Epidemiology, Diagnosis and Management of Penile Cancer: Results from the Spanish National Registry of Penile Cancer.

INTRODUCTION: Penile cancer (PC) is a rare malignancy with an overall incidence in Europe of 1/100,000 males/year. In Europe, few studies report the epidemiology, risk factors, clinical presentation, and treatment of PC. The aim of this study is to present an updated outlook on the aforementioned factors of PC in Spain. MATERIALS AND METHODS: A multicentric, retrospective, observational epidemiological study was designed, and patients with a new diagnosis of PC in 2015 were included. Patients were anonymously identified from the Register of Specialized Care Activity of the Ministry of Health of Spain. All Spanish hospitals recruiting patients in 2015 were invited to participate in the present study. We have followed a descriptive narration of the observed data. Continuous and categorical data were reported by median (p25th-p75th range) and absolute and relative frequencies, respectively. The incidence map shows differences between Spanish regions. RESULTS: The incidence of PC in Spain in 2015 was 2.55/100,000 males per year. A total of 586 patients were identified, and 228 patients from 61 hospitals were included in the analysis. A total of 54/61 (88.5%) centers reported ≤ 5 new cases. The patients accessed the urologist for visually-assessed penile lesions (60.5%), mainly localized in the glans (63.6%). Local hygiene, smoking habits, sexual habits, HPV exposure, and history of penile lesions were reported in 48.2%, 59.6%, 25%, 13.2%, and 69.7%. HPV-positive lesions were 18.1% (28.6% HPV-16). The majority of PC was squamous carcinoma (95.2%). PC was ≥cT2 in 45.2% (103/228) cases. At final pathology, PC was ≥pT2 in 51% of patients and ≥pN1 in 17% of cases. The most common local treatment was partial penectomy (46.9% cases). A total of 47/55 (85.5%) inguinal lymphadenectomies were open. Patients with ≥pN1 disease were treated with chemotherapy in 12/39 (40.8%) of cases. CONCLUSIONS: PC incidence is relatively high in Spain compared to other European countries. The risk factors for PC are usually misreported. The diagnosis and management of PC are suboptimal, encouraging the identification of referral centers for PC management.

Child Care Center Hand Hygiene Programs' Cost-Effectiveness in Preventing Respiratory Infections.

BACKGROUND: We previously demonstrated that a hand hygiene program, including hand sanitizer and educational measures, for day care center (DCC) staff, children, and parents was more effective than a soap-and-water program, with initial observation, in preventing respiratory infections (RIs) in children attending DCCs. We analyzed the cost-effectiveness of these programs in preventing RIs. METHODS: A cluster, randomized, controlled and open study of 911 children aged 0 to 3 years, attending 24 DCCs in Almeria. Two intervention groups of DCC-families performed educational measures and hand hygiene, one with soap-and-water (SWG) and another with hand sanitizer (HSG). The control group (CG) followed usual hand-washing procedures. RI episodes, including symptoms, treatments, medical contacts, complementary analyses, and DCC absenteeism days, were reported by parents. A Bayesian cost-effectiveness model was developed. RESULTS: There were 5201 RI episodes registered. The adjusted mean societal costs of RIs per child per study period were CG: €522.25 (95% confidence interval [CI]: 437.10 to 622.46); HSG: €374.53 (95% CI: 314.90 to 443.07); SWG: €494.51 (95% CI: 419.21 to 585.27). The indirect costs constituted between 35.7% to 43.6% of the total costs. Children belonging to the HSG had an average of 1.39 fewer RI episodes than the CG and 0.93 less than the SWG. It represents a saving of societal cost mean per child per study period of €147.72 and €119.15, respectively. The HSG intervention was dominant versus SWG and CG. CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents are more effective and cost less than a program with soap and water and initial observation in children attending DCCs.

Blood Lead Level in a Paediatric Population of South-Eastern Spain and Associated Risk Factors.

