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In thousands of communities across the United States, drinking water is contaminated with chemicals known as perfluoroalkyl and polyfluoroalkyl substances (PFAS). PFAS are used in a wide range of products, such as non-stick cookware, water and stain repellent fabrics, and fire-fighting foam, because they have properties that repel oil and water, reduce friction, and resist temperature changes. PFAS can leak into the environment where they are made, used, disposed of, or spilled. PFAS exposure has been linked to a number of adverse health effects including certain cancers, thyroid dysfunction, changes in cholesterol, and small reductions in birth weight. This report recommends that the Centers for Disease Control and Prevention (CDC) update its clinical guidance to advise clinicians to offer PFAS blood testing to patients who are likely to have a history of elevated exposure, such as those with occupational exposures or those who live in areas known to be contaminated. If testing reveals PFAS levels associated with an increased risk of adverse effects, patients should receive regular screenings and monitoring for these and other health impacts. Guidance on PFAS Exposure, Testing, and Clinical Follow-Up recommends that the CDC, Agency for Toxic Substances and Disease Registry (ATSDR), and public health departments support clinicians by creating educational materials on PFAS exposure, potential health effects, the limitations of testing, and the benefits and harms of testing.

On May 18-19, 2021, the Condensed Matter and Materials Research Committee of the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine the frontiers of research on moiré quantum matter. Participants at the workshop discussed the challenges and possibilities that this new material presents. This publication summarizes the presentations and discussion of the workshop.

Methadone is a Food and Drug Administration- (FDA-) approved medication for treating opioid use disorder (OUD), a chronic brain disease that affects more than 2.7 million people in the United States aged 12 and older. Despite its effectiveness in saving lives, many barriers impede access to, initiation of, and retention in methadone treatment for OUD. To address these barriers, on March 3 and 4, 2022, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on "Methadone Treatment for Opioid Use Disorder: Examining Federal Regulations and Laws," at the request of the Office of National Drug Control Policy in the Executive Office of the President. This publication summarizes the presentation and discussion of the workshop.

The United States has a complex system of laws and policies that attempt to regulate the distribution, manufacture, and use of a variety of non-legal drug substances as part of its overall criminal justice system. Laws regarding drug use have disproportionately impacted individuals and communities of color at every step of the journey through the criminal justice system, including arrest, conviction, sentencing, and incarceration. These disparities have clear outcomes for both individual and community health. To examine the effects of drug control policies on the health of individuals and communities of color, the Roundtable on the Promotion of Health Equity held a workshop on October 8, 2018, in Washington, DC. This publication summarizes the presentations and discussions of the workshop.

"Chemistry plays a pivotal role in the strength of the U.S. economy and the advancement of humankind. Chemists' achievements include life-saving pharmaceuticals, advanced energy solutions, improved agricultural productivity, and novel materials used in products from clothing to electronic devices. The many sectors reliant on the U.S. chemical economy account for about 25% of the U.S. GDP and support 4.1 million U.S. jobs. However, a new and evolving chemistry landscape requires changes with regard to funding, training, and a focus on integrating sustainability into manufacturing, product usage, and product disposal. This report identifies strategies and options for research investments that will support U.S. leadership while considering environmental sustainability and developing a diverse chemical economy workforce with equitable opportunities for all chemistry talent. The report recommends that funding agencies and philanthropic organizations who support the chemical sciences fund as large a breadth of fundamental research projects as possible. Chemical industry and their partners at universities, scientific research institutions, and national laboratories should align the objectives of fundamental research to directly assist with new practices toward environmental stewardship, sustainability, and clean energy. Additionally, the report recommends that funding agencies make substantial investment toward education research to enable innovative ways of teaching about emerging concepts, tools and technologies"--

"Heritable disorders of connective tissue (HDCTs) are a diverse group of inherited genetic disorders and subtypes. Because connective tissue is found throughout the body, the impairments associated with HDCTs manifest in multiple body systems and may change or vary in severity throughout an affected individual's lifetime. In some cases, these impairments may be severe enough to qualify an eligible child or adult for monetary benefits through the U.S. Social Security Administration's (SSA's) Social Security Disability Insurance or Supplemental Security Income program. SSA asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee that would provide current information regarding the diagnosis, treatment, and prognosis of selected HDCTs, including Marfan syndrome and the Ehlers-Danlos syndromes, and the effect of the disorders and their treatment on functioning. The resulting report, Selected Heritable Disorders of Connective Tissue and Disability, presents the committee's findings and conclusions"--

