Effect of surgical experience and spine subspecialty on the reliability of the {AO} Spine Upper Cervical Injury Classification System

OBJECTIVE The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5–10 years, 10–20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery). METHODS A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson’s chi-square or Fisher’s exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility. RESULTS The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5–10 years: 0.69 vs 10–20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5–10 years: 0.62 vs 10–20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5–10 years: 0.61 vs 10–20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36). CONCLUSIONS The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system

Active Controller: Utilizing Active Databases for Implementing Multi-Step Control of Semiconductor Manufacturing

: Whenever the fabrication process consists of several steps and the dynamic modification of individual steps or step sequences of the process is allowed, multi-step feedback and feed-forward control can be utilized to improve the quality of the fabrication process. Feedback and feed-forward control have been identified as important features of the semiconductor manufacturing facility of the future, and research has been carried out on developing suitable control algorithms. However, the issue of providing generic enabling mechanisms for multi-step control has not been adequately addressed. To fill this gap, we have developed the Active Controller - a generic, adaptable and reusable software enabler for multi-step control in manufacturing facilities. The Active Controller utilizes a recently emerging technology, called active databases, to define and automatically execute powerful and expressive rules for implementing multi-step control algorithms. The conditions of Active Controller r..

Pneumatic retinopexy for displaced macular laceration from intraocular foreign body

Purpose: To report a case of macular laceration from intraocular foreign body (IOFB) treated with pneumatic retinopexy. Observations: A 74 year old man sustained penetrating injury to his left globe with retained metallic intraocular foreign body (IOFB). The patient underwent prompt pars plana vitrectomy, intravitreal antibiotics and removal of IOFB. The posterior point of impact left a displaced foveo-macular laceration which was recognized postoperatively and treated with pneumatic retinopexy for re-approximation of the foveal tissue. Optical coherence tomography confirmed acute traumatic laceration and edema, closure of the tissue and subsequent healing and adjacent retinal and retinal pigment epithelial atrophy. He regained visual acuity of 20/30. Conclusions and importance: Traumatic macular lacerations can be treated with pneumatic retinopexy, after pars plana vitrectomy, with potentially good visual result

Utilizing Fuzzy Data and Rules for Discrete Control of Semiconductor Manufacturing Processes

this paper, we describe the Fuzzy R2R Controller, which is a multi-algorithm control system that utilizes fuzzy rule-based decision making for control of semiconductor processes. The developed controller provides better R2R control by determining which combination of the available control algorithms should be invoked to obtain the optimal advice for the control of the process. The chosen rule syntax allows explicit expression of advice for or against a control algorithm. We also propose new techniques for making decisions on these rules with potentially contradictory information. This controller utilizes a database to store fuzzy rules that relate the suitability of use of different control algorithms to the process conditions. Although significant work has been done in incorporating fuzziness in relational databases (RDBs), little research has been carried out towards modeling fuzziness in conceptual data models [BuP82], [Uma82], [PrT84], [RaM88], [RuB92]. To fill this gap, we have earlier proposed Fuzzy Entity-Relationship Methodology (FERM), a methodology which includes both an extended fuzzy Entity-Relationship model to represent fuzziness in the schema as well as techniques for implementing a fuzzy RDB from this extended fuzzy ER model [CMR94a]. In this paper, we describe FERM, show its application to develop a generic data model for fuzzy rules and then describe how this model is mapped to a RDB to implement the database for the Fuzzy R2R Controller. The rule-base of the Controller is capable of managing knowledge from heterogeneous information sources and is able to make decisions based on this knowledge. The use of the database allows for the dynamic addition of rules. We note that although the system described is targeted for control of a semiconductor manufact..

A Generic Framework for Inter-Cell Control of a Semiconductor Manufacturing Facility

: Whenever the fabrication process consists of several steps and the dynamic modification of individual steps or step sequences of the process is allowed, inter-cell feedback and feedforward control can both be utilized to improve the quality of the fabrication process. Indeed, feedback and feed-forward control have been identified as important features of the semiconductor manufacturing facility of the future. However, the issue of providing enabling mechanisms for inter-cell control has not been adequately addressed. To fill this gap, we propose a novel design of a generic, adaptable and re-usable software enabler for inter-cell control in manufacturing facilities. This inter-cell controller is realized using active database technology. Active database systems, a recently emerging technology, can automatically carry out rule actions when designated events occur and corresponding conditions become true. For carrying out inter-cell control, the conditions of active database rules can b..

Process Automation in Semiconductor Manufacturing: Issues and Solutions

: While the area of process automation in semiconductor manufacturing has many issues in common with process automation and enactment in business processes, the nature of the semiconductor manufacturing process introduces a number of challenging new issues. Among these issues is the need to not only automate the process but also to continuously control and optimize it. Furthermore the semantics of success/failure for a semiconductor manufacturing process are quite different from the typical binary success/failure of business processes. In this paper, the issues in process automation in semiconductor manufacturing are presented, and compared and contrasted with the issues in traditional workflow technology. We then describe a system, based on an active database management system, that we have developed for process automation in semiconductor manufacturing. We also discuss the approach of this system towards addressing the different issues in the automation of semiconductor manufacturing..