Bøker utgitt av National Academies Press

In response to a request from the US Department of Agriculture, the Health and Medicine Division (HMD) of the National Academies established the Standing Committee to Review the Dietary Reference Intake (DRI) Framework. The committee was asked to respond to DRI-related questions to inform the Federal DRI working group about the conduct of new DRI reviews and DRI-related issues more broadly, including their application. This second letter report advises the Federal DRI Working Group on three questions: 1) Are de novo systematic reviews are needed in future DRI reviews or can qualified systematic reviews be used? 2) If qualified systematic reviews can be used, what are the appropriate inclusion and exclusion criteria? 3) Can previously published systematic review be updated? In response, the standing committee developed a report that includes a decision tree that addresses the need for systematic reviews to support the DRI process.

The use and misuse of antibiotics contributes to the rise in drug-resistant bacteria - a serious and worsening threat to human health. The development and use of rapid point-of-care diagnostics in the healthcare setting plays an important role in avoiding unnecessary use of antimicrobials by providing clinicians with the right information at the right time to help them make decisions about appropriate drug treatment for patients. Diagnostics also have the capacity to support early detection and diagnosis of drug-resistant bacterial infections, enable disease surveillance, and help prevent disease spread. The National Academies Forum on Drug Discovery, Development, and Translation; Forum on Medical and Public Health Preparedness for Disasters and Emergencies; and Forum on Microbial Threats hosted an October 2022 workshop exploring the current landscape of rapid diagnostics to address antibiotic resistance, challenges and opportunities for spurring innovation, and practical next steps for accelerating the development of new diagnostic tools.

Nonhuman primates represent a small fraction of animals used in biomedical research, but they remain important research models due to their similarities to humans with respect to genetic makeup, anatomy, physiology, and behavior. Limitations in the availability of nonhuman primates have been exacerbated by the COVID-19 pandemic and recent restrictions on their exportation and transportation, impacting National Institutes of Health (NIH)-funded research necessary for both public health and national security. Additionally, there is continued interest in understanding whether and how nonanimal models can be used to answer scientific questions for which nonhuman primates are currently used. At the direction of the U.S. Congress, NIH asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to conduct a landscape analysis of current and future use of nonhuman primates in NIH-supported biomedical research, as well as opportunities for new approach methodologies to complement or reduce reliance on nonhuman primate models. This report provides the committee findings and conclusions.

The U.S. Social Security Administration (SSA) provides benefits to adults and children who meet the eligibility requirements for a disability as described in Title II and Title XVI of the Social Security Act. To determine whether more accurate or precise techniques exist for determining if a previously evaluated physical impairment is either more or less severe, SSA requested the National Academies assemble a committee to review new or improved diagnostic or evaluative techniques that have become generally available within the past 30 years for cardiovascular, neurological, respiratory, hematological, and digestive conditions. The resulting report presents a summary of the evidence and information around a selected subset of diagnostic and evaluative techniques.

Experiencing poverty during childhood can lead to lasting harmful effects in which poverty is passed on to future generations - a cycle that disproportionately affects Native American families. To identify policies and programs that can reduce long-term, intergenerational poverty among Native Americans in the United States, the Board on Children, Youth, and Families held information-gathering sessions on July 22, 2022 and July 25, 2022. In these sessions, key historical and structural factors that lead to entrenched poverty were examined as well as promising interventions for addressing them. Importantly, these sessions included a conversation with community leaders on their experiences with and work on intergenerational poverty as well as key data and trends on this topic.

The world confronts an existential challenge in responding to climate change, resulting in an urgent need to reduce greenhouse gas emissions from all sectors of the economy. What will it take for new and advanced nuclear reactors to play a role in decarbonization? Nuclear power provides a significant portion of the worlds low-carbon electricity, and advanced nuclear technologies have the potential to be smaller, safer, less expensive to build, and better integrated with the modern grid. However, if the United States wants advanced nuclear reactors to play a role in its plans for decarbonization, there are many key challenges that must be overcome at the technical, economic, and regulatory levels. Laying the Foundation for New and Advanced Nuclear Reactors in the United States discusses how the United States could support the successful commercialization of advanced nuclear reactors with a set of near-term policies and practices. The recommendations of this report address the need to close technology research gaps, explore new business use cases, improve project management and construction, update regulations and security requirements, prioritize community engagement, strengthen the skilled workforce, and develop competitive financing options.--Publishers website.

