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1.
Multimodal observable cues in mood, anxiety, and borderline personality disorders: a review of reviews to inform explainable AI in mental health
Grega Močnik, Ana Rehberger, Žan Smogavc, Izidor Mlakar, Urška Smrke, Sara Močnik, original scientific article

Abstract: Mental health disorders, such as depression, anxiety, and borderline personality disorder (BPD), are common, often begin early, and can cause profound impairment. Traditional assessments rely heavily on subjective reports and clinical observation, which can be inconsistent and biased. Recent advances in AI offer a promising complement by analyzing objective, observable cues from speech, language, facial expressions, physiological signals, and digital behavior. Explainable AI ensures these patterns remain interpretable and clinically meaningful. A synthesis of 24 recent systematic and scoping reviews shows that depression is linked to self-focused negative language, slowed and monotonous speech, reduced facial expressivity, disrupted sleep and activity, and altered phone or online behavior. Anxiety disorders present with negative language bias, monotone speech with pauses, physiological hyperarousal, and avoidance-related behaviors. BPD exhibits more complex patterns, including impersonal or externally focused language, speech dysregulation, paradoxical facial expressions, autonomic dysregulation, and socially ambivalent behaviors. Some cues, like reduced heart rate variability and flattened speech, appear across conditions, suggesting shared transdiagnostic mechanisms, while BPD’s interpersonal and emotional ambivalence stands out. These findings highlight the potential of observable, digitally measurable cues to complement traditional assessments, enabling earlier detection, ongoing monitoring, and more personalized interventions in psychiatry.
Published in DKUM: 10.12.2025; Views: 0; Downloads: 1
URL Link to file

2.
A randomized pilot study evaluating socially assistive robot effects on patient engagement and care quality
Izidor Mlakar, Urška Smrke, Valentino Šafran, Igor Robert Roj, Bojan Ilijevec, Samo Horvat, Vojko Flis, Nejc Plohl, 2025, original scientific article

Abstract: Healthcare faces significant challenges, including workforce shortages and increasing demands. Socially assistive robots (SARs) have emerged as potential solutions to augment care, but their implementation in hospital wards remains largely unexplored. We conducted a randomized external pilot study (ISRCTN Registry, ISRCTN96689284, registered 24/02/2022) evaluating SAR intervention feasibility and effects on patient engagement and perceived quality of care (co-primary outcomes) and health-related quality of life (secondary outcome) in surgical wards. Patients (N = 229) at University Medical Center Maribor were allocated to SAR intervention (standard care + SAR) or control groups (standard care only). The SAR utilized validated, story-driven conversational capabilities providing standardized patient education, support, and basic triage through predefined dialog flows. While overall effects on patient engagement and perceived care quality were limited, the intervention showed positive impact on pain management. Contextual factors moderated intervention effects, highlighting SAR potential in specific domains. No substantial negative effects were detected. High retention rates demonstrated practical feasibility of SAR implementation in surgical settings.
Keywords: healthcare, socially assistive robots, SARs
Published in DKUM: 08.12.2025; Views: 0; Downloads: 1
.pdf Full text (1,08 MB)

3.
Artificial intelligence-based approaches for advance care planning : a scoping review
Umut Arioz, Matthew John Allsop, William D. Goodman, Suzanne Timmons, Kseniya Simbirtseva, Izidor Mlakar, Grega Močnik, 2025, review article

Abstract: Background Advance Care Planning (ACP) empowers individuals to make informed decisions about their future healthcare. However, barriers including time constraints and a lack of clarity on professional responsibilities for ACP hinder its implementation. The application of artificial intelligence (AI) could potentially optimise elements of ACP in practice by, for example, identifying patients for whom ACP may be relevant and aiding ACP-related decision-making. However, it is unclear how applications of AI for ACP are currently being used in the delivery of palliative care. Objectives To explore the use of AI models for ACP, identifying key features that influence model performance, transparency of data used, source code availability, and generalizability. Methods A scoping review was conducted using the Arksey and O’Malley framework and the PRISMA-ScR guidelines. Electronic databases (Scopus and Web of Science (WoS)) and seven preprint servers were searched to identify published research articles and conference papers in English, German and French for the last 10Â years’ records. Our search strategy was based on terms for ACP and artificial intelligence models (including machine learning). The GRADE approach was used to assess the quality of included studies. Results Included studies (N = 41) predominantly used retrospective cohort designs and real-world electronic health record data. Most studies (n = 39) focused on identifying individuals who might benefit from ACP, while fewer studies addressed initiating ACP discussions (n = 10) or documenting and sharing ACP information (n = 8). Among AI and machine learning models, logistic regression was the most frequent analytical method (n = 15). Most models (n = 28) demonstrated good to very good performance. However, concerns remain regarding data and code availability, as many studies lacked transparency and reproducibility (n = 17 and n = 36, respectively). Conclusion Most studies report models with promising results for predicting patient outcomes and supporting decision-making, but significant challenges remain, particularly regarding data and code availability. Future research should prioritize transparency and open-source code to facilitate rigorous evaluation. There is scope to explore novel AI-based approaches to ACP, including to support processes surrounding the review and updating of ACP information.
Keywords: advance care planning, digital tools, palliative care, artificial intelligence, machine learning
Published in DKUM: 29.10.2025; Views: 0; Downloads: 5
.pdf Full text (1,52 MB)

