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How to use Sci-hub to get academic papers for free

• Post author: Emil O. W. Kirkegaard
• Post published: 10. April 2018
• Post category: Science

I regularly tell people on Twitter to use Sci-hub when they say they can’t access papers:

Yes you can, use Sci hub like normal people do. — Emil O W Kirkegaard (@KirkegaardEmil) April 10, 2018

However, it seems that people don’t really know how to use Sci-hub. So here is a simple, visual guide.

1. Go to the Sci-hub website

The URL may change to the website because the lobbyists of Big Publish (Elsevier, SAGE etc.) constantly try to get government to censor the website as it cuts into their rent-seeking profits . You can find the latest URLs via this handy website called Where is Sci-Hub now? (alternatively, via Wikipedia ). Currently, some working URLs are:

• https://sci.hubg.org/
• https://sci-hub.yncjkj.com (global)
• https://sci-hub.mksa.top/ (global)
• https://sci-hub.it.nf/
• https://sci-hub.st/ ( São Tomé and Príncipe )
• https://sci-hub.do (Dominican Republic)
• https://sci-hub.se/ (Sweden)
• https://sci-hub.shop (global) [redirects]
• https://scihub.bban.top (global) [redirects]
• https://scihub.wikicn.top/ (global) [redirects]
• https://sci-hub.pl/ (Poland)
• https://sci-hub.tw (Taiwan)
• https://sci-hub.si (Slovenia)
• https://mg.scihub.ltd/ (global)

If your country blocks the website, use one of the many free general purpose proxies. I tested hide.me for the purpose of writing this article and it works fine for Sci-hub using the Netherlands exit.

2. Go to the journal publisher’s website

Go to the website of whatever article it is you are trying to get. Here we pretend you want the article in my tweet above:

• Seeber, M., Cattaneo, M., Meoli, M., & Malighetti, P. (2017). Self-citations as strategic response to the use of metrics for career decisions . Research Policy.

The website for this is sciencedirect.com which is Elsevier’s cover name. Then, you locate either the URL for this (i.e. https://www.sciencedirect.com/science/article/pii/S004873331730210X) or the article’s DOI. The DOI is that unique document identifier that begins with “10.”. It is almost always shown somewhere on the site, so you can use search “10.” to find it. In rare cases, it is in the page’s source code or may not exist. If it doesn’t exist, it means you usually can’t get the article thru Sci-hub. When you have the article’s URL/DOI, you simply paste this into the Sci-hub search box. Like this:

Then you click “open” and you should get something like this:

In some cases, this may not work. The APA journals seem to cause issues using the URL approach, so use the DOI approach. Sometimes Sci-hub returns the wrong article (<1% I should guess).

Finding articles from APA journals

These journals refuse to give a DOI and they don’t work with URL either usually. Example this paper . A workaround is to search Crossref for the title which gives the DOI, then use the DOI to fetch the paper as usual:

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• About Sci-Hub

How to use Sci-Hub

Sci-Hub is a website built for downloading PDFs of journal articles and papers for free.

You want to read a scientific article or research paper, but it’s not available online, and your university or school doesn’t have a (very expensive) subscription to that particular journal. What are you supposed to do? Just not read it? That seems a bit unfair. Yes, some papers are available for purchase online, but did you know that the actual author of the paper doesn’t get any of that money? Or the peer-reviewers? I don’t mean to diminish the work that journals do, but if I have to decide between letting people read papers, or some publisher making even more money, I will always root for the person who wants to further their knowledge and studies. Downloading a PDF hurts no-one.

Step 01: Find the DOI

First of all, you need to find the DOI of the paper you are searching for.

What is a DOI? It’s numbers and letters that identify the article you’re searching for. Think of it a bit like a phone number. The way that dialling your phone number will only make your phone ring, searching for a DOI will give you exactly the article you are looking for.

How To Download Research Papers For Free: Sci-hub, LibGen, etc.

One of the biggest problems about accessing research papers is the cost. At times, you may have encountered the right papers for your research, only to be frustrated that it needs to be paid for. 

There are many ways to download research papers for free, using websites like Oa.mg, LibGen, and more. This post will talk about these platforms, so you can go try it out yourself.

Open Access vs Paywalled Research Papers

There may be many research papers around, but there are some that remain behind paywalls. While the demand for open access to research is undeniable, certain factors contribute to the persistence of paywalled content.

Publishing Companies Need The Funds

Publishers like Elsevier and Wiley operate on a model where subscription fees and paywalls helps to pay for costs such as:

• peer review,
• typesetting, and
• maintaining digital platforms.

This economic structure ensures the sustainability of publishing houses but limits access to those without the means to pay. 

Protect Copyright Laws

Copyright laws further entrench the paywall system. Publishers hold the rights to the vast majority of journal articles, making it illegal to distribute copyrighted material without consent.

This legal framework underpins the operation of paywalls, despite the ethical debate surrounding access to publicly funded research.

In response, platforms like PaperPanda and Unpaywall have emerged, utilizing clever logic and browser extensions to find open access versions of papers, leveraging repositories like the Directory of Open Access Journals.

Paid Papers Seem To Have Higher Value

The perceived value of peer-reviewed journal articles also plays a role. Academic institutions and researchers place high regard on published work, often equating it with career advancement and credibility.

This prestige associated with peer-reviewed publications incentivizes researchers to publish in traditional journals, despite their papers going to be behind a paywall.

Open access platforms and repositories strive to balance this by offering peer-reviewed articles for free, challenging the traditional valuation of scholarly work.

Despite these challenges, the landscape is shifting. Open access initiatives are gaining traction, challenging the traditional publishing model and advocating for free access to research.

As the academic community and the public demand more equitable access to knowledge, the future might see a paradigm shift towards a more open and accessible repository of human understanding.

Best Websites To Download Research Papers For Free

If you are looking to dive into the vast ocean of academic knowledge without hitting a paywall, certain websites are akin to hidden treasures.

These platforms offer free access to millions of research papers and journal articles, covering various areas of science and beyond.

Often dubbed as the “Pirate Bay” of scientific articles, Sci-Hub breaks down the barriers to knowledge by providing free access to research papers that are otherwise locked behind paywalls.

Founded by Alexandra Elbakyan in 2011, this website uses donated institutional logins to bypass publisher restrictions, offering a direct download button for the paper you’re after.

It’s a controversial but popular choice to download papers, with a repository that includes articles from nearly every field of research. Users simply need to find the DOI (Digital Object Identifier) of the paper they want, and Sci-Hub does the rest.

Library Genesis (LibGen)

This is more than just a repository for scientific papers; it’s a comprehensive database of:

• academic books,
• comics, and

Library Genesis offers a wide range of academic and non-academic content, making it a versatile resource for researchers, students, and the general public alike. 

The platform operates on the principle of sharing knowledge freely, and you can easily find and download PDFs of the research papers you need.

This is a free browser extension for Chrome and Firefox that provides legal access to millions of open access research papers.

When you stumble upon a paper online, Unpaywall’s clever logic checks various open access repositories and finds you a legal, freely available copy. 

It’s like having a digital detective at your disposal, dedicated to finding open-access versions of paywalled articles.

Directory of Open Access Journals (DOAJ)

The DOAJ is an online directory that indexes and provides access to high-quality, open access, peer-reviewed journals.

It covers all subjects and languages, making it an invaluable tool for researchers worldwide.

The directory is meticulously curated, ensuring that all listed journals adhere to a stringent open access policy. For those seeking reputable sources, this is a go-to place to find open access research papers across disciplines.

OA.mg is a tool designed to facilitate free access to scientific papers that are otherwise behind paywalls.

It operates by leveraging the open access movement’s resources, indexing millions of freely available research papers.

To obtain a paper, you typically need the DOI (Digital Object Identifier) of the desired article. By entering this DOI into OA.mg, the platform searches through various open access repositories and databases to find a legally accessible version of the paper.

This service simplifies the process of finding open access versions of research papers, making academic literature more accessible to everyone.

Utilizing some of the most advanced search algorithms, PaperPanda operates by querying various open access repositories to find you the research paper pdfs you need.

It’s especially useful for those who don’t have the DOI of a paper, as PaperPanda’s search capabilities can locate papers based on:

• author names, or

The platform aims to democratize access to scientific literature by making it as straightforward as possible to find and download research papers for free.

Download Research Papers For Free

Each of these websites plays a crucial role in the ongoing push towards open access, ensuring that scientific knowledge is available to anyone curious enough to seek it out.

Whether you’re conducting a literature review, working on a thesis, or simply indulging in a personal quest for knowledge, these platforms can provide you with the resources you need, free of charge.

Dr Andrew Stapleton has a Masters and PhD in Chemistry from the UK and Australia. He has many years of research experience and has worked as a Postdoctoral Fellow and Associate at a number of Universities. Although having secured funding for his own research, he left academia to help others with his YouTube channel all about the inner workings of academia and how to make it work for you.

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Unlocking knowledge: your gateway to open access scientific papers and research data, introduction.

In the digital era, the quest for knowledge and scientific discovery is no longer confined to the walls of academia and research institutions. Welcome to [Your Website Name] , a dedicated platform for finding and downloading open access scientific papers and other research data. Our mission is to democratize access to scientific information, making it freely available to researchers, students, and curious minds across the globe.

What is Open Access?

Open Access (OA) refers to the practice of providing unrestricted access via the Internet to peer-reviewed scholarly research. OA content is available to all, without the usual financial or legal barriers. We believe that open access is crucial in fostering a culture of knowledge sharing and collaboration, thereby accelerating innovation and discovery.

Types of Open Access:

• Gold Open Access: Papers are published in open access journals that provide immediate open access to all of their articles.
• Green Open Access (Self-Archiving): Authors publish in any journal and then self-archive a version of the article for free public use in their institutional repository or on a website.
• Hybrid Open Access: Some articles in a subscription journal are made open access upon the payment of an additional charge.

Downloading Resources

• Direct Downloads: Once you find a paper or dataset, download it directly.
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Open Access

Open access in scientific publishing represents a transformative approach that breaks down traditional barriers to knowledge dissemination. It is a movement dedicated to making scientific research freely available to all, fostering a more inclusive and collaborative scientific community. At its core, open access allows for the unrestricted sharing of research findings, enabling scientists, academicians, and the general public to access and utilize scientific papers without the constraints of subscription fees or licensing restrictions. This paradigm shift in scholarly communication is driven by the belief that knowledge, particularly that which is publicly funded, should be a communal resource, accessible to everyone for the greater good of society.

In the realm of scientific research, open access has numerous advantages. It accelerates the pace of discovery by allowing researchers to build upon existing work without delay, facilitating interdisciplinary collaboration and cross-pollination of ideas across various fields. This is particularly crucial in addressing global challenges, where rapid and unencumbered access to research can lead to faster solutions. Furthermore, open access democratizes knowledge by making it available to researchers in developing countries who may not have the resources for expensive journal subscriptions, thereby narrowing the research gap between high and low-income countries.

The open access model also aligns with the digital age's ethos of openness and transparency. It enables a more efficient validation and critique process, as a larger audience can scrutinize and contribute to the research. This can lead to higher quality and more reliable scientific work. Moreover, it provides an equal platform for emerging researchers and institutions to share their findings, ensuring that the visibility and impact of research are not confined to those within well-funded, prestigious entities.

However, the transition to open access is not without challenges. The sustainability of publishing models, quality assurance, and equitable distribution of costs are ongoing concerns. Despite these hurdles, the open access movement is gaining momentum, driven by the global scientific community's commitment to an open, accessible, and collaborative future in research. As we move forward, open access stands as a beacon of progress, symbolizing a world where knowledge is a shared and freely accessible asset, driving innovation and societal advancement.

