Derivation Web

source_bcb735d229f14476

by researka:v2 · 2026-07-02 00:09:59.615885+04:00

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The conclusion therefore does not support broad causal, clinical, or policy claims.", "type": "claim"}, {"id": "claim_2", "text": "This synthesis tests the thesis that evidence for Calcium Supplementation Effects is context-dependent, separating outcome-specific signals from broader claims and identifying the evidence gaps that should bound interpretation.", "type": "claim"}, {"id": "claim_3", "text": "Calcium supplementation has long been proposed as a low-cost public-health lever for bone, cardiovascular, and pregnancy-related outcomes, yet contemporary evidence has been complicated by discrepant findings across indications, populations, and dosing regimens.", "type": "claim"}, {"id": "claim_4", "text": "We conducted an AI-assisted structured evidence synthesis across the curated source set, applying a transparent audit trail in which each study was tagged for design, directness, outcome class, and direction of effect before integration.", "type": "claim"}, {"id": "claim_5", "text": "Across the corpus, the evidence base is context-dependent rather than uniformly favorable: pre-eclampsia prevention, certain insulin-related endpoints, and selected bone-fracture outcomes show benefit, while older-adult and pregnancy inflammation biomarkers, recurrent cardiovascular events, and several body-composition endpoints remain null or unfavorable, with mechanistic plausibility (Ioannidis 2005) coexisting alongside sparse or mixed human-RCT confirmation.", "type": "claim"}, {"id": "claim_6", "text": "We conclude that calcium supplementation should not be framed as a monolithic intervention: the most defensible indications remain high-risk pregnancy, while bone-fracture benefit in community-dwelling older adults and cardiovascular safety in at-risk populations remain insufficiently resolved and warrant further direct, outcome-stratified randomized evaluation.", "type": "claim"}, {"id": "claim_7", "text": "Evidence-abstraction note.** The 36 retained reference papers are not 36 independent primary clinical trials: 24 are review, indirect, mechanistic, or registered-protocol source-level summaries, and 12 are classified as direct interventional evidence. Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence.", "type": "claim"}, {"id": "claim_8", "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-calcium_supplementation_effects-v06-DAILY-2026-07-01T12-45-35Z-R2`.", "type": "claim"}, {"id": "claim_9", "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_10", "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_11", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, dosing and pharmacokinetics, immune and inflammation, longevity, muscle function, skeletal, fracture, and bone); 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_12", "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_13", "text": "Additional corpus sources included animal/preclinical evidence; | Source | Outcome class | Direction | Directness | Tier | Finding |", "type": "claim"}, {"id": "claim_14", "text": "| Chen 2022 | Cardiometabolic | null | review | B2 | 27 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_15", "text": "| Cormick 2020 | Cardiometabolic | unclear | indirect | B2 | representative non-significant statistic P = .408; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_16", "text": "| Cormick 2023 | Cardiometabolic | null | review | B2 | 20 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_17", "text": "| Cormick 2024 | Cardiometabolic | null | review | B1 | representative non-significant statistic P = 0.45; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_18", "text": "| Dwarkanath 2024 | Cardiometabolic | null | direct | A1 | 24 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_19", "text": "| Fu 2022 | Cardiometabolic | null | review | B2 | representative non-significant statistic P = 0.65; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_20", "text": "| Imdad 2011 | Cardiometabolic | null | review | B2 | 50 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_21", "text": "| Korhonen 2022 | Cardiometabolic | unclear | review | B1 | representative non-significant statistic P > 0.05; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_22", "text": "| Souza 2014 | Cardiometabolic | null | direct | A1 | representative non-significant statistic P=0.112; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_23", "text": "| Zhang 2026 | Cardiometabolic | null | indirect | B2 | 52 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_24", "text": "| Zhang 2020 | Longevity | unclear | review | B2 | representative non-significant statistic P = 0.45; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_25", "text": "| Gupta 2010 | Muscle Function | null | direct | A1 | 4 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_26", "text": "| Coombs 2023 | Skeletal, Fracture, and Bone | null | direct | A1 | 18 