4.
Mobile robot localization based on the PSO algorithm with local minima avoiding the fitness function
Božidar Bratina, Dušan Fister, Suzana Uran, Izidor Mlakar, Erik Rot Weiss, Kristijan Korez, Riko Šafarič, 2025, original scientific article

Abstract: Localization of a semi-humanoid mobile robot Pepper is proposed based on the particle swarm optimization algorithm (PSO) that is robust to the disturbance perturbations of LIDAR-measured distances from the mobile robot to the walls of the robot real laboratory workspace. The novel PSO, with the avoiding local minima algorithm (PSO-ALM), uses a novel fitness function that can prevent the PSO search from trapping into the local minima and thus prevent the mobile robot from misidentifying the actual location. The fitness function penalizes nonsense solutions by introducing continuous integrity checks of solutions between two different consecutive locations. The proposed methodology enables accurate and real-time global localization of a mobile robot, given the underlying a priori map, with a consistent and predictable time complexity. Numerical simulations and real-world laboratory experiments with different a priori map accuracies have been conducted to prove the proper functioning of the method. The results have been compared with the benchmarks, i.e., the plain vanilla PSO and the built-in robot’s odometrical method, a genetic algorithm with included elitism and adaptive mutation rate (GA), the same GA algorithm with the included ALM algorithm (GA-ALM), the state-of-the-art plain vanilla golden eagle optimization (GEO) algorithm, and the same GEO algorithm with the added ALM algorithm (GEO-ALM). The results showed similar performance with the odometrical method right after recalibration and significantly better performance after some traveled distance. The GA and GEO algorithms with or without the ALM extension gave us similar results according to the accuracy of localization. The optimization algorithms’ performance with added ALM algorithms was much better at not getting caught in the local minimum, while the PSO-ALM algorithm gave us the overall best results
Keywords: mobile robot localization, PSO algorithm, avoid the global minima
Published in DKUM: 17.10.2025; Views: 0; Downloads: 7
.pdf Full text (2,95 MB)

5.
Uporabniško usmerjeno načrtovanje mhealth aplikacije za starejše uporabnike : magistrsko delo
Zala Meklav, 2025, master's thesis

Abstract: Demografske spremembe in naraščajoče število starejših predstavljajo izziv za oblikovanje digitalnih zdravstvenih rešitev. Namen raziskave je bil preučiti, kako lahko z uporabo participativnega pristopa oblikujemo uporabniške vmesnike mHealth aplikacij, ki so prilagojeni starejšim osebam in osebam z demenco. V raziskavi smo izvedli fokusno skupino in dve oblikovalski delavnici z enajstimi starejšimi osebami v Dnevno-varstvenem centru Žalec. Rezultati kažejo, da so ključni oblikovni elementi jasni in veliki gumbi, kontrastne barve ter možnost govorne interakcije.
Keywords: mHealth, uporabniški vmesnik, participativno oblikovanje, starejši uporabniki.
Published in DKUM: 23.09.2025; Views: 0; Downloads: 19
.pdf Full text (892,65 KB)

6.
Protocol for an umbrella review of systematic reviews evaluating the efficacy of digital health solutions in supporting adult cancer survivorship care
Danielle Keane, Izidor Mlakar, 2025, original scientific article

