Integrating service robots into contemporary healthcare systems has significantly advanced the scope and complexity of robotic design, especially regarding the materials used in direct interaction with patients and sterile medical environments. This article investigates the pivotal role of biomaterials in shaping both the structural integrity and functional performance of service robots. A key focus was placed on the selection criteria, biocompatibility, sterilization potential, and adaptability of advanced biomaterials used in components that demand mechanical efficiency and safety. A key focus was also placed on the quantitative selection criteria for these materials, including mechanical strength (e.g., tensile strength of more than 50 MPa for polymeric joints), elasticity (Young’s modulus ranging from 10–1000 MPa depending on the application), and biocompatibility ratings based on the ISO 10993 standard.Particular attention was paid to integrating biocompatible polymers and composites that should withstand repeated sterilization cycles (up to 100 autoclave exposures without structural degradation) while maintaining antimicrobial surfaces and hypoallergenic properties. Additionally, the study explored the application of smart materials (e.g., stimuli-responsive hydrogels and shape-memory alloys), which showed response times under 5 s and deformation recovery rates above 90 %, enabling adaptive robotic behavior in dynamic contexts. The study also outlines current research trends, i.e., using responsive polymers, bioinspired composites, and additive manufacturing techniques that enable personalized robotic solutions. Additive manufacturing techniques were analyzed as enablers of rapid prototyping and patient-specific customization, with the article referencing case studies where 3D-printed biopolymer components reduced development time by 40 % and improved fitting precision in assistive robotic devices by 30 %.Emerging research trends were finally examined through bibliometric data, indicating 3.5 times increase in publications related to “biomaterials in medical robotics” from 2015 to 2024 in Scopus. Overall, the research critically examined the challenges associated with material certification processes, emphasizing that the average duration required to obtain regulatory approval typically spans between 18 and 24 months, posing a significant barrier to the timely deployment of advanced robotic systems in actual environments. By adopting an interdisciplinary perspective that combines materials science and robotics engineering, this study underscores the transformative impact of biomaterials in redefining the capabilities, safety, and personalization of medical service robots. The findings highlight technological advancements and future directions in robotic systems’ sustainable and intelligent deployment.
Diabetes mellitus is one of the greatest public health challenges of the 21st century. The number of cases has been on the rise for many years, reaching a pandemic scale. The purpose of this study was to examine the risk factors relevant for the development of type 2 diabetes mellitus. The study was conducted at the Dorćol Primary Healthcare Facility within the Medigroup Healthcare system, with persons who had come in for preventive medical examinations over a period of six months. The study included 150 participants. Data on sex, age, arterial hypertension and pharmacotherapy were collected, and weight, height and glycaemia were measured. The Type 2 Diabetes Risk Assessment Questionnaire was used as the research instrument, in line with the recommendations of the National Guide for the Prevention of Type 2 Diabetes for primary care physicians (FINDRISC). The data were processed using IBM SPSS Statistics 22 (SPSS Inc., Chicago, IL, USA) software package. A higher risk for developing diabetes was observed in participants reporting irregular consumption of fruits and vegetables (38.0%), physical inactivity (34.0%), and in those with abdominal obesity (32.0%) and a positive family history of diabetes (17.3%). A timely intervention aimed at modifiable risk factors, primarily lifestyle interventions, can prevent type 2 diabetes and mitigate complications.
Kupres, Privor and Stolac Pramenka are indigenous sheep breeds from Bosnia and Herzegovina whose milk is traditionally used for cheese production after the lambs are weaned. The main objective was to determine the udder morphology and the changes in milk production during lactation in Kupres (n=107), Privor (n=94) and Stolac (n=121) Pramenka sheep breeds kept on pasture. Milk production, udder morphology and ewe body weight were measured, samples of milk composition (milk fat, protein, lactose and total solids-not-fat content), somatic cells and total bacterial count were collected during early (day 80-100), mid (day 140-160) and late (day 200-220) lactation in Kupres, Privor and Stolac Pramenka sheep breeds. The results of this work confirm that all the breeds studied have low milk production. In addition, milk production decreases during lactation, while the proportion of milk fat, protein and non-fat components increases. The number of somatic cells in the milk increases slightly during lactation, and their concentration shows good udder health. Compared to the Privor and Stolac Pramenka breeds, the Kupres ewes had the highest milk production and the greatest udder height and width. To conclude, the udder and teat measurements in all breeds were acceptable for machine milking, which was reflected in a low teat angle and a cistern height below the teat orifice. Udder width and height show a high positive correlation with milk yield and can be used to predict milk production in all three Pramenka group sheep breeds.
