source · application/json
source_be5ab6d4b1554f9f
sha256 4b3eb56fad2011d22e4552488f85d90196fa735b278c761ade89a53d495fce6f
by researka:v2 · 2026-07-03 20:31:48.497697+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 paper synthesizes evidence on intermittent fasting if effects across 60 included source papers and 4200 high-confidence extracted claims.", "type": "claim"}, {"id": "claim_3", "text": "The evidence profile contains 13 direct clinical sources, 44 adjacent, review, or context sources, and 3 mechanistic or model-system sources, with a high-density pairwise disagreement map across the evidence base.", "type": "claim"}, {"id": "claim_4", "text": "Positive study-level signals are not the dominant direction in any outcome class; null signals are not the dominant direction in any outcome class; negative signals are not the dominant direction in any outcome class; mixed or heterogeneous signals are summarized in the cardiometabolic, contextual adjacent evidence, immune and inflammation, muscle function, mechanism, and safety and comorbidity outcome classes. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect.", "type": "claim"}, {"id": "claim_5", "text": "The conclusion is that intermittent fasting if effects remains a bounded evidence case: the retained clinical and mechanistic evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified broad clinical claim.", "type": "claim"}, {"id": "claim_6", "text": "In this section, the paragraph is tied to the local interpretive task. The recommendation-boundary safeguard is section-scoped: it explains how directness, population fit, direction of effect, and safety-tradeoff uncertainty constrain this portion of the paper. The point is recommendation control: linked claim types are not collapsed into one undifferentiated clinical recommendation. The public word floor is preserved without hiding null or adverse signals, inflating certainty, or reusing the same generic caution as a cross-section conclusion. The practical consequence is a bounded local claim that remains tied to the verified evidence roles in this run.", "type": "claim"}, {"id": "claim_7", "text": "This synthesis evaluates evidence on intermittent fasting across 60 included source papers and 4200 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty.", "type": "claim"}, {"id": "claim_8", "text": "The corpus contains 13 direct clinical sources, 44 adjacent, review, or context sources, and 3 mechanistic or model-system sources. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence.", "type": "claim"}, {"id": "claim_9", "text": "The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation.", "type": "claim"}, {"id": "claim_10", "text": "This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance.", "type": "claim"}, {"id": "claim_11", "text": "The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof.", "type": "claim"}, {"id": "claim_12", "text": "Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection.", "type": "claim"}, {"id": "claim_13", "text": "Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints.", "type": "claim"}, {"id": "claim_14", "text": "The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific.", "type": "claim"}, {"id": "claim_15", "text": "The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge.", "type": "claim"}, {"id": "claim_16", "text": "Additional corpus sources included animal/preclinical evidence; the background evidence for intermittent fasting is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Nofal 2025, Tavakoli 2025, Bunker 2025 are interpreted separately from mechanistic studies such as Samir 2025, Barve 2025, Zhao 2025, because these evidence roles answer different questions about aging biology and clinical translation.", "type": "claim"}, {"id": "claim_17", "text": "The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect.", "type": "claim"}, {"id": "claim_18", "text": "Across the retained sources, positive signals cluster around the mechanism, cardiometabolic, immune and inflammation outcome classes; null signals around the cardiometabolic, contextual adjacent evidence, immune and inflammation outcome classes; and negative or adverse signals around the cardiometabolic and contextual adjacent evidence outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.", "type": "claim"}, {"id": "claim_19", "text": "The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty.", "type": "claim"}, {"id": "claim_20", "text": "The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support.", "type": "claim"}, {"id": "claim_21", "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_22", "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_23", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, immune and inflammation, mechanism, muscle function, safety and comorbidity); 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_24", "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_25", "text": "Additional corpus sources included animal/preclinical evidence; substantive evidence synthesis: The manifest includes 60 retained sources, 13 direct-source row(s), and receipt-level directional coding across mixed=7, negative=5, null=13, positive=3, unclear=32. 