'Long COVID' refers to the wide range of long-lasting symptoms experienced by some patients after a SARS-CoV-2 infection. The most common symptoms include fatigue, headache, brain fog, shortness of breath, hair loss, and pain. At this time, there are many knowledge gaps related to Long COVID, including the prevalence of the condition, the impact of the symptoms on survivors' ability to function, and the long-term course of the condition. While many individuals with Long COVID recover within one year, others experience little or no decrease in symptom severity over time. Long COVID symptoms can affect a person's ability to work and otherwise function in daily life, so people with the condition may need to utilize programs such as Social Security Disability Insurance (SSDI) and the Supplemental Security Income Program (SSI). The Social Security Administration (SSA), which administers both of these programs, requested that the National Academies of Sciences, Engineering, and Medicine host a public workshop to discuss research into the long-term health effects of COVID-19, their impacts on individuals and populations, and how the SSDI and SSI programs can support individuals who suffer disability as a result of Long COVID. This publication summarizes the presentation and discussion of the workshop.

The Forum on Regenerative Medicine of the National Academies of Sciences, Engineering, and Medicine convened a two-day virtual public workshop to address knowledge gaps in the understanding of promising approaches to manipulate the immune system and/or the regenerative medicine product to improve outcomes of tissue repair and regeneration in patients. The workshop, titled Understanding the Role of the Immune System in Improving Tissue Regeneration, explored the role of the immune system in the success or failure of regenerative medicine therapies. Participants considered potential strategies to effectively prepare patients' immune systems to accept regenerative therapies and increase the likelihood of successful clinical outcomes and also discussed risks associated with modulating the immune system. This Proceedings of a Workshop highlights the presentations and discussions that occurred during the workshop.

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop.

Despite being preventable and curable since the middle of the twentieth century, tuberculosis (TB) has long persisted as the world's deadliest infectious disease, with the communities most devastated by TB among the poorest and most vulnerable in the world. Only about half of people with TB receive successful treatment each year. As the global threat of antimicrobial resistance continues to escalate, so do cases of drug-resistant TB, or TB that is resistant to various antibiotics that constitute standard treatment regimens. In response, the National Academies of Sciences, Engineering, and Medicine's Forum on Microbial Threats held a two-part virtual workshop on July 22 and September 14-16, 2021 titled Innovations for Tackling Tuberculosis in the Time of COVID-19. The aims of the workshop were to evaluate the current status of TB elimination, assess the effects of the COVID-19 pandemic on the global fight against TB, and examine technical and strategic innovations that could be leveraged to meet the United Nations High-Level Meeting on Tuberculosis targets in 2022 and The World Health Organization's END TB Strategy targets by 2030. This publication summarizes the presentations and discussions of the workshop.

Within the past decade an ever-growing number of New Space organizations have emerged that are unencumbered by legacy practices and constraints. By reimagining, creating, and continuously improving SmallSat space technology a new and growing space ecosystem is now in place that is capable of serving a broad stakeholder community of both traditional users and new or nontraditional users. Current commercial practices are expanding with capabilities including technology and business-driven applications that open the door to a broad and vibrant ecosystem offering a wide range of solutions capable of supporting a growing range of stakeholders. In parallel to traditional approaches, space infrastructure related to manufacturing, such as customized spacecraft buses, instruments, and sensors--including high-resolution imaging and radar systems rivaling the performance of traditional systems--are emerging in both growing volume and with constantly improving capability. On the operational commercial ground stations are now routinely available, as are data management and analytics including cloud computing for data access and archiving. Thus, if properly encouraged and nourished, a broadly capable ecosystem can emerge including new business opportunities for data fusion, analysis, and databuys, as well as ground/space communications that can equally benefit both traditional and nontraditional user communities. Leveraging Commercial Space for Earth and Ocean Remote Sensing assesses the feasibility and implications of creating and exploiting partnerships for developing, deploying, and operating a system of satellites and supporting infrastructure capable of sensing ocean, coastal, atmospheric, and hydrologic data of sufficient scientific quality to enable prediction models and to support near real time applications of national interest. This report identifies and describes promising options for such a system.

