Search Results (815)

This study evaluated the viability, microbiological composition, functional traits, and safety of probiotic bacteria isolated from commercial products marketed as containing Limosilactobacillus reuteri. Viable cell counts, biochemical characterization, strain-level identification, functional properties, gastrointestinal tolerance, and safety attributes were assessed. Among the evaluated products, only four presented colony-forming units (CFU) counts consistent with label claims (products E, F, G, and H), while two showed no detectable viable microorganisms (products B and L). All isolates were Gram-positive, catalase-negative, and predominantly rod-shaped. rep-PCR analysis revealed strain homogeneity in most products, whereas others (products A and K) exhibited heterogeneous microbial compositions. Molecular identification based on 16S rRNA sequencing showed a predominance of Lmb. reuteri and Lacticaseibacillus rhamnosus, with some products containing additional species such as Lactiplantibacillus plantarum and Lactobacillus acidophilus. Functional assays demonstrated strain-dependent proteolytic and diacetyl-producing capacities, as well as variable tolerance to simulated gastrointestinal conditions. Most strains preferentially produced L-lactate, although some generated substantial amounts of D-lactate. All isolates were susceptible to antibiotics recommended by EFSA, except for intrinsic vancomycin resistance, and no transferable virulence markers, biogenic amine production, or Salmonella contamination were detected. Furthermore, virulence-related genes such as hdc, tdc, odc, hyl, cylA, and ace were not identified. Overall, the results highlight pronounced discrepancies between label claims and microbiological quality among commercial probiotic products and reinforce the importance of strain-level characterization to ensure safety, functional performance, and regulatory compliance. Full article

The metabolism of the four major substances—glucose, lipids, amino acids, and nucleotides—constitutes the most prominent metabolic phenotype of schizophrenia. The pathological axis shared by these substances involves energy pathway imbalances, redox stress, immune-inflammatory activation, and abnormalities in neurotransmitter synthesis/degradation. Existing research confirms that key metabolites within these pathways hold potential as biomarkers for diagnosis or progression monitoring. In recent years, electroconvulsive therapy (ECT) has been shown to improve psychotic symptoms while exerting broad regulatory effects on neurogenesis, immune homeostasis, and the hypothalamic–pituitary–target gland axis, though its precise mechanisms remain unclear. Recent studies indicate that ECT treatment can also regulate changes in brain and peripheral metabolism. We propose an integrated “metabolism-immunity-neuroendocrine” hypothesis to systematically elucidate how metabolic reprogramming during ECT treatment cascades sequentially to the immune, neural, and endocrine systems, thereby revealing the molecular basis of its antipsychotic effects. Furthermore, we conduct a comparative analysis of the effects of antipsychotic drugs on the same metabolic network and explore the universality and specificity of metabolic regulation in other physical therapies (such as rTMS, tDCS) and psychiatric disorders like depression and bipolar disorder. This research aims to provide novel biomarkers and intervention targets for the precision diagnosis and treatment of schizophrenia. Full article

