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Polyphenol Diet And Exercise As Neuroprotection From Effects Of Alzheimer's Disease, Michelle Morgan

Loma Linda University Electronic Theses, Dissertations & Projects

Healthy non-pharmacological lifestyle factors, such as regular physical exercise and a dietary supplementation, have been shown to significantly improve cognitive outcomes over time compared to a more sedentary lifestyle and poor diet. Furthermore, exercise may serve as a potential protective factor in attenuating the effects associated with cognitive decline that are characteristic of neurodegenerative disorders, such as Alzheimer's disease (AD). Further, evidence indicates that certain diet interventions can also attenuate the effects of neurodegeneration and positively impact longevity. Supplementation of polyphenols, such as ellagic acid (EA), which are abundant in pomegranate juice, may help provide neuroprotective benefits and elicit a …

Reduced Lower Extremity Strength, Altered Muscle Activation, And Unchanged Kinetics During Single-Leg Squatting In Males With Patellofemoral Pain Versus Pain-Free Males: A Cross-Sectional Analysis, Lisa T. Hoglund, Amy H. Amabile, Thomas Alexander Hulcher, Victoria K. Polansky, Erin L. Dopke

Department of Physical Therapy Faculty Papers

BACKGROUND: Patellofemoral pain is frequently a cause of reduced quality of life in physically active males. The cause of patellofemoral pain is theorized to include aberrant biomechanics during weight-bearing activities. Altered biomechanics of females with patellofemoral pain have been reported, but there is a dearth of research for males with this condition. This study aimed to compare males with and without patellofemoral pain for hip and knee joint moments and muscle activation during single-leg-squatting and proximal muscle strength.

METHODS: Twenty males with patellofemoral pain and 20 pain-free males aged 20-39 years performed single-leg-squatting while motion, ground reaction force, and proximal …

Assessing The Feasibility Of A Self-Management Intervention For Individuals With Advanced Prostate Cancer And Comorbid Type Ii Diabetes Mellitus, Amy L. Shaver, Christina Steinbock-Malfer, William Tester, Patrick Mille, William K. Kelly, Kevin K. Zarrabi, Costas D. Lallas, Mihir M. Shah, Rose Dimarco, Emily Brand, Shawntel Brown, Swapnil Sharma, Nikita Nikita, Cindy Cogen, Scott W. Keith, Grace Lu-Yao

Kimmel Cancer Center Faculty Papers

BACKGROUND: Many older adults with cancer have at least one comorbidity. Type II diabetes mellitus (T2DM) is a common comorbidity among patients with prostate cancer (PC) and represents an important consideration in this population. Comorbid T2DM can negatively impact cancer-specific outcomes for patients, suggesting the need for better glycemic management, especially for patients on active cancer treatment. The goal of this modified Diabetes Self-Management Education Services (mDSMES) pilot study was to provide patients with the opportunity to learn methods of diabetes self-management, including how to manage their glucose levels, improve their understanding and utilization of medication to promote improvements in …

The Relationship Between Depression And Cognitive Proficiency Index Across Biological Sex, Angela N. Ferdinardo

Dissertations

Depression is a widely studied mood disorder, and understanding its effect on cognitive functioning has become an important area of research. While research has examined relationships among depression, working memory, and cognitive deficits, limited research has explored depressive symptoms and cognitive proficiency across biological sex. Depression manifests similarly in men and women, though men are more likely to experience irritability, impulsivity, and anger, while women tend to experience sadness, stress, and sleep disturbances (Johns Hopkins Medicine, 2023). Women are also more likely to seek treatment and cope differently than men. This study examined the relationship between depression and cognitive proficiency …

Association Between Stress Mindset, Psychological Symptoms, And Psychosocial Risk In Liver Transplant Patients, Sarah Kay Brill

Dissertations

Psychosocial functioning is a central component of liver transplant evaluation, yet less is known about how cognitive factors, such as stress mindset, relate to transplant readiness. The present study examined the association between stress mindset and psychosocial risk, as well as its relationship with depressive symptoms, anxiety, and perceived stress among patients undergoing liver transplant evaluation. Patients included 62 adults completing standard pre-transplant assessment measures, including the Stress Mindset Measure–Specific (SMM-S), Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale (PSS). Hierarchical logistic regression analyses indicated that stress mindset was …

