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Mohsin Al-Maghrabi,1 Silvia Mamede,2 Henk G Schmidt,3 Aamir Omair,4– 6 Sami Al-Nasser,4– 6 Nouf Sulaiman Alharbi,4– 6 Mohi Eldin Mohammed Ali Magzoub7 1Department of Pediatrics, Imam Abdulrahman Alfaisal Hospital, Riyadh, Saudi Arabia; 2Institute of Medical Education Research Rotterdam, Erasmus University Rotterdam, Rotterdam, the Netherlands; 3Department of Psychology, Erasmus University Rotterdam, Rotterdam, the Netherlands; 4Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 5King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 6Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia; 7Department of Medical Education, United Arab Emirates University, Al Ain, United Arab EmiratesCorrespondence: Nouf Sulaiman Alharbi, Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, Email ns.alharbi@gmail.comBackground: Literature suggest that physicians’ high level of confidence has a negative impact on medical decisions, and this may lead to medical errors. Experimental research is lacking; however, this study investigated the effects of high confidence on diagnostic accuracy.Methods: Forty internal medicine residents from different hospitals in Saudi Arabia were divided randomly into two groups: A high-confidence group as an experimental and a low-confidence group acting as a control. Both groups solved each of eight written complex clinical vignettes. Before diagnosing these cases, the high-confidence group was led to believe that the task was easy, while the low-confidence group was presented with information from which it could deduce that the diagnostic task was difficult. Level of confidence, response time, and diagnostic accuracy were recorded.Results: The participants in the high-confidence group had a significantly higher confidence level than those in the control group: 0.75 compared to 0.61 (maximum 1.00). However, neither time on task nor diagnostic accuracy significantly differed between the two groups.Conclusion: In the literature, high confidence as one of common cognitive biases has a strong association with medical error. Even though the high-confidence group spent somewhat less time on the cases, suggesting potential premature decision-making, we failed to find differences in diagnostic accuracy. It is suggested that overconfidence should be studied as a personality trait rather than as a malleable characteristic.Keywords: overconfidence, diagnostic accuracy, medical errors, premature closure

The particle size effects on the kinetic parameters of two overlapping crystallization peaks of Se85Te10Sb5 chalcogenide glass were studied using differential scanning calorimetry (DSC) under experimental and predicted isothermal conditions. The crystallization kinetics parameters of the two peaks were separated based on the application of a multi-peak Gaussian function using the advanced thermokinetics software package (AKTS). The nonisothermal methods of Friedman, Kissinger–Akahira–Sunose and the minimization, in addition to the predicted isothermal method, were used to investigate the variation of the effective activation energy with the extent of crystallization and, hence, with temperature. The local Avrami exponent as a function of the crystalline volume fraction was obtained at a constant heating rate or temperature for nonisothermal and isothermal processes. Its value was found to vary with particle size. The crystallization process of the two peaks was found to follow the Avrami–Erofeev reaction model. [ABSTRACT FROM AUTHOR]

Background: Polyomavirus, known as BK virus, is an important cause of allograft dysfunction in renal transplant patients, leading to BK virus nephropathy. The main study objectives were to assess the disease incidence and disease course in pediatric patients, and assess the diagnostic accuracy of BK screening for asymptomatic patients., Methods: This is a single-center observational study, which included 81 pediatric renal allograft recipients that were transplanted and/or followed at King Fahad Specialist Hospital-Dammam, Saudi Arabia. Screening for BK virus was performed prospectively according to a predetermined hospital protocol. Our BK screening protocol consisted of periodic quantitative real time polymerase chain reaction test in the plasma. In patients with deranged graft function, graft biopsies were evaluated for the presence of BK nephropathy., Results: Our study detected BK viremia in 14 patients (17.3%), while BK nephropathy occurred in seven patients (8.6%). The onset of BK viremia had bimodal distribution, 78 percent occurring within first year post-transplantation, while 21.4% occurred late. Patients who developed BK nephropathy had a higher BK level than BK viremia patients, for both mean and peak values (p = .02, p = .02). A BK cutoff level of 40 000 copies/mL showed sensitivity and specificity of 85.7%, 85.7%, respectively, in predicting the conversion of BK viremia to BK nephropathy., Conclusions: BK viremia and BK nephropathy occur in pediatric patients with similar incidence rates compared to adult patients. Protocolized screening led to early detection of viremia, and could predict the conversion of BK viremia to BK nephropathy and allow for early immunosuppression modulation., (© 2023 Wiley Periodicals LLC.)