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Weight of evidence: Overall evidence is Low-Moderate: multiple animal studies and a growing number of small clinical trials suggest benefits across gutbrain signaling, social and behavioral domains, gastrointestinal symptoms, and neurophysiological patterns, yet most human studies rely on caregiver-reported outcomes, lack biomarker integration, and seldom control for diet, comorbidities, or baseline microbiome composition

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It is estimated that 1.5 million bone grafting procedures are performed annually in the USA and this figure is rapidly increasing due to population ageing [2, 7, 913]

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