Ribonanza: deep learning of RNA structure through dual crowdsourcing.

Prediction of RNA structure from sequence remains an unsolved problem, and progress has been slowed by a paucity of experimental data. Here, we present Ribonanza, a dataset of chemical mapping measurements on two million diverse RNA sequences collected through Eterna and other crowdsourced initiatives. Ribonanza measurements enabled solicitation, training, and prospective evaluation of diverse deep neural networks through a Kaggle challenge, followed by distillation into a single, self-contained model called RibonanzaNet. When fine tuned on auxiliary datasets, RibonanzaNet achieves state-of-the-art performance in modeling experimental sequence dropout, RNA hydrolytic degradation, and RNA secondary structure, with implications for modeling RNA tertiary structure.

Implant-assisted removable partial dentures: Part II. a systematic review of the effects of implant position on the biomechanical behavior.

PURPOSE: This systematic review aimed to evaluate the effects of implant placement sites on the biomechanical behavior of implant-assisted removable partial dentures (IARPDs) using finite element analysis (FEA). STUDY SELECTION: Two reviewers independently conducted manual searches of the PubMed, Scopus, and ProQuest databases for articles investigating implant location in IARPDs using FEA, according to the 2020 Systematic Reviews and Meta-analyses statement. Studies published in English up to August 1, 2022, were included in the analysis based on the critical question. RESULTS: Seven articles meeting the inclusion criteria were systematically reviewed. Six studies investigated mandibular Kennedy Class I and one study investigated mandibular Kennedy Class II. Implant placement reduced the displacement and stress distribution of the IARPD components, including dental implants and abutment teeth, regardless of the Kennedy Class type and dental implant placement site. Most of the included studies showed that, based on the biomechanical behavior, the molar region, rather than the premolar region, is the preferred implant placement site. None of the selected studies investigated the maxillary Kennedy Class I and II. CONCLUSIONS: Based on the FEA regarding mandibular IARPDs, we concluded that implant placement in both the premolar and molar regions improves the biomechanical behaviors of IARPD components, regardless of the Kennedy Class. Implant placement in the molar region results in more suitable biomechanical behaviors compared with implant placement in the premolar region in Kennedy Class I. No conclusion was reached for Kennedy Class II due to the lack of relevant studies.

Effect of intraoral administration of parathyroid hormone on osseous and soft tissue healing around implants in ovariectomized rat maxillae.

OBJECTIVES: Intermittent administration of parathyroid hormone (PTH) increases systemic bone mass. However, the effect of PTH on osseous and soft tissue healing around implants in osteoporosis patients remains unclear. This study aimed to investigate the effects of PTH on tissue healing around implants in ovariectomized rats and to compare systemic and intraoral administration routes. MATERIAL AND METHODS: Implants were placed at the healed sites of ovariectomized rats 3 weeks after maxillary first molar extraction. Rats were randomly divided into two groups that received either daily systemic subcutaneous or local intraoral PTH administration. Maxillae were dissected to examine bone architectures with micro-computed tomography images. Histomorphometric and immunohistochemical analyses were performed to evaluate osseous and soft tissue healing around the implants. RESULTS: Regardless of the administration route, PTH significantly increased bone area and the numbers of osteoblasts, osteoclasts, and osteocytes in the first and second inside and outside areas of implant threads, in addition to decreasing the number of sclerostin+ osteocytes. However, the intraoral PTH administration route was superior to the systemic route by significantly improving bone quality and promoting collagen production in the connective tissue around implants. CONCLUSIONS: Parathyroid hormone administration promoted both osseous and soft tissue healing around implants, irrespective of administration route. Interestingly, intraoral administration improved the evaluated parameters more than systemic administration. Thus, the intraoral route could become a useful treatment strategy for implant treatment in osteoporosis patients.

Preservation of Erectile and Ejaculatory Functions After Tetramodal Bladder-Sparing Therapy Incorporating Consolidative Partial Cystectomy Against Muscle Invasive Bladder Cancer.