Seeing The Unspoken: A Pilot Eye-Tracking Study Of Moral Injury Among Veterans, Eva M. Valdez

Dissertations

This pilot study examined associations between self-reported moral distress, state distress, combat exposure, deployment history, and maximum pupil reactivity among veterans diagnosed with PTSD. Participants viewed neutral and morally relevant images while pupil responses were recorded using eye-tracking technology. Self-report measures included moral distress severity, exposure to potentially morally injurious events, Subjective Units of Distress Scale (SUDS) ratings, total deployments, number of combat deployments, and Combat Exposure Scale scores. Maximum pupil reactivity was calculated by subtracting the mean z-scored maximum pupil response during neutral image presentations from the mean z-scored maximum pupil response during morally relevant image presentations. This variable …

Machine Learning In Flow Cytometry For Acute Myeloid Leukemia Diagnosis: A Scoping Review, Katrina Jezzela M. Dela Pena Md, Mls (Ascp)

Other Specialties

Manuscript version:

Introduction: Flow cytometry is essential for the diagnosis of acute myeloid leukemia (AML), but conventional analysis is labor-intensive, operator-dependent, and increasingly complex. Machine learning (ML) may support automated analysis; however, its readiness for clinical implementation remains unclear. This scoping review mapped ML approaches applied to flow cytometry for AML-related diagnosis.

Methods: PubMed was searched for English-language primary studies applying artificial intelligence, ML, or deep learning to human flow cytometry data for AML diagnosis or classification. Eligible studies reported diagnostic performance metrics. Study characteristics, preprocessing, data representation, model architecture, validation strategy, performance metrics, interpretability, and implementation considerations were descriptively …

Facilitating Occupational Participation In Older Adults With Chronic Pain, Emily K. Ruesch

Occupational Therapy Capstone Presentations

This capstone project developed doctoral-level clinical skills in the management of chronic pain. This capstone project also implemented a six‑week chronic pain management program for independent community‑dwelling older adults at Dow Rummel Village. Eleven adults aged 50–95 participated in weekly 45‑minute group sessions addressing adaptive equipment use, graded exercise, energy conservation, nervous system regulation, stress management, and sleep hygiene. Seven participants completed pre‑ and post‑intervention measures using the Brief Pain Inventory–Short Form and the Pain Self‑Efficacy Questionnaire. A paired samples t‑test assessed changes in pain severity, pain interference, and self‑efficacy. Results demonstrated a decrease in pain severity (t(6) = −3.96, …

Cost-Effectiveness Evaluation Of Artificial Intelligence-Assisted Chest Radiograph Interpretation For Tuberculosis Screening In Rural Health Units In The Philippines, Harold Henrison C. Chiu, Bryan Christopher C. Lao, Gloanne C. Adolor

Graduate School of Business Publications

Background: Tuberculosis remains a major public health burden in the Philippines, where diagnostic delays are amplified by limited radiology capacity in rural health units (RHUs) and geographically isolated and disadvantaged areas (GIDAs). Computer-aided diagnosis (CAD) using artificial intelligence (AI)-assisted chest radiograph interpretation may shorten the screening pathway and reduce reliance on scarce specialist readers. However, its economic value for RHUbased tuberculosis screening has not been fully evaluated.
Methods: We developed a decision-tree cost-effectiveness model in Microsoft Excel 365 to compare AI-assisted chest radiograph interpretation with conventional manual radiologist or teleradiology interpretation among a theoretical annual cohort of 1,000 presumptive tuberculosis …

Feasibility And Acceptability Of An Occupation‑Based Telehealth Intervention For Cancer Survivors: A Pilot Randomized Controlled Trial, Bernard A. Muriithi, Milan Bimali, Mario Schootman

Occupational Therapy Faculty Scholarship

Introduction

Cancer survivors frequently experience occupational performance challenges during early survivorship, and telehealth may offer a feasible approach to deliver interventions during this period.