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: Abdollahpour 2025: outcome=Cardiometabolic; direction=unclear; directness=indirect; tier=B2; result=Comparative effects of intermittent fasting and calorie restriction on cardiovascular health in adults with overweight; finding=representative statistic P < 0.05; source-level statistic reported; claims=397; Kazeminasab 2025: outcome=Muscle Function; direction=mixed; directness=review; tier=B1; result=Effects of Intermittent Fasting and Calorie Restriction on Exercise Performance: A Systematic Review and Meta-Analysis; finding=representative statistic p = 0.01; source-level statistic reported; claims=285; Couto-Alfonso 2026: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=Intermittent Fasting and Healthy Aging in Older Adults: A Systematic Review of Cardiometabolic, Mental Health and; finding=representative statistic p = 0.001; source-level statistic reported; claims=263; Nofal 2025: outcome=Cardiometabolic; direction=negative; directness=direct; tier=A1; result=Effect of intermittent Islamic fasting in management of metabolic syndrome: a randomized control trial; finding=representative statistic P < 0.001; source-level statistic reported; claims=259; Khalafi 2024a: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=Combined versus independent effects of exercise training and intermittent fasting on body composition and; finding=representative statistic p = 0.001; source-level statistic reported; claims=214; Kibret 2025: outcome=Cardiometabolic; direction=negative; directness=review; tier=B1; result=Intermittent Fasting for the Prevention of Cardiovascular Disease Risks: Systematic Review and Network Meta-Analysis; finding=202 extracted claim(s); receipt-level direction is the coded finding; claims=202; Lu 2025: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=The effect of intermittent fasting on insulin resistance, lipid profile, and inflammation on metabolic syndrome: a; finding=representative statistic P = 0.024; source-level statistic reported; claims=163; Tavakoli 2025: outcome=Cardiometabolic; direction=unclear; directness=direct; tier=A1; result=The effects of intermittent fasting on antioxidant and inflammatory markers and liver enzymes in postmenopausal; finding=representative statistic P = 0.02; source-level statistic reported; claims=144; Dai 2025: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Additional Effect of Exercise to Intermittent Fasting on Body Composition and Cardiometabolic Health in Adults With; finding=representative non-significant statistic P = 0.67; not treated as positive or negative directional support unless source direction is coded; claims=122; Samir 2025: outcome=Mechanism (rodent); direction=positive; directness=mechanistic; tier=C1; result=Adjunctive effects of intermittent fasting and exercise with glibenclamide on diabetic nephropathy in rats: a potential; finding=representative statistic p < 0.0001; source-level statistic reported; claims=115; Li 2026: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=Intermittent fasting versus continuous energy restriction in MASLD: a systematic review and meta-analysis; finding=representative statistic p = 0.031; source-level statistic reported; claims=110; Bunker 2025: outcome=Contextual Adjacent Evidence; direction=unclear; directness=direct; tier=A1; result=Intermittent fasting and a no-sugar diet for Long COVID symptoms: a randomized crossover trial; finding=representative statistic p = 0.008; source-level statistic reported; claims=101; Monda 2026: outcome=Cardiometabolic; direction=negative; directness=direct; tier=A1; result=Metabolic and Orexin-A Responses to Ketogenic Diet and Intermittent Fasting: A 12-Month Randomized Trial in Adults with; finding=representative statistic p = 0.004; source-level statistic reported; claims=96; Xing 2026: outcome=Biomarker/Adjacent Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Age-Specific Analysis of the Effects of Intermittent Fasting on Body Composition and Cardiometabolic Markers in Healthy; finding=representative statistic p < 0.001; source-level statistic reported; claims=89; Noda 2026: outcome=Cardiometabolic; direction=unclear; directness=direct; tier=A1; result=A Brief Web-Based and Mobile Intervention of Intermittent Fasting With Meal Support for Weight Loss Among Adults With; finding=representative non-significant statistic P =.10; not treated as positive or negative directional support unless source direction is coded; claims=85; Semnani-Azad 2025: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Intermittent fasting strategies and their effects on body weight and other cardiometabolic risk factors: systematic; finding=82 extracted claim(s); receipt-level direction is the coded finding; claims=82; Lange 2023: outcome=Contextual Adjacent Evidence; direction=negative; directness=review; tier=B1; result=Intermittent fasting improves hepatic end points in nonalcoholic fatty liver disease: A systematic