OBJECTIVE: To cross-sectionally assess erectile and ejaculatory functions after tetramodal bladder-sparing therapy consisting of transurethral resection, chemoradiotherapy, and consolidative partial cystectomy in patients with muscle invasive bladder cancer. MATERIALS AND METHODS: Among 72 enrolled male patients who underwent tetramodal bladder-sparing therapy from 2006 to 2019, 42 who visited the outpatient clinic from February to October 2020 received questionnaires. Erectile function, ejaculatory function, and quality of life were assessed using the International Index of Erectile Function short form, the Male Sexual Health Questionnaire Ejaculatory Dysfunction short form, and the Functional Assessment of Cancer Therapy. RESULTS: Among the 42 patients, 9 were excluded because of incomplete responses and 33 were eligible for analyses. The median (range) age at survey and the time from treatment completion to responding to the questionnaires was 70 (50-87) years and 4.2 (0.4-14.0) years, respectively. The median International Index of Erectile Function short form-5 score was 11 (5-25), and 3 (9.1%) and 9 (27.3%) patients had no and mild erectile dysfunction, respectively. The Male Sexual Health Questionnaire Ejaculatory Dysfunction short form results showed that 23 (69.7%) patients responded that they could ejaculate. Patients with higher Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores had better erectile function and quality of life than those with lower Male Sexual Health Questionnaire Ejaculatory Dysfunction short form scores. CONCLUSION: Preservation of erectile and ejaculatory functions was demonstrated in muscle invasive bladder cancer patients treated with tetramodal bladder-sparing therapy. In addition to lower urinary tract function, preservation of male sexual function, especially ejaculatory function, in bladder-sparing therapy can be an advantage over radical cystectomy.

Stone-event-free survival after ureteroscopic lithotripsy by age: comparison between young and older patients.

The aim of this study is to examine stone-event-free survival after ureteroscopic lithotripsy (URSL) and risk factors for stone events by age. We retrospectively collected data of all URSL cases at our institution from 2008 to 2021. A total of 1334 cases were included and divided into young (< 65 years, 792 cases), young-old (65-74 years, 316 cases), old-old (75-84 years, 172 cases), and oldest-old (≥ 85 years, 54 cases) groups. Patient characteristics, surgical outcomes, and postoperative stone events were evaluated. The stone-event-free survival and risk factors were compared between young and older groups. Overall, 214 (16.0%) cases developed stone events during a mean follow-up period of 763 days and the 2-year, 5-year, and 8-year stone-event-free survival rates were 84.5%, 72.2%, and 57.2%, respectively. The numbers of stone events in young, young-old, old-old, oldest-old groups were 133 (16.8%), 53 (16.8%), 21 (12.2%), and 7 (13.0%), respectively. No significant differences were found in stone-event-free survival between the young group and each of the older groups. Residual fragment > 4 mm and stone burden ≥ 15 mm were common risk factors in both young and older groups. Especially in older patients, preoperative stenting, which was most often performed to treat obstructive pyelonephritis, was the third risk factor. In conclusion, stone-event-free survival after URSL was comparable between young and older patients. Residual fragment > 4 mm and stone burden ≥ 15 mm were common risk factors in both groups. Preoperative stenting was an additional risk factor in older patients, suggesting that urinary tract infection may influence stone events.

A phase II randomized trial of metastasis-directed therapy with alpha emitter radium-223 in men with oligometastatic castration-resistant prostate cancer (MEDAL).

