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This book is largely based on a 1998 forum where participants from across America discussed ways to improve the utilization of science and technology for economic growth over the next several decades. A steering committee of prominent Americans, co-chaired by SEMATECH Chairman William Spencer and former Pennsylvania Governor and U.S. Attorney General Dick Thornburgh, developed consensus recommendations from the forum input. Harnessing Science and Technology for America's Economic Future puts forward long-term goals for the nation and associated action items. It includes background papers and talks from the forum, covers the economics of science and technology-based growth, industry trends, the role of government, education, research universities, and the international context.

Industrial Environmental Performance Metrics is a corporate-focused analysis that brings clarity and practicality to the complex issues of environmental metrics in industry. The book examines the metrics implications to businesses as their responsibilities expand beyond the factory gate—upstream to suppliers and downstream to products and services. It examines implications that arise from greater demand for comparability of metrics among businesses by the investment community and environmental interest groups. The controversy over what sustainable development means for businesses is also addressed. Industrial Environmental Performance Metrics identifies the most useful metrics based on case studies from four industries—automotive, chemical, electronics, and pulp and paper—and includes specific corporate examples. It contains goals and recommendations for public and private sector players interested in encouraging the broader use of metrics to improve industrial environmental performance and those interested in addressing the tough issues of prioritization, weighting of metrics for meaningful comparability, and the longer term metrics needs presented by sustainable development.

How small can a free-living organism be? On the surface, this question is straightforward-in principle, the smallest cells can be identified and measured. But understanding what factors determine this lower limit, and addressing the host of other questions that follow on from this knowledge, require a fundamental understanding of the chemistry and ecology of cellular life. The recent report of evidence for life in a martian meteorite and the prospect of searching for biological signatures in intelligently chosen samples from Mars and elsewhere bring a new immediacy to such questions. How do we recognize the morphological or chemical remnants of life in rocks deposited 4 billion years ago on another planet? Are the empirical limits on cell size identified by observation on Earth applicable to life wherever it may occur, or is minimum size a function of the particular chemistry of an individual planetary surface? These questions formed the focus of a workshop on the size limits of very small organisms, organized by the Steering.Group for the Workshop on Size Limits of Very Small Microorganisms and held on October 22 and 23, 1998. Eighteen invited panelists, representing fields ranging from cell biology and molecular genetics to paleontology and mineralogy, joined with an almost equal number of other participants in a wide-ranging exploration of minimum cell size and the challenge of interpreting micro- and nano-scale features of sedimentary rocks found on Earth or elsewhere in the solar system. This document contains the proceedings of that workshop. It includes position papers presented by the individual panelists, arranged by panel, along with a summary, for each of the four sessions, of extensive roundtable discussions that involved the panelists as well as other workshop participants.

America's cities have symbolized the nation's prosperity, dynamism, and innovation. Even with the trend toward suburbanization, many central cities attract substantial new investment and employment. Within this profile of health, however, many urban areas are beset by problems of economic disparity, physical deterioration, and social distress. This volume addresses the condition of the city from the perspective of the larger metropolitan region. It offers important, thought-provoking perspectives on the structure of metropolitan-level decisionmaking, the disadvantages faced by cities and city residents, and expanding economic opportunity to all residents in a metropolitan area. The book provides data, real-world examples, and analyses in key areas: Distribution of metropolitan populations and what this means for city dwellers, suburbanites, whites, and minorities. How quality of life depends on the spatial structure of a community and how problems are based on inequalities in spatial opportunity—with a focus on the relationship between taxes and services. The role of the central city today, the rationale for revitalizing central cities, and city-suburban interdependence. The book includes papers that provide in-depth examinations of zoning policy in relation to patterns of suburban development; regionalism in transportation and air quality; the geography of economic and social opportunity; social stratification in metropolitan areas; and fiscal and service disparities within metropolitan areas.

