UNASSIGNED: The reliability of interpretation of coronary angiography as a diagnostic tool was investigated. Furthermore, the impact of interobserver variability of coronary lesions on clinical decision-making was assessed. One of our motivations to do this research was the research gaps and our aim to have up-to-date information regarding interobserver variability among different cardiologists.
UNASSIGNED: Our objective was to quantify interobserver variability among cardiologists who have seen angiograms independently. Disagreement among cardiologists in the visual assessment of invasive coronary angiography of coronary artery stenosis is not uncommon in previous studies. Three cardiologists with extensive experience in coronary angiography, including the primary cardiologist of each patient, read the angiograms of 200 patients from Toronto General Hospital independently.
UNASSIGNED: Our research showed the mean agreement among all participating observers was 77.4%; therefore, the interobserver variability of coronary angiography interpretation was 22.6%.
UNASSIGNED: Coronary angiography is still the gold-standard technique for guidance regarding coronary lesions. Sometimes, coronary angiography results in underestimation or overestimation of a lesion\'s functional severity. Interobserver variability should also be considered when interpreting the severity of coronary stenoses via invasive coronary angiography. This research shows that interobserver variability regarding coronary angiograms is still present (22.6%).
Plain language summary: The gold-standard method for diagnosing coronary stenosis, invasive coronary angiography has some challenges too. One of these challenges has been the difference among various cardiologists regarding determination of severity of each coronary stenosis. In this study, we focused on differences in interobserver variability in coronary angiography interpretation. Three cardiologists who were experienced in coronary angiography read each patient’s coronary angiogram separately. Overall, 200 patients with a history of angiography at Toronto General Hospital were selected randomly. The research showed that overall agreement among all participating cardiologists with regard to the reading of coronary angiograms was 77.4%. In other words, interobserver variability of 22.6% was seen among the readers.

Alterations of functional network connectivity have been implicated in the pathophysiology of schizophrenia (SCZ) and bipolar disorder (BD). Recent studies also suggest that the temporal dynamics of functional connectivity (dFC) can be altered in these disorders. Here, we summarized the existing literature on dFC in SCZ and BD, and their association with psychopathological and cognitive features. We systematically searched PubMed, Web of Science, and Scopus for studies investigating dFC in SCZ and BD and identified 77 studies. Our findings support a general model of dysconnectivity of dFC in SCZ, whereas a heterogeneous picture arose in BD. Although dFC alterations are more severe and widespread in SCZ compared to BD, dysfunctions of a triple network system underlying goal-directed behavior and sensory-motor networks were present in both disorders. Furthermore, in SCZ, positive and negative symptoms were associated with abnormal dFC. Implications for understanding the pathophysiology of disorders, the role of neurotransmitters, and treatments on dFC are discussed. The lack of standards for dFC metrics, replication studies, and the use of small samples represent major limitations for the field.

OBJECTIVE: To present two cases of Internal Carotid Artery (ICA) agenesis and conduct a systematic review to assess for associations with other anomalies and intracranial aneurysms.
METHODS: We performed a retrospective review of published cases of patients with ICA agenesis with intercavernous anastomosis in MEDLINE database on August 2022 using search terms \"internal carotid artery\", \"agenesis\" and \"transcavernous anastomosis\". We also included two cases of ICA agenesis with type D collateral that we encountered.
RESULTS: Total of 46 studies that included 48 patients and two of our cases resulted in 50 patients. Only 70% of studies reported the location of a collateral vessel of which more than two-thirds were on the floor of sella. More than half of the vessels connected cavernous segments of ICA. A1 segment ipsilateral to the side of ICA agenesis was absent in most of the cases but was not true for all cases. Aneurysm was seen in more than one-quarter of the patients. It can also mimic microadenoma as in prior reported cases as well as in one of our cases.
CONCLUSIONS: ICA agenesis with type D collateral is a rare anomaly but clinically relevant due to the increased risk of an aneurysm or mimic microadenoma or false alarm for occlusion of ICA but knowledge of this rare variant can help in better management of these patients.

The internal carotid artery (ICA) course has been discussed extensively. Several classification systems have attempted to delineate an accurate and helpful trajectory for microsurgical and endoscopic guidance, thus allowing a better neurosurgical performance while avoiding intraoperative complications. Also, the practicality of the classification systems has been emphasized for scholarly communication among disciplines. Nevertheless, the nomenclature of the ICA remains heterogeneous and confusing for health care professionals, trainees, and students. We present an illustrative review of 8 notable ICA classification systems using lateral and anterior views as a rapid tool for neuroanatomic consultation. The appraisal of the vessel anatomy from different perspectives while recognizing their usefulness and limitations might provide a comprehensive understanding of the ICA, optimize the intraoperative performance, and facilitate communication.

