No abstract

Foundation of America; reports personal fees from Siolta Therapeutics outside the submitted work; has a patent "Reductive prodrug cancer chemotherapy (Stan449-PRV)" issued, a patent "Combination antibiotic and antibody therapy for the treatment of Pseudomonas aeruginosa infection (WO2010091189A1)" with royalties paid by KaloBios, a patent "Therapeutic microbial consortium for induction of immune tolerance" licensed to Siolta Therapeutics, a patent "Systems and methods for detecting antibiotic resistance (WO2012027302A3)" issued, a patent "Nitroreductase enzymes (US7687474B2)" issued, a patent "Sinusitis diagnostics and treatments (WO2013155370A1)" licensed by Reflourish, and a patent "Methods and systems for phylogenetic analysis (US20120264637A1)" issued; and is a cofounder of Siolta Therapeutics, a startup developing a mixed-species microbial oral therapeutic for induction of immune tolerance. The rest of the authors declare that they have no relevant conflicts of interest.

Background: Prevention and management of end-organ disease represent major challenges facing providers of children and adults with sickle cell disease (SCD). Uncertainty and variability in the screening, diagnosis, and management of cardiopulmonary and renal complications in SCD lead to varying outcomes for affected individuals. Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Methods: ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including performing systematic evidence reviews up to September 2017. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 10 recommendations for screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Recommendations related to anticoagulation duration for adults with SCD and venous thromboembolism were also developed. Conclusions: Most recommendations were conditional due to a paucity of direct, high-quality evidence for outcomes of interest. Future research was identified, including the need for prospective studies to better understand the natural history of cardiopulmonary and renal disease, their relationship to patient-important outcomes, and optimal management.

Disparities in sleep health are important but under-recognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socio-economic status, racism, discrimination, neighborhood segregation, geography, social patterns and access to healthcare as well as by cultural beliefs necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.