Precise Discrimination for Multiple Etiologies of Dementia Cases Based on Deep Learning with Electroencephalography.

INTRODUCTION: It is critical to develop accurate and universally available biomarkers for dementia diseases to appropriately deal with the dementia problems under world-wide rapid increasing of patients with dementia. In this sense, electroencephalography (EEG) has been utilized as a promising examination to screen and assist in diagnosing dementia, with advantages of sensitiveness to neural functions, inexpensiveness, and high availability. Moreover, the algorithm-based deep learning can expand EEG applicability, yielding accurate and automatic classification easily applied even in general hospitals without any research specialist. METHODS: We utilized a novel deep neural network, with which high accuracy of discrimination was archived in neurological disorders in the previous study. Based on this network, we analyzed EEG data of healthy volunteers (HVs, N = 55), patients with Alzheimer's disease (AD, N = 101), dementia with Lewy bodies (DLB, N = 75), and idiopathic normal pressure hydrocephalus (iNPH, N = 60) to evaluate the discriminative accuracy of these diseases. RESULTS: High discriminative accuracies were archived between HV and patients with dementia, yielding 81.7% (vs. AD), 93.9% (vs. DLB), 93.1% (vs. iNPH), and 87.7% (vs. AD, DLB, and iNPH). CONCLUSION: This study revealed that the EEG data of patients with dementia were successfully discriminated from HVs based on a novel deep learning algorithm, which could be useful for automatic screening and assisting diagnosis of dementia diseases.

A revision of JPOS/JASCC clinical guidelines for delirium in adult cancer patients: a summary of recommendation statements.

OBJECTIVE: The Japanese Psycho-Oncology Society and the Japanese Association of Supportive Care in Cancer have recently revised the clinical practice guidelines for delirium in adult cancer patients. This article reports the process of developing the revised guidelines and summarizes the recommendations made. METHODS: The guidelines were developed in accordance with the Medical Information Network Distribution Service creation procedures. The guideline development group, consisting of multi-disciplinary members, created three new clinical questions: non-pharmacological intervention and antipsychotics for the prevention of delirium and trazodone for the management of delirium. In addition, systematic reviews of nine existing clinical questions have been updated. Two independent reviewers reviewed the proposed articles. The certainty of evidence and the strength of the recommendations were graded using the grading system developed by the Medical Information Network Distribution Service, following the concept of The Grading of Recommendations Assessment, Development, and Evaluation system. The modified Delphi method was used to validate the recommended statements. RESULTS: This article provides a compendium of the recommendations along with their rationales, as well as a short summary. CONCLUSIONS: These revised guidelines will be useful for the prevention, assessment and management of delirium in adult cancer patients in Japan.

Association between the Rostral Anterior Cingulate Cortex and Anterior Insula in the Salience Network on Response to Antidepressants in Major Depressive Disorder as Revealed by Isolated Effective Coherence.

INTRODUCTION: Functional connectivity is attracting increasing attention for understanding the pathophysiology of depression and predicting the therapeutic efficacy of antidepressants. In this study, we evaluated effective connectivity using isolated effective coherence (iCoh), an effective functional connectivity analysis method developed from low-resolution brain electromagnetic tomography (LORETA) and estimated its practical usefulness for predicting the reaction to antidepressants in theta and alpha band iCoh values. METHODS: We enrolled 25 participants from a depression treatment randomized study (the GUNDAM study) in which electroencephalography was performed before treatment. We conducted iCoh between the rostral anterior cingulate cortex (rACC) and anterior insula (AI), which are associated with the salience network. The patients were divided into responder and nonresponder groups at 4 weeks after the start of treatment, and iCoh values were compared between the two groups. Additionally, the sensitivity and specificity of iCoh were calculated using the receiver-operating characteristic (ROC) curve. RESULTS: The Mann-Whitney U test showed significantly weaker connectivity flow from the rACC to the left AI in the alpha band in the responder group. The ROC curve for the connectivity flow from the rACC to the left AI in the alpha band showed 82% sensitivity and 86% specificity. DISCUSSION/CONCLUSION: These findings suggest the pathological importance of effective connectivity flow from the rACC to the left AI in the alpha and theta bands and suggest its usefulness as a biomarker to distinguish responders to antidepressants.

