Audit: QRS - Combining Ivermectin, Mebendazole & Fenbendazole to Treat Cancer

Audit conducted on 13/09/2026 04:03 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	93
Passed	83
Failed	0
N/A	10
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢	Every populated span traces to ER text: protocol cells to ER Therapeutic Protocol (ER 376–398), gates to Key Interactions & Contraindications (ER 314–352), tiers to Expected Benefits / Potential Risks & Side Effects, markers to the ER monitoring table (ER 471–484).
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	“Fenbendazole has never been studied in people” mirrors ER 520; “the human case is thin and uneven” is ER 518 verbatim.
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	Contraindication thresholds carried unchanged (ALT >3× ULN, ANC <1.5 × 10⁹/L, microfilarial load >8,000/mL); “caution”/”monitor” severity verbs preserved per ER bullet.
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢	No Benefit-Modifying Factors or Risk-Modifying Factors content appears in the gates; metronidazole sits under Contraindications because ER 318 calls it an “absolute contraindication”.
1.5	PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact.	🟢	No PMIDs, no NCT identifiers, no author names and no brand names anywhere in the QRS; every named drug (metronidazole, ketoconazole, rifampicin, apixaban, paclitaxel, quercetin, kava, noscapine …) is an ER generic name.
1.6	The QRS does not introduce new attributions.	🟢	No attributions of any kind in the populated spans.

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢	Matches the ER’s measured, sceptical register; the lede reproduces the ER Conclusion balance of laboratory signal against thin human data.
2.2	The tone of the QRS is simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢	Presents thresholds, ranges and cadences that let a reader act, without exhortation; the negative net reading is the ER’s own objective finding.
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢	Descriptive throughout (“Imaging or tumour-marker change is not assessed earlier in any published protocol”, QRS 519).
2.4	The QRS avoids language that implies medical or clinical advice	🟢	No prescriptive verbs; the gate items carry the ER’s own “caution”/”monitor” classification rather than instructions.
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢	No instance of “recommend”, “advise”, “should” or “must” in document text.
2.6	The QRS never addresses “the reader” directly — it presents evidence, not guidance	🟢	No second-person pronouns anywhere in the rendered content.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms are limited to those the ER itself uses as marker names and drug classes; the lede is jargon-free.
2.8	Information is presented in a concise and very compact manner	🟢	Every tier is a single semicolon-separated line; gate items are one-liners; marker “Why” cells are single clauses.
2.9	It DOES NOT address the reader directly	🟢	Confirmed by scan for “you”/”your”/”we”/”our” — no hits.
2.10	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢	Content assumes a reader who will order a liver panel, a differential blood count and ABCB1 genotyping.
2.11	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢	Compounded-capsule dosing, 6-days-per-week schedules and a front-loaded 1/2/4-week monitoring cadence are presented without hedging on effort.
2.12	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢	Functional (not conventional) laboratory ranges and genotype-level contraindications place it outside general-population framing.
2.13	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢	The lede states plainly that recorded harms are more certain than benefits, which is the decision-relevant weighting for a self-administering reader.
2.14	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	The string “anti-aging” does not occur in the QRS.
2.15	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “oral” / “administered orally” not “taken by mouth” / “given by mouth”; “injection” not “shot”; “adverse event” not “bad reaction”). This holds on EVERY surface, including the QRS lede — the stricter plain-language bar (see 2.7) does not license lay phrasing for route of administration. Direct quotes from sources are exempt.	🟢	“medications”, “administered with the largest fat-containing meal” (QRS 457–458), “adverse events” wording avoided in favour of the ER’s own risk headings; no “pill”, “shot” or “by mouth”.

3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment”; Gate headings: “Contraindications”, “Key Interactions”; Tier labels: “High”, “Medium”, “Low”, “Speculative”; Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢	All fixed strings match the template byte-for-byte (QRS 446, 493, 542, 566, 587, 620, 653, 657–659, 833).
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	Programmatic comparison against [qrs_template]: 0 missing, 0 extra; marker_#_* expanded to 1–12 and qualitative_item_# to 1–5.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	Diff against [qrs_template] shows changes confined to the metadata block and data-qrs-var regions; website="evidence_review", website="audit" and website="full_review" spans, the CSS block and the footer disclaimer are untouched.