BACKGROUND: The significance of metastasis-directed therapy for oligometastatic prostate cancer has been widely discussed, and targeted therapy for progressive sites is a feasible option as a multidisciplinary treatment for castration-resistant prostate cancer (CRPC). When oligometastatic CRPC with only bone metastases progresses after targeted therapy, it tends to progress as multiple bone metastases. The progression of oligometastatic CRPC after targeted therapy may be due in part to the presence of micrometastatic lesions that, though undetected on imaging, were present prior to targeted therapy. Thus the systemic treatment of micrometastases in combination with targeted therapy for progressive sites is expected to enhance the therapeutic effect. Radium-223 dichloride (radium-223) is a radiopharmaceutical that selectively binds to sites of increased bone turnover and inhibits the growth of adjacent tumor cells by emitting alpha rays. Therefore, for oligometastatic CRPC with only bone metastases, radium-223 may enhance the therapeutic effect of radiotherapy for active metastases. METHODS: This phase II, randomized trial of Metastasis-Directed therapy with ALpha emitter radium-223 in men with oligometastatic CRPC (MEDAL) is designed to assess the utility of radium-223 in combination with metastasis-directed radiotherapy in patients with oligometastatic CRPC confined to bone. In this trial, patients with oligometastatic CRPC with three or fewer bone metastases on whole-body MRI with diffusion-weighted MRI (WB-DWI) will be randomized in a 1:1 ratio to receive radiotherapy for active metastases plus radium-223 or radiotherapy for active metastases alone. The prior use of androgen receptor axis-targeted therapy and prostate-specific antigen doubling time will be used as allocation factors. The primary endpoint will be radiological progression-free survival against progression of bone metastases on WB-DWI. DISCUSSION: This will be the first randomized trial to evaluate the effect of radium-223 in combination with targeted therapy in oligometastatic CRPC patients. The combination of targeted therapy for macroscopic metastases with radiopharmaceuticals targeting micrometastasis is expected to be a promising new therapeutic strategy for patients with oligometastatic CRPC confined to bone. Trial registration Japan Registry of Clinical Trials (jRCT) (jRCTs031200358); Registered on March 1, 2021, https://jrct.niph.go.jp/latest-detail/jRCTs031200358.

Controlled mechanical early loads improve bone quality and quantity around implants: An in vivo experimental study.

OBJECTIVES: This study aimed to investigate the effects of early loads on bone quality and quantity around implants and to compare the effects of early loads on bone quality and quantity with the effects of conventional loads. MATERIALS AND METHODS: Grade IV-titanium implants with buttress threads were placed in rat maxillary bone 4 weeks after extraction of first molars. A controlled mechanical load (10 N, 3 Hz, 1800 cycles, 2 days/week) was started via the implants 1 and 3 weeks after implant placement for 2 weeks (early and conventional loads, respectively). Bone quality, defined as distribution of bone cells, types and orientation of collagen fibers, and production of semaphorin3A, its receptor neuropilin-1, and sclerostin, were quantitatively evaluated. RESULTS: Early loads substantially and positively affected bone quality by changing the preferential alignment of collagen fibers with increased production of type I and III collagens, semaphorin3A, and neuropilin-1, increased osteoblast numbers, decreased production of sclerostin, and decreased osteoclast numbers both inside and outside the implant threads, when compared with non-loaded conditions. Conventional loads changed bone quality around implants slightly. Interestingly, early loads had significantly stronger effects on bone quality and quantity based on the evaluation parameters than conventional loads. CONCLUSIONS: This is the first report to provide scientific evidence for load initiation time based on both bone quality and quantity around implants. These new findings show that implants with buttress threads transmitted early loads optimally to bone tissue by improving bone quality and quantity inside and outside the implant threads.

Apparent Diffusion Coefficient Map-Based Texture Analysis for the Differentiation of Chromophobe Renal Cell Carcinoma from Renal Oncocytoma.

Preoperative imaging differentiation between ChRCC and RO is difficult with conventional subjective evaluation, and the development of quantitative analysis is a clinical challenge. Forty-nine patients underwent partial or radical nephrectomy preceded by MRI and followed by pathological diagnosis with ChRCC or RO (ChRCC: n = 41, RO: n = 8). The whole-lesion volume of interest was set on apparent diffusion coefficient (ADC) maps of 1.5T-MRI. The importance of selected texture features (TFs) was evaluated, and diagnostic models were created using random forest (RF) analysis. The Mean Decrease Gini as calculated through RF analysis was the highest for mean_ADC_value. ChRCC had a significantly lower mean_ADC_value than RO (1.26 vs. 1.79 × 10−3 mm2/s, p < 0.0001). Feature selection by the Boruta method identified the first-quartile ADC value and GLZLM_HGZE as important features. ROC curve analysis showed that there was no significant difference in the classification performances between the mean_ADC_value-only model and the Boruta model (AUC: 0.954 vs. 0.969, p = 0.236). The mean ADC value had good predictive ability for the distinction between ChRCC and RO, comparable to that of the combination of TFs optimized for the evaluated cohort. The mean ADC value may be useful in distinguishing between ChRCC and RO.