Disentangling cognitive inflexibility in major depressive disorder: A transcranial direct current stimulation study.

BACKGROUND: Cognitive dysfunction is a persistent residual symptom in major depressive disorders (MDDs) that hinders social and occupational recovery. Cognitive inflexibility is a typical cognitive dysfunction in MDD and refers to difficulty in switching tasks, which requires two subcomponents: forgetting an old task and adapting to a new one. Here, we aimed to disentangle the subcomponents of cognitive inflexibility in MDD and investigate whether they can be improved by transcranial direct current stimulation (tDCS) on the prefrontal cortex. METHODS: The current study included 20 patients with MDD (seven females) and 22 age-matched healthy controls (HCs) (seven females). The participants received anodal tDCS on either the dorsomedial prefrontal cortex (DMPFC) or dorsolateral prefrontal cortex (DLPFC) in a crossover design. Before and after the application of tDCS, the participants performed a modified Wisconsin Card Sorting Test, in which the task-switching rules were explicitly described and proactive interference from a previous task rule was occasionally released. RESULTS: We found that the behavioral cost of a task switch was increased in patients with MDD, but that of proactive interference was comparable between patients with MDD and HCs. The response time for anodal DMPFC tDCS was decreased compared with that for anodal tDCS on the DLPFC in MDD. CONCLUSIONS: These findings suggest that cognitive inflexibility in MDD is primarily explained by the difficulty to adapt to a new task and environment, and that tDCS on the DMPFC improves behavioral performance during cognitively demanding tasks that require conflict resolution.

Effects of a wearable device and functional wear on spinal alignment and jump performance.

BACKGROUND/OBJECTIVE: To elucidate the effects of walking exercise using a wearable device and functional wear on spinal alignment and jump performance. METHODS: In total, 27 female college soccer players were randomly divided into two groups: trunk solution (TS) and compression garments (CGs). Spinal alignment, jump performance, and electromyography activity during the jump performance of the two groups were measured after a 20-min walking exercise. The values for each group were compared t pre- and post-intervention. RESULTS: The flexibility of the lower thoracic vertebrae in spinal alignment was increased during extension in the TS group. However, the post-value of the abdominal external oblique muscle during a countermovement jump (CMJ) was significantly lower than its pre-value (p < 0.05). In addition, even though spinal alignment was not affected in the CG group, post-values of the jump height during squat jump and CMJ were significantly higher than their pre-values (p < 0.05). Furthermore, the post-value of the biceps femoris during the countermovement jump with arm was significantly lower than its pre-value (p < 0.05). CONCLUSION: Our study suggested that walking exercise using TS may increase the range of motion of the lower thoracic vertebrae in athletes and reduce the muscular activity of the vastus lateralis during CMJ. Additionally, although spinal aliment is not affected, the jump height may increase using CGs.

JPOS/JASCC clinical guidelines for delirium in adult cancer patients: a summary of recommendation statements.

BACKGROUND: The Japanese Psycho-Oncology Society and Japanese Association of Supportive Care in Cancer recently launched the clinical practice guidelines for delirium in adult cancer patients. The aim of the guidelines was to provide evidence-based recommendations for the clinical assessment and management of delirium in cancer patients. This article reports the process of developing the guideline and summarizes the recommendations made. METHODS: The guidelines were developed in accordance with the Medical Information Network Distribution Service creation procedures. The guideline development group, consisting of multidisciplinary members, formulated nine clinical questions. A systematic literature search was conducted to identify relevant articles published prior to through 31 May 2016. Each article was reviewed by two independent reviewers. The level of evidence and the strength of the recommendations were graded using the grading system developed by the Medical Information Network Distribution Service, following the concept of The Grading of Recommendations Assessment, Development and Evaluation system. The modified Delphi method was used to validate the recommendation statements. RESULTS: This article provides a summary of the recommendations with rationales for each, as well as a short summary. CONCLUSIONS: These guidelines will support the clinical assessment and management of delirium in cancer patients. However, additional clinical studies are warranted to further improve the management of delirium.