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_27", "text": "Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim.", "type": "claim"}, {"id": "claim_28", "text": "| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |", "type": "claim"}, {"id": "claim_29", "text": "Direction reconciliation: receipt-level null or unclear coding is conservative claim-level coding. Significant but polarity-unsigned statistics remain unclear unless the extraction records a positive, negative, or mixed effect direction.", "type": "claim"}, {"id": "claim_30", "text": "Souza 2014 (Aspirin plus calcium supplementation to prevent superimposed preeclampsia: a randomized trial; representative non-significant statistic P=0.112; not treated as positive or negative directional support unless source direction is coded; outcome=Cardiometabolic; direction=null; directness=direct; tier=A1).", "type": "claim"}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1136/bmjopen-2021-060189", "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": "Effects of a multicomponent resistance-based exercise program with protein, vitamin D and calcium supplementation on cognition in men with prostate cancer treated with ADT: secondary analysis of a 12-month randomised controlled trial", "type": "source", "url": "https://doi.org/10.1136/bmjopen-2021-060189", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1111/nyas.14729", "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": "Calcium supplementation during pregnancy and long‐term offspring outcome: a systematic literature review and meta‐analysis", "type": "source", "url": "https://doi.org/10.1111/nyas.14729", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1177/0379572120944671", "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": "The Effect of Calcium Supplementation on Body Weight Before and During Pregnancy in Women Enrolled in the WHO Calcium and Preeclampsia Trial", "type": "source", "url": "https://doi.org/10.1177/0379572120944671", "year": 2020}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1007/s10654-020-00710-8", "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": "Calcium intake, calcium supplementation and cardiovascular disease and mortality in the British population: EPIC-norfolk prospective cohort study and meta-analysis", "type": "source", "url": "https://doi.org/10.1007/s10654-020-00710-8", "year": 2020}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.7554/eLife.79002", "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": "The effect of calcium supplementation in people under 35 years old: A systematic review and meta-analysis of randomized controlled trials", "type": "source", "url": "https://doi.org/10.7554/eLife.79002", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.preghy.2020.11.012", "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": "The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: A randomized placebo-controlled study", "type": "source", "url": "https://doi.org/10.1016/j.preghy.2020.11.012", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12884-023-06235-8", "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 calcium supplementation on changes in the IL2, IL4, IL6, IL10 axes and oxidative stress in pregnant women at risk for pre-eclampsia", "type": "source", "url": "https://doi.org/10.1186/s12884-023-06235-8", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.18632/aging.202485", "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": "The joint effect of energy reduction with calcium supplementation on the risk factors of type 2 diabetes in the overweight population: a two-year randomized controlled trial", "type": "source", "url": "https://doi.org/10.18632/aging.202485", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.ajcnut.2024.02.025", "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": "Effects of maternal calcium supplementation on offspring blood pressure and growth in childhood and adolescence in a population with a low-calcium intake: follow-up study of a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1016/j.ajcnut.2024.02.025", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1155/2021/8824753", "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": "Effects of Lemon Beverage Containing Citric Acid with Calcium Supplementation on Bone Metabolism and Mineral Density in Postmenopausal Women: Double-Blind 11-Month Intervention Study", "type": "source", "url": "https://doi.org/10.1155/2021/8824753", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1590/1413-785220253306e284103", "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": "EFFECTS OF CALCIUM SUPPLEMENTATION ON THE RISK OF FRACTURE IN OLDER ADULTS", "type": "source", "url": "https://doi.org/10.1590/1413-785220253306e284103", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1161/JAHA.125.047455", "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": "Association Between Calcium Supplementation and Recurrence of Cardiovascular Events in Patients With Cardiovascular Disease: A Population‐Based Cohort