OBJECTIVE: To determine blood lead levels (BLL) in a healthy paediatric population and to analyse related sociodemographic, dietary and haematological factors. METHODS: A cross-sectional study was made of 1427 healthy subjects aged 1-16 years from the city of Almería (south-eastern Spain). BLL, iron parameters and erythropoietin were determined, and sociodemographic and dietary data obtained. The study paramateters was analyses in BLL toxic and BLL no toxic group by multiple logistic regression. RESULTS: The mean BLL was 1.98 ± 1.1 µg/dL (95% CI:1.91-2.04). For 5.7% of the population, mean BLL was 2-5 µg/dL, for 2.1% it was >5 µg/dL and for 0.15% it was >10 µg/dL. Multivariate analysis showed that immigrant origin (OR:11.9; p < 0.0001), low level of parental education (OR:4.6; p < 0.02) and low dietary iron bioavailability (OR: 3.2; p < 0.02) were all risk factors for toxic BLL. Subjects with toxic and non-toxic BLL presented similar iron and erythropoiesis-related parameters, except erythrocyte protoporphyrin, which was significantly higher in the BLL >5 µg/dL group. CONCLUSIONS: BLL and the prevalence of toxic BLL in healthy subjects aged 1-16 years living in south-eastern Spain are low and similar to those found in other developed countries. The factors associated with toxic BLL are immigrant origin, low level of parental education and dietary iron deficiency. The toxicity of BLL was not related to changes in the analytical parameters studied.

[What happens if algorithmic music meets medicine]. / Cosa succede se la musica algoritmica incontra la medicina.

SUMMARY: Since ancient times there has been recognition of music's therapeutic powers, inherent in the properties of sound and its effects on human beings at a psychophysical level. Literature showed the development of therapeutic applications of music in numerous clinical settings. Music-listening itself can qualify as an effective therapeutic means within clinical contexts. Numerous studies document the potentialities of this practice. Whilst, it appears to be difficult to study the phenomenon of music from a scientific point of view, it may be possible to attempt moving music closer to science. Algorithms are of help in this process. Only recently has algorithmic music been used within the context of composing music with therapeutic aims helping to create songs for precise therapeutic aims: music characteristics can be altered and re-modelled and, above all, simplified. It was exactly this intent that recently brought into being an algorithm, Melomics-Health, which composes music with a "therapeutic" logic. Melomics-Health allows us to study the effect of specific musical parameters and structures on individuals (including neuro-scientific aspects) with the possibility to correlate effectiveness and efficiency to those precise musical aspects and to re-model the latter based on these findings. The use of algorithms applied to music as therapy constitutes a new starting point, an attempt to bring art and science closer together, to increase awareness and effectiveness in the use of music in therapeutic contexts; a new perspective integrating art, science and technology in the service of medicine, in clinical work and research.

Machine learning techniques to predict the effectiveness of music therapy: A randomized controlled trial.

BACKGROUND: The literature shows the effectiveness of music listening, but which factors and what types of music produce therapeutic effects, as well as how music therapists can select music, remain unclear. Here, we present a study to establish the main predictive factors of music listening's relaxation effects using machine learning methods. METHODS: Three hundred and twenty healthy participants were evenly distributed by age, education level, presence of musical training, and sex. Each of them listened to music for nine minutes (either to their preferred music or to algorithmically generated music). Relaxation levels were recorded using a visual analogue scale (VAS) before and after the listening experience. The participants were then divided into three classes: increase, decrease, or no change in relaxation. A decision tree was generated to predict the effect of music listening on relaxation. RESULTS: A decision tree with an overall accuracy of 0.79 was produced. An analysis of the structure of the decision tree yielded some inferences as to the most important factors in predicting the effect of music listening, particularly the initial relaxation level, the combination of education and musical training, age, and music listening frequency. CONCLUSIONS: The resulting decision tree and analysis of this interpretable model makes it possible to find predictive factors that influence therapeutic music listening outcomes. The strong subjectivity of therapeutic music listening suggests the use of machine learning techniques as an important and innovative approach to supporting music therapy practice.