Introduction: Resting-state EEG (rsEEG) is a scalable window onto trait-like “executive readiness,” but findings have been fragmented by task impurity on the executive-function (EF) side and heterogeneous EEG pipelines. This review synthesizes rsEEG features that reliably track EF in healthy samples across development and aging and evaluates moderators such as cognitive reserve. Materials and methods: Following PRISMA 2020, we defined PECOS-based eligibility (human participants; eyes-closed/eyes-open rsEEG; spectral, aperiodic, connectivity, topology, microstate, and LRTC features; behavioral EF outcomes) and searched MEDLINE/PubMed, Embase, PsycINFO, Web of Science, Scopus, and IEEE Xplore from inception to 30 August 2025. Two reviewers were screened/double-extracted; the risk of bias in non-randomized studies was assessed using the ROBINS-I tool. Sixty-three studies met criteria (plus citation tracking), spanning from childhood to old age. Results: Across domains, tempo, noise, and wiring jointly explained EF differences. Faster individual/peak alpha frequency (IAF/PAF) related most consistently to manipulation-heavy working may and interference control/vigilance in aging; alpha power was less informative once periodic and aperiodic components were separated. Aperiodic 1/f parameters (slope/offset) indexed domain-general efficiency (processing speed, executive composites) with education-dependent sign flips in later life. Connectivity/topology outperformed local power: efficient, small-world-like alpha networks predicted faster, more consistent decisions and higher WM accuracy, whereas globally heightened alpha/gamma synchrony—and rigid high-beta organization—were behaviorally sluggish. Within-frontal beta/gamma coherence supported span maintenance/sequencing, but excessive fronto-posterior theta coherence selectively undermined WM manipulation/updating. A higher frontal theta/beta ratio forecasts riskier, less adaptive choices and poorer reversal learning for decision policy. Age and reserve consistently moderated effects (e.g., child frontal theta supportive for WM; older-adult slow power often detrimental; stronger EO ↔ EC connectivity modulation and faster alpha with higher reserve). Boundary conditions were common: low-load tasks and homogeneous young samples usually yielded nulls. Conclusions: RsEEG does not diagnose EF independently; single-band metrics or simple ratios lack specificity and can be confounded by age/reserve. Instead, a multi-feature signature—faster alpha pace, steeper 1/f slope with appropriate offset, efficient/flexible alpha-band topology with limited global over-synchrony (especially avoiding long-range theta lock), and supportive within-frontal fast-band coherence—best captures individual differences in executive speed, interference control, stability, and WM manipulation. For reproducible applications, recordings should include ≥5–6 min eyes-closed (plus eyes-open), ≥32 channels, vigilant artifact/drowsiness control, periodic–aperiodic decomposition, lag-insensitive connectivity, and graph metrics; analyses must separate speed from accuracy and distinguish WM maintenance vs. manipulation. Clinical translation should prioritize stratification and monitoring (not diagnosis), interpreted through the lenses of development, aging, and cognitive reserve. Full article

As the mainstream technology solution for deep imaging LiDAR, dToF measurement has been widely applied in emerging fields such as environmental perception and obstacle recognition, 3D terrain reconstruction, real-time motion capture, and drone obstacle avoidance navigation due to its advantages of high resolution, long-range detection capability, and high sensitivity. In order to adapt to functional applications in different scenarios, the resolution of TDC needs to be adjustable and can work normally in different environments. In view of this, this article studies the pixel array and TDC circuit in the chip and locks a voltage-controlled ring oscillator (VCRO) with the same structure as the pixel to a fixed frequency through a PLL structure. Then copy the control voltage of the locked VCRO to the control terminal of the TDC in each pixel. In an ideal situation, this control voltage can make the oscillation frequency of VCRO within the pixel consistent with the locking frequency of VCRO within the PLL, and insensitive to changes in PVT. This study developed a module expandable 16 × 16-pixel array dToF sensor chip based on TDC architecture using CMOS technology. Finally, six configurable 16 × 16-pixel subarrays were integrated and constructed into a 32 × 48 large-scale dToF sensor chip through modular splicing. The top-level layout design was completed using SMIC 180 nm technology, with a layout area of 5285 µm × 3669 µm. Post-simulation verification showed that, under the testing conditions of a 400 MHz system clock and a 33.3 kHz frame rate, the dToF chip system performance indicators were: time measurement resolution of 156 ps, DNL < 1 LSB, INL < 0.85 LSB, and absolute ranging accuracy better than 2.5 cm. Full article

