Digital Commons Network^™

Detection And Monitoring Of Stress Using Wearables: A Systematic Review, Anuja Pinge, Vinaya Gad, Dheryta Jaisinghani, Surjya Ghosh, Sougata Sen

Faculty Publications

Over the last few years, wearable devices have witnessed immense changes in terms of sensing capabilities. Wearable devices, with their ever-increasing number of sensors, have been instrumental in monitoring human activities, health-related indicators, and overall wellness. One health-related area that has rapidly adopted wearable devices is the mental health monitoring and well-being area, which covers problems such as psychological distress. The continuous monitoring capability of wearable devices allows the detection and monitoring of stress, thus enabling early detection of mental health problems. In this paper, we present a systematic review of the different types of sensors and wearable devices used …

Feasibility Of Large Language Models For Ceus Li-Rads Categorization Of Small Liver Nodules In Patients At Risk For Hepatocellular Carcinoma, Jiayan Huang, Rui Yang, Xiaotong Huang, Keyu Zeng, Yan Liu, Jun Luo, Andrej Lyshchik, Qiang Lu

Department of Radiology Faculty Papers

BACKGROUND: Large language models (LLMs) offer opportunities to enhance radiological applications, but their performance in handling complex tasks remains insufficiently investigated.

PURPOSE: To evaluate the performance of LLMs integrated with Contrast-enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) in diagnosing small (≤20mm) hepatocellular carcinoma (sHCC) in high-risk patients.

MATERIALS AND METHODS: From November 2014 to December 2023, high-risk HCC patients with untreated small (≤20mm) focal liver lesions (sFLLs), were included in this retrospective study. ChatGPT-4.0, ChatGPT-4o, ChatGPT-4o mini, and Google Gemini were integrated with imaging features from structured CEUS LI-RADS reports to assess their diagnostic performance for sHCC. …

Achieving Inter- And Transdisciplinarity In Ecohealth: Insights From A Rodent-Borne Disease Project In A Polycrisis Era, Isabelle Arpin, Clémence Massart, Vincent Bourret, Guillaume Castel, Valeria Carolina Colombo, Jana Eccard, Jasmin Firozpoor, Maciej Grzybek, Heikki A. Henttonen, Herwig Leirs, Andrew Mcmanus, Ben Roche, Tarja Sironen, Vincent Sluydts, Peter Stuart, Annetta Zintl, Nathalie Charbonnel

Publications

Introduction: Inter- and transdisciplinary research (ITDR) is increasingly promoted to address “wicked problems”, particularly in health sectors adopting approaches like Ecohealth. Our Ecohealth-inspired project on rodent-borne diseases, initiated just before the COVID-19 pandemic, provided an opportunity to evaluate ITDR implementation.

Methods: We employed a recently developed semi-quantitative evaluation method to measure our project’s success in achieving ITDR and analyzed factors influencing this achievement.

Results: The project showed strengths in system description, team task allocation, and data sharing, but had lower scores in engaging societal actors throughout the project cycle.

Discussion: We identified the underexplored influence of problem wickedness as a …

Examining The Internet Hunting Styles Of Violent Sexual Predators Who Rape And Murder Their Victims, Rebecca Meyers

Walden Dissertations and Doctoral Studies

The proposed study sought to explore the impact of the internet on the hunting styles of sexual predators who sexually assault and kill their victims. A sample of 32 cases, divided equally among offenders who used the internet to target adult females and those who did not use the internet, was used for the study. The findings showed that various internet-based platforms were used for targeting, including dating apps such as Grindr, Match.com, Meetme.com, Tinder, Craigslist, Sex chat rooms, Kik Messenger, and BDSM sites. Three themes emerged about the impact of the internet on the hunting styles of sexual predators …

Strategies Small Business Leaders Use To Retain Employees To Reduce Turnover Costs, Karla Gilchrist-Saunders

Walden Dissertations and Doctoral Studies

Failure to retain employees negatively affects organizational financial sustainability. Small business leaders become concerned when their organizations fail to retain employees, resulting in increased costs and decreased competitiveness, organizational knowledge, team dynamics, and valuable human resources. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry study was to identify and explore leadership strategies some small business leaders use to retain employees to reduce turnover costs. The participants were six small business leaders in the Washington, DC, metropolitan area with successful strategies used to retain employees to reduce turnover costs. Data were collected from semistructured interviews and publicly …