Effectiveness of a Hand Hygiene Program at Child Care Centers: A Cluster Randomized Trial.

OBJECTIVES: Respiratory infections (RIs) are an important cause of morbidity and excessive antibiotic prescriptions in children attending day care centers (DCCs). We aimed to assess the effectiveness of an educational and hand hygiene program in DCCs and homes in reducing RI incidence and antibiotic prescriptions in children. METHODS: A cluster, randomized, controlled, and open study of 911 children aged 0 to 3 years attending 24 DCCs in Almería (Spain) with an 8-month follow-up. Two intervention groups of DCC families performed educational and hand hygiene measures, 1 with soap and water (SWG; n = 274), another with hand sanitizer (HSG; n = 339), and the control group (CG; n = 298) followed usual hand-washing procedures. RI episode rates were compared through multilevel Poisson regression models. The percentage of days missed were compared with Poisson exact tests. RESULTS: There were 5211 RI episodes registered. Children in the HSG had less risk of RI episodes (incidence rate ratio [IRR]: 0.77; 95% confidence interval [CI]: 0.68-0.88) and antibiotic prescriptions (IRR: 0.69; 95% CI: 0.57-0.84) compared with the those in the CG. Children in the SWG had a higher risk of RI episodes (IRR: 1.21; 95% CI: 1.06-1.39) and antibiotic prescriptions (IRR: 1.31; 95% CI: 1.08-1.56) than those in the HSG. Pupils missed 5186 DCC days because of RIs, and the percentage of days absent was significantly lower in the HSG compared with the CG (P < .001) and the SWG (P < .001). CONCLUSIONS: Hand hygiene programs that include hand sanitizer and educational measures for DCC staff, children, and parents, reduce absent days, RIs, and antibiotic prescriptions for these infections in children at DCCs.

Insulinaemia and insulin resistance in Caucasian general paediatric population aged 2 to 10 years: Associated risk factors.

BACKGROUND: The aim of this study is to determine values of insulinaemia, homeostasis model assessment (HOMA) index and quantitative insulin sensitivity check index (QUICKI) among a population of prepubertal Caucasian children, to analyse factors associated with insulin resistance (IR), and to study its association with cardiovascular risk factors. MATERIALS AND METHODS: Population-based study conducted on a randomly selected sample of prepubescent Caucasian subjects aged 2.00 to 9.99 years old. Anthropometric measurements, blood pressure, and fasting blood samples were obtained, including fasting glucose, triglycerides, High Density Lipoprotein (HDL)-cholesterol, and insulin. In addition, QUICKI and HOMA indices were calculated. Generalised additive models for location, scale and shape (GAMLSS) was used to calculate centiles curves and multivariate logistic regression analysis to assess factors associated with IR. RESULTS: A total of 654 subjects were included. Mean values obtained for insulinaemia, HOMA index, and QUICKI were 3.74 µIU/mL, 0.73, and 0.44, respectively, in the overall population and 3.32 µIU/mL, 0.64 and 0.46, respectively, in normal weight subjects. The main factor associated with IR was abdominal obesity (odds ratio [OR] 3.38 [95% CI 1.44-7.94] in the subgroup aged 2.00-5.99 years and OR 9.14 [3.42-24.41] for those aged 6.00-9.99 years). An increased risk of hyperglycaemia (P = 0.043), hypertriglyceridaemia (P < .001), and HDL < p10 (P = 0.021) was described among children aged 2.00 to 5.99 years with IR, and among those aged 6.00 to 9.99 years, IR was associated with an increased risk of hypertriglyceridaemia (P < .001). CONCLUSION: Abdominal obesity was the main factor associated with IR. Metabolic changes associated with IR seem to be present from early stages of life, which highlights the importance of the prevention, early diagnosis and treatment of obesity.

Listening to Relaxing Music Improves Physiological Responses in Premature Infants: A Randomized Controlled Trial.