Association between the ACE I/D polymorphism and muscle injuries in Italian and Japanese elite football players.

ACE I/D polymorphism has been recently associated with the susceptibility to inflammation and muscle damage after exercise. The aim of this study was to understand the association between the ACE I/D polymorphism and muscle injuries in a large cohort of elite football players from two different countries. Seven hundred and ten male elite football players from Italy (n = 341) and Japan (n = 369) were recruited for the study. Genomic DNA was extracted from either the buccal epithelium or saliva using a standard protocol. Structural-mechanical injuries and functional muscle disorders were recorded from 2009 to 2018. A meta-analysis was performed using Review Manager 5.3.5. In the Japanese cohort, the ACE I/D polymorphism was significantly associated with muscle injury using the D-dominant model (OR: 0.48, 95% CI: 0.24-0.97, P = 0.040). The meta-analysis showed that in the pooled model (Italian and Japanese populations), the frequencies of the DD+ID genotypes were significantly lower in the injured groups than in non-injured groups (OR: 0.61, 95% CI: 0.38-0.98, P = 0.04) with a low degree of heterogeneity (I2  = 0%). Our findings suggest that the ACE I/D polymorphism could influence the susceptibility to developing muscle injuries among football players.

Reliability assessment of the functional movement screen for predicting injury risk in Japanese college soccer players.

[Purpose] This study aimed to assess the reliability of the Functional Movement Screen and explore whether this evaluation tool can predict the risks of personal injuries in Japanese soccer players. [Participants and Methods] Seventy-five Japanese college soccer players who participated in our 1 year prospective cohort study underwent a Functional Movement Screen assessment. Demographic data, athletic characteristics, and types and frequency of injuries sustained, were analyzed with the assessment results. [Results] There was no significant difference in the mean Functional Movement Screen composite scores between genders. Although the Functional Movement Screen showed excellent inter-rater reliability (0.92), low overall internal consistency (0.35) was observed. A maximum score of 3 in straight leg raise occurred in 94% of the females and was considered a ceiling effect. None of the cut-off point scores of the Functional Movement Screen were associated with the number of overall injuries, lower limb injuries, and traumatic injuries, or time to return to play. The Functional Movement Screen composite score of ≤15 represented the maximum sensitivity of 76.92% and specificity of 34.78% with 0.56 in the area under the curve. [Conclusion] Functional Movement Screen composite scores do not have sufficient sensitivity and specificity for predicting injuries in Japanese college soccer players.

Automated Source Estimation of Scalp EEG Epileptic Activity Using eLORETA Kurtosis Analysis.

OBJECTIVES: eLORETA (exact low-resolution brain electromagnetic tomography) is a technique created by Pascual-Marqui et al. [Int J Psychophysiol. 1994 Oct; 18(1): 49-65] for the 3-dimensional representation of current source density in the brain by electroencephalography (EEG) data. Kurtosis analysis allows for the identification of spiky activity in the brain. In this study, we focused on the evaluation of the reliability of eLORETA kurtosis analysis. For this purpose, the results of eLORETA kurtosis source localization of paroxysmal activity in EEG were compared with those of eLORETA current source density (CSD) analysis of EEG data in 3 epilepsy patients with partial seizures. METHODS: EEG was measured using a digital EEG system with 19 channels. We set the bandpass filter at traditional frequency band settings (1-4, 4-8, 8-15, 15-30, and 30-60 Hz) and 5-10 and 20-70 Hz and performed eLORETA kurtosis to compare the source localization of paroxysmal activity with that of visual interpretation of EEG data and CSD analysis of eLORETA in focal epilepsy patients. RESULTS: The eLORETA kurtosis analysis of EEG data preprocessed by bandpass filtering from 20 to 70 Hz and traditional frequency band settings did not show any discrete paroxysmal source activity compatible with the results of CSD analysis of eLORETA. In all 3 cases, eLORETA kurtosis analysis filtered at 5-10 Hz showed paroxysmal activities in the theta band, which were all consistent with the visual inspection results and the CSD analysis results. DISCUSSION: Our findings suggested that eLORETA kurtosis analysis of EEG data might be useful for the identification of spiky paroxysmal activity sources in epilepsy patients. Since EEG is widely used in the clinical practice of epilepsy, eLORETA kurtosis analysis is a promising method that can be applied to epileptic activity mapping.

