A systematic review of artificial intelligence-powered (AI-powered) chatbot intervention for managing chronic illness.

BACKGROUND: Utilizing artificial intelligence (AI) in chatbots, especially for chronic diseases, has become increasingly prevalent. These AI-powered chatbots serve as crucial tools for enhancing patient communication, addressing the rising prevalence of chronic conditions, and meeting the growing demand for supportive healthcare applications. However, there is a notable gap in comprehensive reviews evaluating the impact of AI-powered chatbot interventions in healthcare within academic literature. This study aimed to assess user satisfaction, intervention efficacy, and the specific characteristics and AI architectures of chatbot systems designed for chronic diseases. METHOD: A thorough exploration of the existing literature was undertaken by employing diverse databases such as PubMed MEDLINE, CINAHL, EMBASE, PsycINFO, ACM Digital Library and Scopus. The studies incorporated in this analysis encompassed primary research that employed chatbots or other forms of AI architecture in the context of preventing, treating or rehabilitating chronic diseases. The assessment of bias risk was conducted using Risk of 2.0 Tools. RESULTS: Seven hundred and eighty-four results were obtained, and subsequently, eight studies were found to align with the inclusion criteria. The intervention methods encompassed health education (n = 3), behaviour change theory (n = 1), stress and coping (n = 1), cognitive behavioural therapy (n = 2) and self-care behaviour (n = 1). The research provided valuable insights into the effectiveness and user-friendliness of AI-powered chatbots in handling various chronic conditions. Overall, users showed favourable acceptance of these chatbots for self-managing chronic illnesses. CONCLUSIONS: The reviewed studies suggest promising acceptance of AI-powered chatbots for self-managing chronic conditions. However, limited evidence on their efficacy due to insufficient technical documentation calls for future studies to provide detailed descriptions and prioritize patient safety. These chatbots employ natural language processing and multimodal interaction. Subsequent research should focus on evidence-based evaluations, facilitating comparisons across diverse chronic health conditions.

Genistein Ameliorated Vascular Endothelial Growth Factor-A (VEGF-A) and Estrogen Receptor-Alpha (ER-α) in Endometriosis Mice Model, In Vivo and In Silico.

Endometriosis (EM) is a gynecological disorder that causes morbidity in women and is characterized by endometrial tissue in the uterus cavity. This study investigated the mechanism of genistein in the VEGF-A and ER-α expression through in vivo and in silico approaches. An in vivo study was conducted by thirty-six mice that were divided into six groups including control, EM, and EM treatment with genistein with the doses of 1.3, 1.95, 2.6, and 3.25 mg/day for 14 days. Peritoneal tissues with lesions were collected and analyzed by immunohistochemistry to measure the VEGF-A and ER-α expression. The data were analyzed using a statistical approach using one-way ANOVA followed by Tukey HSD test with a significant value p < 0.05. In silico study was conducted for investigating the inhibition mechanism of genistein in VEGF-A and ER-α protein. Genistein significantly reduced the VEGF-A and ER-α expression with the optimum dose of 3.25 mg/day. Molecular docking showed that genistein inhibited VEGF-A in several active site residues of VEGF-A, also blocked the ER-α protein in estradiol binding sites. This study concluded that genistein prevented endometriosis by performing the antiangiogenic activity and showed a similar function to estradiol.

Outcome findings of COVID-19 vaccine among 31 977 pregnant women in Indonesia.

OBJECTIVE: We provide an overview of the safety of messenger RNA and inactivated coronavirus disease 2019 (COVID-19) vaccine and monitoring of pregnant women after COVID-19 vaccination. The vaccine safety outcome profile is beneficial for further recommendations of COVID-19 vaccination in pregnancy. METHODS: This research was conducted as descriptive research. Sampling was performed using an online questionnaire to be filled out voluntarily and distributed to all pregnant women in Indonesia who received the COVID-19 vaccination. Data collection was performed and descriptive statistics were obtained. RESULTS: Among 31 977 pregnant women, 24 212 (75.7%) received the first dose, 7619 (23.8%) received the second dose, and 146 (4.5%) received the third dose of the COVID-19 vaccine. Sinovac vaccine is the most administered vaccine to pregnant women (27 122 [84%]). Most pregnant women (78.7%) who were vaccinated had no adverse effects after immunization, while the most reported adverse effects were mild symptoms. CONCLUSION: The current study contributed evidence that COVID-19 vaccination during pregnancy has minimal adverse effects. These findings may help pregnant women and healthcare providers to make informed decisions regarding vaccination.