4. Formatting

#	Description	Result	Comments
4.1	When the source ER section is empty, the QRS uses the ER’s own empty-state phrasing verbatim. Typical phrasings are “None documented in human trials to date” and “Not formally studied”	N/A	No source ER section drawn on by the QRS is empty.
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢	“Standard combined regimen”, “Fenbendazole substitution”, “Weight-based escalation” and all twelve interaction labels (“Strong CYP3A4 inhibitors”, “Additive microtubule-active supplements”, …) are the ER’s bold labels verbatim.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Protocol, interaction and marker labels reproduce ER labels exactly, including the ER table’s own marker names (ALT, AST, GGT, eGFR, hs-CRP).
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Unicode scan returns no emoji; the ER’s 🟩/🟥/🟨/⭕️/⚠️ markers were correctly dropped in favour of the CSS tiers and bold tier labels.
4.5	The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page.	🟢	Every section is held to its terse form — each benefit and risk tier is one line, gate items are one-liners with trimmed example lists, marker “Why” cells are single clauses — with no ER prose carried across.

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5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢	QRS 2–14: the metadata comment opens on line 2, immediately after <!doctype html> on line 1.
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢	Opening --- on line 3, closing --- on line 13; the preamble text “QRS — Metadata (invisible, parsed by audit tooling)” precedes it.
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢	Enclosed in an HTML comment before <html>; no metadata value is repeated in the header, body or footer.
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Only duration: "00:04" is quoted, correctly, because it contains a colon; all other values are bare and untrimmed of nothing.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	QRS 4: er_filename: ivermectin_mebendazole_fenbendazole_cancer_2026-0912-2347_Opus_ER.md.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	QRS 5: qrs_prompt_version: 26.9.11, matching the QRS.md version badge.
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	QRS 6: qrs_creation_date: 2026-0913-0323.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	QRS 7: qrs_creator_ai_nickname: Opus.
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢	“Opus” — single word, no version or qualifier.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	QRS 8: qrs_creator_ai_fullname: Opus 5.
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢	“Opus 5” — nickname plus version, context-window qualifier correctly omitted.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	QRS 9 matches the file’s own name on disk.
5.13	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Re-verified across all nine keys; git_issue: 6145 and git_user: evipedia-3 are bare and correctly unquoted.

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢	QRS 22: “Combining Ivermectin, Mebendazole & Fenbendazole to Treat Cancer - Quick Reference Sheet”, matching ER canonical_topic with the ampersand encoded.
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢	QRS 417: identical canonical topic, ampersand encoded.
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	QRS 421: 09/13/2026, the correct reformat of 2026-0913-0323.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	QRS 425: Opus 5, matching the frontmatter value.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	Header carries only the title and the template’s fixed subline; the ER’s “Also known as” line was not carried over.

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	QRS 434–438 compresses all three ER Conclusion paragraphs (ER 518–522) into the mechanism, the state of the human evidence and the harm/benefit balance.
7.2	[at_a_glance] is no longer than 60 words	🟢	59 words, counted programmatically.
7.3	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Mechanism → ER 518; “laboratory case is consistent” → ER 518; “thin and uneven” → ER 518; mebendazole-only controlled data and their conflict → ER 520; fenbendazole never studied → ER 520; the four named harms → ER 522.
7.4	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “suppressed blood-cell production” and “interference with cancer care” replace the ER’s clinical phrasings.
7.5	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢	No trial name, year, cohort size or p-value appears.
7.6	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢	No response rates, survival figures, odds ratios or confidence intervals.

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All seven items trace to ER 318 and ER 340–352.
8.2	[stop_items] represent the Contraindications from the ER	🟢	All six “Populations who should avoid” bullets plus the metronidazole absolute contraindication are present — complete coverage.
8.3	Individual [stop_items] are formatted as <li></li>	🟢	QRS 569–582: seven discrete <li> elements inside the stop_items span.
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	ER’s trailing rationales stripped: “because of the risk of fatal encephalopathy on ivermectin” (ER 348) and “outside the target audience but relevant where regimens are shared within households” (ER 352) are both absent; no dash-trailing clauses remain.
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	“first trimester”, “Child-Pugh Class B or C”, “above 3 times the upper limit of normal”, “below 1.5 × 10⁹/L”, “below 100 × 10⁹/L”, “above 8,000 microfilariae/mL”, “below 15 kg”, “under 5 years” all retained.
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER uses no ranking notation inside parentheses in Key Interactions & Contraindications.
8.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no population, condition, or scenario for which the intervention should be avoided, deferred, or used only under specialist supervision.	🟢	The ER names such populations, and the section is correspondingly populated.
8.8	If the section is left empty, an HTML comment inside the [stop_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g.	N/A	The section is not empty.

