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To better understand the inequalities facing lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and the promising interventions being used to address these inequalities, the National Academies of Sciences, Engineering, and Medicine's Board on Children, Youth, and Families hosted a virtual public workshop titled Reducing Inequalities Between LGBTQ Adolescents and Cisgender, Heterosexual Adolescents, which convened on August 25-27, 2021. The workshop was developed by a planning committee composed of experts from the fields of sociology, medicine, public health, psychology, social work, policy, and direct-service provision. This Proceedings of a Workshop summarizes the presentations and discussions from that workshop.

The U.S. Environmental Protection Agency's (EPA) Integrated Risk Information System (IRIS) program develops human health assessments that focus on hazard identification and dose-response analyses for chemicals in the environment. The ORD Staff Handbook for Developing IRIS Assessments (the handbook) provides guidance to scientists who perform the IRIS assessments in order to foster consistency in the assessments and enhance transparency about the IRIS assessment process. At the request of the EPA, this report reviews the procedures and considerations for operationalizing the principles of systematic reviews and the methods described in the handbook for determining the scope of the IRIS assessments, evidence integration, extrapolation techniques, dose-response analyses, and characterization of uncertainties.

More than a decade after the Deepwater Horizon disaster, the Gulf Research Program convened a diverse group of 60 experts in a virtual event to inform its efforts to enhance resilience to future offshore oil disasters in the Gulf of Mexico region. The event, Offshore Situation Room, took place over three half-days during June 15-17, 2021, and had four main objectives: 1) develop a concise, prioritized list of questions that need to be addressed to support successful prevention, response, and recovery that would minimize the impacts of an offshore oil disaster; 2) provide a collaborative atmosphere where participants can share ideas, capabilities, and information, and build a community dedicated to the successful prevention of, response to, and recovery from an offshore oil spill disaster; 3) explore capabilities for and impediments to prevention, response, recovery, and understanding impacts of an offshore oil disaster in the Gulf of Mexico; and 4) highlight how changes in policy, response, resilience, and restoration efforts may affect outcomes of a major offshore incident. This publication summarizes the presentations and discussion of the event.

The U.S. medical countermeasures (MCMs) enterprise is interconnected, complex, and dynamic. It includes public and private entities that develop and manufacture new and existing MCMs, ensure procurement, storage, and distribution of MCMs, and administer, monitor, and evaluate MCMs. The interagency group known as the Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) is the nation's sole coordinating body, responsible for ensuring end-to-end MCM preparedness and response. Ensuring an Effective Public Health Emergency Medical Countermeasures Enterprise provides recommendations from an expert committee for a re-envisioned PHEMCE. Four priority areas of improvement emerged from committee deliberations: (1) articulating PHEMCE's mission and role and explicating the principles guiding PHEMCE's operating principles and processes, (2) revising PHEMCE operations and processes, (3) collaborating more effectively with external public and private partners, and (4) navigating legal and policy issues.

"The Antarctic's unique environment and position on the globe make it a prime location to gain insights into how Earth and the universe operate. This report assesses National Science Foundation (NSF) progress in addressing three priority research areas identified in a 2015 National Academies report: (1) understanding the linkages between ice sheets and sea-level rise, including both a focus on current rates of ice sheet change and studies of past major ice sheet retreat episodes; (2) understanding biological adaptations to the extreme and changing Antarctic environment; and (3) establishing a next-generation cosmic microwave background (CMB) program, partly located in Antarctica, to study the origins of the universe. NSF has made important progress understanding the impacts of current ice sheet change, particularly through studies focused on the ice sheet and ocean interactions driving ongoing ice mass loss at the Thwaites Glacier and Amundsen Sea region in West Antarctica. Less progress has been made on studies of past major ice sheet retreat episodes. Progress is also strong on CMB research to understand the origins of the universe. Progress has lagged on understanding biological adaptations, in part because of limited community organization and collaboration toward the priority. To accelerate progress during the second half of the initiative, NSF could issue specific calls for proposals, develop strategies to foster collaborations and partnerships, and commission a transparent review of logistical capacity to help illuminate strategies and priorities for addressing resource constraints. Such efforts would also help optimize science and proposal development in an environment of inherently constrained logistics." --