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Download pdf papers from a list of doi and a Scihub mirror.

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Download pdf from a list of doi and a Scihub mirror.

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Install the dependencies

Download the binary in the releases

Execute the script

• List of doi as several arguments or file with one doi by line. ./scdl doi1 doi2 doi3 --mirror urlMirror or ./scdl doi.txt --mirror urlMirror
• --mirror: Url to a reachable Scihub mirror.
• --dest: Path to a folder where to store the pdf files.
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How to use Sci-Hub

Sci-Hub is a website created to download PDF files of articles and magazine articles for free.

You want to read a scientific article or research paper, but it’s not available online and your university or school doesn’t have a (very expensive) subscription to that particular newspaper. What should you do? You just don’t read it? It seems a bit unfair. Yes, some documents are available for purchase online, but did you know that the actual author of the document does not receive any of that money? Or peer reviewers? I don’t want to disparage the work that newspapers do, but if I have to decide between letting people read the newspapers or some publisher that makes even more money, I will always encourage the person who wants to deepen their knowledge and studies. . Downloading a PDF doesn’t hurt anyone.

First of all, you need to find the DOI of the card you are looking for.

What is a DOI? These are the numbers and letters that identify the item you are looking for. Think of it a bit like a phone number. The way you dial your phone number will only make your phone ring, searching for a DOI will give you exactly the article you are looking for.

You can find the DOI by googling the title of the document, clicking on one of the links and somewhere on the page there will be the DOI. For example, let’s say the card we want is called “Mapping the Margins” by Kimberle Crenshaw. We type it into Google and we get this:

Click on the first link and it should take you to a page with more information on that particular item. Copy the DOI number:

Then go to Sci-Hub and paste it into the search field:

That’s all! It takes us directly to the PDF. To download the PDF, simply click the download button in the PDF preview or click the left button with the down arrow.

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How to use SCI HUB to download research papers for free

Use Sci-Hub to download research papers

The  Sci-Hub  project supports the Open Access  movement in science. It provides mass & public access to research papers.

Often we have reported that most of the research papers published by some reputed journals are paid. If anyone wants to download such manuscripts, he needs to pay to access such papers.

SCI Hub allows downloading and reading such papers for free . Sci-H ub contains most of the academic and scientific papers. What one has to do is visit the site after finding the research paper link or DOI of the journal article . You can paste the DOI or URL in the search button and click search. If the paper is available, a preview will be shown. You can download this paper and use it for your reference.

Researchers most often use SCI HUB to download research papers for free.

How to use Sci Hub?

Follow the below steps to download paid researchers papers for free using Sci-Hub.

Step 1: Go to the official website of SCI- HUB .

Step 2: Enter the Title/ DOI/ URL of the research paper which you want to download/ read using SCI HUB.

Step 3: Click on Open or press enter key.

Step 4: As soon as you perform step 3, the desired research paper will visible on the website. You can download the paper from click on the download icon.

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scidownl 1.0.2

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Released: Apr 2, 2023

Download pdfs from Scihub.

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• Author: Tishacy

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Project description

An unofficial api for downloading papers from SciHub.

• Support downloading with DOI, PMID or TITLE.
• Easy to update newest SciHub domains.
• Ready for changes: Encapsulate possible future changes of SciHub as configurations.
• Support proxies.

Quick Usage

Installation, install with pip.

Scidownl could be easily install with pip.

Install from source code

Command line tool, 1. update available scihub domains.

There are 2 update modes that you could specify with an option: -m or --mode

crawl : [Default] Crawling the real-time updated SciHub domains website (aka, SciHub domain source) to get available SciHub domains. The SciHub domain source website url is configured in the global config file in the section [scihub.domain.updater.crawl] with the key of scihub_domain_source . You could use scidownl config --location to show the location of the global config file and edit it.

An example of using crawl mode:

search ：Generate combinations according to the rules of SciHub domains and search for available SciHub domains. This will take longer than crawl mode.

An example of using search mode:

2. List all saved SciHub domains

SciDownl use SQLite as the local database to store all updated SciHub domains locally. You can list all saved SciHub domains with the command domain.list .

In addition to the easy-to-understand Url column, the SuccessTimes column is used to record the number of successful paper downloads using this Url, and the FailedTimes column is used to record the number of failed paper downloads using this Url. These two columns are used to calculate the priority of choosing a SciHub domain when downloading papers.

3. Download papers

Download papers with doi(s), pmid(s) or title(s).

Using option -d or --doi to download papers with DOI, option -p or --pmid to download papers with PMID, and option -t or --title to download papers with titles. You can specify these options for multiple times, and even mix of them.

Customize the output location of papers

By default, the downloaded paper is named by the paper's title. With option -o or --out ，you can customize the output location of downloaded papers, whcih could be an absolute path or a relative path, and a direcotry or a file path.

Output the paepr to a directory:

Output the paper with the file path.

NOTE that if there are more than one papers to be downloaded, the value of the --out option will always be considered as a directory, rather than a file path.

If some directories in the option are not exist, SciDownl will create them for you :smile:.

Use a specific SciHub url

With option -u or --scihub-url , you could use a specific SciHub url you want, rather than let SciDownl automatically choose one for you from local saved SciHub domains. It's recommended to let SciDownl choose a SciHub url, so you don't need to use this option in normal use.

You could use scihub_download function to download papers.

More examples could be seen in examples .

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What is a DOI? | Finding and Using Digital Object Identifiers

Published on December 19, 2018 by Courtney Gahan . Revised on February 24, 2023 by Raimo Streefkerk.

A DOI (Digital Object Identifier) is a unique and never-changing string assigned to online (journal) articles , books , and other works. DOIs make it easier to retrieve works, which is why citation styles, like APA and MLA Style , recommend including them in citations.

You may find DOIs formatted in various ways:

• doi:10.1080/02626667.2018.1560449
• https://doi.org/10.1111/hex.12487
• https://dx.doi.org/10.1080/02626667.2018.1560449
• https://doi.org/10.1016/j.jpsychires.2017.11.014

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Table of contents

How to find a doi, apa style guidelines for using dois, mla style guidelines for using dois, chicago style guidelines for using dois, frequently asked questions about dois.

The DOI will usually be clearly visible when you open a journal article on a database.

Examples of where to find DOIs

• Taylor and Francis Online
• SAGE journals

Note: JSTOR uses a different format, but their “stable URL” functions in the same way as a DOI.

What to do when you cannot find the DOI

If you cannot find the DOI for a journal article, you can also check Crossref . Simply paste the relevant information into the “Search Metadata” box to find the DOI. If the DOI does not exist here, the article most likely does not have one; in this case, use a URL instead.

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APA Style guidelines state that DOIs should be included whenever they’re available. In practice, almost all journal articles and most academic books have a DOI assigned to them.

You can find the DOI on the first page of the article or copyright page of a book. Omit the DOI from the APA citation if you cannot find it.

Formatting DOIs in APA Style

DOIs are included at the end of the APA reference entry . In the 6th edition of the APA publication manual, DOIs can be preceded by the label “doi:” or formatted as URLs. In the 7th edition , DOIs should be formatted as URLs with ‘https://doi.org/’ preceding the DOI.

• APA 6th edition: doi: 10.1177/0269881118806297 or https://doi.org/ 10.1177/0269881118806297
• APA 7th edition: https://doi.org/ 10.1177/0269881118806297

APA citation examples with DOI

• Fardouly, J., & Vartanian, L. R. (2016). Social media and body image concerns: Current research and future directions. Current Opinion in Psychology , 9 , 1–5. https://doi.org/10.1016/j.copsyc.2015.09.005
• Sustersic, M., Gauchet, A., Foote, A., & Bosson, J.-L. (2016). How best to use and evaluate Patient Information Leaflets given during a consultation: a systematic review of literature reviews. Health Expectations , 20 (4), 531–542. https://doi.org/10.1111/hex.12487

Generate accurate APA citations with Scribbr

MLA recommends using the format doi:10.1177/0269881118806297.

Generate accurate MLA citations with Scribbr

In Chicago style , the format https://doi.org/10.1177/0269881118806297 is preferred.

A DOI is a unique identifier for a digital document. DOIs are important in academic citation because they are more permanent than URLs, ensuring that your reader can reliably locate the source.

Journal articles and ebooks can often be found on multiple different websites and databases. The URL of the page where an article is hosted can be changed or removed over time, but a DOI is linked to the specific document and never changes.

The DOI is usually clearly visible when you open a journal article on an academic database. It is often listed near the publication date, and includes “doi.org” or “DOI:”. If the database has a “cite this article” button, this should also produce a citation with the DOI included.

If you can’t find the DOI, you can search on Crossref using information like the author, the article title, and the journal name.

Include the DOI at the very end of the APA reference entry . If you’re using the 6th edition APA guidelines, the DOI is preceded by the label “doi:”. In the 7th edition , the DOI is preceded by ‘https://doi.org/’.

• 6th edition: doi: 10.1177/0894439316660340
• 7th edition: https://doi.org/ 10.1177/0894439316660340

APA citation example (7th edition)

Hawi, N. S., & Samaha, M. (2016). The relations among social media addiction, self-esteem, and life satisfaction in university students. Social Science Computer Review , 35 (5), 576–586. https://doi.org/10.1177/0894439316660340

In an APA journal citation , if a DOI (digital object identifier) is available for an article, always include it.

If an article has no DOI, and you accessed it through a database or in print, just omit the DOI.

If an article has no DOI, and you accessed it through a website other than a database (for example, the journal’s own website), include a URL linking to the article.

In MLA style citations , format a DOI as a link, including “https://doi.org/” at the start and then the unique numerical code of the article.

DOIs are used mainly when citing journal articles in MLA .

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Gahan, C. (2023, February 24). What is a DOI? | Finding and Using Digital Object Identifiers. Scribbr. Retrieved September 3, 2024, from https://www.scribbr.com/citing-sources/what-is-a-doi/

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• Instructions

Introduction

Use this guide to learn how to find and download PDF articles using a Direct Object Identifier (DOI) or PubMed ID (PMID).

Step 1. Visit NYIT LibKey

• Visit NYIT LibKey . (https://libkey.io/libraries/532)
• Enter a DOI or PMID.
• Click Find Article.

a. What is a DOI?

A DOI, or Digital Object Identifier , is a string of numbers, letters and symbols used to permanently identify an article or document and link to it on the web.

A DOI will help you easily locate a document. Think of it like a Social Security number for the article you are interesting in; it will always refer to that article, and only that one.

b. What is a PMID?

A PMID, also known as the PubMed reference number, is a number assigned by the NIH National Library of Medicine to papers indexed in PubMed . PubMed Central is an archive of full text journal articles.

Step 2. Check Availability

If the article is available in full text you will see the option  ARTICLE LINK  under Full Text Format Options.

Step 3. Login

If you are off-campus you will be asked to enter your My NYIT username and password.

Step 4. View Article

• The article could be provided by a subscription database or open respository.
• Options frequently include download, email and cite.

Step 5. Download

• If the article is not available you will see linking options.
• Click Library Access Options to view NYIT print holdings or submit an Interlibrary Loan request.

Step 6. Request

• View the library's print holdings.
• If no print holdings are available you can submit an Interlibrary Loan (ILL) Request for the item.

Questions? Chat online with a New York Tech librarian or  email [email protected] .

• Last Updated: Oct 8, 2021 8:29 PM
• URL: https://libguides.nyit.edu/pdf-finder

Reference management. Clean and simple.

How to find a DOI?

Location of DOIs

How to include a doi in your citation, frequently asked questions about finding dois, related articles.