Genistein administration increases the level of superoxide dismutase and glutathione peroxidase in the endometriosis mice model: An experimental study.

Background: Endometriosis and infertility are caused by reactive oxygen species or free radicals, which promote endometrial cell growth and adhesion in the peritoneal cavity. Genistein has been proven to protect cells against reactive oxygen species by scavenging free radicals and decreasing the expression of genes-associated stress responses. Objective: This study was conducted to determine whether genistein also acts as an antioxidant by elevating superoxide dismutase (SOD) and glutathione peroxidase (GPx) in the peritoneal fluid of the endometriosis mice model. Materials and Methods: This experimental study involved 32 healthy female mice (Mus musculus), aged between 2-3 months and weighing 20-30 gr. They were divided into negative control group (healthy mice without genistein), endometriosis group (endometriosis mice without genistein), treatment group that was given different doses of genistein, that is, 0.13; 0.26; 0.52; 0.78; 1.04; and 1.3 mg/day (n = 4/each). SOD level in the peritoneal fluid was measured using the quantitative colorimetric determination method, and a colorimetric assay measured the GPx levels. Results: Results showed that the endometriosis model has lower SOD and GPx levels than the control group. The administration of genistein significantly normalized these changes. Genistein significantly increased SOD levels in the 0.13 mg and 0.26 mg treatment groups. Genistein also increased GPx levels significantly in all treatment groups. Conclusion: Genistein increases SOD and GPx levels in the peritoneal fluid of an endometriosis mice model, and the change is dose-dependent.

Effect of feeding goat meat containing low cholesterol and rich omega-6 fatty acid on blood lipid status of white rat (Rattus norvegicus).

BACKGROUND AND AIM: Healthy goat meat is an essential aspect in increasing consumer acceptance for this livestock product. The research aimed to examine the effect of goat meat containing low cholesterol and rich omega-6 fatty acid on the performance and blood lipid status of white rats (Rattus norvegicus). MATERIALS AND METHODS: Thirty 2-month-old male white rats (R. norvegicus) weighing 195-230 g were randomly divided into three groups, with each group consisting of 10 rats. Group I was treated with a control feed (T0; BR I concentrate). Group II (T1) was treated with a mixed feed containing 50% control feed and 50% goat meat. Group III (T2) was treated with a mixed feed comprising 50% control feed and 50% goat meat with low cholesterol and rich omega-6 fatty acids. Each treatment was given ad libitum for 30 days. The variables measured were dry matter and organic matter consumption, daily body weight gain, feed conversion, triglyceride levels, total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, and atherogenic index (AI). The data were analyzed statistically using analysis of variance in a completely randomized design. RESULTS: The total, HDL, and LDL cholesterol levels at T0, T1, and T2 were as follows: 99.97, 35.97, and 50.43 mg/dL (total cholesterol); 108.35, 33.92, and 58.17 mg/dL (HDL cholesterol); and 101.43, 38.09, and 48.65 mg/dL (LDL cholesterol). The highest HDL and the lowest LDL cholesterol levels (p<0.05) were observed in the T2 treatment group, which had the lowest AI (1.69 vs. 1.77 and 2.19). CONCLUSION: The consumption of goat with low cholesterol and rich omega-6 fatty acids reduces the total cholesterol and LDL cholesterol, raises the HDL cholesterol levels, and decreases the AI.

Phytochemical characteristics from Phaleria macrocarpa and its inhibitory activity on the peritoneal damage of endometriosis.

BACKGROUND: Endometriois represents a gynecological disease that still becomes an issue in community. Phaleria macrocarpa is a plant native to Indonesia that contains an antioxidant substance, which may serve as apoptotic modulator and useful for angiogenesis. OBJECTIVE: This study aims to evaluate the effects of flavonoid isolates from P. macrocarpa (PM) on the development of granulomas, apoptosis, proliferation, and angiogenesis of the disease. MATERIAL AND METHODS: Total thirty mice (Mus musculus) were categorized into six groups, including the normal group (without any treatment), EMT (endometriosis) group, and EMT group treated with PM flavonoid isolates. Identification of the active compounds of P. macrocarpa was done using LC-HRMS. Measurement of granuloma scores and vascular density was done histologically. Apoptosis and proliferation analysis was performed by immunohistochemical techniques. RESULTS: There was an increase in granulomas, proliferation, and apoptosis in the peritoneal tissues of the endometriosis model. This change can be normalized by extract of P. macrocarpa. CONCLUSION: We concluded that the flavonoid isolates from P. macrocarpa can suppress the growth of endometriosis lesions through normalization of proliferation and apoptosis. Thus, the P. macrocarpa flavonoid can be used as an alternative to inhibit the development of endometriosis.