It is a commonly held belief that athletes, particularly body builders, have greater requirements for dietary protein than sedentary individuals. However, the evidence in support of this contention is controversial. This book is the latest in a series of publications designed to inform both civilian and military scientists and personnel about issues related to nutrition and military service. Among the many other stressors they experience, soldiers face unique nutritional demands during combat. Of particular concern is the role that dietary protein might play in controlling muscle mass and strength, response to injury and infection, and cognitive performance. The first part of the book contains the committee's summary of the workshop, responses to the Army's questions, conclusions, and recommendations. The remainder of the book contains papers contributed by speakers at the workshop on such topics as, the effects of aging and hormones on regulation of muscle mass and function, alterations in protein metabolism due to the stress of injury or infection, the role of individual amino acids, the components of proteins, as neurotransmitters, hormones, and modulators of various physiological processes, and the efficacy and safety considerations associated with dietary supplements aimed at enhancing performance.

Written by the foremost authorities in the field, this volume brings together the technical papers from which Volume 1 is drawn. The 10 papers and discussion from a National Research Council symposium cover such topics as soil erosion classification, evaluating how soil erosion damages productivity, calculating soil erosion, understanding ephemeral gully erosion, wind erosion, and the impact of range erosion on land use.

Comparable worth—equal pay for jobs of equal value—has been called the civil rights issue of the 1980s. This volume consists of a committee report that sets forth an agenda of much-needed research on this issue, supported by six papers contributed by eminent social scientists. The research agenda presented is structured around two general themes: (1) occupational wage differentials and discrimination and (2) wage adjustment strategies and their impact. The papers deal with a wide range of topics, including job evaluation, social judgment biases in comparable worth analysis, the economics of comparable worth, and prospects for pay equity.

Are women paid less than men when they hold comparable jobs? Is there gender bias in the way wages are set? Or can wage differences between men and women be explained by legitimate market forces? Pay Equity: Empirical Inquiries answers these questions in 10 original research papers. The papers explore race- and gender-based differences in wages, at the level both of individuals and of occupations. They also assess the effects of the implementation of comparable worth plans for private firms, states, and—on an international level—for Australia, Great Britain, and the United States.

Hydrologic science, an important, interdisciplinary science dealing with the occurrence, distribution, and properties of water on Earth, is key to understanding and resolving many contemporary, large-scale environmental issues. The Water Science and Technology Board used the opportunity of its 1997 Abel Wolman Distinguished Lecture to assess the vitality of the hydrologic sciences by the hydrologic community. The format included focus by lecturer Thomas Dunne on the intellectual vitality of the hydrologic sciences, followed by a symposium featuring several invited papers and discussions. Hydrologic Sciences is a compilation of the Wolman Lecture and the papers, preceded by a summarizing overview. The volume stresses a number of needs for furtherance of hydrologic science, including development of a coherent body of transferable theory and an intellectual center for the science, communication across multiple geo- and environmental science disciplines, appropriate measurements and observations, and provision of central guidance for the field.

This book contains papers presented at a conference which describe studies of a World War II hepatitis epidemic, a genetic analysis of substance use in veteran twins, hemorrhagic fever with renal syndrome, the psychological effects of military captivity, and dioxin in adipose tissue. Other papers discuss radiation risk studies in military populations and resources for epidemiologic research in Vietnam-era veterans. This volume should be of interest to epidemiologists, medical researchers, and others interested in public health.

Treating Drug Problems, Volume 2 presents a wealth of incisive and accessible information on the issue of drug abuse and treatment in America. Several papers lay bare the relationship between drug treatment and other aspects of drug policy, including a powerful overview of twentieth century narcotics use in America and a unique account of how the federal government has built and managed the drug treatment system from the 1960s to the present. Two papers focus on the criminal justice system. The remaining papers focus on Employer policies and practices toward illegal drugs. Patterns and cycles of cocaine use in subcultures and the popular culture. Drug treatment from a marketing, supply-and-demand perspective, including an analysis of policy options. Treating Drug Problems, Volume 2 provides important information to policy makers and administrators, drug treatment specialists, and researchers.