A digital object identifier , or DOI, refers to a handle that recognizes a unique object in the digital world. This label is assigned by the International Organization for Standardization (ISO) to different types of scholarly material, such as papers, journal articles, books, data sets, reports, government publications, and even videos.

A DOI should always be easily available in any source. Usually, you will find it on the first page, either in the header or somewhere close to the title.

Alternatively, you can also find it in the "About this article" or "Cite this article" sections.

If the DOI isn’t available, you can look it up on CrossRef.org by using the “Search Metadata” option. You just have to type in the source's title or author, and it will direct you to its DOI.

The correct format for adding a DOI to your citations will depend on the citation style you use. Here is a list of citation examples with DOIs in major formatting styles:

Hofman, C. A., & Rick, T. C. (2018). Ancient Biological Invasions and Island Ecosystems: Tracking Translocations of Wild Plants and Animals. Journal of Archeological Research , 26 (1), 65–115. https://doi.org/10.1007/s10814-017-9105-3

Hofman, Courtney A., and Torben C. Rick. “Ancient Biological Invasions and Island Ecosystems: Tracking Translocations of Wild Plants and Animals.”  Journal of Archaeological Research , vol. 26, no. 1, 2018, pp. 65–115, doi:10.1007/s10814-017-9105-3.

Hofman, Courtney A., and Torben C. Rick. 2018. “Ancient Biological Invasions and Island Ecosystems: Tracking Translocations of Wild Plants and Animals.”  Journal of Archaeological Research  26 (1): 65–115. https://doi.org/10.1007/s10814-017-9105-3.

The preferred format of a DOI in a citation is using https://doi.org/ followed by the alphanumeric string. It also depends on the style; as you can see that MLA prefers using doi:xxx. Make sure to double-check the citation style you use before adding the DOI.

Tip: Instead of manually adding citations with DOIs to your documents, which is error-prone and strenuous, consider using a reference manager like Paperpile to format and organize your citations. Paperpile allows you to save and organize your citations for later use and cite them in thousands of citation styles directly in Google Docs, Microsoft Word, or LaTeX, including the DOI:

The preferred format of a DOI in a citation is using https://doi.org/ followed by the alphanumeric string. Of course, it depends on the style, as MLA prefers using doi:xxx. Make sure to double check the citation style you use before adding the DOI.

The International Organization for Standardization (ISO) is responsible for assigning DOIs to different types of scholarly material, such as papers, journal articles, books, data sets, reports, government publications, and even videos.

URLs and DOIs are not the same. A DOI is a unique alphanumeric identifier that labels digital material and pinpoints its location on the internet, whereas a URL is a digital locator.

DOIs were invented for a reason. These alphanumeric identifiers allow readers to locate specific material in the digital world. They also add credibility to your sources.

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How do I find an article by DOI in Google Scholar?

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Answered By: Jon Allinder Last Updated: Jul 03, 2023     Views: 135655

You can find an article by DOI by searching from the Library's Journals & Articles page . That search box is configured to automatically connect Google Scholar to the Walden Library databases. 

Note:  If you access Google Scholar directly from the internet you will have to follow  the steps to manually connect Google Scholar to the Walden Library . This connection is erased when you clear your cache and cookies.

Here are the steps for finding an article by searching in Google Scholar for the DOI. In this example we will search for the article with DOI: 10.1177/0741713611402046.

• On the  Library homepage  click on  Publications .
• Scroll down to Find articles and click on the tab: By DOI

• Click the  Search  button.
• Find your article in the results list.

• Click the  Find at Walden  link to get the article's full text. You may need to log in with your myWalden user name and password. Tip: Right click on Find@Walden and open in a new tab to preserve your search results page.   

More information:

How do I find an article by searching for the journal title?

What do I do if there is no Find@Walden link in Google Scholar?

What do I do if the Find@Walden link in Google Scholar does not work?

Learn more about DOIs  

Do you have other questions about DOIs?   Ask a Librarian !

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What are DOIs and PMIDs

Find an article using doi or pmid.

DOI stands for Document Object Identifier . This is a unique identifier that is assigned to an online journal article, online book or online book chapter. Most publishers assign these to their online content. A DOI can take you directly to an online resource, but the Library does not always have access at a publisher site. The DOI lookup links to any online access we have.

PMID is a unique identifier used in the PubMed database and can be used to look up abstracts in PubMed. The PMID lookup links to online access through the Library.

This widget uses Libkey.io, which connects to our FIndIt service to get you to an article. All you need is a DOI or PMID.

Enter a DOI or PMID

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How to batch download papers from a reference list without DOI?

I'm looking to download some papers from a reference list in an Excel file which consisted of all the basic info about a paper (e.g., author, year, title, publication, etc.) but unfortunately not the DOI. I've looked into many methods for batch downloading papers, but they all require the DOI to work. I've also looked into searching for DOI using the title of the paper but to no avail, as all the programs I've came across does the reverse, i.e., use the DOI to retrieve the rest of the metadata. I would greatly appreciate any pointers anybody has.

• reference-managers
• meta-analysis

• Please clarify your specific problem or provide additional details to highlight exactly what you need. As it's currently written, it's hard to tell exactly what you're asking. –  Community Bot Commented Mar 10, 2022 at 22:06
• I think the question is clear. –  gib Commented Mar 10, 2022 at 22:46

2 Answers 2

You can submit batches of references to get DOIs manually through through Crossref Simple Text Query - https://apps.crossref.org/SimpleTextQuery

• 1 Wow! I just tested it and it worked on some really obscure stuff. It did not work on old Soviet journal articles, presumably because they have no DOIs. –  Anonymous Physicist Commented Mar 11, 2022 at 14:14
• Thank you!!! This is a simple solution that worked well for me. –  ambbb Commented Mar 14, 2022 at 22:40

You cannot do it consistently. That is precisely why DOI was created: so that papers can be reliably located by algorithms.

For subscription journals, batch downloads are normally forbidden under the contract. This rule can be enforced by banning you from downloading.

• 1 It might be helpful if anyone knew how to do it 99% accurately, even if it's impossible to do it 100% accurately –  gib Commented Mar 11, 2022 at 8:48

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Not the answer you're looking for browse other questions tagged citations reference-managers doi meta-analysis ..

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Peer Reviewed

GPT-fabricated scientific papers on Google Scholar: Key features, spread, and implications for preempting evidence manipulation

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Academic journals, archives, and repositories are seeing an increasing number of questionable research papers clearly produced using generative AI. They are often created with widely available, general-purpose AI applications, most likely ChatGPT, and mimic scientific writing. Google Scholar easily locates and lists these questionable papers alongside reputable, quality-controlled research. Our analysis of a selection of questionable GPT-fabricated scientific papers found in Google Scholar shows that many are about applied, often controversial topics susceptible to disinformation: the environment, health, and computing. The resulting enhanced potential for malicious manipulation of society’s evidence base, particularly in politically divisive domains, is a growing concern.

Swedish School of Library and Information Science, University of Borås, Sweden

Department of Arts and Cultural Sciences, Lund University, Sweden

Division of Environmental Communication, Swedish University of Agricultural Sciences, Sweden

Research Questions

• Where are questionable publications produced with generative pre-trained transformers (GPTs) that can be found via Google Scholar published or deposited?
• What are the main characteristics of these publications in relation to predominant subject categories?
• How are these publications spread in the research infrastructure for scholarly communication?
• How is the role of the scholarly communication infrastructure challenged in maintaining public trust in science and evidence through inappropriate use of generative AI?

research note Summary

• A sample of scientific papers with signs of GPT-use found on Google Scholar was retrieved, downloaded, and analyzed using a combination of qualitative coding and descriptive statistics. All papers contained at least one of two common phrases returned by conversational agents that use large language models (LLM) like OpenAI’s ChatGPT. Google Search was then used to determine the extent to which copies of questionable, GPT-fabricated papers were available in various repositories, archives, citation databases, and social media platforms.
• Roughly two-thirds of the retrieved papers were found to have been produced, at least in part, through undisclosed, potentially deceptive use of GPT. The majority (57%) of these questionable papers dealt with policy-relevant subjects (i.e., environment, health, computing), susceptible to influence operations. Most were available in several copies on different domains (e.g., social media, archives, and repositories).
• Two main risks arise from the increasingly common use of GPT to (mass-)produce fake, scientific publications. First, the abundance of fabricated “studies” seeping into all areas of the research infrastructure threatens to overwhelm the scholarly communication system and jeopardize the integrity of the scientific record. A second risk lies in the increased possibility that convincingly scientific-looking content was in fact deceitfully created with AI tools and is also optimized to be retrieved by publicly available academic search engines, particularly Google Scholar. However small, this possibility and awareness of it risks undermining the basis for trust in scientific knowledge and poses serious societal risks.

Implications

The use of ChatGPT to generate text for academic papers has raised concerns about research integrity. Discussion of this phenomenon is ongoing in editorials, commentaries, opinion pieces, and on social media (Bom, 2023; Stokel-Walker, 2024; Thorp, 2023). There are now several lists of papers suspected of GPT misuse, and new papers are constantly being added. 1 See for example Academ-AI, https://www.academ-ai.info/ , and Retraction Watch, https://retractionwatch.com/papers-and-peer-reviews-with-evidence-of-chatgpt-writing/ . While many legitimate uses of GPT for research and academic writing exist (Huang & Tan, 2023; Kitamura, 2023; Lund et al., 2023), its undeclared use—beyond proofreading—has potentially far-reaching implications for both science and society, but especially for their relationship. It, therefore, seems important to extend the discussion to one of the most accessible and well-known intermediaries between science, but also certain types of misinformation, and the public, namely Google Scholar, also in response to the legitimate concerns that the discussion of generative AI and misinformation needs to be more nuanced and empirically substantiated  (Simon et al., 2023).

Google Scholar, https://scholar.google.com , is an easy-to-use academic search engine. It is available for free, and its index is extensive (Gusenbauer & Haddaway, 2020). It is also often touted as a credible source for academic literature and even recommended in library guides, by media and information literacy initiatives, and fact checkers (Tripodi et al., 2023). However, Google Scholar lacks the transparency and adherence to standards that usually characterize citation databases. Instead, Google Scholar uses automated crawlers, like Google’s web search engine (Martín-Martín et al., 2021), and the inclusion criteria are based on primarily technical standards, allowing any individual author—with or without scientific affiliation—to upload papers to be indexed (Google Scholar Help, n.d.). It has been shown that Google Scholar is susceptible to manipulation through citation exploits (Antkare, 2020) and by providing access to fake scientific papers (Dadkhah et al., 2017). A large part of Google Scholar’s index consists of publications from established scientific journals or other forms of quality-controlled, scholarly literature. However, the index also contains a large amount of gray literature, including student papers, working papers, reports, preprint servers, and academic networking sites, as well as material from so-called “questionable” academic journals, including paper mills. The search interface does not offer the possibility to filter the results meaningfully by material type, publication status, or form of quality control, such as limiting the search to peer-reviewed material.

To understand the occurrence of ChatGPT (co-)authored work in Google Scholar’s index, we scraped it for publications, including one of two common ChatGPT responses (see Appendix A) that we encountered on social media and in media reports (DeGeurin, 2024). The results of our descriptive statistical analyses showed that around 62% did not declare the use of GPTs. Most of these GPT-fabricated papers were found in non-indexed journals and working papers, but some cases included research published in mainstream scientific journals and conference proceedings. 2 Indexed journals mean scholarly journals indexed by abstract and citation databases such as Scopus and Web of Science, where the indexation implies journals with high scientific quality. Non-indexed journals are journals that fall outside of this indexation. More than half (57%) of these GPT-fabricated papers concerned policy-relevant subject areas susceptible to influence operations. To avoid increasing the visibility of these publications, we abstained from referencing them in this research note. However, we have made the data available in the Harvard Dataverse repository.