This proceedings summarizes the presentations and discussions at the Workshop on the 2020 Census Demographic and Housing Characteristics File, held June 21-22, 2022. The workshop was convened by the Committee on National Statistics of the National Academies of Sciences, Engineering, and Medicine to assist the U.S. Census Bureau with its new disclosure avoidance system for 2020 Census data products, which implements algorithms providing differential privacy. The workshop focused specifically on the Demographic and Housing Characteristics File, a major source of data for local governments, particularly those with small populations, and many other data users in the federal, state, academic, and business sectors. The intent was to garner feedback from users on the usability of the privacy-protected data by evaluating DHC demonstration files produced with the proposed TopDown Algorithm on 2010 Census data.

Chronic sleep disorders affect one in five Americans, and sleep deprivation costs significant U.S. GDP loss annually. Despite the indisputable biological importance of sleep, much remains unknown about underlying mechanisms. The National Academies Forum on Neuroscience and Nervous System Disorders convened a public workshop in November 2022. Experts and leaders from academia, industry, government, philanthropic foundations, and disease-focused non-profit organizations gathered to review current sleep science, examine the relationships between central nervous system disorders and sleep, identify potential cross-disciplinary collaborations, and discuss opportunities to better understand and mitigate sleep disturbances commonly associated with CNS disorders. This proceedings document summarizes workshop discussions.

In 2022, the United States installed its first exascale computing system for the Department of Energy (DOE) Office of Science, with an National Nuclear Security Administration (NNSA) system scheduled for 2023. The DOE Exascale Computing Project (ECP)2 has developed new applications capabilities, parallelization approaches, and software tools, while co-developing the computing systems in collaboration with vendor partners. The NNSA is positioned to take full advantage of exascale computing, but demand for more computing will continue to grow beyond exascale, driven by both familiar applications and new mission drivers and new computational approaches that will use high-end computing. Visionary leaders and creativity will be needed to move existing codes to next-generation platforms, to reconsider the use of advanced computing for current and emerging mission problems, and to envision new types of computing systems, algorithmic techniques implemented in software, partnerships, and models of system acquisition. This report reviews the future of computing beyond exascale computing to meet national security needs at the National Nuclear Security Administration, including computing needs over the next 20 years that exascale computing will not support; future computing technologies for meeting those needs including quantum computing and other novel hardware, computer architecture, and software; and the likely trajectory of promising hardware and software technologies and obstacles to their development and their deployment by NNSA.

Ecosystems form the foundation upon which society can survive and thrive, providing food, water, air, materials, and recreation. These connections between people and their environments are under stress from human-driven climate change, pollution, resource exploitation, and other actions that may have implications for public health. The integral connection between nature and human health is recognized and has been explored through different bodies of work; however, because of the breadth of this issue, many implications regarding public health are not well characterized. This has created a gap in understanding the interconnections between public health and ecosystem health systems and how ecosystem resiliency may affect public health. To inform the development of a research agenda aimed at bridging the knowledge-to-action gap related to integrating public and ecological health to foster resilience, the National Academies of Sciences, Engineering, and Medicine held a workshop across three days that brought together interdisciplinary researchers and practitioners from the public health, natural resource management, and environmental protection communities to exchange knowledge, discuss critical gaps in understanding and practice, and identify promising research that could support the development of domestic and international policy and practice. Day 1 of the workshop, held on September 19, 2022, addressed the following question: What has been learned about how to integrate public health and nature into research, policy, and practice to foster resilience? Days 2 and 3, held on September 29 and 30, 2022, explored advancement opportunities in transdisciplinary and community-engaged scholarship to improve integration of public health and nature and inform policy and practice and opportunities to bridge the knowledge-to-action gap with strategies to translate knowledge into policy and practice. This publication summarizes the presentation and discussion of the workshop.

Behavioral economics examines the evidence for behavioral economics and its application in six public policy domains: health, retirement benefits, climate change, social safety net benefits, climate change, education, and criminal justice. The report concludes that the principles of behavioral economics are indispensable for the design of policy and recommends integrating behavioral specialists into policy development within government units. In addition, the report calls for strengthening research methodology and identifies research priorities for building on the accomplishments of the field to date.

The National Science Foundation (NSF) asked the National Academies of Sciences, Engineering, and Medicine to conduct a quadrennial review of the NSF Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) programs, in accordance with a legislative mandate. Drawing on published research plus existing data, Review of the SBIR and STTR Programs at the National Science Foundation analyzes the effectiveness of NSF award selection process and postaward assistance; the effectiveness of the STTR program in stimulating new collaborations; the economic and noneconomic impacts of the programs; effectiveness of the programs in stimulating technological innovation and supporting small, new firms across the technological spectrum; and the role of the programs in providing early capital to firms without other significant sources of support.

