{
  "schema_version": "chamgap-public-evidence-check-1.0",
  "public_id": "v2989-s1",
  "verdict_number": "2989",
  "title": "Ice-slurry precooling × heat-illness prevention: evidence gaps",
  "view_version": "1.0",
  "view_created_date": "2026-10-16",
  "criteria_version": "1.0",
  "criteria_date": "2026-10-06",
  "review_date": null,
  "legacy_evidence_date": "2026-09-07",
  "review_scope": {
    "materials_read": "Existing review summaries and stored records of methodological application",
    "clinical_papers_directly_read": false,
    "new_clinical_search": false,
    "limitation": "Existing stored summary and preserved methodology application records. External papers, abstracts, registration, protocols, SAPs, original result tables and support disclosures are unread, and review of existing content remains incomplete.",
    "date_meaning": "This is the date the stored materials were checked, not the date of a new search of the clinical literature."
  },
  "claim_context": {
    "population": "This is a within-person crossover trial in 10 healthy men experiencing the same two single-session conditions. Eligibility, age, completion/analysis and missingness by condition/endpoint are unverified. The two conditions are not made into new participant totals or generalized to prevention effects in other populations.",
    "intervention": "Original study exposure is one oral pre-exercise ingestion of −1°C ice slurry. Ingredients, actual exposure distributions, adherence and product correspondence are unverified. No individual amount calculations, product, exercise, cooling, prevention or treatment instructions are created.",
    "dose": "Only original 7.5 g/kg and a single pre-exercise exposure are preserved. Actual ingestion-time/amount distributions, ingredients and adherence are unverified. Total amounts by body weight and calories are not newly calculated or instructed; during-exercise/repeated ingestion is a separate untested question.",
    "comparator": "The control is 4°C cold water at 7.5 g/kg in another single-session condition in the same people. This is not converted into comparisons with no ingestion, other cooling strategies or during-exercise ingestion. Actual adherence, concurrent exposures and expectation differences are unverified.",
    "endpoint": "Selected heat-illness events were unmeasured and original grade is ?. Running time 50.2±8.5 versus 40.7±7.2 minutes, +19±6%, P=.001 and terminal rectal temperature 39.36 versus 39.05°C, P=.001 are separate functional/physiological results. Pre-exercise 0.32°C lower and terminal 0.31°C higher are original statements at different times. Prevention effects, event counts, incidence and CIs are not newly filled.",
    "duration": "This is one acute laboratory exhaustion test with two single-session conditions, running at first ventilatory threshold in 34.0°C and 54.9% relative humidity. Temperature at each exhaustion end time and at the same exercise time are different comparisons. Long-term, field, multiple-sport and repeated-use heat-illness prevention were not tested.",
    "excluded_extensions": [
      "Converting time to exhaustion, temperature or P values into heat-illness-prevention risk ratios, absolute differences, CIs, event counts or incidence",
      "Converting lower pre-exercise temperature and higher terminal temperature into same-time effects, safety benefits, prevention failure or confirmed clinical harm",
      "Adding 10 people, two crossover conditions, repeated measurements or two subclaim sheets as new independent trials, participants or prevention replications",
      "Generalizing single-session laboratory results to real races, other sports, outdoor settings, repeated ingestion during exercise, long-term prevention or all populations",
      "Inheriting parent C54, unrecorded precision, axes or historical checks as subclaim scores, current clinical review or prevention effects",
      "Creating new arithmetic, effects, CIs, hypothetical numbers, grades, independence certification, amounts, products, exercise, cooling, heat-illness-prevention or treatment instructions"
    ]
  },
  "requirements": [
    {
      "item_id": "N01",
      "question_type": "Evidence condition",
      "question": "What are the selected heat-illness-prevention question and original verdict?",
      "needed": "Prevention wording, note and grade versus the parent performance verdict",
      "role": "Required",
      "role_reason": "This condition connects Prevention wording, note and grade versus the parent performance verdict with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Prevention wording, note and grade versus the parent performance verdict must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: The subclaim's own score, status, axes and direct prevention results are unrecorded. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The selected wording is “Prevention of heat illness,” with original grade ? and a note that events were unmeasured and terminal temperature was higher. The subclaim has no score, status or axes; parent C54 and the performance signal do not fill them.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "The subclaim's own score, status, axes and direct prevention results are unrecorded.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The subclaim's own score, status, axes and direct prevention results are unrecorded."