BACKGROUND: Premature infants are exposed to high levels of noise in the neonatal intensive care unit (NICU). PURPOSE: This study evaluated the effect of a relaxing music therapy intervention composed by artificial intelligence on respiratory rate, systolic and diastolic blood pressure, and heart rate. METHODS: A double-blind, randomized, controlled trial was conducted in the NICUs of 2 general public hospitals in Andalusia, Spain. Participants were 17 healthy premature infants, randomly allocated to the intervention group or the control group (silence) at a 1:1 ratio. To be included in the study, the subjects were to be 32 to 36 weeks of gestation at birth (M= 32.33; SD = 1.79) and passed a hearing screening test satisfactorily. The intervention lasted 20 minutes, 3 times a day for 3 consecutive days, while infants were in the incubator. Infants' heart rate, respiratory rate, and blood pressure were assessed before and after each intervention session. RESULTS: After each session, the respiratory rate decreased in the experimental group (main between-groups effect (F1,13 = 6.73, P = .022, ηpartial = 0.34). Across the sessions, the heart rate increased in the control group (main between-groups effect, F1,11 = 5.09, P = .045, ηpartial = 0.32). IMPLICATIONS FOR RESEARCH: Future studies can use this music intervention to assess its potential effects in premature infants. IMPLICATIONS FOR PRACTICE: Nurses can apply the relaxing music intervention presented in this study to ameliorate the impact of the stressful environment on premature infants.

Does obesity modify prostate cancer detection in a European cohort?

INTRODUCTION: To investigate prostate-specific antigen (PSA) accuracy and digital rectal examination (DRE) accuracy in detecting prostate cancer according to body mass index (BMI) in Spanish men with an indication of the first prostate biopsy. MATERIAL AND METHODS: We reviewed the clinical and histopathological data of 1,319 patients who underwent transrectal ultrasound-guided prostate needle biopsy. The patients were categorised according to the BMI as follows: <25 kg/m2 (normal weight); 25-29.9 kg/m2 (overweight); and ≥30 kg/m2 (obese). Receiver operator characteristic curves were used to assess PSA accuracy and DRE accuracy by calculating the area under the curve. RESULTS: The obesity rate of the cohort was 14%. PSA accuracy for predicting prostate cancer in each BMI category was 0.52, 0.58 and 0.62, respectively (p = 0.01). After stratification by DRE findings, there was no difference in the performance accuracy of PSA in predicting the presence of cancer across BMI groups in abnormal DRE (p = 0.90). Serum PSA, DRE and BMI were strong predictors of prostate cancer diagnosis (odds ratio 1.07, 2.02 and 1.4, respectively; p <0.001). When the DRE was abnormal, a BMI ≥30 increased the risk of prostate cancer twice. With the addition of BMI to the model, the area under the curve of the combined PSA and DRE for diagnosing prostate cancer improved from 0.60 to 0.63. CONCLUSIONS: The predictive value of PSA in predicting prostate cancer is not poorer in the obese population and the predictive value of an abnormal DRE in cancer detection is significantly modified by the patient's BMI.

Influence of Music on Anxiety Induced by Fear of Heights in Virtual Reality.

Music is a potent mood regulator that can induce relaxation and reduce anxiety in different situations. While several studies demonstrate that certain types of music have a subjective anxiolytic effect, the reported results from physiological responses are less conclusive. Virtual reality allows us to study diverse scenarios of real life under strict experimental control while preserving high ecological validity. We aimed to study the modulating effect of music on the anxiety responses triggered by an immersive virtual reality scenario designed to induce fear of heights. Subjects experienced a virtual scenario depicting an exterior elevator platform ascending and descending the total height of its 350 meters tall supporting structure. Participants were allocated to either a group that experienced the elevator ride with background music or without, in a between-groups design. Furthermore, each group included participants with different degrees of fear of heights, ranging from low to high fear. Recordings of heart rate, galvanic skin response, body balance, and head movements were obtained during the experiments. Subjective anxiety was measured by means of three questionnaires. The scenario produced significant changes in subjective and physiological measures, confirming its efficacy as a stressor. A significant increase in state anxiety was found between pre and post-assessment in the silence group, but not in the music group, indicating that post-stress recovery was faster in the musical group. Results suggest that music can ameliorate the subjective anxiety produced by fear of heights.

