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  1. Article ; Online: Cross-sectional area and fat infiltration of the lumbar spine muscles in patients with back disorders: a deep learning-based big data analysis.

    Vitale, Jacopo / Sconfienza, Luca Maria / Galbusera, Fabio

    European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

    2023  Volume 33, Issue 1, Page(s) 1–10

    Abstract: Purpose: Validated deep learning models represent a valuable option to perform large-scale research studies aiming to evaluate muscle quality and quantity of paravertebral lumbar muscles at the population level. This study aimed to assess lumbar spine ... ...

    Abstract Purpose: Validated deep learning models represent a valuable option to perform large-scale research studies aiming to evaluate muscle quality and quantity of paravertebral lumbar muscles at the population level. This study aimed to assess lumbar spine muscle cross-sectional area (CSA) and fat infiltration (FI) in a large cohort of subjects with back disorders through a validated deep learning model.
    Methods: T2 axial MRI images of 4434 patients (n = 2609 females, n = 1825 males; mean age: 56.7 ± 16.8) with back disorders, such as fracture, spine surgery or herniation, were retrospectively collected from a clinical database and automatically segmented. CSA, expressed as the ratio between total muscle area (TMA) and the vertebral body area (VBA), and FI, in percentages, of psoas major, quadratus lumborum, erector spinae, and multifidus were analyzed as primary outcomes.
    Results: Male subjects had significantly higher CSA (6.8 ± 1.7 vs. 5.9 ± 1.5 TMA/VBA; p < 0.001) and lower FI (21.9 ± 8.3% vs. 15.0 ± 7.3%; p < 0.001) than females. Multifidus had more FI (27.2 ± 10.6%; p < 0.001) than erector spinae (22.2 ± 9.7%), quadratus lumborum (17.5 ± 7.0%) and psoas (13.7 ± 5.8%) whereas CSA was higher in erector spinae than other lumbar muscles. A high positive correlation between age and total FI was detected (r
    Conclusion: CSA and FI values of paravertebral muscles vary a lot in accordance with subjects' sex, age and clinical conditions. Given also the large inter-muscle differences in CSA and FI, the choice of muscles needs to be considered with attention by spine surgeons or physiotherapists when investigating changes in lumbar muscle morphology in clinical practice.
    MeSH term(s) Female ; Humans ; Male ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Deep Learning ; Lumbar Vertebrae/surgery ; Lumbosacral Region ; Magnetic Resonance Imaging/methods ; Psoas Muscles ; Paraspinal Muscles/diagnostic imaging ; Paraspinal Muscles/pathology
    Language English
    Publishing date 2023-10-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1115375-1
    ISSN 1432-0932 ; 0940-6719
    ISSN (online) 1432-0932
    ISSN 0940-6719
    DOI 10.1007/s00586-023-07982-0
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  2. Article: Automatic classification of the vertebral endplate lesions in magnetic resonance imaging by deep learning model.

    Bassani, Tito / Cina, Andrea / Galbusera, Fabio / Sconfienza, Luca Maria / Albano, Domenico / Barcellona, Federica / Colombini, Alessandra / Luca, Andrea / Brayda-Bruno, Marco

    Frontiers in surgery

    2023  Volume 10, Page(s) 1172313

    Abstract: Introduction: A novel classification scheme for endplate lesions, based on T2-weighted images from magnetic resonance imaging (MRI) scan, has been recently introduced and validated. The scheme categorizes intervertebral spaces as "normal," "wavy/ ... ...