The publications were related to three issue areas—health (14.5%), environment (19.5%) and computing (23%)—with key terms such “healthcare,” “COVID-19,” or “infection”for health-related papers, and “analysis,” “sustainable,” and “global” for environment-related papers. In several cases, the papers had titles that strung together general keywords and buzzwords, thus alluding to very broad and current research. These terms included “biology,” “telehealth,” “climate policy,” “diversity,” and “disrupting,” to name just a few.  While the study’s scope and design did not include a detailed analysis of which parts of the articles included fabricated text, our dataset did contain the surrounding sentences for each occurrence of the suspicious phrases that formed the basis for our search and subsequent selection. Based on that, we can say that the phrases occurred in most sections typically found in scientific publications, including the literature review, methods, conceptual and theoretical frameworks, background, motivation or societal relevance, and even discussion. This was confirmed during the joint coding, where we read and discussed all articles. It became clear that not just the text related to the telltale phrases was created by GPT, but that almost all articles in our sample of questionable articles likely contained traces of GPT-fabricated text everywhere.

Evidence hacking and backfiring effects

Generative pre-trained transformers (GPTs) can be used to produce texts that mimic scientific writing. These texts, when made available online—as we demonstrate—leak into the databases of academic search engines and other parts of the research infrastructure for scholarly communication. This development exacerbates problems that were already present with less sophisticated text generators (Antkare, 2020; Cabanac & Labbé, 2021). Yet, the public release of ChatGPT in 2022, together with the way Google Scholar works, has increased the likelihood of lay people (e.g., media, politicians, patients, students) coming across questionable (or even entirely GPT-fabricated) papers and other problematic research findings. Previous research has emphasized that the ability to determine the value and status of scientific publications for lay people is at stake when misleading articles are passed off as reputable (Haider & Åström, 2017) and that systematic literature reviews risk being compromised (Dadkhah et al., 2017). It has also been highlighted that Google Scholar, in particular, can be and has been exploited for manipulating the evidence base for politically charged issues and to fuel conspiracy narratives (Tripodi et al., 2023). Both concerns are likely to be magnified in the future, increasing the risk of what we suggest calling evidence hacking —the strategic and coordinated malicious manipulation of society’s evidence base.

The authority of quality-controlled research as evidence to support legislation, policy, politics, and other forms of decision-making is undermined by the presence of undeclared GPT-fabricated content in publications professing to be scientific. Due to the large number of archives, repositories, mirror sites, and shadow libraries to which they spread, there is a clear risk that GPT-fabricated, questionable papers will reach audiences even after a possible retraction. There are considerable technical difficulties involved in identifying and tracing computer-fabricated papers (Cabanac & Labbé, 2021; Dadkhah et al., 2023; Jones, 2024), not to mention preventing and curbing their spread and uptake.

However, as the rise of the so-called anti-vaxx movement during the COVID-19 pandemic and the ongoing obstruction and denial of climate change show, retracting erroneous publications often fuels conspiracies and increases the following of these movements rather than stopping them. To illustrate this mechanism, climate deniers frequently question established scientific consensus by pointing to other, supposedly scientific, studies that support their claims. Usually, these are poorly executed, not peer-reviewed, based on obsolete data, or even fraudulent (Dunlap & Brulle, 2020). A similar strategy is successful in the alternative epistemic world of the global anti-vaccination movement (Carrion, 2018) and the persistence of flawed and questionable publications in the scientific record already poses significant problems for health research, policy, and lawmakers, and thus for society as a whole (Littell et al., 2024). Considering that a person’s support for “doing your own research” is associated with increased mistrust in scientific institutions (Chinn & Hasell, 2023), it will be of utmost importance to anticipate and consider such backfiring effects already when designing a technical solution, when suggesting industry or legal regulation, and in the planning of educational measures.

Recommendations

Solutions should be based on simultaneous considerations of technical, educational, and regulatory approaches, as well as incentives, including social ones, across the entire research infrastructure. Paying attention to how these approaches and incentives relate to each other can help identify points and mechanisms for disruption. Recognizing fraudulent academic papers must happen alongside understanding how they reach their audiences and what reasons there might be for some of these papers successfully “sticking around.” A possible way to mitigate some of the risks associated with GPT-fabricated scholarly texts finding their way into academic search engine results would be to provide filtering options for facets such as indexed journals, gray literature, peer-review, and similar on the interface of publicly available academic search engines. Furthermore, evaluation tools for indexed journals 3 Such as LiU Journal CheckUp, https://ep.liu.se/JournalCheckup/default.aspx?lang=eng . could be integrated into the graphical user interfaces and the crawlers of these academic search engines. To enable accountability, it is important that the index (database) of such a search engine is populated according to criteria that are transparent, open to scrutiny, and appropriate to the workings of  science and other forms of academic research. Moreover, considering that Google Scholar has no real competitor, there is a strong case for establishing a freely accessible, non-specialized academic search engine that is not run for commercial reasons but for reasons of public interest. Such measures, together with educational initiatives aimed particularly at policymakers, science communicators, journalists, and other media workers, will be crucial to reducing the possibilities for and effects of malicious manipulation or evidence hacking. It is important not to present this as a technical problem that exists only because of AI text generators but to relate it to the wider concerns in which it is embedded. These range from a largely dysfunctional scholarly publishing system (Haider & Åström, 2017) and academia’s “publish or perish” paradigm to Google’s near-monopoly and ideological battles over the control of information and ultimately knowledge. Any intervention is likely to have systemic effects; these effects need to be considered and assessed in advance and, ideally, followed up on.

Our study focused on a selection of papers that were easily recognizable as fraudulent. We used this relatively small sample as a magnifying glass to examine, delineate, and understand a problem that goes beyond the scope of the sample itself, which however points towards larger concerns that require further investigation. The work of ongoing whistleblowing initiatives 4 Such as Academ-AI, https://www.academ-ai.info/ , and Retraction Watch, https://retractionwatch.com/papers-and-peer-reviews-with-evidence-of-chatgpt-writing/ . , recent media reports of journal closures (Subbaraman, 2024), or GPT-related changes in word use and writing style (Cabanac et al., 2021; Stokel-Walker, 2024) suggest that we only see the tip of the iceberg. There are already more sophisticated cases (Dadkhah et al., 2023) as well as cases involving fabricated images (Gu et al., 2022). Our analysis shows that questionable and potentially manipulative GPT-fabricated papers permeate the research infrastructure and are likely to become a widespread phenomenon. Our findings underline that the risk of fake scientific papers being used to maliciously manipulate evidence (see Dadkhah et al., 2017) must be taken seriously. Manipulation may involve undeclared automatic summaries of texts, inclusion in literature reviews, explicit scientific claims, or the concealment of errors in studies so that they are difficult to detect in peer review. However, the mere possibility of these things happening is a significant risk in its own right that can be strategically exploited and will have ramifications for trust in and perception of science. Society’s methods of evaluating sources and the foundations of media and information literacy are under threat and public trust in science is at risk of further erosion, with far-reaching consequences for society in dealing with information disorders. To address this multifaceted problem, we first need to understand why it exists and proliferates.

Finding 1: 139 GPT-fabricated, questionable papers were found and listed as regular results on the Google Scholar results page. Non-indexed journals dominate.

Most questionable papers we found were in non-indexed journals or were working papers, but we did also find some in established journals, publications, conferences, and repositories. We found a total of 139 papers with a suspected deceptive use of ChatGPT or similar LLM applications (see Table 1). Out of these, 19 were in indexed journals, 89 were in non-indexed journals, 19 were student papers found in university databases, and 12 were working papers (mostly in preprint databases). Table 1 divides these papers into categories. Health and environment papers made up around 34% (47) of the sample. Of these, 66% were present in non-indexed journals.

Finding 2: GPT-fabricated, questionable papers are disseminated online, permeating the research infrastructure for scholarly communication, often in multiple copies. Applied topics with practical implications dominate.

The 20 papers concerning health-related issues are distributed across 20 unique domains, accounting for 46 URLs. The 27 papers dealing with environmental issues can be found across 26 unique domains, accounting for 56 URLs.  Most of the identified papers exist in multiple copies and have already spread to several archives, repositories, and social media. It would be difficult, or impossible, to remove them from the scientific record.

As apparent from Table 2, GPT-fabricated, questionable papers are seeping into most parts of the online research infrastructure for scholarly communication. Platforms on which identified papers have appeared include ResearchGate, ORCiD, Journal of Population Therapeutics and Clinical Pharmacology (JPTCP), Easychair, Frontiers, the Institute of Electrical and Electronics Engineer (IEEE), and X/Twitter. Thus, even if they are retracted from their original source, it will prove very difficult to track, remove, or even just mark them up on other platforms. Moreover, unless regulated, Google Scholar will enable their continued and most likely unlabeled discoverability.

A word rain visualization (Centre for Digital Humanities Uppsala, 2023), which combines word prominences through TF-IDF 5 Term frequency–inverse document frequency , a method for measuring the significance of a word in a document compared to its frequency across all documents in a collection. scores with semantic similarity of the full texts of our sample of GPT-generated articles that fall into the “Environment” and “Health” categories, reflects the two categories in question. However, as can be seen in Figure 1, it also reveals overlap and sub-areas. The y-axis shows word prominences through word positions and font sizes, while the x-axis indicates semantic similarity. In addition to a certain amount of overlap, this reveals sub-areas, which are best described as two distinct events within the word rain. The event on the left bundles terms related to the development and management of health and healthcare with “challenges,” “impact,” and “potential of artificial intelligence”emerging as semantically related terms. Terms related to research infrastructures, environmental, epistemic, and technological concepts are arranged further down in the same event (e.g., “system,” “climate,” “understanding,” “knowledge,” “learning,” “education,” “sustainable”). A second distinct event further to the right bundles terms associated with fish farming and aquatic medicinal plants, highlighting the presence of an aquaculture cluster.  Here, the prominence of groups of terms such as “used,” “model,” “-based,” and “traditional” suggests the presence of applied research on these topics. The two events making up the word rain visualization, are linked by a less dominant but overlapping cluster of terms related to “energy” and “water.”

The bar chart of the terms in the paper subset (see Figure 2) complements the word rain visualization by depicting the most prominent terms in the full texts along the y-axis. Here, word prominences across health and environment papers are arranged descendingly, where values outside parentheses are TF-IDF values (relative frequencies) and values inside parentheses are raw term frequencies (absolute frequencies).

Finding 3: Google Scholar presents results from quality-controlled and non-controlled citation databases on the same interface, providing unfiltered access to GPT-fabricated questionable papers.

Google Scholar’s central position in the publicly accessible scholarly communication infrastructure, as well as its lack of standards, transparency, and accountability in terms of inclusion criteria, has potentially serious implications for public trust in science. This is likely to exacerbate the already-known potential to exploit Google Scholar for evidence hacking (Tripodi et al., 2023) and will have implications for any attempts to retract or remove fraudulent papers from their original publication venues. Any solution must consider the entirety of the research infrastructure for scholarly communication and the interplay of different actors, interests, and incentives.

We searched and scraped Google Scholar using the Python library Scholarly (Cholewiak et al., 2023) for papers that included specific phrases known to be common responses from ChatGPT and similar applications with the same underlying model (GPT3.5 or GPT4): “as of my last knowledge update” and/or “I don’t have access to real-time data” (see Appendix A). This facilitated the identification of papers that likely used generative AI to produce text, resulting in 227 retrieved papers. The papers’ bibliographic information was automatically added to a spreadsheet and downloaded into Zotero. 6 An open-source reference manager, https://zotero.org .