Prevalencia de sobrepeso y obesidad en niños y adolescentes de 2 a 16 años / Prevalence of overweight and obesity in children and adolescents aged 2-16 years

Objetivos Calcular la prevalencia de obesidad y sobrepeso en niños y adolescentes de nuestra ciudad e investigar los factores asociados. Sujetos y métodos Estudio transversal de 1.317 niños y adolescentes de 2 a 16 años. Mediante muestreo probabilístico polietápico se seleccionaron 3 grupos: 411 de 12 a 16, 504 de 6 a 12 y 402 de 2 a 6 años. Se les calculó el índice de masa corporal y se definió obesidad y sobrepeso según la International Obesity Task Force. Se realizó un cuestionario de consumo de alimentos y de características clínicas y sociodemográficas. Los resultados se expresan como porcentajes (intervalos de confianza al 95%). Mediante regresión logística múltiple se estudió la asociación entre exceso de peso (obesidad y sobrepeso) y las distintas variables, calculando la odds ratio (OR) ajustada. Resultados El 9,5% (8,0-11,0) de los niños y adolescentes de 2 a 16 años son obesos y 22,4% (23,3-24,6) tienen sobrepeso. En el grupo de 12 a 16 años, el 8,5% (5,9-11,2) son obesos y el 20,5% (16,7-24,3) tienen sobrepeso, en el grupo de 6 a 12 años el 11,6% (8,9-14,3) y el 31,0% (27,0-35,0) y en el de 2 a 6 años el 8,0% (5,4-10,6) y el 13,6% (10,3-16,9), respectivamente. Se asocian con el exceso de peso la edad (OR 1,21; p<0,001), la obesidad materna (OR 10,99; p = 0,008), el peso al nacer mayor de 4kg (OR 2,91; p = 0,002) y la lactancia artificial exclusiva (OR 1,82; p = 0,005).Conclusión La obesidad y el sobrepeso infantil y juvenil son problemas extraordinariamente prevalentes en nuestra ciudad (AU)

Objectives To estimate the prevalence of obesity and overweight in children and adolescents in our city and to investigate the associated factors. Subjects and methods A cross-sectional study of 1317 children and adolescents aged 2-16 years. Multistage probability sampling was used to select three groups of subjects: 411 aged 12 to 16 years, 504 aged 6 to 12 years, and 402 aged 2 to 6 years. Body mass index was calculated, and obesity and overweight were diagnosed using the threshold levels of the International Obesity Task Force for children and adolescents. Parents were asked about eating habits, health, social, and demographic aspects. Results are given as percentages (95% confidence interval). The relationship between obesity and overweight and the different variables was studied using multiple logistic regression. The adjusted odds ratio (OR) was calculated. Results Among children and adolescentes aged 2-16 years, 9.5% (8.0%-11.0%) were obese and 22.4% (23.3%-24.6%) were overweight. Of subjects aged 12-16 years, 8.5% (5.9%-11.2%) were obese and 20.5% (16.7%-24.3%) were overweight. In the groups aged 6-12 years and 2-6 years, rates of obesity and overweight were 11.6% (8.9% -14.3%) and 31.0% (27.0-35.0) and 8.0% (5.4%-10.6%) and 13.6% (10.3%-16.9%) respectively. Obesity or overweight was associated to age (OR 1.21; P <0.001), maternal obesity (OR 10.99; P= 0.008), a birthweight higher than 4kg (OR 2.91; p 0.002), and formula feeding (OR 1.82; P= 0.005).Conclusion Obesity and overweight in children and adolescents are highly prevalent problems in our city (AU)

Prevalence of overweight and obesity in children and adolescents aged 2-16 years.