Structural Variant Allelic Heterogeneity In Mecp2 Duplication Syndrome Provides Insight Into Clinical Severity And Variability Of Disease Expression., Davut Pehlivan, Jesse D. Bengtsson, Sameer S. Bajikar, Christopher M. Grochowski, Ming Yin Lun, Mira Gandhi, Angad Jolly, Alexander J. Trostle, Holly K. Harris, Bernhard Suter, Sukru Aras, Melissa B. Ramocki, Haowei Du, Michele G. Mehaffey, Kyunghee Park, Ellen Wilkey, Cemal Karakas, Jesper J. Eisfeldt, Maria Pettersson, Lynn Liu, Marwan S. Shinawi, Virginia E. Kimonis, Wojciech Wiszniewski, Kyle Mckenzie, Timo Roser, Angela M. Vianna-Morgante, Alberto S. Cornier, Ahmed Abdelmoity, James P. Hwang, Shalini N. Jhangiani, Donna M. Muzny, Tadahiro Mitani, Kazuhiro Muramatsu, Shin Nabatame, Daniel G. Glaze, Jawid M. Fatih, Richard A. Gibbs, Zhandong Liu, Anna Lindstrand, Fritz J. Sedlazeck, James R. Lupski, Huda Y. Zoghbi, Claudia M B Carvalho

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: MECP2 Duplication Syndrome, also known as X-linked intellectual developmental disorder Lubs type (MRXSL; MIM: 300260), is a neurodevelopmental disorder caused by copy number gains spanning MECP2. Despite varying genomic rearrangement structures, including duplications and triplications, and a wide range of duplication sizes, no clear correlation exists between DNA rearrangement and clinical features. We had previously demonstrated that up to 38% of MRXSL families are characterized by complex genomic rearrangements (CGRs) of intermediate complexity (2 ≤ copy number variant breakpoints < 5), yet the impact of these genomic structures on regulation of gene expression and phenotypic manifestations have not been investigated.

METHODS: To study the role of the genomic rearrangement structures on an individual's clinical phenotypic variability, we employed a comprehensive …

Strategies Small Business Leaders Use To Retain Employees To Reduce Turnover Costs, Karla Gilchrist-Saunders

Walden Dissertations and Doctoral Studies

Failure to retain employees negatively affects organizational financial sustainability. Small business leaders become concerned when their organizations fail to retain employees, resulting in increased costs and decreased competitiveness, organizational knowledge, team dynamics, and valuable human resources. Grounded in transformational leadership theory, the purpose of this qualitative pragmatic inquiry study was to identify and explore leadership strategies some small business leaders use to retain employees to reduce turnover costs. The participants were six small business leaders in the Washington, DC, metropolitan area with successful strategies used to retain employees to reduce turnover costs. Data were collected from semistructured interviews and publicly …

Autoethnographic Examination Of Moral Distress While Working For The For-Profit Substance Use Disorder Treatment Sector, Kapil Nayar

Walden Dissertations and Doctoral Studies

Interpersonal conflicts and moral distress due to authority figures' unethical and illegal practices are widely discussed topics in the literature. Coping with these experiences and becoming a whistleblower, however are understudied in the counseling field, and are often stigmatized yet advocated for in our codes of ethics. The purpose of this qualitative autoethnographic study is to (1) show moral distress exists in the for-profit sector of substance use disorder treatment; (2) moral distress results from counselors discovering evidence of unethical and illegal activities; (3) moral distress results from the act of blowing the whistle and (4) offers a roadmap for …

Deceased Donor Renal Allograft Utility In Adult Single And Multi-Organ Transplantation In The United States, Peter J. Altshuler, Adam S. Bodzin, Kenneth A. Andreoni, Pooja Singh, Anju Yadav, Jaime M. Glorioso, Ashesh P. Shah, Carlo B. Ramirez, Warren R. Maley, Adam M. Frank

Department of Surgery Faculty Papers

BACKGROUND: Deceased donor multiorgan transplants utilizing kidneys (MOTs) can improve outcomes for multiorgan recipients but reduces kidneys for chronic renal failure patients.