    },
    {
      "item_id": "N02",
      "question_type": "Evidence condition",
      "question": "Were heat-illness events actually measured?",
      "needed": "Clinical-event definitions, confirmation, denominators and occurrence results",
      "role": "Required",
      "role_reason": "This condition connects Clinical-event definitions, confirmation, denominators and occurrence results with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Clinical-event definitions, confirmation, denominators and occurrence results must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Heat-illness definitions, clinical confirmation, event denominators, observation periods and comparative prevention effects are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original text and citation note record that heat-illness events were not measured or tested. Unmeasured events are not converted into 0 heat-illness cases, no harm, prevention success or failure.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Heat-illness definitions, clinical confirmation, event denominators, observation periods and comparative prevention effects are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Heat-illness definitions, clinical confirmation, event denominators, observation periods and comparative prevention effects are unverified."
    },
    {
      "item_id": "N03",
      "question_type": "Evidence condition",
      "question": "Are participants distinguished from the two condition denominators?",
      "needed": "Eligibility, allocation, completion and analysis counts by condition",
      "role": "Required",
      "role_reason": "This condition connects Eligibility, allocation, completion and analysis counts by condition with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Eligibility, allocation, completion and analysis counts by condition must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Detailed eligibility, age, allocation by sequence and completion/analysis counts by condition are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "S01 is a crossover trial of two single-session conditions in 10 healthy men. The two conditions are not counted as separate groups of 10 or as new participant totals.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Detailed eligibility, age, allocation by sequence and completion/analysis counts by condition are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Detailed eligibility, age, allocation by sequence and completion/analysis counts by condition are unverified."
    },
    {
      "item_id": "N04",
      "question_type": "Evidence condition",
      "question": "What was the original pre-exercise precooling exposure?",
      "needed": "Temperature, formulation, amount, timing and actual exposure records",
      "role": "Required",
      "role_reason": "This condition connects Temperature, formulation, amount, timing and actual exposure records with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Temperature, formulation, amount, timing and actual exposure records must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Ingredients, actual ingestion-time/amount distributions, adherence and correspondence with other products are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original study used pre-exercise −1°C ice slurry at 7.5 g/kg. This is an original study-condition record, not a body-weight calculation, product recommendation or cooling instruction.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Ingredients, actual ingestion-time/amount distributions, adherence and correspondence with other products are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Ingredients, actual ingestion-time/amount distributions, adherence and correspondence with other products are unverified."
    },
    {
      "item_id": "N05",
      "question_type": "Evidence condition",
      "question": "What does the cold-water comparison represent?",
      "needed": "Control temperature, amount, ingestion and contact records",
      "role": "Required",
      "role_reason": "This condition connects Control temperature, amount, ingestion and contact records with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Control temperature, amount, ingestion and contact records must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The comparison is 4°C cold water at 7.5 g/kg in another condition in the same people. It is not a direct comparison with no ingestion, other precooling methods or ingestion during exercise.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified."
    },
    {
      "item_id": "N06",
      "question_type": "Evidence condition",
      "question": "What were the heat and exercise conditions?",
      "needed": "Temperature, humidity, exposure and exercise records",
      "role": "Required",
      "role_reason": "This condition connects Temperature, humidity, exposure and exercise records with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Temperature, humidity, exposure and exercise records must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Actual environmental variation, airflow, acclimation, individual workload and heat-exposure correspondence are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original study records running at first ventilatory threshold in 34.0°C and 54.9% relative humidity. This is not extended to prevention conditions in all heat, sports or outdoor environments.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Actual environmental variation, airflow, acclimation, individual workload and heat-exposure correspondence are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Actual environmental variation, airflow, acclimation, individual workload and heat-exposure correspondence are unverified."
    },
    {
      "item_id": "N07",
      "question_type": "Evidence condition",
      "question": "Is time to exhaustion the same as a clinical event?",
      "needed": "Functional tests and exhaustion definitions versus clinical outcomes",
      "role": "Required",
      "role_reason": "This condition connects Functional tests and exhaustion definitions versus clinical outcomes with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Functional tests and exhaustion definitions versus clinical outcomes must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The preserved direct endpoints are time to exhaustion and temperature while running at first ventilatory threshold in heat. Longer duration is not a direct event result for heat-illness prevention or safety benefit.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified."
