{ "schema_version": "chamgap-public-evidence-check-1.0", "public_id": "v2999-s0", "verdict_number": "2999", "title": "Repeated post-exercise cold immersion × smaller hypertrophy gains", "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": "R01 Roberts concerns resistance-trained young men, with 24 assigned/21 completed. R02 Fyfe is a separate trial of 16 participants; detailed eligibility and arm-/measurement-specific denominators are unverified. Age, training history, disease/sex range, baseline nutrition and exclusions are not invented and the two sample sizes are not summed.", "intervention": "The selected question concerns hypertrophy gains with repeated cold immersion after resistance training. Distinguish Roberts lower-body training with active recovery from Fyfe whole-body training in the bibliography with passive rest. Immersion extent, training load/progression, actual exposure, nutrition and adherence details are unverified. Research specifications are not turned into new instructions.", "dose": "Roberts original specification is 10°C for 10 minutes within 10 minutes after training, repeated 2 times weekly. The separate Fyfe trial uses 10°C for 15 minutes versus indoor rest at 23°C. Actual temperatures, adherence and interruptions are unverified; no new total exposure, optimal temperature/timing or implementation method is calculated or recommended.", "comparator": "Roberts compared cold immersion with 10 minutes of low-intensity cycling as active recovery; Fyfe used passive indoor rest at 23°C. Active and passive controls are not combined as the same comparison. Contact, nutrition products/diet, training load, actual exposure and their matching or separate contributions are unverified.", "endpoint": "Roberts MRI quadriceps gains are active recovery 309±73 g versus cold immersion 103±71 g, with original difference -206 g/P<.001. Parent explanation d=-4.1 is also an original value. The meaning of ±, exact denominators, effects/95% CIs and prospective hierarchy are unverified. Fyfe type II area, maximum strength and acute signaling are different outcomes; attenuated gains are not muscle loss from baseline.", "duration": "Roberts reports 12 weeks of training and the separate Fyfe trial 7 weeks. Post-training recovery, persistence, other temperatures/timing/frequencies, subgroups and medical-harm follow-up are unverified. Acute perceived recovery/soreness is distinguished from longer-term adaptation and does not establish benefit, impairment or safety under other conditions.", "excluded_extensions": [ "Transferring a gain difference of -206 g into muscle loss from baseline or impairment of every strength adaptation", "Combining MRI grams, type II fiber area, maximum strength and acute signaling as the same endpoint/effect", "Treating active/passive controls, training/exposure, duration and nutrition as identical conditions", "Summing assigned/completer counts, multiple outcomes, acute/longer-term populations, related reports or both sheets into new participant/unique-trial totals", "Inheriting original parent grade D with 28 points, E-, historical verification or independence wording as absent subclaim values or new verdicts/certification", "Treating adverse adaptation for a training goal or unrelated-injury withdrawal as confirmed cold-induced medical harm", "Creating new effects, CIs, attrition counts/rates, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions" ] }, "requirements": [ { "item_id": "N01", "question_type": "Evidence condition", "question": "Which hypertrophy-gain claim is being checked?", "needed": "Selected subclaim and boundaries with other outcomes", "role": "Required", "role_reason": "This condition connects Selected subclaim and boundaries with other outcomes with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Selected subclaim and boundaries with other outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original subclaim record and hypertrophy endpoint plans. Muscle loss, all strength outcomes and acute recovery remain distinct. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 question concerns attenuated hypertrophy gains with repeated cold immersion. The parent covers hypertrophy/strength adaptation together; the other subclaim concerns muscle loss or impairment of every strength outcome. This sheet preserves the selected gain question.", "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": "Original subclaim record and hypertrophy endpoint plans. Muscle loss, all strength outcomes and acute recovery remain distinct.", "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": "Original subclaim record and hypertrophy endpoint plans. Muscle loss, all strength outcomes and acute recovery remain distinct." }, { "item_id": "N02", "question_type": "Evidence condition", "question": "Is subclaim D distinct from parent grade D with 28 points?", "needed": "Original grade, direction and absent values", "role": "Required", "role_reason": "This condition connects Original grade, direction and absent values with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Original grade, direction and absent values must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original verdict, direction, subclaim records and correction material. Parent values do not fill absent subclaim values. This records needed materials; no new research was executed.", "current_reports": [], "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 subclaim is D, with a note that two small trials supported an adverse E- direction. Score/status are absent. Parent grade D with 28 points and adverse-direction explanation are parent context, not a new subclaim score or a null-result verdict.", "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": "Original verdict, direction, subclaim records and correction material. Parent values do not fill absent subclaim values.", "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": "Original verdict, direction, subclaim records and correction material. Parent values do not fill absent subclaim values." }, { "item_id": "N03", "question_type": "Evidence condition", "question": "Which trainees provide the hypertrophy data?", "needed": "Population, training history and baseline conditions", "role": "Required", "role_reason": "This condition connects Population, training history and baseline conditions with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Population, training history and baseline conditions must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original population, exclusion, training-history and baseline nutrition/disease tables. A representative population is not assigned to every report. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 main trial concerns resistance-trained young men. Population details of the separate Fyfe trial of 16 participants are absent from the summary. Report-specific age, training history, exclusions and disease/sex range are unverified.", "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": "Original population, exclusion, training-history and baseline nutrition/disease tables. A representative population is not assigned to every report.", "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": "Original population, exclusion, training-history and baseline nutrition/disease tables. A representative population is not assigned to every report." }, { "item_id": "N04", "question_type": "Evidence condition", "question": "What were the original repeated-cold-immersion specifications?", "needed": "Cold exposure specifications and actual adherence", "role": "Required", "role_reason": "This condition connects Cold exposure specifications and actual adherence with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Cold exposure specifications and actual adherence must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Exposure specifications, actual temperature, adherence and interruption records. Research specifications are not new cold-water instructions. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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": "Main-trial specifications are 10°C for 10 minutes within 10 minutes after training, repeated 2 times weekly. Actual temperature variation, immersion extent, adherence, interruptions and exposure-specific effects are unverified.", "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": "Exposure specifications, actual temperature, adherence and interruption records. Research specifications are not new cold-water instructions.", "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": "Exposure specifications, actual temperature, adherence and interruption records. Research specifications are not new cold-water instructions." }, { "item_id": "N05", "question_type": "Evidence condition", "question": "How do training region, repetition and duration differ?", "needed": "Training programs and outcome timing", "role": "Required", "role_reason": "This condition connects Training programs and outcome timing with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Training programs and outcome timing must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Training protocols, load/progression, adherence and measurement times. Different programs are not combined as the same exposure. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Roberts records 12 weeks of lower-body resistance training 2 times weekly. Fyfe bibliography concerns whole-body training; the evidence summary records 7 weeks with passive rest as control. Load, progression, components, adherence and muscle-specific details are unverified.", "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": "Training protocols, load/progression, adherence and measurement times. Different programs are not combined as the same exposure.", "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": "Training protocols, load/progression, adherence and measurement times. Different programs are not combined as the same exposure." }, { "item_id": "N06", "question_type": "Evidence condition", "question": "What comparison does active recovery provide?", "needed": "Roberts control and accompanying management", "role": "Required", "role_reason": "This condition connects Roberts control and accompanying management with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Roberts control and accompanying management must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Control specifications, activity/contact and shared training/nutrition records. Active recovery is not substituted for passive rest. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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": "Roberts control is 10 minutes of low-intensity cycling as active recovery, rather than passive rest. This compares gains during the same training; active recovery's separate contribution and matching of contact/nutrition/load are unverified.", "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": "Control specifications, activity/contact and shared training/nutrition records. Active recovery is not substituted for passive rest.", "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": "Control specifications, activity/contact and shared training/nutrition records. Active recovery is not substituted for passive rest." }, { "item_id": "N07", "question_type": "Evidence condition", "question": "What are the passive-rest control and different cold specifications?", "needed": "Fyfe intervention, control and duration", "role": "Required", "role_reason": "This condition connects Fyfe intervention, control and duration with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Fyfe intervention, control and duration must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Fyfe intervention, control, adherence, training and original outcome tables. Temperatures, times and controls remain report-specific. This records needed materials; no new research was executed.", "current_reports": [ "R02" ], "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 separate trial of 16 participants compared 10°C for 15 minutes with indoor rest at 23°C over 7 weeks. This differs from Roberts 10-minute/active-recovery comparison; contact, rest, adherence/load details are unverified.", "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": "Fyfe intervention, control, adherence, training and original outcome tables. Temperatures, times and controls remain report-specific.", "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": "Fyfe intervention, control, adherence, training and original outcome tables. Temperatures, times and controls remain report-specific." }, { "item_id": "N08", "question_type": "Evidence condition", "question": "What outcome is MRI quadriceps gain?", "needed": "MRI measurement and change derivation", "role": "Required", "role_reason": "This condition connects MRI measurement and change derivation with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for MRI measurement and change derivation must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original MRI tables, measurement/derivation procedures, baseline/end values and denominators. These are not converted into other muscles or strength outcomes. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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": "Roberts endpoints are MRI quadriceps gain and strength. The selected question links to MRI gain; measurement/derivation procedures, assessors, muscle-region details and arm-specific analysis denominators are unverified.", "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": "Original MRI tables, measurement/derivation procedures, baseline/end values and denominators. These are not converted into other muscles or strength outcomes.", "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": "Original MRI tables, measurement/derivation procedures, baseline/end values and denominators. These are not converted into other muscles or strength outcomes." }, { "item_id": "N09", "question_type": "Evidence condition", "question": "What are the arm-specific gains and P value?", "needed": "Original MRI values, difference and uncertainty", "role": "Required", "role_reason": "This condition connects Original MRI values, difference and uncertainty with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Original MRI values, difference and uncertainty must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original MRI outcome tables, legends, tests, denominators and intervals. ± is not read as a CI and no new difference is calculated. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 results are active recovery 309±73 g versus CWI 103±71 g, difference -206 g/P<.001. These are preserved original values; the meaning of ±, exact arm analysis denominators and CIs are unverified.", "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": "Original MRI outcome tables, legends, tests, denominators and intervals. ± is not read as a CI and no new difference is calculated.", "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": "Original MRI outcome tables, legends, tests, denominators and intervals. ± is not read as a CI and no new difference is calculated." }, { "item_id": "N10", "question_type": "Evidence condition", "question": "What original record contains d=-4.1?", "needed": "Definition and derivation of the original effect size", "role": "Required", "role_reason": "This condition connects Definition and derivation of the original effect size with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Definition and derivation of the original effect size must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original effect derivation, models, intervals and denominators. No new d or CI is estimated. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 explanation records MRI gain difference -206 g, d=-4.1 and P<.001. The definition/derivation of d, arm denominators, intervals and adjustment are unverified in the current summary.", "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": "Original effect derivation, models, intervals and denominators. No new d or CI is estimated.", "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": "Original effect derivation, models, intervals and denominators. No new d or CI is estimated." }, { "item_id": "N11", "question_type": "Evidence condition", "question": "Were 95% CIs and prospective primary hierarchy verified?", "needed": "Prospective hierarchy, intervals and sample-size rationale", "role": "Required", "role_reason": "This condition connects Prospective hierarchy, intervals and sample-size rationale with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Prospective hierarchy, intervals and sample-size rationale must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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, protocols, SAPs, original intervals and sample-size rationale. Metadata and verification of prospective plans remain distinct. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 explanation lists unverified prospective primary hierarchy and 95% CIs as limitations. Representative MRI-gain/strength endpoint labels do not certify prospective hierarchy.", "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, protocols, SAPs, original intervals and sample-size rationale. Metadata and verification of prospective plans remain distinct.", "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, protocols, SAPs, original intervals and sample-size rationale. Metadata and verification of prospective plans remain distinct." }, { "item_id": "N12", "question_type": "Evidence condition", "question": "How does less gain differ from muscle loss?", "needed": "Change from baseline and between-group comparison", "role": "Required", "role_reason": "This condition connects Change from baseline and between-group comparison with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Change from baseline and between-group comparison must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original baseline, end/change tables and analysis scope. Smaller gains are not converted into negative change from baseline. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 records muscle gains in both groups, including 103 g in the cold group. -206 g compares gains during the same training; it is not muscle loss from baseline.", "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": "Original baseline, end/change tables and analysis scope. Smaller gains are not converted into negative change from baseline.", "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": "Original baseline, end/change tables and analysis scope. Smaller gains are not converted into negative change from baseline." }, { "item_id": "N13", "question_type": "Evidence condition", "question": "Is type II hypertrophy the same as MRI grams?", "needed": "Fiber area versus MRI", "role": "Required", "role_reason": "This condition connects Fiber area versus MRI with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Fiber area versus MRI must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original fiber tables, measurement/derivation, regions and denominators/CIs. Fiber area is not converted into MRI grams. This records needed materials; no new research was executed.", "current_reports": [ "R02" ], "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": "Fyfe endpoints are muscle-fiber area and strength, with less type II hypertrophy reported. Preserve the original directional support; exact original values, units, effects/CIs, analysis denominators and other fiber outcomes are unverified.", "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": "Original fiber tables, measurement/derivation, regions and denominators/CIs. Fiber area is not converted into MRI grams.", "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": "Original fiber tables, measurement/derivation, regions and denominators/CIs. Fiber area is not converted into MRI grams." }, { "item_id": "N14", "question_type": "Evidence condition", "question": "How do maximum-strength outcomes differ from hypertrophy?", "needed": "Strength-specific results and disagreement", "role": "Required", "role_reason": "This condition connects Strength-specific results and disagreement with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Strength-specific results and disagreement must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original tables, models, denominators and intervals for each strength measure. Null results do not establish 0 effect, equivalence or impairment of all strength outcomes. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 records no clear attenuation of maximum-strength gains in Fyfe; the preserved summary describes a null maximum-strength difference. Strength findings differ across trials, and detailed measures, estimates and CIs are unverified.", "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": "Original tables, models, denominators and intervals for each strength measure. Null results do not establish 0 effect, equivalence or impairment of all strength outcomes.", "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": "Original tables, models, denominators and intervals for each strength measure. Null results do not establish 0 effect, equivalence or impairment of all strength outcomes." }, { "item_id": "N15", "question_type": "Evidence condition", "question": "Does acute anabolic signaling replace longer-term hypertrophy?", "needed": "Linkage of acute/longer-term outcomes and samples", "role": "Required", "role_reason": "This condition connects Linkage of acute/longer-term outcomes and samples with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Linkage of acute/longer-term outcomes and samples must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Within-report acute/longer-term distinctions, sample/timing and identity material. Titles alone do not create acute values or new trials. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Both paper titles mention anabolic signaling, but stored evidence summaries concern longer-term MRI, fiber and strength outcomes. Exact acute-marker values, times, samples and relationships to longer-term populations are unverified.", "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": "Within-report acute/longer-term distinctions, sample/timing and identity material. Titles alone do not create acute values or new trials.", "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": "Within-report acute/longer-term distinctions, sample/timing and identity material. Titles alone do not create acute values or new trials." }, { "item_id": "N16", "question_type": "Evidence condition", "question": "Are perceived recovery/soreness and hypertrophy the same goal?", "needed": "Boundaries between acute recovery and longer-term adaptation", "role": "Required", "role_reason": "This condition connects Boundaries between acute recovery and longer-term adaptation with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Boundaries between acute recovery and longer-term adaptation must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Outcome definitions, timing and cohort material for the same/different questions. Acute recovery is not transferred into hypertrophy benefit. This records needed materials; no new research was executed.", "current_reports": [], "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 distinguishes acute recovery, soreness/perceived recovery and longer-term adaptation. Verdict 1247 identifies a different question; its material was not read in this work.", "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": "Outcome definitions, timing and cohort material for the same/different questions. Acute recovery is not transferred into hypertrophy benefit.", "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": "Outcome definitions, timing and cohort material for the same/different questions. Acute recovery is not transferred into hypertrophy benefit." }, { "item_id": "N17", "question_type": "Evidence condition", "question": "Which stage does the assigned count of 24 describe?", "needed": "Recruitment/allocation flow and procedures", "role": "Required", "role_reason": "This condition connects Recruitment/allocation flow and procedures with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Recruitment/allocation flow and procedures must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Arm-specific flowcharts, allocation/recruitment and procedures. Overall counts are not automatically assigned as arm or endpoint denominators. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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": "Roberts records 24 assigned/21 completed. Arm assignment denominators, recruitment/eligibility/exclusions and exact sequence-generation/concealment procedures are unverified.", "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": "Arm-specific flowcharts, allocation/recruitment and procedures. Overall counts are not automatically assigned as arm or endpoint denominators.", "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": "Arm-specific flowcharts, allocation/recruitment and procedures. Overall counts are not automatically assigned as arm or endpoint denominators." }, { "item_id": "N18", "question_type": "Evidence condition", "question": "Are 21 completers linked to measurement-specific denominators?", "needed": "Complete-case analysis and outcome denominators", "role": "Required", "role_reason": "This condition connects Complete-case analysis and outcome denominators with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Complete-case analysis and outcome denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Arm denominators, flow and exclusions in original MRI/strength tables. Completer counts do not replace every outcome's analysis denominator. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 lists complete-case analysis as a limitation and records 21 completers. Arm denominators, exclusions, interruptions/missingness for MRI, strength and acute analyses are separately unverified.", "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": "Arm denominators, flow and exclusions in original MRI/strength tables. Completer counts do not replace every outcome's analysis denominator.", "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": "Arm denominators, flow and exclusions in original MRI/strength tables. Completer counts do not replace every outcome's analysis denominator." }, { "item_id": "N19", "question_type": "Evidence condition", "question": "Were withdrawal causes kept distinct from cold-induced harm?", "needed": "Injury/withdrawal causes and timing", "role": "Required", "role_reason": "This condition connects Injury/withdrawal causes and timing with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Injury/withdrawal causes and timing must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Flowcharts, injury/withdrawal causes, timing and analysis handling. No new attrition counts/rates or causal judgment are created. This records needed materials; no new research was executed.", "current_reports": [ "R01" ], "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 safety wording did not attribute unrelated-injury withdrawal to cold immersion. Arm-specific withdrawal, exact causes/timing, observation loss and analysis handling are unverified.", "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": "Flowcharts, injury/withdrawal causes, timing and analysis handling. No new attrition counts/rates or causal judgment are created.", "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": "Flowcharts, injury/withdrawal causes, timing and analysis handling. No new attrition counts/rates or causal judgment are created." }, { "item_id": "N20", "question_type": "Evidence condition", "question": "Are 16 participants the fiber/strength denominators?", "needed": "Fyfe flow and measurement-specific denominators", "role": "Required", "role_reason": "This condition connects Fyfe flow and measurement-specific denominators with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Fyfe flow and measurement-specific denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Flow, measurement denominators, missing data and analyses. Overall sample size does not replace all endpoint denominators. This records needed materials; no new research was executed.", "current_reports": [ "R02" ], "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": "Fyfe records 16 participants. Arm assignment/completion, fiber/strength analysis denominators and missing biopsy/measurement data and their handling are unverified.", "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": "Flow, measurement denominators, missing data and analyses. Overall sample size does not replace all endpoint denominators.", "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": "Flow, measurement denominators, missing data and analyses. Overall sample size does not replace all endpoint denominators." }, { "item_id": "N21", "question_type": "Evidence condition", "question": "What do completer, assigned and actual-use analyses estimate?", "needed": "Analysis populations, missingness and sensitivity", "role": "Required", "role_reason": "This condition connects Analysis populations, missingness and sensitivity with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Analysis populations, missingness and sensitivity must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: SAPs, actual models, analysis populations and missingness/sensitivity material. No new analysis or adjustment is executed. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Roberts complete-case analysis is recorded. Full-assignment analysis, baseline/load/nutrition adjustment, missingness/sensitivity, actual-exposure estimates and Fyfe analysis details are unverified.", "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": "SAPs, actual models, analysis populations and missingness/sensitivity material. No new analysis or adjustment is executed.", "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": "SAPs, actual models, analysis populations and missingness/sensitivity material. No new analysis or adjustment is executed." }, { "item_id": "N22", "question_type": "Evidence condition", "question": "How were MRI, biopsy and strength assessed?", "needed": "Measurement, allocation awareness and reliability", "role": "Required", "role_reason": "This condition connects Measurement, allocation awareness and reliability with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Measurement, allocation awareness and reliability must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 procedures, assessor/analyst records and repetition/reliability. Measurement names alone do not certify blinding or precision. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "MRI, fiber-area and strength measurement names are present, but measurement/derivation procedures, repetition, assessor/analyst allocation awareness, standardization and reliability are unverified.", "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": "Measurement procedures, assessor/analyst records and repetition/reliability. Measurement names alone do not certify blinding or precision.", "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 procedures, assessor/analyst records and repetition/reliability. Measurement names alone do not certify blinding or precision." }, { "item_id": "N23", "question_type": "Evidence condition", "question": "Are contributions of nutrition products, diet and training management known?", "needed": "Nutrition, load, adherence and shared management", "role": "Required", "role_reason": "This condition connects Nutrition, load, adherence and shared management with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Nutrition, load, adherence and shared management must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Nutrition, supplements, training/adherence and shared-management records. Product provision does not establish matched intake or a separate effect. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Roberts records in-kind nutrition products from Body Science. Actual products, intake/arm distribution, diet/nutrition, training load and observational control are unverified.", "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": "Nutrition, supplements, training/adherence and shared-management records. Product provision does not establish matched intake or a separate effect.", "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": "Nutrition, supplements, training/adherence and shared-management records. Product provision does not establish matched intake or a separate effect." }, { "item_id": "N24", "question_type": "Evidence condition", "question": "How does an absent registration field differ from prospective endpoint verification?", "needed": "Registration identity, content, timing and plans", "role": "Required", "role_reason": "This condition connects Registration identity, content, timing and plans with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Registration identity, content, timing and plans must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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, protocols, SAPs and changes linked to the papers. An absent field does not establish no registration or prospective verification. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Both original evidence summaries lack registration-identifier fields. The explanation explicitly notes unverified prospective primary hierarchy. Registration identity/content, timing relative to recruitment, changes and protocols are unverified and were not accessed.", "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": "Registration, protocols, SAPs and changes linked to the papers. An absent field does not establish no registration or prospective verification.", "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, protocols, SAPs and changes linked to the papers. An absent field does not establish no registration or prospective verification." }, { "item_id": "N25", "question_type": "Evidence condition", "question": "How are longer-term, acute and multiple outcomes in the same report linked?", "needed": "Overlap across reports, cohorts and outcomes", "role": "Required", "role_reason": "This condition connects Overlap across reports, cohorts and outcomes with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Overlap across reports, cohorts and outcomes must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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, recruitment dates and report/cohort/outcome identity. Multiple outcomes or both sheets are not summed as new participants or independent trials. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Roberts and Fyfe have separate preserved bibliographies. Multiple outcomes, acute/longer-term sample relationships and related-report overlap are unverified. Support from two small trials is original wording, not new independence certification.", "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": "Registration, recruitment dates and report/cohort/outcome identity. Multiple outcomes or both sheets are not summed as new participants or independent trials.", "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, recruitment dates and report/cohort/outcome identity. Multiple outcomes or both sheets are not summed as new participants or independent trials." }, { "item_id": "N26", "question_type": "Evidence condition", "question": "What verification level applies to support, interests and original I1?", "needed": "Support, in-kind provision, company roles and historical values", "role": "Required", "role_reason": "This condition connects Support, in-kind provision, company roles and historical values with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Support, in-kind provision, company roles and historical values must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Support/interest declarations, product distribution, affiliations and investigator roles. No new absence of company-employed authors or analysis/publication involvement is established. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Roberts records public/university support and Body Science in-kind nutrition products; Fyfe records public sport/university support. Parent mixed-support wording and I1 are historical values; detailed roles, interests, involvement/independence are unverified.", "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": "Support/interest declarations, product distribution, affiliations and investigator roles. No new absence of company-employed authors or analysis/publication involvement is established.", "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": "Support/interest declarations, product distribution, affiliations and investigator roles. No new absence of company-employed authors or analysis/publication involvement is established." }, { "item_id": "N27", "question_type": "Evidence condition", "question": "Can two supportive directions generalize to every exposure/population?", "needed": "Directness of measures, controls, training and exposure", "role": "Required", "role_reason": "This condition connects Directness of measures, controls, training and exposure with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Directness of measures, controls, training and exposure must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Condition-specific original tables, measurements/comparisons and identity material. Different supportive directions are not calculated as one pooled effect. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 note describes two small trials supporting the direction, but MRI gains and type II area differ. Active/passive controls, duration, training and exposure also differ; maximum-strength disagreement is preserved.", "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": "Condition-specific original tables, measurements/comparisons and identity material. Different supportive directions are not calculated as one pooled effect.", "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": "Condition-specific original tables, measurements/comparisons and identity material. Different supportive directions are not calculated as one pooled effect." }, { "item_id": "N28", "question_type": "Evidence condition", "question": "What persists after exposure and under other conditions?", "needed": "Post-training outcomes, other exposures and subgroups", "role": "Required", "role_reason": "This condition connects Post-training outcomes, other exposures and subgroups with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Post-training outcomes, other exposures and subgroups must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original post-training, other-exposure and subgroup data. No sustained effect beyond original durations is created. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 material concerns 12 and 7 weeks of training. Post-training recovery/persistence, other temperatures/timing/frequencies and subgroup effects are unverified.", "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": "Original post-training, other-exposure and subgroup data. No sustained effect beyond original durations is created.", "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": "Original post-training, other-exposure and subgroup data. No sustained effect beyond original durations is created." }, { "item_id": "N29", "question_type": "Evidence condition", "question": "Do hypertrophy measures answer medical-injury or disease-safety questions?", "needed": "Adverse training-goal adaptation versus medical harm", "role": "Required", "role_reason": "This condition connects Adverse training-goal adaptation versus medical harm with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Adverse training-goal adaptation versus medical harm must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 harm/disease-population reports, exposure, events and denominators. Goal-related disadvantage is not converted into medical-harm incidence. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 calls smaller hypertrophy gains adverse to that training goal while separately leaving medical adverse-event rates and safety across diseases unverified. MRI gains/fiber measures are not direct medical-harm data.", "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 harm/disease-population reports, exposure, events and denominators. Goal-related disadvantage is not converted into medical-harm incidence.", "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 harm/disease-population reports, exposure, events and denominators. Goal-related disadvantage is not converted into medical-harm incidence." }, { "item_id": "N30", "question_type": "Evidence condition", "question": "What material was actually read here?", "needed": "Reading scope of stored summaries and external originals", "role": "Required", "role_reason": "This condition connects Stored summaries versus external originals with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Reading scope of stored summaries and external originals must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Report-specific abstracts, full texts, registration/plans, original tables, support material and actual reading records. Bibliography/PMCID presence does not mean full-text reading. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 JSON was read and preserved byte for byte. Bibliographies/summaries for both reports were read; external abstracts, full texts, registration, planning and support materials remain unread. No external links/access were 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": "Report-specific abstracts, full texts, registration/plans, original tables, support material and actual reading records. Bibliography/PMCID presence does not mean full-text reading.", "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": "Report-specific abstracts, full texts, registration/plans, original tables, support material and actual reading records. Bibliography/PMCID presence does not mean full-text reading." }, { "item_id": "N31", "question_type": "Evidence condition", "question": "Are historical verification and current production/review distinct?", "needed": "Original evidence date, corrections and historical checks", "role": "Required", "role_reason": "This condition connects Original evidence date, corrections and historical checks with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Original evidence date, corrections and historical checks must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Complete actual correction/evidence-update records. Original dates are not production/review dates and do not certify no external corrections. This records needed materials; no new research was executed.", "current_reports": [], "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 date is 2026-09-07, the correction array is empty and the deliberation note an empty string. Parent historical verification of longer-term trials, MRI, strength and funding does not establish completed content review in this work.", "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": "Complete actual correction/evidence-update records. Original dates are not production/review dates and do not certify no external corrections.", "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": "Complete actual correction/evidence-update records. Original dates are not production/review dates and do not certify no external corrections." }, { "item_id": "N32", "question_type": "Evidence condition", "question": "Were gain/loss boundaries in both original languages preserved?", "needed": "Correspondence of original languages and scope", "role": "Required", "role_reason": "This condition connects Correspondence of original languages and scope with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Correspondence of original languages and scope must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Complete needed original reports, translations and corrections. Original bilingual distinctions do not create new verification or broader claims. This records needed materials; no new research was executed.", "current_reports": [], "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 English claim concerns attenuated hypertrophy gains with repeated cold immersion. The parent distinguishes less muscle gain from muscle loss and limits the strength claim. Detailed translation checks against external papers were not performed.", "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": "Complete needed original reports, translations and corrections. Original bilingual distinctions do not create new verification or broader claims.", "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": "Complete needed original reports, translations and corrections. Original bilingual distinctions do not create new verification or broader claims." }, { "item_id": "N33", "question_type": "Evidence condition", "question": "How are parent axes and absent subclaim values retained?", "needed": "Original axes and selected-field boundaries", "role": "Required", "role_reason": "This condition connects Original axes and selected-field boundaries with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Original axes and selected-field boundaries must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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 axis/subclaim-record correction material. Parent axes/scores do not fill absent subclaim values. This records needed materials; no new research was executed.", "current_reports": [], "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 axes are B/S/R1/I1/E-/B2/CX, with derived grade D. Four false flags and empty override reasons are also original values. Separate selected-subclaim score, status and axes are absent.", "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 axis/subclaim-record correction material. Parent axes/scores do not fill absent subclaim values.", "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 axis/subclaim-record correction material. Parent axes/scores do not fill absent subclaim values." }, { "item_id": "N34", "question_type": "Evidence condition", "question": "Which medical adverse events were collected?", "needed": "Harm definitions, collection, assessment and original events", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Harm definitions, collection, assessment and original events with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Harm definitions, collection, assessment and original events must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Harm definitions, collection and withdrawal/event tables. Caution does not establish actual incidence, no harm or safety certification. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 safety is Caution and medical adverse-event rates are explicitly unverified. Actual harm definitions, collection/assessors and original event tables are unverified.", "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": "Harm definitions, collection and withdrawal/event tables. Caution does not establish actual incidence, no harm or safety certification.", "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": "Harm definitions, collection and withdrawal/event tables. Caution does not establish actual incidence, no harm or safety certification." }, { "item_id": "N35", "question_type": "Evidence condition", "question": "How do exposure, injury, interruption and follow-up times differ?", "needed": "Exposure duration versus event/follow-up time", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Exposure duration versus event/follow-up time with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Exposure duration versus event/follow-up time must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Exposure, event, interruption and later timelines. Training duration is not substituted for harm follow-up duration. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 12-/7-week training exposure durations are preserved. Actual harm timing, recovery/interruption, post-training follow-up and temporal order of injuries are unverified.", "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": "Exposure, event, interruption and later timelines. Training duration is not substituted for harm follow-up duration.", "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": "Exposure, event, interruption and later timelines. Training duration is not substituted for harm follow-up duration." }, { "item_id": "N36", "question_type": "Evidence condition", "question": "Were harms compared equally with active/passive controls?", "needed": "Arm-specific harm collection, duration and direct comparison", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Arm-specific harm collection, duration and direct comparison with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Arm-specific harm collection, duration and direct comparison must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Arm-specific harm collection, periods and withdrawal/event tables. A control arm alone does not establish matched collection or a direct risk comparison. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Active recovery and passive rest controls are preserved. Matched harm collection, observation periods and original direct medical-risk comparisons by arm are unverified.", "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": "Arm-specific harm collection, periods and withdrawal/event tables. A control arm alone does not establish matched collection or a direct risk comparison.", "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": "Arm-specific harm collection, periods and withdrawal/event tables. A control arm alone does not establish matched collection or a direct risk comparison." }, { "item_id": "N37", "question_type": "Evidence condition", "question": "What are harm event counts and exposure/observation denominators?", "needed": "Original medical-harm events and denominators", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Original medical-harm events and denominators with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Original medical-harm events and denominators must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Original harm tables, actual exposure/observation flow and interruptions. Trial counts do not establish harm denominators or 0 events. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Preserve original 24 assigned/21 completed and the separate 16 participants. Medical-harm event counts, exposure/observation denominators and arm-specific interruptions are unverified.", "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": "Original harm tables, actual exposure/observation flow and interruptions. Trial counts do not establish harm denominators or 0 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": "Original harm tables, actual exposure/observation flow and interruptions. Trial counts do not establish harm denominators or 0 events." }, { "item_id": "N38", "question_type": "Evidence condition", "question": "Are injury, training load, nutrition and exposure causality distinguished?", "needed": "Baseline risk, accompanying management and causal assessment", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Baseline risk, accompanying management and causal assessment with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Baseline risk, accompanying management and causal assessment must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Injury timing, training/nutrition, baseline risks and causal-assessment records. No new medical causality is established. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 did not attribute unrelated-injury withdrawal to cold exposure. Detailed training load, nutrition, baseline disease and injury/exposure timing and causal assessment are unverified.", "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": "Injury timing, training/nutrition, baseline risks and causal-assessment records. No new medical causality is established.", "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": "Injury timing, training/nutrition, baseline risks and causal-assessment records. No new medical causality is established." }, { "item_id": "N39", "question_type": "Evidence condition", "question": "Are interruptions/withdrawals linked to missing harm data?", "needed": "Interruption, data loss, selective reporting and follow-up", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Interruption, data loss, selective reporting and follow-up with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Interruption, data loss, selective reporting and follow-up must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Interruption/withdrawal reasons, harm records, follow-up and published tables. Missing data do not establish no harm. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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": "Complete-case analysis and original unrelated-injury withdrawal wording are present. Arm-specific interruptions, lost harm collection, selective reporting and subsequent follow-up are unverified.", "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": "Interruption/withdrawal reasons, harm records, follow-up and published tables. Missing data do not establish no harm.", "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": "Interruption/withdrawal reasons, harm records, follow-up and published tables. Missing data do not establish no harm." }, { "item_id": "N40", "question_type": "Evidence condition", "question": "What independent, disease-population or later harm material is available?", "needed": "Direct medical-harm evidence and other populations", "role": "Supplementary; required for extending medical safety conclusions", "role_reason": "This condition connects Direct medical-harm evidence and other populations with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Direct medical-harm evidence and other populations must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Related harm/disease-population, exposure/collection/denominator and later material. No safety or risk certification beyond the original scope is created. This records needed materials; no new research was executed.", "current_reports": [ "R01", "R02" ], "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 separately leaves safety across diseases unverified. Independent medical-harm, vulnerable-population and post-training event material for the same exposure is unverified in the current preserved scope.", "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": "Related harm/disease-population, exposure/collection/denominator and later material. No safety or risk certification beyond the original scope is created.", "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": "Related harm/disease-population, exposure/collection/denominator and later material. No safety or risk certification beyond the original scope is created." }, { "item_id": "N41", "question_type": "Evidence condition", "question": "Are conditions, method copies, application and review separate?", "needed": "Condition freezing, observations and