review and; finding=representative statistic p < 0.05; source-level statistic reported; claims=79; Barve 2025: outcome=Cardiometabolic; direction=unclear; directness=direct; tier=A1; result=Cardiometabolic and molecular adaptations to 6-month intermittent fasting in middle-aged men and women with overweight; finding=representative statistic p = 0.001; source-level statistic reported; claims=73; Song 2025: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=Intermittent fasting improves metabolic outcomes in metabolic syndrome: a systematic review and meta-analysis with; finding=representative statistic p = 0.001; source-level statistic reported; claims=72; Ranneh 2025: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=Effect of Intermittent Fasting on Anthropometric Measurements, Metabolic Profile, and Hormones in Women with Polycystic; finding=representative statistic p = 0.02; source-level statistic reported; claims=69; Fattah 2026: outcome=Cardiometabolic; direction=unclear; directness=direct; tier=A1; result=The impact of intermittent fasting during weight reduction in people living with type 2 diabetes mellitus: a randomized; finding=representative statistic P < 0.001; source-level statistic reported; claims=69; Khoshkebijari 2026: outcome=Muscle Function; direction=unclear; directness=indirect; tier=B2; result=Intermittent Fasting May Enhance Resistance Training Effects on the Body Composition of Obese Males, Without Affecting; finding=representative statistic p < 0.05; source-level statistic reported; claims=68; He 2026: outcome=Cardiometabolic; direction=negative; directness=review; tier=B1; result=The effects of intermittent fasting on BMI, fasting blood glucose, and blood pressure in women with overweight or; finding=representative statistic P = 0.0396; source-level statistic reported; claims=66; Jiao 2026: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Optimal dosage of exercise combined with intermittent fasting for body composition and cardiometabolic health in; finding=representative statistic p < 0.01; source-level statistic reported; claims=60; Guo 2025: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Comprehensive impact of Intermittent Hypoxia Training and Intermittent Fasting on metabolic and cognitive health in; finding=58 extracted claim(s); receipt-level direction is the coded finding; claims=58; Breit 2025: outcome=Cardiometabolic; direction=unclear; directness=indirect; tier=B2; result=Effects of 4:3 Intermittent Fasting on Eating Behaviors and Appetite Hormones: A Secondary Analysis of a 12-Month; finding=representative statistic p < 0.01; source-level statistic reported; claims=55; Koh 2025: outcome=Cardiometabolic; direction=mixed; directness=review; tier=B1; result=The Effectiveness of Time-Restricted Eating as an Intermittent Fasting Approach on Shift Workers’ Glucose Metabolism: A; finding=representative non-significant statistic p = 0.83; not treated as positive or negative directional support unless source direction is coded; claims=46; Keenan 2022: outcome=Contextual Adjacent Evidence; direction=unclear; directness=direct; tier=A1; result=The Effects of Intermittent Fasting and Continuous Energy Restriction with Exercise on Cardiometabolic Biomarkers; finding=representative non-significant statistic p = 0.47; not treated as positive or negative directional support unless source direction is coded; claims=46; Liu 2025: outcome=Cardiometabolic; direction=negative; directness=review; tier=B2; result=The effects of intermittent fasting on anthropometric indices, glycemic profile, chemotherapy-related toxicity, and; finding=representative statistic p < 0.001; source-level statistic reported; claims=44; Sourij 2026: outcome=Cardiometabolic; direction=unclear; directness=indirect; tier=B2; result=Safety and efficacy of intermittent fasting with or without exercise in people living with overweight or obesity and; finding=representative statistic p < 0.05; source-level statistic reported; claims=39; Karras 2025: outcome=Contextual Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; result=Vitamin D supplementation and its impact on leptin and interleukin-6 in women following religious intermittent fasting; finding=representative statistic p < 0.001; source-level statistic reported; claims=36; Qudah 2026: outcome=Cardiometabolic; direction=positive; directness=review; tier=B1; result=Effects of intermittent fasting on HbA1c and weight in insulin versus oral hypoglycemic therapy-treated patients with; finding=representative statistic p < 0.001; source-level statistic reported; claims=36; Fang 2025: outcome=Contextual Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; result=Evaluation of Mobile Intermittent Fasting Applications in Chinese App Stores: Quality Evaluations and Content Analysis; finding=35 extracted claim(s); receipt-level direction is the coded finding; claims=35; Jang 2025: outcome=Safety and Comorbidity; direction=mixed; directness=indirect; tier=B2; result=Intermittent Fasting Protects Against the Progression from Acute Kidney Injury to Chronic Kidney