Abstract: The growing number of people living with, through and beyond cancer poses a new challenge for sustainable survivorship care solutions. Digital health solutions which incorporate various information and communication technologies are reshaping healthcare; offering huge potential to facilitate health promotion, support healthcare efficiencies, improve access to healthcare and positively impact health outcomes. Digital health solutions include websites and mobile applications, health information technologies, telehealth solutions, wearable devices, AI-supported chatbots and other technologically assisted provision of health information, communication and services. The breadth and scope of digital health solutions necessitate a synthesis of evidence on their use in supportive care in cancer. This umbrella review will identify, synthesise, and compare systematic reviews which have evaluated the efficacy or effectiveness of digital solutions for adult cancer survivorship care with a particular focus on surveillance and management of physical effects, psychosocial effects, new cancer/ recurring cancers and supporting health promotion and disease prevention.
Published in DKUM: 25.07.2025; Views: 0; Downloads: 1
URL Link to file

7.
(Bio)markers for the prognostication of breast cancer recurrence
Rigon Sallauka, Matej Horvat, Maja Ravnik, Hatem Rashwan, Umut Arioz, Izidor Mlakar, 2025, review article

Abstract: Background The aim of this study is to gain a comprehensive understanding of the latest advancements in breast cancer recurrence markers, with the aim of identifying minimally invasive or minimally intrusive markers as necessary approach for screening for breast cancer recurrence. Methods We followed PRISMA guidelines, systematically searching Web of Science, Scopus, and PubMed from 2010 to December 2023 for secondary papers on breast cancer markers of recurrence. Keywords used to search the databases include but are not limited to: “breast cancer recurrence”, “markers”, “radiology”, “pathology”, “clinical features”. Studies focusing solely on outcomes after recurrence, such as survival or treatment response, were excluded to ensure the review targeted markers relevant to early prediction. The search was limited to English language. Selected papers underwent screening process according to inclusion/exclusion criteria, and data extraction included publication details, markers, marker modality, among others. Results The number of papers considered for this review was 1,138. After two phases of screening process, a total number of 28 reviews were included in this scoping review. We have categorized markers into radiological, clinical, and histopathological types. Among the most relevant clinical markers correlated with breast cancer (BC) recurrence are clinical stage, carcinoembryogenic antigen (CEA), and cancer antigen 15.3 (CA 15.3). We have also identified that the following radiological markers are the most mentioned markers associated with recurrence: mammographic density (MD), tumor heterogeneity, most enhancing tumor volume (METV), radiomic features, and more. Furthermore, we identified nuclear grade, microenvironment heterogeneity, estrogen receptor (ER), androgen receptor (AR), human epidermal growth factor receptor 2 (HER2), Ki-67 antigen, as the most significant histopathological markers of breast cancer recurrence. Conclusion This review identified promising markers for breast cancer recurrence in three categories: clinical, radiological and histopathological. General practitioners can leverage these insights for enhanced pre-screening, aiding in earlier detection and intervention, thus improving patient outcomes. Unclear cut-off values and disagreement on their use remain obstacles.
Keywords: breast cancer, diagnostic markers, genetic markers, predictive markers, prognostic markers, tumour biomarkers
Published in DKUM: 24.07.2025; Views: 0; Downloads: 8
.pdf Full text (1,34 MB)

8.
Feasibility of a computerized clinical decision support system delivered via a socially assistive robot during grand rounds : a pilot study
Valentino Šafran, Urška Smrke, Bojan Ilijevec, Samo Horvat, Vojko Flis, Nejc Plohl, Izidor Mlakar, 2025, original scientific article

Abstract: Aims and Objective: The aim of this study was to explore the feasibility, usability and acceptance of integrating Clinical Decision Support Systems with Socially Assistive Robots into hospital grand rounds. Background: Adopting Clinical Decision Support Systems in healthcare faces challenges such as complexity, poor integration with workflows, and concerns about data privacy and quality. Issues such as too many alerts, confusing errors, and difficulty using the technology in front of patients make adoption challenging and prevent it from fitting into daily workflows. Making Clinical Decision Support System simple, intuitive and user-friendly is essential to enable its use in daily practice to improve patient care and decision-making. Methods: This six-month pilot study had two participant groups, with total of 40 participants: a longitudinal intervention group (n =8) and a single-session evaluation group (n=32). Participants were medical doctors at the University Clinical Center Maribor. The intervention involved implementing a Clinical Decision Support System delivered via a Socially Assistive Robot during hospital grand rounds. We developed a system that employed the HL7 FHIR standard for integrating data from hospital monitors, electronic health records, and patient-reported outcomes into a single dashboard. A Pepper-based SAR provided patient specific recommendations through a voice and SAR tablet enabled interface. Key evaluation metrics were assessed using the System Usability Scale (SUS) and the Unified Theory of Acceptance, Use of Technology (UTAUT2) questionnaire, including Effort Expectancy, Performance Expectancy and open ended questions. The longitudinal group used the system for 6 months and completed the assessments twice, after one week and at the end of the study. The single-session group completed the assessment once, immediately after the experiment. Qualitative data were gathered through open-ended questions. Data analysis included descriptive statistics, paired t-tests, and thematic analysis. Results: System usability was rated highly across both groups, with the longitudinal group reporting consistently excellent scores (M =82.08 at final evaluation) compared to the acceptable scores of the single-session group (M =68.96). Extended exposure improved user engagement, reflected in significant increases in Effort Expectancy and Habit over time. Participants found the system enjoyable to use, and while no significant changes were seen in Performance Expectancy, feedback emphasized its efficiency in saving time and improving access to clinical data, supporting its feasibility and acceptability. Conclusions: This research supports the potential of robotic technologies to transform CDSS into more interactive, efficient, and user-friendly tools for healthcare professionals. The paper also suggests further research directions and technical improvements to maximize the impact of innovative technologies in healthcare.
Keywords: clinical decision support systems, clinical decision-making, hospital grand rounds, patient data integration, perceived quality of care, socially assistive robots, usability and familiarity, user experience questionnaire, workload reduction
Published in DKUM: 30.05.2025; Views: 0; Downloads: 3
.pdf Full text (3,02 MB)