Since the 1980s, national and international planetary protection policies have sought to avoid contamination by terrestrial organisms that could compromise future investigations regarding the origin or presence of Martian life. Over the last decade, the number of national space agencies planning, participating in, and undertaking missions to Mars has increased, and private-sector enterprises are engaged in activities designed to enable commercial missions to Mars. The nature of missions to Mars is also evolving to feature more diversity in purposes and technologies. As missions to Mars increase and diversify, national and international processes for developing planetary protection measures recognize the need to consider the interests of scientific discovery, commercial activity, and human exploration. The implications of these changes for planetary protection should be considered in the context of how much science has learned about Mars, and about terrestrial life, in recent years. At the request of NASA, this report identifies criteria for determining locations on Mars potentially suitable for landed robotic missions that satisfy less stringent bioburden requirements, which are intended to manage the risk of forward contamination.

"To better support the need for timely, effective manufacturing technology development and transition, the Department of Defense (DoD) has established nine Manufacturing Innovation Institutes (MIIs) through its Defense-wide Manufacturing Science and Technology program element within the DoD Manufacturing Technology program. The institutes are considered by DoD to be important facilitators that bring together innovative ecosystems in key technology and market sectors in the United States. DoD MIIs are industry-led public private partnerships, with dual, public and private benefit, providing large commercial market potential while also meeting key U.S. defense industrial needs. The mission of the nine DoD-established institutes addresses both defense and commercial manufacturing needs within specific, defense-relevant technology areas. DoD Engagement with Its Manufacturing Innovation Institutes Phase 2 Study provides strategic guidance on protocols for conducting long term engagement assessments of the MIIs including evaluation metrics; best practices for MII education and workforce development programs; and development of strategies for better connecting MIIs to the broader DoD community and to other federal agencies. An interim report focused on the MII assessment protocol topic was published in April 2021 and is also included in this report, in appendixes C and D. This final report provides findings and recommendations relevant to education and workforce development best practices and DoD and other federal agency engagement strategies." --

"Rigorous operational testing (OT) of weapon systems procured by the U.S. Department of Defense (DoD) is fundamental to ensuring that these sophisticated systems not only meet their stated requirements, but also perform under realistic operational conditions when faced by determined adversaries employing their own highly capable offensive and defensive weaponry. DoD's test and training range enterprise provides the geography, infrastructure, technology, expertise, processes, and management that make safe, secure, and comprehensive OT possible. The challenges facing the nation's range infrastructure are both increasing and accelerating. Limited test capacity in physical resources and workforce, the age of test infrastructure, the capability to test advanced technologies, and encroachment impact the ability to inform system performance, integrated system performance and the overall pace of testing. Necessary DoD Range Capabilities to Ensure Operational Superiority of U.S. Defense Systems assesses the physical and technical suitability of DoD test and evaluation ranges, infrastructure, and tools for determining the operational effectiveness, suitability, survivability, and lethality of military systems. This report explores modernization, sustainment, operations, and resource challenges for test and evaluation ranges, and makes recommendations to put the DoD range enterprise on a modernization trajectory to meet the needs of OT in the years ahead."--Publisher's website.

The U.S. Food and Drug Administration (FDA) has approved dozens of hormone therapy products for men and women, including estrogen, progesterone, testosterone, and related compounds. These products have been reviewed for safety and efficacy and are indicated for treatment of symptoms resulting from hormonal changes associated with menopause or other endocrine-based disorders. In recent decades, an increasing number of health care providers and patients have turned to custom-formulated, or compounded, drug preparations as an alternative to FDA-approved drug products for hormone-related health concerns. These compounded hormone preparations are often marketed as "bioidentical" or "natural" and are commonly referred to as compounded bioidentical hormone therapy (cBHT). In light of the fast-growing popularity of cBHT preparations, the clinical utility of these compounded preparations is a substantial public health concern for various stakeholders, including medical practitioners, patients, health advocacy organizations, and federal and state public health agencies. This report examines the clinical utility and uses of cBHT drug preparations and reviews the available evidence that would support marketing claims of the safety and effectiveness of cBHT preparations. It also assesses whether the available evidence suggests that these preparations have clinical utility and safety profiles warranting their clinical use and identifies patient populations that might benefit from cBHT preparations in lieu of FDA-approved BHT.