Rapidly recurring ovarian fibrosarcoma after optimal debulking surgery in a 46-year-old woman.

Ovarian fibrosarcoma is an extremely rare tumour with no universally accepted guidelines for treatment. We present a 46-year-old nulliparous woman with ovarian fibrosarcoma who mainly presented with a painful abdominal enlargement. Optimal debulking surgery was performed, and a specimen of the tumour was examined. A frozen section examined during surgery revealed spindle cell morphology, raising the suspicion of ovarian fibrosarcoma, which was later confirmed by immunohistochemistry staining. Our patient refused to undergo chemotherapy and died 3 months after surgery due to tumour recurrence. Although no clear consensus exists for administering chemotherapy for fibrosarcoma, some published case reports have shown a lower chance of recurrence and better prognosis in patients who undergo chemotherapy compared with our patient.

Genistein modulates the estrogen receptor and suppresses angiogenesis and inflammation in the murine model of peritoneal endometriosis.

The purpose of this study was to investigate the effect of genistein administration on the modulation of the estrogen receptor, inhibition of inflammation and angiogenesis in the murine model of peritoneal endometriosis. A total of thirty-six mice (Mus musculus) were divided into six groups (n = 6), including the control group, endometriosis group, endometriosis group treated with various doses of genistein (0.78; 1.04; 1.3 mg/day), and endometriosis group treated with leuprolide acetate (0.00975 mg/day every 5 days for 15 days). Analysis of estrogen receptor-α, estrogen receptor-ß, TNF-α, IL-6, VEGF, and HIF-1α were performed immunohistochemically. Expression of estrogen receptor-α, estrogen receptor-ß, TNF-α, IL-6, VEGF and HIF-1α increased significantly compared with the control group (p < 0.05). All doses of genistein decreased the expression of estrogen receptor-α, increased estrogen receptor-ß, lowered VEGF and HIF-1α significantly compared with endometriosis group (p > 0.05). Genistein also decreased the expression of TNF-α and IL-6 (1.04 and 1.3 mg/day) compared with the endometriosis group, reaching level comparable to that of the control group (p > 0.05). It was concluded that genistein is able to modulate estrogen receptor-α and estrogen receptor-ß and inhibit the development of inflammation and angiogenesis in the murine model of peritoneal endometriosis. Thus, genistein can be a candidate in the treatment of endometriosis.

Effect of human ZP3 monoclonal antibody on expression of GDF-9 and number of theca cells in ovary of mice (Mus musculus).

OBJECTIVES: This study investigated the effects of a human ZP3 monoclonal antibody (mAb hZP3) on the expression of growth differentiation factor-9 (GDF-9) and number of theca cells in the ovaries of mice (Mus musculus). METHODS: Our study employed a true experiment posttest-only control group design of 48 mice that were divided into the control and three mAb hZP3-treatment groups (20, 40, and 60 µg). Mice in each group were terminated on days 10, 15, and 20. GDF-9 expression was measured by immunohistochemistry and the number of theca cells was counted. RESULTS: Analysis of the effects of mAb hZP3 (at 20-60 µg) on the expression of GDF-9 and amount of theca cells did not show significant differences. Similar findings were observed throughout the study period (at 10-20 days). Therefore, mAb hZP3 had no effect on GDF-9 expression and theca cells. CONCLUSION: This study showed that mAb hZP3 can be considered to be an effective and safe immunocontraception.

Patients with secondary amenorrhea due to tuberculosis endometritis towards the induced anti-tuberculosis drug category 1.

Tuberculosis (TB) is a disease which can affect various organs, including human's genital organs such as the endometrium. Tuberculosis endometritis can cause clinical symptoms of secondary amenorrhea and infertility. Infertility in genital TB caused by the involvement of the endometrium. The case presentation is 33-year-old woman from dr. Saiful Anwar Public Hospital to consult that she has not menstruated since 5 years ago (28 years old). The diagnosis was done by performing a clinical examination until the diagnosis of secondary amenorrhea due to tuberculosis endometritis is obtained. A treatment by using category I of anti-tuberculosis drugs was done for 6 months, afterward an Anatomical Pathology observation found no signs of the tuberculosis symptoms. Based on that, patient, who was diagnosed to have secondary amenorrhea due to tuberculosis endometritis, has no signs of tuberculosis process after being treated by using category I of anti-tuberculosis drugs for 6 months.