9.
Facilitating acceptance, trust, and ethical integration of socially assistive robots among nurses : a quasi-experimental study
Izidor Mlakar, Igor Robert Roj, Vojko Flis, Valentino Šafran, Urška Smrke, 2025, original scientific article

Abstract: Objectives: To evaluate the impact of different types of demonstrations (no demonstration, video demonstration, and face-to-face demonstration) on nurses’ acceptance, trust, and ethical considerations regarding socially assistive robots. Methods: The study employed a quasi-experimental design involving 312 nurses: 201 with no exposure to socially assistive robots, 97 exposed via video demonstrations, and 14 exposed through live face-to-face demonstrations in a hospital room. Participants completed self-report measures assessing their perceptions of ethical acceptability, trust, and acceptance of socially assistive robots. Results: Participants exposed to any kind of demonstration reported significantly higher perceptions of ethical acceptability compared to those with no exposure. Among demonstration types, live face-to-face demonstrations resulted in higher overall ethical acceptability, satisfaction, and acceptance compared to video demonstrations. Conclusions: Demonstrations, particularly face-to-face interactions, play a crucial role in fostering ethical acceptability and overall acceptance of socially assistive robots. These findings highlight the importance of incorporating live demonstrations in strategies to improve healthcare professionals’ trust and acceptance of robotic technology.
Keywords: ethical acceptability, acceptance, socially assistive robots, nurses, quasi experimental study
Published in DKUM: 29.05.2025; Views: 0; Downloads: 2
.pdf Full text (7,33 MB)

10.
Weakly-supervised multilingual medical NER for symptom extraction for low-resource languages
Rigon Sallauka, Umut Arioz, Matej Rojc, Izidor Mlakar, 2025, original scientific article

Abstract: Patient-reported health data, especially patient-reported outcomes measures, are vital for improving clinical care but are often limited by memory bias, cognitive load, and inflexible questionnaires. Patients prefer conversational symptom reporting, highlighting the need for robust methods in symptom extraction and conversational intelligence. This study presents a weakly-supervised pipeline for training and evaluating medical Named Entity Recognition (NER) models across eight languages, with a focus on low-resource settings. A merged English medical corpus, annotated using the Stanza i2b2 model, was translated into German, Greek, Spanish, Italian, Portuguese, Polish, and Slovenian, preserving the entity annotations medical problems, diagnostic tests, and treatments. Data augmentation addressed the class imbalance, and the fine-tuned BERT-based models outperformed baselines consistently. The English model achieved the highest F1 score (80.07%), followed by German (78.70%), Spanish (77.61%), Portuguese (77.21%), Slovenian (75.72%), Italian (75.60%), Polish (75.56%), and Greek (69.10%). Compared to the existing baselines, our models demonstrated notable performance gains, particularly in English, Spanish, and Italian. This research underscores the feasibility and effectiveness of weakly-supervised multilingual approaches for medical entity extraction, contributing to improved information access in clinical narratives—especially in under-resourced languages.
Keywords: low-resource languages, machine translation, medical entity extraction, NER, NLP, patient-reported outcomes, weakly-supervised learning
Published in DKUM: 19.05.2025; Views: 0; Downloads: 4
.pdf Full text (338,94 KB)

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