{
  "schema_version": "2.0.0",
  "source_index_schema_version": "2.0.0",
  "manifest_kind": "heavy_metal_index_evidence_packet",
  "retrieval_timestamp": "2026-09-20T15:55:35.458Z",
  "page": {
    "slug": "sources/authors2026-published-18-may-2026-malignancy-many-patients-continue",
    "title": "PUBLISHED 18 May 2026 malignancy. Many patients continue to have poor outcomes even after decades",
    "description": null,
    "page_type": "source",
    "audience": [],
    "canonical_url": "https://heavymetalindex.com/sources/authors2026-published-18-may-2026-malignancy-many-patients-continue",
    "wiki_doi": null
  },
  "content_pin": {
    "status": "preserved_verified_git",
    "reason": null,
    "content_hash_scheme": "sha256-utf8-authored-markdown-v2",
    "content_hash_description": "Strip leading YAML; remove only generated hmi-page-history and hmi-page-references marker blocks; trim trailing whitespace and append one LF. Other Markdown bytes are preserved.",
    "content_sha256": "5ff54f77a381e585f42e867fcd556a601e2696581e53d0ed21ae2a9e356cad46",
    "content_bytes": 8215,
    "metadata_sha256": "bb28e60828c3edc7569c1c5445cadc8ea1ad81665068a8f78ea11ace29a46708",
    "metadata_hash_description": "SHA-256 of recursively key-sorted JSON from parsed YAML, excluding updated and numeric sources (generated display metadata). All other frontmatter fields are included.",
    "published_body_sha256": "76fe4741ba536443629b22944854f920564219f0e288763ecbefcdccf1a84dfa",
    "published_body_bytes": 8453,
    "published_checksum_note": "Published-body and full-Markdown checksums describe the build input, including generated display sections. They are not claimed to equal the Git revision's display sections.",
    "markdown_sha256": "3a2e6069ed74855a42bee32535b9f80e1a8d4624a21acb0a7a141739cfb5507b",
    "markdown_bytes": 9502,
    "git_commit_sha": "70e164c26892e9564cf209039385a2a03079e1e1",
    "last_commit_sha": "5552206e60d4a0b568d15a388b5589d7a469d871",
    "last_commit_date": "2026-09-10",
    "git_remote": "https://github.com/paleofoundation/heavymetalindex",
    "verify_command": "node tools/verify-evidence-packet.mjs --commit 70e164c26892e9564cf209039385a2a03079e1e1 --slug sources/authors2026-published-18-may-2026-malignancy-many-patients-continue --sha256 5ff54f77a381e585f42e867fcd556a601e2696581e53d0ed21ae2a9e356cad46 --metadata-sha256 bb28e60828c3edc7569c1c5445cadc8ea1ad81665068a8f78ea11ace29a46708"
  },
  "contributing_sources": [],
  "data_downloads": [],
  "ingest_contract": {
    "metadata_complete": false,
    "ingest_complete": false,
    "gaps": [
      "evidence_fitness"
    ],
    "completion_note": "Metadata completeness alone does not prove extraction, routing, or primary-source coverage. Completed ingest requires its reconciliation and route audits."
  },
  "license": {
    "prose": "CC BY 4.0",
    "structured_data": "EU database rights reserved — see https://heavymetalindex.com/licensing",
    "attribution": "Heavy Metal Index (heavymetalindex.com), Institute of Contaminant Standards. Cite canonical_url or wiki_doi.",
    "contact": "karen@paleofoundation.com"
  },
  "attestation": {
    "for_use": "Citation, regulatory submission, or peer-review supplementary record.",
    "verifiable_by": "The verify_command checks the authored Markdown and semantic frontmatter against the named Git revision using the documented canonical hash scheme. Generated history and reference blocks are excluded from that pin; separate published checksums include them.",
    "not_a_certification": "This manifest records publication provenance. It does not certify products or independently validate the page's scientific claims.",
    "license_terms": "https://heavymetalindex.com/licensing"
  },
  "generated_at": "2026-09-14T11:17:46.199Z"
}