Audit: QRS - Follistatin for Muscle Growth

Audit conducted on 22/09/2026 17:51 using AI4L / Opus 5

Iterations

Summary

Items	Count
Total	94
Passed	85
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.	🟢	Protocol cells, gates, tiers, monitoring rows and qualitative items all trace to ER Therapeutic Protocol, Key Interactions & Contraindications, Expected Benefits, Potential Risks & Side Effects, Practical Considerations and Monitoring Protocol & Defining Success.
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.	🟢	ER’s “⚠️ Conflicted” markers are carried as “conflicted”; “⭕️ Not Central to Muscle Growth” is carried as “Not central to muscle growth”.
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”).	🟢	Absolute exclusions stay in Contraindications; the anti-VEGF “Absolute contraindication” bullet is placed in the stop gate, not the caution gate.
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.	🟢	All gate items come from ER Key Interactions & Contraindications; no Benefit-Modifying Factors or Risk-Modifying Factors content is surfaced as a gate.
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, no NCT identifiers, no author names. “ACE-083” and all named drugs appear in the ER for the same facts.
1.6	The QRS does not introduce new attributions.	🟢	No attributions present.

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 simultaneously expert, accessible, objective, and data-driven, but also empowering and encouraging	🟢
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	🟢	Content is descriptive throughout (“Measured at…”, “Detects…”, “the actual outcome being purchased”).
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 forms anywhere in the sheet.
2.7	The QRS is written in plain language, avoiding unnecessary medical jargon	🟢
2.8	Information is presented in a concise and very compact manner	🟢
2.9	It DOES NOT address the reader directly	🟢
2.10	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.	🟢
2.11	The target audience is willing to employ lifestyle and behavioral changes as well as follow protocols that may be inconvenient, costly, or require effort.	🟢	Offshore clinic regimens, indefinite monitoring and vector antibody screening are presented without hedging on inconvenience.
2.12	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.	🟢
2.13	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.	🟢	The volume-without-strength result and the irreversibility of viral gene transfer are foregrounded.
2.14	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.	🟢	Uses “longevity-clinic regimen”; no occurrence of “anti-aging”.
2.15	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.	🟢	Lede uses “given by injection or gene therapy”; body uses “intramuscular”, “subcutaneous”, “injection-site reactions”, “repetitions”.

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 strings verified present and unmodified.
3.2	All “…” from the [qrs_template] are present in the the QRS.	🟢	All 38 template variables present; marker_#_* and qualitative_item_# correctly expanded to 10 and 6 instances.
3.3	Spans that are not addressed in a checklist item are left unchanged	🟢	website="evidence_review", website="audit" and website="full_review" spans are unchanged; the <style> block is byte-identical to the template.

4. Formatting

#	Description	Result	Comments
4.1	When the source ER section is empty, the QRS uses the ER’s own empty-state phrasing verbatim. Typical phrasings are “None documented in human trials to date” and “Not formally studied”	N/A	No ER section feeding the QRS is empty; the vacant Medium benefit tier is governed by the more specific rule 12.5.
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.	🟢	All three protocol cell labels and all ten monitoring row labels are verbatim from the ER.
4.3	Labels are not paraphrased, abbreviated, or invented.	🟢
4.4	The QRS DOES NOT use emoji indicators (no 🟩, 🟥, 🟨, etc.). Color and emphasis are conveyed through CSS and bold labels.	🟢	Scan for high-codepoint characters returns none.
4.5	The QRS is designed to render on one A4 page. Any section that has more content in the ER than fits the per-section budget is condensed by the LLM, not extended onto a second page.	🟢	Every section is condensed to short items; tiers are collapsed into single lines and monitoring cells are trimmed rather than carried over in full.