Hyperactivation of the Frontal Control Network Revealed by Symptom Provocation in Obsessive-Compulsive Disorder Using EEG Microstate and sLORETA Analyses.

The aim of this study was to investigate the changes of brain electric field induced by symptom provocation in patients with obsessive-compulsive disorder (OCD) in comparison to healthy controls in the resting state. For this purpose, EEG recordings in conditions of initial rest, clean control, symptom provocation by imaginal exposure, and final rest were used for computing spatiotemporal activity characteristics based on microstate segmentation. Within-group comparisons were significant for the symptom provocation condition: OCD showed high global field power (GFP) and transition rates into a medial frontal microstate, whereas healthy controls showed high frequency of occurrence and high percent of dwelling time for a medial occipitoparietal microstate. Between-group comparisons demonstrated significantly lower GFP and dwelling time for the medial occipitoparietal microstate in OCD in several conditions including initial rest and symptom provocation. In addition, OCD compared to healthy controls showed significant instability of the medial occipitoparietal microstate, with high preference for transitions into the medial frontal microstate. In conclusion, during rest and symptom provocation, OCD patients make preferential use of a medial frontal brain network, with concomitant reduction of use of a medial occipitoparietal network, as shown by dwelling times, explained variance, and dynamic transition rates. These findings support the idea of a possible biological marker for OCD, which might correspond to pathological hyperactivation of the frontal control network.

[A Case Report of Bypass Surgery for a Perforated and Unresectable Gastric Cancer].

A 74-year-old man was admitted to a clinic because of epigastralgia in June 2018. He was referred to our hospital for further examination of right hydronephrosis. He was diagnosed as having type 2 gastric cancer in the middle gastric body and lesser curvature, with an upper gastric fiber, swollen para-aortic lymph node, and right hydronephrosis by using abdominal computed tomography. PET-CT revealed no hot spot in the para-aortic lymph node but revealed a hot spot in the lower small bowel. He was admitted to our hospital because of severe abdominal pain and appetite loss and underwent a reduction and palliative surgery for the unresectable gastric cancer. The omental cavity was perforated and penetrated into the retroperitoneum. He underwent esophageal jejunal bypass and intestinal fistula tube insertion in the stomach. He had a central vein port and was discharged from our hospital. He was able to eat during his short overnight stay at our hospital after the operation but died on postoperative day 30.

The Comparative Effects of Risperidone Long-Acting Injection and Paliperidone Palmitate on Social Functioning in Schizophrenia: A 6-Month, Open-Label, Randomized Controlled Pilot Trial.