    Abstract Introduction: A novel classification scheme for endplate lesions, based on T2-weighted images from magnetic resonance imaging (MRI) scan, has been recently introduced and validated. The scheme categorizes intervertebral spaces as "normal," "wavy/irregular," "notched," and "Schmorl's node." These lesions have been associated with spinal pathologies, including disc degeneration and low back pain. The exploitation of an automatic tool for the detection of the lesions would facilitate clinical practice by reducing the workload and the diagnosis time. The present work exploits a deep learning application based on convolutional neural networks to automatically classify the type of lesion.
    Methods: T2-weighted MRI scans of the sagittal lumbosacral spine of consecutive patients were retrospectively collected. The middle slice of each scan was manually processed to identify the intervertebral spaces from L1L2 to L5S1, and the corresponding lesion type was labeled. A total of 1,559 gradable discs were obtained, with the following types of distribution: "normal" (567 discs), "wavy/irregular" (485), "notched" (362), and "Schmorl's node" (145). The dataset was divided randomly into a training set and a validation set while preserving the original distribution of lesion types in each set. A pretrained network for image classification was utilized, and fine-tuning was performed using the training set. The retrained net was then applied to the validation set to evaluate the overall accuracy and accuracy for each specific lesion type.
    Results: The overall rate of accuracy was found equal to 88%. The accuracy for the specific lesion type was found as follows: 91% (normal), 82% (wavy/irregular), 93% (notched), and 83% (Schmorl's node).
    Discussion: The results indicate that the deep learning approach achieved high accuracy for both overall classification and individual lesion types. In clinical applications, this implementation could be employed as part of an automatic detection tool for pathological conditions characterized by the presence of endplate lesions, such as spinal osteochondrosis.
    Language English
    Publishing date 2023-06-22
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2773823-1
    ISSN 2296-875X
    ISSN 2296-875X
    DOI 10.3389/fsurg.2023.1172313
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  3. Article: The ERNCIP survey on COVID-19: Emergency & Business Continuity for fostering resilience in critical infrastructures.

    Galbusera, Luca / Cardarilli, Monica / Giannopoulos, Georgios

    Safety science

    2021  Volume 139, Page(s) 105161

    Abstract: Among the many repercussions of the COVID-19 emergency to be assessed, those on critical infrastructures and the associated businesses and professions are certainly important ones. In this paper, we document the conception, implementation and outcome of ... ...

    Abstract Among the many repercussions of the COVID-19 emergency to be assessed, those on critical infrastructures and the associated businesses and professions are certainly important ones. In this paper, we document the conception, implementation and outcome of a survey organized by European Commission's Joint Research Centre and entitled
    Language English
    Publishing date 2021-02-01
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1074634-1
    ISSN 1879-1042 ; 0925-7535
    ISSN (online) 1879-1042
    ISSN 0925-7535
    DOI 10.1016/j.ssci.2021.105161
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  4. Article ; Online: Electron Beam Susceptibility of Enteric Viruses and Surrogate Organisms on Fruit, Seed and Spice Matrices.

    Butot, Sophie / Galbusera, Luca / Putallaz, Thierry / Zuber, Sophie

    Food and environmental virology

    2021  Volume 13, Issue 2, Page(s) 218–228

    Abstract: The objective of this study was to use high-energy electron beam (HEEB) treatments to find surrogate microorganisms for enteric viruses and to use the selected surrogates as proof of concept to investigate low-energy electron beam (LEEB) treatments for ... ...

    Abstract The objective of this study was to use high-energy electron beam (HEEB) treatments to find surrogate microorganisms for enteric viruses and to use the selected surrogates as proof of concept to investigate low-energy electron beam (LEEB) treatments for enteric virus inactivation at industrial scale on frozen blueberries. Six food matrices inoculated with HAV (hepatitis A virus), MNV S99 (murine norovirus), bacteriophages MS2 and Qβ, and Geobacillus stearothermophilus spores were treated with HEEB at 10 MeV using 4, 8 and 16 kGy doses. G. stearothermophilus spores showed the highest inactivation on all matrices except on raisins, with a dose-dependent effect. HAV reached the maximum measurable log
    MeSH term(s) Food Irradiation/methods ; Fruit/radiation effects ; Fruit/virology ; Hepatitis A virus/physiology ; Hepatitis A virus/radiation effects ; Levivirus/physiology ; Levivirus/radiation effects ; Norovirus/physiology ; Norovirus/radiation effects ; Seeds/radiation effects ; Seeds/virology ; Spices/radiation effects ; Spices/virology ; Virus Inactivation/radiation effects
    Language English
    Publishing date 2021-02-10
    Publishing country United States
    Document type Evaluation Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2487173-4
    ISSN 1867-0342 ; 1867-0334
    ISSN (online) 1867-0342
    ISSN 1867-0334
    DOI 10.1007/s12560-021-09463-3
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  5. Article ; Online: Effect of a mattress on lumbar spine alignment in supine position in healthy subjects: an MRI study.