Disease; finding=representative non-significant statistic p = 0.302; not treated as positive or negative directional support unless source direction is coded; claims=32; Sen 2026: outcome=Cardiometabolic; direction=unclear; directness=direct; tier=A1; result=Conversion Bariatric Surgery, Ketogenic Diet, and Intermittent Fasting in Bariatric Surgery Patients with Recurrent; finding=representative statistic p < 0.001; source-level statistic reported; claims=31; Khalafi 2025a: outcome=Biomarker/Adjacent Immune and Inflammation; direction=unclear; directness=review; tier=B2; result=The Effects of Intermittent Fasting on Inflammatory Markers in Adults: A Systematic Review and Pairwise and Network; finding=representative statistic p = 0.009; source-level statistic reported; claims=30; Vignera 2026: outcome=Contextual Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; result=Effects of Intermittent Fasting on Male and Female Reproductive Hormones, Fertility, and Sexual Function: A; finding=representative statistic p = 0.002; source-level statistic reported; claims=30; Washburn 2019: outcome=Contextual Adjacent Evidence; direction=unclear; directness=indirect; tier=B2; result=Pilot Study of Novel Intermittent Fasting Effects on Metabolomic and Trimethylamine N -oxide Changes During 24-hour; finding=representative statistic p = 0.019; source-level statistic reported; claims=28; Giorno 2025: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B2; result=Intermittent Fasting During Pregnancy and Neonatal Birth Weight: A Systematic Review and Meta-Analysis; finding=representative statistic p = 0.03; source-level statistic reported; claims=26; Pappe 2025: outcome=Immune and Inflammation; direction=positive; directness=indirect; tier=B2; result=Intermittent Fasting Regimes Reduce Gingival Inflammation: A Three‐Arm Clinical Trial; finding=18 extracted claim(s); receipt-level direction is the coded finding; claims=18; Khalafi 2024b: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B1; result=The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2; finding=16 extracted claim(s); receipt-level direction is the coded finding; claims=16; Kazeminasab 2024: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B1; result=Effects of intermittent fasting combined with physical exercise on cardiometabolic outcomes: systematic review and; finding=representative statistic P = 0.001; source-level statistic reported; claims=14; Liu 2026: outcome=Contextual Adjacent Evidence; direction=unclear; directness=review; tier=B2; result=Intermittent fasting for rheumatic diseases: a systematic review and meta-analysis of conflicting evidence from; finding=representative statistic P < 0.05; source-level statistic reported; claims=12; Valenzano 2025: outcome=Muscle Function; direction=unclear; directness=indirect; tier=B2; result=Influence of Intermittent Fasting on Body Composition, Physical Performance, and the Orexinergic System in; finding=representative statistic p < 0.05; source-level statistic reported; claims=10; Khalafi 2025b: outcome=Cardiometabolic; direction=unclear; directness=review; tier=B1; result=Longer-term effects of intermittent fasting on body composition and cardiometabolic health in adults with overweight; finding=8 extracted claim(s); receipt-level direction is the coded finding; claims=8; Impact of Intermittent Fasting 2025: outcome=Immune and Inflammation; direction=unclear; directness=review; tier=B1; result=Impact of Intermittent Fasting on Gut Barrier Function and Inflammation; finding=2 extracted claim(s); receipt-level direction is the coded finding; claims=2; Couto 2025: outcome=Contextual Adjacent Evidence; direction=unclear; directness=direct; tier=A1; result=The impact of intermittent fasting and Mediterranean diet on older adults' physical health and quality of life: A; finding=2 extracted claim(s); receipt-level direction is the coded finding; claims=2; Yang 2021: outcome=Cardiometabolic; direction=null; directness=review; tier=B1; result=Effect of Epidemic Intermittent Fasting on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of; finding=representative statistic p <0.05; source-level statistic reported; claims=70; Neema 2025: outcome=Immune and Inflammation; direction=null; directness=indirect; tier=B2; result=Efficacy of Intermittent Fasting in the Management of Chronic Plaque Psoriasis: A Phase IIb Clinical Trial; finding=39 extracted claim(s); receipt-level direction is the coded finding; claims=39; Bamberg 2025: outcome=Contextual Adjacent Evidence; direction=null; directness=direct; tier=A1; result=Stable cognitive performance while adapting to intermittent fasting: A randomised controlled trial; finding=28 extracted claim(s); receipt-level direction is the coded finding; claims=28; Zhao 2025: outcome=Mechanism (mouse); direction=null; directness=mechanistic; tier=C1; result=Hepatic lipidomics analysis reveals the anti-obesity effects of insoluble dietary fiber from okara combined with; finding=representative statistic p < 0.05; source-level statistic reported; claims=26; Wang 2025: outcome=Cardiometabolic; direction=null; directness=review; tier=B2; result=The impact of intermittent fasting on body composition and cardiometabolic outcomes in overweight and obese adults: a; finding=24 extracted claim(s); receipt-level direction is the coded finding; claims=24; Struven 2025: outcome=Contextual Adjacent Evidence; direction=null; directness=indirect; tier=B2; result=Impact of intermittent fasting on sleep physiology: A prospective observational study using smartwatch technology; finding=representative non-significant statistic P = .322; not treated as positive or negative directional support unless source direction is coded; claims=18; Choi 2022: outcome=Cardiometabolic; direction=null; directness=indirect; tier=B2; result=Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension; finding=16 extracted claim(s); receipt-level direction is the coded finding; claims=16; Zhang 2025: outcome=Cardiometabolic; direction=null; directness=review; tier=B2; result=Effect of intermittent fasting on obesity and metabolic indices in patients with metabolic syndrome: a systematic; finding=13 extracted claim(s); receipt-level direction is the coded finding; claims=13; Ranjbar 2024: outcome=Immune and Inflammation; direction=null; directness=direct; tier=A1; result=The effects of intermittent fasting diet on quality of life, clinical symptoms, inflammation, and oxidative stress in; finding=10 extracted claim(s); receipt-level direction is the coded finding; claims=10; Beveridge 2025: outcome=Contextual Adjacent Evidence; direction=null; directness=indirect; tier=B2; result=Intermittent fasting and neurocognitive disorders: What the evidence shows; finding=8 extracted claim(s); receipt-level direction is the coded finding; claims=8; Steger 2025: outcome=Cardiometabolic; direction=null; directness=direct; tier=A1; result=Rationale and protocol for a randomized parallel intervention trial of two intermittent fasting approaches in patients; finding=8 extracted claim(s); receipt-level direction is the coded finding; claims=8; Sudasinghe 2026: outcome=Mechanism/Cardiometabolic (cell/in vitro); direction=null; directness=indirect; tier=B2; result=Intermittent fasting and neuroprotection in Alzheimer’s disease: metabolic mechanisms, cellular signaling, and; finding=2 extracted claim(s); receipt-level direction is the coded finding; claims=2; Khalifa 2025: outcome=Contextual Adjacent Evidence; direction=null; directness=indirect; tier=B2; result=Intermittent fasting and liver disease: Insights from the Ramadan model; finding=1 extracted claim(s); receipt-level direction is the coded finding; claims=1. Contextual-adjacent subdomain map: - adjacent clinical-context evidence: Bunker 2025, Lange 2023, Keenan 2022, Fang 2025, Vignera 2026, Bamberg 2025, Washburn 2019, Struven 2025; additional sources retained in manifest - treatment or intervention-response evidence: Karras 2025 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": "| Evidence domain | Source | Direction | Directness | Tier | Evidence role | Finding |", "type": "claim"}, {"id": "claim_27", "text": "| Cardiometabolic | Choi 2022: Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of Obesity, Korean Diabetes Association, and Korean Society of Hypertension | direction=null | directness=indirect | B2 | outcome=Cardiometabolic; direction=null | finding=16 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_28", "text": "| Cardiometabolic | Dai 2025: Additional Effect of Exercise to Intermittent Fasting on Body Composition and Cardiometabolic Health in Adults With Overweight/obesity: A Systematic Review and Meta-analysis | direction=unclear | directness=review | B2 | outcome=Cardiometabolic; direction=unclear | finding=representative non-significant statistic P = 0.67; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"id": "claim_29", "text": "| Cardiometabolic | Kibret 2025: Intermittent Fasting for the Prevention of Cardiovascular Disease Risks: Systematic Review and Network Meta-Analysis | direction=negative | directness=review | B1 | outcome=Cardiometabolic; direction=negative | finding=202 extracted claim(s); receipt-level direction is the coded finding |", "type": "claim"}, {"id": "claim_30", "text": "| Cardiometabolic | Koh 2025: The Effectiveness of Time-Restricted Eating as an Intermittent Fasting Approach on Shift Workers’ Glucose Metabolism: A Systematic Review and Meta-Analysis | direction=mixed | directness=review | B1 | outcome=Cardiometabolic; direction=mixed | finding=representative non-significant statistic p = 0.83; not treated as positive or negative directional support unless source direction is coded |", "type": "claim"}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-025-32673-9", "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": "Comparative effects of intermittent fasting and calorie restriction on cardiovascular health in adults with overweight or obesity", "type": "source", "url": "https://doi.org/10.1038/s41598-025-32673-9", "year": 