    },
    {
      "item_id": "N08",
      "question_type": "Evidence condition",
      "question": "What are the original performance values and within-person signal?",
      "needed": "Condition-specific functional results, units, denominators and comparison",
      "role": "Required",
      "role_reason": "This condition connects Condition-specific functional results, units, denominators and comparison with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Condition-specific functional results, units, denominators and comparison must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: The statistical definition of ±, analysis denominators/model, exact functional-effect CI and prevention effects are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "Original 50.2±8.5 versus 40.7±7.2 minutes, +19±6%, P=.001 and the statement that all 10 moved in the same direction are preserved. They are not converted into prevention-event effects, new calculations or exact CIs.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "The statistical definition of ±, analysis denominators/model, exact functional-effect CI and prevention effects are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The statistical definition of ±, analysis denominators/model, exact functional-effect CI and prevention effects are unverified."
    },
    {
      "item_id": "N09",
      "question_type": "Evidence condition",
      "question": "At what time was pre-exercise temperature measured?",
      "needed": "Pre-exercise measurement, units, comparison and methods",
      "role": "Required",
      "role_reason": "This condition connects Pre-exercise measurement, units, comparison and methods with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Pre-exercise measurement, units, comparison and methods must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Exact pre-exercise timing, original condition values, denominators, measurement methods and CIs are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original text records rectal temperature 0.32°C lower before exercise. A change at one acute time point does not establish sustained cooling until exhaustion or heat-illness prevention.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Exact pre-exercise timing, original condition values, denominators, measurement methods and CIs are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Exact pre-exercise timing, original condition values, denominators, measurement methods and CIs are unverified."
    },
    {
      "item_id": "N10",
      "question_type": "Evidence condition",
      "question": "How did temperature at exhaustion differ?",
      "needed": "End times, original condition values and comparison scope",
      "role": "Required",
      "role_reason": "This condition connects End times, original condition values and comparison scope with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for End times, original condition values and comparison scope must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Measurement times, denominators, exact CIs and correspondence with clinical heat-illness confirmation are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "Terminal rectal temperature 39.36 versus 39.05°C, P=.001 and the text's 0.31°C higher are preserved values. This is a different time point from the pre-exercise decrease. Actual heat-illness occurrence, prevention failure or incidence is not calculated from them.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Measurement times, denominators, exact CIs and correspondence with clinical heat-illness confirmation are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Measurement times, denominators, exact CIs and correspondence with clinical heat-illness confirmation are unverified."
    },
    {
      "item_id": "N11",
      "question_type": "Evidence condition",
      "question": "Are temperature at each exhaustion time and at the same exercise time the same comparison?",
      "needed": "Temperature at matched exercise times and each condition's end time",
      "role": "Required",
      "role_reason": "This condition connects Temperature at matched exercise times and each condition's end time with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Temperature at matched exercise times and each condition's end time must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Temperature trajectories at the same time/workload, end-time correspondence and exposure/event relationships are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "Time to exhaustion was 50.2 versus 40.7 minutes in the two conditions. Temperature at each end time and comparison at the same exercise time are different questions; the stored summary is not used to fill them as equivalent.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Temperature trajectories at the same time/workload, end-time correspondence and exposure/event relationships are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Temperature trajectories at the same time/workload, end-time correspondence and exposure/event relationships are unverified."
    },
    {
      "item_id": "N12",
      "question_type": "Evidence condition",
      "question": "How much of randomization, counterbalancing and crossover was confirmed?",
      "needed": "Sequence generation, washout, periods and carryover",
      "role": "Required",
      "role_reason": "This condition connects Sequence generation, washout, periods and carryover with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Sequence generation, washout, periods and carryover must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Sequence generation/concealment, between-condition intervals, carryover and within-person analysis models are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "S01's original design is a randomized counterbalanced within-person crossover trial. The design wording does not establish sufficient washout, controlled period effects or confirmed concealment.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Sequence generation/concealment, between-condition intervals, carryover and within-person analysis models are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Sequence generation/concealment, between-condition intervals, carryover and within-person analysis models are unverified."
    },
    {
      "item_id": "N13",
      "question_type": "Evidence condition",
      "question": "Were masking, exhaustion assessment and expectations confirmed?",
      "needed": "Participant/assessor masking and stopping assessment",
      "role": "Required",
      "role_reason": "This condition connects Participant/assessor masking and stopping assessment with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Participant/assessor masking and stopping assessment must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "This is a functional trial comparing different temperatures/formulations. The stored summary does not confirm participant, stopping-assessor or analyst masking or expectation control.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified."