Methods

This pilot randomized controlled trial included 17 adults in the first year following breast or prostate cancer diagnosis, assigned to the ActiveHeal Cancer Program (ACP) or a control group. ACP consisted of six 75‑minute occupation‑focused virtual group sessions and weekly follow‑up telephone calls delivered by occupational therapists over 12 weeks. Control participants attended three brief virtual meetings without therapeutic intervention. Feasibility and acceptability were assessed using validated measures, attendance, and completion rates. The exploratory outcomes …

Analysis Of The Cannabinoid Compositions, Byproducts And Heavy Metals In Unregulated Cannabinoid Products By Hplc-Ms/Icp-Ms, Simone K. Melle

All NMU Master's Theses

The rapid expansion of unregulated hemp-derived products has created a need for analytical methods that characterize both cannabinoid composition and contaminant occurrence. This thesis used liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify cannabidiol (CBD), Δ8-tetrahydrocannabinol (Δ8-THC), and Δ9-tetrahydrocannabinol (Δ9-THC), and inductively coupled plasma mass spectrometry (ICP-MS) to measure Al, As, Cd, Cr, Cu, Fe, Mg, Ni, Pb, and Zn in commercial hemp-derived products, laboratory-prepared hemp oils, cultivated hemp tissues, extracted material, and post-harvest soil. Commercial products showed wide cannabinoid variability, with several samples containing more than one target cannabinoid, while laboratory-prepared plant oils showed a more consistent profile dominated by …

Parkinson's Disease: Immunometabolic Control Points Across Neural, Vascular, And Peripheral Systems, Y Narvaez Irizarry Felix, Alondr M. Bermudez Adorno, Boris Ermolinsky, Lilia Kucheryavykh, Mikhail Inyushin

School of Integrative Biological & Chemical Sciences Faculty Publications

Parkinson's disease (PD) is a progressive neurodegenerative disorder most associated with degeneration of dopaminergic neurons in the substantia nigra pars compacta. Increasing clinical and experimental evidence, however, indicates that PD is a multisystem disease in which immune, metabolic, vascular, and peripheral nervous system dysfunction precede and shape motor circuit failure. Nonmotor manifestations, including olfactory impairment, sleep and autonomic disturbances, gastrointestinal dysfunction, and cognitive decline, often arise years before motor diagnosis, highlighting pathogenic mechanisms beyond dopamine deficiency alone. In this review, we synthesize evidence supporting the view that PD represents a disorder of chronic immunometabolic dysregulation rather than isolated neuronal loss. …

Recover Well: Reducing Readmissions Through Nurse-Led Follow-Up After Urologic Surgery – A Quality Improvement Project, Candace Brigette Mike

Doctor of Nursing Practice Projects

Hospital readmissions within 30 days following urologic surgeries are often associated with catheter complications, infections, poor pain management, and limited patient understanding of discharge instructions and therefore represent a significant quality and safety concern for patients and institutions alike. The purpose of this quality improvement project was to evaluate whether implementing structured, nurse-led telephone follow-up in conjunction with standard discharge education reduced unplanned 30-day hospital readmissions among adult patients undergoing urologic surgery. Guided by the Logic Model framework, this project used a quasi-experimental, two-group pre- and post-intervention design to compare outcomes at a high-volume outpatient urology clinic in Houston, Texas. …

Quality Improvement Initiative To Improve Adherence To Ob Hemorrhage Policy And Standardize Pitocin Administration During Cesarean Sections To Reduce Postpartum Hemorrhage Risk, Lauren R. Litz, Monica Blauser

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Postpartum hemorrhage remains a leading cause of maternal morbidity and mortality, and Pitocin administration is an important component of hemorrhage prevention and management during cesarean delivery. Variation in Pitocin timing, dosing, method of administration, and adherence to evidence-based recommendations may compromise patient safety and create barriers to standardized obstetric anesthesia care. The purpose of this Doctorate of Nurse Anesthesia Practice quality improvement project was to evaluate current anesthesia provider practices for Pitocin administration during cesarean delivery, compare observed practices with the California Maternal Quality Care Collaborative hemorrhage toolkit and Society for Obstetric Anesthesia and Perinatology Enhanced Recovery After Cesarean recommendations, …

Enhancing Patient Outcomes In Obstetric Neuraxial Anesthesia: Evaluation Of A Structured Documentation Tool For Post-Dural Puncture Headache Tracking (Pdph), Jacqueline Saldana Tovar, Ahmad Hasaan