While societies have always had information infrastructures, the power and reach of today's information technologies offer opportunities to transform work and family lives in an unprecedented fashion. This volume, a collection of six papers presented at the 1994 National Academy of Engineering Meeting Technical Session, presents a range of views on the subject of the revolution in the U.S. information infrastructure. The papers cover a variety of current issues including an overview of the technological developments driving the evolution of information infrastructures and where they will lead; the development of the Internet, particularly the government's role in its evolution; the impact of regulatory reform and antitrust enforcement on the telecommunications revolution; and perspectives from the computer, wireless, and satellite communications industries.

One of a continuing series on Frontiers of Visual Science, this short volume contains papers presented at a recent symposium. These papers describe techniques for assessing the structure and function of photoreception, both in isolation and in aggregation as the'receptor mosaic'of the retina. Also described are dynamic and spatial sampling properties of photoreceptors, with an emphasis on techniques of measurement and associated models of retinal function. This volume should be of interest to basic vision scientists, clinical ophthalmologists, workers in human factors, and computer scientists curious about the visual apparatus of biological systems.

Use of the term'multiple chemical sensitivity'(MCS) as a diagnostic label has generated increasing controversy during the past few decades as a phenomenon related to exposure to chemical agents sustained both in indoor and outdoor environments. This volume, prepared in conjunction with Biologic Markers in Immunotoxicology, contains the authored papers of a workshop held to develop an agenda to study the phenomenon of multiple chemical sensitivity. Authored by clinicians, immunologists, toxicologists, epidemiologists, psychiatrists, psychologists, and others involved in research or clinical activities relevant to the problem, the papers contain case evaluations and criteria for diagnosis, mechanisms potentially underlying MCS, and epidemiologic approaches to investigation.

With discussion on how paper conservation procedures work, how they are put to use, and how deterioration may be prevented, this comprehensive volume examines how vast quantities of documentation can best be preserved. It provides detailed information and recommendations about various preservation methods, including mechanical copying, photographic film, magnetic recording, and optical disk recording, and on the expected useful lives of each. Also included are a method for scoring and assessing the condition of collections and a decision tree that provides a guide for orderly progress in preserving a collection of documents. Printed on permanent, acid-free paper.

Since the onset of the coronavirus disease 2019 (COVID-19) pandemic in early 2020, many individuals infected with the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have continued to experience lingering symptoms for months or even years following infection. Some symptoms can affect a person's ability to work or attend school for an extended period of time. Consequently, in 2022, the Social Security Administration requested that the National Academies convene a committee of relevant experts to investigate and provide an overview of the current status of diagnosis, treatment, and prognosis of long-term health effects related to Long COVID. This report presents the committee conclusions.

Myopia, commonly called nearsightedness, has been increasing globally. If current trends continue, there will be 5 billion near-sighted individuals globally by 2050. The understanding of myopia has been enhanced by advances in genetics, investigations employing animal models, understanding of physiology, ocular imaging, epidemiology, environmental research, and clinical trials of interventional strategies. To further develop the knowledge base related to myopia and to reduce the incidence and negative consequences of the disease, eye care professionals, federal agencies, and funding agencies need to make improvements to standardize care, increase funding to study treatments, encourage outdoor time, and overall facilitate the standardization of assessments and diagnostics. Progress in these areas is imperative to address the current increase in myopia across the country. Myopia: Causes, Prevention, and Treatment of an Increasingly Common Disease identifies and assesses the current mechanistic understanding of myopia pathogenesis and the causes of its increased prevalence. This report also examines knowledge gaps and barriers to progress and develops a research agenda aimed at better understanding the biological and environmental factors that could explain the increasing incidence of myopia.

In 2018, the National Academies released Thriving on Our Changing Planet: A Decadal Strategy for Earth Observation from Space. The decadal survey identified key science questions and prioritized observational needs to advance U.S. efforts in Earth science and support critical applications such as climate modeling and weather prediction. In the past few years, the need for actionable data and better scientific information on Earth's interacting systems has increased in urgency, as global climate change accelerates coupled with increasing numbers of extreme weather events. At the request of NASA, this mid-term assessment evaluates progress and recommends actions to meet decadal survey priorities. This report explores ways that NASA's Earth Science Division can maintain programmatic balance, improve alignment with decadal survey priorities, and prepare for the next decadal survey.

