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Background Student Evaluations of Teaching (SET), of individual instructors and of courses, are routinely utilized by university administrators for consequential decisions regarding individual faculty members, courses, and curricula. Despite their ubiquity, much evidence exists that they are biased, amongst other factors by expected and received student grades. To our knowledge, this issue has not been examined in veterinary education until recently. Furthermore, it remains unclear whether observed combinations of higher grades and more favorable student evaluations using common survey instruments reflect enhanced learning. Our study evaluates the relationship between (A) student evaluations of courses in a veterinary curriculum, (B) grades earned in those courses, and (C) an independent measure of learning in those subjects. Methods The Veterinary Educational Assessment (VEA) is an independent, external examination in basic sciences subjects prepared by the National Board of Medical Examiners and administered by the International Council for Veterinary Assessment and is taken by Ross University School of Veterinary Medicine (RUSVM) students in their fifth semester of study. It offers an external means of measuring student learning in specific subjects and relating them to course evaluations. RUSVM has three terms each year with three separate intakes of students. Course evaluations and student grades were recorded for courses from fall 2018 to summer 2022, spanning 12 cohorts of students, and 160 individual courses. Courses were aligned to the relevant section of the VEA taken by each cohort. Spearman correlation coefficients were calculated. Results Mean course evaluations were significantly positively correlated to median grade in the course ( rho  = 0.35, P  < 0.0001) and the proportion of students earning A-grades ( rho  = 0.38, P  < 0.0001). The relationship between course evaluation and relevant VEA score was negative ( rho  = -0.18, P  = 0.02), indicating that students judged courses favorably when higher grades were expected without necessarily learning more from those courses. Conclusions We confirmed the well-known relationship between SET and student grades but, for the first time in veterinary medicine, describe a small but negative and statistically significant relationship between SET and an independent measure of learning. SET should be interpreted with caution; their use for evaluation of teachers or courses may have unintended consequences including reduced expectations for student achievement.

A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the ability of Echinacea purpurea to prevent infection with rhinovirus type 39 (RV-39). Forty-eight previously healthy adults received echinacea or placebo, 2.5 mL 3 times per day, for 7 days before and 7 days after intranasal inoculation with RV-39. Symptoms were assessed to evaluate clinical illness. Viral culture and serologic studies were performed to evaluate the presence of rhinovirus infection. A total of 92% of echinacea recipients and 95% of placebo recipients were infected. Colds developed in 58% of echinacea recipients and 82% of placebo recipients (P = .114, by Fisher's exact test). Administration of echinacea before and after exposure to rhinovirus did not decrease the rate of infection; however, because of the small sample size, statistical hypothesis testing had relatively poor power to detect statistically significant differences in the frequency and severity of illness.

Adhesion of thin or thick films on substrates is a critical issue in systems where the thermal-expansion coefficients of the coating and bulk material are significantly different from each other. The large mismatch of the expansion coefficients results in the generation of very high stresses in the coating that may lead to delamination, cracking, or other deleterious effects. A method to increase the adherence of diamond coatings on tungstencarbide and stainless steel substrates is reported based on a substrate-modification process that creates a three-dimensional thermally and compositionally graded interface. Scratch and indentation tests on diamond-coated steel and tungsten-carbide samples did not exhibit film fracture at the interface and concomitant catastrophic propagation of interfacial cracks.

The effects of high blood pressure on growth are not fully understood and while hypertension may be associated with failure to thrive, hypertension causing failure to thrive in children is poorly documented. We describe four children presenting with failure to thrive due to hypertension consequent to various aetiologies. Control of hypertension with appropriate therapy resulted in improved growth. The exact pathogenesis of failure to thrive in hypertensive children is not known. These cases demonstrate the importance of careful measurement of blood pressure in children with failure to thrive.

We have studied diamond films grown by electron cyclotron resonance (ECR)-assisted chemical vapor deposition (CVD) on Si (100) substrates seeded with diamond, boron nitride and unseeded. Relatively low temperatures (550–710°C) and low pressures (1–2 Torr) were employed. Raman spectroscopy, scanning electron microscopy (SEM), and X-ray diffraction (XRD) were used to characterize the crystalline quality, diamond yield, and stresses developed in these films. Most of the diamond films exhibit a Raman blue-shift with respect to natural diamond, indicating that the net stress is compressive. However, this net stress is significantly more compressive than the one estimated by taking into account the thermal interfacial stress and the stress developed at the grain boundaries. In addition, this net stress exhibits an inverse correlation with diamond yield, and a direct correlation with crystalline quality. These results were interpreted in terms of the critical interplay between the supply of precursor species to the growing surface and the surface mobility of adsorbed species. The excess (or intrinsic) compressive stress shows an inverse correlation with diamond crystalline quality, indicating that the creation of point defects serves as a stress-relieving mechanism. Seeding effects, in general, are deleterious to diamond quality, in this temperature and pressure regime studied. Seeding with boron nitride had the effect of reversing the net stress from compressive into tensile, but this effect was rapidly lost as the diamond yield increased.

