Analyzing the Interdiction of Sea-Borne Threats Using Simulation Optimization

Worldwide, maritime trade accounts for approximately 80% of all trade by volume and is expected to double in the next twenty years. Prior to September 11, 2001, Ports, Waterways and Coastal Security (PWCS) was afforded only 1 percent of United States Coast Guard (USCG) resources. Today, it accounts for nearly 22 percent of dedicated USCG resources. Tactical assessment of resource requirements and operational limitations on the PWCS mission is necessary for more effective management of USCG assets to meet the broader range of competing missions. This research effort involves the development and validation of a discrete-event simulation model of the at-sea vessel interdiction process utilizing USCG deepwater assets. A discrete-event simulation model of the interdiction, control and boarding, and inspection processes has been developed and validated. Through a simulation optimization approach, our research utilizes the efficiency of a localized search algorithm interfaced with the simulation model to allocate USCG resources in the interception, boarding, and inspection processes with the objective of minimizing overall process time requirements. The model is tested with actual USCG data to gain insight on the development of efficient and effective interdiction operations

Assembly of Connexin43 into Gap Junctions Is Regulated Differentially by E-Cadherin and N-Cadherin in Rat Liver Epithelial Cells

E-cadherin and N-cadherin affect the assembly of connexin43 into gap junctions differentially. N-cadherin disrupts assembly by triggering endocytosis of connexin43, whereas E-cadherin facilitates the assembly

Nusinersen versus Sham Control in Later-Onset Spinal Muscular Atrophy

International audienceBACKGROUND Nusinersen is an antisense oligonucleotide drug that modulates pre-messenger RNA splicing of the survival motor neuron 2 (SMN2) gene. It has been developed for the treatment of spinal muscular atrophy (SMA). METHODS We conducted a multicenter, double-blind, sham-controlled, phase 3 trial of nusinersen in 126 children with SMA who had symptom onset after 6 months of age. The children were randomly assigned, in a 2: 1 ratio, to undergo intrathecal administration of nusinersen at a dose of 12 mg (nusinersen group) or a sham procedure (control group) on days 1, 29, 85, and 274. The primary end point was the least-squares mean change from baseline in the Hammersmith Functional Motor Scale-Expanded (HFMSE) score at 15 months of treatment; HFMSE scores range from 0 to 66, with higher scores indicating better motor function. Secondary end points included the percentage of children with a clinically meaningful increase from baseline in the HFMSE score (>= 3 points), an outcome that indicates improvement in at least two motor skills. RESULTS In the prespecified interim analysis, there was a least-squares mean increase from baseline to month 15 in the HFMSE score in the nusinersen group (by 4.0 points) and a least-squares mean decrease in the control group (by -1.9 points), with a significant between-group difference favoring nusinersen (least-squares mean difference in change, 5.9 points; 95% confidence interval, 3.7 to 8.1; P< 0.001). This result prompted early termination of the trial. Results of the final analysis were consistent with results of the interim analysis. In the final analysis, 57% of the children in the nusinersen group as compared with 26% in the control group had an increase from baseline to month 15 in the HFMSE score of at least 3 points (P< 0.001), and the overall incidence of adverse events was similar in the nusinersen group and the control group (93% and 100%, respectively). CONCLUSIONS Among children with later-onset SMA, those who received nusinersen had significant and clinically meaningful improvement in motor function as compared with those in the control group. (Funded by Biogen and Ionis Pharmaceuticals; CHERISH ClinicalTrials. gov number, NCT02292537.