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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.	🟢	Lines 2–14.
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.	🟢	Lines 3 and 13.
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: "00:03" is quoted, and it contains a colon.
5.5	The filename of the source ER is stated as “er_filename: [er_filename]”	🟢	Line 4.
5.6	Version of the QRS.md file used to create the document is stated as “qrs_prompt_version: [Version of QRS.md]”	🟢	26.9.22, matching 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)	🟢	2026-0922-1706.
5.8	The nickname of the AI used to create the document is stated as “qrs_creator_ai_nickname: [qrs_creator_ai_nickname]”	🟢	Line 7.
5.9	The nickname of the AI is just a single word model name without version, etc. (e.g., Opus, Sonnet, Grok, Gemini, ChatGPT)	🟢	“Opus”.
5.10	The full name of the AI used to create the document is stated as “qrs_creator_ai_fullname: [qrs_creator_ai_fullname]”	🟢	Line 8.
5.11	The full name of the AI consists of the [qrs_creator_ai_nickname] and the model version number and no additional qualifier (e.g., Opus 4.6, Sonnet 3.2, Grok 4.5, Gemini 3.1, ChatGPT 5.4)	🟢	“Opus 5”.
5.12	The filename of the document is stated as “qrs_filename: [filename of this document]”	🟢	Matches the file on disk.
5.13	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.	🟢

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 &)	🟢	“Follistatin for Muscle Growth - Quick Reference Sheet”; no entity encoding required.
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]	🟢	2026-0922-1706 → 09/22/2026.
6.4	[header_subline_model] is set to [qrs_creator_ai_fullname]	🟢	“Opus 5”.
6.5	No additional header content appears: no badge, version stamp, AKA / alternate names line, source-AI attribution, audit date, or QRS variant marker.	🟢	Header block is identical to the template apart from the two variables.

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	🟢	“Follistatin is a protein the body makes itself, given by injection or gene therapy to build muscle by blocking the body’s brake on growth.”
7.2	[at_a_glance] is dense, execution-oriented summary of the ER Conclusion section	🟢	Compresses all four paragraphs of the ER Conclusion.
7.3	[at_a_glance] is no longer than 70 words	🟢	67 words.
7.4	Every fact in [at_a_glance] is supported by a distinct passage in the ER.	🟢	Volume-not-strength, the cardiometabolic cohort signal, the grey-market failure rate and the irreversibility of gene transfer each map to a distinct Conclusion passage.
7.5	It DOES NOT use acronyms or technical classifications that require specialist knowledge, uses plain-language terms instead	🟢	No acronyms; “brake on growth” replaces the myostatin/activin mechanism.
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	🟢	All ten “Populations who should avoid Follistatin” bullets plus the anti-VEGF absolute contraindication are present (11 items).
8.3	Individual [stop_items] are formatted as <li></li>	🟢	11 <li> elements.
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.	🟢	The ER’s em-dash gloss on BRCA1/2 and the dysferlinopathy and rhabdomyolysis explanations are stripped; no trailing clauses remain.
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).	🟢	Glucose ≥126 mg/dL, A1c ≥6.5%, CKD stage 3–5 with the 60 mL/min/1.73 m² threshold, EF <50%, LV wall ≥15 mm, titre 1:100 and the six-month contraception window are all retained.
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	The ER uses no ranking notation in this section.
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.	🟢	The ER names ten populations, so the section is correctly populated.
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	The 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 Key Interactions from the ER, excluding any that are already listed as Contraindications	🟢	Ten of the ER’s eleven interaction bullets; the anti-VEGF bullet is excluded here and carried in the stop gate.
9.3	Individual [caution_items] are formatted as <li></li>	🟢	10 <li> elements.
9.4	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.	🟢	Each item is label plus example drugs; the ER’s rationale sentences and em-dash glosses are stripped.
9.5	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).	🟢	Every ER example-drug list is retained.
9.6	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	The ER uses no ranking notation in this section.
9.7	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.	🟢	The ER names eleven interactions, so the section is correctly populated.
9.8	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. E.g.	N/A	The section is not empty.

10. Protocol

#	Description	Result	Comments
10.1	The section is derived from the ER Protocol section	🟢	Drawn from ER Therapeutic Protocol.
10.2	The three sets of [action] items cover the three most important actionable implementation aspects from the ER Protocol section	🟢	The two gene-transfer regimens and the engineered-protein regimen — the only three ER bullets carrying a stated dose.
10.3	If less that three distinct actionable implementation aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	The ER mentions more than three; all three sets are used.
10.4	All used [action_#label], [action#value], [action#_sub] items are filled with meaningful content derived from the ER Protocol section.	🟢	Labels are verbatim ER bold labels; values carry the ER vector-genome and milligram doses; subs carry route, sites and schedule.

