{"publication_id":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","content_hash":"sha256:bc612e52b3cc63785fb99d6a26cb5dfb5200ff243eb2ce2b727e6db08c600841","nodes":[{"id":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","type":"publication","title":"Research Synthesis: Fasting Intervention Intermittent Fasting Effects"},{"id":"claim_1","type":"claim","text":"Evidence supporting IF as a direct anti-aging intervention in older adults remains incomplete: most included sources are review-level or indirect, mechanistic plausibility coexists with mixed human-RCT findings, and key boundary conditions — protocol type, baseline cardiometabolic status, age stratum, and exercise co-intervention — have not been definitively established."},{"id":"claim_2","type":"claim","text":"Evidence-abstraction note.** The 17 retained reference papers are not 17 independent primary clinical trials: 16 are review, indirect, or mechanistic source-level summaries, and 1 are classified as direct interventional evidence. Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence."},{"id":"claim_3","type":"claim","text":"Evidence-honesty note: 16/17 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims."},{"id":"claim_4","type":"claim","text":"This paper synthesizes evidence on fasting intervention intermittent fasting effects across 17 included source papers and 1812 high-confidence extracted claims."},{"id":"claim_5","type":"claim","text":"The evidence profile contains 1 direct clinical source, 2 adjacent clinical sources, and no sources classified primarily as mechanistic or model-system evidence, with 47 cross-study disagreements across the evidence base."},{"id":"claim_6","type":"claim","text":"Positive study-level signals are not the dominant direction in any outcome class; null signals are summarized in the contextual adjacent evidence outcome class; negative signals are not the dominant direction in any outcome class; mixed or heterogeneous signals are summarized in the cardiometabolic, immune, and muscle function outcome classes. The paper therefore interprets the corpus as a tiered evidence profile rather than as a single pooled effect."},{"id":"claim_7","type":"claim","text":"The conclusion is that fasting intervention intermittent fasting effects should be treated as a bounded geroscience hypothesis: the retained clinical and adjacent evidence profile defines the scope for targeted testing, while mixed and null findings limit any unqualified anti-aging claim."},{"id":"claim_8","type":"claim","text":"Current evidence does not support clinical or policy use for geroprotection; the synthesis is evidentiary, not medical guidance."},{"id":"claim_9","type":"claim","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."},{"id":"claim_10","type":"claim","text":"| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |"},{"id":"claim_11","type":"claim","text":"| Contextual Adjacent Evidence | n=3; claims=136 | no extracted directional signal in 2/3 sources | 1 direct; 2 review | limited corpus depth in this outcome class |"},{"id":"claim_12","type":"claim","text":"This evidence brief reports outcome packets as a map of retained evidence rather than as a full journal Results narrative or pooled effect estimate."},{"id":"claim_13","type":"claim","text":"10 included sources were assigned to this outcome class. Directional coding: mixed=4, null=2, positive=1, unclear=3. Directness coding: indirect=1, review=9."},{"id":"claim_14","type":"claim","text":"3 included sources were assigned to this outcome class. Directional coding: null=2, unclear=1. Directness coding: direct=1, review=2."},{"id":"claim_15","type":"claim","text":"2 included sources were assigned to this outcome class. Directional coding: null=1, unclear=1. Directness coding: review=2."},{"id":"claim_16","type":"claim","text":"2 included sources were assigned to this outcome class. Directional coding: mixed=1, null=1. Directness coding: indirect=1, review=1."},{"id":"claim_17","type":"claim","text":"Verification note:** Reference-only or no-abstract records are treated as verification-limited context, not as equal-weight support for the main claim."},{"id":"claim_18","type":"claim","text":"The curated corpus is dominated by systematic reviews and meta-analyses and contains very few primary randomised controlled trials. The 16 remaining sources are review-level syntheses, which means the headline signals about cardiometabolic, immune, and muscle-function outcomes rest on summary effect sizes rather than on a primary trial base that can be re-examined. The corpus therefore cannot support within-study replication of any single finding, and conclusions about fasting effects in the general adult population inherit the inclusion criteria, follow-up windows, and risk-of-stringency judgements of the included reviews."},{"id":"claim_19","type":"claim","text":"The populations enrolled across the curated reviews are heterogeneous and not balanced, which restricts external validity. The 17-source corpus therefore supports disease-specific or sex-specific claims more robustly than it supports a generalisable statement about healthy aging."