Experiencing a single disaster - a hurricane, tornado, flood, severe winter storm, or a global pandemic - can wreak havoc on the lives and livelihoods of individuals, families, communities and entire regions. For many people who live in communities in the U.S. Gulf of Mexico region, the reality of disaster is starker. Endemic socioeconomic and health disparities have made many living in Gulf of Mexico communities particularly vulnerable to the effects of weather-climate hazards. Prolonged disaster recovery and increasing disaster risk is an enduring reality for many living in Gulf of Mexico communities. Between 2020 and 2021, seven major hurricanes and a severe winter storm affected communities across the region. As a backdrop to these acute weather events, the global COVID-19 pandemic was unfolding, producing a complex and unprecedented public health and socioeconomic crisis. Traditionally, the impacts of disasters are quantified individually and often in economic terms of property damage and loss. In this case, each of these major events occurring in the Gulf of Mexico during this time period subsequently earned the moniker of'billion-dollar'disaster. However, this characterization does not reflect the non-financial human toll and disparate effects caused by multiple disruptive events that increase underlying physical and social vulnerabilities, reduce adaptive capacities and ultimately make communities more sensitive to the effects of future disruptive events. This report explores the interconnections, impacts, and lessons learned of compounding disasters that impair resilience, response, and recovery efforts. While Compounding Disasters in Gulf Coast Communities, 2020-2021 focuses on the Gulf of Mexico region, its findings apply to any region that has similar vulnerabilities and that is frequently at risk for disasters.

High magnetic fields are a vital tool in many areas of science and technology that impact our everyday lives. Magnetic resonance imaging enables a wide range of medical diagnostics and research, while nuclear magnetic resonance is critical for drug discovery research and more. High magnetic fields are an essential component to many proposed fusion energy reactors and are necessary to push the boundaries towards the development of new quantum technologies and semiconductors. At the request of the National Science Foundation, the National Academies organized a study to identify scientific opportunities and key applications for high-magnetic-field science and technology for the next decade and beyond. This report explores the current state and future prospects for high-magnetic-field technologies and recommends actions to support the workforce, facilities, magnet development, and critical materials access necessary to promote U.S. innovation.

People with disabilities can be any age, face chronic health conditions or mental illness, be racial or ethnic minorities, experience low income or housing insecurity, have limited English proficiency, or a combination of many of these conditions. To better understand the effect of health inequities and the manner in which they affect Social Security Administration's (SSA) disability programs, the National Academies hosted a public workshop in April 2024 that examined the variety of different experiences of individuals with disabilities and the consequences of those experiences on an individual's health status, medical record, and SSA disability determinations.

The National Academies Roundtable on Obesity Solutions hosted a public workshop in March 2024 to explore the current understanding of pharmacotherapy for overweight or obesity, the effects of medications intended for obesity and obesity-related comorbidities, and how complementary treatment options (such as nutrition and behavioral interventions) advance obesity care in conjunction with medication use. Speakers took care to highlight lived experiences, existing weight bias and stigma, and implications of pharmacotherapy on health policy, economics, access, clinical practice, and public health.

Engineering advances economic growth, enhances manufacturing capacity, enhances infrastructure resilience, improves healthcare, and strengthens national security. However, the impact of engineering research - and, by extension, engineering education - is often hidden from the public eye. Promoting comprehension of how engineering affects society is thus a crucial aspect of garnering and sustaining public backing of policies aimed at ensuring that technology continues to serve the greater good of humanity. One part of this effort is highlighting the pivotal role of federal support of engineering research. Such support furnishes researchers with the necessary resources to pursue ambitious projects, fostering exploration into fundamental questions, groundbreaking technology and engineered systems developments, and practical applications. Since its inception in 1950, the National Science Foundation (NSF)—an independent federal agency—has played a critical role in funding cutting-edge research, including in engineering. At the request of NSF, Impacts of National Science Foundation Engineering Research Support on Society explores how investment in engineering research and education has led to positive societal impacts, focusing on the stories of the people responsible for these impacts. This report presents clear, compelling narratives for the public about the sources and effects of engineering innovations and offer recommendations on how to bring this information to the attention of diverse audiences.