Optimal methods for estimating sports vision in kendo athletes.

This study investigated whether the eight standard tests of sports vision used in Japan appropriately reflect sports vision; whether all eight tests are necessary; and if not, which combination yields the optimal model. Participants were kendo practitioners (exercise group, n = 41) and those with no exercise habits (non-exercise group, n = 65). The performance of the two groups on all eight tests were compared. The groups differed in static visual acuity, kinetic visual acuity, and eye/hand coordination. A high correlation (r = 0.75) was observed between static visual acuity and kinetic visual acuity, while contrast sensitivity was moderately correlated with static visual acuity and kinetic visual acuity (r = 0.6), and dynamic visual acuity was moderately correlated with eye/hand coordination (r = - 0.66). Logistic regression analysis indicated that it is not necessary to conduct all eight tests; the optimal model included static visual acuity, visual reaction time, and eye/hand coordination. Our results suggest that static visual acuity, visual reaction time, and eye/hand coordination are sufficient for assessing visual function in kendo practitioners. For other sports, it may be possible to construct discriminative models using the same method and determine which aspects of visual function and which training methods to emphasise in a given sport.

Long-term survival after radical cystectomy and mesenteric lymph node dissection for squamous cell carcinoma arising from augmented bladder with lymph node metastasis: a case report.

Surgical resection is commonly performed for augmented bladder cancer, yet an optimal treatment strategy for augmented bladder cancer with lymph node metastasis has not been established. Here, we report a case that achieved 7 years of survival after radical cystectomy and mesenteric lymph node dissection for squamous cell carcinoma arising from augmented bladder with lymph node metastasis. Extended surgery could be a useful treatment option for locally advanced augmented bladder cancer including mesenteric lymph node metastasis.

Effects of surface sub-micrometer topography following oxalic acid treatment on bone quantity and quality around dental implants in rabbit tibiae.

BACKGROUND: To explore the effects of topographical modification of titanium substrates at submicron level by oxalic acid treatment on bone quality and quantity around dental implants in rabbit tibiae. METHODS: A total of 60 blasted CP-grade IV titanium dental implants were used. Twenty-eight control implant surfaces were treated with a mixture of HCl/H2SO4, whereas 28 other test implant surfaces were treated with oxalic acid following HCl/H2SO4 treatment. Two randomly selected sets of control or test implants were placed in randomly selected proximal tibiae of 14 female Japanese white rabbits. Euthanasia was performed 4 and 8 weeks post-implant placement. Bone to implant contact (BIC), bone area fraction (BAF), ratios of mature and immature bone to total bone, and the amount and types of collagen fibers were evaluated quantitatively. Two control and two test implants were used to analyze surface characteristics. RESULTS: Treatment by oxalic acid significantly decreased Sa and increased Ra of test implant surfaces. BIC in test implants was increased without alteration of BAF and collagen contents at 4 and 8 weeks after implant placement when compared with control implants. The ratios of immature and mature bone to total bone differed significantly between groups at 4 weeks post-implantation. Treatment by oxalic acid increased type I collagen and decreased type III collagen in bone matrices around test implants when compared with control implants at 8 weeks after implant placement. The effects of topographical changes of implant surfaces induced by oxalic acid on BAF, mature bone, collagen contents, and type I collagen were significantly promoted with decreased immature bone formation and type III collagen in the later 4 weeks post-implantation. CONCLUSIONS: Treatment of implant surfaces with oxalic acid rapidly increases osseointegration from the early stages after implantation. Moreover, submicron topographical changes of dental implants induced by oxalic acid improve bone quality based on bone maturation and increased production of type I collagen surrounding dental implants in the late stage after implant placement.

Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi.

Due to the aging population, the number of completely bedridden individuals is expected to increase, and such individuals are at high risk of developing urinary calculi. This retrospective study included 32 consecutive bedridden patients, who had undergone endoscopic lithotripsy between 2010 and 2019, and aimed to identify the treatment outcomes of endoscopic lithotripsy for bedridden patients. A total of 45 endoscopic lithotripsies were performed to treat stones (median cumulative diameter, 24 mm). The stone-free rate (SFR) < 4 mm and complete SFR (0 mm) were achieved in 81% and 63% of patients, respectively. Postoperatively, 10 patients (22%) developed symptoms of systemic inflammatory response syndrome, and three patients (7%) had bloodstream infections. Except for one patient (3%) having a retained ureteral stent ultimately died from septic shock, drainage tube-free discharge was achieved in all patients. The 2-year cumulative incidence of stone-related events, and overall mortality rate, were 18% and 27%, respectively. Endoscopic lithotripsy is well tolerated and is associated with a high success rate, even with severe comorbidities and a relatively large stone burden. Physicians should consider performing endoscopic lithotripsy in bedridden patients with symptomatic urinary calculi regardless of their relatively short life expectancy and the remote risk of perioperative mortality.

Intermittent administration of parathyroid hormone improves bone quality and quantity around implants in rat tibiae.

OBJECTIVES: Intermittent injection of parathyroid hormone (PTH) is used to treat osteoporosis. The concept of bone quality was updated 20 years ago; however, these updates have not been adopted in implant dentistry. This study aimed to investigate the effects of intermittent administration of PTH on bone quality around implants in rat tibiae. METHODS: Grade IV-titanium-threaded implants that were 3.5 mm long and 2.0 mm wide were placed in a randomly selected side of the proximal tibiae of 12-week-old female Wistar rats. Three weeks after implant placement, the rats were randomly divided into PTH-administration and saline-injection groups (PTH and VC, respectively; n = 7 per group). Micro-computed tomographical, histomorphometric, and immunohistochemical analyses were performed to evaluate bone quality and quantity surrounding the implants. RESULTS: PTH significantly increased bone volume and bone mineral density in bones not associated with the implants as compared to these values in the VC group. PTH significantly increased bone area and the amount of collagen within the total inside areas of all implant threads compared to that observed in VC. Moreover, PTH significantly increased the number of osteoblasts, osteocytes, and osteoclasts in the total inside and/or outside areas of all implant threads and altered the ratio of type I and III collagen to total collagen fibers. CONCLUSIONS: Within the limitations of this study, intermittent administration of PTH improved both bone quantity and bone quality based on the types and numbers of bone cells and the types of collagen fibers surrounding implants placed into rat tibiae.

Longitudinal changes in patient-reported outcomes after artificial urinary sphincter implantation.

OBJECTIVE: To evaluate the time course of lower urinary tract symptoms (LUTS) after artificial urinary sphincter (AUS) implantation based on individual longitudinal changes of patient-reported outcomes. METHODS: This retrospective study included 66 male patients with severe urinary incontinence who were treated with primary AUS implantation between 2009 and 2019. International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) and International Prostate Symptom Score (IPSS) questionnaires were used to evaluate continence status and LUTS preoperatively, 1, 3, and 12 months after activation, and then annually. The annual changes in scores were calculated with a linear mixed model. RESULTS: Of the 66 patients, 63 (95%) achieved complete or social continence (number of pads used ≤1/d) at 1 month after activation. Mean preoperative ICIQ-SF, IPSS, and IPSS-quality of life (QOL) score were 18.9, 14.9, and 5.4, respectively; the corresponding scores at 1 month after activation were 4.5, 9.0, and 1.7 (all P < .001), respectively. During the mean follow-up period of 36 months, the annual changes in the scores from 1 month after activation were 0.51 (P = .002), -0.30 (P = .184), and 0.19 (P < .001), respectively. As for individual IPSS items, while incomplete emptying, frequency, urgency, and weak stream improved significantly 1 month after activation, no significant changes from 1 month after activation were observed except for longitudinal deterioration of incomplete emptying score (0.08/y, P = .029). CONCLUSION: Continence status and QOL score markedly improved by AUS implantation immediately, but deteriorated over time. Improved LUTS were maintained without a worsening trend, however.