},{"id":"claim_20","type":"claim","text":"Hard clinical endpoints are largely absent from the curated evidence base. No source in the corpus reports long-term mortality, incident cardiovascular events, incident type 2 diabetes, fracture, or hospitalisation as a primary outcome, and no long-term mortality RCT of intermittent fasting in non-diabetic adults is present. The cross-domain tensions catalogued in the matrix — for example the null cardiometabolic direction in Wang 2025 and Abdollahpour 2025 versus the positive direction in Qudah 2026, and the mixed direction in Ranneh 2025, Lu 2025, Couto-Alfonso 2026, and Li 2026 — therefore cannot be resolved by appealing to clinical-event data, and the synthesis can describe only biomarker-level concordance and discordance."},{"id":"claim_21","type":"claim","text":"Several clinically relevant claims rest on indirect or review-level evidence rather than on direct measurements in the population of interest. The PCOS-specific weight-loss signal in Ranneh 2025 and the HbA1c signal in Qudah 2026 (2.8% reduction in insulin-treated patients) are mechanistically plausible but are not paired within the corpus with mechanistic biomarker trials that can adjudicate pathways, and no source in the bundle directly links a measured mechanistic change (for example, a hepatic or pancreatic-axis intermediate) to a downstream clinical outcome in the same enrolled cohort. The single trialist RCT (Couto 2025) is described in available excerpts as a feasibility-oriented Mediterranean-diet comparison with limited willingness to maintain the assigned arm, which constrains the inferences that can be drawn from it. As a result, the mechanistic-to-clinical gap for intermittent fasting cannot be closed from this corpus, and any anti-aging or disease-prevention claim derived from it is supported only by indirect review-level evidence."},{"id":"claim_22","type":"claim","text":"For intermittent fasting effects, the final interpretation is deliberately tiered: the retained clinical and adjacent evidence profile defines a bounded geroscience rationale, but the corpus does not support treating mechanistic target engagement, intermediate biomarkers, and patient-relevant outcomes as interchangeable evidence. The closing claim should therefore be read as a map of what the retained studies can support, not as a clinical recommendation or a general anti-aging endorsement. Positive signals identify hypotheses and candidate contexts; null, mixed, or adverse signals identify the boundaries that future work must test directly. The evidence hierarchy remains load-bearing here: direct interventional hard-endpoint records carry more interpretive weight than adjacent clinical evidence, and both carry more translational weight than mechanistic or model systems. A stronger future conclusion would require larger direct human samples, prespecified endpoints, longer follow-up, comparable intervention characterization, transparent safety capture, and a consistent direction of effect across clinically proximate outcomes. Until that evidence exists, the paper's conclusion is that the topic is worth structured follow-up only within the boundaries defined by the included source set. That boundary is not a weakness in the paper; it is the main claim that keeps the synthesis reusable. Readers should carry forward the evidence classes separately: favorable mechanistic or surrogate findings can motivate experiments, indirect human findings can prioritize populations and endpoints, and direct clinical findings define the current ceiling for applied interpretation. The current corpus may support intermittent fasting effects as a general health or lifestyle intervention where otherwise indicated, but does not justify marketing it as a standalone geroprotective or anti-aging intervention with proven hard-longevity effects. Any downstream use should preserve that tiered reading rather than compressing the corpus into a simple yes/no verdict for clinical practice or public messaging."},{"id":"claim_23","type":"claim","text":"Current evidence does not support clinical or policy use for geroprotection; the synthesis is evidentiary, not medical guidance."},{"id":"claim_24","type":"claim","text":"This synthesis maps 17 included sources on intermittent fasting effects across 4 outcome classes and 47 cross-study disagreements. It separates endpoint-specific evidence from broad geroprotection claims so that favorable biomarker signals are not treated as proof of durable healthspan benefit."},{"id":"claim_25","type":"claim","text":"Across 17 curated reference papers, the evidence base for intermittent fasting effects shows a context-dependent profile. Positive signals appear in: cardiometabolic. Null findings dominate: cardiometabolic, contextual other. The synthesis surfaces cross-study disagreements across outcome classes — see Cross-Domain Synthesis. The intermittent fasting effects anti-aging case as currently constituted is incomplete: mechanistic plausibility coexists with mixed or sparse human-RCT evidence, and the boundary conditions remain to be established."