Comment: Boosting Algorithms: Regularization, Prediction and Model Fitting

The authors are doing the readers of Statistical Science a true service with a well-written and up-to-date overview of boosting that originated with the seminal algorithms of Freund and Schapire. Equally, we are grateful for high-level software that will permit a larger readership to experiment with, or simply apply, boosting-inspired model fitting. The authors show us a world of methodology that illustrates how a fundamental innovation can penetrate every nook and cranny of statistical thinking and practice. They introduce the reader to one particular interpretation of boosting and then give a display of its potential with extensions from classification (where it all started) to least squares, exponential family models, survival analysis, to base-learners other than trees such as smoothing splines, to degrees of freedom and regularization, and to fascinating recent work in model selection. The uninitiated reader will find that the authors did a nice job of presenting a certain coherent and useful interpretation of boosting. The other reader, though, who has watched the business of boosting for a while, may have quibbles with the authors over details of the historic record and, more importantly, over their optimism about the current state of theoretical knowledge. In fact, as much as ``the statistical view'' has proven fruitful, it has also resulted in some ideas about why boosting works that may be misconceived, and in some recommendations that may be misguided. [arXiv:0804.2752]Comment: Published in at http://dx.doi.org/10.1214/07-STS242B the Statistical Science (http://www.imstat.org/sts/) by the Institute of Mathematical Statistics (http://www.imstat.org

Secukinumab Provides Significant and Sustained Inhibition of Joint Structural Damage in a Phase III Study of Active Psoriatic Arthritis

In this phase III, double-blind, placebo-controlled study, 606 patients with psoriatic arthritis were randomised to intravenous (IV) secukinumab 10 mg/kg (weeks 0, 2, 4) followed by subcutaneous secukinumab 150 mg (IV→150 mg) or 75 mg (IV→75 mg), or placebo. Patients were stratified by prior anti-TNF (tumour necrosis factor) exposure (71% anti-TNF-naïve). At week 16, placebo-treated patients who had ≥20% reduction in tender and swollen joint count (responders) remained on placebo until week 24; non-responders were re-randomised to secukinumab 150 or 75 mg. The van der Heijde modified total Sharp score (mTSS) was determined at baseline, week 16/24 and week 52.In the overall population, radiographic progression was inhibited through 52 weeks; efficacy was demonstrated for both erosion and joint space narrowing scores and in patients who switched from placebo to secukinumab at week 24. Subgroup analyses showed secukinumab reduced progression at week 24, regardless of prior anti-TNF use; mean change from baseline to week 24 in mTSS in the secukinumab pooled and placebo groups was 0.05 and 0.57, respectively for anti-TNF-naïve patients and 0.16 and 0.58, respectively in anti-TNF-IR patients. Anti-TNF-naïve patients showed negligible progression through week 52. Inhibition of structural damage was observed through week 52, irrespective of concomitant methotrexate use. A high proportion of patients showed no progression (≤0.5) with secukinumab from baseline to week 24 (IV→150 mg, 82.3%; IV→75 mg, 92.3%) and from week 24 to week 52 (IV→150 mg, 85.7%; IV→75 mg, 85.8%).Secukinumab inhibited radiographic progression in patients with active psoriatic arthritis through 52 weeks of therapy