PURPOSE: The aim of this study was to compare the effects of risperidone long-acting injection (RLAI) and paliperidone palmitate (PP) on non-acute-phase social functioning in patients with schizophrenia. PATIENTS AND METHODS: In this 6-month pilot, open-label, randomized controlled study, 30 patients with schizophrenia who had been treated with RLAI were randomly allocated to the RLAI continuation group or switched to the PP group. Patients were evaluated at baseline and 6 months with the Social Functioning Scale (SFS) as the primary outcome variable and University of California San Diego Performance-Based Skills Assessment Brief (UPSA-B), Social Emotional Cognition Task (SECT), Positive and Negative Syndrome Scale (PANSS), and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) scores as secondary outcomes. RESULTS: At baseline, the two groups did not significantly differ in demographic or clinical features. The two groups did not differ in total score changes for the UPSA-B, the SECT, the PANSS, and the DIEPSS. However, the total scores and the two subscales of the SFS, i.e. independence-competence and independence-performance, were more improved in the PP group compared to the RLAI group (total scores, p = 0.038; competence, p = 0.001, and performance, p = 0.007, respectively). CONCLUSION: These results suggest that PP may improve the total social functioning, independent life competence, and performance as compared to the RLAI group. However, these results are preliminary and need independent replication in larger samples before any definitive statement can be made.

Cognitive function and risperidone long-acting injection vs. paliperidone palmitate in schizophrenia: a 6-month, open-label, randomized, pilot trial.

BACKGROUND: Recently, long-acting injection (LAI) of second-generation antipsychotics has become a valuable strategy for the treatment of schizophrenia. However, few studies have compared the effects of different LAI antipsychotics on cognitive functions so far. The present study aimed to compare the influence of risperidone LAIs (RLAI) and paliperidone palmitate LAIs (PP) on cognitive function in outpatients with schizophrenia. METHODS: In this 6-month, open-label, randomized, and controlled study, 30 patients with schizophrenia who were treated with RLAIs were randomly allocated to the RLAI-continued group or the PP group. At baseline and 6 months, the patients were evaluated using the Brief Assessment of Cognition in Schizophrenia (BACS) that was the primary outcome of the study. The Subjective Well-being under Neuroleptic drug treatment-Short form (SWNS), the Positive and Negative Syndrome Scale (PANSS), and the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS) scores were secondary outcome variables and they were tested at the same time points. RESULTS: The two groups did not differ in terms of PANSS, DIEPSS, or SWNS total score changes. However, the BACS score for the attention and processing speed item showed higher improvement in the PP group than the RLAI group (p = 0.039). CONCLUSIONS: The results of this preliminary study suggest that PPs may improve attention and processing speed more than RLAIs. Anyway, a replication in a larger and double-blind study is needed. TRIAL REGISTRATION: UMIN000014470 . Registered 10 July 2014.

[Vascular dementia: an update].

The concept of vascular dementia(VaD) has been under discussion for long time. The most widely used guideline is NINDS-AIREN. However, this guideline tends to emphasize memory impairment, which seems very unrealistic in some cases. Although several guidelines have been created in addition to NINDS-AIREN, each of these guidelines has its advantages and disadvantages. With respect to the pathophysiology, there have been recent important findings, particularly about subcortical vascular dementia(SVD). From the therapeutic point of view, there have been high expectations for cholinesterase inhibitors and memantine, but the effectiveness of these drugs has not proved impressive so far. In this manuscript, we summarized the concept of VaD. In addition, we described recent findings related to pathophysiology and medication by cholinesterase inhibitors and memantine.

Integrating Different Aspects of Resting Brain Activity: A Review of Electroencephalographic Signatures in Resting State Networks Derived from Functional Magnetic Resonance Imaging.

Electroencephalography (EEG) is an established measure in the field of brain resting state with a range of quantitative methods (qEEG) that yield unique information about neuronal activation and synchronization. Meanwhile, in the last decade, functional magnetic resonance imaging (fMRI) studies have revealed the existence of more than a dozen resting state networks (RSNs), and combined qEEG and fMRI have allowed us to gain understanding about the relationship of qEEG and fMRI-RSNs. However, the overall picture is less clear because there is no a priori hypothesis about which EEG features correspond well to fMRI-RSNs. We reviewed the associations of several types of qEEG features to four RSNs considered as neurocognitive systems central for higher brain processes: the default mode network, dorsal and ventral frontoparietal networks, and the salience network. We could identify 12 papers correlating qEEG and RSNs in adult human subjects and employing a simultaneous design under a no-task resting state condition. A systematic overview investigates which qEEG features replicably relate to the chosen RSNs. This review article leads to the conclusion that spatially delimited θ and whole/local α may be the most promising measures, but the time domain methods add important additional information. © 2015 S. Karger AG, Basel.