This is the twenty-fifth volume in the Memorial Tributes series compiled by the National Academy of Engineering as a personal remembrance of the lives and outstanding achievements of its members and international members. These volumes are intended to stand as an enduring record of the many contributions of engineers and engineering to the benefit of humankind. In most cases, the authors of the tributes are contemporaries or colleagues who have personal knowledge of the interests and engineering accomplishments of the deceased.

Efforts over the last several decades to increase the participation and leadership of Black men and women in the scientific and medical workforce have had limited results. Despite many individual successes, the number of Black professionals in science, engineering, and medicine (SEM) fields has not reached a level that corresponds with African American representation in the country at large. Structural racism affects progress at all stages along the pathway - from young children through graduate and medical students through faculty and clinicians at all levels. Beyond entry into educational programs or recruitment into workplaces seeking to diversify, challenges persist to achieve equity and inclusion for Black males and females. Moreover, psychological barriers confound the engagement of Black men and women in SEM fields. To explore these issues and suggest solutions, the National Academies of Sciences, Engineering, and Medicine launched the Roundtable on Black Men and Black Women in Science, Engineering, and Medicine. Over the past 2 years, the Roundtable has convened workshops on K-12 education, the impact of COVID-19, financial burdens to pursuing SEM careers, and other topics. Sessions during each of these workshops identified psychological factors related to those specific topics. To have a more targeted discussion, the Roundtable convened a virtual workshop on September 14-15, 2021. As summarized in this proceedings, panelists and participants identified policies and practices that perpetuate these factors and explored solutions toward achieving and maintaining wellness, especially among students and young professionals.

Research to advance understanding of the ecology and biology of wildlife species is more important than ever as the world confronts issues ranging from biodiversity loss to the emergence of zoonotic diseases. However, the current understanding of animal welfare in research and education has been based on laboratory work with specific domesticated species. Wildlife research represents a starkly different context and with different implications for animal welfare. Wild species that are the subject of research have extremely diverse physiologies and behaviors and live in diverse habitats. This makes it challenging and sometimes impossible for wildlife researchers to follow the recommendations outlined in the Guide for the Care and Use of Laboratory Animals (NRC 2011) and other guidelines developed for a laboratory-based, biomedically focused research context. To explore issues associated with the unique welfare considerations of wildlife research, the National Academies of Sciences, Engineering, and Medicine (under the auspices of the Roundtable on Science and Animal Welfare in Laboratory Animal Use), hosted a workshop titled Discussing and Understanding Animal Welfare Challenges in Research and Education on Wildlife, Non-Model Animal Species, and Biodiversity on February 9-10, 2022. The event, held virtually, included pre-recorded presentations and overarching discussions to explore this topic in breadth and depth. More than 1,800 participants from academia, industry, government, and nonprofit organizations joined the webcast. This proceedings summarizes key topics covered in the workshop presentations and discussions based on transcripts, recordings, and slides from the event.

As part of a multiyear project to promote a cooperative relationship between U.S. and Pakistani human and animal health and infectious disease experts, the Pakistan Academy of Sciences, together with the U.S. National Academies of Sciences, Engineering, and Medicine, convened a bilateral workshop in Islamabad, Pakistan, to promote best practices in and improved communications, cooperation, and coordination among public, private, military, and animal health clinical laboratories in Pakistan. The workshop, "Strengthening and Sustaining a Network of Public and Animal Health Clinical Laboratories in Pakistan," was held on September 27-29, 2016. Pakistani life science, public health, veterinary, and clinical laboratory experts, graduate students from Pakistani institutions of higher learning, and U.S. scientists/clinicians met at the workshop to explore questions facing human and animal health policy makers in Pakistan. This publication summarizes presentations and discussions of the workshop.

Human milk is considered the biologic norm for feeding the human infant during the first 6 months of life, and it is a preferred food from 6 to 12 months. It is a complex food and exerts its biologic effects well beyond its known nutritional value; however, human milk composition and the complexity of its composition is not wholly known or understood. Thus, defining the composition of milk, as well as both the individual and combined effects of milk components and the volume consumed on infant growth and development, is central to optimizing infant health. Furthermore, defining human milk composition, volume, and the myriad factors that influence milk components is needed for developing future Dietary Reference Intake (DRI) standards for nutrient intakes during the first 12 months of life. Scanning for New Evidence on the Nutrient Content of Human Milk examines the new and emerging evidence describing the nutrient content of human milk as well as the volume of milk consumed, both of which are needed to understand nutrient consumption by healthy breastfed infants. An evidence scan approach was used to summarize the status of the published literature on the nutrient content of human milk and to identify new evidence on nutrients in human milk that could inform the need for a systematic review as a component of the DRI process.

