An evidence-based systematic review on medical therapies for inflammatory bowel disease

Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders of the gastrointestinal tract. Collectively they are termed inflammatory bowel disease (IBD) and it is estimated that 1.5 million Americans suffer from UC and CD. Their etiologies are unknown, although both are thought to arise from a disordered immune response to the gut contents in genetically predisposed individuals. The characteristics of the inflammatory response are different, with CD typically causing transmural inflammation and occasionally associated with granulomas, whereas in UC the inflammation is usually confined to the mucosa. Both UC and CD exhibit a relapsing and remitting course and there is a significant, often dramatic, reduction in quality of life during exacerbations of the disease. This has an impact on psychological health, with active IBD patients experiencing greater levels of distress and feelings of lack of sense of self-control compared with the normal population and patients with inactive IBD. Extrapolation from US administrative claims databases suggests that IBD is responsible for 2.3 million physician visits, 180,000 hospital admissions, and costs $6.3 billion annually. There have been recent guidelines on the management of both UC and CD that direct the clinician on diagnosis and treatment. Approximately 33% of the cost of IBD is due to medical therapy, and given the substantial clinical burden and economic cost of IBD it is important to establish the effectiveness of current medical therapies in both UC and CD. Although there have been several systematic reviews on the efficacy of therapy, this is a rapidly changing field and there is a need for a comprehensive review of the literature. The American College of Gastroenterology IBD Task Force developed a protocol for systematically reviewing the data on currently available therapies for UC and CD, both in inducing remission and in preventing relapse of the disease. Evidence-based statements were then developed and the strength of recommendation for each was graded according to standard criteria

SEIS: Insight’s Seismic Experiment for Internal Structure of Mars

By the end of 2018, 42 years after the landing of the two Viking seismometers on Mars, InSight will deploy onto Mars’ surface the SEIS (Seismic Experiment for Internal Structure) instrument; a six-axes seismometer equipped with both a long-period three-axes Very Broad Band (VBB) instrument and a three-axes short-period (SP) instrument. These six sensors will cover a broad range of the seismic bandwidth, from 0.01 Hz to 50 Hz, with possible extension to longer periods. Data will be transmitted in the form of three continuous VBB components at 2 sample per second (sps), an estimation of the short period energy content from the SP at 1 sps and a continuous compound VBB/SP vertical axis at 10 sps. The continuous streams will be augmented by requested event data with sample rates from 20 to 100 sps. SEIS will improve upon the existing resolution of Viking’s Mars seismic monitoring by a factor of ∼2500 at 1 Hz and ∼200000 at 0.1 Hz. An additional major improvement is that, contrary to Viking, the seismometers will be deployed via a robotic arm directly onto Mars’ surface and will be protected against temperature and wind by highly efficient thermal and wind shielding. Based on existing knowledge of Mars, it is reasonable to infer a moment magnitude detection threshold of ∼3 at 40∘ epicentral distance and a potential to detect several tens of quakes and about five impacts per year. In this paper, we first describe the science goals of the experiment and the rationale used to define its requirements. We then provide a detailed description of the hardware, from the sensors to the deployment system and associated performance, including transfer functions of the seismic sensors and temperature sensors. We conclude by describing the experiment ground segment, including data processing services, outreach and education networks and provide a description of the format to be used for future data distribution