Drinking Water Quality Assessment Using a Fuzzy Inference System Method: A Case Study of Rome (Italy).

Drinking water quality assessment is a major issue today, as it is crucial to supply safe drinking water to ensure the well-being of society. Predicting drinking water quality helps strengthen water management and fight water pollution; technologies and practices for drinking water quality assessment are continuously improving; artificial intelligence methods prove their efficiency in this domain. This research effort seeks a hierarchical fuzzy model for predicting drinking water quality in Rome (Italy). The Mamdani fuzzy inference system is applied with different defuzzification methods. The proposed model includes three fuzzy intermediate models and one fuzzy final model. Each model consists of three input parameters and 27 fuzzy rules. A water quality assessment model is developed with a dataset that considers nine parameters (alkalinity, hardness, pH, Ca, Mg, fluoride, sulphate, nitrates, and iron). These nine parameters of drinking water are anticipated to be within the acceptable limits set to protect human health. Fuzzy-logic-based methods have been demonstrated to be appropriate to address uncertainty and subjectivity in drinking water quality assessment; they are an effective method for managing complicated, uncertain water systems and predicting drinking water quality. The proposed method can provide an effective solution for complex systems; this method can be modified easily to improve performance.

A bilateral N2pc (N2pcb) component is elicited by search targets displayed on the vertical midline.

The study of visually elicited event-related potentials (ERPs) detected at posterior recording sites during visual search has enormously advanced our knowledge about how and when visuo-spatial attention locks onto one or more laterally presented target objects. The N2pc component to lateral targets has been pivotal to further our understanding of the mechanisms and time course of target selection in visual search. However, the N2pc cannot track visuo-spatial attention deployment to targets displayed along the vertical midline. Here, we introduce a new ERP marker (N2pcb component) that is elicited during the selection of such midline targets. In line with retinal and callosal projections from striate to ventral extrastriate cortex, this component reflects an enhanced negativity elicited by midline targets over both posterior hemispheres. By comparing the attentional selection of lateral and midline targets in a singleton search condition and a feature search condition, we show that the N2pcb is triggered at the same time as the N2pc to lateral targets, and shows the same onset latency difference between singleton and feature search. We conclude that the N2pcb and N2pc components reflect the same attentional target selection processes in visual search.

Recurrent episodes of very late stent thrombosis in a patient with aspirin hypersensitivity, stent fracture and malapposition.

Late stent thrombosis represents a life-threatening event, usually triggered by inadequate antiplatelet therapy and promoted by multiple risk factors, such as stenting of a chronic total occlusion, overlapping stenting, an abnormal vascular response to the eluted drug, stent malapposition and stent fracture. A 57-year-old man with aspirin hypersensitivity underwent successful percutaneous revascularization of a chronic total occlusion of the left anterior descending artery (LAD). He received two sirolimus-eluting stents overlapping for 2 mm and was discharged on clopidogrel and picotamide. Two years later, 15 days after clopidogrel discontinuation, he experienced an anterior ST-segment elevation myocardial infarction and underwent rescue percutaneous LAD thrombectomy after unsuccessful fibrinolysis. Coronary angiography showed fracture of the distal stent, with a 5 mm gap between the two portions, as well as severe late stent malapposition, confirmed by optical coherence tomography. Despite treatment with clopidogrel and picotamide, in the following days the patient experienced two new episodes of stent thrombosis, treated with thrombectomy and deployment of bioengineered stents. The patient underwent successful oral aspirin desensitization, with a complete in vitro inhibition of platelet function, and was discharged on aspirin, clopidogrel and warfarin, without experiencing other events at 6-month follow-up.

Usefulness of intravascular ultrasound in a case of angiographically unapparent myocardial bridging.

A patient with an acute coronary syndrome underwent coronary angiography, which showed only a moderate stenosis in the mid portion of the left anterior descending artery. Intravascular ultrasound was performed for a better assessment of the lesion, and surprisingly, it showed a myocardial bridge over the narrowed segment, which was unapparent at angiography. In fact, the systolic compression of the artery was very limited, and no 'step down-step up' course was recognized. Given the absence of significant atherosclerosis in the intramyocardial and adjacent segments, and considering the poor results reported for stenting of tunnelled coronary arteries, we decided to treat the patient medically. At 6-month follow-up, the patient is asymptomatic and has no inducible ischemia.In conclusion, this case shows how intravascular ultrasound can be useful in patients with an unclear angiographic diagnosis for a better patient management.