: With the increasing complexity of hotel selection, traditional decision-making models often struggle to account for uncertainty and interrelated criteria. Multi-criteria decision-making (MCDM) techniques, particularly those based on fuzzy logic, provide a robust framework for handling such challenges. This paper presents a novel approach to MCDM within the framework of Circular Intuitionistic Fuzzy Sets (C-IFS) by combining three distinct methodologies: Weighted Aggregated Sum Product Assessment (WASPAS), an Alternative Ranking Order Method Accounting for Two-Step Normalization (AROMAN), and the CRITIC method (Criteria Importance Through Inter-criteria Correlation). To address the dynamic nature of traveler preferences in hotel selection, the study employs a comprehensive set of criteria encompassing aspects such as location proximity, amenities, pricing, customer reviews, environmental impact, safety, booking flexibility, and cultural experiences. The CRITIC method is used to determine the importance of each criterion by assessing intercriteria correlations. AROMAN is employed for the systematic evaluation of alternatives, considering their additive relationships and providing a weighted assessment. WASPAS further analyzes the results obtained from AROMAN, incorporating both positive and negative aspects for a comprehensive evaluation. The integration of C-IFS enhances the model’s ability to manage uncertainty and imprecision in the decision-making process. Through a case study, we demonstrate the effectiveness of this integrated approach, offering decision-makers valuable insights for selecting the most suitable hotel option in alignment with the diverse preferences of contemporary travelers. This research contributes to the evolving field of decision science by showcasing the practical applicability of these methodologies within a C-IFS framework for complex decision scenarios.
The aim of this work was to rank and select the most favorable of six sweet cherry cultivars using the web-oriented FRUITrank application, which incorporates the MARCOS (the Measurement of Alternatives and Ranking according to Compromise Solution) multi-criteria decision-making algorithm. During the ranking, 10 criteria were taken into account, one of which relates to the harvest start time, three to the physical characteristics of the fruit (including the pedicel), four to the chemical properties of the fruit, and one to the organoleptic characteristics. Alternative A3 (Kordia cultivar) was ranked as the best, the Izabela cultivar (A4) as second place, while Summit (A5) was placed at the bottom of the ranking. Considering the fact that the complexity of algorithms of various MCDM (Multi-Criteria Decision Making) methods often limits their application, based on the results obtained, it can be concluded that the mentioned and similar digital solutions solve the mentioned problem, i.e., enable wider application of MCDM techniques both in fruit production and in agriculture in general.
Background: Malnutrition is a frequent yet often overlooked comorbidity in patients undergoing surgery for colorectal cancer. It is associated with adverse postoperative outcomes, including increased complications, prolonged hospital stay, and elevated mortality. Objective: This study aimed to assess the clinical impact of short-term preoperative enteral nutrition in malnourished patients undergoing elective colorectal cancer surgery. Methods: A prospective cohort study was conducted involving 68 malnourished patients with histologically confirmed stage I–III colorectal cancer. Patients were divided into three groups: Group A (14-day enteral nutrition), Group B (7-day enteral nutrition), and Group C (no supplementation). Nutritional status, laboratory parameters, postoperative complications, transfusion needs, and hospitalization metrics were compared among groups. Results: Group A demonstrated the most favorable outcomes, including significantly fewer postoperative complications such as anastomotic leakage (5.0% vs. 17.9%, p = 0.030), reduced transfusion and albumin requirements, and shorter ICU and hospital stays (1.6 ± 0.7 and 7.1 ± 2.4 days, respectively). Group C showed the highest complication and mortality rates. Improvements in biochemical markers were observed in both intervention groups, supporting the efficacy of enteral supplementation. Conclusion: Short-term preoperative enteral nutrition significantly improves clinical outcomes in malnourished colorectal cancer patients undergoing elective surgery. These findings support the integration of nutritional screening and intervention as standard components of perioperative care in oncologic surgery.
Background: The upper mini sternotomy Bentall (mini-Bentall) procedure may result in less trauma and earlier recovery compared with the usual full sternotomy Bentall procedure (Usual Bentall-DeBono procedure). Objective: This study evaluates the efficacy and safety of mini sternotomy aortic root surgery (MSARS), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs. Methods: The upper mini sternotomy (UMS) approach was performed in ten patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSARS markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy. Results: The median postoperative length of stay was seven days for MSARS versus 11 days for traditional sternotomy, with ICU stays of 27 hours and 105 hours, respectively. Our study also highlights the cost-effectiveness of MSARS, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSARS is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency. Conclusion: Mini sternotomy aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy, marking a significant advancement in the field of cardiac surgery.
Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a rare hereditary disease affecting small vessels in the brain caused by mutations in the NOTCH3 gene. It has a wide palette of clinical manifestations, usually starting with cognitive decline, migraine and headaches. Therefore, it is frequently misdiagnosed as a transitory ischaemic attack (TIA), ischaemic stroke, or migraine. As advances in genetic testing enable the detection of patients with CADASIL, its incidence is rising. However, CADASIL is still rarely diagnosed, especially in countries with scarce socio-economic resources in healthcare, such as genetic testing that is mandatory to diagnosticate CADASIL. However, it should be considered in everyday clinical practice as a differential diagnosis, especially in younger patients with positive family history. To our knowledge, there has not been a CADASIL case reported in Bosnia and Herzegovina. Objective: This case report aims to present rare confirmed case of CADASIL in a 56-year-old man that presented with rapid cognitive decline. Case presentation: A 56-year-old man was admitted to the Department of Neurology accompanied by his wife, who gave heteroanamnestic information. The patient works abroad and in the past month, during a telephone conversation, the wife noticed that the patient forgets what he has just said to her. The test results showed the presence of heterozygote mutation (c.401G>A) on the NOTCH3 gene, which confirmed the CADASIL diagnosis in this patient. He was further prescribed dual antiplatelet therapy and advised to do a follow-up exam in one month. Genetic advisory and testing of other family members was recommended, but it has not yet been conducted. He can still perform all activities of daily living. The importance of exome sequencing that enables the detection of a genetic mutations causing this rare disease is highlighted. Conclusion: Family members should also be advised to do genetic testing, as this enables the detection of CADASIL before the onset of symptoms. In addition, more aggressive preventive methods, life-style changes and symptomatic treatment can be included on-time, which will increase patient’s quality of life and decrease the development of various neurological complications.