METHODS: We reviewed the Organ Procurement and Transplantation Network database from 2015 through 2019, for adult deceased donor kidney transplants. Recipients were classified as kidney transplant alone (KTA) (n = 62,252) or MOTs pancreas-kidney, simultaneous pancreas-kidney (n = 3,976), liver-kidney, simultaneous liver-kidney (n = 3,212), heart-kidney, simultaneous heart-kidney (n = 808), and "other"-kidney, simultaneous "other" kidney (n = 73).

RESULTS: Liver, heart, and lung-alone transplants were at least 7 times more frequent than their MOT correlate, whereas the …

Sensitivity And Application Of Frequency Domain High-Density Diffuse Optical Tomography (Fd Hd-Dot), Weihao Fan

Arts & Sciences Graduate Student Theses and Dissertations

Functional near-infrared spectroscopy (fNIRS) is a non-invasive imaging technique that measures hemodynamic responses in the brain, similar to functional magnetic resonance imaging (fMRI) but with distinct advantages. By utilizing near-infrared light, fNIRS can penetrate biological tissues and detect changes in oxygenated and deoxygenated hemoglobin. Additionally, fNIRS is portable, noninvasive and inexpensive. Within the realm of fNIRS, several measurement techniques exist, including Continuous Wave (CW), Frequency Domain (FD), and Time Domain (TD) methods. In this dissertation, we focused on the effects, fundamental principles and applications of FD designs. We provided the introduction in Chapter 1, and discussed the background theory and …

Amorfe: An Ai-Integrated Interactive Brainstorming Interface, Ipshita Pal

Theses

Amorfe is an interactive multi-touch digital interface that reimagines brainstorming and collaboration using artificial intelligence (AI). Designed to make ideation more dynamic, the platform allows participants to explore, merge, and refine ideas in real time. AI is a creative catalyst, offering unpredictable outcomes and streamlining the brainstorming process. This makes Amorfe engaging, intuitive, and inclusive, encouraging active participation. The platform’s potential was demonstrated through a hypothetical scenario: “How do we create more green spaces on the RIT campus?” Four participants explored various brainstorming phases through touch interaction, leading to the creation of a prototype simulation video and a promotional video. …

Dissonance, Shreya Talegaonkar

Theses

Cognitive dissonance represents a profound psychological phenomenon where conflicting beliefs create mental tension. My thesis, Dissonance, transforms this abstract concept into an immersive multimedia installation that visually explores the human mind's intricate journey of reconciling internal contradictions. Using Cinema 4D, Adobe AfterEffects, and Resolume Arena, the project creates dynamic 3D animations projection-mapped across an 8x8x6 cubic feet space. Carefully designed blackout curtains and strategic seating immerse participants in a transformative narrative of psychological exploration. Audiences navigate through four distinct phases: Consistency, Chaos, Turmoil, and Adaptation. Each phase invites viewers to experience the unsettling yet profound journey of internal conflict resolution, …

Legacy Effects Of Crop Diversity On Weed-Crop Competition In Maize Production, Uriel D. Menalled, K Ann Bybee-Finley, Richard G. Smith, Antonio Ditommaso, Heather M. Darby, Sarah J. Pethybridge, Matthew R. Ryan

Faculty Publications

The legacy effects of crop diversity on maize (Zea mays L.) tissue nutrient composition, weed community structure, and intensity of weed-crop competition were assessed through a field experiment at two sites in the northeastern United States. Fields were conditioned with crop diversity gradients from summer 2016 to spring 2019. The crop diversity gradients ranged from a single cultivar to sixteen intercropped cultivars (four species, four cultivars per species) and were established in organic annual and perennial cropping systems. Following the three-year conditioning phase, maize was planted across the entire experiment, and each conditioning-phase diversity treatment was split into weed-free, ambient-weed, …

Legacy Effects Of Crop Diversity On Weed-Crop Competition In Maize Production, Uriel D. Menalled, K Ann Bybee-Finley, Richard G. Smith, Antonio Ditommaso, Heather M. Darby, Sarah J. Pethybridge, Matthew R. Ryan

Faculty Publications

The legacy effects of crop diversity on maize (Zea mays L.) tissue nutrient composition, weed community structure, and intensity of weed-crop competition were assessed through a field experiment at two sites in the northeastern United States. Fields were conditioned with crop diversity gradients from summer 2016 to spring 2019. The crop diversity gradients ranged from a single cultivar to sixteen intercropped cultivars (four species, four cultivars per species) and were established in organic annual and perennial cropping systems. Following the three-year conditioning phase, maize was planted across the entire experiment, and each conditioning-phase diversity treatment was split into weed-free, ambient-weed, …