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"type": "source", "url": "https://doi.org/10.3390/nu18091450", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s12889-025-23493-7", "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": "Effect of intermittent Islamic fasting in management of metabolic syndrome: a randomized control trial", "type": "source", "url": "https://doi.org/10.1186/s12889-025-23493-7", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12937-023-00909-x", "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": "Combined versus independent effects of exercise training and intermittent fasting on body composition and 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"review-level", "doi": "10.3389/fnut.2026.1833688", "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": "Intermittent fasting versus continuous energy restriction in MASLD: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.3389/fnut.2026.1833688", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-025-07461-0", "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": "Intermittent fasting and a no-sugar diet for Long COVID symptoms: a randomized crossover trial", "type": "source", "url": "https://doi.org/10.1038/s41598-025-07461-0", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu18020238", "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": "Metabolic and Orexin-A Responses to Ketogenic Diet and Intermittent Fasting: A 12-Month Randomized Trial in Adults with Obesity", "type": "source", "url": "https://doi.org/10.3390/nu18020238", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu18111799", "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": "Age-Specific Analysis of the Effects of Intermittent Fasting on Body Composition and Cardiometabolic Markers in Healthy Adults and Individuals with Overweight or Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled 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"not appraised in public sidecar", "study": "Cardiometabolic and molecular adaptations to 6-month intermittent fasting in middle-aged men and women with overweight: secondary outcomes of a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1038/s41467-025-66366-8", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fnut.2025.1664811", "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": "Intermittent fasting improves metabolic outcomes in metabolic syndrome: a systematic review and meta-analysis with GRADE evaluation", "type": "source", "url": "https://doi.org/10.3389/fnut.2025.1664811", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3389/fnut.2021.669325", "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": "Effect of Epidemic Intermittent Fasting on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials", "type": "source", "url": "https://doi.org/10.3389/fnut.2021.669325", "year": 2021}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41430-025-01693-z", "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": "The impact of intermittent fasting during weight reduction in people living with type 2 diabetes mellitus: a randomized clinical trial", "type": "source", "url": "https://doi.org/10.1038/s41430-025-01693-z", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu17152436", "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": "Effect of Intermittent Fasting on Anthropometric Measurements, Metabolic Profile, and Hormones in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.3390/nu17152436", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1155/jobe/6409069", "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": "Intermittent Fasting May Enhance Resistance Training Effects on the Body Composition of Obese Males, Without Affecting Muscular Strength and Anabolic Index", "type": "source", "url": "https://doi.org/10.1155/jobe/6409069", "year": 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"risk_of_bias": "not appraised in public sidecar", "study": "Effects of 4:3 Intermittent Fasting on Eating Behaviors and Appetite Hormones: A Secondary Analysis of a 12-Month Behavioral Weight Loss Intervention", "type": "source", "url": "https://doi.org/10.3390/nu17142385", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu17101689", "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": "The Effectiveness of Time-Restricted Eating as an Intermittent Fasting Approach on Shift Workers’ Glucose Metabolism: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.3390/nu17101689", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu14153071", "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 Effects of Intermittent Fasting and Continuous Energy Restriction with Exercise on Cardiometabolic Biomarkers, Dietary Compliance, and Perceived Hunger and Mood: Secondary Outcomes of a Randomised, Controlled Trial", "type": "source", "url": "https://doi.org/10.3390/nu14153071", "year": 2022}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12885-025-13806-9", "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": "The effects of intermittent fasting on anthropometric indices, glycemic profile, chemotherapy-related toxicity, and subjective perception in