For more than 75 years, high-hazard structures in the U.S., including dams and nuclear power plants, have been engineered to withstand floods resulting from the most unlikely but possible precipitation, termed Probable Maximum Precipitation (PMP). Failure of any one of the more than 16,000 high-hazard dams and 50 nuclear power plants in the United States could result in the loss of life and impose significant economic losses and widespread environmental damage, especially under the pressures of climate change. While PMP estimates have provided useful guidance for designing critical infrastructure, weaknesses in the scientific foundations of PMP, combined with advances in understanding, observing, and modeling extreme storms, call for fundamental changes to the definition of PMP and the methods used to estimate it. Modernizing Probable Maximum Precipitation Estimation recommends a new definition of PMP and presents a vision for a methodology relevant for design, operation, and regulation of critical infrastructure. The new definition targets precipitation depths with an extremely low exceedance probability instead of assuming rainfall is bounded, and considers specified climate periods so that PMP estimates can change as the climate changes. Near-term enhancements to PMP include improved data collection, model-based storm reconstructions, and strengthened scientific grounding for PMP methods. Long-term model-based PMP estimation will employ kilometer-scale climate models capable of resolving PMP storms and producing PMP-magnitude precipitation. A Model Evaluation Project will provide scientific grounding for model-based PMP estimation and determine when transition to a model-based PMP estimation should occur. Scientific and modeling advances along this front will contribute to addressing the societal challenges linked to the changes in extreme storms and precipitation in a warming climate, which are critical steps to ensuring the safety of our infrastructure and society.

Women in the United States experience a higher prevalence of many chronic conditions, including Alzheimer's disease, depression, and osteoporosis, than men; they also experience female-specific conditions, such as endometriosis and pelvic floor disorders. A lack of research into both the biological and social factors that influence these conditions greatly hinders diagnosis, treatment, and prevention efforts, thus contributing to poorer health outcomes for women and substantial costs to individuals and for society. The National Institutes of Health's Office of Research on Women's Health asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to identify gaps in the science on chronic conditions that are specific to or predominantly impact women, or affect women differently, and propose a research agenda. The committee's report presents their conclusions and recommendations.

The United States is an important food producer globally, in part because of its abundance of agriculturally productive soils. However, management practices that maximize yields have caused losses in soil organic matter, poor soil structure and water-holding capacity, and increased salinity on millions of acres of land - and have adversely affected the microbial communities that are the drivers of many soil processes. At the same time, recent scientific advances have spurred interest in how microbial communities can support soil health, food quality, and human health. It is in this context that the U.S. Department of Agriculture National Institute of Food and Agriculture asked the National Academies to explore the linkages between soil health and human health. The report finds that to improve soil health, federal agencies need to promote the importance of soil health, support translational research, and develop a coordinated national approach to monitor soil health over time and space. Given the potential that microbiomes have in modulating soil, plant, and human health, there is also a pressing need to determine which microbial features, if any, contribute to quantifying or fortifying health in both human and soil systems and to understand the direct and indirect roles of soil, alongside other environmental factors, in influencing human microbial colonization and subsequent health outcomes. Such investigation involves delving into the relatively sparse or disconnected research regarding the microbiome continuum that links soil and human systems.

A high-quality preschool education can foster critical development and learning that promotes joyful, affirming, and enriching learning opportunities that prepare children for success in school and life. While preschool programs generally provide emotionally supportive environments, their curricula often fall short in advancing learning in math, early literacy, and science, and lack the necessary support for multilingual learners emerging bilingualism. Additionally, access to high-quality, effective early learning experiences may be limited and inadequate based on factors such as a childs race, location, gender, language, identified disability, and socioeconomic status. A New Vision for High-Quality Preschool Curriculum examines preschool curriculum quality for children from ages three to five, with special attention to the needs of Black and Latine children, multilingual learners, children with disabilities and children experiencing poverty in the United States. The report articulates a vision for high-quality preschool curricula for all children, grounded in an equity and justice-oriented principles from inception to implementation and evaluation.