change records", "role": "Required", "role_reason": "This condition connects Condition freezing, observations and change records with hypertrophy gains under repeated cold immersion, MRI/fiber/strength/acute outcomes, exposure, training, controls, nutrition, assigned/completer/measurement denominators, support and medical harms.", "application_exception": "Preserve selected subclaim D and the original note that two small trials supported an adverse E- direction. Distinguish absent subclaim score/status/axes from parent grade D with 28 points/Caution. Preserve original gain differences, signs, P values and d without turning them into muscle loss or impairment of every strength outcome. Create no new effects, CIs, attrition counts/rates, totals, grades, independence/safety certification or cold-water, exercise, recovery or treatment instructions.", "criterion": "Material for Condition freezing, observations and change records must be linked to the selected subclaim, parent context, same report/trial, outcome units, times, actual 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: Complete new reports, registration, corrections and original tables, plus full prior originals, condition versions, application and review records. Material additions, condition revisions and verdict changes remain separate events. This records needed materials; no new research was executed.", "current_reports": [], "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 5 method HTML snapshots, family conditions and quality contract are linked as preserved copies. Condition saving/freezing and separate application are distinct; content/model/boundary review is not marked complete.", "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": "Complete new reports, registration, corrections and original tables, plus full prior originals, condition versions, application and review records. Material additions, condition revisions and verdict changes remain 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": "Complete new reports, registration, corrections and original tables, plus full prior originals, condition versions, application and review records. Material additions, condition revisions and verdict changes remain separate events." } ], "reports": [ { "report_id": "R01", "title": "Roberts LA et al. Post-exercise cold water immersion attenuates acute anabolic signalling and long-term adaptations in muscle to strength training. J Physiol. 2015;593(18):4285-4301. PMID: 26174323. PMCID: PMC4594298. DOI: 10.1113/JP270570.", "url": "https://pubmed.ncbi.nlm.nih.gov/26174323/", "report_type": "Twelve-week active-recovery controlled resistance-training trial", "existence": "Report linked in the original parent stored summary evidence/citation lists. External public availability, access and current acquisition of the original are unverified.", "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread", "study_family": "Original report R01; unique counts and independent replication unverified", "independent_replication": "Roberts and Fyfe have separate preserved bibliographies; the parent and both subclaim sheets share these reports. Roberts longer-term MRI/strength and acute signaling, and Fyfe fiber/strength outcomes are different results. Acute/longer-term cohort relationships, overlap with related reports and unique-trial/participant totals are unverified. Multiple measures, subgroups, repeated measurements, sheets and reports are not summed into new participants or independent replications.", "observed_result": "Active recovery 309±73 g vs CWI 103±71 g; difference -206 g, P<.001", "result_level": "12-week MRI gain comparison with active recovery. Preserve 24 assigned/21 completed, 309±73 g versus 103±71 g, original difference -206 g/P<.001 and parent d=-4.1. Both groups gained muscle. Complete-case analysis is distinguished from unverified arm denominators, ± definitions, prospective hierarchy and 95% CIs. No new difference/effect/CI or attrition count is calculated.", "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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred." }, { "material_type": "External abstract", "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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred." }, { "material_type": "External full text", "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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is 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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is 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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred." }, { "material_type": "Analysis plan and original tables", "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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. This does not establish no registration; no new identifier/URL, prospective status or external reading is inferred." }, { "material_type": "Intervention and harms", "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": "Preserve original PubMed URL, PMID 26174323, DOI 10.1113/JP270570, PMCID PMC4594298 and bibliographic wording unchanged. Original evidence summaries lack a registration-identifier field and citation registration wording is unrecorded. 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Cold water immersion attenuates anabolic signaling and skeletal muscle fiber hypertrophy, but not strength gain, following whole-body resistance training. J Appl Physiol. 2019;127(5):1403-1418. PMID: 31513450. DOI: 10.1152/japplphysiol.00127.2019.", "url": "https://pubmed.ncbi.nlm.nih.gov/31513450/", "report_type": "Seven-week passive-rest controlled resistance-training trial", "existence": "Report linked in the original parent stored summary evidence/citation lists. External public availability, access and current acquisition of the original are unverified.", "acquired_read": "Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread", "study_family": "Original report R02; unique counts and independent replication unverified", "independent_replication": "Roberts and Fyfe have separate preserved bibliographies; the parent and both subclaim sheets share these reports. 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This status is not used in this preparation.", "Partly verified": "Some information in the stored summary was linked during preparation; clinical verification or review is not complete.", "Unverified": "Required direct values, definitions or materials have not been established within the current storage and reading scope. This does not mean zero effect, no papers or failed access.", "Review incomplete": "Awaiting user review, or actual review remains incomplete.", "Not reported": "Used only when original materials were actually read and the outcome was judged unreported. Not used for external materials unread in this work.", "Inaccessible": "Used only when an actual access attempt has a recorded failure. Not used for access that was not attempted in this work.", "Insufficient evidence for the conditions": "Indicates insufficient direct materials for the relevant scope or conditions; it is not a new grade.", "Not applicable": "Used when the reason it does not apply to the original question is stated.", "Conflicting data": "Retains the scope of conflicting statements in original materials; it is not an arbitrary reassessment." }, "study_overlap": { "state": "Unverified", "unique_trial_count": null, "unique_participant_count": null, "reason": "Roberts and Fyfe have separate preserved bibliographies; the parent and both subclaim sheets share these reports. Roberts longer-term MRI/strength and acute signaling, and Fyfe fiber/strength outcomes are different results. Acute/longer-term cohort relationships, overlap with related reports and unique-trial/participant totals are unverified. 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