High-precision phase difference measurement based on field-programmable gate arrays (FPGA) has important application requirements in fields such as high-stability time-frequency transmission, signal synchronization, and precision testing. Addressing the limitations of traditional methods in terms of temperature stability and measurement accuracy, this paper proposes two high-precision phase difference measurement schemes based on the FPGA platform. An eight-parallel-multi-carry chain time-to-digital converter (TDC) and digital dual-mixer time difference (DDMTD) measurement modules are constructed to perform high-precision phase difference measurements on the phase-shifted output signal of the MMCM dynamic phase-shifted module. Results show that at room temperature (25 °C), the single-carry chain TDC exhibits better measurement accuracy than the DDMTD, and the single-carry chain TDC’s measurement error range of 4.7–6.0 ps is superior to the DDMTD’s 20–75 ps error range. Under different temperature conditions, the eight-parallel-multi-carry chain TDC consistently demonstrates superior measurement accuracy, resolution, and temperature stability compared to the single-carry chain TDC. In terms of measurement accuracy, under room temperature conditions, in three sets of phase difference tests (178.5714 ps, 357.1428 ps, and 535.7142 ps), the measurement error of the eight-parallel-multi-carry chain TDC was controlled within 4.6 ps, which is better than the 4.7–6.0 ps error range of the single-carry chain TDC. Average resolution: The average resolution of the single-carry chain TDC was 6.329 ps, while the average resolution of the eight-parallel-multi-carry chain TDC improved to 0.833 ps. Temperature stability: Within the temperature range of 10 °C to 100 °C, the temperature coefficient of the single-carry chain TDC was 0.002127 ps/°C, while the temperature coefficient of the eight-parallel-multi-carry chain TDC decreased to 0.000564 ps/°C. This paper also summarizes the advantages and limitations of the above methods in terms of implementation complexity and robustness, providing a reference for the optimized design of high-precision phase difference measurement technology for FPGA platforms. Full article

Background/Objectives: Transcranial direct current stimulation (tDCS) is increasingly used by athletes, yet sport-performance-enhancement findings are mixed and often small, with outcomes depending on stimulation target, timing, and task demands. Aim: This scoping review mapped and synthesized the soccer-specific trial evidence to identify (i) which tDCS targets and application schedules have been tested in soccer players, (ii) which soccer-relevant outcomes show the most consistent immediate (minutes–hours) or training-mediated benefits, and (iii) where evidence gaps persist. Methods: We conducted a scoping review of clinical trials in footballers, following review best-practice guidance (PRISMA-informed) and a preregistered protocol. Searches (August 2025) spanned PubMed/MEDLINE, ResearchGate, Google Scholar, and Cochrane, using combinations of “football/soccer” and “tDCS/transcranial direct current stimulation,” with inclusion restricted to trials from 2008–2025. Dual independent screening was applied. Of 47 records identified, 21 studies met the criteria. Across these, the total N was 593 (predominantly male adolescents/young adults; wide range of levels). Results: Prefrontal protocols—most commonly left-dominant dorsolateral prefrontal cortex (DLPFC) (+F3/−F4, ~2 mA, ~20 min)—most consistently improved post-match recovery status/well-being (e.g., fatigue, sleep quality, muscle soreness, stress, mood), and when repeated and/or paired with practice, shortened decision times and promoted more efficient visual search. Effects on classic executive tests were inconsistent, and bilateral anodal DLPFC under fatigue increased risk-tolerant choices. Motor-cortex targeting (C3/C4/Cz) rarely changed rapid force–power performance after a single session—e.g., multiple well-controlled trials found no immediate CMJ gains—but when paired with multi-week training (core/lumbar stability, plyometrics, HIIT, sling), it augmented strength, jump height, sprint/agility, aerobic capacity, and task-relevant EMG. Autonomic markers (exercise HR, early HR recovery) showed time-dependent normalization without specific tDCS effects in single-session, randomized designs. In contrast, a season-long applied program that added prefrontal stimulation to standard recovery reported significantly reduced creatine kinase. Across studies, protocols and masking were athlete-friendly and rigorous (~2 mA for ~20 min; robust sham/blinding), with only mild, transient sensations reported and no serious adverse events. Conclusions: In soccer players, tDCS shows a qualified pattern of benefits that follows a specificity model: prefrontal stimulation can support post-match recovery status/well-being and decision efficiency, while M1-centered stimulation is most effective when coupled with structured training to bias neuromuscular adaptation. Effects are generally modest and heterogeneous; practitioners should treat tDCS as an adjunct, not a stand-alone enhancer, and align montage × task × timing while monitoring individual responses. Full article

