LDL cholesterol goal. For these patients, non-statin therapies offer complementary and alternative approaches to LDL cholesterol reduction.

RECENT FINDINGS: Recent advancements in non-statin therapies have expanded the options available to clinicians to lower LDL cholesterol in high-risk primary prevention patients. Yet these medications are often under-utilized in clinical practice. Observational studies, …

Using A Cadaveric Model Of Lumbar Scoliosis To Determine Optimal Patient Positioning For Reliable Bone Mineral Density Measures Using A Hologic Dexa Scanner, Caleb B. Schuring, Alexander H.K. Montoye

The Journal of Integrative Physiology

Introduction: Osteoporosis and osteopenia affect roughly 10 million and 43 million older adults, respectively, in the United States. The primary way to detect osteoporosis and osteopenia is through a bone mineral density (BMD) scan, as is often done using dual energy x-ray absorptiometry (DEXA). However, previous research shows DEXA to be unreliable when assessing BMD in individuals with lumbar scoliosis. The purpose of this study was to test the effect of spine orientation on the DEXA scanning bed on lumbar BMD measures, using a cadaver spine as a model. Methods: One female cadaver was dissected to the skeletal …

Complete Closure Of Chronic Ankle Ulcerations In The Presence Of Lymphadema With Use Of Adipose Stem Cell Injectable Allograft, A Case Report, Orlexia Thomas Dpm, Francois M. Lokenye Dpm, Jasmine Sheikh Bs, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

This case illustrates the promising role of adipose stem cell injectable allografts in the management of complex chronic wounds, particularly in patients presenting with lymphedema and fat pad atrophy.

Reevaluating Informed Consent: Integrating Shared Decision-Making Into Spinal Surgery For Better Patient Outcomes., Jeffrey N Wang, Mohamed A Elhakeem, Matthew J Mesimer, Paul G Mastrokostas, Salman Ahmad, Tim Reed, Brandon Klein, Lucas E Bartlett, Adam D Bitterman, Andrew Megas

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Study Design: Narrative review.

Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods: N/A.

Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, …

Examining The Role Of Corticosteroids In The Management Of Acute Interstitial Pneumonia: A Systematic Review., Carlos Valladares, Aalia Narvel, Bianna Koutsenko, Alexa Simonetti, Fatima Mossolem, Alexis Chow, Samrat Gollapudi, Usmaan Al-Shehab, Nicholas Averell, Katherine Chiapaikeo-Poco, Adam Kaplan

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Acute interstitial pneumonia (AIP), also known as Hamman-Rich syndrome, is a rapidly progressive interstitial lung disease. In addition to being challenging to diagnose, AIP is also difficult to treat. The mortality rate of AIP is greater than 70% due to the disease's rapid progression. Furthermore, survivors are likely to develop chronic interstitial lung disease as a sequela. Treatment primarily focuses on supportive care, which consists of oxygenation through mechanical ventilation, administration of broad-spectrum antibiotics, and the use of corticosteroids. Although the use of steroids as empiric treatment is controversial and results on its mortality benefit are variable, some studies …

Improving The Rates Of Sexually Transmitted Infection Diagnosis By Increasing Provider Knowledge About Testing, Lauren Cunningham

Student Scholarship & Creative Works

There has been a significant increase in sexually transmitted infection rates since 2021. Though this issue is nationwide, rural providers require education regarding testing, screening, and transmission of disease processes. The infections with the most significant increase being gonorrhea, chlamydia, and syphilis. The purpose of this project was to provide education to providers regarding local statistics, in addition to when to and not to test for sexually transmitted infections. Education was given to three Advance Practice Nurse Practitioners on disease signs and symptoms, transmission, and local STI statistic rates. STI testing rates were observed three months prior to an educational …

Adipose Injectable Filler With Use Of Meshed Dermal Matrix And Porcine Urinary Bladder Matrix For The Management Of A Complex Achilles Wound, Francois M. Lokenye Dpm, Orlexia Thomas Dpm, Mariam Kamil Bs, Lady Paula Dejesus Dpm, Facfas, Facpm, Dwsp

Posters

Chronic Achilles wounds present a significant clinical challenge due to limited vascularity, high mechanical stress, and the complex anatomy of the posterior lower leg.