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢	All twelve items trace to ER 314–338.
9.2	[caution_items] represent the Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Twelve of the ER’s thirteen interaction bullets are present; the thirteenth, metronidazole, is correctly excluded because it sits in Contraindications.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	QRS 590–610: twelve discrete <li> elements inside the caution_items span.
9.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢	Every ER mechanism sentence and “Mitigation:” clause is stripped; each item is label, trimmed example list and the ER’s severity verb only.
9.5	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Every ER bullet that carries an example list retains one or two representatives (ketoconazole/grapefruit juice, rifampicin/St John’s wort, apixaban, methotrexate/checkpoint inhibitors, platinum, paclitaxel, diphenhydramine, quercetin/curcumin/cannabidiol, green tea extract/kava, colchicine/noscapine); none is dropped entirely.
9.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	The ER uses no ranking notation inside parentheses in Key Interactions & Contraindications.
9.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used.	🟢	The ER names thirteen such interactions, and the section is correspondingly populated.
9.8	If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g.	N/A	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	All three cells trace to the ER Therapeutic Protocol bullets at ER 376, 378, 380 and 388.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The standard combined regimen, the fenbendazole substitution and the weight-based escalation are the ER’s three own-protocol dosing bullets; the remaining bullets are competing approaches, attribution and pharmacology.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER provides three or more distinct actionable aspects, and all three sets are used.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	QRS 450–489: doses, ratio, dosing-day pattern and the fat-containing-meal timing all present and ER-sourced.

11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢	Parasite clearance (ER 168), tumour-response assessment at 8–12 weeks and the six-month outcome horizon (both ER 439) are the ER’s only quantified time-to-effect statements.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	time_1 maps to the High benefit (parasite eradication), time_2 and time_3 to the Medium benefit (tumour response and disease control), in descending order.
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER provides three distinct time-to-effect aspects, and all three sets are used.
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢	QRS 499–535: “Single dose”, “8–12 weeks” and “6 months” each carry an ER-sourced sub-line.
11.5	If the ER does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	The ER provides time-to-effect information (ER 439), so the section is correctly retained.

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢	All six ER benefit headings (ER 164–198) are represented.
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢	All four spans present and populated (QRS 544–559).
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each tier reduces to the ER heading text alone; no Magnitude figures (95% cure rate, 65% vs 10% ORR, 2.6-fold exposure) carried over.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any benefits item.
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	The ER populates all four benefit tiers.

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢	All eleven ER risk headings (ER 224–292) are represented across the four tiers.
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢	All four spans present and populated (QRS 622–647).
13.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢	Each tier is a semicolon-separated list of ER headings; the ER’s incidence figures (81.8% anaemia, odds ratio 9.5, ALT 1,764 U/L) are all absent.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses appear in any risks item; the ER’s glossing parentheses are dropped.
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	The ER populates all four risk tiers.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Marker names, targets and rationales all trace to the ER table at ER 471–484.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All twelve ER biomarkers present in ER order: ALT, AST, GGT, total bilirubin, alkaline phosphatase, absolute neutrophil count, haemoglobin, platelets, albumin, eGFR, hs-CRP, disease-specific tumour marker.
14.3	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from the ER Monitoring section. It is not left with placeholder text or empty.	🟢	QRS 824–826 reproduces the ER’s front-loaded cadence (ER 469), including the dose-escalation reset to the 2-week interval.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢	All five items trace to the ER’s qualitative-marker list at ER 486–496.
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All five present and verbatim: energy/exercise tolerance, appetite and nausea, right upper abdominal discomfort, cognitive clarity and balance, pain scores and analgesic requirement.

Issues 13/09/2026 04:03

Pass rate 100.00%. No issues found.

Issues 13/09/2026 03:56

1. 1.3 — Conditional turned into assertion: In qualitative_item_4 (line 853) the QRS states “signalling ivermectin central nervous system penetration”, while the ER writes “which would signal ivermectin central nervous system penetration” — a hypothetical presented as an established fact.

Fixes 13/09/2026 03:56

1. 1.3 — Conditional phrasing restored: qualitative_item_4 changed from “balance and visual disturbance, signalling ivermectin central nervous system penetration” to the ER’s conditional wording “balance and any visual disturbance, which would signal ivermectin central nervous system penetration”.