According to the Government Accountability Office, sustainment of weapon systems accounts for approximately 70 percent of the total life-cycle costs. When sustainment is not considered early in the development process or as an integral part of the systems engineering design, it can negatively affect the ability of the Air Force to maintain and improve the weapon system once it enters service. At the request of the Assistant Secretary of the Air Force for Acquisition, Technology, and Logistics, Weapons Systems Sustainment Planning Early in the Development Life Cycle identifies at what point or phase of the development of a weapons system sustainment planning should be integrated into the program; examines and provides recommendations regarding how sustainment planning should be evaluated throughout the development process; investigates and describes the current challenges with sustainment planning and determines what changes have occurred throughout the acquisition process that may have eroded sustainment planning; and identifies opportunities for acquisitions offices to gain greater access to sustainment expertise.

The National Academies Forum on Traumatic Brain Injury (TBI) convened a workshop in September 2022 to explore biomarkers used to more precisely and objectively diagnose and categorize suspected TBIs. Session discussions addressed developments in TBI biomarker classes including neuroimaging, blood-based, electrophysiological, and other physiological markers; how biomarkers may be used to better guide and monitor treatment after injury; and how they can be used to refine future research studies. Speakers also discussed potential impacts of biomarkers across the trajectory of TBI care and research, efforts to translate and incorporate biomarkers from research settings into clinical practice, and opportunities to advance the field. This Proceedings of a Workshop summarizes the presentations and discussions from the event.

Antifungal use in plant agriculture is a widespread practice necessary to safeguard food safety and security. While the impact of antimicrobial resistance (AMR) is a significant global health concern, knowledge gaps exist surrounding antifungal resistance, the connection to plant agriculture, and its implications for human health. The National Academies Forum on Microbial Threats hosted a workshop series in June 2022 exploring the role of plant agricultural practices in AMR development and implications for human health, with a focus on plant crop production. Sessions explored the magnitude of environmentally induced/selected antifungal resistance connected to plant agriculture, agricultural practices that may contribute to AMR in human pathogens, and strategies for surveillance and mitigation.This Proceedings document summarizes workshop discussions.

The Gulf Research Program of the National Academies of Sciences, Engineering, and Medicine has developed a program to strengthen community resilience, the Enhancing Community Resilience (EnCoRe) initiative. EnCoRe aims to reduce inequities in health and community resilience; advance research and practice in health and community resilience; and build the capacity of communities for addressing the impacts of climate change and disasters on at-risk populations. To achieve these goals, EnCoRe will support long-term, multiyear community engagement projects that partner directly with select communities across the Gulf region and Alaska. This report develops findings and recommendations intended to help guide EnCoRe in identifying, selecting, and engaging with communities as it moves forward with the initiative. Strengthening Equitable Community Resilience examines past and current community engagement efforts and other relevant materials, particularly those that have included communities in the Gulf region and Alaska, for the purpose of identifying guiding principles and lessons learned and then develops a set of guiding principles to identify criteria for selecting the participating communities in the EnCoRe program.

The National Academies Roundtable on Genomics and Precision Health, in collaboration with the National Cancer Policy Forum, hosted a public workshop that examined how genomic data are used in health care, outside of the traditional settings for clinical genetics. The workshop identified opportunities for advancement of precision health care delivery. The event also explored how patients, clinicians, and payers assess and act upon the risks and benefits of genomic screening and diagnostic testing. Discussions focused on strategies to ensure that genomic applications are responsibly and equitably adopted to benefit populations as well as individuals over time. This Proceedings of a Workshop summarizes content from the event.

Much of the statistical information currently produced by federal statistical agencies - information about economic, social, and physical well-being that is essential for the functioning of modern society - comes from sample surveys. In recent years, there has been a proliferation of data from other sources, including data collected by government agencies while administering programs, satellite and sensor data, private-sector data such as electronic health records and credit card transaction data, and massive amounts of data available on the internet. How can these data sources be used to enhance the information currently collected on surveys, and to provide new frontiers for producing information and statistics to benefit American society? Toward a 21st Century National Data Infrastructure: Enhancing Survey Programs by Using Multiple Data Sources, the second report in a series funded by the National Science Foundation, discusses how use of multiple data sources can improve the quality of national and subnational statistics while promoting data equity. This report explores implications of combining survey data with other data sources through examples relating to the areas of income, health, crime, and agriculture.

