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sha256 3588d39a00c73774816c203c16b40f21b5293f5c1c481a614a8e958ebde3436d

by researka:v2 · 2026-06-29 00:28:37.701517+04:00

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The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect.", "type": "claim"}, {"id": "claim_4", "text": "The conclusion is that Mitochondrial DNA damage remains a bounded geroscience case: the retained clinical and adjacent evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified anti-aging claim.", "type": "claim"}, {"id": "claim_5", "text": "This manuscript is reported as a Thin-corpus evidence brief. A deterministic protocol governed source retrieval, screening, extraction, and synthesis; the protocol was frozen before manuscript rendering. The full audit trail is in the supplementary `methods_pack.json` and the timestamped submission directory `synthesis-mitochondrial_dna_damage-v06-DAILY-2026-06-28T20-23-21Z-R2`.", "type": "claim"}, {"id": "claim_6", "text": "The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text.", "type": "claim"}, {"id": "claim_7", "text": "Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification.", "type": "claim"}, {"id": "claim_8", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, cognitive, contextual adjacent evidence, deficiency prevalence, longevity, mechanism, muscle function); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates.", "type": "claim"}, {"id": "claim_9", "text": "Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified.", "type": "claim"}, {"id": "claim_10", "text": "The principal limitation is evidence-role imbalance. The retained corpus contains no sources classified primarily as direct interventional hard-endpoint evidence, 11 adjacent clinical sources, and 4 mechanistic or model-system sources, which means causal interpretation depends on how much weight is assigned to each evidence tier.", "type": "claim"}, {"id": "claim_11", "text": "A second limitation is endpoint heterogeneity. Study-level signals span no dominant outcome class, the contextual adjacent evidence and mechanism outcome classes, the cardiometabolic and muscle function outcome classes, and no dominant outcome class; these domains cannot be pooled narratively without losing clinically relevant differences in measurement, population, and study design.", "type": "claim"}, {"id": "claim_12", "text": "For Mitochondrial DNA damage, the final interpretation is deliberately tiered: the retained clinical and adjacent evidence profile defines a bounded geroscience rationale, but the corpus does not support treating mechanistic target engagement, intermediate biomarkers, and patient-relevant outcomes as interchangeable evidence. The closing claim should therefore be read as a map of what the retained studies can support, not as a clinical recommendation or a general anti-aging endorsement. Positive signals identify hypotheses and candidate contexts; null, mixed, or adverse signals identify the boundaries that future work must test directly. The evidence hierarchy remains load-bearing here: direct interventional hard-endpoint records carry more interpretive weight than adjacent clinical evidence, and both carry more translational weight than mechanistic or model systems. A stronger future conclusion would require larger direct human samples, prespecified endpoints, longer follow-up, comparable intervention characterization, transparent safety capture, and a consistent direction of effect across clinically proximate outcomes. Until that evidence exists, the paper's conclusion is that the topic is worth structured follow-up only within the boundaries defined by the included source set. That boundary is not a weakness in the paper; it is the main claim that keeps the synthesis reusable. Readers should carry forward the evidence classes separately: favorable mechanistic or surrogate findings can motivate experiments, indirect human findings can prioritize populations and endpoints, and direct clinical findings define the current ceiling for applied interpretation. Pending further trials, the intervention should not be used off-label for geroprotection or anti-aging purposes outside clinical-trial settings given current evidence. Any downstream use should preserve that tiered reading rather than compressing the corpus into a simple yes/no verdict for clinical practice or public messaging.", "type": "claim"}, {"id": "claim_13", "text": "Tension-accounting note: disagreement counts are claim-level. Substantive tension still remains between biomarker-elevating studies and mixed/null clinical-endpoint