This paper presents an all-digital fractional-N phase-locked loop (ADPLL) operating in the 2.86–3.2 GHz range, optimized for IoT and high-frequency RF transceiver applications demanding stringent phase noise performance, fast settling time, and high integration capability. The key innovation lies in the introduction of a bandpass delta-sigma time-to-digital converter (BPDSTDC) that achieves high-resolution phase detection, an extended detection range of ±2$\pi$, and superior noise-shaping characteristics, completely eliminating the complex calibration procedures typically required in conventional TDC designs. The proposed architecture synergistically combines the BPDSTDC with digital down-conversion blocks to extract phase error at baseband, a divider chain integrated with phase interpolators achieving 1/4 fractional resolution to suppress in-band quantization noise, and a wide-bandwidth digital loop filter (>1 MHz) ensuring fast dynamic response and robust stability. The bandpass delta-sigma modulator is implemented with compact resonator structures and a flash quantizer, achieving an optimal balance among resolution, power consumption, and silicon area. The incorporation of highly linear phase interpolators extends fractional frequency synthesis capability without requiring complex digital-to-time converters (DTCs), significantly reducing design complexity and calibration overhead. Fabricated in a 180-nm CMOS technology, the proposed chip demonstrates robust measured performance. The band-pass delta-sigma TDC achieves a low integrated rms timing noise of 183 fs within a 1-MHz bandwidth. Leveraging this low TDC noise, the complete ADPLL exhibits a measured in-band phase noise of −120 dBc/Hz at a 1-MHz offset for a 3.2-GHz output frequency while operating with a loop bandwidth exceeding 1 MHz. This corresponds to a normalized phase noise of −216 dBc/Hz. The system operates from a 1.8-V supply and consumes 10 mW, achieving competitive performance compared with prior noise-shaping TDC-based all-digital PLLs. Full article

Background/Objectives: People with Parkinson’s disease (PwPD) exhibit impairments in postural responses to perturbations, increasing their risk of falls. While transcranial direct current stimulation (tDCS) has been shown to enhance postural responses in PwPD, its effects considering history of falls remain unclear. Thus, we aimed to analyse the effect of tDCS on postural responses after external perturbation in PwPD with and without a history of falls. Methods: Twenty-two PwPD were distributed into two groups—faller (n = 12) and non-faller (n = 10)—based on their history of falls over the 12 months preceding the experiment. A 20 min anodal tDCS was applied to the primary motor cortex (M1) under two conditions (2 mA and sham), performed on two different visits (at least 2 weeks apart) with a randomised order. Seven trials with temporally unpredictable external perturbation (i.e., backward translation of the support base) were performed after tDCS. Electromyographic (i.e., medial gastrocnemius (MG) onset latency, magnitude of muscle activation of MG and tibialis anterior (TA), and MG/TA coactivation index) and centre of pressure (CoP) parameters (i.e., range of CoP, peak of CoP velocity, and recovery time) were analysed to assess postural response. A two-way ANOVA (Group × Stimulation Condition) was performed. Results: Both groups had shorter recovery time (determined by CoP) and MG onset latency in the active vs. sham condition. Conclusions: The results of our pilot study suggest that a single 20 min tDCS session (2 mA) applied over M1 enhances postural responses similarly in PwPD with and without a history of falls in the past year. Full article