    Vitale, Jacopo Antonino / Borghi, Stefano / Bassani, Tito / Messina, Carmelo / Sconfienza, Luca Maria / Galbusera, Fabio

    European radiology experimental

    2023  Volume 7, Issue 1, Page(s) 47

    Abstract: Background: Humans should sleep for about a third of their lifetime and the choice of the mattress is very important from a quality-of-life perspective. Therefore, the primary aim of this study was to assess the changes of lumbar angles, evaluated in a ... ...

    Abstract Background: Humans should sleep for about a third of their lifetime and the choice of the mattress is very important from a quality-of-life perspective. Therefore, the primary aim of this study was to assess the changes of lumbar angles, evaluated in a supine position using magnetic resonance imaging (MRI), on a mattress versus a rigid surface.
    Methods: Twenty healthy subjects (10 females, 10 males), aged 32.3 ± 6.5 (mean ± standard deviation), with body mass index 22.4 ± 2.9, completed three evaluations: (i) spine MRI in supine position on a mattress (MAT); (ii) spine MRI in supine position on rigid surface (CON); and (iii) biplanar radiographic imaging in standing position. The following indexes were calculated for both MAT and CON: lumbar lordosis angles L1-L5, L1-S1, L5-S1, and the sacral slope (SS). Further, pelvic incidence (PI) was calculated from the biplanar radiographic images.
    Results: Main findings were (i) L1-L5 and SS were greater in MAT than CON (L1:L5: +2.9°; SS: +2.0°); (ii) L5-S1 was lower in MAT than CON (-1.6°); (iii) L1-S1 was greater in MAT than CON only for male subjects (+2.0°); (iv) significant and positive correlations between PI and L1-L5, L1-S1 and SS were observed in both CON and MAT.
    Conclusions: The use of a mattress determined small but statistically significant changes in lumbar angles.
    Relevance statement: The use of a mattress determines small but statistically significant changes in radiological angles describing the sagittal alignment of the lumbar spine when lying in the supine position.
    Key points: • Lordosis angle L1-L5 was greater in MAT than in CON condition (+2.9°). • Sacral slope was greater in MAT than in CON condition (+2.0°). • Lordosis angle L5-S1 was lower in MAT than in CON condition (-1.6°).
    MeSH term(s) Female ; Animals ; Male ; Humans ; Lumbar Vertebrae/diagnostic imaging ; Lordosis ; Healthy Volunteers ; Supine Position ; Magnetic Resonance Imaging
    Language English
    Publishing date 2023-09-04
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2509-9280
    ISSN (online) 2509-9280
    DOI 10.1186/s41747-023-00361-w
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  6. Article ; Online: Correction to: Measuring the critical shoulder angle on radiographs: an accurate and repeatable deep learning model.

    Minelli, Marco / Cina, Andrea / Galbusera, Fabio / Castagna, Alessandro / Savevski, Victor / Sconfienza, Luca Maria

    Skeletal radiology

    2022  Volume 51, Issue 9, Page(s) 1905

    Language English
    Publishing date 2022-04-04
    Publishing country Germany
    Document type Published Erratum
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-022-04052-2
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  7. Article: Linking healthcare and societal resilience during the Covid-19 pandemic.

    Pescaroli, Gianluca / Galbusera, Luca / Cardarilli, Monica / Giannopoulos, Georgios / Alexander, David

    Safety science

    2021  Volume 140, Page(s) 105291

    Abstract: Coronavirus disease 2019 (Covid-19) has highlighted the link between public healthcare and the broader context of operational response to complex crises. Data are needed to support the work of the emergency services and enhance governance. This study ... ...