How Do Female Arab International Students Negotiate Their Identities In The Esl Classroom In The Mid-Southern United States?, Sinaria Elmardi Hassan

Electronic Theses and Dissertations Archive

This dissertation explores how women of Islamic faith, as international students, negotiate their identities within the ESL classrooms in the mid-southern United States. Students in such categories face singular challenges at each juncture of gender, religion, and cultural background, especially in an educational system that does not always recognize or accommodate particular needs and experiences. The qualitative research design involved in-depth interviews with female Muslim students from various countries. This study aimed to determine how these students balanced their cultural and religious lives amidst the demands of the American academic environment, particularly in ESL settings where language acquisition was a …

Multi-Antigen Elephant Endotheliotropic Herpesvirus (Eehv) Mrna Vaccine Induces Humoral And Cell-Mediated Responses In Mice, Jessica R Watts, Jennifer L Spencer Clinton, Jeroen Pollet, Rongsheng Peng, Jie Tan, Paul D Ling

Faculty, Staff and Students Publications

Background/Objectives: Elephant endotheliotropic herpesvirus (EEHV) causes lethal hemorrhagic disease (HD) in Asian and African elephants in human care and the wild. It is the leading cause of death for young Asian elephants in North American and European zoos despite sensitive diagnostic tests and improved treatments. Thus, there is a critical need to develop an effective vaccine to prevent severe illness and reduce mortality from EEHV-HD. We generated a multi-antigenic EEHV mRNA vaccine to address this need that encodes the EEHV1A-subtype glycoproteins gB, gH, gL, and gO. These conserved proteins are the entry machinery for several herpesviruses in the betaherpesvirus subfamily …

Office Of Research, Economic Engagement And Outreach Update, December 18, 2024, Office Of Research, Economic Engagement And Outreach

Office of Research, Economic Engagement and Outreach

No abstract provided.

Lindenwood Digest, December 18, 2024, Lindenwood University

Lindenwood Digest

The Lindenwood Digest has been a digital employee newsletter since 2009.

Patterns Of Grief And Bereavement Following A Covid Death, Karuna Thomas

Arts & Sciences Graduate Student Theses and Dissertations

The large number of deaths due to COVID-19 has resulted in a similarly high number of people experiencing grief. The aim of this qualitative study was to understand patterns of grief and bereavement following a COVID death. Semi-structured interviews were conducted with individuals who had lost someone close to them to COVID (N = 32). Thematic analysis was used to identify themes and patterns. Participants described specific features of COVID as well as the interdependence within the community that shaped their unique experiences of grieving a COVID death. These unique experiences, in turn, led to disruptions in coping and …

Multi-Omic Analysis Of Phototrophic Extracellular Electron Uptake In Novel Rhodovulum Spp. Isolated From A Marine Estuary, Emily J. Davenport

Arts & Sciences Graduate Student Theses and Dissertations

Microbial metabolisms are incredibly versatile and dynamic, allowing adaptive strategies for growth in even the most limiting environments. For an ever-increasing number of microbes, this includes utilizing soluble or insoluble inorganic mineral species as electron donors, driving geochemical cycles and microbial metabolisms. This metabolic function of transporting electrons derived from the extracellular environment across cell membranes is called extracellular electron uptake (EEU). Within (photo)autotrophs, (p)EEU also sustains CO2 fixation to cell biomass, implicating a potentially fundamental role of microbial carbon cycling in aquatic and soil ecosystems. A model metabolic scheme of pEEU occurring in natural environments is photoferrotrophy, which pairs …

A Computational And Mathematical Approach To The Preclinical Development Of Alpha Emitting Radiopharmaceutical Therapies, Abdulaziz Said

McKelvey School of Engineering Graduate Student Theses & Dissertations

Numerous candidate nuclides have been undergoing rigorous preclinical development in the pursuit of novel targeted therapies. Successful development of these drugs relies on the understanding of physiological impacts at the macro and micro scales, in addition to a scalable process for their production. Here, mathematical and computerized approaches have been developed to guide this preclinical development. In this report, two alpha emitting nuclides Pb-212 and Ra-223 are modeled. Radium-223 dichloride citrate a newly approved ion indicated for treatment of bone metastatic castrate resistant prostate cancer, irradiates lesions through targeted uptake in bone at sites of disease. We have undertaken the …