Background: Stroke patients have significant disability and an increased risk of falling. Objective: To determine the incidence of falls and the degree of disability in stroke patients and to determine the correlation of falls with the degree of disability. Methods: This is a prospective study of 100 stroke patients confirmed by computed tomography and magnetic resonance imaging of the brain. We used a demographic questionnaire together with the Glasgow Coma Scale, Stroke Assessment Scale, Rankin Scale and Morse Scale to collect data and analyzed them using SPSS 17, including statistical measures, including Pearson correlation. Results: Hemorrhagic stroke patients had a higher incidence of falls (p = 0.06). There was no difference in the incidence of falls according to the gender of the patients (p = 0.07). Older people had a higher frequency of falls, and women and patients with hemorrhagic stroke had a higher risk of falling (p = 0.2). Patients with a stroke in the area of the anterior circulation were statistically significantly more disabled (p < 0.05). A weak positive correlation was calculated between the frequency of falls of patients after stroke and the degree of disability (r = 0.08, n = 94, p = 0.4). Stroke patients who also had atrial fibrillation as a comorbidity had a statistically significantly higher frequency of falls compared to patients with other comorbidities (p = 0.02). Conclusion: Patients with hemorrhagic stroke have a higher frequency of falls. Women, elderly people, patients with a stroke in the area of the anterior circulation and with atrial fibrillation as a comorbidity are statistically significantly more disabled after a stroke. There is a positive correlation between the frequency of falls in patients after a stroke and the degree of disability.
Background: Hydrocephalus is the accumulation of cerebrospinal fluid in the ventricles of the brain. Ventriculoperitoneal shunt placement is one of the most commonly performed neurosurgical procedures and is necessary for the treatment of most forms of hydrocephalus. Objective: The aim of the study was to determine demographic indicators, comorbidities, complications and outcome of patients with hydrocephalus after ventriculoperitoneal shunt implantation. Methods: This is a retrospective study. Data on the subjects' age, gender, symptoms, degree of disability, complications, comorbidities and outcome after ventriculoperitoneal shunt implantation were recorded. All patients were clinically examined by neurologists and neurosurgeons and diagnosed through unified and standardized algorithms according to established guidelines for hydrocephalus. Cognitive functionality was assessed according to the Mini Mental State Test. Urinary incontinence was assessed based on patients' subjective feelings. Data on comorbidities and complications were collected from the patients' medical records. The degree of disability was assessed using the modified Rankin scale. Results: The average age of the subjects was 58.7 years, and the highest frequency of subjects was in the age group over 61 years (62.2%). There was no statistically significant difference in age in men (X=54.69, SD=18.77), or women (X=60.88, SD=19.96); t (35)=0.8, p=0.3. A statistically significant number of patients with hydrocephalus had a lower degree of disability after ventriculoperitoneal shunt implantation (p<0.05). Hypertension was the most common comorbidity with hydrocephalus (35.1%). Pneumonia was the most common general complication in patients with hydrocephalus (8.1%). Females had a statistically significantly worse survival (p=0.01). There was no statistically significant difference in the outcome of hydrocephalus patients in relation to age groups, comorbidities, general and complications after ventriculoperitoneal shunt implantation (p>0.05). Conclusion: Patients with hydrocephalus after ventriculoperitoneal shunt implantation have a lower degree of disability, and female patients have statistically significantly worse survival. Hypertension is the most common comorbidity, and pneumonia the most common complication in patients with hydrocephalus. There is no statistically significant difference in the outcome of hydrocephalus patients in relation to age groups, comorbidities, general and complications after ventriculoperitoneal shunt implantation.
The objective of this study was to provide decision-making assistance in selecting electric vehicles (EVs). The multi-criteria decision-making methods (MCDM), criteria importance through inter-criteria correlation (CRITIC) and evaluation by distance from ideal solution of alternatives (EDISA), along with the technical specifications of EVs, were employed to facilitate the decision on purchasing an EV. A total of 14 minivans were analysed based on 10 criteria. The findings from the CRITIC method indicated that the most significant criteria are battery charging and vehicle consumption. The EDISA method indicated that EV11 exhibited the best characteristics and represented a prudent purchase decision. Nevertheless, the ultimate decision must consider additional factors beyond just the technical specifications, as numerous elements affect the final choice, necessitating an examination of other attributes of the EV.
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