Background: Transcranial Direct Current Stimulation (tDCS) has shown potential in improving negative symptoms (NS) and Cognitive Impairment Associated with Schizophrenia (CIAS). However, heterogeneity in stimulation protocols and sample characteristics limit definitive conclusions regarding tDCS effectiveness in schizophrenia. Given the detrimental effects of cigarette smoking, particularly on cognition, this study explored the role of cigarette smoking as a modifiable individual factor potentially contributing to methodological heterogeneity by evaluating tDCS effects on NS and CIAS in Smoker (SM) and Non-Smoker (NoSM) patients. Methods: Post hoc analyses of a double-blind RCT were performed on 50 patients, randomized to 2 mA active or sham-tDCS (15 weekday sessions) with bilateral bipolar-nonbalanced prefrontal placement. The sample was divided according to the smoking status, consisting of 28 SM and 22 NoSM. Separate one-way analyses of covariance (ANCOVA) were performed within each subgroup to assess changes over time between treatment conditions. Clinical outcomes included Positive and Negative Symptoms Scale (PANSS), Brief Assessment of Cognition in Schizophrenia (BACS), Clinical Global Impression (CGI) and Calgary Depression Scale for Schizophrenia (CDSS) total scores. Results: SM exhibited baseline lower cognitive scores in verbal memory, motor speed and working memory domains. NS improved in both SM and NoSM with large effect size. Significant improvement in CIAS, specifically in working memory and verbal fluency, were found exclusively in NoSM. Conclusions: Cigarette smoking appeared to limit tDCS effectiveness in improving CIAS but not NS in schizophrenia. We suggested that the neurotoxic milieu linked to chronic exposure to neurotoxins of cigarette smoking could be responsible for these effects, counterbalancing the neuroprotective effects of tDCS. Further studies are warranted to replicate these findings. Full article

With the rapid development of the low-altitude economy, the deployment of unmanned aircraft vehicles (UAVs) in many fields is increasing continuously, and the demand for collaborative flights is also growing. However, the issue of flight safety in complex airspace remains a pressing concern. Precise flight path prediction, collision detection, and avoidance are paramount for secure collaborative operations. This study proposes an integrated framework that combines an EKF-LSTM model for trajectory prediction, a Trajectory Dispersion Cone (TDC) method for probabilistic collision risk assessment, and a Velocity Obstacle-Model Predictive Control (VO-MPC) strategy for dynamic collision avoidance. Experimental results demonstrate the advantages of our approach: the EKF-LSTM model reduces prediction errors in complex flight states. Furthermore, the VO-MPC method achieves a 99.8% collision avoidance success rate under low-noise conditions—an 8.6% improvement over traditional MPC—while reducing the average collision probability by 66.7%. It also maintains stable performance under medium- and high-noise conditions, reducing the collision probability to only 27.7% and 34.2% of that of conventional MPC, respectively. The proposed framework offers a solution for safe manned–unmanned collaboration in complex environments. Future work will extend these methods to multi-aircraft cooperative scenarios. Full article

Background/Objectives: This study examined the effects of a computerized naming intervention combined with either cerebellar anodal transcranial direct-current stimulation (A-tDCS) or sham (S-tDCS) on noun and verb naming in Cantonese-speaking persons with chronic stroke-related aphasia (PWA). Methods: A double-blind, randomized, crossover, sham-controlled clinical trial was conducted with six Cantonese-speaking PWA following stroke. Participants received a 60 min computerized naming intervention incorporating audio–visual speech perception cues over five consecutive days, paired with concurrent 20 min of either 2 mA cerebellar A-tDCS or S-tDCS. Generalized linear mixed-effects models (GLMM) and linear mixed-effects models (LME) were used to evaluate naming accuracy and reaction time (RT). Individual variability was further explored through single-case analyses of naming accuracy changes across conditions and grammatical categories. Results: The GLMM showed a significant three-way interaction of condition, grammatical category, and time (p < 0.05). Specifically, the intervention paired with S-tDCS significantly improved verb naming, whereas A-tDCS did not induce significant improvements at the group level, effectively showing significantly smaller gains regarding verb naming compared to S-tDCS. Overall, RT decreased post-treatment across groups, but no significant differences emerged by the tDCS condition. The results support the promising efficacy of the Cantonese computerized audio–visual noun and verb naming therapy. Single-case analyses revealed high inter-individual variability in response to neuromodulation effects on naming and behavioral treatment outcomes. Conclusions: This study contributes to the emerging literature on cerebellar neuromodulation in post-stroke aphasia and underscores the need for larger trials examining grammar-specific (particularly verb-related) effects and polarity-dependent outcomes. It also highlights the value of developing personalized neuromodulation protocols to optimize the efficacy of behavioral language interventions in people with aphasia. Full article