Brazilian Instrumental Music, U.S. Jazz, And Transnationalism: A Study Of National Identity In The Twentieth Century And Present, Felipe Guz Tinoco

Arts & Sciences Graduate Student Theses and Dissertations

This dissertation considers the relationship between Brazilian instrumental music, U.S. jazz, and Brazilian national identity from the early twentieth century to the present. Though the time frame is broad, the present work uses nationalism as an anchoring point through which I analyze multiple musical genres. Previous works have primarily examined songs and lyrics, particularly during the military dictatorship (1964-85), when words against the regime were censored and songwriters persecuted. However, listeners and musicians of instrumental music also engaged with discourses of national identity in profound terms before, during, and after this period, posing ideals of Brasilidade against cultural productions abroad, …

Rental Property Demand And Supply Analysis Using Machine Learning, Ahmed Amiri

Theses

The real estate market in Dubai is famous for its activity and stimulating potential due to the geographical position of the emirate, well-developed transport and legal framework. Timely determination and prediction of rental price is crucial for investors, property owners and managers, tenants and authorities in their decision making to maximize returns and ensure market stability. Traditional approaches are insufficient for the analysis of the temporal and spatial relations between property characteristics and market processes, which require the use of sophisticated machine learning algorithms. This paper aims to predict the rental prices of properties in Dubai using machine learning models …

Social Media Intelligence: Responding To Crime And Violence In The Digital World, Chloe Lynn Sitton

Theses

The integration of social media into everyday life has transformed how crime is committed, communicated, and investigated. This capstone project examines the emerging field of social media intelligence and its growing influence on modern policing, surveillance, and the community. Drawing from sociological theory, law enforcement practice, legal analysis, and community-based research, this project offers a far-reaching interdisciplinary view of how social media is shaping crime and justice in the United States.

Structural Variant Allelic Heterogeneity In Mecp2 Duplication Syndrome Provides Insight Into Clinical Severity And Variability Of Disease Expression, Davut Pehlivan, Jesse D Bengtsson, Sameer S Bajikar, Christopher M Grochowski, Ming Yin Lun, Mira Gandhi, Angad Jolly, Alexander J Trostle, Holly K Harris, Bernhard Suter, Sukru Aras, Melissa B Ramocki, Haowei Du, Michele G Mehaffey, Kyunghee Park, Ellen Wilkey, Cemal Karakas, Jesper J Eisfeldt, Maria Pettersson, Lynn Liu, Marwan S Shinawi, Virginia E Kimonis, Wojciech Wiszniewski, Kyle Mckenzie, Timo Roser, Angela M Vianna-Morgante, Alberto S Cornier, Ahmed Abdelmoity, James P Hwang, Shalini N Jhangiani, Donna M Muzny, Tadahiro Mitani, Kazuhiro Muramatsu, Shin Nabatame, Daniel G Glaze, Jawid M Fatih, Richard A Gibbs, Zhandong Liu, Anna Lindstrand, Fritz J Sedlazeck, James R Lupski, Huda Y Zoghbi, Claudia M B Carvalho

Faculty, Staff and Students Publications

BACKGROUND: MECP2 Duplication Syndrome, also known as X-linked intellectual developmental disorder Lubs type (MRXSL; MIM: 300260), is a neurodevelopmental disorder caused by copy number gains spanning MECP2. Despite varying genomic rearrangement structures, including duplications and triplications, and a wide range of duplication sizes, no clear correlation exists between DNA rearrangement and clinical features. We had previously demonstrated that up to 38% of MRXSL families are characterized by complex genomic rearrangements (CGRs) of intermediate complexity (2 ≤ copy number variant breakpoints < 5), yet the impact of these genomic structures on regulation of gene expression and phenotypic manifestations have not been investigated.