We employed multiple coding (Barbour, 2001) to classify the papers based on their content. First, we jointly assessed whether the paper was suspected of fraudulent use of ChatGPT (or similar) based on how the text was integrated into the papers and whether the paper was presented as original research output or the AI tool’s role was acknowledged. Second, in analyzing the content of the papers, we continued the multiple coding by classifying the fraudulent papers into four categories identified during an initial round of analysis—health, environment, computing, and others—and then determining which subjects were most affected by this issue (see Table 1). Out of the 227 retrieved papers, 88 papers were written with legitimate and/or declared use of GPTs (i.e., false positives, which were excluded from further analysis), and 139 papers were written with undeclared and/or fraudulent use (i.e., true positives, which were included in further analysis). The multiple coding was conducted jointly by all authors of the present article, who collaboratively coded and cross-checked each other’s interpretation of the data simultaneously in a shared spreadsheet file. This was done to single out coding discrepancies and settle coding disagreements, which in turn ensured methodological thoroughness and analytical consensus (see Barbour, 2001). Redoing the category coding later based on our established coding schedule, we achieved an intercoder reliability (Cohen’s kappa) of 0.806 after eradicating obvious differences.

The ranking algorithm of Google Scholar prioritizes highly cited and older publications (Martín-Martín et al., 2016). Therefore, the position of the articles on the search engine results pages was not particularly informative, considering the relatively small number of results in combination with the recency of the publications. Only the query “as of my last knowledge update” had more than two search engine result pages. On those, questionable articles with undeclared use of GPTs were evenly distributed across all result pages (min: 4, max: 9, mode: 8), with the proportion of undeclared use being slightly higher on average on later search result pages.

To understand how the papers making fraudulent use of generative AI were disseminated online, we programmatically searched for the paper titles (with exact string matching) in Google Search from our local IP address (see Appendix B) using the googlesearch – python library(Vikramaditya, 2020). We manually verified each search result to filter out false positives—results that were not related to the paper—and then compiled the most prominent URLs by field. This enabled the identification of other platforms through which the papers had been spread. We did not, however, investigate whether copies had spread into SciHub or other shadow libraries, or if they were referenced in Wikipedia.

We used descriptive statistics to count the prevalence of the number of GPT-fabricated papers across topics and venues and top domains by subject. The pandas software library for the Python programming language (The pandas development team, 2024) was used for this part of the analysis. Based on the multiple coding, paper occurrences were counted in relation to their categories, divided into indexed journals, non-indexed journals, student papers, and working papers. The schemes, subdomains, and subdirectories of the URL strings were filtered out while top-level domains and second-level domains were kept, which led to normalizing domain names. This, in turn, allowed the counting of domain frequencies in the environment and health categories. To distinguish word prominences and meanings in the environment and health-related GPT-fabricated questionable papers, a semantically-aware word cloud visualization was produced through the use of a word rain (Centre for Digital Humanities Uppsala, 2023) for full-text versions of the papers. Font size and y-axis positions indicate word prominences through TF-IDF scores for the environment and health papers (also visualized in a separate bar chart with raw term frequencies in parentheses), and words are positioned along the x-axis to reflect semantic similarity (Skeppstedt et al., 2024), with an English Word2vec skip gram model space (Fares et al., 2017). An English stop word list was used, along with a manually produced list including terms such as “https,” “volume,” or “years.”

• Artificial Intelligence
• / Search engines

Cite this Essay

Haider, J., Söderström, K. R., Ekström, B., & Rödl, M. (2024). GPT-fabricated scientific papers on Google Scholar: Key features, spread, and implications for preempting evidence manipulation. Harvard Kennedy School (HKS) Misinformation Review . https://doi.org/10.37016/mr-2020-156

• / Appendix B

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This research has been supported by Mistra, the Swedish Foundation for Strategic Environmental Research, through the research program Mistra Environmental Communication (Haider, Ekström, Rödl) and the Marcus and Amalia Wallenberg Foundation [2020.0004] (Söderström).

Competing Interests

The authors declare no competing interests.

The research described in this article was carried out under Swedish legislation. According to the relevant EU and Swedish legislation (2003:460) on the ethical review of research involving humans (“Ethical Review Act”), the research reported on here is not subject to authorization by the Swedish Ethical Review Authority (“etikprövningsmyndigheten”) (SRC, 2017).

This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided that the original author and source are properly credited.

Data Availability

All data needed to replicate this study are available at the Harvard Dataverse: https://doi.org/10.7910/DVN/WUVD8X

Acknowledgements

The authors wish to thank two anonymous reviewers for their valuable comments on the article manuscript as well as the editorial group of Harvard Kennedy School (HKS) Misinformation Review for their thoughtful feedback and input.

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• CAREER FEATURE
• 02 September 2024

How can I publish open access when I can’t afford the fees?

• Nikki Forrester 0

Nikki Forrester is a science journalist based in Davis, West Virginia.

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Dear Nature ,

I’m a paediatrician based in South Africa. Last year, my colleagues and I were invited to submit an editorial to a medical journal. We felt that the article, about medicine in resource-limited settings, should be published open access (OA) because it contains information that health-care workers and researchers in sub-Saharan Africa need access to. The problem is that the OA fee for that journal is US$1,000, which is more than most doctors earn per month in, say, Uganda. Now, we’re not sure whether we can move forward with the editorial. Are there any resources or funds available to authors in low-income countries to cover OA fees? — A paediatrician on a budget

Nature reached out to three researchers for tips on article processing charges (APCs). These fees can range from several hundred to thousands of dollars, and are requested by journals in return for making their articles OA — free for everyone to read.

According to a study published in 2023, the average fee for publishing an OA article is close to US$1,400 1 . OA fees can create significant barriers to publishing and sharing one’s work, especially for researchers based in low- and middle-income countries (LMICs). For instance, among the top 40 journals in ecology, the average OA fee was $3,150, according to a 2021 study 2 . The authors described it as a hardship for African scholars, who typically do not receive grant funding and whose monthly salaries at the time of the study ranged from $365 to $2,300.

I’m worried I’ve been contacted by a predatory publisher — how do I find out?

Most scientific journals are transparent about their publishing fees, which are typically included in the author guidelines or stated on their website. “If a journal suddenly asks for payment” having not mentioned such a requirement initially, says Kit Magellan, an independent behavioural ecologist based in Siem Reap, Cambodia, “it is likely a predatory journal — run away!” Predatory journals present themselves as legitimate publications, but use the OA publishing model to dupe authors into paying them fees.

If the APCs for a legitimate journal are too steep for you to afford, there are multiple ways to tackle the cost. “The first thing to do is check in with your co-authors to see if they have any funds available,” says Magellan, because scientists might be eligible to have APCs covered by their grants or by funding organizations. If not, she recommends asking your institution if it provides researchers with financial support to publish OA.

Institutional support for APCs is highly variable, ranging from offering no funding to covering the full cost. “Processing fees can get prohibitively expensive,” says Thulani Makhalanyane, a microbial ecologist at Stellenbosch University in South Africa. “My institution will reimburse half the cost, but I still have to think about where the other half of that expense will come from.”

Both Magellan and Makhalanyane note that scientific societies often offer their members grants or financial support — separate from funding for day-to-day laboratory work — to pay for APCs. For example, in December 2023, the American Physical Society announced a partnership with the non-profit organization Research4Life to cover APCs for paper submissions from scientists in 100 LMICs. Since 2002, Research4Life has helped researchers at more than 11,500 institutions in 125 LMICs access peer-reviewed papers from over 200,000 journals and books. Other governmental partnerships and programmes, such as the European Commission’s Open Research Europe and the library partnership SCOAP , pay OA fees directly to publishers, to avoid publishers passing those costs on to authors.

Another option is to contact the journal you want to publish with, to see whether it can offer assistance or flexibility with APCs. When approaching a journal editor, Makhalanyane recommends being upfront and open about your budget. “Tell the editor you’d like to submit your paper to their journal because you think it’s a good fit, but that you can’t afford the fee,” he says. As a journal editor himself, Makhalanyane receives several OA fee waivers from the publisher each year that he can offer to researchers. “Most of these vouchers are never taken,” he adds.

Springer Nature was asked whether it provides assistance with APCs for researchers in LMICs. (Springer Nature publishes Nature , but the magazine’s careers team is editorially independent of its publisher.) “Enabling open-access equity remains a key part of our focus,” said a spokesperson, who made reference to the publisher’s waiver policy for fully OA journals, Transformative Agreements and partnerships with organizations such as Research4Life .

The spokesperson also noted that the company has an initiative for Nature and the Nature research journals that means that accepted papers by authors from more than 70 LMICs are published at no cost to them . Finally, a tiered-pricing pilot adjusts the APC on the basis of the lead author’s country of residence, the spokesperson said.

Other researchers who want to pursue the OA route wait until their paper is close to publication before approaching an editor about the cost. “I don’t consider budget issues when I submit papers,” says Noam Shomron, a genomicist and computational biologist at Tel Aviv University in Israel. The peer-review and publication process can span months to a year or longer, and researchers’ budgets can fluctuate drastically over that period, he explains. “If I’m running out of funding at the time, I just tell the publication I don’t have the money. Very often they give me a 10% or 20% discount, which is nice.” Even if a discount isn’t possible, Shomron says that journals might defer payment for a year or two.

Magellan, who also has experience as a journal editor, emphasizes that vouchers and fee waivers are meant for exceptional circumstances, in which the author lacks access to funding to cover APCs. For those who are paying the standard charges, she is keen to see more-flexible payment plans from publishers. “It would be good for journals to allow authors to pay in instalments so the APC vouchers can remain available for the people who really need it,” she says.

Collection: Careers toolkit

“The recent proliferation of online fee-paying journals seems to sometimes result in the perception that you have to pay to publish,” says Magellan. But researchers who can’t afford OA fees can still publish their work for free in many scientific journals, with the caveat that their articles might be hidden behind a paywall. “You can still share your article with colleagues in the field, use it in presentations and cite it; it just can’t be freely accessed,” she says. However, researchers at eligible institutions in LMICs can access paywalled papers through resources such as Hinari, a branch of Research4Life that provides access to thousands of medical and health journals.

“Submissions that come from the parts of the world where researchers can’t afford to publish are usually such a minor fraction of the papers that end up being published,” says Makhalanyane. “I would encourage people who want to publish and genuinely cannot afford the APCs to ask for vouchers. The fees shouldn’t stop you from showcasing your science in the best journals you can.”

doi: https://doi.org/10.1038/d41586-024-02849-w

This is part of a series in Nature in which we share advice on career issues faced by readers. Have a problem? E-mail us at [email protected]

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The impact of climate on human dengue infections in the caribbean.

Graphical Abstract

1. Introduction

2.1. bibliographic search, 2.2. selection criteria, 2.3. search string, 2.4. study selection and quality assessment, 3.1. bibliographic search, 3.2. selected studies.

4. Discussion

4.1. rainfall or precipitation factor, 4.2. temperature factor, 4.3. multiple co-factors, 4.3.1. mosquito vector distribution, 4.3.2. human and social factors, 4.3.3. infrastructure, 4.3.4. travel and trade, 4.4. limitations, 5. conclusions, supplementary materials, author contributions, institutional review board statement, data availability statement, acknowledgments, conflicts of interest.