Background: Transcranial Direct Current Stimulation (tDCS) in conjunction with behavioural language therapy in PPA has previously been modified for variation at the group level, but not at the individual level. This pilot study used individualised tDCS targeting by identifying regions of peak atrophy in the language system. Methods: Six PPA participants (four semantic and two non-fluent variant) were randomly allocated to receive tDCS or sham stimulation. The target electrode was selected for each based on their region of peak atrophy. Participants received naming therapy, individually calibrated according to baseline naming performance. Three sets of therapy were delivered in conjunction with tDCS (1 mA) or sham stimulation within participants’ homes. The study was not powered to demonstrate efficacy but to show proof-of-concept for an individualised, home-based tDCS targeting method. Results: All participants successfully completed the protocol. In one participant the region of peak atrophy differed from that predicted by clinical syndrome. Significant gains were observed at an individual level for treated items in both groups (2/3 tDCS and 2/3 Sham). No significant changes in untreated items were observed at an individual level. Significant naming improvement in untreated items was not observed for the tDCS group and was seen at one time point only for the Sham group. Conclusions: We have demonstrated the feasibility of a novel method for selecting neurostimulation targets for PPA at the individual level. A larger study would be required to determine the long-term therapeutic efficacy of this method. Full article

Introduction: Massage therapy delivers structured mechanosensory input that can influence brain function, yet the central mechanisms and potential for neuroplastic change have not been synthesized across neuroimaging modalities. This mechanistic review integrates evidence from electroencephalography (EEG), functional MRI (fMRI), and functional near-infrared spectroscopy (fNIRS) to map how massage alters human brain activity acutely and over time and to identify signals of longitudinal adaptation. Materials and Methods: We conducted a scoping, mechanistic review informed by PRISMA/PRISMA-ScR principles. PubMed/MEDLINE, Cochrane Library, Google Scholar, and ResearchGate were queried for English-language human trials (January 1990–July 2025) that (1) delivered a practitioner-applied manual massage (e.g., Swedish, Thai, shiatsu, tuina, reflexology, myofascial techniques) and (2) measured brain activity with EEG, fMRI, or fNIRS pre/post or between groups. Non-manual stimulation, structural-only imaging, protocols, and non-English reports were excluded. Two reviewers independently screened and extracted study, intervention, and neuroimaging details; heterogeneity precluded meta-analysis, so results were narratively synthesized by modality and linked to putative mechanisms and longitudinal effects. Results: Forty-seven studies met the criteria: 30 EEG, 12 fMRI, and 5 fNIRS. Results: Regarding EEG, massage commonly increased alpha across single sessions with reductions in beta/gamma, alongside pressure-dependent autonomic shifts; moderate pressure favored a parasympathetic/relaxation profile. Connectivity effects were state- and modality-specific (e.g., reduced inter-occipital alpha coherence after facial massage, preserved or reorganized coupling with hands-on vs. mechanical delivery). Frontal alpha asymmetry frequently shifted leftward (approach/positive affect). Pain cohorts showed decreased cortical entropy and a shift toward slower rhythms, which tracked analgesia. Somatotopy emerged during unilateral treatments (contralateral central beta suppression). Adjuncts (e.g., binaural beats) enhanced anti-fatigue indices. Longitudinally, repeated programs showed attenuation of acute EEG/cortisol responses yet improvements in stress and performance; in one program, BDNF increased across weeks. In preterm infants, twice-daily massage accelerated EEG maturation (higher alpha/beta, lower delta) in a dose-responsive fashion; the EEG background was more continuous. In fMRI studies, in-scanner touch and reflexology engaged the insula, anterior cingulate, striatum, and periaqueductal gray; somatotopic specificity was observed for mapped foot areas. Resting-state studies in chronic pain reported normalization of regional homogeneity and/or connectivity within default-mode and salience/interoceptive networks after multi-session tuina or osteopathic interventions, paralleling symptom improvement; some task-based effects persisted at delayed follow-up. fNIRS studies generally showed increased prefrontal oxygenation during/after massage; in motor-impaired cohorts, acupressure/massage enhanced lateralized sensorimotor activation, consistent with use-dependent plasticity. Some reports paired hemodynamic changes with oxytocin and autonomic markers. Conclusions: Across modalities, massage reliably modulates central activity acutely and shows convergent signals of neuroplastic adaptation with repeated dosing and in developmental windows. Evidence supports (i) rapid induction of relaxed/analgesic states (alpha increases, network rebalancing) and (ii) longer-horizon changes—network normalization in chronic pain, EEG maturation in preterm infants, and neurotrophic up-shifts—consistent with trait-level recalibration of stress, interoception, and pain circuits. These findings justify integrating massage into rehabilitation, pain management, mental health, and neonatal care and motivate larger, standardized, multimodal longitudinal trials to define dose–response relationships, durability, and mechanistic mediators (e.g., connectivity targets, neuropeptides). Full article

