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Povzetek: Growth factors are key inducers of fibrosis but can also mediate inflammatory responses resulting in increasing pleural effusion and acute respiratory distress syndrome. The primary aim of the study was to analyse growth factors release after performing chemical and mechanical pleurodesis in the first 48 hours at the patients with malignant pleural effusion. The secondary endpoints were to evaluate the effectiveness of the both pleurodeses, symptoms release and the quality of life of patients after the treatment. Patients and methods. A prospective randomized study included 36 consecutive female patients with breast carcinoma and malignant pleural effusion in an intention-to-treat analysis. We treated 18 patients by means of thoracoscopic mechanical pleurodesis and 18 patients by chemical pleurodesis with talcum applied over a chest tube. We gathered the pleural fluid and serum samples in the following 48 hours under a dedicated protocol and tested them for growth factors levels. A quality of life and visual analogue pain score surveys were also performed. Results. Median measured serum vascular endothelial growth factor (VEGF) level after chemical pleurodesis was 930.68 pg/ml (95% CI: 388.22-4656.65) and after mechanical pleurodesis 808.54 pg/ml. (95% CI: 463.20-1235.13) (p = 0.103). Median pleural levels of transforming growth factor (TGF) ß1 were higher after performing mechanical pleurodesis (4814.00 pg/ml [95% CI: 2726.51-7292.94]) when compared to those after performing chemical pleurodesis (1976.50 pg/ml [95% CI: 1659.82-5136.26]) (p = 0.078). We observed similar results for fibroblast growth factor (FGF) ß; the serum level was higher after mechanical pleurodesis (30.45 pg/ml [95% CI: 20.40-59.42]), compared to those after chemical pleurodesis (13.39 pg/ml [95% CI: 5.04-74.60]) (p = 0.076). Mechanical pleurodesis was equally effective as chemical pleurodesis in terms of hospital stay, pleural effusion re-accumulation, requiring of additional thoracentesis, median overall survival, but, it shortened the mean thoracic drainage duration (p = 0.030) and resulted in a higher symptoms release and in a better quality of life (p = 0.047). Conclusions. We recorded an increase in serum VEGF levels after chemical pleurodesis, however on the contrary, an increase in the pleural fluid level of TGF%1 and FGF%] after mechanical pleurodesis with respect to compared group. Although the differences did not reach statistical significance, VEGF, TGFß1 and FGFß remain the most interesting parameters for future research. Considering the mechanisms of growth factors action, we conclude that in our study group mechanical pleurodesis might be more efficient in terms of growth factors release, thoracic drainage duration and resulted in a higher symptoms release and in a better quality of life than chemical pleurodesis.
Ključne besede: malignant pleural effusion, pleurodesis, growth factors, quality of life
Objavljeno v DiRROS: 23.04.2024; Ogledov: 45; Prenosov: 25
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Povzetek: To foster sustainable development in construction sectors, environmental impacts need to be reduced dramatically. The Life Cycle Assessment (LCA) technique is the most firmly established methodology used to quantify these environmental impacts and, therefore, has been applied with increasing frequency to assess the environmental performance of buildings. To effectively improve a building's environmental performance, an integration of LCA in the design process is required. This can be achieved by coupling LCA with digital design tools, e.g., Building Information Modelling (BIM). To identify the pro and cons of streamlining the integration of LCA and BIM, a comprehensive Systematic Literature Review (SLR) was performed. We identified more than 50 relevant BIM-LCA case studies and analysed the applied BIM-LCA workflows in detail. In most of the studies reviewed, the LCA has been applied in an early design stage. The authors primarily used LCA tools and manual or semi-automatic methods to exchange data between BIM models. In most cases, contemporary BIM-LCA workflows utilized conventional spreadsheets (e.g., Excel worksheets). However, the results of the analysis show that an automated link between LCA and BIM can be achieved if certain challenges are overcome. By automating exchange of information between BIM and LCA tools and improving the reliability of this process, the LCA application can be streamlined in design practice and, hence, the necessary improvements of the environmental performance of buildings can be supported.
Ključne besede: building information modelling, life cycle assessment, systematic Literature Review
Objavljeno v DiRROS: 18.03.2024; Ogledov: 91; Prenosov: 72
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Povzetek: To foster sustainable development, the environmental impacts of the construction sector need to be reduced substantially. Life cycle assessment (LCA) is the established methodology for the quantification of environmental impacts, and therefore has been increasingly applied to assess the environmental performance of buildings. By coupling LCAs with digital design tools, e.g., building information modeling (BIM), the identification of environmental hotspots and their mitigation is possible during the design process. The objective of the study is to identify the current integration approaches, and determine the pros and cons of the integration process from different viewpoints, namely, technical, informational, organizational and functional issues. Therefore, a comprehensive systematic literature review (SLR) was performed. We identified 60 relevant BIM-LCA case studies and analyzed the applied BIM-LCA workflows in detail. A total of 16 of the reviewed studies applied LCA during the early design stage. These studies used a manual or semiautomatic data exchange between the BIM models and LCA tools. In most cases, contemporary BIM-LCA workflows utilized conventional spreadsheets (e.g., Excel sheets in 16 cases). However, the analysis shows that an automated link between LCA and BIM can be achieved when overcoming the technical, organizational and informational issues discussed in the paper. This could enable the streamlining of LCA applications in design practice, and thus support the necessary improvements in the environmental performance of buildings.
Ključne besede: building information modeling (BIM), life cycle assessment (LCA), systematic literaturereview (SLR), environmental product declarations (EPD), workflow, bill of quantities (BoQ)
Objavljeno v DiRROS: 05.03.2024; Ogledov: 159; Prenosov: 52
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Ključne besede: projekt Life IP CARE4CLIMATE, raba tal, spremembe rabe tal, gozdarstvo, aktivnosti
Objavljeno v DiRROS: 16.01.2024; Ogledov: 211; Prenosov: 0

Ključne besede: project Life IP CARE4CLIMATE, land use, land use changes, forestry, activities
Objavljeno v DiRROS: 09.01.2024; Ogledov: 188; Prenosov: 0