OBJECTIVES: To estimate the prevalence of obesity and overweight in children and adolescents in our city and to investigate the associated factors. SUBJECTS AND METHODS: A cross-sectional study of 1317 children and adolescents aged 2-16 years. Multistage probability sampling was used to select three groups of subjects: 411 aged 12 to 16 years, 504 aged 6 to 12 years, and 402 aged 2 to 6 years. Body mass index was calculated, and obesity and overweight were diagnosed using the threshold levels of the International Obesity Task Force for children and adolescents. Parents were asked about eating habits, health, social, and demographic aspects. Results are given as percentages (95% confidence interval). The relationship between obesity and overweight and the different variables was studied using multiple logistic regression. The adjusted odds ratio (OR) was calculated. RESULTS: Among children and adolescents aged 2-16 years, 9.5% (8.0%-11.0%) were obese and 22.4% (23.3%-24.6%) were overweight. Of subjects aged 12-16 years, 8.5% (5.9%-11.2%) were obese and 20.5% (16.7%-24.3%) were overweight. In the groups aged 6-12 years and 2-6 years, rates of obesity and overweight were 11.6% (8.9% -14.3%) and 31.0% (27.0-35.0) and 8.0% (5.4%-10.6%) and 13.6% (10.3%-16.9%) respectively. Obesity or overweight was associated to age (OR 1.21; P<0.001), maternal obesity (OR 10.99; P= 0.008), a birthweight higher than 4kg (OR 2.91; p 0.002), and formula feeding (OR 1.82; P= 0.005). CONCLUSION: Obesity and overweight in children and adolescents are highly prevalent problems in our city.

Emergent diversity in an open-ended evolving virtual community.

Understanding the dynamics of biodiversity has become an important line of research in theoretical ecology and, in particular, conservation biology. However, studying the evolution of ecological communities under traditional modeling approaches based on differential calculus requires species' characteristics to be predefined, which limits the generality of the results. An alternative but less standardized methodology relies on intensive computer simulation of evolving communities made of simple, explicitly described individuals. We study here the formation, evolution, and diversity dynamics of a community of virtual plants with a novel individual-centered model involving three different scales: the genetic, the developmental, and the physiological scales. It constitutes an original attempt at combining development, evolution, and population dynamics (based on multi-agent interactions) into one comprehensive, yet simple model. In this world, we observe that our simulated plants evolve increasingly elaborate canopies, which are capable of intercepting ever greater amounts of light. Generated morphologies vary from the simplest one-branch structure of promoter plants to a complex arborization of several hundred thousand branches in highly evolved variants. On the population scale, the heterogeneous spatial structuration of the plant community at each generation depends solely on the evolution of its component plants. Using this virtual data, the morphologies and the dynamics of diversity production were analyzed by various statistical methods, based on genotypic and phenotypic distance metrics. The results demonstrate that diversity can spontaneously emerge in a community of mutually interacting individuals under the influence of specific environmental conditions.

Análisis de las variables clínico-patológicas, grupos de estadiaje y pronósticos y resultados terapéuticos de 106 tumores testiculares germinales / Analysis of clinical-pathologic variables, staging and prognostic groups, and therapeutic results of 106 germ-cell testicular tumors

OBJETIVO: Revisión retrospectiva de 106 tumores germinales testiculares tratados en nuestro centro entre 1992 y 2009.METODOS: Descripción y análisis de determinadas variables clínico-patológicas, pronósticas y análisis de supervivencia(AU)