    },
    {
      "item_id": "N14",
      "question_type": "Evidence condition",
      "question": "Were condition completion, missingness and analysis populations confirmed?",
      "needed": "Analyses and missingness by person, condition and endpoint",
      "role": "Required",
      "role_reason": "This condition connects Analyses and missingness by person, condition and endpoint with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Analyses and missingness by person, condition and endpoint must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Completion by condition, missing endpoints, exclusions, analysis populations and missing-data handling are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original 10 healthy men and two single-session conditions are preserved. Condition counts and repeated temperature measurements are not converted into participants or independent trials.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Completion by condition, missing endpoints, exclusions, analysis populations and missing-data handling are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Completion by condition, missing endpoints, exclusions, analysis populations and missing-data handling are unverified."
    },
    {
      "item_id": "N15",
      "question_type": "Evidence condition",
      "question": "Are event data available to establish prevention effects and precision?",
      "needed": "Clinical prevention estimates, event analyses and CIs",
      "role": "Required",
      "role_reason": "This condition connects Clinical prevention estimates, event analyses and CIs with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Clinical prevention estimates, event analyses and CIs must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The parent's large within-person performance signal and P=.001 are functional results. Heat-illness events were unmeasured, so prevention risk ratios, absolute differences and CIs are not presented.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified."
    },
    {
      "item_id": "N16",
      "question_type": "Evidence condition",
      "question": "Were registration, protocol and prespecified hierarchy read?",
      "needed": "Trial registration, plans, outcome hierarchy and changes",
      "role": "Required",
      "role_reason": "This condition connects Trial registration, plans, outcome hierarchy and changes with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Trial registration, plans, outcome hierarchy and changes must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Registration existence, prespecified endpoints, protocol, SAP and change history are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original evidence/citation lists contain no registration identifier. Time/temperature endpoints in the parent's classification record do not confirm registration or prior prevention plans. Absence of a number is not treated as proof of no registration.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Registration existence, prespecified endpoints, protocol, SAP and change history are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Registration existence, prespecified endpoints, protocol, SAP and change history are unverified."
    },
    {
      "item_id": "N17",
      "question_type": "Evidence condition",
      "question": "Were concurrent hydration, environment and activity controlled?",
      "needed": "Other exposures, shared management and adherence",
      "role": "Required",
      "role_reason": "This condition connects Other exposures, shared management and adherence with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Other exposures, shared management and adherence must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Detailed concurrent exposures/management before and during the experiment, workload adjustment and adherence are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The stored text records conditions of a pre-exercise cooling comparison. Concurrent hydration, meals, previous exercise and heat acclimation are not filled as identical or fully controlled.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Detailed concurrent exposures/management before and during the experiment, workload adjustment and adherence are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Detailed concurrent exposures/management before and during the experiment, workload adjustment and adherence are unverified."
    },
    {
      "item_id": "N18",
      "question_type": "Evidence condition",
      "question": "Are ingestion during exercise and repeated use the same question?",
      "needed": "Direct data for exposures other than a single pre-exercise dose",
      "role": "Required",
      "role_reason": "This condition connects Direct data for exposures other than a single pre-exercise dose with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Direct data for exposures other than a single pre-exercise dose must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Functional, heat-illness and safety data for other times and repeated exposure are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original text records that repeated-ingestion strategies during exercise were not tested. A single pre-exercise result is not transferred to repeated or during-exercise prevention strategies.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Functional, heat-illness and safety data for other times and repeated exposure are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Functional, heat-illness and safety data for other times and repeated exposure are unverified."
    },
    {
      "item_id": "N19",
      "question_type": "Evidence condition",
      "question": "Does laboratory function answer real race or other-sport questions?",
      "needed": "Direct field and sport-specific results",
      "role": "Required",
      "role_reason": "This condition connects Direct field and sport-specific results with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Direct field and sport-specific results must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Clinical prevention results in actual races, other sports and field settings are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original text records that actual race performance, multiple sports and heat-illness occurrence were not tested. Time to exhaustion is not converted into race time, records or field prevention effects.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Clinical prevention results in actual races, other sports and field settings are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Clinical prevention results in actual races, other sports and field settings are unverified."