New Cerebello-Cortical Pathway Involved in Higher-Order Oculomotor Control.

The cerebellum and the basal ganglia play an important role in the control of voluntary eye movement associated with complex behavior, but little is known about how cerebellar projections project to cortical eye movement areas. Here we used retrograde transneuronal transport of rabies virus to identify neurons in the cerebellar nuclei that project via the thalamus to supplementary eye field (SEF) of the frontal cortex of macaques. After rabies injections into the SEF, many neurons in the restricted region, the ventral aspects of the dentate nucleus (DN), the caudal pole of the DN, and the posterior interpositus nucleus (PIN) were labeled disynaptically via the thalamus, whereas no neuron labeling was found in the anterior interpositus nucleus (AIN). The distribution of the labeled neurons was dorsoventrally different from that of DN and PIN neurons labeled from the motor cortex. In the basal ganglia, a large number of labeled neurons were confined to the dorsomedial portion of the internal segment of the globus pallidus (GPi) as more neurons were labeled in the inner portion of the GPi (GPii) than in the outer portion of the GPi (GPio). This is the first evidence of a projection between cerebellum/basal ganglia and the SEF that could enable the cerebellum to modulate the cognitive control of voluntary eye movement.

Progressive Site-Directed Therapy for Castration-Resistant Prostate Cancer: Localization of the Progressive Site as a Prognostic Factor.

PURPOSE: Locoregional therapy for oligometastatic prostate cancer has generated great interest. However, its benefit for castration-resistant prostate cancer (CRPC) has not been fully demonstrated. Our objective was to evaluate the treatment outcome of progressive site-directed therapy (PSDT) for oligoprogressive CRPC (OP-CRPC). METHODS AND MATERIALS: This study cohort consisted of 101 patients with CRPC who underwent whole-body diffusion-weighted magnetic resonance imaging between 2014 and 2018, when a new line of anticancer therapy was being considered. For OP-CRPC, PSDT with radiation therapy and unchanged continuation of systemic therapy were recommended. RESULTS: Thirty-eight patients received a diagnosis of OP-CRPC, and 23 (61%) underwent PSDT at a median prostate-specific antigen (PSA) level of 7.8 ng/mL. The regional radiation therapy targets were the prostate/pelvic lymph nodes (n = 7), bone (n = 15), or both (n = 1). A decrease in PSA levels of at least 50% in response to PSDT (50% PSA decline) was observed in 16 cases (70%); the median time to PSA progression was 8.7 months. Intrapelvic localization of progressive lesions was a significant predictor of time to PSA progression (hazard ratio, 6.6; P = .007) as well as volumes of abnormal signal intensity on whole-body diffusion-weighted magnetic resonance imaging (hazard ratio, 0.5; P = .045). A 50% PSA decline was achieved in 16 of the 18 patients with intrapelvic OP-CRPC (89%) and in none of the 5 patients with non-intrapelvic OP-CRPC (P < .001). Intrapelvic OP-CRPC had a significantly longer time to PSA progression than non-intrapelvic OP-CRPC (10.1 vs 4.8 months, P = .0014). CONCLUSIONS: PSDT can be an effective treatment option for OP-CRPC. Progressive site localization was an important factor in good PSA response.

The significance of intraoperative renal pelvic urine and stone cultures for patients at a high risk of post-ureteroscopy systemic inflammatory response syndrome.