    Abstract Coronavirus disease 2019 (Covid-19) has highlighted the link between public healthcare and the broader context of operational response to complex crises. Data are needed to support the work of the emergency services and enhance governance. This study develops a Europe-wide analysis of perceptions, needs and priorities of the public affected by the Covid-19 emergency. An online multilingual survey was conducted from mid-May until mid-July 2020. The questionnaire investigates perceptions of public healthcare, emergency management and societal resilience. In total, N = 3029 valid answers were collected. They were analysed both as a whole and focusing on the most represented countries (Italy, Romania, Spain and the United Kingdom). Our findings highlight some perceived weaknesses in emergency management that are associated with the underlying vulnerability of the global interconnected society and public healthcare systems. The spreading of the epidemic in Italy represented a 'tipping point' for perceiving Covid-19 as an 'emergency' in the surveyed countries. The respondents uniformly suggested a preference for gradually restarting activities. We observed a tendency to ignore the cascading effects of Covid-19 and possible concurrence of threats. Our study highlights the need for practices designed to address the next phases of the Covid-19 crisis and prepare for future systemic shocks. Cascading effects that could compromise operational capacity need to be considered more carefully. We make the case for the reinforcement of cross-border coordination of public health initiatives, for standardization in business continuity management, and for dealing with the recovery at the European level.
    Language English
    Publishing date 2021-04-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1074634-1
    ISSN 1879-1042 ; 0925-7535
    ISSN (online) 1879-1042
    ISSN 0925-7535
    DOI 10.1016/j.ssci.2021.105291
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  8. Article: A fresh look at spinal alignment and deformities: Automated analysis of a large database of 9832 biplanar radiographs.

    Galbusera, Fabio / Bassani, Tito / Panico, Matteo / Sconfienza, Luca Maria / Cina, Andrea

    Frontiers in bioengineering and biotechnology

    2022  Volume 10, Page(s) 863054

    Abstract: We developed and used a deep learning tool to process biplanar radiographs of 9,832 non-surgical patients suffering from spinal deformities, with the aim of reporting the statistical distribution of radiological parameters describing the spinal shape and ...

    Abstract We developed and used a deep learning tool to process biplanar radiographs of 9,832 non-surgical patients suffering from spinal deformities, with the aim of reporting the statistical distribution of radiological parameters describing the spinal shape and the correlations and interdependencies between them. An existing tool able to automatically perform a three-dimensional reconstruction of the thoracolumbar spine has been improved and used to analyze a large set of biplanar radiographs of the trunk. For all patients, the following parameters were calculated: spinopelvic parameters; lumbar lordosis; mismatch between pelvic incidence and lumbar lordosis; thoracic kyphosis; maximal coronal Cobb angle; sagittal vertical axis; T1-pelvic angle; maximal vertebral rotation in the transverse plane. The radiological parameters describing the sagittal alignment were found to be highly interrelated with each other, as well as dependent on age, while sex had relatively minor but statistically significant importance. Lumbar lordosis was associated with thoracic kyphosis, pelvic incidence and sagittal vertical axis. The pelvic incidence-lumbar lordosis mismatch was found to be dependent on the pelvic incidence and on age. Scoliosis had a distinct association with the sagittal alignment in adolescent and adult subjects. The deep learning-based tool allowed for the analysis of a large imaging database which would not be reasonably feasible if performed by human operators. The large set of results will be valuable to trigger new research questions in the field of spinal deformities, as well as to challenge the current knowledge.
    Language English
    Publishing date 2022-07-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2719493-0
    ISSN 2296-4185
    ISSN 2296-4185
    DOI 10.3389/fbioe.2022.863054
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  9. Article ; Online: Measuring the critical shoulder angle on radiographs: an accurate and repeatable deep learning model.

    Minelli, Marco / Cina, Andrea / Galbusera, Fabio / Castagna, Alessandro / Savevski, Victor / Sconfienza, Luca Maria

    Skeletal radiology

    2022  Volume 51, Issue 9, Page(s) 1873–1878

    Abstract: Purpose: Since the critical shoulder angle (CSA) is considered a risk factor for shoulder pathology and the intra- and inter-rater variabilities in its calculation are not negligible, we developed a deep learning model that calculates it automatically ... ...

