# Repeated post-exercise cold immersion × smaller hypertrophy gains Verdict 2999 · Evidence Check Stored-material review date: Not recorded Original evidence cut-off: 2026-09-07 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-16 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: 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. - Ingredient, formulation and route: 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. - Measured outcome: 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. - Questions outside this scope: 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 ## Checklist items ### N01 · Which hypertrophy-gain claim is being checked? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original subclaim record and hypertrophy endpoint plans. Muscle loss, all strength outcomes and acute recovery remain distinct. - Required materials and conditions: Selected subclaim and boundaries with other outcomes - Materials to obtain first: Original subclaim record and hypertrophy endpoint plans. Muscle loss, all strength outcomes and acute recovery remain distinct. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N02 · Is subclaim D distinct from parent grade D with 28 points? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original verdict, direction, subclaim records and correction material. Parent values do not fill absent subclaim values. - Required materials and conditions: Original grade, direction and absent values - Materials to obtain first: Original verdict, direction, subclaim records and correction material. Parent values do not fill absent subclaim values. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N03 · Which trainees provide the hypertrophy data? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original population, exclusion, training-history and baseline nutrition/disease tables. A representative population is not assigned to every report. - Required materials and conditions: Population, training history and baseline conditions - Materials to obtain first: Original population, exclusion, training-history and baseline nutrition/disease tables. A representative population is not assigned to every report. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N04 · What were the original repeated-cold-immersion specifications? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exposure specifications, actual temperature, adherence and interruption records. Research specifications are not new cold-water instructions. - Required materials and conditions: Cold exposure specifications and actual adherence - Materials to obtain first: Exposure specifications, actual temperature, adherence and interruption records. Research specifications are not new cold-water instructions. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N05 · How do training region, repetition and duration differ? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Training protocols, load/progression, adherence and measurement times. Different programs are not combined as the same exposure. - Required materials and conditions: Training programs and outcome timing - Materials to obtain first: Training protocols, load/progression, adherence and measurement times. Different programs are not combined as the same exposure. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N06 · What comparison does active recovery provide? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Control specifications, activity/contact and shared training/nutrition records. Active recovery is not substituted for passive rest. - Required materials and conditions: Roberts control and accompanying management - Materials to obtain first: Control specifications, activity/contact and shared training/nutrition records. Active recovery is not substituted for passive rest. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N07 · What are the passive-rest control and different cold specifications? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Fyfe intervention, control, adherence, training and original outcome tables. Temperatures, times and controls remain report-specific. - Required materials and conditions: Fyfe intervention, control and duration - Materials to obtain first: Fyfe intervention, control, adherence, training and original outcome tables. Temperatures, times and controls remain report-specific. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02 ### N08 · What outcome is MRI quadriceps gain? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original MRI tables, measurement/derivation procedures, baseline/end values and denominators. These are not converted into other muscles or strength outcomes. - Required materials and conditions: MRI measurement and change derivation - Materials to obtain first: Original MRI tables, measurement/derivation procedures, baseline/end values and denominators. These are not converted into other muscles or strength outcomes. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N09 · What are the arm-specific gains and P value? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original MRI outcome tables, legends, tests, denominators and intervals. ± is not read as a CI and no new difference is calculated. - Required materials and conditions: Original MRI values, difference and uncertainty - Materials to obtain first: Original MRI outcome tables, legends, tests, denominators and intervals. ± is not read as a CI and no new difference is calculated. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N10 · What original record contains d=-4.1? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original effect derivation, models, intervals and denominators. No new d or CI is estimated. - Required materials and conditions: Definition and derivation of the original effect size - Materials to obtain first: Original effect derivation, models, intervals and denominators. No new d or CI is estimated. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N11 · Were 95% CIs and prospective primary hierarchy verified? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The original explanation lists unverified prospective primary hierarchy and 95% CIs as limitations. Representative MRI-gain/strength endpoint labels do not certify prospective hierarchy. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration, protocols, SAPs, original intervals and sample-size rationale. Metadata and verification of prospective plans remain distinct. - Required materials and conditions: Prospective hierarchy, intervals and sample-size rationale - Materials to obtain first: Registration, protocols, SAPs, original intervals and sample-size rationale. Metadata and verification of prospective plans remain distinct. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N12 · How does less gain differ from muscle loss? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original baseline, end/change tables and analysis scope. Smaller gains are not converted into negative change from baseline. - Required materials and conditions: Change from baseline and between-group comparison - Materials to obtain first: Original baseline, end/change tables and analysis scope. Smaller gains are not converted into negative change from baseline. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N13 · Is type II hypertrophy the same as MRI grams? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original fiber tables, measurement/derivation, regions and denominators/CIs. Fiber area is not converted into MRI grams. - Required materials and conditions: Fiber area versus MRI - Materials to obtain first: Original fiber tables, measurement/derivation, regions and denominators/CIs. Fiber area is not converted into MRI grams. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02 ### N14 · How do maximum-strength outcomes differ from hypertrophy? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original tables, models, denominators and intervals for each strength measure. Null results do not establish 0 effect, equivalence or impairment of all strength outcomes. - Required materials and conditions: Strength-specific results and disagreement - Materials to obtain first: Original tables, models, denominators and intervals for each strength measure. Null results do not establish 0 effect, equivalence or impairment of all strength outcomes. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N15 · Does acute anabolic signaling replace longer-term hypertrophy? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Within-report acute/longer-term distinctions, sample/timing and identity material. Titles alone do not create acute values or new trials. - Required materials and conditions: Linkage of acute/longer-term outcomes and samples - Materials to obtain first: Within-report acute/longer-term distinctions, sample/timing and identity material. Titles alone do not create acute values or new trials. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N16 · Are perceived recovery/soreness and hypertrophy the same goal? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Outcome definitions, timing and cohort material for the same/different questions. Acute recovery is not transferred into hypertrophy benefit. - Required materials and conditions: Boundaries between acute recovery and longer-term adaptation - Materials to obtain first: Outcome definitions, timing and cohort material for the same/different questions. Acute recovery is not transferred into hypertrophy benefit. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N17 · Which stage does the assigned count of 24 describe? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts records 24 assigned/21 completed. Arm assignment denominators, recruitment/eligibility/exclusions and exact sequence-generation/concealment procedures are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm-specific flowcharts, allocation/recruitment and procedures. Overall counts are not automatically assigned as arm or endpoint denominators. - Required materials and conditions: Recruitment/allocation flow and procedures - Materials to obtain first: Arm-specific flowcharts, allocation/recruitment and procedures. Overall counts are not automatically assigned as arm or endpoint denominators. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N18 · Are 21 completers linked to measurement-specific denominators? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm denominators, flow and exclusions in original MRI/strength tables. Completer counts do not replace every outcome's analysis denominator. - Required materials and conditions: Complete-case analysis and outcome denominators - Materials to obtain first: Arm denominators, flow and exclusions in original MRI/strength tables. Completer counts do not replace every outcome's analysis denominator. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N19 · Were withdrawal causes kept distinct from cold-induced harm? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Flowcharts, injury/withdrawal causes, timing and analysis handling. No new attrition counts/rates or causal judgment are created. - Required materials and conditions: Injury/withdrawal causes and timing - Materials to obtain first: Flowcharts, injury/withdrawal causes, timing and analysis handling. No new attrition counts/rates or causal judgment are created. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01 ### N20 · Are 16 participants the fiber/strength denominators? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Fyfe records 16 participants. Arm assignment/completion, fiber/strength analysis denominators and missing biopsy/measurement data and their handling are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Flow, measurement denominators, missing data and analyses. Overall sample size does not replace all endpoint denominators. - Required materials and conditions: Fyfe flow and measurement-specific denominators - Materials to obtain first: Flow, measurement denominators, missing data and analyses. Overall sample size does not replace all endpoint denominators. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R02 ### N21 · What do completer, assigned and actual-use analyses estimate? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts complete-case analysis is recorded. Full-assignment analysis, baseline/load/nutrition adjustment, missingness/sensitivity, actual-exposure estimates and Fyfe analysis details are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: SAPs, actual models, analysis populations and missingness/sensitivity material. No new analysis or adjustment is executed. - Required materials and conditions: Analysis populations, missingness and sensitivity - Materials to obtain first: SAPs, actual models, analysis populations and missingness/sensitivity material. No new analysis or adjustment is executed. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N22 · How were MRI, biopsy and strength assessed? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: MRI, fiber-area and strength measurement names are present, but measurement/derivation procedures, repetition, assessor/analyst allocation awareness, standardization and reliability are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Measurement procedures, assessor/analyst records and repetition/reliability. Measurement names alone do not certify blinding or precision. - Required materials and conditions: Measurement, allocation awareness and reliability - Materials to obtain first: Measurement procedures, assessor/analyst records and repetition/reliability. Measurement names alone do not certify blinding or precision. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N23 · Are contributions of nutrition products, diet and training management known? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Roberts records in-kind nutrition products from Body Science. Actual products, intake/arm distribution, diet/nutrition, training load and observational control are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Nutrition, supplements, training/adherence and shared-management records. Product provision does not establish matched intake or a separate effect. - Required materials and conditions: Nutrition, load, adherence and shared management - Materials to obtain first: Nutrition, supplements, training/adherence and shared-management records. Product provision does not establish matched intake or a separate effect. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N24 · How does an absent registration field differ from prospective endpoint verification? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration, protocols, SAPs and changes linked to the papers. An absent field does not establish no registration or prospective verification. - Required materials and conditions: Registration identity, content, timing and plans - Materials to obtain first: Registration, protocols, SAPs and changes linked to the papers. An absent field does not establish no registration or prospective verification. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N25 · How are longer-term, acute and multiple outcomes in the same report linked? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Registration, recruitment dates and report/cohort/outcome identity. Multiple outcomes or both sheets are not summed as new participants or independent trials. - Required materials and conditions: Overlap across reports, cohorts and outcomes - Materials to obtain first: Registration, recruitment dates and report/cohort/outcome identity. Multiple outcomes or both sheets are not summed as new participants or independent trials. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N26 · What verification level applies to support, interests and original I1? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Support/interest declarations, product distribution, affiliations and investigator roles. No new absence of company-employed authors or analysis/publication involvement is established. - Required materials and conditions: Support, in-kind provision, company roles and historical values - Materials to obtain first: Support/interest declarations, product distribution, affiliations and investigator roles. No new absence of company-employed authors or analysis/publication involvement is established. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N27 · Can two supportive directions generalize to every exposure/population? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Condition-specific original tables, measurements/comparisons and identity material. Different supportive directions are not calculated as one pooled effect. - Required materials and conditions: Directness of measures, controls, training and exposure - Materials to obtain first: Condition-specific original tables, measurements/comparisons and identity material. Different supportive directions are not calculated as one pooled effect. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N28 · What persists after exposure and under other conditions? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original material concerns 12 and 7 weeks of training. Post-training recovery/persistence, other temperatures/timing/frequencies and subgroup effects are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original post-training, other-exposure and subgroup data. No sustained effect beyond original durations is created. - Required materials and conditions: Post-training outcomes, other exposures and subgroups - Materials to obtain first: Original post-training, other-exposure and subgroup data. No sustained effect beyond original durations is created. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N29 · Do hypertrophy measures answer medical-injury or disease-safety questions? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Separate harm/disease-population reports, exposure, events and denominators. Goal-related disadvantage is not converted into medical-harm incidence. - Required materials and conditions: Adverse training-goal adaptation versus medical harm - Materials to obtain first: Separate harm/disease-population reports, exposure, events and denominators. Goal-related disadvantage is not converted into medical-harm incidence. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N30 · What material was actually read here? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: The complete parent 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Report-specific abstracts, full texts, registration/plans, original tables, support material and actual reading records. Bibliography/PMCID presence does not mean full-text reading. - Required materials and conditions: Reading scope of stored summaries and external originals - Materials to obtain first: Report-specific abstracts, full texts, registration/plans, original tables, support material and actual reading records. Bibliography/PMCID presence does not mean full-text reading. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N31 · Are historical verification and current production/review distinct? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Complete actual correction/evidence-update records. Original dates are not production/review dates and do not certify no external corrections. - Required materials and conditions: Original evidence date, corrections and historical checks - Materials to obtain first: Complete actual correction/evidence-update records. Original dates are not production/review dates and do not certify no external corrections. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N32 · Were gain/loss boundaries in both original languages preserved? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Complete needed original reports, translations and corrections. Original bilingual distinctions do not create new verification or broader claims. - Required materials and conditions: Correspondence of original languages and scope - Materials to obtain first: Complete needed original reports, translations and corrections. Original bilingual distinctions do not create new verification or broader claims. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N33 · How are parent axes and absent subclaim values retained? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Actual axis/subclaim-record correction material. Parent axes/scores do not fill absent subclaim values. - Required materials and conditions: Original axes and selected-field boundaries - Materials to obtain first: Actual axis/subclaim-record correction material. Parent axes/scores do not fill absent subclaim values. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ### N34 · Which medical adverse events were collected? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Original safety is Caution and medical adverse-event rates are explicitly unverified. Actual harm definitions, collection/assessors and original event tables are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Harm definitions, collection and withdrawal/event tables. Caution does not establish actual incidence, no harm or safety certification. - Required materials and conditions: Harm definitions, collection, assessment and original events - Materials to obtain first: Harm definitions, collection and withdrawal/event tables. Caution does not establish actual incidence, no harm or safety certification. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N35 · How do exposure, injury, interruption and follow-up times differ? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Exposure, event, interruption and later timelines. Training duration is not substituted for harm follow-up duration. - Required materials and conditions: Exposure duration versus event/follow-up time - Materials to obtain first: Exposure, event, interruption and later timelines. Training duration is not substituted for harm follow-up duration. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N36 · Were harms compared equally with active/passive controls? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Active recovery and passive rest controls are preserved. Matched harm collection, observation periods and original direct medical-risk comparisons by arm are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Arm-specific harm collection, periods and withdrawal/event tables. A control arm alone does not establish matched collection or a direct risk comparison. - Required materials and conditions: Arm-specific harm collection, duration and direct comparison - Materials to obtain first: Arm-specific harm collection, periods and withdrawal/event tables. A control arm alone does not establish matched collection or a direct risk comparison. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N37 · What are harm event counts and exposure/observation denominators? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: Preserve original 24 assigned/21 completed and the separate 16 participants. Medical-harm event counts, exposure/observation denominators and arm-specific interruptions are unverified. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Original harm tables, actual exposure/observation flow and interruptions. Trial counts do not establish harm denominators or 0 events. - Required materials and conditions: Original medical-harm events and denominators - Materials to obtain first: Original harm tables, actual exposure/observation flow and interruptions. Trial counts do not establish harm denominators or 0 events. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N38 · Are injury, training load, nutrition and exposure causality distinguished? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Injury timing, training/nutrition, baseline risks and causal-assessment records. No new medical causality is established. - Required materials and conditions: Baseline risk, accompanying management and causal assessment - Materials to obtain first: Injury timing, training/nutrition, baseline risks and causal-assessment records. No new medical causality is established. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N39 · Are interruptions/withdrawals linked to missing harm data? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Interruption/withdrawal reasons, harm records, follow-up and published tables. Missing data do not establish no harm. - Required materials and conditions: Interruption, data loss, selective reporting and follow-up - Materials to obtain first: Interruption/withdrawal reasons, harm records, follow-up and published tables. Missing data do not establish no harm. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N40 · What independent, disease-population or later harm material is available? Verification status: Unverified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: Related harm/disease-population, exposure/collection/denominator and later material. No safety or risk certification beyond the original scope is created. - Required materials and conditions: Direct medical-harm evidence and other populations - Materials to obtain first: Related harm/disease-population, exposure/collection/denominator and later material. No safety or risk certification beyond the original scope is created. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: R01, R02 ### N41 · Are conditions, method copies, application and review separate? Verification status: Partly verified Reading scope: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread - Current findings: 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. - Why unverified: The selected claim, parent material and reports are distinguished and transferred from the stored summary. Detailed original material is unverified and review of existing content remains incomplete. This does not establish completed clinical review or certification. - Reason for missing information: 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. - Required materials and conditions: Condition freezing, observations and change records - Materials to obtain first: 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. - Further 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. - Conditions for verification: 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. - Why this condition is needed: 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 exceptions: 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. - Remaining uncertainty: External original material is unread and review of existing content remains incomplete. Original grades, scores, axes, historical verification and independence statements are not treated as new verdicts or certification. - Referenced methods: Preserved C/E/H application conditions concerning questions, populations, interventions, comparators, reports versus studies, endpoints, denominators and harms were referenced. - Related sources: ## Evidence and sources ### R01 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. [PubMed](https://pubmed.ncbi.nlm.nih.gov/26174323/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Active recovery 309±73 g vs CWI 103±71 g; difference -206 g, P<.001 Record 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. 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. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | 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. | | External abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | External full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Analysis plan and original tables | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Intervention and harms | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | | Support and interests | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | 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. | ### R02 Fyfe JJ et al. 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. [PubMed](https://pubmed.ncbi.nlm.nih.gov/31513450/) Materials actually read: Stored summary read; external abstracts, full texts, registration, protocols, SAPs and support disclosures unread Findings recorded in the summary: Less type II hypertrophy; no clear maximum-strength attenuation Record level: Separate trial of 16 participants over 7 weeks. Preserve both the direction of less type II fiber hypertrophy and the original summary of no clear maximum-strength attenuation. Exact fiber/strength values, units, effects/CIs, measurement denominators and other fiber outcomes are unverified. These are not converted into MRI grams or impairment of every strength outcome. 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. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Stored existing review summary | Preserved copy of the complete parent-verdict stored summary | Stored summary | Summary read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | External abstract | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | External full text | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | Registration material | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | Protocol | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | Analysis plan and original tables | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | Intervention and harms | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | | Support and interests | Original bibliographic link or needed material; external public availability/access status unverified | Unread; access not attempted | Not read | Preserve original PubMed URL, PMID 31513450, DOI 10.1152/japplphysiol.00127.2019, PMCID unrecorded 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. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Existing methodological links were reused for production. External originals were not reread and methodological content was not reassessed. ## What the statuses mean - Met: The original content has been reviewed as meeting the conditions. 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. ## Change history 2026-10-16 · Public page/materials 1.0. The reader view and materials were prepared from the existing 41 items. No new clinical search, verification-status changes or scoring were performed.