Workshop information found on publisher's Web site.

The Food Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Challenges and Opportunities for Precision and Personalized Nutrition, on August 10-12, 2021. The workshop explored potential challenges and opportunities in the application of precision and personalized nutrition approaches to optimize dietary guidance and improve nutritional status. Workshops presenters discussed current precision and personalized nutrition research methodologies, limitations in data and design, adapting technologies for utilization, and policy and regulatory challenges. This Proceedings of a Workshop summarizes the presentations and discussions of the workshop.

Science, technology, engineering and mathematics (STEM) professionals generate a stream of scientific discoveries and technological innovations that fuel job creation and national economic growth. Ensuring a robust supply of these professionals is critical for sustaining growth and creating jobs growth at a time of intense global competition. Undergraduate STEM education prepares the STEM professionals of today and those of tomorrow, while also helping all students develop knowledge and skills they can draw on in a variety of occupations and as individual citizens. However, many capable students intending to major in STEM later switch to another field or drop out of higher education altogether, partly because of documented weaknesses in STEM teaching, learning and student supports. Improving undergraduate STEM education to address these weaknesses is a national imperative. Many initiatives are now underway to improve the quality of undergraduate STEM teaching and learning. Some focus on the national level, others involve multi-institution collaborations, and others take place on individual campuses. At present, however, policymakers and the public do not know whether these various initiatives are accomplishing their goals and leading to nationwide improvement in undergraduate STEM education. Indicators for Monitoring Undergraduate STEM Education outlines a framework and a set of indicators that document the status and quality of undergraduate STEM education at the national level over multiple years. It also indicates areas where additional research is needed in order to develop appropriate measures. This publication will be valuable to government agencies that make investments in higher education, institutions of higher education, private funders of higher education programs, and industry stakeholders. It will also be of interest to researchers who study higher education.

The U.S. Department of Energy (DOE) issues standards regulations for energy conservation pursuant to the Energy Policy and Conservation Act of 1975, as amended, and other authorities. These standards regulations apply to certain consumer products and commercial and industrial equipment. These can include air conditioning and heating systems, washing machines, and commercial refrigeration, among numerous other examples. DOE issues standards regulations by rulemaking and includes quantitative maximum water and energy use or minimum energy conservation standards. There are currently standards regulations for more than 70 product classes (i.e., a specific type of consumer product or commercial or industrial equipment). This report reviews the assumptions, models, and methodologies that DOE uses in setting the quantitative portion of the standards regulations following the Office of Management and Budget's guidance on the use of scientific information. Review of Methods Used by the U.S. Department of Energy in Setting Appliance and Equipment Standards makes findings and recommendations on how DOE can improve its analyses and align its regulatory analyses with best practices for cost-benefit analysis.

A planning committee convened by the Forum on Microbial Threats of the National Academies of Sciences, Engineering, and Medicine held a virtual workshop on February 23-25, 2021, titled Systematizing the One Health Approach in Preparedness and Response Efforts for Infectious Disease Outbreaks. The workshop gave particular consideration to research opportunities, multisectoral collaboration mechanisms, community-engagement strategies, educational opportunities, and policies that speakers have found effective in implementing the core capacities and interventions of One Health principles to strengthen national health systems and enhance global health security. This Proceedings of a Workshop summarizes the presentations and discussions of the workshop.