Regenerative medicine offers a promising alternative to traditional wound management through the use of advanced biologic materials.

This case highlights a novel approach utilizing a combination of adipose-derived injectable filler, acellular dermal matrix, and porcine urinary bladder matrix to enhance tissue regeneration, provide structural support, and promote wound healing.

1st Place Contest Entry: Effectiveness Of Intravesical Bcg In The Treatment Of Nonmuscle Invasive Bladder Cancer: An Umbrella Review, Gerald Obinna Ozota

Eric M. Scandrett Graduate Library Research Prize

This is Gerald Obinna Ozota's submission for the 2025 Eric M. Scandrett Graduate Research Prize, which won first place. It contains their essay on using library resources, their bibliography, and a summary of their research project on conducting a systematic literature search to identify all relevant systematic reviews and meta-analyses investigating the effectiveness of intravesical Bacillus Calmette-Guerin (BCG) on Non-muscle-invasive Bladder Cancer (NIMBC).

Gerald is a student in the Ph.D. in Pharmaceutical Sciences program at Chapman University. Their faculty mentor is Dr. Lawrence Brown.

Physiological Indicators Of Social Anxiety In Preschoolers With The Fragile X Premutation, Olivia Cyburt

Senior Theses

The Fragile X premutation (FXpm) is a common genetic disorder often characterized by psychiatric impairments, including anxiety. It results from a trinucleotide repeat expansion (CGG) of 55-200 repeats on the FMR1 gene. Despite its association with psychiatric symptoms, there is limited research regarding the relationship between FXpm and anxiety, particularly social anxiety. Early detection of social anxiety is essential for timely intervention, yet it remains challenging to identify in young individuals with FXpm due to limited research. The present study aimed to bridge this gap by examining social anxiety in preschoolers with the FXpm, utilizing both a physiological and behavioral …

Study Of Proportion Of Cardiac Involvement Secondary To Dengue Infection In Pediatric Population Admitted In A Tertiary Hospital- A Prospective Cross-Sectional Study, Neha Bhongale, Qudsiya Ansari, Ravindra Chittal

Digital Journal of Clinical Medicine

Background- Dengue is one of the most important mosquito-borne illnesses worldwide. Cardiac manifestations of dengue illness can range from asymptomatic bradycardia to life-threatening myocarditis. There is an overall paucity of published Indian studies of clear demonstration of cardiac manifestations secondary to dengue in the pediatric population. Aim- To study the proportion of patients with cardiac involvement secondary to dengue viral infection in the pediatric age group based on clinical manifestations of cardiac enzymes (CKMB, Troponin I) and ECG (electrocardiography), in a tertiary center. Methodology- This study is undertaken to find out the proportion of patients with cardiac manifestations secondary to …

Training The Brain For Better Aging, Abby Martin

Honors Projects

Aging is associated with natural changes in brain function, but certain interventions can help sustain cognitive health and mitigate risks of neurodegenerative diseases such as Alzheimer’s. This presentation explores the significance of brain fitness as a non-pharmacological approach to enhancing cognitive function. It covers the normal aging process of the brain, key indicators of abnormal aging, and the impact of Alzheimer’s disease, including genetic predispositions and current treatment limitations. Emphasis is placed on brain training exercises, such as puzzles, board games, video games, and nostalgia-based activities, which have been shown to improve memory, attention, and problem-solving skills. Additionally, the role …

Analysis Of Mycoplasma Pneumoniae Cards Toxin In The Air-Liquid Interface Bronchial Culture Model, Alexandria Hernandez

Posters - 2025

Mycoplasma pneumoniae is a pathogen that can cause severe respiratory infection that can rarely be life threating. There are currently no vaccines against M. pneumoniae, and the prevalence of antibiotic-resistant strains of M. pneumoniae is on the rise.1 During infection, M. pneumoniae produces a toxin called Community Acquired Respiratory Distress Syndrome (CARDS) toxin, which plays a role in establishing infection. Analysis of the crystal structure of CARDS toxin protein reveals three protein domains: D1, D2,and D3.