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• Was the appropriate method used to answer the question posed?
• Was/Were the climate exposure factor(s) accurately measured to minimize bias?
• Was the outcome accurately measured to minimize bias?
• Were all the important confounding factors identified?
• Are these confounding factors addressed in the design and or analysis?
• What are the results of this study?—Yes/Unsure/No Follow and ask some of these other questions to evaluate the rating.
• What is the level of precision of the results? What is the level of precision for the risk estimate used?
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Douglas, K.O.; Payne, K.; Sabino-Santos, G.; Chami, P.; Lorde, T. The Impact of Climate on Human Dengue Infections in the Caribbean. Pathogens 2024 , 13 , 756. https://doi.org/10.3390/pathogens13090756

Douglas KO, Payne K, Sabino-Santos G, Chami P, Lorde T. The Impact of Climate on Human Dengue Infections in the Caribbean. Pathogens . 2024; 13(9):756. https://doi.org/10.3390/pathogens13090756

Douglas, Kirk Osmond, Karl Payne, Gilberto Sabino-Santos, Peter Chami, and Troy Lorde. 2024. "The Impact of Climate on Human Dengue Infections in the Caribbean" Pathogens 13, no. 9: 756. https://doi.org/10.3390/pathogens13090756

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• Published: 28 August 2024

Perspectives of midwives on the use of Kaligutim (local oxytocin) for induction of labour among pregnant women in the government hospitals in Tamale

• Ahmad Sukerazu Alhassan 1 ,
• Shivera Dakurah 2 &
• Joseph Lasong 1  

BMC Pregnancy and Childbirth volume  24 , Article number:  561 ( 2024 ) Cite this article

Metrics details

The use of herbal medicine and/or its products is common throughout the world. In Tamale Metropolis, pregnant women frequently use local oxytocin to induce labour, as shown by the fact that 90% of midwives reported managing patients who used kaligutim (local oxytocin) to speed up labour. Early career midwives are also aware of this and have personally observed it being used by their clients. The purpose of the study was to assess midwives’ opinions on pregnant women’s use of the well-known kaligutim (local oxytocin) for labour induction in the Tamale Metropolis.

A facility-based, quantitative, cross-sectional research design was used for the study. A total of 214 working midwives from Tamale’s three main public hospitals participated. Data for the study were gathered through a standardized questionnaire. For the analysis and presentation of the data, descriptive and analytical statistics, such as basic frequencies, percentages, Fisher’s exact test, chi square test and multivariate analysis, were employed.

According to the findings of this study, the safety, dosages, and contraindications of kaligutim during pregnancy and labour are unknown. The cessation of contractions was reported by 44 (22.4%) of the respondents whose clients used local oxytocin. The study also revealed that women in Tamale metropolis use “walgu”, a spiritual form of oxytocin, to induce and augment labour. Respondents who responded, “yes” to baby admission to the new-born care unit were 25% more likely to use kaligutim (local oxytocin) than were those who responded, “no” to baby admission to the new-born care unit (AOR = 0.25 95% CI (0.01, 0.53), P  = 0.021).

Conclusions

It can be concluded that using kaligutim to start labour has negative effects on both the mother and the foetus. Additional research is required to evaluate the efficacy, effectiveness, biochemical makeup, and safety of these herbal medicines, particularly during pregnancy and delivery, as well as the spiritual significance of kaligutim (Walgu) and its forms.

Peer Review reports

Introduction

Herbal medicines, traditional treatments, and traditional practitioners are the main source of health care for many millions of people, and sometimes the only source of care [ 1 ]. Herbal medicines include herbs, herbal materials, herbal preparations and finished herbal products, that contain as active ingredients parts of plants, or other plant materials, or combinations [ 1 , 2 ]. Women in both developed and developing countries use herbal medicine before pregnancy and during pregnancy and delivery, which has several consequences [ 3 ]. The use of herbal medicine has a long history, tracing its roots back to ancient and biblical days when there was no Orthodox medicine. Currently, both developed and developing countries use herbal medicine due to the presence of many traditional medicine practitioners [ 4 ].

Many cultures worldwide use herbal medicine to induce or accelerate labour, and the incidence of labour induction to shorten the duration of labour is on the rise. Most herbal medicine users are pregnant women who have no formal education, who have a low level of income and who mostly stay far from health facilities [ 5 ]. The majority of pregnant women use herbal medicine through the oral route and have confidence in its efficacy, safety and effectiveness [ 6 ]. Herbal medicine is used by women for maternal health-related issues, such as to induce abortion and labour, to correct infertility, for the treatment of pregnancy-related issues, for breast milk secretion and for general wellbeing during pregnancy [ 5 ].

Women who use herbal medicine during pregnancy and/or labour usually have a high risk of postpartum complications [ 7 ]. The use of herbal uterotonics can lead to hyperstimulation of the uterus, foetal asphyxia and several other adverse effects of labour [ 8 ]. Moreover, traditional medicine used by pregnant women is associated with several complications, including a ruptured uterus, a fresh still birth, a macerated still birth, a caesarean section and even death [ 9 ]. These herbal medicines have both uterotonic and nonuterotonic effects on labour and delivery and are mostly used to induce or augment labour in prolonged labour or postdate or to relax or widen the pelvis for delivery [ 8 ].

Maternal and neonatal deaths are still major challenges for most developing countries, with obstetric complications, especially postpartum haemorrhage (P.P.H.) being the major cause of maternal mortality [ 10 ]. The delivery of healthcare services is still poor quality in developing nations [ 11 ]. Maternal and foetal mortality and morbidity have remained high due to inadequate health services and inadequate emergency obstetric treatment. Childbirth is accompanied by numerous customs that are subject to ethnological research and are often rooted in traditional medicine or religion. Cultural influences and sociodemographic characteristics play an important role in a woman’s decision to seek maternal and child health services.

The induction of labour is the process of artificially starting labour by stimulating the uterus with oxytocin or manually through the rupture of amniotic membranes. This process is usually not risk free, and most women find it to be uncomfortable [ 12 ]. The induction of labour is an obstetric procedure recommended when the benefits to the baby and mother outweigh the benefits of continuing the pregnancy. The procedure usually involves complications and failures and must be performed under close monitoring, proper selection of clients and good preparation [ 13 ].

Labour induction also changes the normal physiological processes that accompany childbirth and increases the risk of adverse pregnancy outcomes such as postpartum haemorrhage, neonatal mortality, foetal distress, uterine rapture and premature birth [ 14 ]. Oxytocin is a natural hormone produced by the hypothalamus and is responsible for the activation of sensory nerves during labour and breastfeeding [ 15 ]. Clinically, commercially manufactured synthetic oxytocin is administered to commence or increase uterine activity to reduce the duration of labour [ 16 ].

The induction of labour is not free from risk and must be performed with caution because the procedure involves hyperstimulation of the uterus and foetal distress. Herbal medicine used by pregnant women has long-term effects on both mothers and babies [ 17 ]. Many pregnant women in the Tamale Metropolis use prepackaged herbal medicine before and during pregnancy [ 18 ]. Health-related factors such as cost, distance, access and unavailability of medications influence the utilization of herbal medicine by pregnant women [ 17 ].

All women should be given a prophylactic dose of oxytocin as soon as they give birth. If they start to haemorrhage, they should also be given a treatment dose of oxytocin, which is greater than the prophylactic dose [ 19 ]. There is also a traditional manufactured form of oxytocin (kaligutim) that pregnant women use to start labour. Kaligutim is the local name for the mixture of some special plant parts or a combination of plants prepared and given to pregnant women to start or accelerate the process of labour in the northern part of Ghana [ 17 ].

Ideally, women should take medical drugs during pregnancy (folic acid and fersolate) to help prevent birth defects and congenital malformations such as neural tube defects of the foetus and spinal bifida during pregnancy [ 20 ]. However, in recent decades, women worldwide have used herbal medications during pregnancy and labour, with some taking both herbal medicine and orthodox medicine at the same time [ 21 ]. However, little is known about the use and safety of these medicines, especially during pregnancy, and their dosages, indications and contraindications are not known [ 22 ].

There are studies on herbal medicine use by women during pregnancy and labour, but there is currently no literature on the use of Kaligutim (local oxytocin) for labour induction among pregnant women in Ghana, but similar studies have been conducted in Uganda, Malawi, Tanzania, and Nigeria. Despite the efforts of the government and other nongovernmental organizations to ensure maximum coverage of skilled delivery to help reduce maternal and neonatal mortalities, women still use locally prepared oxytocin to induce labour. Although herbal medicine is commonly used by pregnant women, healthcare providers, especially midwives, are often unprepared to communicate effectively with patients or make proper decisions concerning complementary and alternative medicine use, especially during pregnancy and labour [ 23 ].

It is well known that herbs have played a vital role since the precolonial era during pregnancy, delivery and postpartum care in many parts of the country, but there are still few data on the use of herbs among pregnant women in Ghana [ 24 ]. Towards the end of pregnancy, many women are tired and eager to welcome their babies into the world. Moreover, as the expected date of delivery approaches, these women are given local oxytocin by their mothers’ in-laws, grandmothers, mothers, or TBAs or even by the women themselves to start labour at home before going to the health facility [ 25 ].

Medicinal plants that are used to hasten or speed up labour are mostly taken towards the end of pregnancy or the beginning of labour [ 26 ]. Even after delivery, these herbs may be found in small amounts in the mother’s breast, and some may cross the placental barrier and have harmful effects on the baby. The use of herbal medication by pregnant women is inevitable given that up to 80% of people who live in developing nations rely on traditional medicine for their healthcare needs [ 18 ].

The situation in Ghana, especially Northern Ghana, is not different, as pregnant women continue to use herbs despite the availability of health facilities [ 24 ]. The use of herbal medicine (kaligutim) among the Ghanaian population is alarming. Pregnant women in Tamale use herbal products at a rate of 42.5% prior to pregnancy and 52.7% during pregnancy [ 27 ]. Residents of Tamales who seek healthcare services in hospitals or herbal clinics are therefore at a greater risk of experiencing adverse consequences from drug-herb interactions [ 28 ].

Herbal product manufacturers should clearly state that pregnancy is a contraindication, and vendors should use caution when selling these items to pregnant women [ 27 ]. The use of Kaligutim (local oxytocin) by pregnant women is a maternal and child health problem. Herbal medicine used by pregnant women has long-term effects on both mothers and babies [ 17 ]. Unfortunately, maternal, and neonatal deaths may occur, and hence, there is a need to examine midwives’ perspectives on local oxytocin use during labour, its effects on the progress and outcome of labour, and the relationship between kaligutim use and birth outcomes among pregnant women in the three major government hospitals in Tamale Metropolis.

Theoretical foundation

This study adopted and adapted Andersen’s (1968) behavioural model of healthcare service utilization (use and nonuse of health services [ 29 ]. Andersen’s healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use/nonuse of health services [ 29 ]. This study was guided by Andersen’s behavioural model of health service use as a theoretical framework to identify the effects of Kaligutim on the progress and outcome of labour and to establish the relationship between the use of Kaligutim and nonuse of kaligutim and birth outcomes. The behavioural model is a multilevel model that incorporates both individual and contextual determinants of health service use.

Conceptual framework

Many people rely on products made from medicinal plants to maintain their health or treat illness, and current general development trends in developing and developed countries suggest that the consumption of medicinal plants is unlikely to decline in the short to medium term because of the benefits to consumers, producers, and society as a whole [ 29 ]. Therefore, there is a need to increase our understanding of what motivates the consumption of medicinal plants, despite the barriers to the establishment of solid evidence on the safety and efficacy of herbal medicines and related products [ 29 ].