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

The purpose of this Doctor of Nursing Practice (DNP) project is to evaluate the incidence, management, and practice variation of post-dural puncture headache (PDPH) in an obstetric population using retrospective data from standardized follow-up tools. The project aims to identify inconsistencies in procedural techniques, documentation practices, and adherence to evidence-based guidelines across anesthesia provider levels. By analyzing key clinical variables and patient outcomes, this project seeks to identify gaps in current practice, improve data reliability, and support the development of standardized protocols for PDPH assessment and management. Ultimately, the goal is to enhance quality of care, promote evidence-based decision-making, and …

Enhancing Sbar Documentation And Telecommunication Between Nursing And Anesthesia Teams In The Obstetric And Labor And Delivery Unit, Apollonia C. Anderson, Celeste Meda

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Effective communication during obstetric handoffs is essential for promoting maternal and neonatal safety, yet communication failures remain a significant contributor to adverse events due to inconsistent and unstructured handoff practices. This Doctor of Nursing Anesthesia Practice (DNAP) quality improvement project was developed following the recommendations of the 2025 DNAP project, which implemented the OB/L&D-specific SBAR tool. This project evaluated the use of this communication tool in areas of OB interdisciplinary team communication accuracy, efficiency, and collaboration, particularly during obstetric epidural requests within a community-based labor and delivery unit. Guided by the Plan-Do-Study-Act (PDSA) framework (Institute for Healthcare Improvement, 2020). Utilized …

Dnp Final Report: Improving Diabetes Self-Efficacy Through Nutrition Education: A Quality Improvement Project, Lakimberely S. Wooten

DNP Final Reports

Diabetes affects 12.7% of residents in Northeast Texas and is the 7th leading cause of death. Internal evidence indicates low health literacy and a heavy disease burden in the service area, underscoring the need for a standardized, low-cost, and feasible approach to nutrition education. This quality improvement project evaluated the feasibility of implementing an instructor-led nutrition education session. Guided by the Johns Hopkins Evidence-Based Practice Framework and the ADKAR behavioral change model, adult participants with Type 2 diabetes received instruction on the Plate Method. Participants enrolled in a 4-week, instructor-led diabetes education class completed a 1-hour, nutrition education session using …

Dnp Final Report: Improving School Nurse Confidence In Managing Student Anxiety Through Simulation-Based Training, Jessica Marish

DNP Final Reports

Evidence has shown that students with untreated or poorly managed mental health concerns are at higher risk for absenteeism, psychiatric hospitalization, and school dropout. School nurses are often among the first healthcare professionals students encounter when experiencing emotional distress; however, many report limited preparation in mental health screening, grounding techniques, and referral support. The purpose of this quality improvement project was to determine the feasibility of a simulation-based educational intervention for school nurses in managing student anxiety. Guided by the Johns Hopkins Nursing Evidence-Based Practice Model and Neuman Systems Model, this initiative also included the Plan-Do-Study-Act (PDSA) quality improvement model …

Perceived Effectiveness Of Cigar Warnings Among Young People In The U.S., Leah M. Ranney, Rime Jebai, Michael Jetsupphasuk, Sonia A. Clark, Kristen L. Jarman, Sarah D. Kowitt, Jim Thrasher Ph.D., Ma, Ms, Adam O. Goldstein, Jennifer Cornacchione Ross

Faculty Publications

Introduction: The effectiveness of warning size and format on cigar packaging in influencing youth and young adult smoking behaviors is not well understood. This study tested these cigar warning characteristics among youth and young adults who use or are susceptible to using little cigars or cigarillos.

Methods: The study recruited 506 U.S. youth and young adults, aged 15−20 years, between April and June 2023. Participants reported ever or past 30-day use of little cigars or cigarillos or were susceptible to using little cigars or cigarillos. A 2 £ 2 between-subjects online experiment was conducted where youth and young adults were …

Supporting Occupational Engagement And Regulation For Pediatric Multiple Sclerosis, Robert E. Oehl 3rd, Zeida Gutierrez

