Browsing by Author "Skelton L"

Now showing 1 - 5 of 5
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    A study of design change management for infrastructure development projects in New Zealand
    (MDPI AG, 19/09/2022) Wang R; Samarasinghe DAS; Skelton L; Rotimi JOB
    Design changes seem to be an inevitable part of engineering, procurement and construction EPC projects. Such changes create a need for a proactive approach to adjusting project scope, cost and time (the triple constraints) for efficiency and effectiveness in overall delivery. This study investigates the causes and implications of design changes in order to improve design change management practices. Data for the study were obtained through online interviews with New Zealand industry practitioners. Thematic analysis was used to collate the results into meaningful data. The study found that design changes were predominantly caused by clients’ inadequate strategic planning, insufficient attention to design, EPC contractors’ inadequate design ability, and on-site variations. There were three categories of such design changes: direct impact on the project, the reciprocal and complementary effect on stakeholders, and the far-reaching impact on the community. The study concludes by suggesting improvements, such as strengthening the integration of project teams to enhance design quality, strategic alignment of stakeholders at the planning stage, early contractor involvement (ECI) between the planning and design phases, and improving collaboration between design and construction teams. Further, a combination of high technical skills (e.g., design ability) and soft skills (can-do attitude, interpersonal skills, problem-solving skills, documentation skills, etc.) are needed to generate the desired improvement in design change management.
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    A Study of Design Change Management for Infrastructure Development Projects in New Zealand
    (MDPI (Basel, Switzerland), 2022-09-19) Wang R; Samarasinghe DAS; Skelton L; Rotimi JOB
    Design changes seem to be an inevitable part of engineering, procurement and construction EPC projects. Such changes create a need for a proactive approach to adjusting project scope, cost and time (the triple constraints) for efficiency and effectiveness in overall delivery. This study investigates the causes and implications of design changes in order to improve design change management practices. Data for the study were obtained through online interviews with New Zealand industry practitioners. Thematic analysis was used to collate the results into meaningful data. The study found that design changes were predominantly caused by clients’ inadequate strategic planning, insufficient attention to design, EPC contractors’ inadequate design ability, and on-site variations. There were three categories of such design changes: direct impact on the project, the reciprocal and complementary effect on stakeholders, and the far-reaching impact on the community. The study concludes by suggesting improvements, such as strengthening the integration of project teams to enhance design quality, strategic alignment of stakeholders at the planning stage, early contractor involvement (ECI) between the planning and design phases, and improving collaboration between design and construction teams. Further, a combination of high technical skills (e.g., design ability) and soft skills (can-do attitude, interpersonal skills, problem-solving skills, documentation skills, etc.) are needed to generate the desired improvement in design change management.
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    Genetic polymorphism rs6922269 in the MTHFD1L gene is associated with survival and baseline active vitamin B12 levels in post-acute coronary syndromes patients.
    (2014) Palmer BR; Slow S; Ellis KL; Pilbrow AP; Skelton L; Frampton CM; Palmer SC; Troughton RW; Yandle TG; Doughty RN; Whalley GA; Lever M; George PM; Chambers ST; Ellis C; Richards AM; Cameron VA
    BACKGROUND AND AIMS: The methylene-tetrahydrofolate dehydrogenase (NADP+ dependent) 1-like (MTHFD1L) gene is involved in mitochondrial tetrahydrofolate metabolism. Polymorphisms in MTHFD1L, including rs6922269, have been implicated in risk for coronary artery disease (CAD). We investigated the association between rs6922269 and known metabolic risk factors and survival in two independent cohorts of coronary heart disease patients. METHODS AND RESULTS: DNA and plasma from 1940 patients with acute coronary syndromes were collected a median of 32 days after index hospital admission (Coronary Disease Cohort Study, CDCS). Samples from a validation cohort of 842 patients post-myocardial infarction (PMI) were taken 24-96 hours after hospitalization. DNA samples were genotyped for rs6922269, using a TaqMan assay. Homocysteine and active vitamin B12 were measured by immunoassay in baseline CDCS plasma samples, but not PMI plasma. All cause mortality was documented over follow-up of 4.1 (CDCS) and 8.8 (PMI) years, respectively. rs6922269 genotype frequencies were AA n = 135, 7.0%; GA n = 785, 40.5% and GG n = 1020, 52.5% in the CDCS and similar in the PMI cohort. CDCS patients with AA genotype for rs6922269 had lower levels of co-variate adjusted baseline plasma active vitamin B12 (p = 0.017) and poorer survival than patients with GG or GA genotype (mortality: AA 19.6%, GA 12.0%, GG 11.6%; p = 0.007). In multivariate analysis, rs6922269 genotype predicted survival, independent of established covariate predictors (p = 0.03). However the association between genotype and survival was not validated in the PMI cohort. CONCLUSION: MTHFD1L rs6922269 genotype is associated with active vitamin B12 levels at baseline and may be a marker of prognostic risk in patients with established coronary heart disease.
