source · application/json
source_e7285aed70794aff
sha256 af0f469e809fc686a26a14864f6999664d017d23d33574ded996b90efa56ec7c
by researka:v2 · 2026-06-30 01:21:35.430281+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 physical exercise effects remains a bounded geroscience case: the retained direct, adjacent, and context 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": "For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint.", "type": "claim"}, {"id": "claim_6", "text": "This synthesis evaluates evidence on physical exercise effects across 55 included source papers and 2160 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_7", "text": "The corpus contains 11 direct clinical sources, 44 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. 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_8", "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_9", "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_10", "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_11", "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_12", "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_13", "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_14", "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_15", "text": "The background evidence for physical exercise effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Suikkanen 2025, Arici 2025, Adnan 2026 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation.", "type": "claim"}, {"id": "claim_16", "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_17", "text": "Across the retained sources, positive signals cluster around the safety and comorbidity, deficiency prevalence, contextual adjacent evidence outcome classes; null signals around the contextual adjacent evidence, cognitive and muscle function outcome classes; and negative or adverse signals around the contextual adjacent evidence outcome class. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation.", "type": "claim"}, {"id": "claim_18", "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_19", "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_20", "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_21", "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_22", "text": "Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, cognitive, contextual adjacent evidence, deficiency prevalence, dosing and pharmacokinetics, frailty, muscle function, safety and comorbidity, 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_23", "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_24", "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_25", "text": "| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |", "type": "claim"}, {"id": "claim_26", "text": "| Physical Exercise Effects / Contextual Adjacent Evidence | n=35; claims=1431 | significant source statistic in 25/35 sources; receipt-level direction coded unclear | 3 direct; 11 indirect; 1 protocol; 20 review | limited corpus depth in this outcome class |", "type": "claim"}, {"id": "claim_27", "text": "| Physical Exercise Effects / Frailty | n=1; claims=105 | significant source statistic in 1/1 sources; receipt-level direction coded null | 1 review | single-source slice; hypothesis-generating |", "type": "claim"}, {"id": "claim_28", "text": "Contextual Adjacent Evidence: n=35; claims=1431; mixed signal in 20/35 sources | directness: 3 direct; 11 indirect; 20 review; 1 protocol; main limitation: directionally heterogeneous.", "type": "claim"}, {"id": "claim_29", "text": "The cardiometabolic evidence base for physical exercise effects spans three principal sources, each anchored in different study designs and populations. Pela 2025 reported on a randomized control trial conducted in frail, sarcopenic older subjects aged 70 years or older, evaluating a two-year adapted physical exercise program combined with nutritional counselling on cardio-sarcopenia syndrome, with multiple endpoints reaching statistical significance (P = 0.004, P = 0.037, P = 0.034, P < 0.001, P = 0.012, P < 0.05, P = 0.038, P < 0.005, P = 0.003). Ancin-Oses 2025 contributed a systematic review with meta-analysis of randomized controlled trials examining physical exercise on metabolic syndrome in psychotic disorders, pooling across enrolled trials. Kazeminasab 2024 provided a systematic review and meta-analysis of clinical studies evaluating intermittent fasting combined with physical exercise on cardiometabolic outcomes. Together these sources define a cardiometabolic outcome class whose evidence strength depends on population, intervention pairing, and endpoint specificity.", "type": "claim"}, {"id": "claim_30", "text": "Mechanistically, the divergence between Pela 2025 and Ancin-Oses 2025 maps onto population substrate and intervention pairing. Pela 2025 enrolled frail, sarcopenic older adults with low muscle function — a clinical RCT population in which a combined adapted exercise plus nutritional counselling regimen can plausibly act on both the muscular and cardiovascular axes of cardio-sarcopenia. Ancin-Oses 2025, by contrast, drew from trials in psychotic disorders, where antipsychotic medication burden, lifestyle factors, and diagnostic heterogeneity may attenuate the cardiometabolic signal of exercise alone. Kazeminasab 2024 supplies a third mechanistic context — combined intermittent fasting plus exercise — in which the synergistic metabolic stress of energy restriction amplifies weight, lipid, and blood pressure effects beyond exercise monotherapy. The mechanistic substrate underlying these functional findings therefore includes the population's baseline cardiometabolic risk, the presence or absence of dietary co-interventions, and the duration of follow-up, all of which vary across the three sources.", "type": "claim"}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1590/1414-431X2025e14194", "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 physical exercise on the lipid profile of perimenopausal and postmenopausal women: a systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1590/1414-431X2025e14194", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1590/S0004-2803.24612025-024", "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": "EFFECT OF PHYSICAL EXERCISE ON THE HEALTH-RELATED QUALITY OF LIFE ASSESSED BY CLDQ OF LIVER CIRRHOSIS PATIENTS: SYSTEMATIC REVIEW WITH META-ANALYSIS", "type": "source", "url": "https://doi.org/10.1590/S0004-2803.24612025-024", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s12887-025-05575-y", "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": "Effects of different physical exercise programs on blood pressure in overweight children and adolescents: systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1186/s12887-025-05575-y", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1007/s00520-025-10194-5", "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": "Effects of physical exercise in patients undergoing haematopoietic stem cell transplantation: systematic review and meta-analysis", "type": "source", "url": "https://doi.org/10.1007/s00520-025-10194-5", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1038/s41598-025-26683-w", "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 role of physical exercise in enhancing Health, quality of life and joy among older adults", "type": "source", "url": "https://doi.org/10.1038/s41598-025-26683-w", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1111/sms.70010", "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": "Residual Effects of Physical Exercise After Periods of Training Cessation in Older Adults: A Systematic Review With Meta‐Analysis and Meta‐Regression", "type": "source", "url": "https://doi.org/10.1111/sms.70010", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1186/s11556-025-00377-8", "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 two-year adapted physical exercise program and nutritional counselling on cardio-sarcopenia syndrome in older adults with low muscle function", "type": "source", "url": "https://doi.org/10.1186/s11556-025-00377-8", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.3390/sports13050152", "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 Effects of Exercise Intervention in Older Adults With and Without Sarcopenia: A Systematic Review", "type": "source", "url": "https://doi.org/10.3390/sports13050152", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1016/j.tjfa.2025.100069", "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": "Benefits of physical activity on cognitive function in patients with neurocognitive disorders: A systematic review", "type": "source", "url": "https://doi.org/10.1016/j.tjfa.2025.100069", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu18101557", "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": "Is Adapted Physical Exercise an Innovative Adjuvant Approach to Combine with Low-Protein Diet in Chronic Kidney Disease?", "type": "source", "url": "https://doi.org/10.3390/nu18101557", "year": 2026}, {"comparator": "not extracted", "directness": "primary", "doi": "10.3390/nu17091509", "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": "Feasibility of a Pre-Operative Morphofunctional Assessment and the Effect of an Intervention Program with Oral Nutritional Supplements and Physical Exercise", "type": "source", "url": "https://doi.org/10.3390/nu17091509", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.1177/02692155251389435", "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": "Long-term home-based physical exercise, pain, and use of pain medication over a year after hip fracture – A secondary analysis of a randomised controlled trial", "type": "source", "url": "https://doi.org/10.1177/02692155251389435", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1080/0886022X.2026.2654288", "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": "Benefits of physical exercises in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials", "type": "source", "url": "https://doi.org/10.1080/0886022X.2026.2654288", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1186/s40798-025-00929-3", "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": "Comparing Aerobic Interval Training with Other Forms of Physical Exercise for Brachial Artery Endothelial Function Improvement: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials", "type": "source", "url": "https://doi.org/10.1186/s40798-025-00929-3", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1093/ageing/afaf171", "effect": "not extracted", "endpoint": "not extracted", "id": "source_15", "intervention_or_exposure": "not 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"source_17", "intervention_or_exposure": "not extracted", "population": "not extracted", "risk_of_bias": "not appraised in public sidecar", "study": "Personalized Diet With or Without Physical Exercise Improves Nutritional Status, Muscle Strength, Physical Performance, and Quality of Life in Malnourished Older Adults: A Prospective Randomized Controlled Study", "type": "source", "url": "https://doi.org/10.3390/nu17040675", "year": 2025}, {"comparator": "not extracted", "directness": "primary", "doi": "10.2196/73242", "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": "The Chain Mediation Role of Self-Efficacy, Health Literacy, and Physical Exercise in the Relationship Between Internet Use and Older Adults’ Health: Cross-Sectional Questionnaire Study", "type": "source", "url": "https://doi.org/10.2196/73242", "year": 2025}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1002/jcsm.70206", "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": "Physical Activity Improves Quality of Life in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta‐Analysis", "type": "source", "url": "https://doi.org/10.1002/jcsm.70206", "year": 2026}, {"comparator": "not extracted", "directness": "review-level", "doi": "10.1155/2024/9363464", "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": "The Effects of Various Types of Physical Exercise on Health Outcomes in Older Adults with Depression: A Systematic Review and Meta-Analysis of Controlled Trials", "type": "source", 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