Summer 2026 OTD Capstone Symposium

Children diagnosed with pediatric multiple sclerosis (MS) can face cognitive, physical, and emotional symptoms. The symptoms they experience can be barriers to participation in occupations and activities of daily living. For occupational therapy, there is very limited resources for pediatric MS specifically, and it is almost an unknown diagnosis. Occupational therapy in management can help ensure that children reach their developmental milestones in mobility, grasp, social, cognitive, and academic circles. This capstone project was meant to improve awareness and comprehensive treatment and resources through program development. The capstone experience resulted in a project featuring a webinar about pediatric MS and …

Unleashing Potential: Educating Ot Practitioners On Animal-Assisted Therapy For Children With Cp, Karley B. Smith, Lakeisa Boykin

Summer 2026 OTD Capstone Symposium

The purpose of this capstone project is to develop and evaluate the efficacy of an animal-assisted therapy educational package for occupational therapy practitioners treating children with cerebral palsy. This educational package serves as an adjunctive occupational therapy service to address the ongoing need for engaging, holistic interventions that support motor development and participation. The primary focus of this project is practitioner education and training to promote safe, structured, and clinically sound integration of animal-assisted therapy into occupational therapy practice. The methods for this project included a literature review, informal needs assessment, development of an educational package, QR code video demonstrations, …

​​Hospital-Acquired Pressure Injury Prevention In The Sutter Sacramento Cardiac Care Unit ​Qi Proposal, Angelina Lucido, Amy Roderick, Karly Link

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Background: Hospital-acquired pressure injuries (HAPIs) remain a significant source of preventable patient harm despite established prevention protocols. In the Cardiac Care Unit (CCU) at Sutter Medical Center Sacramento, inconsistent patient education and limited patient engagement were identified as potential contributors to ongoing HAPI occurrence. This quality improvement (QI) project evaluated whether implementing structured, individualized patient education could strengthen existing pressure injury prevention efforts.

Methods: A seven-week QI project was conducted in the CCU using the Plan-Do-Study-Act (PDSA) framework. The intervention consisted of nurse-led, individualized pressure injury prevention (PIP) education supported by a standardized patient handout tailored to each patient's risk …

Reducing Falls In The Cardiac Care Unit: An Improvement Project, Andrea Otero, Aryanna Campa, Nia Butac

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Abstract

Background: Patient falls persist as a leading cause of preventable harm in hospitals, particularly among cardiac care patients who are at increased risk because of medication effects and mobility limitations. Despite existing fall `prevention measures in the Cardiac Care Unit (CCU) at Sutter Medical Center, Sacramento, 43 falls occurred, highlighting the need for improved patient education and consistent staff communication.

Purpose: This quality improvement project evaluated the effectiveness of implementing a standardized fall prevention communication script to reduce the average monthly fall rate in the CCU from 3.583 to fewer than 2 falls per month.

Methods: Using the Plan-Do-Study-Act …

Improving Clostridioides Difficile Prevention Practices Through Standardized Stool Collection And Hand Hygiene, Dunya Khateeb, Laura Martin, Jessica Zhang

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

Healthcare-associated Clostridioides difficile (C. diff) infections increase patient morbidity, length of stay, and healthcare costs (Simor, 2010). Our quality improvement project seeks to reduce C. diff infection rates and enhance prevention practices on the Med-Acute Unit at Sutter Medical Center Sacramento (SMCS) by utilizing the Plan-Do-Study-Act (PDSA) framework. Interventions will be implemented between March 2026 and July 2026. The project examined whether introducing a standardized stool collection tote and improving hand hygiene compliance would reduce C. diff infection rates. Participants included all nursing staff on the unit. Data is being collected through observational hand hygiene audits, collaboration with the SMCS …

Improving Knowledge Of Obesity-Related Risks And Healthy Lifestyle Behaviors In Adolescents, Tehroop Notra, Samreet Kaur, Karina Heredia

ELMSN E-Portfolio. A collection of Scholarly and Creative Works

This quality improvement project evaluated the effectiveness of a school-based educational intervention aimed at improving ninth-grade students’ knowledge and understanding of obesity prevention, nutrition, and physical activity. Adolescent obesity remains a significant public health concern, showcasing the need for early, evidence-based education. A total of 57 students participated in the two classroom sessions. Of these students, 49 completed the pre-intervention survey, and 48 completed the post-intervention survey. The intervention included an interactive presentation, group discussions, and educational materials. Student knowledge was assessed using a six-item survey administered before and after the session. The results demonstrated improvements across multiple knowledge areas, …