After entering a cell, CARDS toxin traffics by a retrograde process to the ER of the cell, where it undergoes processing.4 Our current studies …

Streamlining The Journey Of Research Into Clinical Practice: Making Your Patients And Practice Flourish Evaluation And Treatment Of Pyogenic Spondylodiscitis Of The Spine: Ao Spine Knowledge Forum Trauma And Infection, Sebastian F. Bigdon, Emiliano Vialle, Charlotte Dandurand, Julian Scherer, Gaston Camino-Willhuber, Andrei F. Joaquim, Harvinder S. Chhabra, Mohammad El-Sharkawi, Richard Bransford, Charles G. Fisher, Klaus J. Schnake, Gregory D. Schroeder

Rothman Institute Papers

Study DesignLiterature Review with clinical recommendations.ObjectiveTo highlight impactful studies on pyogenic spondylodiscitis (PS), identified by the AO Spine Knowledge Forum Trauma and Infection, with recommendations for their integration into clinical practice.MethodsFive influential studies on PS that have the potential to shape current practice in spinal infections were selected and reviewed. Each study was chosen for its contribution to a critical phase in PS management: diagnosis, imaging, surgical vs conservative treatment, and antibiotic duration. Recommendations were graded as strong or conditional following the GRADE methodology.ResultsFive studies were highlighted. Article 1: Pluemer et al introduced the Spinal Infection Treatment Evaluation (SITE) Score, …

Machine Learning Predicts Non-Preferred And Preferred Vertebrate Hosts Of Tsetse Flies (Glossina Spp.) Based On Skin Volatile Emission Profiles, Olabimpe Y. Orubuloye, David P. Tchouassi, Abdullahi A. Yusuf, Christian W.W. Pirk, Daniel K. Masiga, Edward Kariuki, Baldwyn Torto

All Peer-Reviewed Publications

Tsetse fly vectors of African trypanosomosis preferentially feed on certain vertebrates largely determined by olfactory cues they emit. Previously, we established that three skin-derived ketones including 6-methyl-5-hepten-2-one, acetophenone and geranyl acetone accounted for avoidance of zebra by tsetse flies. Here, we tested the hypothesis that these three ketones serve as biomarkers for tsetse flies to distinguish between non-preferred- and preferred-vertebrate hosts. We used coupled gas chromatography/mass spectrometry to analyze and compare the skin volatile emissions of two non-preferred- (waterbuck and zebra) and four preferred- (buffalo, donkey, horse, warthog) vertebrate hosts in two wildlife parks in Kenya. We detected a total …

The Impact Of Provider Communication On Treatment Adherence In Patients With Hypertension And Diabetes, Trey Carlson

Honors Program: Senior Projects (Public)

Current research cites effective provider communication as an important factor in improving treatment adherence and the health outcomes of patients. This study examines the effect of provider communication on treatment adherence in patients with chronic illnesses with a specific focus on hypertension and diabetes. Provider communication was measured using patient satisfaction surveys and treatment compliance was measured as the percentage of hypertensive and diabetic patients with a blood pressure below 140/90 mmHg and hemoglobin A1C levels below 9%. A one-way MANOVA revealed that provider communication had no significant impact on the combined treatment compliance variables for hypertension and diabetes (Wilk’s …

The Epidemiology Of Sports And Recreation Related Toe Fractures In The United States, Dogerno Norceide, Gabriel I. Onor, Oluwatomi Akingbola, William Justice, Nana F. Amponsah, Abimbola Okulaja, Ifeanyichukwu Onor, Michael Okoronkwo, Chibuikem Nwizu, David Pedowitz