gynecological and breast cancer patients: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s12885-025-13806-9", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1111/dme.70328", "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": "Safety and efficacy of intermittent fasting with or without exercise in people living with overweight or obesity and type 2 diabetes—The INTERFAST ‐3 study design", "type": "source", "url": "https://doi.org/10.1111/dme.70328", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.4103/idoj.idoj_635_24", "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": "Efficacy of Intermittent Fasting in the Management of Chronic Plaque Psoriasis: A Phase IIb 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"study": "Intermittent Fasting Protects Against the Progression from Acute Kidney Injury to Chronic Kidney Disease", "type": "source", "url": "https://doi.org/10.3390/antiox14010119", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1007/s11695-026-08654-w", "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": "Conversion Bariatric Surgery, Ketogenic Diet, and Intermittent Fasting in Bariatric Surgery Patients with Recurrent Weight Gain: a Prospective Randomized Controlled Trial", "type": "source", "url": "https://doi.org/10.1007/s11695-026-08654-w", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu18111817", "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": "Effects of Intermittent Fasting on Male and Female Reproductive Hormones, Fertility, and Sexual Function: A Comprehensive Review with Emphasis on the Existing Evidence Gap in Women", "type": "source", "url": "https://doi.org/10.3390/nu18111817", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu17152388", "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": "The Effects of Intermittent Fasting on Inflammatory Markers in Adults: A Systematic Review and Pairwise and Network Meta-Analyses", "type": "source", "url": "https://doi.org/10.3390/nu17152388", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1177/13591053251351204", "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": "Stable cognitive performance while adapting to intermittent fasting: A randomised controlled trial", "type": "source", "url": "https://doi.org/10.1177/13591053251351204", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fnut.2025.1549105", "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": "Hepatic lipidomics analysis reveals the anti-obesity effects of insoluble dietary fiber from okara combined with intermittent fasting treatment in high-fat diet-fed mice", "type": "source", "url": "https://doi.org/10.3389/fnut.2025.1549105", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/nu17223546", "effect": "not extracted", "endpoint": "not extracted", "id": "source_42", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Intermittent Fasting During Pregnancy and Neonatal Birth Weight: A Systematic Review and Meta-Analysis", "type": "source", "url": "https://doi.org/10.3390/nu17223546", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12937-025-01178-6", "effect": "not extracted", "endpoint": "not extracted", "id": "source_43", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The impact of intermittent fasting on body composition and cardiometabolic outcomes in overweight and obese adults: a systematic review and meta-analysis of randomized controlled trials", "type": "source", "url": "https://doi.org/10.1186/s12937-025-01178-6", "year": 2025}, {"comparator": "not 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"review-level", "doi": "10.1111/dom.15730", "effect": "not extracted", "endpoint": "not extracted", "id": "source_46", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The effects of intermittent fasting on body composition and cardiometabolic health in adults with prediabetes or type 2 diabetes: A systematic review and meta-analysis.", "type": "source", "url": "https://doi.org/10.1111/dom.15730", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.4093/dmj.2022.0038", "effect": "not extracted", "endpoint": "not extracted", "id": "source_47", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Effect of Carbohydrate-Restricted Diets and Intermittent Fasting on Obesity, Type 2 Diabetes Mellitus, and Hypertension Management: Consensus Statement of the Korean Society for the Study of 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"study": "Effect of intermittent fasting on obesity and metabolic indices in patients with metabolic syndrome: a systematic review and meta analysis", "type": "source", "url": "https://doi.org/10.1186/s12902-025-01952-x", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.7717/peerj.21185", "effect": "not extracted", "endpoint": "not extracted", "id": "source_50", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Intermittent fasting for rheumatic diseases: a systematic review and meta-analysis of conflicting evidence from observational studies and randomized controlled trials", "type": "source", "url": "https://doi.org/10.7717/peerj.21185", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu17071121", "effect": "not