Study", "type": "source", "url": "https://doi.org/10.1161/JAHA.125.047455", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1155/2022/2520695", "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": "The Positive and Negative Effects of Calcium Supplementation on Mortality in Septic ICU Patients Depend on Disease Severity: A Retrospective Study from the MIMIC-III", "type": "source", "url": "https://doi.org/10.1155/2022/2520695", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fmed.2025.1434416", "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": "Effects of calcium supplementation on the prevention of preeclampsia: an umbrella review of systematic reviews and meta-analyses", "type": "source", "url": "https://doi.org/10.3389/fmed.2025.1434416", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1002/ece3.70483", "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": "Increased Reproductive Output and Telomere Shortening Following Calcium Supplementation in a Wild Songbird", "type": "source", "url": "https://doi.org/10.1002/ece3.70483", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/jvim.16715", "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": "Effects of calcium supplementation to resuscitation fluids in endurance horses: A randomized, blinded, clinical trial", "type": "source", "url": "https://doi.org/10.1111/jvim.16715", "year": 2023}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s13063-021-05811-7", "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": "Non-inferiority of low-dose compared to standard high-dose calcium supplementation in pregnancy: study protocol for two randomized, parallel group, non-inferiority trials in India and Tanzania", "type": "source", "url": "https://doi.org/10.1186/s13063-021-05811-7", "year": 2021}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/medicina61071195", "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": "Calcium Supplementation in Pregnancy: A Systematic Review of Clinical Studies", "type": "source", "url": "https://doi.org/10.3390/medicina61071195", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s13063-026-09513-w", "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": "Calcium supplementation for prevention of pre-eclampsia in high-risk women: study protocol for a randomised triple-blind placebo-controlled trial (CaPE)", "type": "source", "url": "https://doi.org/10.1186/s13063-026-09513-w", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fnut.2021.795667", "effect": "not extracted", "endpoint": "not extracted", "id": "source_20", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Different Doses of Calcium Supplementation to Prevent Gestational Hypertension and Pre-Eclampsia: A Systematic Review and Network Meta-Analysis", "type": "source", "url": "https://doi.org/10.3389/fnut.2021.795667", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fneur.2022.970111", "effect": "not extracted", "endpoint": "not extracted", "id": "source_21", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Vitamin D supplementation and risk of stroke: A meta-analysis of randomized controlled trials", "type": "source", "url": "https://doi.org/10.3389/fneur.2022.970111", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1056/NEJMoa2307212", "effect": "not extracted", "endpoint": "not extracted", "id": "source_22", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Two Randomized Trials of Low-Dose Calcium Supplementation in Pregnancy", "type": "source", "url": "https://doi.org/10.1056/NEJMoa2307212", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1136/bmjopen-2022-070677", "effect": "not extracted", "endpoint": "not extracted", "id": "source_23", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Factors affecting the implementation of calcium supplementation strategies during pregnancy to prevent pre-eclampsia: a mixed-methods systematic review", "type": "source", "url": "https://doi.org/10.1136/bmjopen-2022-070677", "year": 2023}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1007/s12603-020-1551-9", "effect": "not extracted", "endpoint": "not extracted", "id": "source_24", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis", "type": "source", "url": "https://doi.org/10.1007/s12603-020-1551-9", "year": 2020}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12891-023-06600-w", "effect": "not extracted", "endpoint": "not extracted", "id": "source_25", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The effect of calcium supplementation on calcium and bone metabolism during load carriage in women: protocol for a randomised controlled crossover trial", "type": "source", "url": "https://doi.org/10.1186/s12891-023-06600-w", "year": 2023}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s40001-025-02412-x", "effect": "not extracted", "endpoint": "not extracted", "id": "source_26", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Vitamin D and calcium supplementation in women undergoing pharmacological management for postmenopausal osteoporosis: a level I of evidence systematic