Intelligence analysts conduct these analyses every day, using decades of propriety tradecraft techniques and an arsenal of clandestine information gathering sources, but the resources available are not unlimited. Open source public opinion tools can provide timely and relatively inexpensive methods of understanding fast-moving conditions, acting as a force multiplier to help policymakers have a truly all-source understanding of complex events. By providing analysts with the best practices in survey methodology and nonsurvey methods for gathering data on public opinion, they will be armed with a clearer sense of important shifts in attitudes, elections, and unrest. In order to provide guidance to analysts on strategies for assessing public opinion, representatives from the intelligence community approached the National Academies of Sciences, Engineering, and Medicine to request preparation of a framework on Measuring and Analyzing Public Opinion. This analytic framework includes three layers of information. Layer 1 comprises four authored papers that review literature from various disciplines containing overview information as well as how the topic/situation of interest can enable better analysis across different situational constraints. Layer 2 is a distilled layer of information in the form of an authored summary of the four Layer 1 papers, both summarizing and describing key points. Finally, Layer 3 provides an even further distillation of the key concepts, in a one-page visual graphic, that displays key drivers from the work in Layers 1 and 2 to help the intended audience apply knowledge to the situation of interest.

Training police in the knowledge and skills necessary to support the rule of law and protect the public is a substantial component of the activities of international organizations that provide foreign assistance. Significant challenges with such training activities arise with the wide range of cultural, institutional, political, and social contexts across countries. In addition, foreign assistance donors often have to leverage programs and capacity in their own countries to provide training in partner countries, and there are many examples of training, including in the United States, that do not rely on the best scientific evidence of policing practices and training design. Studies have shown disconnects between the reported goals of training, notably that of protecting the population, and actual behaviors by police officers. These realities present a diversity of challenges and opportunities for foreign assistance donors and police training. At the request of the U.S. State Department's Bureau of International Narcotics and Law Enforcement Affairs, the Committee on Law and Justice of the National Academies of Sciences, Engineering, and Medicine examined scientific evidence and assessed research needs for effective policing in the context of the challenges above. This report, the second in a series of five, responds to the following questions: What are the core knowledge and skills needed for police to promote the rule of law and protect the population? What is known about mechanisms (e.g., basic and continuing education or other capacity building programs) for developing the core skills needed for police to promote the rule of law and protect the population?

Academic preparation is critical to increase Black representation in Science, Engineering, and Medicine, but so, too, are such interrelated factors as providing mentoring and role models in sufficient numbers, adequately funding school and community support services, and analyzing the intentional and unintentional consequences of a range of policies and practices. To address these issues, the Roundtable on Black Men and Black Women of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop on September 2 and 3, 2020. Titled "Educational Pathways for Blacks in Science, Engineering, and Medicine: Exploring Barriers and Possible Interventions," the workshop provided a platform to explore challenges and opportunities, beginning in the earliest years of life through K-12 schooling, undergraduate and postgraduate education, and into the workforce. Presenters throughout the workshop provided perspectives from research and from their own experiences to discuss the need for systemic solutions inside and outside of formal education institutions. This publication summarizes the presentation and discussion of the workshop.

During the past 25 years, the U.S. National Academies of Sciences, Engineering, and Medicine, in collaboration with the Russian Academy of Sciences, have carried out a wide variety of activities to improve understanding of the challenges in containing and reducing ethnic conflicts, violent extremism, and terrorism. Roots and Trajectories of Violent Extremism and Terrorism provides an overview of this cross-ocean program, which has involved American and Russian scientists, engineers, and medical professionals from a large number of government agencies, leading research institutions, think tanks, educational institutions, analytical centers, and consulting and commercial firms in the two countries. This report highlights challenges addressed by the academies over many years that remain of current interest as the U.S., Russian, and other governments continue to cope with old and new forms of aggression that threaten the livelihood of populations at home and abroad.

Since 1944, the National Research Council (NRC) has published seven editions of the Nutrient Requirements of Beef Cattle. This reference has guided nutritionists and other professionals in academia and the cattle and feed industries in developing and implementing nutritional and feeding programs for beef cattle. The cattle industry has undergone considerable changes since the seventh revised edition was published in 2000 and some of the requirements and recommendations set forth at that time are no longer relevant or appropriate. The eighth revised edition of the Nutrient Requirements of Beef Cattle builds on the previous editions. A great deal of new research has been published during the past 14 years and there is a large amount of new information for many nutrients. In addition to a thorough and current evaluation of the literature on the energy and nutrient requirements of beef in all stages of life, this volume includes new information about phosphorus and sulfur contents; a review of nutritional and feeding strategies to minimize nutrient losses in manure and reduce greenhouse gas production; a discussion of the effect of feeding on the nutritional quality and food safety of beef; new information about nutrient metabolism and utilization; new information on feed additives that alter rumen metabolism and postabsorptive metabolism; and future areas of needed research. The tables of feed ingredient composition are significantly updated. Nutrient Requirements of Beef Cattle represents a comprehensive review of the most recent information available on beef cattle nutrition and ingredient composition that will allow efficient, profitable, and environmentally conscious beef production.