METHODS: To study the role of the genomic rearrangement structures on an individual's clinical phenotypic variability, we employed a comprehensive …

Methodological Report Of A Cross-Sectional Survey Of Abortion-Related Knowledge, Attitudes And Practices Amongst Health Professionals In Britain, Strategies Adopted And Lessons Learned: Evidence From The Sacha Study, The Sacha Study Team, R. S. French, M. J. Palmer, O. Mccarthy, N. Salaria, R. Meiksin, J. Shawe, M. Lewandowska, R. Scott, K. Wellings, G. Wong, S. Sheldon, J. Reiter, W. V. Norman, C. Murphy, P. A. Lohr, L. Keogh, C. Free, S. Cameron, P. Baraitser, A. Aronsson

School of Nursing and Midwifery

Background: Most surveys examining health professionals’ knowledge, attitudes and practices around abortion have used convenience samples and have targeted doctors. Our goal in the SACHA Study, drawing on evidence-based strategies to maximise response rates, was to achieve a representative sample of a wider range of health professionals, working in general practice, maternity services, pharmacies, sexual and reproductive health (SRH) clinics and specialist abortion services in Britain, to explore the knowledge, attitudes and experience of abortion care and views on future models of delivery. Methods: A cross-sectional questionnaire-based survey of midwives, doctors, nurses and pharmacists in England, Scotland and Wales was …

Interaction Of Cumulus-Oocyte Complex (Coc) Number, Oocyte Quality, And Blastocyst Numbers By Repeated Ovum Pick-Up (Opu) In In Vitro Embryo Production, Sakine Ülküm Çizmeci, Dursun Ali Dinc, Mustafa Numan Bucak, Ömer Faruk Yesilkaya, Muhammed Furkan Ciftci, Mehmet Buğra Kivrak, Ayşe Sari, Hasan Ali Cay, Maide Golbasi, Mustafa Bodu

The Thai Journal of Veterinary Medicine

Ovum pick-up (OPU) is a repeatable technique that is used for the retrieval of large numbers of immature oocytes from the antral follicles of live animals. The aim of the present study was to determine the effect of repeated OPU application on cumulus-oocyte complex (COC) number, oocyte quality, and blastocyst rates. The animal material for the study consisted of 10 Holstein heifers. Heifers selected as donors were administered OPU a total of 9 times on random days of the cycle at 1-week intervals. All antral follicles with a diameter of 2-8 mm were aspirated during the OPU procedure. In vitro …

Teaching Sociology Through Reality Tv: Understanding Society Through The Small Screen, Monica Bixby Radu

Journal on Empowering Teaching Excellence

Access the online Pressbooks version of this introduction here.

This article explores reality TV’s value in teaching sociological concepts and theories for a better understanding contemporary society. Reality TV serves as a rich canvas for illustrating key tenets of major sociological theories such as structural functionalism, conflict theory, and symbolic interactionism. By analyzing reality TV through a sociological lens, insights into societal dynamics emerge, revealing how individuals navigate social norms. Additionally, reality TV serves as a cultural mirror, reflecting and shaping societal values. Globally, it influences cultural attitudes and social dynamics, transcending geographical boundaries through adaptations and social media engagement. …

Full Issue: Journal On Empowering Teaching Excellence, Volume 8, Issue 2, Fall 2024

Journal on Empowering Teaching Excellence

The full-length Spring 2024 issue (Volume 8, Issue 1) of the Journal on Empowering Teaching Excellence

Access the online Pressbooks version (with downloadable EPUB format) here.

The Fall 2024 issue presents practical ideas and prompts for those who teach at colleges and universities in a variety of disciplines. Articles ways to use popular culture (in this case, reality TV) to teach higher-level concepts; strategies for adapting Lesson Study techniques for preservice teachers; and a review of McNair et al.'s 2022 book on creating student ready colleges.

Leveraging Gamification And Social Media To Teach Heart Failure Clinical Practice Guidelines In Entry-Level Physical Therapist Education, Kaelee Brockway

Journal of Innovation in Health Sciences Education

Introduction: Clinical practice guideline adherence remains a challenge in health care, with reported rates as low as 26%. Research shows multiple barriers to adherence, including limited access and guideline complexity. Integrating guidelines into education is crucial, demanding innovative methods to enhance translation into practice.

Methods: This multiple methods study explored application of the substitution, augmentation, modification, and redefinition model to integrate social media and gamification activities to engage students in learning action statements of a clinical practice guideline for the management of heart failure. Performance on exam items relevant to the guideline content were used to determine if this …