The use of coronavirus disease 2019 (COVID-19) serological testing to diagnose acute infection or determine population seroprevalence relies on understanding assay accuracy during early infection. We aimed to evaluate the diagnostic performance of serological testing in COVID-19 by providing summary sensitivity and specificity estimates with time from symptom onset.
A systematic search of Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL) and PubMed was performed up to May 13, 2020. All English language, original peer-reviewed publications reporting the diagnostic performance of serological testing vis-à-vis virologically confirmed SARS-CoV-2 infection were included.
Our search yielded 599 unique publications. A total of 39 publications reporting 11 516 samples from 8872 human participants met eligibility criteria for inclusion in our study. Pooled percentages of IgM and IgG seroconversion by Day 7, 14, 21, 28 and after Day 28 were 37.5%, 73.3%, 81.3%, 72.3% and 73.3%, and 35.4%, 80.6%, 93.3%, 84.4% and 98.9%, respectively. By Day 21, summary estimate of IgM sensitivity was 0.872 (95% CI: 0.784-0.928) and specificity 0.973 (95% CI: 0.938-0.988), while IgG sensitivity was 0.913 (95% CI: 0.823-0.959) and specificity 0.960 (95% CI: 0.919-0.980). On meta-regression, IgM and IgG test accuracy was significantly higher at Day 14 using enzyme-linked immunosorbent assay (ELISA) compared to other methods.
Serological assays offer imperfect sensitivity for the diagnosis of acute SARS-CoV-2 infection. Estimates of population seroprevalence during or shortly after an outbreak will need to adjust for the delay between infection, symptom onset and seroconversion.

Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity-mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy.

OBJECTIVE: To assess the safety of the suprabrow approach (SBCA) for aneurysm surgery by comparing intraoperative rupture rates with those for the standard pterional approach.
METHODS: A systematic review of all literature published in or after 1997 was performed using specified search words. All articles described aneurysm surgery by one of two approaches--pterional or suprabrow--and mentioned the rate of intraoperative rupture. A total of 41 articles were found fit for inclusion for the final analysis. Articles that focused on giant, bilateral, posterior fossa, or previously coiled aneurysms were not included. The χ(2) test was used to compare the two cohorts and various subgroup analyses were carried out. A P value of <0.05 was considered significant.
RESULTS: The search of literature yielded 9488 aneurysm reports (41 articles), 7535 operated by the pterional approach and 1953 aneurysms by the SBCA. The overall intraoperative rupture (IOR) rate for the entire group was 9.20%. In the pterional craniotomy approach (PtCA) group, the rate of IOR was 10.09% and in the SBCA group, IOR occurred in 5.78%. The IOR rate in the PtCA group was almost double that in the SBCA group and the odds ratio (OR) for this difference was 1.8 (95% confidence interval [CI] 1.49-2.26; P< 0.001). A total of 3039 ruptured aneurysms were analyzed--2848 aneurysms in the PtCA group and 191 in the SBCA group. The rate of IOR was 14.15% for the overall group, 13.8% in the PtCA group, and 19.37% in the SBCA group. The difference in IOR between the PtCA group and the SBCA group for ruptured aneurysms was found to be significant (OR 1.5, 95% CI 1.003-2.119; P< 0.05). The number of unruptured aneurysms in the PtCA group was 862 (39.4%) and in the SBCA group, it was 232 (49.1%). The difference in the number of unruptured aneurysms between the groups was significant (P< 0.001). The rate of IOR was significantly less with the SBCA than with the pterional approach.
CONCLUSIONS: The rate of intraoperative rupture is significantly higher when ruptured aneurysms are operated with the SBCA (in comparison to the pterional approach). However, the SBCA may be safer for unruptured and middle cerebral artery aneurysms with a lower rate of IOR.

OBJECTIVE: To review the management of aneurysms arising at the origin of a duplicated middle cerebral artery (DMCA), which is an extremely rare entity.
METHODS: Four patients with internal carotid artery-DMCA aneurysms are presented, and 24 previously published cases are reviewed.
RESULTS: Of the 28 internal carotid artery-DMCA aneurysms, 17 were ruptured, and 11 were unruptured. The aneurysms were equally distributed on the right and left sides and were small in size (≤6 mm) except for two that were of medium size. All aneurysms were treated surgically except for two very small aneurysms, which have been managed conservatively and followed for 9 years.
CONCLUSIONS: Although all previously published clinical cases of internal carotid artery-DMCA aneurysms were treated surgically, conservative management with follow-up is a viable option in very small unruptured aneurysms.

Schizophrenia (SZ) is one of the most cryptic and costly mental disorders in terms of human suffering and societal expenditure (van Os and Kapur, 2009). Though strong evidence for functional, structural, and genetic abnormalities associated with this disease exists, there is yet no replicable finding which has proven accurate enough to be useful in clinical decision making (Fornito et al., 2009), and its diagnosis relies primarily upon symptom assessment (Williams et al., 2010a). It is likely in part that the lack of consistent neuroimaging findings is because most models favor only one data type or do not combine data from different imaging modalities effectively, thus missing potentially important differences which are only partially detected by each modality (Calhoun et al., 2006a). It is becoming increasingly clear that multimodal fusion, a technique which takes advantage of the fact that each modality provides a limited view of the brain/gene and may uncover hidden relationships, is an important tool to help unravel the black box of schizophrenia. In this review paper, we survey a number of multimodal fusion applications which enable us to study the schizophrenia macro-connectome, including brain functional, structural, and genetic aspects and may help us understand the disorder in a more comprehensive and integrated manner. We also provide a table that characterizes these applications by the methods used and compare these methods in detail, especially for multivariate models, which may serve as a valuable reference that helps readers select an appropriate method based on a given research question.