"An accurate measure of poverty is necessary to fully understand how the economy is performing across all segments of the population and to assess the effects of government policies on communities and families. In addition, poverty statistics are essential in determining the size and composition of the population whose basic needs are going unmet and to help society target resources to address those needs.An Updated Measure of Poverty: (Re)Drawing the Line recommends updating the methodology used by the Census Bureau to calculate the Supplemental Poverty Measure (SPM) to reflect household basic needs. This report recommends that the more comprehensive SPM replace the current Official Poverty Measure as the primary statistical measure of poverty the Census Bureau uses. The report assesses the strengths and weaknesses of the SPM and provides recommendations for updating its methodology and expanding its use in recognition of the needs of most American families such as medical care, childcare, and housing costs."--

Genetic and genomic information has become far more accessible, and research using human genetic data has grown exponentially over the past decade. Genetics and genomics research is now being conducted by a wide range of investigators across disciplines, who often use population descriptors inconsistently and/or inappropriately to capture the complex patterns of continuous human genetic variation. In response to a request from the National Institutes of Health, the National Academies assembled an interdisciplinary committee of expert volunteers to conduct a study to review and assess existing methodologies, benefits, and challenges in using race, ethnicity, ancestry, and other population descriptors in genomics research. The resulting report focuses on understanding the current use of population descriptors in genomics research, examining best practices for researchers, and identifying processes for adopting best practices within the biomedical and scientific communities.

Most of the offshore oil and gas industry in the Gulf of Mexico has shown considerable improvement in systemic risk management, which is now approaching a middle stage of maturity across most risk elements. Advancing Understanding of Offshore Oil and Gas Systemic Risk in the U.S. Gulf of Mexico: Current State and Safety Reforms Since the Macondo Well-Deepwater Horizon Blowout assesses both industry and regulatory progress against the reforms that were recommended following the Deepwater Horizon disaster in 2010. The report also states that progress has been uneven, and critical gaps remain in comprehensively addressing the management of systemic risk offshore.

The Comprehensive Addiction and Recovery Act (CARA; P.L. 114-198) was signed into law in 2016 to help address the challenges of overdose deaths and opioid use disorder, and to expand access to evidence-based treatment. Among these efforts was the authorization of four grant programs to be overseen by the Substance Abuse and Mental Health Services Administration (SAMHSA). In 2018, SAMHSA requested that the National Academies establish a committee to conduct a review of the four programs, which focus primarily on opioids, but occasionally include treatment and recovery services for co-occurring substance use disorders. The review resulted in three consensus study reports over five years. This third and final report aims to (1) understand the processes of the four grant programs; actions taken by grantees and their partners; impacts to clients, patients, the community, and public; and structural or environmental changes that might have resulted from grant funding, and (2) analyze how future congressionally mandated evaluations can be structured and carried out to better support policy makers.

Roughly every four years, the U.S. Global Change Research Program produces a congressionally mandated assessment of global change science and the impacts, adaptation, and mitigation of climate change in the United States. The draft Fifth National Climate Assessment (NCA5), released publicly in November 2022, covers a wide range of U.S. impacts, from human health and community well-being to the built environment, businesses and economies, and ecosystems and water resources. NCA5 had the largest scale of collaboration to date in the series, with input from hundreds of experts from all levels of governments, academia, non-government organizations, the private sector, and the public. The National Academies report provides an independent, comprehensive review and makes recommendations to strengthen the accuracy, credibility, and accessibility of the draft NCA5 report. The National Academies' review of the draft NCA5 report finds that it successfully meets the requirements of the federal mandate, provides accurate information, and effectively communicates climate science to the public, decision makers, and other stakeholders. The review makes recommendations for ways the draft NCA5 report could be strengthened, including: adopting more clear and consistent structure for key messages and figures across the report; resolving inconsistencies between chapters in how terms and topics are discussed, for example the use of scenarios and projections; intentionally applying an equity and justice lens across chapters; and increasing emphasis on certain topical areas.

Spatial justice is about equitable access to parks, housing, and more. During societal emergencies, including pandemics and climate change, the relationship between people and places requires greater attention and action to integrate the knowledge of people with lived experience, especially historically marginalized communities. On September 20 and 21, 2021, the National Academies Roundtable on Population Health Improvement hosted a virtual workshop to explore the nature, use, design of, threats, and changes to places as a resource for health and public spaces as a shared resource. This Proceedings document summarizes workshop discussions.