Bioengineering

Chronic obstructive pulmonary disease, interstitial lung disease, and post-lung trans-plantation are often accompanied by skeletal muscle dysfunction that worsens the quality of life. Such physiological changes are driven by physical inactivity, systemic inflammation, oxidative stress, anabolic and hormonal resistance, and medication effects. Structural changes include impaired capillarization, fiber-type shifts (slow-to-fast in limb muscle and fast-to-slow in respiratory muscles), mitochondrial dysfunction, reduced oxidative capacity, and early lactate accumulation. Electromyography and dynamometry, both isokinetic and isometric, quantify neuromuscular drive through measuring strength, power, and endurance and are associated with functional outcomes (6-min walk, sit-to-stand, stair climbing tests). Pulmonary rehabilitation (PR) improves neuromuscular efficiency, dyspnea, exercise tolerance, and quality of life by combining resistance, endurance, and eccentric training. The effects of PR generally plateau at three months, emphasizing the need for maintenance and the personalization of rehabilitation plans. While nutritional optimization is important, supplements have shown little benefit. Future priorities include defining EMG/dynamometry thresholds to allow standardized routine testing for comparable benchmarks and more precise PR protocols. Future research targeting mitochondrial remodeling, inflammatory signaling, and anabolic resistance offer potential pathways for preventing and reversing muscle wasting.

The goal of this paper was to determine the efficacy of the surgical treatment of two-wall peri-implant defects filled with L-PRF/xenograft block in the reduction of peri-implant marginal bone levels after 12 months. Ten patients with two-wall peri-implant defects were included. Patients received presurgical treatment followed by a surgical reconstructive intervention with bone blocks obtained by mixing bovine origin xenogeneic bone graft grains with L-PRF membranes. Patients were followed up at 3, 6, 9, and 12 months for oral hygiene and disease relapse evaluation and assessment of the primary outcome marginal bone levels (MBL) and clinical outcome variables such as probing depth (PD), bleeding on probing (BOP), and mucosal recession. Data was analyzed for changes between baseline and the 6- and 12-month follow-ups. Mean MBL was 5.1 ± 1.7 mm and 1.58 ± 0.92 mm at baseline and 6 months after the procedure, indicating a statistically significant decrease (p = 0.0005). At 12 months post-surgery, marginal bone levels remained stable at 1.8 ± 0.9 mm, with no statistically significant difference from the previous evaluation (p > 0.05). From baseline to 6 months there was also a statistically significant decrease in PD (from 8.07 ± 1.51 mm to 3.33 ± 0.59, p < 0.0001) and BOP (from 60.0% to 13.0% of affected surfaces, p < 0.001). No changes were observed from the intermediate to the 12-month follow-up (p > 0.05 for all variables).

Background: Revision anterior cruciate ligament reconstruction (ACLR) presents an increasing clinical challenge with higher failure rates than primary reconstruction. However, the evolving research landscape and clinical evidence regarding key biomechanical risk factors remain incompletely synthesized. Methods: A sequential dual methodological approach was applied. First, a bibliometric analysis of the Web of Science Core Collection was performed to map global research trends and identify emerging hotspots. Based on the identified hotspot, a PRISMA-compliant meta-analysis of studies retrieved from PubMed, Embase, the Cochrane Library, and Web of Science was subsequently conducted. Clinical and radiographic outcomes were synthesized using random-effects models in R. Results: The bibliometric analysis included 4213 publications and demonstrated exponential growth in revision ACLR research, identifying posterior tibial slope (PTS) as the dominant research hotspot. A meta-analysis of 11 studies involving 299 patients showed significant postoperative improvements in patient-reported outcomes and objective knee stability measures, along with a mean PTS reduction of 8.72° (95% CI 7.84–9.60; p < 0.001), while no significant change in patellar height was observed. The pooled return-to-sport rate was 74% (95% CI 64–82%), and the most common complications were symptomatic hardware and postoperative recurvatum. Conclusions: PTS has emerged as a key focus in revision ACLR research, and addressing this biomechanical factor may be associated with improved functional and radiographic outcomes. However, current evidence is mainly derived from retrospective studies, and further prospective research is needed to confirm long-term efficacy and refine surgical indications.