Secukinumab: a new treatment option for psoriatic arthritis

Introduction: Psoriatic arthritis (PsA) is an immune-mediated chronic inflammatory arthropathy associated with impaired physical function and reduced quality of life. Biologic therapies that target tumor necrosis factor (anti-TNF) have significantly improved clinical outcomes. Partial, non- and transient responses remain common comprising significant unmet clinical need. New therapies with novel modes of action are urgently required. Objectives: The interleukin (IL)-17 pathway has recently been attributed a critical role in the pathogenesis of spondyloarthritides. Herein, we review data from clinical studies with secukinumab, a novel fully human IgG1κ anti-IL-17A monoclonal antibody (mAb), in patients with active PsA. Results: Across two pivotal phase 3 studies, secukinumab provided significant and sustained reductions in the signs and symptoms of PsA, inhibition of radiographic progression, and improved patient-reported outcomes and measures of quality of life. The primary efficacy endpoint, a ≥20% improvement from baseline according to the American College of Rheumatology 20 (ACR20) response at Week 24, was significantly higher in patients treated with secukinumab compared with placebo, with improvements sustained through at least 52 weeks. Clinical benefits were seen with secukinumab regardless of concomitant methotrexate treatment and in patients who were either anti-TNF-naïve or who were inadequate responders to anti-TNF therapy. Secukinumab was well-tolerated, with a safety profile consistent with that previously reported in psoriasis trials. The most common adverse events were nasopharyngitis, upper respiratory tract infections, and headache. Conclusion: Secukinumab offers an effective new addition to the available treatment options for PsA. Regulatory submissions have been filed worldwide, with the first approvals recently obtained in Japan and Europe. Future studies are required to define the optimal timing and strategic use of this novel treatment modality

Robust and real-time control of magnetic bearings for space engines

Currently, NASA Lewis Research Center is developing magnetic bearings for Space Shuttle Main Engine (SSME) turbopumps. The control algorithms which have been used are based on either the proportional-intergral-derivative control (PID) approach or the linear quadratic (LQ) state space approach. These approaches lead to an acceptable performance only when the system model is accurately known, which is seldom true in practice. For example, the rotor eccentricity, which is a major source of vibration at high speeds, cannot be predicted accurately. Furthermore, the dynamics of a rotor shaft, which must be treated as a flexible system to model the elastic rotor shaft, is infinite dimensional in theory and the controller can only be developed on the basis of a finite number of modes. Therefore, the development of the control system is further complicated by the possibility of closed loop system instability because of residual or uncontrolled modes, the so called spillover problem. Consequently, novel control algorithms for magnetic bearings are being developed to be robust to inevitable parametric uncertainties, external disturbances, spillover phenomenon and noise. Also, as pointed out earlier, magnetic bearings must exhibit good performance at a speed over 30,000 rpm. This implies that the sampling period available for the design of a digital control system has to be of the order of 0.5 milli-seconds. Therefore, feedback coefficients and other required controller parameters have to be computed off-line so that the on-line computational burden is extremely small. The development of the robust and real-time control algorithms is based on the sliding mode control theory. In this method, a dynamic system is made to move along a manifold of sliding hyperplanes to the origin of the state space. The number of sliding hyperplanes equals that of actuators. The sliding mode controller has two parts; linear state feedback and nonlinear terms. The nonlinear terms guarantee that the systems would reach the intersection of all sliding hyperplanes and remain on it when bounds on the errors in the system parameters and external disturbances are known. The linear part of the control drives the system to the origin of state space. Another important feature is that the controller parameter can be computed off-line. Consequently, on-line computational burden is small

Implications of single-neuron gain scaling for information transmission in networks

Summary: 

Many neural systems are equipped with mechanisms to efficiently encode sensory information. To represent natural stimuli with time-varying statistical properties, neural systems should adjust their gain to the inputs' statistical distribution. Such matching of dynamic range to input statistics has been shown to maximize the information transmitted by the output spike trains (Brenner et al., 2000, Fairhall et al., 2001). Gain scaling has not only been observed as a system response property, but also in single neurons in developing somatosensory cortex stimulated with currents of different amplitude (Mease et al., 2010). While gain scaling holds for cortical neurons at the end of the first post-natal week, at birth these neurons lack this property. The observed improvement in gain scaling coincides with the disappearance of spontaneous waves of activity in cortex (Conheim et al., 2010).