Awareness of fifth metatarsal stress fractures among soccer coaches in Japan: A cross-sectional study.

Although a fifth metatarsal stress fracture is the most frequent stress fracture in soccer players, awareness of fifth metatarsal stress fractures among soccer coaches is unclear. Therefore, we performed an online survey of soccer coaches affiliated with the Japan Football Association to assess their awareness of fifth metatarsal stress fractures. A total of 150 soccer coaches were invited for an original online survey. Data on participants' age, sex, types of coaching licence, coaching category, types of training surface, awareness of fifth metatarsal stress fractures, and measures employed to prevent fifth metatarsal stress fractures were collected using the survey. Data from 117 coaches were analysed. Eighty-seven of the 117 coaches were aware of fifth metatarsal stress fractures; however, only 30% reported awareness of preventive and treatment measures for fifth metatarsal stress fractures. Licensed coaches (i.e., licensed higher than level C) were also more likely to be aware of fifth metatarsal stress fractures than unlicensed coaches were. Furthermore, although playing on artificial turf is an established risk factor for numerous sports injuries, soccer coaches who usually trained on artificial turf were more likely to be unaware of the risks associated with fifth metatarsal stress fractures than coaches who trained on other surfaces were (e.g., clay fields). Soccer coaches in the study population were generally aware of fifth metatarsal stress fractures; however, most were unaware of specific treatment or preventive training strategies for fifth metatarsal stress fractures. Additionally, coaches who practised on artificial turf were not well educated on fifth metatarsal stress fractures. Our findings suggest the need for increased awareness of fifth metatarsal stress fractures and improved education of soccer coaches regarding injury prevention strategies.　.

Effects of high-frequency hyperthermia on the elastic modulus of the lumbar muscle in female athletes with low back pain: A randomized crossover trial.

OBJECTIVE: To investigate the effects of capacitive and resistive monopolar radiofrequency (CRMF) on the shear elastic modulus of the multifidus and erector spinae muscles in female athletes with low back pain (LBP) and a history of LBP. DESIGN: Randomized crossover trial. SETTING: Academic institution. PARTICIPANTS: Twenty female university athletes with LBP or a history of LBP were included. INTERVENTIONS: All participants received CRMF, hotpack, and sham (CRMF without power) in a random order on the right side of the lumbar region. More than 2 days were allocated between the experiments to eliminate any residual effects. MAIN OUTCOME MEASURES: The shear elastic moduli of the right multifidus and erector spinae were evaluated in the prone (rest) position while sitting with 35° trunk flexion (stretched) using shear wave ultrasound imaging equipment. The moduli were measured before, immediately after, and 30 minutes after the intervention. RESULTS: Repeated-measures 2-way analysis of variance and post hoc analysis showed that the moduli of the CRMF group were significantly lower than those of the sham group in the stretched position immediately after intervention (P = .045). This difference diminished 30 minutes after the intervention (P = .920). CONCLUSIONS: CRMF can be used to reduce the shear elastic modulus of the multifidus muscle in the short term. Further studies are warranted to determine how to provide longer effects. TRIAL REGISTRATION: None.

Vitamin D levels and bone mineral density of middle-aged premenopausal female football and volleyball players in Japan: a cross-sectional study.