We examined the renal pelvic urine culture (RPUC) and stone culture (SC) during ureteroscopy and evaluated their associations with postoperative systemic inflammatory response syndrome (SIRS). We prospectively collected data of 224 patients who underwent ureteroscopic laser lithotripsy from March 2015 to December 2017. We examined the bladder urine culture pre-operatively. If the patients had positive culture results, we treated them with antibiotics for 5-7 days before surgery based on the sensitivity profile. We collected RPUC and SC samples during surgery. After ureteroscopy, patients were closely monitored for any signs of SIRS. Using a logistic regression model, we analyzed how the clinical factors affected the incidence of SIRS. Pre-operative bladder urine culture (PBUC) was positive in 111 patients (49.6%). Intraoperative RPUC was positive in 43 patients (19.2%), and SC was positive in 34 patients (15.2%). Postoperatively, 23 patients (10.3%) were diagnosed with SIRS. A multivariate analysis revealed that female gender, struvite calculi and positive intraoperative RPUC results were significantly associated with postoperative SIRS. Among the 31 patients who were positive for both PBUC and intraoperative RPUC, the pathogens were not consistent in 11 patients (35.5%). Among the 25 patients who were positive for both PBUC and intraoperative SC, the pathogens were not consistent in 13 patients (52.0%). We recommend collecting RPUC and SC samples during ureteroscopy, especially for patients with high risk factors, including female gender, expected struvite calculi and positive PBUC results.

Measurement of time-varying kinematics of a dolphin in burst accelerating swimming.

Dolphins are well known as excellent swimmers for being capable of efficient cruising and sharp acceleration. While studies of the thrust production and power consumption of dolphin swimming have been the main subject for decades, time-varying acceleration process during successive fluke beats still remains poorly understood. In this study, we quantified the time-varying kinematics of a dolphin (Lagenorhynchus obliquidens) by directly recording its burst-accelerating swimming before vertical jump in an aquarium with two synchronized high-speed video cameras. We tracked the three-dimensional trajectories of its beak, body sides, and fluke. We found that dolphin could quickly accelerate from 5.0 m s-1 to 8.7 m s-1 merely by 5 strokes (i.e. 2.5 fluke beats) in 0.7 seconds. During the strokes, it was further found that the dolphin demonstrated a great acceleration in downstroke but less acceleration or even a slight deceleration in upstroke. Hydrodynamic forces and thrust power for each stroke were further estimated based on the equation of body motion and a static hydrodynamic model. The drag coefficient of the dolphin was estimated through computational fluid dynamics (CFD) modeling of the steady flows around a realistic geometric model based on 3-D scan data. The thrust and thrust power were then calculated by combining the body kinematics and the drag coefficient, resulting in a maximum stroke-averaged thrust and power-to-mass ratio of 1.3 × 103 N and 90 W kg-1 at downstroke, and 3.3 × 102 N and 19 W kg-1 at upstroke, respectively. Our results point out the importance of asymmetric kinematics in burst acceleration of dolphin, which may be a useful mechanism for biomimetic design of high-performance underwater robots.

Proposal for a Simple Anatomical Classification of the Pelvicaliceal System for Endoscopic Surgery.

We herein propose a nomenclature for renal calices and anatomical classification of the renal pelvis for endoscopic surgery. We prospectively collected data on a total of 270 patients (540 kidneys) who underwent CT-urography. We then constructed three-dimensional images of the renal pelvis and examined their morphologic classification. Forty-eight kidneys were excluded from this study because of severe hydronephrosis or large renal cysts. The remaining 492 kidneys were included. We systematically categorized each minor calix into five levels: top, upper, middle, lower, and bottom. The upper, middle, and lower calices were typically found in pairs: anterior and posterior. The most common total number of minor calices was eight (51%), followed by seven (30%). We also classified the form of the pelvis into type I: single pelvis (58%) and type II: divided pelvis (42%), according to the branch patterns of the renal pelvis. In type II, the renal pelvis is always bifurcated into the upper branch (top and upper) and lower branch (middle, lower, and bottom). Type I was subclassified into three types: type Ia (43%), the standard type; type Ib (4%), with a wide pelvis; and type Ic (11%), with a narrow pelvis. This anatomical classification can divide the renal pelvis into two major types (subdivided into four types) and name each minor calix. This simple classification enables to share common intrarenal information, thus leading to the development of concrete treatment strategies.