We studied how single-neuron gain scaling affects the dynamics of signal transmission in networks, using the developing cortex as a model. In a one-layer feedforward network, we showed that the absence of gain control made the network relatively insensitive to uncorrelated local input fluctuations. As a result, these neurons selectively and synchronously responded to large slowly-varying correlated input--the slow build up of synaptic noise generated in pacemaker circuits which most likely triggers waves. Neurons in gain scaling networks were more sensitive to the small-scale input fluctuations, and responded asynchronously to the slow envelope. Thus, gain scaling both increases information in individual neurons about private inputs and allows the population average to encode the slow fluctuations in the input. Paradoxically, the synchronous firing that corresponds to wave propagation is associated with low information transfer. We therefore suggest that the emergence of gain scaling may help the system to increase information transmission on multiple timescales as sensory stimuli become important later in development. 

Methods:

Networks with one and two layers consisting of hundreds of model neurons were constructed. The ability of single neurons to gain scale was controlled by changing the ratio of sodium to potassium conductances in Hodgkin-Huxley neurons (Mainen et al., 1995). The response of single layer networks was studied with ramp-like stimuli with slopes that varied over several hundreds of milliseconds. Fast fluctuations were superimposed on this slowly-varying mean. Then the response to these networks was tested with continuous stimuli. Gain scaling networks captured the slow fluctuations in the inputs, while non-scaling networks simply thresholded the input. Quantifying information transmission confirmed that gain scaling neurons transmit more information about the stimulus. With the two-layer networks we simulated a cortical network where waves could spontaneously emerge, propagate and degrade, based on the gain scaling properties of the neurons in the network

Trajectory optimization and guidance for an aerospace plane

The first step in the approach to developing guidance laws for a horizontal take-off, air breathing single-stage-to-orbit vehicle is to characterize the minimum-fuel ascent trajectories. The capability to generate constrained, minimum fuel ascent trajectories for a single-stage-to-orbit vehicle was developed. A key component of this capability is the general purpose trajectory optimization program OTIS. The pre-production version, OTIS 0.96 was installed and run on a Convex C-1. A propulsion model was developed covering the entire flight envelope of a single-stage-to-orbit vehicle. Three separate propulsion modes, corresponding to an after burning turbojet, a ramjet and a scramjet, are used in the air breathing propulsion phase. The Generic Hypersonic Aerodynamic Model Example aerodynamic model of a hypersonic air breathing single-stage-to-orbit vehicle was obtained and implemented. Preliminary results pertaining to the effects of variations in acceleration constraints, available thrust level and fuel specific impulse on the shape of the minimum-fuel ascent trajectories were obtained. The results show that, if the air breathing engines are sized for acceleration to orbital velocity, it is the acceleration constraint rather than the dynamic pressure constraint that is active during ascent

Lived experiences of informal caregivers of people with chronic musculoskeletal pain: a systematic review and meta-ethnography

BACKGROUND: People with chronic pain often seek support from friends and family for everyday tasks. These individuals are termed informal caregivers. There remains uncertainty regarding the lived experiences of these people who care for individuals with chronic musculoskeletal pain. The aim of this paper is to synthase the evidence on the lived experiences of informal caregivers providing care to people with chronic musculoskeletal pain. METHODS: A systematic literature review was undertaken of published and unpublished literature databases including: EMBASE, MEDLINE, CINAHL, PubMed, the WHO International Clinical Trial Registry and ClinicalTrials.gov registry (to September 2019). Qualitative studies exploring the lived experiences of informal caregivers of people with chronic musculoskeletal pain were included. Data were synthesised using a meta-ethnography approach. Evidence was evaluated using the Critical Appraisal Skills Programme (CASP) qualitative appraisal tool. RESULTS: From 534 citations, 10 studies were eligible (360 participants: 171 informal caregivers of 189 care recipients). The evidence was moderate quality. Seven themes arose: the relationship of caregivers to healthcare professionals, role reversal with care recipients; acting the confidant to the care recipient; a constant burden in caregiving; legitimising care recipient’s condition; knowledge and skills to provide caregiving; and the perception of other family members and wider-society to the caregiver/care recipient dyad. CONCLUSIONS: The lived experiences of caregivers of people with chronic musculoskeletal pain is complex and dynamic. There is an inter-connected relationship between caregivers, care recipients and healthcare professionals. Exploring how these experiences can be modified to improve a caregiving dyad’s lived experience is now warranted