Sediments, ice, corals, and trees are just some of the natural storehouses of information that help tell the complicated history of Earth's climate. Paleoclimate researchers use these "proxies," in combination with numerical models, to gain understanding of the magnitudes, rates, and drivers of past climate variability with the goal of informing understanding of current and future change in Earth's climate system. The Paleo Perspectives on Climate Change (P2C2) program of the National Science Foundation (NSF) has advanced paleoclimate research through proxy development, data-model comparisons, and synthesis work, and has facilitated interdisciplinary collaboration that has contributed to the growth of the field. This new publication highlights discussions at a June 2021 workshop that focused on identifying potential future paleoclimate research directions to further advance understanding of past climate and better inform the public and decision makers about the expected future.

Widely available, trustworthy government statistics are essential for policy makers and program administrators at all levels of government, for private sector decision makers, for researchers, and for the media and the public. In the United States, principal statistical agencies as well as units and programs in many other agencies produce various key statistics in areas ranging from the science and engineering enterprise to education and economic welfare. Official statistics are often the result of complex data collection, processing, and estimation methods. These methods can be challenging for agencies to document and for users to understand. At the request of the National Center for Science and Engineering Statistics (NCSES), this report studies issues of documentation and archiving of NCSES statistical data products in order to enable NCSES to enhance the transparency and reproducibility of the agency's statistics and facilitate improvement of the statistical program workflow processes of the agency and its contractors. Transparency in Statistical Information for the National Center for Science and Engineering Statistics and All Federal Statistical Agencies also explores how NCSES could work with other federal statistical agencies to facilitate the adoption of currently available documentation and archiving standards and tools.

"Quantum concepts hold the potential to enable significant advances in sensing and imaging technologies that could be vital to the study of biological systems. The workshop Quantum Science Concepts in Enhancing Sensing and Imaging Technologies: Applications for Biology, held online March 8-10, 2021, was organized to examine the research and development needs to advance biological applications of quantum technology. Hosted by the National Academies of Sciences, Engineering, and Medicine, the event brought together experts working on state-of-the-art, quantum-enabled technologies and scientists who are interested in applying these technologies to biological systems. Through talks, panels, and discussions, the workshop facilitated a better understanding of the current and future biological applications of quantum-enabled technologies in fields such as microbiology, molecular biology, cell biology, plant science, mycology, and many others. This publication summarizes the presentation and discussion of the workshop." --

"The National Academies Roundtable on Aligning Incentives for Open Science, established in 2019, has taken on an important role in addressing issues with open science. The roundtable convenes critical stakeholders to discuss the effectiveness of current incentives for adopting open science practices, current barriers of all types, and ways to move forward in order to align reward structures and institutional values. The Roundtable convened a virtual public workshop on fostering open science practices on November 5, 2020. The broad goal of the workshop was to identify paths to growing the nascent coalition of stakeholders committed to reenvisioning credit/reward systems (e.g., academic hiring, tenure and promotion, and grants)to fully incentivize open science practices. The workshop explored the information and resource needs of researchers, research institutions, government agencies, philanthropies, professional societies, and other stakeholders interested in further supporting and implementing open science practices. This publication summarizes the presentations and discussion of the workshop."--

During the past century, the Everglades, one of the world's treasured ecosystems, has been dramatically altered by drainage and water management infrastructure to improve flood management, urban water supply, and agricultural production. The remnants of the original Everglades now compete for water with urban and agricultural interests and are impaired by contaminated runoff from these two sectors. The Comprehensive Everglades Restoration Plan (CERP), a joint effort launched by the state and the federal government in 2000, seeks to reverse the decline of the ecosystem. The multibillion-dollar project was originally envisioned as a 30- to 40-year effort to achieve ecological restoration by reestablishing the natural hydrologic characteristics of the Everglades, where feasible, and to create a water system that serves the needs of both the natural and the human systems of South Florida. In establishing the CERP, Congress also requested that an independent scientific review be conducted on progress toward restoration with biennial reports. The National Academies' Committee on Independent Scientific Review of Everglades Restoration Progress has provided biennial reviews of restoration progress and advice on scientific and engineering issues that may impact progress since 2004. This eighth study of the series describes substantive accomplishments over the past 2 years and reviews developments in research, monitoring, and assessment that inform restoration decision making. Progress Toward Restoring the Everglades: The Eighth Biennial Review - 2020 also reviews the recently developed Combined Operational Plan, which is a prerequisite for CERP progress in the central Everglades, and examines issues facing the northern and southern estuaries, including priorities for science to support restoration decision making.