RESULTADOS: Un 68 % se diagnosticaron en los últimos 5 años. Un 54.7 % presentaron histología seminomatosa. La edad media (años) al diagnóstico para seminoma (S) y no seminoma (NS) fue de 33.47 y 27.63 respectivamente; p=0.001. El tamaño tumoral (TT) medio (mm) globalmente fue de 45.99 mm. 29.3% de S y 60.4 % de NS presentaron elevación de al menos un marcador tumoral (alfafetoproteina (AFP) o gonadotropina coriónica humana (HCG)); p= 0.02 . El porcentaje de pacientes con elevación de HCG para S y NS fue de 29.3 % y 52.1 % respectivamente ; p=0.017 y de AFP para S y NS de 5.2 % y 45.8 % respectivamente; p< 0.001. Atendiendo a la clasificación del Royal Marsden Hospital 96.5 % de S y 83.2% de NS respectivamente se presentaron como estadios I-II. Según la clasificación del International Germ Cell Cancer Collaborative Group (IGCCG) para pacientes con enfermedad avanzada 98.2 % de S y 89.6 % de NS pertenecieron al grupo de buen pronóstico (BP). En cuanto a los factores de riesgo para recidiva (FRR) en S en estadio I (invasión rete testis (IRT) y tamaño tumoral > 4 cm) un 28 % presentaron ambos FRR. Un 18 % de NS en estadio I presentaron invasión vascular o linfática (IVoL). En cuanto al protocolo de tratamiento por histología, estadio y FRR el 100% de S en estadio I con presencia de 2 FRR y el 100 %de NS en estadio I con IVoL recibieron adyuvancia. El resto de S y NS estadios II-IV recibieron e su inmensa mayoría tratamiento con distintos protocolos de quimioterapia (QT). En el 2.8% de NS estadio II se practico linfadenectomía retroperitoneal. Un 38.1 % de NS estadio II-IV fueron sometidos a cirugía de rescate de masa residual retroperitoneal. Con una mediana de seguimiento de 60 meses la supervivencia libre de eventos (SLE) global fue de 93.3 %CONCLUSIONES: Nuestra serie presenta características similares a los obtenidos en otros centros(AU)

OBJECTIVES: Retrospective review of 106 germ-cell testicular tumors treated in our center between 1992 and 2009.METHODS: Description and analysis of several clinical-pathologic and prognostic variables and survival analysis.RESULTS: 68% of our patients were diagnosed in the last 5 years. 54.7% presented seminoma histology. The mean age at diagnosis was 33.47 for the seminoma (S) and 27.63 for non seminoma (NS), p=0,001. The median tumoral size in mm was 45.99mm (globally). 44.3% presented elevation of at least one tumor marker; Alpha-fetoprotein(AFP) or Human chorionic gonadotropin (HCG) .29.3% in the S and 60.4% in NS; p=0.02. The percentage of patients with increased HCG in S was 29.3% and 52.1% in NS; p=0.017 and AFP was elevated in 5.2% of S and 45.8% of NS; P <0.001. Accordingly to the classification of The Royal Marsden Hospital 96.5% of S and 83.2% of NS were diagnosed in stage I-II. Using the classification of the International Germ Cell Cancer Collaborative Group (IGCCG) for patients with advanced disease, 98.2% of S and 83.2% of NS belonged to the good prognostic group. Regarding the risk factors for relapse in stage I S (Rete testis invasion (RTI) and tumoral size (TS)> 4cm) 28% of our patients presented both risk factors. 18% of stage I NS presented vascular (VI) or lymphatic invasion (LI). Following the treatment protocols in consideration with the histology, stage and risk factors, 100 % of stage I S with both risk factors and 100% of NS with vascular or lymphatic invasion received adjuvant therapy. Almost all the stage II-IV S and NS received different protocols of chemotherapy. In 2.8% of stage II NS a retroperitoneal lymph node dissection was performed. Residual tumor resection was documented in eight patients with stage II-IV NS. With a median follow-up of 60 months, the event free survival (EFS) was 93.3%.CONCLUSIONS: Our study has similar characteristics compared to other studies(AU)

Automating the search of molecular motor templates by evolutionary methods.