School of Medicine Faculty Publications

BACKGROUND: Fractures of the toes are among the most frequently diagnosed lower extremity fractures. In sports, toe fractures may present after diverse mechanisms of injury, varying severity, and varying implications for management. This study aimed to discern trends in toe fractures presenting to US emergency departments (EDs) particularly in association with sports and recreational activities. An additional aim of the study was to identify if rates of toe fracture presentation significantly decreased during the year 2020 at the height of the COVID-19 pandemic. METHODS: We queried the National Electronic Injury Surveillance System (NEISS) database to identify toe fractures presented to …

Developing And Validating Brain Tumor Organoid Models To Evaluate Novel Therapeutics In Vitro, Dev P. Patel

Senior Theses

Glioblastoma (GBM), a World Health Organization Grade IV brain tumor, remains one of the most aggressive and treatment-resistant malignancies. It is characterized by rapid proliferation, deep infiltration, and a high level of genotypic and phenotypic heterogeneity. Despite advancements in medical technology and neuro-oncology, GBM remains one of the most treatment-resistant cancers with a median survival rate of only nine months post-diagnosis and less than 5% of patients surviving beyond 5 years of diagnosis. The standard treatment constitutes maximum surgical resection followed by chemotherapy and radiation. These therapeutic strategies are blocked by significant challenges like the blood-brain barrier (BBB), and intratumoral …

Evaluation Of Angiogenesis In An Ex-Ovo Chick Chorioallantoic Membrane (Cam) Assay To Study The Mmp9 Gene In Pediatric Cancer Cell Lines, Franchesca Tinacba, Kahlie Hernandez, Terry Jo Shackleford

Posters - 2025

Model organisms are widely utilized in cancer research due to their ability to allow researchers to study biological processes that occur within cancer progression. One model organism that is used is the Chorioallantoic Membrane (CAM) assays. Chicken embryos are a sufficient model that are used to study processes such as angiogenesis, tumor growth, and drug effects. What makes these models useful is due to the cost efficiency, accessibility, and the increased speed the blood vessels can grow. Despite the results, it can be difficult to image the results or monitor the CAM assay. That is why Ex-ovo CAM assays have …

Investigating The Drug Response Of Pdac Cells To Pan-Kras Inhibitor, Jalyn De La Fuente, Yi Xu, Jun Liu, Angel Dominquez, Ava Sanchez, Pei Wang

Posters - 2025

Pancreatic ductal adenocarcinoma (PDAC) is an exocrine pancreatic cancer. It is one of the most lethal types of cancer and is projected to become the second leading cause of cancer-related deaths by 20401 . One major challenge in treating PDAC is drug resistance and the lack of effective treatments. Oncogenic KRAS mutation and loss of function mutation in tumor suppressor genes including P16, TP53, and SMAD4 are found in most PDAC patients. It is unclear whether the different driver mutations can affect the tumor responses to chemo- and targeted therapy. Gemcitabine, a chemotherapy drug, is a cytotoxic agent that has …

Larotrectinib Compared With Real-World Non-Tropomyosin Receptor Kinase Inhibitor Therapies In Patients With Tropomyosin Receptor Kinase Fusion Cancer, Marcia S. Brose, C. Benedikt Westphalen, Xiaoyun Pan, Vadim Bernard-Gauthier, Milena Kurtinecz, Helen Guo, Virginie Aris, Neil R. Brett, Abdelali Majdi, Vivek Subbiah, Nathan A. Pennell, Kenneth L. Kehl, Alexander Drilon

Kimmel Cancer Center Faculty Papers

PURPOSE: Neurotrophic tyrosine receptor kinase gene fusions are oncogenic drivers of various solid tumors. Larotrectinib is a highly selective tropomyosin receptor kinase (TRK) inhibitor approved for patients with TRK fusion cancer on the basis of single-arm trials. This study was a matched comparative effectiveness study of larotrectinib in clinical trials versus standard of care (SOC) in the real-world (RW) setting.