studies, so these contrasts are treated as unresolved evidence gaps.", "type": "claim"}, {"id": "claim_14", "text": "Additional corpus sources included animal/preclinical evidence; findings Map completeness note: all 15 admitted manifest rows are surfaced below (Ng 2019, Pena 2024, Gureev 2022, Hsiao 2026, Reid 2023, Kennedy 2025, Shimizu 2026, Liang 2022, Chan 2012, Picca 2019, Chakraborty 2026, Roca-Bayerri 2020, Perez-Perez 2025, Picca 2020, Luo 2024).", "type": "claim"}, {"id": "claim_15", "text": "In animal/preclinical evidence, Ng 2019: Mitochondrial DNA Damage Does Not Determine C. elegans Lifespan: outcome=Mechanism/Longevity (C. elegans); direction=null; directness=mechanistic; tier=C1; finding=representative statistic p < 0.0001; source-level statistic reported.", "type": "claim"}, {"id": "claim_16", "text": "Pena 2024: G2019S selective LRRK2 kinase inhibitor abrogates mitochondrial DNA damage: outcome=Biomarker/Adjacent Evidence; direction=mixed; directness=indirect; tier=B2; finding=representative non-significant statistic p = 0.92; not treated as positive or negative directional support unless source direction is coded.", "type": "claim"}, {"id": "claim_17", "text": "In animal/preclinical evidence, Gureev 2022: Age-Related Decline in Nrf2/ARE Signaling Is Associated with the Mitochondrial DNA Damage and Cognitive Impairments: outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2; finding=representative statistic p < 0.01; source-level statistic reported.", "type": "claim"}, {"id": "claim_18", "text": "Hsiao 2026: Airway microbial dysbiosis and oxidative mitochondrial DNA damage in the development of bronchopulmonary dysplasia: outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2; finding=representative statistic p<0.05; source-level statistic reported.", "type": "claim"}, {"id": "claim_19", "text": "Reid 2023: Integrative blood-based characterization of oxidative mitochondrial DNA damage variants implicates Mexican American’s metabolic risk for developing Alzheimer’s disease: outcome=Biomarker/Adjacent Cognitive; direction=negative; directness=indirect; tier=B2; finding=representative statistic P = 0.0007; source-level statistic reported.", "type": "claim"}, {"id": "claim_20", "text": "Kennedy 2025: Methods for Mitochondrial DNA Damage and Depletion in Immortalized Trabecular Meshwork Cells: outcome=Mechanism/Contextual Adjacent Evidence (cell/in vitro); direction=unclear; directness=indirect; tier=B2; finding=representative statistic p < 0.0001; source-level statistic reported.", "type": "claim"}, {"id": "claim_21", "text": "Shimizu 2026: A PUFA-rich diet increases endogenous genotoxic stress and mitochondrial DNA damage in mice: outcome=Mechanism/Cardiometabolic (mouse); direction=negative; directness=mechanistic; tier=C1; finding=representative statistic P < 0.05; source-level statistic reported.", "type": "claim"}, {"id": "claim_22", "text": "Liang 2022: Effects of Treadmill Exercise on Mitochondrial DNA Damage and Cardiomyocyte Telomerase Activity in Aging Model Rats Based on Classical Apoptosis Signaling Pathway: outcome=Mechanism (rodent); direction=null; directness=mechanistic; tier=C1; finding=representative statistic P < 0.05; source-level statistic reported.", "type": "claim"}, {"id": "claim_23", "text": "Chan 2012: Simultaneous Quantification of Mitochondrial DNA Damage and Copy Number in Circulating Blood: A Sensitive Approach to Systemic Oxidative Stress: outcome=Biomarker/Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; finding=representative statistic P < 0.01; source-level statistic reported.", "type": "claim"}, {"id": "claim_24", "text": "Chakraborty 2026: F2,6BP restores mitochondrial genome integrity in Huntington’s disease: outcome=Contextual Adjacent Evidence; direction=positive; directness=indirect; tier=B2; finding=representative statistic p < 0.005; source-level statistic reported.", "type": "claim"}, {"id": "claim_25", "text": "Substantive evidence synthesis: The manifest includes 15 retained sources, 0 direct-source row(s), and receipt-level directional coding across negative=2, null=2, unclear=11. Receipt-level direction is not a statement that the source abstracts lack directional statistics; source-level signals are reported separately. Full source-level signals are: Pena 2024: outcome=Biomarker/Adjacent Evidence; direction=mixed; directness=indirect; tier=B2; result=G2019S selective LRRK2 kinase inhibitor abrogates mitochondrial DNA damage; finding=representative non-significant statistic p = 0.92; not treated as positive or negative directional support unless source direction is coded; claims=50; Gureev 