    Abstract Purpose: Since the critical shoulder angle (CSA) is considered a risk factor for shoulder pathology and the intra- and inter-rater variabilities in its calculation are not negligible, we developed a deep learning model that calculates it automatically and accurately.
    Methods: We used a dataset of 8467 anteroposterior x-ray images of the shoulder annotated with 3 landmarks of interest. A Convolutional Neural Network model coupled with a spatial to numerical transform (DSNT) layer was used to predict the landmark coordinates from which the CSA was calculated. The performances were evaluated by calculating the Euclidean distance between the ground truth coordinates and the predicted ones normalized with respect to the distance between the first and the second points, and the error between the CSA angle measured by a human observer and the predicted one.
    Results: Regarding the normalized point distances, we obtained a median error of 2.9%, 2.5%, and 2% for the three points among the entire set. Considering CSA calculations, the median errors were 1° (standard deviation 1.2°), 0.88° (standard deviation 0.87°), and 0.99° (standard deviation 1°) for angles below 30°, between 30° and 35°, and above 35°, respectively.
    Discussion: These results demonstrate that the model has the potential to be used in clinical settings where the replicability is important. The reported standard error of the CSA measurement is greater than 2° that is above the median error of our model, indicating a potential accuracy sufficient to be used in a clinical setting.
    MeSH term(s) Deep Learning ; Humans ; Radiography ; Retrospective Studies ; Shoulder/diagnostic imaging ; Shoulder Joint/diagnostic imaging
    Language English
    Publishing date 2022-03-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 527592-1
    ISSN 1432-2161 ; 0364-2348
    ISSN (online) 1432-2161
    ISSN 0364-2348
    DOI 10.1007/s00256-022-04041-5
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  10. Article ; Online: Genome-wide gene expression noise in Escherichia coli is condition-dependent and determined by propagation of noise through the regulatory network.

    Urchueguía, Arantxa / Galbusera, Luca / Chauvin, Dany / Bellement, Gwendoline / Julou, Thomas / van Nimwegen, Erik

    PLoS biology

    2021  Volume 19, Issue 12, Page(s) e3001491

    Abstract: Although it is well appreciated that gene expression is inherently noisy and that transcriptional noise is encoded in a promoter's sequence, little is known about the extent to which noise levels of individual promoters vary across growth conditions. ... ...

    Abstract Although it is well appreciated that gene expression is inherently noisy and that transcriptional noise is encoded in a promoter's sequence, little is known about the extent to which noise levels of individual promoters vary across growth conditions. Using flow cytometry, we here quantify transcriptional noise in Escherichia coli genome-wide across 8 growth conditions and find that noise levels systematically decrease with growth rate, with a condition-dependent lower bound on noise. Whereas constitutive promoters consistently exhibit low noise in all conditions, regulated promoters are both more noisy on average and more variable in noise across conditions. Moreover, individual promoters show highly distinct variation in noise across conditions. We show that a simple model of noise propagation from regulators to their targets can explain a significant fraction of the variation in relative noise levels and identifies TFs that most contribute to both condition-specific and condition-independent noise propagation. In addition, analysis of the genome-wide correlation structure of various gene properties shows that gene regulation, expression noise, and noise plasticity are all positively correlated genome-wide and vary independently of variations in absolute expression, codon bias, and evolutionary rate. Together, our results show that while absolute expression noise tends to decrease with growth rate, relative noise levels of genes are highly condition-dependent and determined by the propagation of noise through the gene regulatory network.
    MeSH term(s) Escherichia coli/genetics ; Escherichia coli Proteins/genetics ; Gene Expression/genetics ; Gene Expression Profiling/methods ; Gene Expression Regulation, Bacterial/genetics ; Gene Regulatory Networks/genetics ; Genes, Reporter/genetics ; Promoter Regions, Genetic/genetics ; Transcriptome/genetics
    Chemical Substances Escherichia coli Proteins
    Language English
    Publishing date 2021-12-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2126776-5
    ISSN 1545-7885 ; 1544-9173
    ISSN (online) 1545-7885
    ISSN 1544-9173
    DOI 10.1371/journal.pbio.3001491
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