METHODS: Adult patients with advanced/metastatic TRK fusion non-small cell lung cancer, colorectal cancer, soft tissue sarcoma, thyroid cancer, or salivary gland carcinoma were included. Deduplicated data from RW patients were from US and ex-US data sources. Patients in the larotrectinib …

Vpac Receptor Positivity In Comparison With Mp-Mri In The Diagnosis Of Prostate Cancer: A Preliminary Study, Nishant Setya, Shridhar Ghagane, Rajendra Nerli, Ashwin Bokare, Mathew Thakur, Leonard Gomella

Kimmel Cancer Center Faculty Papers

Objective: The study aimed to prospectively evaluate the feasibility of diagnosing PCa using voided urine samples and by targeting the genomic VPAC (vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide) receptors in comparison with multiparametric magnetic resonance imaging (mp-MRI) in male patients (≥40 years of age) with lower urinary tract symptoms and having a serum PSA of >4 but < 15 ng/ml.

Patients and methods: Male patients attending urological services ≥40 years old, with lower urinary tract symptoms and serum PSA levels of >4 but < 15 ng/ml formed the study group. Voided urine samples were collected to target VPAC receptors on malignant cells. All patients underwent mp-MRI. A 12-core transrectal ultrasound-guided prostate biopsy was performed in all, and the results were compared for the diagnosis of PCa.

Results: A total of 61 patients with a median age of 65.33 ± 8.11 years and with a …

Proposed Evaluation Of Nonpharmacological Treatments And Therapies For Paclitaxel Based Chemotherapy-Induced Peripheral Neuropathy (Cipn), Mackenzie Lesczcynski

D.U.Quark

Chemotherapy-induced Peripheral Neuropathy (CIPN) is a common complication in breast cancer patients receiving Paclitaxel, a chemotherapeutic agent (1). CIPN symptoms range from numbness to extreme pain and sensitivity in bodily extremities, forcing chemotherapy to be halted (2). The mechanism of this side effect is not well understood and there is no standard pharmacological treatment available to improve effects. Nonpharmacological treatments have been attempted on small patient cohorts, but there are no conclusive findings (3). Due to this, we believe that a comprehensive murine model must be developed in order to assess nonpharmacological treatment efficacy and potential molecular targets for pharmacological …

Death Becomes Us: The Consumptive Body In Nineteenth-Century Gothic Literature, Jennifer Marie Mcmahon

All NMU Master's Theses

This thesis examines the impacts of nineteenth-century tuberculosis epidemics on gothic literature published between 1842 and 1872. In this period of time, tuberculosis was the leading cause of death in the United States and in Europe, killing an estimated one in seven people. Using theoretical lenses of psychoanalysis and material ecocriticism, this project considers borders between material bodies—specifically those between bacterial agents and humans—to be illusory and socially constructed. The first chapter focuses on the ways in which representations of tuberculosis, and its associated entanglement with the environment, appear in the work of two authors from the United States: Edgar …

Advancing Pandemic Response: Integrated Strategies For Testing, Prediction, And Bias Mitigation, Tianshu Gu

Theses and Dissertations (ETD)

The COVID-19 pandemic, along with prior outbreaks such as SARS and Ebola, has revealed critical gaps in global pandemic preparedness, emphasizing the need for integrated approaches to infectious disease management. This dissertation addresses three key areas of pandemic response: developing scalable screening strategies, constructing reliable predictive models, and mitigating demographic biases in artificial intelligence (AI) models used for healthcare decision-making.

The first study introduces a global screening strategy designed to optimize resource use and increase testing capacity, particularly in low- and middle-income countries (LMICs) where resources are limited. This study leverages pooled testing methods, where multiple samples are combined into …