The Bureau of Ocean Energy Management (BOEM) manages the energy and mineral resources on the outer continental shelf. BOEM's environmental program, by producing environmental studies and conducting environmental assessments, ensures that environmental protection is a critical element of BOEM's decision making. This report addresses BOEM's aspirations to conduct a first-in-class science program within their Environmental Studies Program (ESP). This report describes attributes identified by the committee of a first-in-class, use-inspired, management-oriented science program (in this case, BOEM's ESP and its connection to the broader BOEM environmental program). The report recommends that BOEM develop procedures and conduct regular evaluations to assess whether and how well its environmental program meets the attributes of a first-in-class program and identify areas for improvement. It also outlines a framework for conducting such an evaluation. The report contains guidance and examples drawn from a workshop series with BOEM's peer agencies and other science programs, as well as other information gathering efforts. The guidance contained in this report is offered to BOEM as a starting point for developing more detailed processes for evaluating and improving its program.

Advances in materials science and engineering play a crucial role in supporting the U.S. economy and national security. To maintain its leading edge in the field, the United States relies on a rich and diverse innovation ecosystem encompassing industry, academic institutions, and government laboratories. While this ecosystem has generated numerous gains for defense agencies, the technology sector, consumers, and the country as a whole over many decades, recent years have brought new challenges and a shifting global dynamic in the field. The United States, long a global magnet for science, technology, engineering, and mathematics education and expertise, has seen its competitive edge slip as other countries in Europe and Asia have increased their investments in cultivating science and engineering talent and innovation. In 2020, the emergence of the COVID-19 pandemic caused far-reaching disruptions for both education and supply chains across the world, compounding many of the dynamics that were already affecting materials science and engineering in the United States. To explore these issues, the Workshop on Materials Science and Engineering in a Post-Pandemic World was organized as part of a workshop series on Defense Materials Manufacturing and Its Infrastructure. Hosted by the National Academies of Sciences, Engineering, and Medicine, the virtual event brought together approximately 30 speakers and attendees representing materials science, engineering, and manufacturing experts from industry, academia, and government agencies. The 3-day workshop explored education and workforce trends across the nation and the globe, with particular focus on the U.S. Department of Defense and university-government collaborations. Participants discussed how the COVID-19 pandemic has affected science and engineering education, opportunities to reimagine traditional education for the field, and the imperative to develop a more diverse workforce. Several speakers presented their views on what the post-pandemic future may hold, and many offered perspectives on key concerns and priorities for the field moving forward. This publication summarizes the presentations and discussion of the workshop.

The radio frequency spectrum is a limited resource for which there is an ever-increasing demand from an expansive range of applications - all the way from commercial, such as mobile phones, to scientific, such as hurricane monitoring from space. Since radio waves do not stop at national borders, international regulation is necessary to ensure effective use of the radio spectrum for all parties. Use of the radio spectrum is regulated internationally by the Radio Regulations (RR), an international treaty. The International Telecommunication Union (ITU) has as its mission the facilitation of the efficient and interference-free use of the radio spectrum. Every 2 to 5 years, the ITU convenes a World Radiocommunication Conference (WRC) to review and revise the international RR. Changes to the RR are formulated through proposals to the conference according to Agenda Items, which are agreed on at the previous WRC. At the request of the National Science Foundation and the National Aeronautics and Space Administration, this report provides guidance to U.S. spectrum managers and policymakers as they prepare for the 2023 WRC to protect the scientific exploration of Earth and the universe using the radio spectrum. This report identifies the 2023 agenda items of relevance to U.S. radio astronomers and Earth remote sensing researchers, along with proposed agenda items for the 2027 WRC.

Investment and innovation in drug research and development (R&D) for highly prevalent chronic diseases has stalled in recent decades, despite half of all Americans living with at least one chronic disease. As a result, prevalent chronic diseases are producing immense health care costs as well as preventable suffering and death. On February 22, March 2, and March 8, 2021, the National Academies of Sciences, Engineering, and Medicine, convened a workshop to discuss barriers to innovation in this space and examine strategies and incentives to support equitable, person-centered drug R&D for prevalent chronic diseases.