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	🟢	The three facts in the ER Practical Considerations “Time to effect” bullet.
11.2	The sets are picked and ordered by the magnitude of the related benefit	🟢	Muscle volume and engineered-protein volume gain (High tier) precede walking distance (Low tier).
11.3	If less that three distinct time-to-effect aspects are mentioned in the ER the unused sets are left empty and made invisible, not filled with placeholder text or empty-state phrasing.	N/A	Three distinct aspects are present.
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 does not provide any information on time to effect, the section is removed completely from the Protocol Panel	N/A	The 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]	🟢	All four present.
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.	🟢	Sub-heading text only; the ER’s magnitude figures and Acceleron attributions are absent.
12.4	Parenthetical content — including effect sizes, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses in any benefit tier.
12.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	🟢	The ER states no benefit reaches Medium; benefits_medium carries style="display: none" and is empty.

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]	🟢	All four present and populated.
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.	🟢	Hazard ratios, the 9-of-17 figure and the 90% injection-site rate are all absent.
13.4	Parenthetical content — including frequencies, severity grades, sample notes, mechanistic hints, and example studies — is stripped, NOT preserved.	🟢	No parentheses in any risk tier.
13.5	If no items of a specific sub-section (high, medium, low, speculative) are present the respective is set to “display=none”, not filled with “None documented in human trials to date” or similar empty-state phrasing.	N/A	All four ER risk tiers contain items.

14. Monitoring

#	Description	Result	Comments
14.1	The section is derived from the ER Monitoring section	🟢	Drawn from ER Monitoring Protocol & Defining Success.
14.2	All measurable/quantifiable biomarkers from the Monitoring section are listed	🟢	All ten ER table rows present, in ER order, with names verbatim.
14.3	[monitoring_cadence] is populated with the monitoring cadence/frequency derived from the ER Monitoring section. It is not left with placeholder text or empty.	🟢	Baseline, weekly-for-eight-weeks, three/six/twelve months, then six-to-twelve-monthly, plus the single pre-dose vector titre.

15. Qualitative Assessment

#	Description	Result	Comments
15.1	The section is derived from the ER Monitoring section	🟢
15.2	All subjective/qualitative biomarkers from the Monitoring section are listed	🟢	All six ER qualitative markers present, in ER order.

Issues 22/09/2026 17:51

Pass rate 100.00%. No issues found.

Issues 22/09/2026 17:44

1. 8.5 — Cardiac time window dropped: The contraindication at line 581 reads “prior infarction or stroke”, dropping the ER’s time window “at any interval” (ER line 325) and the anatomical qualifier “left ventricular” from the ≥15 mm wall-thickness threshold.
2. 4.3 — Statin class dropped from label: The interaction at line 596 is labelled “Muscle-toxic drugs”, abbreviating the ER’s bold label “Statins and other muscle-toxic drugs” (ER line 301).
3. 9.5 — Secretagogue class dropped: The interaction at line 597 lists “ipamorelin” bare, dropping the ER’s drug class “growth hormone secretagogues … such as ipamorelin” (ER line 303).

Fixes 22/09/2026 17:44

1. 8.5 — Cardiac time window restored: Restored “at any interval” after “prior infarction or stroke” and “left ventricular” before “wall thickness ≥15 mm” in the cardiac contraindication, matching the ER.
2. 4.3 — Statin class restored to label: Changed the interaction label from “Muscle-toxic drugs” to the ER’s verbatim label “Statins and other muscle-toxic drugs”.
3. 9.5 — Secretagogue class restored: Changed “ipamorelin” to “growth hormone secretagogues such as ipamorelin” in the muscle-targeting interventions parenthetical.

Issues 22/09/2026 17:36

1. 2.15 — Colloquial muscle names in protocol: [action_2_sub] at line 478 reads “quadriceps, glutei, calves and biceps” where the ER (line 354) names “quadriceps, gluteus maximus, gastrocnemius and biceps brachii”; “glutei”, “calves” and bare “biceps” are consumer-grade rather than formal anatomical terminology.

Fixes 22/09/2026 17:36

1. 2.15 — Colloquial muscle names in protocol: Replaced the consumer-grade anatomy in [action_2_sub] with the ER’s formal terminology, changing “quadriceps, glutei, calves and biceps” to “quadriceps, gluteus maximus, gastrocnemius and biceps brachii”.

