Standardising Clinical Caremaps: Model, Method and Graphical Notation for Caremap Specification

Standardising care can improve patient safety and outcomes, and reduce the cost of providing healthcare services. Caremaps were developed to standardise care, but contemporary caremaps are not standardised. Confusion persists in terms of terminology, structure, content and development process. Unlike existing methods in the literature, the approach, model and notation presented in this chapter pays special attention to incorporation of clinical decision points as first-class citizens within the modelling process. The resulting caremap with decision points is evaluated through creation of a caremap for women with gestational diabetes mellitus. The proposed method was found to be an effective way for comprehensively specifying all features of caremaps in a standardised way that can be easily understood by clinicians. This chapter contributes a new standardised method, model and notation for caremap content, structure and development

Acoustic testing and response prediction of the CASSIOPE spacecraft

A high intensity acoustic test in a reverberant chamber was conducted on the CASSIOPE spacecraft in the final stages of integration and test campaign to ensure that it would survive the acoustic loads during launch. This paper describes the acoustic test methodology, the details of the model used for analytical prediction of the structural response for acoustic excitation and discussion of the predicted response comparison with test results that provided confidence in the spacecraft structural design for acoustic loads. The objective of the spacecraft acoustic test was to demonstrate the ability of the structure and avionics to withstand the broadband random acoustic environment experienced within the launch vehicle payload fairing. The CASSIOPE spacecraft was tested in the reverberant chamber at overall sound pressure level up to 142.1 dB. The automatic spectral control system of the acoustic test facility, which used six control microphones, was able to achieve and the maintain target spectrum levels around the spacecraft within tolerances without manual adjustments to the noise generators' controls. The dynamic response of the CASSIOPE spacecraft during the test was measured using a large number of accelerometers installed on critical locations of the structure. Low level pre-test and post-test structural response signatures as well as electrical integrity checks performed after the exposure to the proto-flight acoustic environment demonstrated the ability of the spacecraft to survive the launch. The acoustic response of the spacecraft was also predicted based on a finite element model analysis to identify the critical components, evaluate structural margins and assess the risks in proceeding with a proto-flight acoustic test based on the specified launch vehicle spectrum. The analysis method used to predict the responses combines the NX/NASTRAN solver and RAYON, a vibro-acoustic simulation software. The RAYON software functionality is based on a boundary element model that enables the creation of an accurate fluid loading on the structure, with consideration of fluid mass and damping effects. The study used a finite element model of the structure that was correlated through an experimental modal survey test and actual spectrum levels achieved during the acoustic test. Responses of most locations compared favourably with the predictions in critical locations such as the solar arrays. Due to the limited availability of the satellite as well as time and cost constraints in a spacecraft development program, it is important to perform both qualification tests as well as analytical predictions in an efficient and timely manner to validate structural designs of spacecraft.Peer reviewed: YesNRC publication: Ye

Clathrin light chains function in mannose phosphate receptor trafficking via regulation of actin assembly

Clathrin-coated vesicles (CCVs) are major carriers for endocytic cargo and mediate important intracellular trafficking events at the trans-Golgi network (TGN) and endosomes. Whereas clathrin heavy chain provides the structural backbone of the clathrin coat, the role of clathrin light chains (CLCs) is poorly understood. We now demonstrate that CLCs are not required for clathrin-mediated endocytosis but are critical for clathrin-mediated trafficking between the TGN and the endosomal system. Specifically, CLC knockdown (KD) causes the cation-independent mannose-6 phosphate receptor (CI-MPR) to cluster near the TGN leading to a delay in processing of the lysosomal hydrolase cathepsin D. A recently identified binding partner for CLCs is huntingtin-interacting protein 1-related (HIP1R), which is required for productive interactions of CCVs with the actin cytoskeleton. CLC KD causes mislocalization of HIP1R and overassembly of actin, which accumulates in patches around the clustered CI-MPR. A dominant-negative CLC construct that disrupts HIP1R/CLC interactions causes similar alterations in CI-MPR trafficking and actin assembly. Thus, in mammalian cells CLCs function in intracellular membrane trafficking by acting as recruitment proteins for HIP1R, enabling HIP1R to regulate actin assembly on clathrin-coated structures