http://hdl.handle.net/10453/37630 2026-06-28T16:37:48Z http://hdl.handle.net/10453/195410 Title: Hormonal regulation and reproductive improvement with adjunctive Zishen Yutai Pill in polycystic ovary syndrome: a systematic review with meta-analysis. Authors: Lu, X; Lim, ECN; Zeng, G; Lim, CED; Zeng, L Abstract: OBJECTIVE: To systematically evaluate the therapeutic efficacy and safety of Zishen Yutai Pill (ZYP) as an adjunctive treatment for women with polycystic ovary syndrome (PCOS) through systematic review and meta-analysis of randomized controlled trials. MATERIALS AND METHODS: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Seven major databases, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP, and Wan Fang Database, were searched from inception through March 1, 2025. Randomized controlled trials comparing ZYP combined with Western medicines vs. Western medicines alone were included. RESULTS: Eighteen randomized controlled trials encompassing 1,751 participants with PCOS met the inclusion criteria. Meta-analysis demonstrated that ZYP, when combined with Western medicines, produced statistically significant improvements compared with Western medicines alone. Combination therapy significantly enhanced pregnancy rates [relative risk [RR] = 1.52, 95% confidence interval [CI] = 1.35-1.76, P < 0.00001] and ovulation rates (RR = 1.20, 95% CI = 1.12-1.30, P < 0.00001). ZYP combination therapy significantly increased endometrial thickness [mean difference (MD) = 1.34, 95% CI = 1.03-1.65, P < 0.00001]. Hormonal analysis revealed significant reductions in testosterone levels [standard mean difference (SMD) = -1.90, 95% CI = -2.94 to -0.86, P = 0.0003] and luteinizing hormone levels (SMD = -0.77, 95% CI = -1.21 to -0.33, P = 0.0006). Combination therapy significantly reduced miscarriage rates (RR = 0.54, 95% CI = 0.40-0.72, P < 0.0001). CONCLUSION: This systematic review and meta-analysis suggests that adjunctive ZYP combined with Western medicines may improve reproductive outcomes in women with PCOS. However, the certainty of evidence for most outcomes was low or very low, and many trials had high or unclear risk of bias. Accordingly, these findings should be interpreted as hypothesis-supporting rather than practice-changing, and well-designed, independently funded multicenter randomized controlled trials with standardized outcome definitions are required before routine clinical use or guideline integration can be considered. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024522660. 2025-01-01T00:00:00Z http://hdl.handle.net/10453/195409 Title: Phenylephrine’s Heterogeneous Renal Effects in Non-Cardiac Surgery: A Causal Machine Learning Study Authors: Cui, J; Lim, ECN; Wu, X; Lim, CED 2026-01-02T00:00:00Z http://hdl.handle.net/10453/195408 Title: Evolving health policy and regulatory oversight of medicinal cannabis in Australia: lessons for sustainable integration. Authors: Lim, ECN; Lim, CED Abstract: Since federal legalisation in November 2016, Australia’s medical cannabis regulation has evolved into a complex framework that involves the Therapeutic Goods Administration, state health departments, and multiple professional oversight bodies. This narrative review examines the policy hurdles and coordination gaps that have emerged between 2016 and 2024, providing a longitudinal perspective on the ongoing debate. Evidence shows patient access expanded dramatically: the number of prescriptions jumped from 231 in 2017 to more than one million by early 2024, generating an estimated market value of AUD $445.6 million. Yet notable barriers remain, including monthly costs that average between $200 and $600, uneven availability in remote areas, and variable knowledge levels among general practitioners and specialists. Core obstacles, therefore, include the tangled federal-state regulatory maze, persistent equity problems for rural patients, challenges in embedding medical cannabis into standard clinical pathways, and a supply chain that still relies heavily on imported products. A comparative analysis with Canada’s opt-out insurance model, Germany’s pharmacist-led dispensing, and the Netherlands’ community-growth scheme highlights Australia’s relatively restrictive approach, particularly in terms of reimbursement and comprehensive provider training. Policy options thus centre on extending Pharmaceutical Benefits Scheme (PBS) subsidies, building domestic cultivation and manufacturing capacity, mandating uniform educational modules for prescribers, and streamlining inter-agency oversight. This review aims to inform Australian reforms while also offering transferable lessons for other jurisdictions contemplating or revising therapeutic cannabis programmes. 2026-01-27T00:00:00Z http://hdl.handle.net/10453/195407 Title: Uncertain hands: ethical implications of AI dependency in medical education Authors: Lim, ECN; Lim, CED Abstract: As artificial intelligence (AI) systems are increasingly adopted into educational frameworks, the medical field is undergoing a radical revolution. Incorporating a poem, this review analyses the ethical concerns of technology dependency among medical students who grew up with smartphones and digital devices, focusing on both sides of the AI integration debate. From literature review and case analyses, we address some emerging ethical issues like loss of clinical intuition, empathic deficits, and diagnostic overconfidence bias. There are undeniable advantages to AI technologies, such as improved efficiency in learning and increased access to medical knowledge globally; however, reliance on algorithms raises critical issues regarding the preservation of basic skills in patient-centred care. We suggest an ethical boundary framework that focuses on integration, emphasising assistance rather than secession, to avoid technological disintegration that impedes the development of high-level thinking among clinicians. The results indicate a need for a balance between leveraging AI’s capabilities and developing humanistic clinical skills in preparing graduates for complex patient interactions. 2026-04-01T00:00:00Z