Implantable brain stimulation has had a profound impact on neuroscience research and the treatment of central nervous system disorders by allowing physicians to directly intervene in the pathological neural circuits of their patients. To explore the logistical, educational, and economic barriers to adopting this technology into regular use in clinical care, the National Academies Forum on Neuroscience and Nervous System Disorders hosted a public workshop in October 2023.

The lack of a clear and consistent definition for Long COVID presents challenges for policymakers, researchers, public health professionals, clinicians, support services, and patients. As such, the Administration for Strategic Preparedness and Response and the Office of the Assistant Secretary for Health asked the National Academies to assemble a committee of experts to produce a consensus definition for Long COVID. The resulting report, A Long COVID Definition: A Chronic, Systemic Disease State with Profound Consequences, presents the 2024 NASEM Long COVID Definition, developed based on findings reported in existing literature, as well as stakeholder and patient input.

The convergence of imaging, pathology, and laboratory testing data, augmented with information technology, is referred to as integrated diagnostics. To examine the current state of the science and strategies to facilitate precision cancer care through integrated diagnostics, the National Academies National Cancer Policy Forum hosted a public workshop in collaboration with the Computer Science and Telecommunications Board and the Board on Human-Systems Integration.

The National Academies Global Forum on Innovations in Health Professional Education held a public workshop in November 2023. Speakers explored how health professional educators and providers with health systems science (HSS) training can prepare learners to work together within health systems, resulting in better patient care, improved population health, and enhanced health professional well-being. Organizers hosted a public pre-workshop in October 2023 to create a foundational understanding of HSS prior to their workshop.

Research supported by scientific ocean drilling has fundamentally transformed our understanding of the planet with key contributions to the discovery and theory of plate tectonics; the formation and destruction of ocean crust; the reconstruction of extreme greenhouse and icehouse climates; the identification of major extinctions; and the discovery of a diverse community of microbes living deep ocean seafloor. With the retirement in 2024 of the JOIDES Resolution-- the U.S. dedicated drilling vessel for deep sea research and the workhorse for the international scientific ocean drilling community-- the scientific ocean drilling landscape will change. At this critical juncture, the National Science Foundation (NSF) is looking to identify the most urgent research questions that can only be answered with scientific ocean drilling and what infrastructure is needed to progress those priorities. This interim report that is the first part of a broader study of decadal survey of ocean science provides a broad perspective of future research and associated infrastructure needs. The report concludes that the rapid pace of climate change, related extreme events, sea level rise, changes in ocean currents, chemistry threatening ocean ecosystems, and devastating natural hazards are among the greatest challenges facing society. By coring the past to inform the future, U.S. based scientific ocean drilling research continues to have unique and essential roles in addressing these vital and urgent challenges.

Concerted efforts to deepen understanding of RNA modifications and their role in living systems hold the potential to advance human health, improve crop yields, and address other pressing societal challenges. RNA, which carries the information encoded by DNA to the places where it is needed, is amazingly diverse and dynamic. RNA is processed and modified through natural biological pathways, giving rise to hundreds, in some cases thousands, of distinct RNA molecules for each gene, thereby diversifying genetic information. RNA modifications are known to be pivotal players in nearly all biological processes, and their dysregulation has been implicated in a wide range of human diseases and disorders. Yet, our knowledge of RNA modifications remains incomplete, hindered by current technological limitations. Existing methods cannot discover all RNA modifications, let alone comprehensively sequence them on every RNA molecule. Nonetheless, what is known about RNA modifications has already been leveraged in the development of vaccines that helped saved millions of lives worldwide during the COVID-19 pandemic. RNA modifications also have applications beyond health, for example, enhancing agricultural productivity. Charting a Future for Sequencing RNA and Its Modifications: A New Era for Biology and Medicine calls for a focused, large-scale effort to accelerate technological innovation to harness the full potential of RNA modifications to address pressing societal challenges in health, agriculture, and beyond. This report assesses the scientific and technological breakthroughs, workforce, and infrastructure needs to sequence RNA and its modifications, and ultimately understand the roles RNA modifications play in biological processes and disease. It proposes a roadmap of innovation that will make it possible for any RNA from any biological system to be sequenced end-to-end with all of its modifications - a capability that could lead to more personalized and targeted treatments and instigate transformative changes across various sectors beyond health and medicine.