This unified conceptual framework offers a step towards establishing a comprehensive approach to understanding the experiences midwives encounter when their clients use herbal medicine to induce their labour. The exposure variable in this study refers to kaligutim (local oxytocin) used by pregnant women in the three major government hospitals to induce labour through several routes, including oral, rectal, and vaginal routes, among others. When oxytocin is used by pregnant women, it can produce several results that can be immediate or late.

The results elicited on labour are termed the outcome variables, which can be immediate outcomes (the progress of labour) or outcomes after delivery (the outcome of labour). The progression of labour includes three stages: progressive dilatation of the cervix from 1 cm to 10 cm, delivery of the baby and expulsion of the placenta. Several factors can be used to determine the progress of labour (obstructed labour, prolonged labour, nature of uterine contractions, precipitated labour, foetal distress, and poor progress of labour).

The outcome of labour on the hand refers to what happens during the delivery of the baby, how the baby was delivered, foetal conditions and maternal conditions. The following factors were used for the purpose of this study to determine the outcome of labour (mode of delivery, postpartum haemorrhage, ruptured uterus, cervical tear, birth asphyxia, uterine atony, maternal mortality, and neonatal mortality). This study focused on the immediate effects of Kaligutim (on labour progress) and the effects of Kaligutim after delivery (on labour outcomes) and the relationship between the use of Kaligutim and birth outcomes.

The study was carried out in Tamale, which is the capital city of the northern region of Ghana. According to the 2021 World Urbanization Review, Tamales has an estimated population of 671,812 people. Tamale still has a blend of typical rural and urban communities, although it has attained the status of a metropolitan area. There are three major government hospitals in Tamale: Tamale Central Hospital, Tamale West Hospital and Tamale Teaching Hospital. The Tamale Teaching Hospital is the only tertiary facility in the northern region and serves as the main reference centre for the five regions of the north.

Study population

The main study population was midwives working in Tamale Metropolis. The sampling frame was all midwives practicing in the three major hospitals in Tamale Metropolis who were willing to participate in the study.

Study design

A facility-based cross-sectional research design was used for this study. A cross-sectional study is a type of observational study design carried out at one point in time or over a short period of time to estimate the prevalence of the outcome of interest for a given population for the purpose of public health planning [ 30 ]. This study adopted a quantitative research approach to obtain information.

Sampling technique

A purposive sampling technique was used for this study. Purposive sampling is a nonprobability sampling method in which participants are selected for inclusion in the sample based on their characteristics, knowledge, or experiences. This is because of the midwives’ knowledge, experiences, and objective of the study.

Sample size calculation

Total number of midwives = 458

Yamane formula (1967) was used with a confidence interval of 95% and a margin of error of 5%.

N = population size (458).

n = the sample size (?)

e = margin of error (5%).

n \(\:=\frac{N}{1\:+N\left(e\right)2}\)

n= \(\:\frac{458}{1\:+458\left(0.05\right)2}\)

n  = 214.01 = 214.

Sample size = 214 midwives.

Inclusion criteria

All midwives practicing in the three major government hospitals in Tamale Metropolis who were willing to participate in the study were included.

All midwives in the three-government hospital with experience with kaligutim use during labour were also included in the study.

Exclusion criteria

All midwives who were not practising at the three major government hospitals in Tamale Metropolis were excluded from the study.

Midwives who were practicing at the three major government hospitals in Tamale and who were not willing to participate in the study were also excluded from the study.

All midwives who did not have experience with kaligutim use for the induction of labour were excluded from the study.

Data collection instrument

The data collection tool that was used for the study was a standardized questionnaire. The questionnaire was constructed by reviewing various documents, including existing questionnaires that have been used in previous research. Close-ended questions with few open-ended questions were used as the question format. It was designed in line with the objectives of the study to help obtain the necessary information needed for the study. The questionnaire was pretested with midwives before the actual data collection took place.

Data management and analysis

Data collected from the field were coded, cleaned, and entered into the Statistical Package for Social Services (SPSS) version 21.0. Descriptive and analytical statistics, including simple frequencies and percentages, were used for the analysis and presentation of the data. The relationships between predictor and outcome variables were assessed by means of bivariate (chi-square test) analysis to determine potential predictors of kaligutim (local oxytocin) at p values less than 0.05. Adjusted odds ratios were reported, and p values less than 0.05 were deemed to indicate statistical significance at the 95% confidence level after multivariate analysis.

Ethical consideration

The following ethical principles guided this study: respect for persons, beneficence, and justice for all. These principles are based on the human rights that must be protected during any research project, including the right to self-determination, privacy, anonymity, confidentiality, fair treatment and protection from discomfort and harm. First, an introductory letter was obtained from the University for Development Studies authorities. This letter was then presented to the authorities of the three major government hospitals in Tamale, namely, Tamale West Hospital (T.W.H.), Tamale Central Hospital (T.C.H.) and Tamale Teaching Hospital (TTH.), to seek permission to undertake the study. Ethical clearance was also obtained from the Kwame Nkrumah University of Science and Technology (KNUST) (CHRPE/AP/332/22).

Permission was once sought through a consent form to which participants were asked to consent if they were willing to participate in the study. The participants were assured of the confidentiality of all the information they were going to provide. They were also encouraged to participate in the study as much as they could but were also made aware that the study was voluntary and that they could withdraw at any point in time during the process if needed. There was no compensation for the study participants.

The study revealed that 45% of the respondents were between the ages of 20 and 30. Most of the respondents were in their twenties or thirties. Those who were in the first half of their work life constituted 73% of the respondents, while 17% were in the second half of their working life. The majority of the respondents were diploma midwives, representing 48% of the respondents; post basic midwives, constituting 32%; and degree and master’s holders, representing 19% and 1%, respectively. Staff midwives composed the largest group of respondents, while Principal Midwifery officers composed the group with the lowest participation in the study. The lowest rank in midwifery practice in the study was staff midwives, and the highest was principal midwifery officers. This is presented in Table  1 .

The experience of using local oxytocin to induce labour

Approximately 90% of the respondents have prior knowledge or heard that some of their clients take local oxytocin at home to start labour, and only 10% of respondents have no prior knowledge of that. Approximately 63.4% of the respondents encountered local oxytocin cases more than three times every week. This is presented in Fig.  1 .

Average number of local oxytocin cases per week

Approximately 72.9% of the respondents said that their clients had ever induced labour during the previous C/S, and 59.6% of the respondents said that they met clients who also induced their labour during twin pregnancy. Another 64.5% of the respondents said that they also met clients with large babies who also induced labour using local oxytocin, while 86.2% of the respondents said that they also met clients who induced labour with local oxytocin even when they had grand multiparity. Another 11.3% of the respondents said that they met clients who used local oxytocin to induce labour during transverse lies, and 15.3% of the respondents said that they had experienced when clients with mal presentations used local oxytocin to induce labour. This is presented in Fig.  2 .

Induction of labour by clients through local oxytocin under certain conditions

The study additionally asked midwives to report on how pregnant women who had taken local oxytocin to induce labour coped during their care. Midwives were expected to respond whether the women they cared for experienced good, difficult, bad, painful, life-threatening, terrible, or normal labour. As shown in Fig.  3 , generally, the experience that pregnant women experience when they use local oxytocin to induce labour is not good. A total of 93.5% of the respondents said that the women who used local oxytocin had very bad experiences.

Experience of using local oxytocin to induce labour

The study further revealed that 15.2% of the respondents had experienced situations where some pregnant women died because of the use of local oxytocin.

Effects of local oxytocin on the progress of labour

The effects of local oxytocin (Kaligutim) on the progress of labour were diverse. The study revealed that the effects of Kaligutim on the progress of labour are negative, as it causes prolonged labour for some, obstructed labour for others, precipitated labour, and poor progress of labour for others. With obstructed labour being the leading effect of kaligutim on the progress of labour, most of the respondents chose caesarean section as the preferred delivery for most clients who used kaligutim at birth. The use of local oxytocin also has some effect on the amniotic fluid of pregnant women, as 99% of the midwives who responded to the study said that there were some levels of stain of the amniotic fluid, and only 1% said it was clear. It is evident from the study that for most pregnant women who use local oxytocin, there is hyperstimulation of the uterus, as most of the midwives confirmed this for the study. Most pregnant women who use kaligutim suffer excessive contractions, which could have an effect on both mothers and babies. Again, more than half (53.75) of the respondents also said that their foetal heart rate was above 160 bpm. The majority (77.65) of the respondents said that there was no cessation of the contractions for those who took the local oxytocin. The results are presented in Table  2 .

Impact of local oxytocin on the outcome of labour

To understand how local oxytocin impacts labour, the study went further to ask participants what the mode of delivery was for those who used Kaligutim. According to the data, caesarean section is the mode of delivery for most women (56.5%) who use local oxytocin, and most are unable to achieve spontaneous delivery. This has contributed to the increasing number of caesarean sections recorded daily. Most of the babies had an Apgar score of 4/10 to 6/10. Many babies born to mothers who used herbal oxytocin were born with moderate birth asphyxia (69.6%) and severe birth asphyxia (24%). The study also reported that 20.8% of midwives reported that hysterectomy was carried out on their clients who had used herbal preparations to induce or hasten labour. This is alarming because many women have their uterus removed as a result of herbal oxytocin (kaligutm) usage. Most clients who used Kaligutim experienced postpartum haemorrhage after delivery. It was also evident that some pregnant women (34.5%) had uterine atony, although it cannot be said that Kaligutim was the cause of uterine atony. Several pregnant women (65.3 years old) who used Kaligutim also developed a ruptured uterus. See Table  3 .

Relationship between kaligutim (local oxytocin) use and birth outcome

Table  4 shows the associations between kaligutim (local oxytocin) use and birth outcomes among the respondents. Fisher’s exact test and the chi-square test showed that several birth outcome variables were significantly associated with kaligutim (local oxytocin). Do women who go through the normal process of labour and those who use kaligutim to induce their labour have the same birth outcome? (P value = 0.021), what was the foetal wellbeing? (P value = 0.041), When do most neonates whose mothers have taken Kaligutim die? (P value = 0.038), was baby admitted at the Newborn Care Unit? (P value = 0.001), were significantly associated with kaligutim. Additionally, having recorded a maternal death because of the use of Kaligutim (p value = 0.002) was also significantly associated with kaligutim, as presented in Table  4 .

Multivariate analysis of birth outcome predictors of Kaligutim (local oxytocin) among pregnant women in three major government hospitals in Tamale metropolis

In Table  5 , three birth outcome variables strongly depicted kaligutim use among the respondents: foetal wellbeing, admission to the new-born care unit, and death of most neonates because of the use of Kaligutim by their mothers. Respondents who responded, “yes” to baby admission to the Newborn Care Unit were 25% more likely to use kaligutim (local oxytocin) than were those who responded “no” to baby admission to the Newborn Care Unit [(AOR = 0.25 95% CI (0.01, 0.53), P  = 0.021)].

Discussions

Although the respondents cut across with regard to the number of years of experience, most of the respondents were early career midwives. The fact that these early career midwives are familiar with and have experienced the use of local oxytocin by their clients shows that it is widely used by pregnant women in the Tamale metropolis. Approximately 90% of respondents were aware of the usage of kaligutim (local oxytocin) for inducing labour at home before going to the hospital for delivery. However, a study conducted in the Ashanti region of Ghana revealed that midwives and other healthcare professionals lack proper knowledge about herbal medicine usage among pregnant women, even though this information is urgently needed so that appropriate action may be taken to address the issue [ 31 ]. The study findings also demonstrated that pregnant women frequently utilize local oxytocin and that many of them are unaware of the potential negative effects that these herbs may have on them in certain circumstances. Figure  2 shows that the use of local oxytocin was not limited to only one condition. These findings further show that the use of local oxytocin by pregnant women is widespread and that pregnant women do not know the effect that local oxytocin can have on them when they have certain conditions. Additionally, pregnant women are ignorant of the fact that local oxytocin can be contraindicated under certain conditions and must be avoided. Hence, it may put the life of the pregnant mother and her baby in danger.

