Audit: QRS - Cepharanthine as a Senolytic Therapy

Audit conducted on 11/11/2026 06:17 using AI4L / Opus 5.5

Iterations

Summary

Items	Count
Total	97
Passed	88
Failed	0
N/A	9
Pass Rate	100.00%

• Total = Passed + Failed + N/A
• Pass Rate = Passed / (Passed + Failed) × 100
• N/A items are excluded from the pass rate calculation

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1. General Rules

#	Description	Result	Comments
1.1	Every claim, magnitude, label, recommendation, and statement in the QRS is literally supported by content in the source ER.	🟢	Lede, Protocol, Time to effect, gates, Benefits, Risks, Monitoring and Qualitative items each trace to ER text (Conclusion, Therapeutic Protocol, Practical Considerations, Expected Benefits, Potential Risks, Key Interactions, Monitoring)
1.2	Where the ER uses cautious phrasing (“not formally studied”, “None documented in human trials to date”, “theoretical concern”, “data are limited”), the QRS uses the same phrasing.	🟢	Hedges kept: “Unknown in humans” (ER: “Unknown for cepharanthine in humans”), “no senolytic protocol has been tested in humans”, “no such cepharanthine regimen has been tested”, “report later corrected”
1.3	The QRS never strengthens an ER claim (e.g., “not formally studied” → “not required”) or softens one (e.g., “do not use during pregnancy” → “use with caution during pregnancy”).	🟢	No strengthening or softening; all six contraindications come from the ER’s “Populations who should avoid” list
1.4	The QRS does not relabel an ER fact under a different decision category. A “Benefit-Modifying Factor” from ER section is not surfaced as a “Caution”; a “Risk-Modifying Factor” is not surfaced as a “Side Effect”; etc.	🟢	Modifying factors are not surfaced as cautions or side effects; every item sits in its ER category
1.5	PubMed IDs, study citations, expert names, clinical trial identifiers (NCT*), and brand names appear in the QRS only if they appear in the source ER for the same fact.	🟢	No PMIDs, citations, expert names, NCT IDs or brand names in the QRS

2. Focus, Tone & Audience

#	Description	Result	Comments
2.1	The QRS follows the tone of the ER, which is determined by the ER’s own language, phrasing, and framing.	🟢
2.2	The tone of the QRS is expert, accessible, objective, and data-driven	🟢
2.3	The QRS reads as a trusted, knowledgeable guide rather than a prescriptive doctor	🟢
2.4	The QRS avoids language that implies medical or clinical advice	🟢
2.5	The QRS “presents information” instead of “providing guidance”, “recommending”, or “advising”	🟢
2.6	The QRS never addresses the reader directly — it presents evidence, not guidance	🟢	No second-person address
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢	Technical terms (leukopenia, CYP3A4 substrates, P-gp, p16INK4a) are ER labels or marker names carried verbatim
2.8	Information is presented in a concise and very compact manner	🟢
2.9	The target audience is health- and longevity-oriented adults who are risk-aware, proactive, and actively seeking to optimize health or apply the intervention under review.	🟢
2.10	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢
2.11	The document is NOT written for the general population, who are unwilling to employ lifestyle and behavioral changes or follow protocols that may be inconvenient, costly, or require effort.	🟢
2.12	Framing, takeaways, and risk/benefit weighting throughout the document reflect this audience, including where an intervention’s signal for the average person differs from its signal for this audience.	🟢
2.13	The document’s own voice frames usage in longevity terms, not “anti-aging” (e.g., “anti-aging clinics”, “anti-aging community”, “anti-aging medicine”). Proper names that contain “anti-aging” (e.g., “American Academy of Anti-Aging Medicine”) are quoted verbatim.	🟢	No “anti-aging” wording
2.14	The document’s own voice uses formal clinical and scientific terminology, not colloquial or consumer-grade language (e.g., “oral medication” not “pill(s)”; “oral” / “administered orally” not “taken by mouth” / “given by mouth”; “injection” not “shot”; “adverse event” not “bad reaction”). This holds on EVERY surface, including the QRS lede — the stricter plain-language bar (see 2.7) does not license lay phrasing for route of administration. Direct quotes from sources are exempt.	🟢	No lay route or consumer wording (“pill”, “by mouth”, “shot”)

3. Template Integrity

#	Description	Result	Comments
3.1	The following labels and headings on the QRS are fixed and not modified: • Card and section headings: “Protocol”, “Time to effect”, “Benefits”, “Risk & Side Effects”, “Monitoring”, “Qualitative Assessment” • Gate headings: “Contraindications”, “Key Interactions” • Tier labels: “High”, “Medium”, “Low”, “Speculative” • Table column headers in Monitoring: “Marker”, “Target”, “Why”	🟢	All fixed headings, gate headings, tier labels and table headers unchanged
3.2	Every element carrying a data-qrs-var attribute in [qrs_template] is present in the QRS with the same name	🟢	All template variables present; marker_# and qualitative_item_# expanded to 1-6 per 14.2 / 15.2
3.3	Everything outside the data-qrs-var spans — markup, text, styles, comments — is as in the template; spans that no checklist item addresses are left unchanged as well	🟢	Diff against template shows changes only inside data-qrs-var spans (plus workflow metadata keys)