BACKGROUND: The number of football teams in senior categories has increased. As outdoor sports entail players being exposed to sunlight, playing football may contribute to maintaining vitamin D stores and body mineral density while preventing osteoporosis. This study aimed to determine the bone mineral density and vitamin D levels in middle-aged premenopausal female football players. METHODS: Participants were premenopausal females in their 40s. We evaluated bone mineral density of the second to the fourth lumbar vertebrae and femoral neck, serum 25-hydroxy vitamin D (25-OHD) levels, which is an indicator of vitamin D stores, and body composition. In addition, we administered a questionnaire survey on exercise habits and lifestyle. Ninety-two participants were categorised into three groups: the football group (n = 27), volleyball group (n = 40), and non-exercise group (n = 25). RESULTS: Bone mineral density was higher in the football and volleyball groups than in the non-exercise group (P < 0.01). The volleyball group had a significantly higher bone mineral density of the lumbar spine and femoral neck than the non-exercise group (P < 0.01). The football group had a significantly higher bone mineral density of the femoral neck than the non-exercise group (P < 0.01). Although the football group had played fewer years than the volleyball group (P < 0.01), serum 25-OHD levels were the highest in the football group and were significantly higher than those in the volleyball and non-exercise groups (P < 0.01). CONCLUSIONS: Middle-aged premenopausal football players had higher body vitamin D levels and bone mineral densities than non-active females. These results suggest that playing football may contribute to the prevention of osteoporosis. TRIAL REGISTRATION: UMIN Clinical Trials Registry UMIN000054235. 2024/04/23. Retrospectively registered.

Differences in the elastic modulus of the lumbar muscles between female athletes with and without low back pain.

BACKGROUND: Low back pain is the most prevalent musculoskeletal disorder affecting performance and sports participation among athletes and is more prevalent among female athletes. Evaluating the stiffness of the lumbar muscles is important for understanding the pathophysiology of low back pain. Therefore, this study examined the differences in stiffness of the lumbar multifidus and erector spinae muscles between female university athletes with and without low back pain. METHODS: This was a cross-sectional study. The study was conducted at a single centre, the university research laboratory. Twenty female university athletes with low back pain or a history of low back pain and 20 without low back pain participated in this study. The shear elastic moduli of the multifidus and erector spinae muscles were evaluated in the prone (to relax the muscles) and sitting with 35° of trunk flexion (to stretch the muscles) positions using shear wave ultrasound imaging equipment. FINDINGS: The low back pain group showed significantly greater shear elastic modulus in the multifidus in both prone and sitting positions than the non-low back pain group. There were no differences in the erector spinae muscle between the two groups at either position. INTERPRETATION: These results provide new insights into the microscopic characteristics of low back pain pathophysiology in young female athletes. Stiffness assessment using shear wave elastography will help provide a specific treatment strategy for female athletes with low back pain or a history of low back pain.

Comparing Accuracy of the Final Height Prediction Models for Elite Football Players and Developing a New Model.

Objective: This study aimed to assess the accuracy of previously developed height prediction models in male Japanese football players and create new height prediction models. Materials: The participants were elite academy male football players. We collected current height, parent's height, calendar age and bone age in 6th grade of primary school and obtained actual final height at 20 to 28 years old. Methods: We compared the accuracy of two conventional models for predicting final height. These used current height, calendar age and either bone age (Model 1) or parental height (Model 2). We then developed a new model to optimize the coefficients of Model 1 (Model 3). The final model added parental height to Model 3 and optimized the coefficients (Model 4). Results: Prediction accuracy was higher for Model 2 (R = 0.52, P < 0.001) than Model 1 (p = 0.33, P < 0.001). The equation of Model 3 was final height = 0.63229313×actual measured height-8.2541327×calendar age-2.3009853×bone age (TW2)+206.627184. The R-square was 0.49 (P < 0.0001). The equation of Model 4 was final height = 0.32156081×actual measured height - 4.6652063×calendar age+0.41903909×father's height+0.34952508×mother's height-0.740469×bone age(TW2)+62.1007751. The R-square was 0.61 (P < 0.0001). Conclusions: In the two previous conventional models, a formula using parental height had better predictive accuracy. We developed a new height prediction model using current height, calendar age, father's and mother's height and bone age.