# Ice-slurry precooling × heat-illness prevention: evidence gaps Verdict 2989 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-09-07 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-16 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - 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. - Ingredient, formulation and route: 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. - Measured outcome: 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. - Questions outside this scope: 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 ## Checklist items ### N01 · What are the selected heat-illness-prevention question and original verdict? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: The subclaim's own score, status, axes and direct prevention results are unrecorded. - Required materials and conditions: Prevention wording, note and grade versus the parent performance verdict - Materials to obtain first: The subclaim's own score, status, axes and direct prevention results are unrecorded. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N02 · Were heat-illness events actually measured? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Heat-illness definitions, clinical confirmation, event denominators, observation periods and comparative prevention effects are unverified. - Required materials and conditions: Clinical-event definitions, confirmation, denominators and occurrence results - Materials to obtain first: Heat-illness definitions, clinical confirmation, event denominators, observation periods and comparative prevention effects are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N03 · Are participants distinguished from the two condition denominators? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Detailed eligibility, age, allocation by sequence and completion/analysis counts by condition are unverified. - Required materials and conditions: Eligibility, allocation, completion and analysis counts by condition - Materials to obtain first: Detailed eligibility, age, allocation by sequence and completion/analysis counts by condition are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N04 · What was the original pre-exercise precooling exposure? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Ingredients, actual ingestion-time/amount distributions, adherence and correspondence with other products are unverified. - Required materials and conditions: Temperature, formulation, amount, timing and actual exposure records - Materials to obtain first: Ingredients, actual ingestion-time/amount distributions, adherence and correspondence with other products are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N05 · What does the cold-water comparison represent? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified. - Required materials and conditions: Control temperature, amount, ingestion and contact records - Materials to obtain first: Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified. - Further research: Material needed: Actual control adherence, concurrent hydration/heat exposure and expectation differences are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N06 · What were the heat and exercise conditions? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Actual environmental variation, airflow, acclimation, individual workload and heat-exposure correspondence are unverified. - Required materials and conditions: Temperature, humidity, exposure and exercise records - Materials to obtain first: Actual environmental variation, airflow, acclimation, individual workload and heat-exposure correspondence are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N07 · Is time to exhaustion the same as a clinical event? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified. - Required materials and conditions: Functional tests and exhaustion definitions versus clinical outcomes - Materials to obtain first: Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified. - Further research: Material needed: Exhaustion assessment, stopping criteria and correspondence with clinical events are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N08 · What are the original performance values and within-person signal? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: The statistical definition of ±, analysis denominators/model, exact functional-effect CI and prevention effects are unverified. - Required materials and conditions: Condition-specific functional results, units, denominators and comparison - Materials to obtain first: The statistical definition of ±, analysis denominators/model, exact functional-effect CI and prevention effects are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N09 · At what time was pre-exercise temperature measured? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Exact pre-exercise timing, original condition values, denominators, measurement methods and CIs are unverified. - Required materials and conditions: Pre-exercise measurement, units, comparison and methods - Materials to obtain first: Exact pre-exercise timing, original condition values, denominators, measurement methods and CIs are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N10 · How did temperature at exhaustion differ? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Measurement times, denominators, exact CIs and correspondence with clinical heat-illness confirmation are unverified. - Required materials and conditions: End times, original condition values and comparison scope - Materials to obtain first: Measurement times, denominators, exact CIs and correspondence with clinical heat-illness confirmation are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N11 · Are temperature at each exhaustion time and at the same exercise time the same comparison? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Temperature trajectories at the same time/workload, end-time correspondence and exposure/event relationships are unverified. - Required materials and conditions: Temperature at matched exercise times and each condition's end time - Materials to obtain first: Temperature trajectories at the same time/workload, end-time correspondence and exposure/event relationships are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N12 · How much of randomization, counterbalancing and crossover was confirmed? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Sequence generation/concealment, between-condition intervals, carryover and within-person analysis models are unverified. - Required materials and conditions: Sequence generation, washout, periods and carryover - Materials to obtain first: Sequence generation/concealment, between-condition intervals, carryover and within-person analysis models are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N13 · Were masking, exhaustion assessment and expectations confirmed? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: This is a functional trial comparing different temperatures/formulations. The stored summary does not confirm participant, stopping-assessor or analyst masking or expectation control. - Why unverified: 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. - Reason for missing information: Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified. - Required materials and conditions: Participant/assessor masking and stopping assessment - Materials to obtain first: Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified. - Further research: Material needed: Masking, expectation differences, stopping assessment and analyst awareness of conditions are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N14 · Were condition completion, missingness and analysis populations confirmed? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Completion by condition, missing endpoints, exclusions, analysis populations and missing-data handling are unverified. - Required materials and conditions: Analyses and missingness by person, condition and endpoint - Materials to obtain first: Completion by condition, missing endpoints, exclusions, analysis populations and missing-data handling are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N15 · Are event data available to establish prevention effects and precision? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified. - Required materials and conditions: Clinical prevention estimates, event analyses and CIs - Materials to obtain first: Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified. - Further research: Material needed: Clinical prevention estimates, event counts, denominators, CIs and relevance criteria are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N16 · Were registration, protocol and prespecified hierarchy read? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Registration existence, prespecified endpoints, protocol, SAP and change history are unverified. - Required materials and conditions: Trial registration, plans, outcome hierarchy and changes - Materials to obtain first: Registration existence, prespecified endpoints, protocol, SAP and change history are unverified. - Further research: Material needed: Registration existence, prespecified endpoints, protocol, SAP and change history are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N17 · Were concurrent hydration, environment and activity controlled? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Detailed concurrent exposures/management before and during the experiment, workload adjustment and adherence are unverified. - Required materials and conditions: Other exposures, shared management and adherence - Materials to obtain first: Detailed concurrent exposures/management before and during the experiment, workload adjustment and adherence are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N18 · Are ingestion during exercise and repeated use the same question? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Functional, heat-illness and safety data for other times and repeated exposure are unverified. - Required materials and conditions: Direct data for exposures other than a single pre-exercise dose - Materials to obtain first: Functional, heat-illness and safety data for other times and repeated exposure are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N19 · Does laboratory function answer real race or other-sport questions? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Clinical prevention results in actual races, other sports and field settings are unverified. - Required materials and conditions: Direct field and sport-specific results - Materials to obtain first: Clinical prevention results in actual races, other sports and field settings are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N20 · Are there data for generalization to other populations? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Eligibility, exposure, clinical-event and safety data in other populations are unverified. - Required materials and conditions: Direct data by age, sex, disease and heat acclimation - Materials to obtain first: Eligibility, exposure, clinical-event and safety data in other populations are unverified. - Further research: Material needed: Eligibility, exposure, clinical-event and safety data in other populations are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N21 · What is the scope of the original support/commercial-involvement statement? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Funding roles, products/free support, employee authors and detailed COI information are unverified. - Required materials and conditions: Original funding, product support, employee authors and COI disclosures - Materials to obtain first: Funding roles, products/free support, employee authors and detailed COI information are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N22 · Were gastrointestinal discomfort and adverse events actually collected? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Systematic adverse-event definitions, collection, denominators, discontinuation and harms in long-term/vulnerable populations are unverified. - Required materials and conditions: Actual event collection, exposure, denominators and discontinuation - Materials to obtain first: Systematic adverse-event definitions, collection, denominators, discontinuation and harms in long-term/vulnerable populations are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N23 · Are the same crossover trial and independent replication distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Separate direct trials matching the same prevention/exposure question and study-family independence are unverified. - Required materials and conditions: Relationships among reports, people, conditions and study families - Materials to obtain first: Separate direct trials matching the same prevention/exposure question and study-family independence are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N24 · Does a single experiment answer long-term clinical questions? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: Long-term/repeated clinical prevention, safety and persistent-effect data are unverified. - Required materials and conditions: Acute function/temperature versus long-term events - Materials to obtain first: Long-term/repeated clinical prevention, safety and persistent-effect data are unverified. - Further research: Material needed: Long-term/repeated clinical prevention, safety and persistent-effect data are unverified. This records needed materials; no new research was executed. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N25 · Were original values, axes, bilingual text, dates and history preserved? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: The subclaim's score/status/axes, new corrections and external comparison of detailed historical checks are unverified. - Required materials and conditions: Original parent C54, subclaim ?, axes and correction records - Materials to obtain first: The subclaim's score/status/axes, new corrections and external comparison of detailed historical checks are unverified. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ### N26 · What was actually read and what can be updated? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: 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. - Reason for missing information: 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. - Required materials and conditions: Stored summary versus unread external materials and update records - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining 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. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: S01 ## Evidence and sources ### S01 Siegel R et al. 2010 [PubMed](https://pubmed.ncbi.nlm.nih.gov/19952832/) Materials actually read: Stored summary read; external paper, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: 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 Record 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. Independent replication: 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. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | 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. | | External paper | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Statistical analysis plan | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Funding, product-support and COI material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved method HTML copies; no current method-content re-review or official tool execution - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved method HTML copies; no current method-content re-review or official tool execution - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved method HTML copies; no current method-content re-review or official tool execution - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved method HTML copies; no current method-content re-review or official tool execution - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved method HTML copies; no current method-content re-review or official tool execution ## What the statuses mean - 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. ## Change history 2026-10-16 · Public page/materials 1.0. The reader view and materials were prepared from the existing 26 items. No new clinical search, verification-status changes or scoring were performed.