4. Formatting

#	Description	Result	Comments
4.1	An empty ER section never produces visible empty-state text in the QRS: the corresponding region is hidden or left empty. Phrases such as “None documented in human trials to date” or “Not formally studied” appear only where the ER uses them for a fact the QRS carries over.	🟢	No empty-state text; “Not specified in the ER” is the form 14.3 requires
4.2	Where the ER presents a bulleted item as “Label: content”, the QRS uses the ER’s bold label verbatim as the cell or row label.	🟢	Protocol labels are the ER bold labels verbatim
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢	Interaction labels kept verbatim with trimmed example lists; tier items use ER headings
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	No emoji
4.5	The QRS is designed to render on one A4 page. It fails this item only for one of four things: a trailing clause after a dash, an optional gloss, an example list left untrimmed, or a repetition. Nothing else is cut to fit.	🟢	No trailing dash clause, optional gloss, untrimmed example list or repetition

5. Metadata

#	Description	Result	Comments
5.1	The metadata is placed inside a single HTML comment that is the first element after “<!doctype html>” and before any other comment, head, or body content.	🟢
5.2	Inside that HTML comment the YAML block is delimited by a line “—” opening and a line “—” closing. Text before the opening “—” is permitted but is not parsed as YAML.	🟢
5.3	The metadata is not visible in any rendered view of the QRS and is not surfaced by any other element on the sheet.	🟢
5.4	All frontmatter values are trimmed: no leading or trailing whitespace, no surrounding quotes unless the value contains a colon, bracket, or leading special character that requires YAML quoting.	🟢	Only duration is quoted; its value contains a colon
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	26.11.9 matches QRS.md
5.7	Creation date and time of the document is stated as “qrs_creation_date: [YYYY-MMDD-HHMM]” (e.g., 2026-0501-1430)	🟢	2026-1111-0600
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢
5.9	The nickname of the AI is the full name without the version number, with all remaining words joined by hyphens (e.g., Opus, Sonnet, Grok, Gemini-Flash, GPT); when the full name has no version number or is “Unknown”, the nickname equals the full name	🟢
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢
5.11	The full name of the AI consists of the model name (the word or words directly before the version number, leaving out the first if there is more than one, e.g., Claude Opus 5.5 → Opus 5.5), the model version number and the variant (if any) as stated in the system prompt or developer instructions of the creating model, with every word capitalized and without product, effort or pricing names (e.g., Opus X.Y, Sonnet X.Y, Grok X.Y, Gemini X.Y Flash, GPT X.Y), the model name alone when the system prompt or developer instructions name a model without a version number (e.g., Grok), or “Unknown” when neither the system prompt nor the developer instructions of the creating model name a model	🟢
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢

6. Page Title & Header

#	Description	Result	Comments
6.1	[page_title] is set to the [canonical_topic] of the ER frontmatter followed by “ - Quick Reference Sheet” (e.g., “Intervention - Quick Reference Sheet”). The [canonical_topic] is HTML-entity-encoded as needed (e.g., & for &)	🟢
6.2	[header_topic] is set to the [canonical_topic] of the ER frontmatter, with HTML entities encoded as needed (e.g., & for &)	🟢
6.3	[header_subline_date] is set to [qrs_creation_date reformatted as MM/DD/YYYY]	🟢	11/11/2026
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢

7. At-A-Glance Section

#	Description	Result	Comments
7.1	[at_a_glance] opens by saying what the intervention is — its kind (e.g., dietary supplement, prescription medication, peptide, plant, procedure, practice) — and what it is used for, in plain language, before any verdict on the evidence	🟢	Opens with “a Japanese prescription medicine made from a climbing plant and used for low white blood cell counts and hair loss”
7.2	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢
7.3	[at_a_glance] is no longer than 70 words	🟢	68 words
7.4	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Each fact maps to the ER Conclusion and Historical Context
7.5	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢
7.6	It DOES NOT cite specific trials (names, years, sample sizes, p-values)	🟢
7.7	It DOES NOT cite effect sizes, relative risks, or statistical results	🟢

