Evaluating Therabot: A Randomized Control Trial Investigating the Feasibility and Effectiveness of a Generative AI Therapy Chatbot for Depression, Anxiety, and Eating Disorder Symptom Treatment

Background: Chatbots powered by generative AI (Gen-AI) hold promise for building highly personalized, effective mental health treatments at scale, while also addressing existing user engagement and retention issues common among digital therapeutics. We present the first RCT testing an expert-fine-tuned Gen-AI-powered chatbot, Therabot, for mental health treatment. Methods: Participants (N=210) were randomized to a four-week Therabot intervention (N=106) or waitlist control (WLC; N=104). Subjects were clinically stratified into major depressive disorder (MDD), generalized anxiety disorder (GAD), or clinically high risk feeding and eating disorder (CHR-FED) groups using baseline symptom severity. Primary outcomes included disorder-specific symptom changes from baseline to four and eight weeks. Secondary outcomes included user engagement, acceptability, and therapeutic alliance. Cumulative link mixed models examined differential changes pre- to post-intervention and from pre-intervention to follow-up, between the Therabot and WLC groups. Results: The Therabot group showed large and significantly greater reductions in MDD (d = 0.845-0.903), GAD (d = 0.794-0.840), and CHR-FED (d = 0.627-0.819) symptoms relative to controls at post-intervention and follow-up. Therabot was well received and well-utilized (average use >6 hours), and participants rated the therapeutic alliance comparable to human therapists. Conclusions: This is the first RCT demonstrating the effectiveness of a fully Gen-AI therapy chatbot for treating mental health disorders. Results are promising for MDD, GAD, and CHR-FED symptom reduction. Participants were engaged with Therabot, reported exceptional therapeutic alliance, and rated the intervention highly. Fine-tuned Gen-AI chatbots are a feasible method for creating scalable, personalized interventions in mental health

The hemodynamic approach to evaluating adolescent varicocele

During adolescence, the risk of developing a varicocele increases. Prevalence is less than 1% in boys aged younger than 10 years, but approaches that of the general adult population (about 15%) during puberty. For adolescent males with varicoceles, surgical risk factors have not yet been clearly delineated and clinical severity correlates poorly with prognosis. Fortunately, the widespread use of Doppler ultrasonography is transforming the diagnostic work-up for this demographic. A continuous reflux detected by color Doppler ultrasound (CDUS) is thought to have a negative prognostic value and evidence suggests that a peak retrograde flow above 38 cm per second is a powerful predictor of lack of spontaneous improvement in adolescent patients with >= 20% asymmetry between testes. CDUS also enables the detection of varicocele resulting from reflux in the deferential vein adjunctive to a refluxing internal spermatic vein; a causality that accounts for approximately 15% of cases. In addition to a diagnostic role, hemodynamic parameters can be used to predict the risk of persistence or worsening asymmetry. Although further studies are necessary to validate single parameters, it seems that the more severe the reflux, the greater the likelihood that the patient will develop testicular asymmetry

ECO-labels as a multidimensional research topic: Trends and opportunities

This study analyzes the importance of ecolabels as an eco-innovation tool that can contribute to the sustainable design, production and consumption of products. Our research has a dual objective. The first is to build a theoretical framework that explains the relationship between ecolabels and eco-innovation, their determinants (demand, supply; and institutional and political influences) and the dimensions that arise from them. Second, according to this framework, a systematic literature review was carried out to identify the trends and opportunities in ecolabeling as a multidimensional topic, from empirical, geographical and sectorial perspective. The main contributions of this paper are a proposal for cyclical ecolabeling innovation process, an understanding of the ecolabeling dimensions according to the studies analyzed, and ecolabel performance in the market. Additionally, the systematic literature review revealed that ecolabels have been mainly explored in food sectors and, developed countries, and researchers tend to assess their performance from the dimension of market dynamics