Although herbal medicines are natural, not all herbs are safe to use while pregnant. Thus, expectant mothers should consult their midwives for guidance before taking herbal remedies. The experience that pregnant women have when they use local oxytocin to induce labour is not a positive one. A total of 188 respondents, or 93.5% of the respondents, stated that the women who used local oxytocin had a very unpleasant experience. This is supported by additional research results showing that between 50 and 80% of pregnant women use traditional plant remedies, which could have adverse perinatal effects [ 32 ]. The statistics indicate that local oxytocin is frequently used by pregnant women in the Tamale Metropolis. Most of the midwives reported seeing these cases virtually daily. This finding supports a study conducted in Ghana’s Ashanti region (Kumasi), which revealed that knowledge of herbal medicine is widely shared and that there is evidence of an increase in the usage of herbs [ 33 ].

The study revealed that local oxytocin (Kaligutim) has a diverse range of effects on the progress of labour, including precipitating labour, prolonging labour, obstructing labour, and slowing labour. The partograph is a great tool for keeping track of labour progress and serving as a warning system for abnormalities in normal labour, which helps to prevent obstructed labour and improves maternal and foetal outcomes [ 34 ]. This is supported by the study’s findings, which indicate that using a partograph to monitor labour progress and identify any deviations is essential [ 34 ].

According to this study, most midwives, who make up 65.2% of the respondents, also claimed that pregnant women who use local oxytocin (Kaligutim) have excessive contractions, while only 71 of them, or 34.8% of the respondents, claimed that they do not notice excessive contractions in their clients. This is supported by research performed in Zambia, which revealed that these herbal medicines also elicit greater than normal uterine contractions [ 26 ].

Most pregnant women who use kaligutim experience excessive contractions, which may have an impact on both the mother and the unborn child. Similarly, other authors have also claimed that using herbal remedies during labour causes stronger and more frequent uterine contractions, which do not necessarily result in cervical dilatation [ 35 ]. This was confirmed in the study’s findings, which also noted that herbal oxytocin not only produces excessive uterine contractions but also may cause contractions to cease, as 44 (22.4%) of the respondents reported that those who took local oxytocin had a halt in contractions. Intravenous fluids such as normal saline and Ringer’s lactate are used to flush out the local oxytocin in the system and CS in the case of an emergency. Nifedipine is also given in certain circumstances to prevent contractions.

According to the study, 121 midwives, or 59.6% of the respondents, stated that caesarean sections were the preferred method of delivery for women who used kaligutim to induce labour. Both [ 36 ] in South Africa and [ 34 ] in Western Uganda reported these findings. Moderate birth asphyxia (69.6%) and severe birth asphyxia (23%) are common in newborns whose mothers utilize herbal oxytocin. According to the survey, 20.8% of midwives said they had performed hysterectomy procedures on clients who had utilized herbal induction or hastening methods to induce labour.

One of the main causes of maternal deaths worldwide, including in Ghana, is postpartum haemorrhage [ 10 ]. 91% of midwives said that when their patients use herbal oxytocin during labour, more of them suffer from postpartum haemorrhage. This is corroborated by research by Frank (2018), who found a connection between postpartum haemorrhage and the use of herbal medications during labour [ 37 ]. In contrast, other studies [ 38 ] have shown that using herbal medication during childbirth is linked to a lower risk of postpartum haemorrhage. Individuals who experienced postpartum haemorrhage were managed with uterine massage, intravenous fluids, Cytotec, repairs to tears, expulsion of retained products, blood transfusions, cervical repairs, and catheter use.

This report supports the findings of a study conducted in the Ugandan village of Kiganda, where the researcher [ 37 ] reported that the use of herbal medicines has been linked to labour induction, which can cause significant birth canal tearing, postpartum haemorrhage, uterine atony, a raptured uterus, and, if untreated, maternal mortality. Medical experts who are aware of the dangers of herbal remedies and who are obliged to advise patients against using them do so themselves. The majority of women who use herbal preparations during pregnancy have a high school education or higher, according to evidence showing that more than 57.5% of pregnant women who use herbs have a high school diploma or higher, which is consistent with findings from Saudi Arabia by [ 39 ] that show that formal education cannot even prevent women from taking herbs during pregnancy and labour.

Kaligutim also causes excessive uterine contractions, foetal discomfort, excessive uterine stimulation, uterine atony, PPH, birth hypoxia, and premature bearing down, claims this study. This is supported by the results of a study carried out in Europe, where researchers [ 40 ] found that the majority of herbal drugs taken by pregnant women have undesirable side effects. An Iranian study, however, revealed that utilizing herbal treatments during labour can lessen discomfort, speed up the process, and enhance both the quality of a woman’s delivery experience and her odds of having a healthy baby [ 41 ].

According to the study’s findings, three birth outcome variables strongly affected kaligutim (local oxytocin) use among the respondents: foetal wellbeing, admission to the newborn care unit, and death of most neonates as a result of the use of Kaligutim by their mothers. Respondents who responded, “yes to baby” and were admitted to the new-born care unit were 25% more likely to use kaligutim (local oxytocin) than were those who responded, “no to baby” and were admitted to the new-born care unit (AOR = 0.25 95% CI (0.01, 0.53), P  = 0.021). This is probably one of the effects of taking local oxytocin. These infants were hospitalized for a variety of reasons, including asphyxia, respiratory distress, and low Apgar scores.

Additionally, the study results indicated that respondents who responded that a still birth outcome affected foetal wellbeing were 1.9 times more likely to use kaligutim (local oxytocin) than those who responded no to having live births were (AOR = 1.9 95% CI (0.01, 1.21), P  = 0.047)]. This finding is consistent with findings from a sub-Saharan African study that showed that herbal medications used to speed up and induce labour have uterotonic effects and increase the risk of neonatal asphyxia attributable to uterine hyperstimulation [ 42 ]. This could be ascribed to the fact that the respondents wanted fast and easy delivery, which subsequently caused this effect.

Another interesting finding was that respondents who responded that having a birth asphyxia outcome to foetal wellbeing were 0.16 times more likely to use kaligutim (local oxytocin) than were those who responded no to having live births (AOR = 0.16, 95% CI (0.08, 3.08), P  = 0.047). This result is similar to that of [ 42 ], who conducted their study in sub-Saharan Africa. This could be a result of the effects of kaligutim on foetal well-being, which results in birth asphyxia.

Furthermore, newborns whose mothers used kaligutim during labour and who died within the first hour of birth were 3.4 times more likely to use kaligutim (local oxytocin) than those whose mothers used kaligutim during labour [AOR = 3.4 95% CI (0.74, 1.5), P  = 0.045]. In support of the findings from this study, a study on the consumption of herbal drugs among pregnant women in rural Malawi revealed that consumption was linked to pregnancy-related issues and that users had a greater risk of neonatal mortality/morbidity within the first hour of life than nonusers [ 14 ]. This could be attributed to the dangers this herb poses to the foetus during delivery.

Newborns whose mothers used kaligutim during labor and who died within the first week of life were 2.23 times more likely to use kaligutim (local oxytocin) than those whose mothers used intrauterine kaligutim [(AOR = 2.23 95% CI (0.00, 0.02), P  = 0.045)]. This is supported by findings from a Malawian study that revealed that the use of labour-inducing plants during pregnancy has negative effects on obstetric and labour outcomes, such as uterine rapture, which can cause neonatal mortality and morbidity [ 35 ]. This could be attributed to the fact that PPH, uterine rapture, cervical tear, DIC, and hypoxia were the main causes of death.

Every life matter, which is why mothers’ lives and that of their newborn babies must be safeguarded at all costs. A sufficient level of knowledge is always vital since it exacerbates doubt. Therefore, it is crucial that people are informed of their rights, their health, and the services they can utilize to maintain and improve health to have a healthy increasing population. Although herbal medicine could be effective in treating certain ailments associated with pregnancy and delivery and is easily accessible to pregnant women, especially in rural communities, the possibility of overdose, drug-herb interactions, contraindications, and the unhygienic conditions under which they are prepared may influence both maternal and neonatal conditions.

The results showed that the use of kaligutim by pregnant women in Tamale Metropolis is on the rise. This means that much needs to be done to do away with the use of kaligutim, and this must start with midwives. Pregnancies and births can be improved with a healthy and qualified midwifery care model in improving and protecting women’s and newborn health in Tamale.

It can be concluded that the use of this herbal medicine (Kaligutim) poses a greater long-term health challenge for mothers and their babies. Midwives and other healthcare workers in the Tamale Metropolis must therefore intensify their public health campaigns against the use of Kaligutim for labour induction.

Recommendations

The findings of the study have important implications for maternal and child health. The nonuse of kaligutim (local oxytocin) for the induction of labour is the best option for pregnant women. Pregnant women should visit the hospital for all their health needs during the entire pregnancy. This will help prevent adverse pregnancy and labour outcomes as well as maternal and neonatal mortalities and morbidities.

Future researchers should perform further studies on the spiritual aspects of kaligutim (Walgu) and its types. Like synthetic oxytocin, an Islamic form of oxytocin is prepared by Mallams and causes uterine contractions and dilates the cervix.

However, studies should also be conducted on the efficiency, effectiveness and biochemical composition of these herbal preparations and their safety, especially during pregnancy and delivery. Samples of these herbal preparations should be taken for laboratory investigations.

Data availability

All data generated or analysed during this study are included in this article and its supplementary information files are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the Management and Healthcare Staff of the Tamale West Hospital (T.W.H), Tamale Central Hospital (T.C.H) and Tamale Teaching Hospital (TTH) for their support throughout the data collection process. We acknowledge the contributions of all the midwives who shared their knowledge and experiences with us, your efforts are well appreciated.

No funding was available for the study.

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Department of Population and Reproductive Health, School of Public Health, University for Development Studies, P. O. Box 1883, Tamale, Northern Region, Ghana

Ahmad Sukerazu Alhassan & Joseph Lasong

Nandom Nursing and Midwifery Training College, Upper West Region, Nandom, Ghana

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ASA and SD conceptualised and drafted the research proposal. ASA, SD, and JL performed the statistical analysis, assisted with interpretation of the results, and co-drafted the manuscript. All authors contributed to the discussion of the paper, read, and approved the final manuscript.

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Correspondence to Ahmad Sukerazu Alhassan .

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An introductory letter from the University for Development Studies was presented to the three government hospitals, Tamale West Hospital (T.W.H), Tamale Central Hospital (T.C.H) and Tamale Teaching Hospital (TTH) to seek for permission to undertake the study. Ethical clearance was also obtained from the Kwame Nkrumah University of Science and Technology (KNUST) with reference number (CHRPE/AP/332/22). Permission was also sought through a consent form of which participants were asked to consent to if they were willing to participate in the study. They were assured of confidentiality of every information they were going to provide. All other methods were performed in accordance with relevant guidelines and regulations on subject selection and participation.

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Alhassan, A.S., Dakurah, S. & Lasong, J. Perspectives of midwives on the use of Kaligutim (local oxytocin) for induction of labour among pregnant women in the government hospitals in Tamale. BMC Pregnancy Childbirth 24 , 561 (2024). https://doi.org/10.1186/s12884-024-06745-z

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Received : 15 April 2024

Accepted : 08 August 2024

Published : 28 August 2024

DOI : https://doi.org/10.1186/s12884-024-06745-z

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