    },
    {
      "item_id": "N20",
      "question_type": "Evidence condition",
      "question": "Are there data for generalization to other populations?",
      "needed": "Direct data by age, sex, disease and heat acclimation",
      "role": "Required",
      "role_reason": "This condition connects Direct data by age, sex, disease and heat acclimation with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Direct data by age, sex, disease and heat acclimation must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Eligibility, exposure, clinical-event and safety data in other populations are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The direct context is the selected experiment in 10 healthy men. It is not generalized to heat-illness prevention or safety in other ages, sexes, diseases or functional levels.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Eligibility, exposure, clinical-event and safety data in other populations are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Eligibility, exposure, clinical-event and safety data in other populations are unverified."
    },
    {
      "item_id": "N21",
      "question_type": "Evidence condition",
      "question": "What is the scope of the original support/commercial-involvement statement?",
      "needed": "Original funding, product support, employee authors and COI disclosures",
      "role": "Required",
      "role_reason": "This condition connects Original funding, product support, employee authors and COI disclosures with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Original funding, product support, employee authors and COI disclosures must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Funding roles, products/free support, employee authors and detailed COI information are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The original funding record is a limited statement of university investigators and no commercial manufacturer involvement recorded in the PubMed trial record. It is not expanded into confirmed complete funding, product involvement or COI assessment.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Funding roles, products/free support, employee authors and detailed COI information are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Funding roles, products/free support, employee authors and detailed COI information are unverified."
    },
    {
      "item_id": "N22",
      "question_type": "Evidence condition",
      "question": "Were gastrointestinal discomfort and adverse events actually collected?",
      "needed": "Actual event collection, exposure, denominators and discontinuation",
      "role": "Supplementary",
      "role_reason": "This condition connects Actual event collection, exposure, denominators and discontinuation with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Actual event collection, exposure, denominators and discontinuation must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Systematic adverse-event definitions, collection, denominators, discontinuation and harms in long-term/vulnerable populations are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "Parent safety is Caution and describes possible gastrointestinal discomfort from rapid ingestion of a large cold volume and higher terminal rectal temperature. These statements are not used as trial event incidence or confirmation of clinical heat injury.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Systematic adverse-event definitions, collection, denominators, discontinuation and harms in long-term/vulnerable populations are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Systematic adverse-event definitions, collection, denominators, discontinuation and harms in long-term/vulnerable populations are unverified."
    },
    {
      "item_id": "N23",
      "question_type": "Evidence condition",
      "question": "Are the same crossover trial and independent replication distinguished?",
      "needed": "Relationships among reports, people, conditions and study families",
      "role": "Required",
      "role_reason": "This condition connects Relationships among reports, people, conditions and study families with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Relationships among reports, people, conditions and study families must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Separate direct trials matching the same prevention/exposure question and study-family independence are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The 10 men, two conditions and multiple temperature/time results in the single S01 report are the same crossover trial. They are not separately added as new independent trials, participants or prevention replications.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Separate direct trials matching the same prevention/exposure question and study-family independence are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Separate direct trials matching the same prevention/exposure question and study-family independence are unverified."
    },
    {
      "item_id": "N24",
      "question_type": "Evidence condition",
      "question": "Does a single experiment answer long-term clinical questions?",
      "needed": "Acute function/temperature versus long-term events",
      "role": "Required",
      "role_reason": "This condition connects Acute function/temperature versus long-term events with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Acute function/temperature versus long-term events must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: Long-term/repeated clinical prevention, safety and persistent-effect data are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The parent is C54 for a single-session laboratory functional/surrogate endpoint and records that clinical heat-illness safety was untested. Repeated use, long-term prevention and safety in all environments are not established.",
      "condition_status": "Unverified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "Long-term/repeated clinical prevention, safety and persistent-effect data are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "Long-term/repeated clinical prevention, safety and persistent-effect data are unverified."
    },
    {
      "item_id": "N25",
      "question_type": "Evidence condition",
      "question": "Were original values, axes, bilingual text, dates and history preserved?",
      "needed": "Original parent C54, subclaim ?, axes and correction records",
      "role": "Required",
      "role_reason": "This condition connects Original parent C54, subclaim ?, axes and correction records with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Original parent C54, subclaim ?, axes and correction records must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: The subclaim's score/status/axes, new corrections and external comparison of detailed historical checks are unverified. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "Parent C54, B/S/R1/I2/E+/B2, unrecorded precision, four false flags, empty grade-override reasons and subclaim ?/note are preserved. Bilingual text, 2026-09-07, an empty corrections array, empty deliberation string and historical PubMed/DOI/effect checks are not inherited as current review or grades.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "The subclaim's score/status/axes, new corrections and external comparison of detailed historical checks are unverified.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "The subclaim's score/status/axes, new corrections and external comparison of detailed historical checks are unverified."