This report describes the rationale and design of a study assessing tolvaptan in children with autosomal dominant polycystic kidney disease (ADPKD). Phase A is a 1-year, randomized, double-blind, placebo-controlled, multicenter trial. Phase B is a 2-year, open-label extension. The target population is at least 60 children aged 12–17 years, diagnosed by family history and/or genetic criteria and the presence of ≥ 10 renal cysts, each ≥ 0.5 cm on magnetic resonance imaging. Subjects will be allocated into 4 groups: females 15–17 years; females 12–14 years; males 15–17 years; and males 12–14 years. Up to 40 subjects aged 4–11 years may also enroll, provided they meet the entry criteria. Weight-adjusted tolvaptan doses, titrated once to achieve a tolerated maintenance dose, and matching placebo will be administered twice-daily. Assessments include spot urine osmolality and specific gravity (co-primary endpoints), height-adjusted total kidney volume, estimated glomerular filtration rate, pharmacodynamic parameters (urine volume, fluid intake and fluid balance, serum sodium, serum creatinine, free water clearance), pharmacokinetic parameters, safety (aquaretic adverse events, changes from baseline in creatinine, vital signs, laboratory values including liver function tests), and generic pediatric quality of life assessments.Conclusion: This will be the first clinical study to evaluate tolvaptan in pediatric ADPKD.What is Known:• Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder causing the development of cysts that impede kidney function over time and eventually induce renal failure• There are few data on the effects of tolvaptan, the only treatment approved for adults to slow disease progression, in pediatric ADPKD patients with early-stage diseaseWhat is New:• A phase 3, placebo-controlled study is evaluating tolvaptan over 3 years in children and adolescents with ADPKD• This study is designed to account for challenges of tolvaptan dosing and outcome assessment specific to the pediatric population

Invasive bacterial infection in children infected with the human immunodeficiency virus (HIV) is common. South African data on this problem are limited. Over 1 year we prospectively studied 108 HIV-infected children hospitalized for 136 presumed infective episodes. Blood culture was positive in 24.8% of episodes. Streptococcus pneumoniae predominated (14/30 positive blood cultures); one-third of isolates showed resistance to penicillin. Acute lower respiratory tract infection accounted for 44% of clinical diagnoses, a bacterial cause being established for 23.8% of these. Age and stage of HIV infection did not influence the likelihood of a positive culture. A high proportion of presumed infective episodes requiring hospitalization of young HIV-infected children have a bacterial cause. Blood culture appears to be a useful method of obtaining the microbiological information required to focus antibiotic therapy.

Immunotherapy is a promising area of therapy in patients with neuro-oncological malignancies. However, early-phase studies show unique challenges associated with the assessment of radiological changes in response to immunotherapy reflecting delayed responses or therapy-induced inflammation. Clinical benefit, including long-term survival and tumour regression, can still occur after initial disease progression or after the appearance of new lesions. Refinement of the response assessment criteria for patients with neuro-oncological malignancies undergoing immunotherapy is therefore warranted. Herein, a multinational and multidisciplinary panel of neuro-oncology immunotherapy experts describe immunotherapy Response Assessment for Neuro-Oncology (iRANO) criteria based on guidance for the determination of tumour progression outlined by the immune-related response criteria and the RANO working group. Among patients who demonstrate imaging findings meeting RANO criteria for progressive disease within 6 months of initiating immunotherapy, including the development of new lesions, confirmation of radiographic progression on follow-up imaging is recommended provided that the patient is not significantly worse clinically. The proposed criteria also include guidelines for the use of corticosteroids. We review the role of advanced imaging techniques and the role of measurement of clinical benefit endpoints including neurological and immunological functions. The iRANO guidelines put forth in this Review will evolve successively to improve their usefulness as further experience from immunotherapy trials in neuro-oncology accumulate.

Clinical trials of treatments for high-grade gliomas have traditionally relied on measures of response or time-dependent metrics; however, these endpoints have limitations because they do not characterise the functional or symptomatic effect of the condition on the person. Including clinical outcome assessments, such as patient- reported outcomes (PROs), to determine net clinical benefit of a treatment strategy is needed because of the substantial burden of symptoms and impaired functioning in this patient population. The US National Cancer Institute convened a meeting to review previous recommendations and existing PRO measures of symptoms and function that can be applied to current trials and clinical practice for high-grade gliomas. Measures were assessed for relevance, relationship to disease and therapy, sensitivity to change, psychometric properties, response format, patient acceptability, and use of self-report. The group also relied on patient input including the results of an online survey, a literature review on available clinical outcomes, expert opinion, and alignment with work done by other organisations. A core set of priority constructs was proposed that allows more comprehensive evaluation of therapies and comparison of outcomes among studies, and enhances efforts to improve the measurement of these core clinical outcomes. The proposed set of constructs was then presented to the Society for Neuro-Oncology Response Assessment in Neuro-Oncology Working Group and feedback was solicited.