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    Plasma levels of soluble VEGF receptor isoforms, circulating pterins and VEGF system SNPs as prognostic biomarkers in patients with acute coronary syndromes
    (BioMed Central Ltd, 15/08/2018) Marks ECA; Wilkinson TM; Frampton CM; Skelton L; Pilbrow AP; Yandle TG; Pemberton CJ; Doughty RN; Whalley GA; Ellis CJ; Troughton RW; Owen MC; Pattinson NR; Cameron VA; Richards AM; Gieseg SP; Palmer BR
    BACKGROUND: Development of collateral circulation in coronary artery disease is cardio-protective. A key process in forming new blood vessels is attraction to occluded arteries of monocytes with their subsequent activation as macrophages. In patients from a prospectively recruited post-acute coronary syndromes cohort we investigated the prognostic performance of three products of activated macrophages, soluble vascular endothelial growth factor (VEGF) receptors (sFlt-1 and sKDR) and pterins, alongside genetic variants in VEGF receptor genes, VEGFR-1 and VEGFR-2. METHODS: Baseline levels of sFlt-1 (VEGFR1), sKDR (VEGFR2) and pterins were measured in plasma samples from subgroups (n = 513; 211; 144, respectively) of the Coronary Disease Cohort Study (CDCS, n = 2067). DNA samples from the cohort were genotyped for polymorphisms from the VEGFR-1 gene SNPs (rs748252 n = 2027, rs9513070 n = 2048) and VEGFR-2 gene SNPs (rs2071559 n = 2050, rs2305948 n = 2066, rs1870377 n = 2042). RESULTS: At baseline, levels of sFlt-1 were significantly correlated with age, alcohol consumption, NTproBNP, BNP and other covariates relevant to cardiovascular pathophysiology. Total neopterin levels were associated with alcohol consumption at baseline. 7,8 dihydroneopterin was associated with BMI. The A allele of VEGFR-2 variant rs1870377 was associated with higher plasma sFlt-1 and lower levels of sKDR at baseline. Baseline plasma sFlt-1 was univariately associated with all cause mortality with (p < 0.001) and in a Cox's proportional hazards regression model sFlt-1 and pterins were both associated with mortality independent of established predictors (p < 0.027). CONCLUSIONS: sFlt-1 and pterins may have potential as prognostic biomarkers in acute coronary syndromes patients. Genetic markers from VEGF system genes warrant further investigation as markers of levels of VEGF system components in these patients. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry. ACTRN12605000431628 . 16 September 2005, Retrospectively registered.
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    Vascular endothelial growth factor-A promoter polymorphisms, circulating VEGF-A and survival in acute coronary syndromes
    (PLOS, 2021-07-14) Palmer BR; Paterson MA; Frampton CM; Pilbrow AP; Skelton L; Pemberton CJ; Doughty RN; Ellis CJ; Troughton RW; Richards AM; Cameron VA; Zirlik A
    BACKGROUND: Development of a competent collateral circulation in established coronary artery disease is cardio-protective. The vascular endothelial growth factor (VEGF) system plays a key role in this process. We investigated the prognostic performance of circulating VEGF-A and three genetic variants in the VEGFA gene in a clinical coronary cohort. METHODS AND RESULTS: The Coronary Disease Cohort Study (CDCS) recruited 2,140 patients, with a diagnosis of acute coronary syndrome (ACS), after admission to Christchurch or Auckland City Hospitals between July 2002 and January 2009. We present data for 1927 patients from the cohort genotyped for three SNPs in the VEGF-A gene, rs699947 (C-2578A), rs2010963 (C405G) and rs3025039 (C936T). Plasma VEGF-A concentrations were assayed in a subgroup (n = 550) of CDCS patients (geometric mean 36.6 [34.7-38.5] pg/ml). VEGF-A levels correlated with patient heart rate at baseline (p = 0.034). None of rs699947, rs3025039, nor rs2010963 genotypes were significantly associated with VEGF-A levels, but rs3025039 genotype was positively associated with collateral vessels perfusion according to the Rentrop classification (p = 0.01) and baseline natriuretic peptide levels (p<0.05). Survival in the CDCS cohort was independently associated with baseline VEGF-A levels and (in males) with rs699947 genotype. CONCLUSIONS: This study is strongly suggestive that VEGF-A levels have value as a prognostic biomarker in coronary heart disease patients and SNPs in VEGF-A deserve further investigation as prognostic markers and indicators of angiogenic potential influencing the formation of collateral circulation.