extracted", "endpoint": "not extracted", "id": "source_51", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Influence of Intermittent Fasting on Body Composition, Physical Performance, and the Orexinergic System in Postmenopausal Women: A Pilot Study", "type": "source", "url": "https://doi.org/10.3390/nu17071121", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s13063-024-07977-2", "effect": "not extracted", "endpoint": "not extracted", "id": "source_52", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The effects of intermittent fasting diet on quality of life, clinical symptoms, inflammation, and oxidative stress in overweight and obese postmenopausal women with rheumatoid arthritis: study protocol of a randomized controlled trial", "type": "source", "url": "https://doi.org/10.1186/s13063-024-07977-2", "year": 2024}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.jnha.2025.100480", "effect": "not extracted", "endpoint": "not extracted", "id": "source_53", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Intermittent fasting and neurocognitive disorders: What the evidence shows", "type": "source", "url": "https://doi.org/10.1016/j.jnha.2025.100480", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.cct.2025.108118", "effect": "not extracted", "endpoint": "not extracted", "id": "source_54", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Rationale and protocol for a randomized parallel intervention trial of two intermittent fasting approaches in patients with type 2 diabetes", "type": "source", "url": "https://doi.org/10.1016/j.cct.2025.108118", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1111/obr.13855", "effect": "not extracted", "endpoint": "not extracted", "id": "source_55", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Longer-term effects of intermittent fasting on body composition and cardiometabolic health in adults with overweight and obesity: A systematic review and meta-analysis.", "type": "source", "url": "https://doi.org/10.1111/obr.13855", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3389/fnut.2026.1839995", "effect": "not extracted", "endpoint": "not extracted", "id": "source_56", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Intermittent fasting and neuroprotection in Alzheimer’s disease: metabolic mechanisms, cellular signaling, and brain-peripheral crosstalk", "type": "source", "url": "https://doi.org/10.3389/fnut.2026.1839995", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.64149/j.carcinog.24.10s.2833", "effect": "not extracted", "endpoint": "not extracted", "id": "source_57", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Impact of Intermittent Fasting on Gut Barrier Function and Inflammation", "type": "source", "url": "https://doi.org/10.64149/j.carcinog.24.10s.2833", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1016/j.numecd.2025.104132", "effect": "not extracted", "endpoint": "not extracted", "id": "source_58", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "The impact of intermittent fasting and Mediterranean diet on older adults' physical health and quality of life: A randomized clinical trial.", "type": "source", "url": "https://doi.org/10.1016/j.numecd.2025.104132", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.4103/sjg.sjg_120_25", "effect": "not extracted", "endpoint": "not extracted", "id": "source_59", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Intermittent fasting and liver disease: Insights from the Ramadan model", "type": "source", "url": "https://doi.org/10.4103/sjg.sjg_120_25", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu11020246", "effect": "not extracted", "endpoint": "not extracted", "id": "source_60", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Pilot Study of Novel Intermittent Fasting Effects on Metabolomic and Trimethylamine N -oxide Changes During 24-hour Water-Only Fasting in the FEELGOOD Trial", "type": "source", "url": "https://doi.org/10.3390/nu11020246", "year": 2019}, {"comparator": "not extracted", "directness": "citation", "doi": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_61", "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_62", "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_63", "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_64", "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": null, "effect": "not extracted", "endpoint": "not extracted", "id": "source_65", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Anisimov 2008", "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_66", "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": "7e5ce8c6-78d4-4732-b449-7c9ff84676ce", "screening": {"excluded": 0, "exclusion_reasons": ["No PRISMA full-text exclusion-stage filter was applied."], "flow": ["identified", "screened", "excluded_with_reasons", "included"], "identified": 60, "included": 60, "included_or_retained": 60, "screened": 60, "wording": "60 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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