Issues 22/09/2026 17:31

1. 4.5 — Sheet overruns one A4 page: Nothing was condensed to the per-section budget — the 11 Contraindications (lines 574–584) and 10 Key Interactions (lines 592–601) run to two or three rendered lines each, the protocol sub cells to four (lines 459–494), and together with the 10-row Monitoring table and 6-item Qualitative list the sheet renders to roughly two A4 pages.

Fixes 22/09/2026 17:31

1. 4.5 — Condensed to the one-page budget: Trimmed every over-budget region without dropping any fact — all 11 Contraindications and 10 Key Interactions shortened to at most two rendered lines each (thresholds, staging and named example drugs retained), the three protocol sub cells and three time-to-effect sub cells tightened, the monitoring cadence and the Serum follistatin target shortened, and the trailing rationale clauses trimmed from three Qualitative Assessment items.

Issues 22/09/2026 17:26

1. 2.15 — “Natural” consumer-grade framing: At-A-Glance (QRS lines 434 and 437) calls follistatin “a natural protein” and refers to “High natural follistatin”; “natural” is consumer-grade language, where the ER’s own voice says “a protein the body makes on its own” and “People whose own follistatin runs high”.

Fixes 22/09/2026 17:26

1. 2.15 — Consumer-grade “natural” removed: Rewrote the At-A-Glance lede from “Follistatin is a natural protein” to “Follistatin is a protein the body makes itself” and from “High natural follistatin” to “Follistatin running high on its own”, matching the ER’s own voice; the passage was re-tightened to 67 words to stay within the 70-word budget.

Issues 22/09/2026 17:19

1. 1.1 / 1.3 / 7.4 — At-A-Glance conflates follistatin with the engineered protein: The lede (line 435) says “Injecting it into a single muscle makes that muscle measurably bigger”, attributing the placebo-controlled volume result to follistatin itself; the ER Conclusion (line 493) says “Injecting a follistatin-based protein”, and the ER’s Medium-tier note (line 161) makes that distinction explicit because no controlled human evidence exists for follistatin as such.

Fixes 22/09/2026 17:19

1. 1.1 / 1.3 / 7.4 — At-A-Glance follistatin conflation: Rewrote the lede’s second sentence from “Injecting it into a single muscle makes that muscle measurably bigger” to “Injecting a follistatin-based protein into a single muscle makes it measurably bigger”, restoring the ER Conclusion’s wording and the distinction the ER draws between follistatin itself and the engineered follistatin-domain protein. The section remains within the 70-word budget at 69 words.

Issues 22/09/2026 17:09

1. 4.2 / 4.3 — Protocol labels abbreviated: [action_1_label] (line 450) and [action_2_label] (line 467) read “Gene transfer, the trial regimen” and “Gene transfer, the longevity-clinic regimen”, dropping “Intramuscular” from the ER’s bold labels “Intramuscular gene transfer, the trial regimen:” and “Intramuscular gene transfer, the longevity-clinic regimen:” (ER lines 352, 354).
2. 11.1 / 11.2 — Third time cell is not time-to-effect: The third time set (lines 529-542) uses “Plasmid expression / Weeks to months” taken from the ER Discontinuation & Cycling section (ER line 385), which describes decay of effect and has no related benefit to order by; the ER’s own “Time to effect” bullet (ER line 417) supplies a third onset aspect — the engineered protein’s significant volume gain by six months — that is currently buried inside [time_1_sub].

Fixes 22/09/2026 17:09

1. 4.2 / 4.3 — Protocol labels restored verbatim: Changed [action_1_label] from “Gene transfer, the trial regimen” to “Intramuscular gene transfer, the trial regimen” and [action_2_label] from “Gene transfer, the longevity-clinic regimen” to “Intramuscular gene transfer, the longevity-clinic regimen”, matching the ER’s bold labels.
2. 11.1 / 11.2 — Third time cell replaced: Dropped the “Plasmid expression / Weeks to months” cell taken from ER Discontinuation & Cycling and rebuilt the row from the ER’s own “Time to effect” bullet: muscle volume (three to six months), engineered-protein volume gain (by six months), walking distance (six months to one year), ordered by the magnitude of the related benefit.