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.

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.

: 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 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.

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.

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.

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.

The critical role of high-voltage circuit breakers in the power grid underscores the need for reliable and efficient methods to assess their condition and operational parameters. To support the integration of smart grid concepts and enable condition assessment during circuit breaker exploitation, non-invasive approaches are essential. Among these, methods leveraging vibration fingerprints generated during the opening or closing of circuit breakers have shown significant promise. This paper presents a comprehensive survey of state-of-the-art research in this area, systematically analyzing over 100 influential works from the past two decades. The survey categorizes these methods based on their domain-specific approaches and highlights key challenges related to signal analysis, data acquisition, feature extraction, interpretation, and reasoning. By offering a structured analysis, this survey serves as a valuable resource for researchers and practitioners, providing insights and direction for future advancements in this niche field.

Background: Date palm fruits (Phoenix dactylifera L.) are a widely available product that contains numerous macronutrients including a high sugar content. Research has shown that date fruit extracts possess antibacterial and antifungal properties, as well as antimutagenic and antiatherogenic effects. Date fruit can also have a beneficial effect on the female reproductive system. Several studies have examined the impact of date consumption during pregnancy on the outcome of labor, providing useful results. Objective: This study aims to determine the effects of date fruit consumption on the onset and progression of labor. Methods: The study included 120 pregnant women who were pregnant at GAK Sarajevo, in the period from 01.01. 2020 to 31.12. 2020. The patients were divided into two groups, the first group of 60 patients who consumed 6 dates during the last four weeks of pregnancy, and the second group of 60 patients who did not consume dates during pregnancy. Results: There was a significant positive effect of consuming date fruits on maternal outcomes in the first and third stages of labor. The group of pregnant women who consumed dates had a shortened latent phase of labor, which meant that their cervix reached maximum dilation (10 cm) faster. Pregnant women in this group gave birth 8.5 hours faster than pregnant women who did not consume dates, in whom labor lasted about 15 hours. Of the 60 pregnant women in the first group, 60% had a spontaneous natural birth, and only 40% of the patients received oxytocin, because dates enhance the effect of oxytocin, which is responsible for uterine contractions. Conclusion: This study showed a promising effect of consuming date fruits on the duration of the stages of labor. Saturated and unsaturated fatty acids found in dates stimulate the production of prostaglandins, which are necessary for labor. Dates are also rich in folic acid, vitamin K, iron, potassium, and magnesium.

This review is remembrance on occasion of 35 years of MIE ‘90 held in Glasgow which organized by UK and Scottish Association of Medical Informatics, and chaired by John Bryden and his team with support by European Federation for Medical Informatics (EFMI). It was my first participation at MIE Conferences, in that time as General Secretary of Yugoslav Association of Medical Informatics (YAMI) and officially accepted as a member of EFMI and IMIA. Besides our President of YAMI, Professor Gjuro Dezelic, one of founders YAMI (with Izet Masic, Stefan Adamic, Rajko Vukasinovic, as presidents of Bosnia and Herzegovina, Slovenian and Serbian Societies of Medical Informatics in 1987) participants at MIE ‘90 have been, also, our colleagues: Josipa Kern, Nada Dezelic, Silvije Vuletic, Visnja Lovrek, Miroslav Madjaric, etc. It was my first active participation at MIE Conferences, and after this meeting, year by year I continued until today. Let me say some important facts about it as my personal story -„Medical Informatics Journey“, during the last 35 years, from Glasgow 1990 until today.

Water constitutes a substantial input in food production, exerting a direct influence on the quality of the final product. Water quality affects every stage of the food value chain, from primary production to final consumption. Contaminated water can introduce impurities, unpleasant aromas, and odors, compromise the taste and appearance of the product, and, most significantly, compromise its healthfulness. Pathogens transferred through water pose a grave health risk to consumers. Consequently, ensuring the integrity of water quality is paramount to the overall quality and safety of food. Water from natural sources, including rivers, lakes, and wells, may contain a variety of contaminants that can adversely affect food quality. The treatment of water for food production involves the removal of impurities, contaminants, and bacteria that may be present in water sources. The application of diverse treatment methods can yield water that meets quality and safety standards. It is incumbent upon food manufacturers to prioritize water quality and adhere to regulatory guidelines to ensure the highest standards of food safety and quality.

Summary Explosive energy can be used in metal forming processes, e.g. for bulk forming, sheet forming and for other processes. This paper presents the experimental research and numerical modelling of the process of sphere deformation by explosive forming. The assembly for forming a sphere with a diameter of 210 mm was welded from flat segments and annealed after welding. The material of the sphere was steel St12 according to DIN 1629/3. The thickness of the sheet metal was 2.0 mm. The sphere was modelled in the SolidWorks program and 3D-printed with the polylactic acid (PLA) material. The Poladyn 31ECO explosive was used for the experimental investigation into the process of deep drawing of the sphere by explosion, while the LS-DYNA hydrodynamic software was used for simulation. The pressure in the sphere was measured with a pair of copper crushers. It is shown that the simulation satisfactorily reproduces the experimentally measured pressure.

Background: Minimally invasive coronary artery bypass grafting (MICS CABG) via left anterior thoracotomy has emerged as a less invasive alternative to conventional open sternotomy (OPEN CABG), offering potential benefits in perioperative outcomes and complication rates. Objective. The aim of this study was to compare procedural characteristics, ventilation duration, drainage volumes, and postoperative complications between MICS CABG and OPEN CABG in a single-center cohort in Bosnia and Herzegovina. Methods. This retrospective cross-sectional study included 262 patients who underwent surgical revascularization between January 2019 and June 2023. Results. MICS CABG was associated with a shorter median procedure time (2.5 vs. 3.5 hours, p<0.001) and reduced mechanical ventilation duration (11.0 vs. 14.0 hours, p<0.001). Although ICU stay was similar (3.0 days, p=0.001), total hospitalization was shorter for MICS CABG (6.0 vs. 7.0 days, p<0.001). Postoperative drainage was significantly lower at all measured time points (p<0.05), and transfusion requirements were reduced for red blood cells (0 vs. 2 units, p<0.001), fresh frozen plasma (0 vs. 2.5 units, p<0.001), and platelets (p=0.035). Use of inotropic agents was less frequent in MICS CABG, both at low (50.4% vs. 62.8%, p=0.043) and medium doses (4.0% vs. 16.0%, p=0.001). Wound infections were numerically lower in the MICS group (p=0.437). Conclusions. Compared to open sternotomy, MICS CABG demonstrated significant advantages in operative time, ventilation duration, blood loss, and complication rates, supporting its role as a safe and effective alternative for coronary revascularization.