},{"id":"claim_26","type":"claim","text":"Prior reviews in the corpus (Kazeminasab 2025, Couto-Alfonso 2026, Kibret 2025, Lu 2025, Li 2026) emphasize convergent signals on intermittent fasting effects. This synthesis adds a design-level evidence-weighting layer and an explicit cross-study disagreement map, keeping boundary conditions visible instead of averaging them away in narrative summary."},{"id":"claim_27","type":"claim","text":"| Evidence domain | Direct sources | Indirect / mechanism sources | Direction profile | Interpretation boundary |"},{"id":"claim_28","type":"claim","text":"| cardiometabolic | 0 | 10 | mixed, null, positive, unclear | conflict-resolution gap |"},{"id":"claim_29","type":"claim","text":"| P1 | cardiometabolic: conflict-resolution gap | 0 direct and 10 indirect sources; direction profile: mixed, null, positive, unclear |"},{"id":"claim_30","type":"claim","text":"| P2 | muscle function: conflict-resolution gap | 0 direct and 2 indirect sources; direction profile: mixed, null |"},{"id":"source_1","type":"source","study":"Comparative effects of intermittent fasting and calorie restriction on cardiovascular health in adults with overweight or obesity","year":2025,"doi":"10.1038/s41598-025-32673-9","url":"https://doi.org/10.1038/s41598-025-32673-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_2","type":"source","study":"Effects of Intermittent Fasting and Calorie Restriction on Exercise Performance: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.3390/nu17121992","url":"https://doi.org/10.3390/nu17121992","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_3","type":"source","study":"Intermittent Fasting and Healthy Aging in Older Adults: A Systematic Review of Cardiometabolic, Mental Health and Cognitive Outcomes with a Network Meta-Analysis of Anthropometric Measures","year":2026,"doi":"10.3390/nu18091450","url":"https://doi.org/10.3390/nu18091450","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_4","type":"source","study":"Intermittent Fasting for the Prevention of Cardiovascular Disease Risks: Systematic Review and Network Meta-Analysis","year":2025,"doi":"10.1007/s13668-025-00684-7","url":"https://doi.org/10.1007/s13668-025-00684-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_5","type":"source","study":"The effect of intermittent fasting on insulin resistance, lipid profile, and inflammation on metabolic syndrome: a GRADE assessed systematic review and meta-analysis","year":2025,"doi":"10.1186/s41043-025-01039-2","url":"https://doi.org/10.1186/s41043-025-01039-2","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_6","type":"source","study":"Additional Effect of Exercise to Intermittent Fasting on Body Composition and Cardiometabolic Health in Adults With Overweight/obesity: A Systematic Review and Meta-analysis","year":2025,"doi":"10.1007/s13679-025-00645-9","url":"https://doi.org/10.1007/s13679-025-00645-9","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_7","type":"source","study":"Intermittent fasting versus continuous energy restriction in MASLD: a systematic review and meta-analysis","year":2026,"doi":"10.3389/fnut.2026.1833688","url":"https://doi.org/10.3389/fnut.2026.1833688","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_8","type":"source","study":"Intermittent fasting strategies and their effects on body weight and other cardiometabolic risk factors: systematic review and network meta-analysis of randomised clinical trials","year":2025,"doi":"10.1136/bmj-2024-082007","url":"https://doi.org/10.1136/bmj-2024-082007","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_9","type":"source","study":"Effect of Intermittent Fasting on Anthropometric Measurements, Metabolic Profile, and Hormones in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.3390/nu17152436","url":"https://doi.org/10.3390/nu17152436","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_10","type":"source","study":"Effects of intermittent fasting on HbA1c and weight in insulin versus oral hypoglycemic therapy-treated patients with type 2 diabetes mellitus: a systematic review and meta-analysis","year":2026,"doi":"10.3389/fnut.2026.1699384","url":"https://doi.org/10.3389/fnut.2026.1699384","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_11","type":"source","study":"The Effects of Intermittent Fasting on Inflammatory Markers in Adults: A Systematic Review and Pairwise and Network Meta-Analyses","year":2025,"doi":"10.3390/nu17152388","url":"https://doi.org/10.3390/nu17152388","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_12","type":"source","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","year":2025,"doi":"10.1186/s12937-025-01178-6","url":"https://doi.org/10.1186/s12937-025-01178-6","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_13","type":"source","study":"Intermittent fasting for