Early Measurement of Blood sST2 Is a Good Predictor of Death and Poor Outcomes in Patients Admitted for COVID-19 Infection

Although several biomarkers have shown correlation to prognosis in COVID-19 patients, their clinical value is limited because of lack of specificity, suboptimal sensibility or poor dynamic behavior. We hypothesized that circulating soluble ST2 (sST2) could be associated to a worse outcome in COVID-19. In total, 152 patients admitted for confirmed COVID-19 were included in a prospective non-interventional, observational study. Blood samples were drawn at admission, 48–72 h later and at discharge. sST2 concentrations and routine blood laboratory were analyzed. Primary endpoints were admission at intensive care unit (ICU) and mortality. Median age was 57.5 years [Standard Deviation (SD: 12.8)], 60.4% males. 10% of patients (n = 15) were derived to ICU and/or died during admission. Median (IQR) sST2 serum concentration (ng/mL) rose to 53.1 (30.9) at admission, peaked at 48–72 h (79.5(64)) and returned to admission levels at discharge (44.9[36.7]). A concentration of sST2 above 58.9 ng/mL was identified patients progressing to ICU admission or death. Results remained significant after multivariable analysis. The area under the receiver operating characteristics curve (AUC) of sST2 for endpoints was 0.776 (p = 0.001). In patients admitted for COVID-19 infection, early measurement of sST2 was able to identify patients at risk of severe complications or death.

Fuzzy Based Stable Maintainability Metric for Software Projects

To make software better in view of its maintainability, its software development process must be controlled and continuously observed. Researchers and software managers have stressed on the early measurement of maintainability starting from design phase itself so that timely steps could be taken for producing maintainable software. This paper evaluates and compares several methodologies for improving the numerical stability of a fuzzy-logic-based maintainability metrics system. Fuzzy parameters are adjusted using heuristic methods. A number of alternates were considered, in which training data sets were generated using different methods and these sets were used to evaluate objective functions in GA and accordingly fuzzy parameters were tuned. After conditioning, real projects’ maintainability data is used to show that fuzzy model performance is increased, however marginally, after conditioning

Challenging presentations of germ cell tumours in routine clinical practice

Testicular cancer is the most common malignancy in young men. We discuss four cases of germ cell tumours (GCTs) presenting to general practitioners and physicians where there were notable preventable delays in the diagnosis and management. This diagnostic delay is associated with a more advanced stage of disease, and subsequent increased treatment-related morbidity and decreased survival. Our series highlights the variety of ways in which GCTs may present and we discuss the importance of prompt diagnosis through a thorough history and examination, early measurement of serum tumour markers and appropriate multidisciplinary team discussion. GCTs are highly curable cancers in the majority of patients and delays in management can, therefore, have devastating consequences.

Introduction and early measurement of carbon footprint concepts to respond the challenge of SDGs-Goal 13

One of the efforts to prevent the effects of climate change was the introduction of the concept of carbon footprints from an early age to students. Science subjects in this school have included elements of environmental knowledge in their subject matter. However, mitigation and adaptation efforts to climate change were still lacking recognition. The purpose of this study was to introduce and measure the extent to which elementary students are able to recognize the concept of carbon footprints and can use a simple carbon footprint calculator application in climate change mitigation and adaptation efforts. The study was conducted at MIM Kupang Karangdowo Klaten, Central Java. The activity was carried out on February 19, 2020 with the method of lectures, interviews, and simulations, followed by 11 teachers and 21 grade VI students. The flow of activities was divided into 3, namely: (1) counseling/explanation of the carbon cycle, global warming, carbon footprint and carbon footprint calculator, (2) interviews about the student's daily and weekly lifestyle or carbon footprint pattern, (3) socialization of the footprint calculator application carbon and usability observations. The activity ended with a simulation of a carbon footprint calculator for several students. From the study conducted, it can be seen that students are interested in this carbon footprint concept and were technically assessed as being able to use a carbon calculator without significant obstacles.