2022: outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2; result=Age-Related Decline in Nrf2/ARE Signaling Is Associated with the Mitochondrial DNA Damage and Cognitive Impairments; finding=representative statistic p < 0.01; source-level statistic reported; claims=48; Hsiao 2026: outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2; result=Airway microbial dysbiosis and oxidative mitochondrial DNA damage in the development of bronchopulmonary dysplasia; finding=representative statistic p<0.05; source-level statistic reported; claims=32; Reid 2023: outcome=Biomarker/Adjacent Cognitive; direction=negative; directness=indirect; tier=B2; result=Integrative blood-based characterization of oxidative mitochondrial DNA damage variants implicates Mexican American’s; finding=representative statistic P = 0.0007; source-level statistic reported; claims=27; Kennedy 2025: outcome=Mechanism/Contextual Adjacent Evidence (cell/in vitro); direction=unclear; directness=indirect; tier=B2; result=Methods for Mitochondrial DNA Damage and Depletion in Immortalized Trabecular Meshwork Cells; finding=representative statistic p < 0.0001; source-level statistic reported; claims=27; Shimizu 2026: outcome=Mechanism/Cardiometabolic (mouse); direction=negative; directness=mechanistic; tier=C1; result=A PUFA-rich diet increases endogenous genotoxic stress and mitochondrial DNA damage in mice; finding=representative statistic P < 0.05; source-level statistic reported; claims=26; Chan 2012: outcome=Biomarker/Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; result=Simultaneous Quantification of Mitochondrial DNA Damage and Copy Number in Circulating Blood: A Sensitive Approach to; finding=representative statistic P < 0.01; source-level statistic reported; claims=21; Picca 2019: outcome=Biomarker/Adjacent Muscle Function; direction=unclear; directness=indirect; tier=B2; result=Advanced Age Is Associated with Iron Dyshomeostasis and Mitochondrial DNA Damage in Human Skeletal Muscle; finding=representative statistic p = 0.0002; source-level statistic reported; claims=17; Chakraborty 2026: outcome=Contextual Adjacent Evidence; direction=positive; directness=indirect; tier=B2; result=F2,6BP restores mitochondrial genome integrity in Huntington’s disease; finding=representative statistic p < 0.005; source-level statistic reported; claims=14; Roca-Bayerri 2020: outcome=Biomarker/Adjacent Deficiency Prevalence; direction=unclear; directness=indirect; tier=B2; result=Mitochondrial DNA Damage and Brain Aging in Human Immunodeficiency Virus; finding=representative statistic P < .05; source-level statistic reported; claims=14; Perez-Perez 2025: outcome=Mechanism (mouse); direction=unclear; directness=mechanistic; tier=C1; result=Mitochondrial DNA Damage and Histological Features in Liver Tissue of Azoxymethane-Treated Apex1 Haploinsufficient Mice; finding=representative statistic p = 0.0003; source-level statistic reported; claims=12; Picca 2020: outcome=Biomarker/Adjacent Muscle Function; direction=unclear; directness=indirect; tier=B2; result=Altered Expression of Mitoferrin and Frataxin, Larger Labile Iron Pool and Greater Mitochondrial DNA Damage in the; finding=representative statistic p = 0.0002; source-level statistic reported; claims=9; Luo 2024: outcome=Biomarker/Adjacent Muscle Function; direction=negative; directness=indirect; tier=B2; result=Cancerous Conditions Accelerate the Aging of Skeletal Muscle via Mitochondrial DNA Damage; finding=7 extracted claim(s); receipt-level direction is the coded finding; claims=7; Ng 2019: outcome=Mechanism/Longevity (C. elegans); direction=null; directness=mechanistic; tier=C1; result=Mitochondrial DNA Damage Does Not Determine C. elegans Lifespan; finding=representative statistic p < 0.0001; source-level statistic reported; claims=60; Liang 2022: outcome=Mechanism (rodent); direction=null; directness=mechanistic; tier=C1; result=Effects of Treadmill Exercise on Mitochondrial DNA Damage and Cardiomyocyte Telomerase Activity in Aging Model Rats; finding=representative statistic P < 0.05; source-level statistic reported; claims=23. Contextual-adjacent subdomain map:  - biology-mechanism and molecular-context evidence: Pena 2024, Gureev 2022, Hsiao 2026, Kennedy 2025, Chan 2012, Chakraborty 2026  These signals inform the bounded conclusion by separating effect direction from evidence tier/directness; indirect, review-level, mechanistic, or contextual evidence remains hypothesis-generating.", "type": "claim"}, {"id": "claim_26", "text": "Additional corpus sources included animal/preclinical evidence; manifest outcome-class count summary: Contextual Adjacent Evidence: admitted n=6 (mixed=1, negative=2, positive=1, unclear=2); leading sources: Pena 2024, Gureev 2022, Hsiao 2026; Muscle Function: admitted n=3 (negative=1, unclear=2); leading sources: Picca 2019, Picca 2020, Luo 2024; Mechanism: admitted n=2 (null=1, unclear=1); leading sources: Liang 2022, Perez-Perez 2025; Cardiometabolic: admitted n=1 (negative=1); leading sources: Shimizu 2026; Cognitive: admitted n=1 (negative=1); leading sources: Reid 2023.", "type": "claim"}, {"id": "claim_27", "text": "Ng 2019: Mitochondrial DNA Damage Does Not Determine C. elegans Lifespan; representative statistic p < 0.0001; source-level statistic reported; outcome=Mechanism/Longevity (C. elegans); direction=null; directness=mechanistic; tier=C1.", "type": "claim"}, {"id": "claim_28", "text": "Pena 2024: G2019S selective LRRK2 kinase inhibitor abrogates mitochondrial DNA damage; representative non-significant statistic p = 0.92; not treated as positive or negative directional support unless source direction is coded; outcome=Biomarker/Adjacent Evidence; direction=mixed; directness=indirect; tier=B2.", "type": "claim"}, {"id": "claim_29", "text": "Gureev 2022: Age-Related Decline in Nrf2/ARE Signaling Is Associated with the Mitochondrial DNA Damage and Cognitive Impairments; representative statistic p < 0.01; source-level statistic reported; outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2.", "type": "claim"}, {"id": "claim_30", "text": "Hsiao 2026: Airway microbial dysbiosis and oxidative mitochondrial DNA damage in the development of bronchopulmonary dysplasia; representative statistic p<0.05; source-level statistic reported; outcome=Biomarker/Adjacent Evidence; direction=negative; directness=indirect; tier=B2.", "type": "claim"}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41531-024-00660-y", "effect": "not extracted", "endpoint": "not extracted", "id": "source_1", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "G2019S selective LRRK2 kinase inhibitor abrogates mitochondrial DNA damage", "type": "source", "url": "https://doi.org/10.1038/s41531-024-00660-y", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/ijms232315197", "effect": "not extracted", "endpoint": "not extracted", "id": "source_2", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Age-Related Decline in Nrf2/ARE Signaling Is Associated with the Mitochondrial DNA Damage and Cognitive Impairments", "type": "source", "url": "https://doi.org/10.3390/ijms232315197", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1183/23120541.00874-2025", "effect": "not extracted", "endpoint": "not extracted", "id": "source_3", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Airway microbial dysbiosis and oxidative mitochondrial DNA damage in the development of bronchopulmonary dysplasia", "type": "source", "url": "https://doi.org/10.1183/23120541.00874-2025", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/ijms26136255", "effect": "not extracted", "endpoint": "not extracted", "id": "source_4", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Methods for Mitochondrial DNA Damage and Depletion in Immortalized Trabecular Meshwork Cells", "type": "source", "url": "https://doi.org/10.3390/ijms26136255", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-023-41190-6", "effect": "not extracted", "endpoint": "not extracted", "id": "source_5", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Integrative blood-based characterization of oxidative mitochondrial DNA damage variants implicates Mexican American’s metabolic risk for developing Alzheimer’s disease", "type": "source", "url": "https://doi.org/10.1038/s41598-023-41190-6", "year": 2023}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s41021-026-00360-4", "effect": "not extracted", "endpoint": "not extracted", "id": "source_6", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "A PUFA-rich diet increases endogenous genotoxic stress and mitochondrial DNA damage in mice", "type": "source", "url": "https://doi.org/10.1186/s41021-026-00360-4", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1155/2022/3529499", "effect": "not extracted", "endpoint": "not extracted", "id": "source_7", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of Treadmill Exercise on Mitochondrial DNA Damage and Cardiomyocyte Telomerase Activity in Aging Model Rats Based on Classical Apoptosis Signaling Pathway", "type": "source", "url": "https://doi.org/10.1155/2022/3529499", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.jbc.2026.111156", "effect": "not extracted", "endpoint": "not extracted", "id": "source_8", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "F2,6BP