Biological molecular motors are nanoscale devices capable of transforming chemical energy into mechanical work, which are being researched in many scientific disciplines. From a computational point of view, the characteristics and dynamics of these motors are studied at multiple time scales, ranging from very detailed and complex molecular dynamics simulations spanning a few microseconds, to extremely simple and coarse-grained theoretical models of their working cycles. However, this research is performed only in the (relatively few) instances known from molecular biology. In this work, results from elastic network analysis and behaviour-finding methods are applied to explore a subset of the configuration space of template molecular structures that are able to transform chemical energy into directed movement, for a fixed instance of working cycle. While using methods based on elastic networks limits the scope of our results, it enables the implementation of computationally lightweight methods, in a way that evolutionary search techniques can be applied to discover novel molecular motor templates. The results show that molecular motion can be attained from a variety of structural configurations, when a functional working cycle is provided. Additionally, these methods enable a new computational way to test hypotheses about molecular motors.

Analysis of clinical-pathologic variables, staging and prognostic groups, and therapeutic results of 106 germ-cell testicular tumors.

OBJECTIVES: Retrospective review of 106 germ-cell testicular tumors treated in our center between 1992 and 2009. METHODS: Description and analysis of several clinical-pathologic and prognostic variables and survival analysis. RESULTS: 68% of our patients were diagnosed in the last 5 years. 54.7% presented seminoma histology. The mean age at diagnosis was 33.47 for the seminoma (S) and 27.63 for non seminoma (NS), p=0,001. The median tumoral size in mm was 45.99mm (globally). 44.3% presented elevation of at least one tumor marker; Alpha-fetoprotein (AFP) or Human chorionic gonadotropin (HCG) .29.3% in the S and 60.4% in NS; p=0.02. The percentage of patients with increased HCG in S was 29.3% and 52.1% in NS; p=0.017 and AFP was elevated in 5.2% of S and 45.8% of NS; P <0.001. Accordingly to the classification of The Royal Marsden Hospital 96.5% of S and 83.2% of NS were diagnosed in stage I-II. Using the classification of the International Germ Cell Cancer Collaborative Group (IGCCG) for patients with advanced disease, 98.2% of S and 83.2% of NS belonged to the good prognostic group. Regarding the risk factors for relapse in stage I S (Rete testis invasion (RTI) and tumoral size (TS)> 4cm) 28% of our patients presented both risk factors. 18% of stage I NS presented vascular (VI) or lymphatic invasion (LI). Following the treatment protocols in consideration with the histology, stage and risk factors, 100% of stage I S with both risk factors and 100% of NS with vascular or lymphatic invasion received adjuvant therapy. Almost all the stage II-IV S and NS received different protocols of chemotherapy. In 2.8% of stage II NS a retroperitoneal lymph node dissection was performed. Residual tumor resection was documented in eight patients with stage II-IV NS. With a median follow-up of 60 months, the event free survival (EFS) was 93.3%. CONCLUSIONS: Our study has similar characteristics compared to other studies.

Evolution of form and function in a model of differentiated multicellular organisms with gene regulatory networks.

The emergence of novelties, as a generator of diversity, in the form and function of the organisms have long puzzled biologists. The study of the developmental process and the anatomical properties of an organism provides scarce information into the means by which its morphology evolved. Some have argued that the very nature of novelty is believed to be linked to the evolution of gene regulation, rather than to the emergence of new structural genes. In order to gain further insight into the evolution of novelty and diversity, we describe a simple computational model of gene regulation that controls the development of locomotive multicellular organisms through a fixed set of simple structural genes. Organisms, modeled as two-dimensional spring networks, are simulated in a virtual environment to evaluate their steering skills for path-following. Proposed as a behavior-finding problem, this fitness function guides an evolutionary algorithm that produces structures whose function is well-adapted to the environment (i.e., good path-followers). We show that, despite the fixed simple set of structural genes, the evolution of gene regulation yields a rich variety of body plans, including symmetries, body segments, and modularity, resulting in a diversity of original behaviors to follow a simple path. These results suggest that the sole variation in the regulation of gene expression is a sufficient condition for the emergence of novelty and diversity.