Pain in children and adolescents remains an underestimated and undertreated condition, with long-term physical and psychosocial consequences. Non-invasive neuromodulation has emerged as a promising, low-risk approach for managing acute and chronic pain by modulating central and peripheral neural pathways. This systematic review followed PRISMA 2020 guidelines to evaluate the efficacy, safety, and clinical applicability of non-invasive neuromodulation techniques in pediatric pain. Searches were conducted in PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, and ScienceDirect for randomized controlled trials (RCTs) published between 2015 and 2025. Six RCTs met the inclusion criteria, encompassing percutaneous electrical nerve field stimulation (PENFS), transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous electrical acupoint stimulation (TEAS), and transcutaneous electrical nerve stimulation (TENS). Four trials reported significant reductions in pain intensity alongside improvements in functional outcomes and quality of life, particularly in functional abdominal pain and postoperative contexts. Most studies showed low or moderate risk across domains, with appropriate randomization and blinded assessment. No serious adverse events were reported, confirming an excellent safety profile. These findings support non-invasive neuromodulation as a feasible and well-tolerated adjunct to conventional pediatric pain management. Further high-quality trials are warranted to standardize protocols and explore mechanisms of neuroplasticity in the developing nervous system. PROSPERO (CRD420251170866). Full article

Orchid seed germination requires symbiotic association with mycorrhizal fungi that provide essential nutrients for germination and subsequent growth. Extensive research has elucidated the pivotal role of the mycorrhizal fungus Tulasnella sp. in the modulation of seed germination and growth processes in Bletilla striata (Thunb.) Reiehb.f. However, the molecular mechanisms underlying this symbiosis remain poorly characterized. Our integrated transcriptomic-metabolomic analysis of symbiotic germination revealed that co-cultivation of Tulasnella sp. bj1 with B. striata seeds significantly downregulates the expression of plant-derived flavonoid biosynthetic genes, with flavonoid degradation potentially alleviating germination and growth inhibition. The bj1 strain modulates indoleacetic acid (IAA) biosynthesis in B. striata by upregulating the expression of plant-derived tryptophan decarboxylase (TDC) in the tryptophan pathway and hydrolytic enzymes (NtAMI) in the indoleacetamide pathway, with elevated IAA potentially contributing to seed germination and growth. Moreover, bj1 suppresses the jasmonic acid (JA) biosynthetic pathway of B. striata by downregulating key plant-derived biosynthetic genes, concurrently promoting the accumulation of 12-hydroxyjasmonic acid—a metabolite associated with plant immune regulation that may favor colonization and symbiotic establishment with B. striata seeds. Additionally, bj1 induces the expression of polysaccharide-degrading enzymes, potentially improving carbon source utilization to support protocorm development. In conclusion, bj1 modulates the immune response of B. striata seeds, facilitating the establishment of a symbiotic relationship. Subsequently, the germination and growth of B. striata seeds are enhanced through reduced flavonoid accumulation, increased IAA synthesis, and improved carbon source utilization. Consequently, this investigation provides a crucial foundation for elucidating mechanisms governing symbiotic germination in B. striata. Full article