review", "type": "source", "url": "https://doi.org/10.1186/s40001-025-02412-x", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.preghy.2024.101174", "effect": "not extracted", "endpoint": "not extracted", "id": "source_27", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effectiveness of calcium supplementation in the prevention of gestational hypertension: A systematic review and meta-analysis of randomised controlled trials.", "type": "source", "url": "https://doi.org/10.1016/j.preghy.2024.101174", "year": 2024}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1002/14651858.cd012268.pub2", "effect": "not extracted", "endpoint": "not extracted", "id": "source_28", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Calcium supplementation for people with overweight or obesity.", "type": "source", "url": "https://doi.org/10.1002/14651858.cd012268.pub2", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1080/1028415x.2019.1707396", "effect": "not extracted", "endpoint": "not extracted", "id": "source_29", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinical trial.", "type": "source", "url": "https://doi.org/10.1080/1028415x.2019.1707396", "year": 2022}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1371/journal.pone.0109607", "effect": "not extracted", "endpoint": "not extracted", "id": "source_30", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effects of Combined Calcium and Vitamin D Supplementation on Insulin Secretion, Insulin Sensitivity and β-Cell Function in Multi-Ethnic Vitamin D-Deficient Adults at Risk for Type 2 Diabetes: A Pilot Randomized, Placebo-Controlled Trial", "type": "source", "url": "https://doi.org/10.1371/journal.pone.0109607", "year": 2014}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1590/1414-431X20143629", "effect": "not extracted", "endpoint": "not extracted", "id": "source_31", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Aspirin plus calcium supplementation to prevent superimposed preeclampsia: a randomized trial", "type": "source", "url": "https://doi.org/10.1590/1414-431X20143629", "year": 2014}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1371/journal.pone.0108094", "effect": "not extracted", "endpoint": "not extracted", "id": "source_32", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Calcium Supplementation Increases Blood Creatinine Concentration in a Randomized Controlled Trial", "type": "source", "url": "https://doi.org/10.1371/journal.pone.0108094", "year": 2014}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/1471-2458-11-S3-S18", "effect": "not extracted", "endpoint": "not extracted", "id": "source_33", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Role of calcium supplementation during pregnancy in reducing risk of developing gestational hypertensive disorders: a meta-analysis of studies from developing countries", "type": "source", "url": "https://doi.org/10.1186/1471-2458-11-S3-S18", "year": 2011}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu10030294", "effect": "not extracted", "endpoint": "not extracted", "id": "source_34", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Systematic Review of Vitamin D and Hypertensive Disorders of Pregnancy", "type": "source", "url": "https://doi.org/10.3390/nu10030294", "year": 2018}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1161/JAHA.117.005795", "effect": "not extracted", "endpoint": "not extracted", "id": "source_35", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Risk of Ischemic Stroke Associated With Calcium Supplements With or Without Vitamin D: A Nested Case‐Control Study", "type": "source", "url": "https://doi.org/10.1161/JAHA.117.005795", "year": 2017}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/j.1365-2265.2010.03816.x", "effect": "not extracted", "endpoint": "not extracted", "id": "source_36", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effect of cholecalciferol and calcium supplementation on muscle strength and energy metabolism in vitamin D-deficient Asian Indians: a randomized, controlled trial.", "type": "source", "url": "https://doi.org/10.1111/j.1365-2265.2010.03816.x", "year": 2010}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_37", "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_38", "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_39", "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_40", "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}, {"comparator": "not extracted", "directness": "citation", "doi": "10.1371/journal.pmed.0020124", "effect": "not extracted", "endpoint": "not extracted", "id": "source_41", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Ioannidis 2005", "type": "source", "url": "https://doi.org/10.1371/journal.pmed.0020124", "year": null}], "publication_id": "798fcdb7-5e51-43e8-978e-937dfca0ad1c", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 36, "included": 36, "included_or_retained": 36, "screened": 36, "wording": "36 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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