    },
    {
      "item_id": "N26",
      "question_type": "Evidence condition",
      "question": "What was actually read and what can be updated?",
      "needed": "Stored summary versus unread external materials and update records",
      "role": "Required",
      "role_reason": "This condition connects Stored summary versus unread external materials and update records with the selected heat-illness-prevention question, unmeasured events, original ice slurry/cold water, within-person crossover, people/conditions, environment, time, temperature, denominators and harms.",
      "application_exception": "Preserve original numbers while distinguishing unmeasured prevention events and grade ? from acute running time and temperature. Distinguish single pre-exercise ice slurry/cold water, people/two conditions, different exhaustion times, pre-exercise/terminal times and laboratory/field settings. No new arithmetic, effects, CIs, hypothetical examples, grades, independence certification or ingestion, product, exercise, cooling, prevention or treatment instructions are created.",
      "criterion": "Material for Stored summary versus unread external materials and update records must be linked to the selected subclaim, parent performance context, same report/crossover trial, outcome units, times, comparator and denominators, distinguishing unread external material.",
      "basis": "Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced.",
      "condition_origin": "Internally applied conditions preserved for the existing subclaim. They do not establish preregistration, official-tool certification or completed content review.",
      "proposed_research": "Material needed: External original acquisition, actual reading and review of existing content remain incomplete. Additional-material identities, before/after values, condition revisions and verdict changes must be separate events. This records needed materials; no new research was executed.",
      "current_reports": [
        "S01"
      ],
      "existence": "Display information in the original parent stored summary is preserved. Public availability, acquisition and actual reading of detailed external material are separately unverified.",
      "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread",
      "observation": "The complete parent stored summary and bibliography were read for production and the original paper link is retained. External abstracts, full texts, registration, protocols, SAPs and support disclosures are unread; access/clicks were not attempted.",
      "condition_status": "Partly verified",
      "status_reason": "The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification.",
      "missingness": "External original acquisition, actual reading and review of existing content remain incomplete. Additional-material identities, before/after values, condition revisions and verdict changes must be separate events.",
      "uncertainty": "External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification.",
      "review_date": null,
      "reading_status": "Full text not read · Stored summary read",
      "additional_material": "External original acquisition, actual reading and review of existing content remain incomplete. Additional-material identities, before/after values, condition revisions and verdict changes must be separate events."
    }
  ],
  "reports": [
    {
      "report_id": "S01",
      "title": "Siegel R et al. 2010",
      "url": "https://pubmed.ncbi.nlm.nih.gov/19952832/",
      "report_type": "Randomized counterbalanced within-person crossover heat-exercise trial",
      "existence": "The stored evidence/citation lists contain the original report bibliography. External public availability and access status are unverified.",
      "acquired_read": "Stored summary read; external paper, registration, protocols, SAPs and support disclosures unread",
      "study_family": "RG2989-SIEGEL-2010",
      "independent_replication": "The same report, 10 people, two crossover conditions, time/temperature and two sheets are not counted as new independent trials, participants or prevention replications. Review of existing content remains incomplete.",
      "observed_result": "50.2±8.5 versus 40.7±7.2 minutes, +19±6%, P=.001; terminal rectal temperature 39.36 versus 39.05°C, P=.001",
      "result_level": "Stored-summary single-session laboratory performance and rectal-temperature results. Heat-illness events were unmeasured and original prevention grade is ?. Definition of ±, within-person CI, detailed denominators and prespecified hierarchy are unverified; functional/physiological signals are not transferred to clinical prevention or harm events.",
      "source_evidence_date": "2026-09-07",
      "materials": [
        {
          "material_type": "Stored existing review summary",
          "public_status": "Preserved copy of the complete parent-verdict stored summary",
          "access_status": "Stored summary",
          "acquired": true,
          "actually_read": "Summary read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        },
        {
          "material_type": "External paper",
          "public_status": "Original bibliographic link or needed material; external public availability/access status unverified",
          "access_status": "Unread; access not attempted",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        },
        {
          "material_type": "Registration material",
          "public_status": "Original bibliographic link or needed material; external public availability/access status unverified",
          "access_status": "Unread; access not attempted",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        },
        {
          "material_type": "Protocol",
          "public_status": "Original bibliographic link or needed material; external public availability/access status unverified",
          "access_status": "Unread; access not attempted",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        },
        {
          "material_type": "Statistical analysis plan",
          "public_status": "Original bibliographic link or needed material; external public availability/access status unverified",
          "access_status": "Unread; access not attempted",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        },
        {
          "material_type": "Funding, product-support and COI material",
          "public_status": "Original bibliographic link or needed material; external public availability/access status unverified",
          "access_status": "Unread; access not attempted",
          "acquired": false,
          "actually_read": "Not read",
          "as_of": "2026-09-07",
          "qualification": "Original PubMed URL, PMID 19952832 and DOI 10.1249/MSS.0b013e3181bf257a are preserved. Registration identifier and PMCID are unrecorded. Bibliography alone does not certify current reading, acquisition, prior plans or condition fulfillment, and new URLs are not inferred."