Id-More Vision: Real-Data Machine-Learning Assessment For A Digital-Twin-Inspired, Xr-Ready Rehabilitation Prototype, Rickey L. Clark

Master's Theses

Rehabilitation assessment often relies on periodic observation, while many XR prototypes show scripted rather than recorded-motion evidence. iD-MORE Vision is an offline pipeline trained on KIMORE and IRDS and linked through JSON packets to a two-mode Unity desktop prototype. Both datasets include controls and rehabilitation participants with neurologic, musculoskeletal, or mobility impairments. This improves relevance but does not clinically validate the system.

Under fixed subject-wise splits, the primary five-seed Random Forest predicted KIMORE clinician scores with MAE 6.087 ± 0.044 cTS and R² 0.568 ± 0.006; the subject-level R² interval crossed zero. The primary IRDS five-run CUDA GRU averaged 0.877 …

Characterization Of Catechol-Type Siderophore(S) From P. Mosselii Cfml 90-83, Kemper R. Rasnake

Electronic Theses and Dissertations

Iron is essential for many biological processes, where it is used as a cofactor. Even though it is abundant in the Earth’s crust, it is in an insoluble form unavailable to microorganisms in the soil. To overcome this, bacteria produce siderophores, which are secondary metabolites that have a high affinity for iron. This allows bacterial cells to obtain insoluble iron that is essential for survival. Pseudomonas mosselii, a Gram negative bacterium, was isolated from soil. It was selected for further analysis as it was found to produce siderophore(s) under iron-limited conditions, which have not been characterized previously. Therefore, we aimed …

A Geometric Morphometric Analysis Of Acetabular Shape Variation Across Bat Families, Jordan L. Huff

Electronic Theses and Dissertations

Bats are the only mammals capable of powered flight, and research is concentrated on this adaptation. Their non-flight locomotion has received comparatively little attention. Previous studies show that non-flight locomotor behaviors vary across families. Members of Pteropodidae are efficient climbers but cannot effectively walk, whereas Phyllostomidae and Vespertilionidae are better at terrestrial locomotion but show reduced arboreal capabilities. The non-flight locomotion of Hipposideridae and Rhinolophidae is less understood, although rhinolophids exhibit limited terrestrial locomotion. This study examined whether differences in locomotor behavior are associated with variation in acetabular morphology. A geometric morphometric analysis of acetabular shape was conducted across multiple …

Weathering More Than Storms: Understanding The Mental Health Disparities Of Black Farmers In The Appalachian Region, Aliyah Smith

Electronic Theses and Dissertations

Black farmers in Appalachia represent a vital and historically marginalized population within one of America’s most economically distressed regions. Black farmers have endured generations of systemic racism, resulting in land loss, economic hardship, and mental stressors. This study examines the intersection of race, agriculture, and behavioral health to illustrate how structural barriers and cultural stigmas shape the mental well-being of Black farmers across Appalachia.

Findings from the analysis will guide the development of a conceptual model based on constructs from the Social-Ecological Model (SEM), Intersectionality Theory, and Critical Race Theory (CRT). This study will use Key Informant Interviews (KIIs) conducted …

A Longitudinal Multi‑Proxy Geospatial Classification Of Peri‑Urban Transitions Across Community Health Units In Coastal Kenya, Prissy Makena, Felix Oluoch, Rosebella Iseme, Fredrick Gudda, Alfred Keter, Jai Das, Zulfiqar Bhutta, Anthony Ngugi

Population Health, East Africa

Background Urbanization is spatially heterogeneous in many sub-Saharan African settings. This complicates community health planning when rural and peri-urban labels are applied informally or updated inconsistently. We assessed whether multiple publicly available geospatial proxies could characterize settlement dynamics and support Community Health Unit (CHU) level classification within the Kaloleni Rabai Health and Demographic Surveillance System (KRHDSS) in coastal Kenya.

Methods We conducted a longitudinal ecological analysis across 10 CHUs in Kilifi County with annual observations from 2017 to 2024. Five geospatial proxy indicators of settlement intensity were summarized within CHU boundaries: Visible Infrared Imaging Radiometer Suite (VIIRS) nighttime lights radiance, …