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Study design:This is a retrospective analysis.Objectives:The objective of this study was to describe and quantify the discrepancy in the classification of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) by clinicians versus a validated computational algorithm.Settings:European Multicenter Study on Human Spinal Cord Injury (EMSCI).Methods:Fully documented ISNCSCI data sets from EMSCI's first years (2003-2005) classified by clinicians (mostly spinal cord medicine residents, who received in-house ISNCSCI training by senior SCI physicians) were computationally reclassified. Any differences in the scoring of sensory and motor levels, American Spinal Injury Association Impairment Scale (AIS) or the zone of partial preservation (ZPP) were quantified.Results:Four hundred and twenty ISNCSCI data sets were evaluated. The lowest agreement was found in motor levels (right: 62.1%, P=0.002; left: 61.8%, P=0.003), followed by motor ZPP (right: 81.6%, P=0.74; left 80.0%, P=0.27) and then AIS (83.4%, P=0.001). Sensory levels and sensory ZPP showed the best concordance (right sensory level: 90.8%, P=0.66; left sensory level: 90.0%, P=0.30; right sensory ZPP: 91.0%, P=0.18; left sensory ZPP: 92.2%, P=0.03). AIS B was most often misinterpreted as AIS C and vice versa (AIS B as C: 29.4% and AIS C as B: 38.6%).Conclusion:Most difficult classification tasks were the correct determination of motor levels and the differentiation between AIS B and AIS C/D. These issues should be addressed in upcoming ISNCSCI revisions. Training is strongly recommended to improve classification skills for clinical practice, as well as for clinical investigators conducting spinal cord studies.Sponsorship:This study is partially funded by the International Foundation for Research in Paraplegia, Zurich, Switzerland. [ABSTRACT FROM AUTHOR]

Abstract: ALFA is a high-precision scintillating fibre tracking detector under construction for the absolute determination of the LHC luminosity at the ATLAS interaction point. This detector, mounted in so-called Roman Pots, will track protons elastically scattered under μrad angles at IP1.In total there are four pairs of vertically arranged detector modules which approach the LHC beam axis to mm distance. Each detector module consists of ten layers of two times 64 scintillating fibres each (U and V planes). The fibres are coupled to 64 channels Multi-Anodes PhotoMultipliers Tubes read out by compact front-end electronics. Each detector module is complemented by so-called overlap detectors: Three layers of two times 30 scintillating fibres which will be used to measure the relative positioning of two vertically arranged main detectors. The total number of channels is about 15000. Conventional plastic scintillator tiles are mounted in front of the fibre detectors and will serve as trigger counter. The extremely restricted space inside the pots makes the coupling to the read out devices very challenging. Several technologies have been tested in a beam at DESY and a cosmic-ray setup at CERN. A possible upgrade of the photo detection could consist in the replacement of the PMT by Geiger-mode avalanche photodiodes. Preliminary tests are being performed comparing the performance of these devices with the ones of the PMTs. [Copyright &y& Elsevier]