Development of responder definitions for fibromyalgia clinical trials

Objective To develop responder definitions for fibromyalgia (FM) clinical trials using key symptom and function domains. Methods Twenty‐four candidate responder definitions were developed by expert consensus and were evaluated in 12 randomized, placebo‐controlled trials of 4 medications for the treatment of FM. For each definition, the treatment effects of the medication compared with placebo were analyzed using Cochran‐Mantel‐Haenszel tests or chi‐square tests. A meta‐analysis of the pooled results for the 4 medications established risk ratios to determine the definitions that best favored medication over placebo. Results Two definitions performed best in the analyses. Both definitions included ≥30% reduction in pain and ≥10% improvement in physical function. The definitions differed in that one (≥30% improvement in FM [FM30] short version) included ≥30% improvement in sleep or fatigue, and the other (FM30 long version) required ≥30% improvement in 2 of the following symptoms: sleep, fatigue, depression, anxiety, or cognition. In the analysis of both versions, the response rate was ≥15% for each medication and was significantly greater compared with placebo. The risk ratio favoring drug over placebo in the pooled analysis for FM30 version 3 (short version) was 1.50 (95% confidence interval [95% CI] 1.24–1.82; P ≤ 0.0001); the risk ratio for FM30 version 6 (long version) was 1.60 (95% CI 1.31–1.96; P ≤ 0.00001). Conclusion Among the 24 responder definitions tested, 2 were identified as most sensitive in identifying response to treatment. The identification of responder definitions for FM clinical trials that include assessments of key symptom and function domains may improve the sensitivity of clinical trials to identify meaningful improvements, leading to improved management of FM.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90281/1/33360_ftp.pd

Secukinumab versus adalimumab for psoriatic arthritis: comparative effectiveness up to 48 weeks using a matching-adjusted indirect comparison

Secukinumab and adalimumab are approved for adults with active psoriatic arthritis (PsA). In the absence of direct randomized controlled trial (RCT) data, matching-adjusted indirect comparison can estimate the comparative effectiveness in anti-tumor necrosis factor (TNF)-naïve populations. Individual patient data from the FUTURE 2 RCT (secukinumab vs. placebo; N = 299) were adjusted to match baseline characteristics of the ADEPT RCT (adalimumab vs. placebo; N = 313). Logistic regression determined adjustment weights for age, body weight, sex, race, methotrexate use, psoriasis affecting ≥ 3% of body surface area, Psoriasis Area and Severity Index score, Health Assessment Questionnaire Disability Index score, presence of dactylitis and enthesitis, and previous anti-TNF therapy. Recalculated secukinumab outcomes were compared with adalimumab outcomes at weeks 12 (placebo-adjusted), 16, 24, and 48 (nonplacebo-adjusted). After matching, the effective sample size for FUTURE 2 was 101. Week 12 American College of Rheumatology (ACR) response rates were not significantly different between secukinumab and adalimumab. Week 16 ACR 20 and 50 response rates were higher for secukinumab 150 mg than for adalimumab (P = 0.017, P = 0.033), as was ACR 50 for secukinumab 300 mg (P = 0.030). Week 24 ACR 20 and 50 were higher for secukinumab 150 mg than for adalimumab (P = 0.001, P = 0.019), as was ACR 20 for secukinumab 300 mg (P = 0.048). Week 48 ACR 20 was higher for secukinumab 150 and 300 mg than for adalimumab (P = 0.002, P = 0.027), as was ACR 50 for secukinumab 300 mg (P = 0.032). In our analysis, patients with PsA receiving secukinumab were more likely to achieve higher ACR responses through 1 year (weeks 16-48) than those treated with adalimumab. Although informative, these observations rely on a subgroup of patients from FUTURE 2 and thus should be considered interim until the ongoing head-to-head RCT EXCEED can validate these findings. Novartis Pharma AG