rheumatic diseases: a systematic review and meta-analysis of conflicting evidence from observational studies and randomized controlled trials","year":2026,"doi":"10.7717/peerj.21185","url":"https://doi.org/10.7717/peerj.21185","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_14","type":"source","study":"Influence of Intermittent Fasting on Body Composition, Physical Performance, and the Orexinergic System in Postmenopausal Women: A Pilot Study","year":2025,"doi":"10.3390/nu17071121","url":"https://doi.org/10.3390/nu17071121","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not 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extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_17","type":"source","study":"The impact of intermittent fasting and Mediterranean diet on older adults' physical health and quality of life: A randomized clinical trial.","year":2025,"doi":"10.1016/j.numecd.2025.104132","url":"https://doi.org/10.1016/j.numecd.2025.104132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"primary"},{"id":"source_18","type":"source","study":"**Schulz 2010.** _Schulz KF, Altman DG, Moher D. CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332._ DOI: 10.1136/bmj.c332.","year":2010,"doi":"10.1136/bmj.c332","url":"https://doi.org/10.1136/bmj.c332","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_19","type":"source","study":"**Ioannidis 2005.** _Ioannidis JPA. Why most published research findings are false. PLoS Med. 2005;2(8):e124._ DOI: 10.1371/journal.pmed.0020124. PMID: 16060722.","year":2005,"doi":"10.1371/journal.pmed.0020124","url":"https://doi.org/10.1371/journal.pmed.0020124","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_20","type":"source","study":"**ADA 2024.** _American Diabetes Association. Standards of Care in Diabetes. Diabetes Care. 2024;47(Suppl 1)._ DOI: 10.2337/dc24-S006.","year":2024,"doi":"10.2337/dc24-s006","url":"https://doi.org/10.2337/dc24-s006","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review-level"},{"id":"source_21","type":"source","study":"**Outcome class** is assigned from the source's bound endpoint, population, and claim text; adjacent/background sources are separated from clinical outcome slices.","year":null,"doi":null,"url":null,"population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"citation"},{"id":"source_22","type":"source","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.","year":null,"doi":null,"url":null,"population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"citation"},{"id":"source_23","type":"source","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.","year":null,"doi":null,"url":null,"population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"citation"},{"id":"source_24","type":"source","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.","year":null,"doi":null,"url":null,"population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"citation"}],"edges":[{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_1","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_2","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_3","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_4","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_5","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_6","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_7","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_8","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_9","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_10","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_11","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_12","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_13","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_14","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_15","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_16","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_17","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_18","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_19","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_20","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_21","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_22","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_23","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_24","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_25","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_26","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_27","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_28","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_29","type":"contains_claim"},{"from":"b1750150-b7b0-4272-9e1c-c6eaf8f52abc","to":"claim_30","type":"contains_claim"}],"screening":{"identified":21,"screened":21,"excluded":0,"included":21,"included_or_retained":21,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"21 candidate receipts retained after source retrieval, deduplication, and topic filtering. 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