Issues 13/09/2026 03:49

1. 4.5 — Sheet exceeds one A4 page: Estimated rendered height is roughly twice the single-A4 budget; the Key Interactions gate (~22 wrapped lines at 9.5pt), the 13-row Monitoring table and an over-long [action_1_sub] (line 456, which folds the ER’s separate “Best time of day” bullet into the regimen cell) are the main contributors.
2. 1.3 — Cohort attribution dropped: [time_3_sub] (line 532) states “Outcomes were measured at six months”, generalising the ER’s “The observational cohort measured outcomes at six months” (ER line 439) into an unqualified claim.
3. 2.15 — Colloquial “cheap” in the lede: [at_a_glance] (line 434) uses “cheap antiparasitic medications” where the formal register is “inexpensive”, the term the ER itself uses at line 38.

Fixes 13/09/2026 03:49

1. 1.3 — Cohort attribution restored: [time_3_sub] changed from “Outcomes were measured at six months” to “The observational cohort measured outcomes at six months”, matching the ER’s qualified wording.
2. 2.15 — Colloquial adjective in lede: [at_a_glance] changed “Three cheap antiparasitic medications” to “Three inexpensive antiparasitic medications”, the formal register the ER uses at line 38. Word count remains 59.
3. 4.5 — Protocol and qualitative cells condensed: [action_1_sub] reduced from two sentences to one (“One compounded capsule, 6 days per week — a 1:10 ratio, administered with the largest fat-containing meal”), and [qualitative_item_5 / item 4] shortened to “…visual disturbance, signalling ivermectin central nervous system penetration”.
4. 4.5 — Key Interaction example lists trimmed: Example drugs reduced to the class-defining ones — CYP3A4 inducers to “(rifampicin, St John’s wort)”, myelosuppressive chemotherapy to “(platinum)”, microtubule-targeting agents to “(paclitaxel)” — with at least one example retained in every item per 9.5.
5. 4.5 / 8.4 — Contraindication shortened: The hepatic-impairment gate now reads “baseline ALT above 3 times the upper limit of normal” instead of spelling out “alanine aminotransferase”, which is already defined by the Monitoring table.

Issues 13/09/2026 03:39

1. 10.2 — Fenbendazole dosing absent from Protocol: The three Protocol cells (lines 461-474) select “Best time of day” — the ER’s seventh Protocol bullet (ER line 388) — over “Fenbendazole substitution”, the ER’s third bullet (ER line 380), leaving the QRS with no fenbendazole regimen anywhere despite fenbendazole being one of the three agents in the canonical topic.

Fixes 13/09/2026 03:39

1. 10.2 — Fenbendazole regimen added to Protocol: Replaced the second Protocol cell “Best time of day / With the largest fat-containing meal” with “Fenbendazole substitution / Fenbendazole 222 mg daily, 3 days on, 4 days off”, per ER line 380, so the panel now carries a regimen for all three named agents. The fat-containing-meal timing was folded into [action_1_sub] so no ER content was lost.

Issues 13/09/2026 03:31

1. 4.5 — Content exceeds one A4 page: Total content volume overruns the single-page budget — the 12-item Key Interactions gate (lines 591–633) alone occupies roughly 125mm in its ~347px column, and together with the 12-row Monitoring table plus cadence (lines 676–851) and the Protocol panel (lines 445–540) exceeds the ~273mm of printable height before the header, At-A-Glance, Benefits, Risks, Qualitative Assessment and footer are counted; the long parenthetical drug lists and three-line sub/why cells were not trimmed to the per-section budget.

Fixes 13/09/2026 03:31

1. 4.5 — Key Interactions parentheticals trimmed: Shortened the example drug list in every Key Interactions item to one or two representatives (e.g., “ketoconazole, itraconazole, clarithromycin, grapefruit juice” → “ketoconazole, grapefruit juice”), cutting the gate from roughly 25 wrapped lines to 14 while keeping every interaction and its caution/monitor classification.
2. 4.5 — Protocol and Time-to-Effect subs condensed: Tightened all three Protocol sub cells and two Time-to-Effect sub cells (e.g., “One compounded capsule, both agents co-administered, 6 days per week” → “Both agents in one compounded capsule, 6 days per week”), removing about four wrapped lines from the Protocol panel.
3. 4.5 — Low-tier risk duplication merged: Combined the two separately repeated trailing phrases into “glomerulonephritis and alopecia on prolonged high-dose mebendazole”, saving a wrapped line without dropping either risk.
4. 4.5 — Monitoring cells and cadence shortened: Condensed six marker why/target cells and the cadence sentence (e.g., “then every 4–8 weeks while dosing continues” → “then every 4–8 weeks”), reducing multi-line table rows and the cadence block while preserving all 12 markers and the escalation reset rule.
5. 4.5 — Qualitative item tightened: Trimmed the ivermectin central-nervous-system item (“any visual disturbance” → “visual disturbance”) to fit its line budget.