To explore how mobile technology can be employed to enhance the lives of older adults, the Board on Behavioral, Cognitive, and Sensory Sciences of the National Academies of Sciences, Engineering, and Medicine commissioned 6 papers, which were presented at a workshop held on December 11 and 12, 2019. These papers review research on mobile technologies and aging, and highlight promising avenues for further research. --

"The National Academies of Sciences, Engineering, and Medicine last reviewed the state of the science on nutrition during pregnancy and lactation 30 years ago. The resulting consensus study reports from the Institute of Medicine--Nutrition During Pregnancy (IOM, 1990) and Nutrition During Lactation (IOM, 1991)--summarized the scientific evidence and provided nutrient recommendations. In the decades since the release of these two reports, the body of evidence on the relationships between nutrition during pregnancy and lactation and maternal and infant health and chronic disease has continued to grow and evolve. At the same time, the demographics of the population have shifted, giving rise to new considerations. To explore the evidence that has emerged, the National Academies conducted a 2-day workshop in January 2020. This publication summarizes the presentations and discussions from the workshop."--

The workshop participants "examine the current state of clinical trial data sharing and reuse and consider ways in which policy, technology, incentives, and governance could be leveraged to further encourage and enhance data sharing"--

"Biomedical research results in the collection and storage of increasingly large and complex data sets. Preserving those data so that they are discoverable, accessible, and interpretable accelerates scientific discovery and improves health outcomes, but requires that researchers, data curators, and data archivists consider the long-term disposition of data and the costs of preserving, archiving, and promoting access to them. Life Cycle Decisions for Biomedical Data examines and assesses approaches and considerations for forecasting costs for preserving, archiving, and promoting access to biomedical research data. This report provides a comprehensive conceptual framework for cost-effective decision making that encourages data accessibility and reuse for researchers, data managers, data archivists, data scientists, and institutions that support platforms that enable biomedical research data preservation, discoverability, and use."--

"Sickle cell disease (SCD) is a genetic condition that affects approximately 100,000 people in the United States and millions more globally. Individuals with SCD endure the psychological and physiological toll of repetitive pain as well as side effects from the pain treatments they undergo. Some adults with SCD report reluctance to use health care services, unless as a last resort, due to the racism and discrimination they face in the health care system. Additionally, many aspects of SCD are inadequately studied, understood, and addressed. Addressing Sickle Cell Disease examines the epidemiology, health outcomes, genetic implications, and societal factors associated with SCD and sickle cell trait (SCT). This report explores the current guidelines and best practices for the care of patients with SCD and recommends priorities for programs, policies, and research. It also discusses limitations and opportunities for developing national SCD patient registries and surveillance systems, barriers in the healthcare sector associated with SCD and SCT, and the role of patient advocacy and community engagement groups." --

Proactive policing, as a strategic approach used by police agencies to prevent crime, is a relatively new phenomenon in the United States. It developed from a crisis in confidence in policing that began to emerge in the 1960s because of social unrest, rising crime rates, and growing skepticism regarding the effectiveness of standard approaches to policing. In response, beginning in the 1980s and 1990s, innovative police practices and policies that took a more proactive approach began to develop. This report uses the term "proactive policing" to refer to all policing strategies that have as one of their goals the prevention or reduction of crime and disorder and that are not reactive in terms of focusing primarily on uncovering ongoing crime or on investigating or responding to crimes once they have occurred. Proactive policing is distinguished from the everyday decisions of police officers to be proactive in specific situations and instead refers to a strategic decision by police agencies to use proactive police responses in a programmatic way to reduce crime. Today, proactive policing strategies are used widely in the United States. They are not isolated programs used by a select group of agencies but rather a set of ideas that have spread across the landscape of policing. Proactive Policing reviews the evidence and discusses the data and methodological gaps on: (1) the effects of different forms of proactive policing on crime; (2) whether they are applied in a discriminatory manner; (3) whether they are being used in a legal fashion; and (4) community reaction. This report offers a comprehensive evaluation of proactive policing that includes not only its crime prevention impacts but also its broader implications for justice and U.S. communities.