restores mitochondrial genome integrity in Huntington’s disease", "type": "source", "url": "https://doi.org/10.1016/j.jbc.2026.111156", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1093/cid/ciaa984", "effect": "not extracted", "endpoint": "not extracted", "id": "source_9", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Mitochondrial DNA Damage and Brain Aging in Human Immunodeficiency Virus", "type": "source", "url": "https://doi.org/10.1093/cid/ciaa984", "year": 2020}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/biom15121706", "effect": "not extracted", "endpoint": "not extracted", "id": "source_10", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Mitochondrial DNA Damage and Histological Features in Liver Tissue of Azoxymethane-Treated Apex1 Haploinsufficient Mice", "type": "source", "url": "https://doi.org/10.3390/biom15121706", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/cells9122579", "effect": "not extracted", "endpoint": "not extracted", "id": "source_11", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Altered Expression of Mitoferrin and Frataxin, Larger Labile Iron Pool and Greater Mitochondrial DNA Damage in the Skeletal Muscle of Older Adults", "type": "source", "url": "https://doi.org/10.3390/cells9122579", "year": 2020}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/ijms25137060", "effect": "not extracted", "endpoint": "not extracted", "id": "source_12", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Cancerous Conditions Accelerate the Aging of Skeletal Muscle via Mitochondrial DNA Damage", "type": "source", "url": "https://doi.org/10.3390/ijms25137060", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fgene.2019.00311", "effect": "not extracted", "endpoint": "not extracted", "id": "source_13", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Mitochondrial DNA Damage Does Not Determine C. elegans Lifespan", "type": "source", "url": "https://doi.org/10.3389/fgene.2019.00311", "year": 2019}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1155/2013/157547", "effect": "not extracted", "endpoint": "not extracted", "id": "source_14", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Simultaneous Quantification of Mitochondrial DNA Damage and Copy Number in Circulating Blood: A Sensitive Approach to Systemic Oxidative Stress", "type": "source", "url": "https://doi.org/10.1155/2013/157547", "year": 2012}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/cells8121525", "effect": "not extracted", "endpoint": "not extracted", "id": "source_15", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Advanced Age Is Associated with Iron Dyshomeostasis and Mitochondrial DNA Damage in Human Skeletal Muscle", "type": "source", "url": "https://doi.org/10.3390/cells8121525", "year": 2019}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_16", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Outcome class** is assigned from the source's bound endpoint, population, and claim text; adjacent/background sources are separated from clinical outcome slices.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_17", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Directness** is coded as direct only when a source tests the topic against a clinically proximate outcome in the relevant population; a qualifying direct source would be a human interventional or hard-endpoint study of the topic itself. Indirect human, review-level, and mechanistic sources are weighted separately.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_18", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Directional signal** is counted within the assigned outcome class only. A `no extracted directional signal` cell means the retained sources in that outcome slice did not yield a coded positive, negative, or mixed direction for that slice; it is not a claim that the source reports no associations anywhere else.", "type": "source", "url": null, "year": null}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_19", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "**Evidence tier** follows the deterministic tier/directness taxonomy used in the source builder; the prose writer cannot move a source between classes after sources are frozen.", "type": "source", "url": null, "year": null}], "publication_id": "82831700-7ed3-4b2a-87cf-b14d27b3ea02", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 15, "included": 15, "included_or_retained": 15, "screened": 15, "wording": "15 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit."}}
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