        }
      ],
      "links": [
        {
          "label": "PubMed",
          "url": "https://pubmed.ncbi.nlm.nih.gov/19952832/"
        }
      ]
    }
  ],
  "method_sources": [
    {
      "id": "M03",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03",
      "section": "§3.1, §3.2.1–3.2.3, MECIR C5/C7/C13",
      "official_principle": "Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions.",
      "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution"
    },
    {
      "id": "M04",
      "version": "Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04",
      "section": "§4.5, §4.6.1–4.6.3, MECIR C42",
      "official_principle": "Distinguish studies from reports and link them; do not omit a study solely because results are unreported.",
      "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution"
    },
    {
      "id": "M08",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08",
      "section": "§8.1–8.2.3, Table 8.2.a",
      "official_principle": "Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting.",
      "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution"
    },
    {
      "id": "M15",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2023-08",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15",
      "section": "§15.2.4, §15.3.1–15.3.3",
      "official_principle": "Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision.",
      "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution"
    },
    {
      "id": "M19",
      "version": "Cochrane Handbook 6.5 (2024), chapter updated 2019-10",
      "url": "https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19",
      "section": "§19.1.2, §19.2.1–19.2.4",
      "official_principle": "Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates.",
      "review_level": "Preserved method HTML copies; no current method-content re-review or official tool execution"
    }
  ],
  "status_dictionary": {
    "Met": "A state used when required evidence is confirmed after user review. This production does not declare that review complete.",
    "Partly verified": "Some information in the stored summary is linked into the table. External comparison/content review is not complete.",
    "Unverified": "The article leaves this unverified, or required material is absent from the current stored summary. This is distinct from zero, absence or safety.",
    "Review incomplete": "User review pending.",
    "Not reported": "Not reported within the stored material actually read; not extended to the entire primary paper.",
    "Inaccessible": "Means an actual access failure. Access not attempted here is not assigned this state.",
    "Not applicable": "Not used as a substitute for an evidence gap.",
    "Conflicting data": "Requires an observed disagreement under the same comparison criteria; not automatically judged in this production.",
    "Insufficient evidence for the conditions": "Marks a gap in additional material required by the selected conditions; not a new efficacy grade."
  },
  "study_overlap": {
    "state": "Unverified",
    "unique_trial_count": null,
    "unique_participant_count": null,
    "reason": "The single Siegel 2010 report of 10 healthy men in two single-session ice-slurry/cold-water conditions is the same randomized counterbalanced within-person crossover trial. Original time to exhaustion 50.2±8.5 versus 40.7±7.2 minutes, +19±6%, P=.001; rectal temperature 39.36 versus 39.05°C, P=.001; pre-exercise 0.32°C lower and terminal 0.31°C higher are distinguished. Heat-illness events were unmeasured and prevention grade is ?. Definition of ±, within-person CI, exact denominators and prespecified hierarchy are unverified. The two conditions, time points, functional/physiological results and two subclaim sheets are not added as new independent trials, participants or prevention replications. Confirmed unique-trial, participant and independent-replication totals remain unrecorded."
  },
  "history": [
    {
      "date": "2026-10-16",
      "kind": "Separation of public-facing pages and materials",
      "view_version": "1.0",
      "change": "The reader view and materials were prepared from the existing 26 items. No new clinical search, verification-status changes or scoring were performed."
    }
  ],
  "language": "en",
  "translation_date": "2026-10-16"
}