8. Contraindications

#	Description	Result	Comments
8.1	The section is derived from the ER Key Interactions & Contraindications section	🟢
8.2	[stop_items] represent the Contraindications from the ER	🟢	Six items match the ER’s six avoid populations
8.3	Individual [stop_items] are formatted as <li></li>	🟢
8.4	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢
8.5	Parenthetical qualifiers from the ER bullet — time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	No qualifiers dropped; “(anemia from red-cell destruction)” is a gloss, not a qualifier
8.6	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	No ranking notation in the ER
8.7	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no population, condition, or scenario for which the intervention should be avoided, deferred, or used only under specialist supervision.	🟢	Section is populated, and the ER names avoid populations
8.8	If the section is left empty, an HTML comment inside the [stop_items] span records the ER basis for the absence, naming or quoting the ER text relied on. E.g.	N/A	Section is not empty

9. Key Interactions

#	Description	Result	Comments
9.1	The section is derived from the ER Key Interactions & Contraindications section	🟢
9.2	[caution_items] represent the ER’s documented interactions — the items under its “Documented interactions:” label — excluding any that are already listed as Contraindications and any entry phrased as no interaction found	🟢	ER documented group is “None identified”; caution_items is empty and carries a basis comment
9.3	[caution_theoretical_items] represent the ER’s theoretical interactions — the items under its “Theoretical interactions (inferred from mechanism, not studied in humans):” label	🟢	All ten ER theoretical interactions are listed
9.4	The ER placeholder “None identified” is never an item: it means that group is empty	🟢
9.5	Individual [caution_items] and [caution_theoretical_items] are formatted as <li></li>. The template’s bold “Theoretical (inferred from mechanism)” sub-heading is the only marker of the second list’s status: no item carries “(theoretical)”, “inferred from” or a mechanism clause	🟢
9.6	Items are as concise as possible. No trailing explanations, no elaborations, no mechanistic rationale, no attributions, no citations, no study details. No content after an em-dash, en-dash, or hyphen-dash (e.g., “— dose reduction required”, “— reduced efficacy”) — these trailing clauses are stripped. Just the key fact.	🟢
9.7	Parenthetical qualifiers from the ER bullet — example drug lists, time windows, severity classes, threshold values, clinical staging — ARE preserved as part of the item, kept as concise as possible (shortened or trimmed where needed to fit the one-page budget, but never dropped entirely).	🟢	Example lists kept, trimmed to at least one ER example each
9.8	When the ER uses ranking notation inside parens (e.g., “>” for severity ordering) that depends on an explanatory phrase to interpret, normalize the items to a plain comma-separated list rather than carrying through the bare symbol.	N/A	No ranking notation in the ER
9.9	If the ER’s theoretical group is empty, the whole Theoretical block — the caution_theoretical span with its sub-heading and list — is hidden with style="display:none", not removed: its spans stay in place, empty.	N/A	ER theoretical group is not empty
9.10	The section is left empty ONLY IF the ER’s Key Interactions & Contraindications section identifies no interaction, additive effect, or exposure that changes how the intervention is used.	🟢	Section is populated (theoretical items)
9.11	If the section is left empty, an HTML comment inside the [caution_items] span records the ER basis for the absence, naming or quoting the ER text relied on, and the Theoretical block is hidden per 9.9. E.g.	N/A	Section is not empty

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Therapeutic Protocol section	🟢
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from that section	🟢	Continuous low-dose, short high-dose and intermittent senolytic approaches
10.3	If fewer than three distinct actionable implementation aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing.	N/A	ER gives more than three actionable aspects
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from that section.	🟢

11. Time to Effect

#	Description	Result	Comments
11.1	The three sets of [time] items cover the three most important time-to-effect aspects from the ER	🟢	ER gives two time-to-effect aspects: platelet rise at 12 months (Yamazaki) and the senolytic time to effect (unknown; D+Q 11 days)
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Low-tier platelet recovery before Speculative senescent-cell clearance
11.3	If fewer than three distinct time-to-effect aspects are mentioned in the ER, the unused sets are left empty and hidden with style="display:none", not filled with placeholder text or empty-state phrasing.	🟢	time_3 spans empty and hidden
11.4	All used [time_#label], [time#value], [time#_sub] items are filled with meaningful content derived from the ER.	🟢
11.5	If the ER provides no information on time to effect at all, the whole Time to effect block (its subhead and all three sets) is hidden with style="display:none", not removed: its spans stay in place, empty.	N/A	ER provides time-to-effect information

12. Benefits

#	Description	Result	Comments
12.1	The section is derived from the ER Expected Benefits section	🟢
12.2	Key variables are [benefits_high], [benefits_medium], [benefits_low], [benefits_speculative]	🟢
12.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢
12.5	If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing.	🟢	High and Medium hidden

13. Risks

#	Description	Result	Comments
13.1	The section is derived from the ER Potential Risks & Side Effects section	🟢
13.2	Key variables are [risks_high], [risks_medium], [risks_low], [risks_speculative]	🟢
13.3	Items are as concise as possible. No explanations, no elaborations, no effect sizes, no qualifiers, no attributions, no citations, no study details, no mechanistic explanations, etc. Just the key fact.	🟢
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	“(Injectable Form)” stripped from injection-site pain
13.5	If a tier (high, medium, low, speculative) has no items, its span is hidden with style="display:none", not filled with “None documented in human trials to date” or similar empty-state phrasing.	🟢	High hidden

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring Protocol & Defining Success section	🟢
14.2	All measurable/quantifiable biomarkers from that section are listed, one table row per marker; the template’s # row is the pattern, repeated with # replaced by 1, 2, 3 … in the data-qrs-var names	🟢	ALT, AST, hemoglobin, IL-6 from the table plus reticulocyte count and p16INK4a named in the section
14.3	[marker_#name] is the marker, [marker#target] its target value or range as given in the ER, [marker#_why] its purpose in a few words; a target the ER does not give is written “Not specified in the ER”	🟢	Targets match the ER table; reticulocyte count and p16INK4a marked “Not specified in the ER”
14.4	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from that section. It is not left with placeholder text or empty.	🟢
14.5	If the ER names no measurable biomarker, the table is hidden with style="display:none" and the single # row is left as in the template	N/A	ER names measurable biomarkers

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring Protocol & Defining Success section	🟢
15.2	All subjective/qualitative markers from that section are listed, one <li> per marker; the template’s # item is the pattern, repeated with # replaced by 1, 2, 3 …	🟢	All six ER qualitative markers listed
15.3	If the ER names no qualitative marker, the card’s list is hidden with style="display:none" and the single # item is left as in the template	N/A	ER names qualitative markers

Issues 11/11/2026 06:17

Pass rate 100.00%. No issues found.

Issues 11/11/2026 06:13

1. 1.2 — Protocol caveat dropped: The ER Therapeutic Protocol states “No senolytic protocol for cepharanthine has been tested in humans”, but the QRS Protocol carries it only for action 3 (line 478); action 2 (lines 461-468, 60 or 120 mg/day for 5 days, a COVID-19 trial dose) reads as a tested senolytic regimen.

Fixes 11/11/2026 06:13

1. 1.2 — Protocol caveat restored: Changed action_2_sub from “20 or 40 mg every 8 hours” to “20 or 40 mg every 8 hours, in a COVID-19 trial; no senolytic protocol has been tested in humans”, carrying the ER’s Therapeutic Protocol caveat.

Issues 11/11/2026 06:10

1. 11.1 / 11.3 — Absorption filler in Time: The third Time to effect set (QRS lines 509-519, “Absorption / 1.1–2.5 hours / Peak after single oral doses of 10–120 mg in healthy men”) is a pharmacokinetic peak-level time from the ER’s Mechanism of Action, not a time to effect; with only two time-to-effect aspects in the ER, this set should be empty and hidden with style=”display:none”.

Fixes 11/11/2026 06:10

1. 11.1 / 11.3 — Absorption filler removed: Emptied the time_3_label, time_3_value and time_3_sub spans (“Absorption / 1.1–2.5 hours / Peak after single oral doses…”) and hidden them with style=”display:none”, since the ER gives only two time-to-effect aspects.

Issues 11/11/2026 06:06

1. 4.2 / 4.3 — Time-to-effect label paraphrased: time_3_label at line 511 reads “Peak blood level” instead of the ER’s bold bullet label “Absorption” (ER line 124) from which the cell is drawn.
2. 4.5 — Repeated untested-protocol caveat: action_1_sub at line 456 appends “no senolytic protocol for cepharanthine has been tested in humans”, repeating the caveat already carried by action_3_sub (line 478) and the lede (line 439).

Fixes 11/11/2026 06:06

1. 4.2 / 4.3 — Time-to-effect label restored: Changed time_3_label from “Peak blood level” to the ER bold label “Absorption”, and time_3_sub to “Peak after single oral doses of 10–120 mg in healthy men” so the peak meaning is kept.
2. 4.5 — Repeated caveat removed: Dropped “; no senolytic protocol for cepharanthine has been tested in humans” from action_1_sub, leaving “In 2–3 divided doses after meals”; the caveat stays in action_3_sub and the lede.

Issues 11/11/2026 06:03

1. 14.2 — Reticulocyte count missing: The ER Monitoring table (line 398) names reticulocyte count as the paired follow-up to hemoglobin, but the QRS biomarker table (lines 617-673) has no row for it.

Fixes 11/11/2026 06:03

1. 14.2 — Reticulocyte count added: Added a Monitoring row for reticulocyte count (target “Not specified in the ER”, why “Follow-up if hemoglobin falls”) after hemoglobin, renumbering IL-6 and p16INK4a to marker_5 and marker_6.