Individuals, institutions, and communities all have a role in strengthening representation of Black men and Black women in science, engineering, and medicine (SEM). The SEM workplace has historically not been an equitable space for students, faculty, staff, and professionals, but promising practices nationwide are changing that narrative. On September 19-20, 2022, the Roundtable on Black Men and Black Women in Science, Engineering, and Medicine of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop to examine local, regional, and national opportunities to engage with and leverage community support and mutually beneficial partnerships that build inclusive environments for Black undergraduate, graduate, and medical students and increase the representation of Black professionals in SEM. Workshop participants helped identify practices, policies, and partnerships with demonstrated success; laid a foundation for collaborative dialogue that involves student involvement in the planning, implementation, and evaluation of SEM programs; and identified the resources and actions necessary to further positive change for Black SEM students and professionals.

Traumatic brain injuries (TBI) affect millions of Americans each year, causing symptoms that can be debilitating and long-lasting and resulting in physical, cognitive, emotional, and financial ramifications. The complexity and heterogeneity of TBI make it challenging to target the right interventions to the right patient at the right time. For those who do receive care, unlinked health records, fragmented care delivery, and gaps in medical surveillance means many questions remain unanswered about TBI prevalence, comorbidities, adverse outcome risk factors, and long-term outcomes. To help address this challenge, learning health care systems that bidirectionally exchange data and insights across clinical research, care services, and public health have been identified as key to improving patient outcomes. To help move the field forward, the National Academies Forum on Traumatic Brain Injury hosted a public workshop to explore the role of learning health systems in advancing TBI research and care. This Proceedings of a Workshop summarizes discussions and key messages from the workshop.

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.

Young people often engage and lead efforts to improve the social, economic, and environmental factors that influence the health and equity of communities and the nation. The National Academies Roundtable on Population Health Improvement hosted a hybrid public workshop in September 2023 at The California Endowment Center for Healthy Communities in Oakland, California to discuss the power of youth leadership in creating conditions for health and equity and the civic infrastructure and resources that support youth participation and leadership in change efforts.

The Survey of Income and Program Participation (SIPP) is one of the U.S. Census Bureau's major surveys with features making it a uniquely valuable resource for researchers and policy analysts. However, the Census Bureau faces the challenge of protecting the confidentiality of survey respondents which has become increasingly difficult because numerous databases exist with personal identifying information that collectively contain data on household finances, home values, purchasing behavior, and other SIPP-relevant characteristics. A Roadmap for Disclosure Avoidance in the Survey of Income and Program Participation addresses these issues and how to make data from SIPP available to researchers and policymakers while protecting the confidentiality of survey respondents. The report considers factors such as evolving privacy risks, development of new methods for protecting privacy, the nature of the data collected through SIPP, the practice of linking SIPP data with administrative data, the types of data products produced, and the desire to provide timely access to SIPP data. The report seeks to balance minimizing the risk of disclosure against allowing researchers and policymakers to have timely access to data that support valid inferences.

Antarctica hosts some of the harshest and most remote environments on Earth - and it is a region of vital importance for scientific research. The environment and position of Antarctica on the globe mean that research conducted there can offer unique insights on important Earth processes, including rising sea level, the carbon cycle, ecosystem structure. As the climate warms, data gathered from Antarctic research will be essential to understanding how Earth processes are changing and the potential social, economic, and health impacts on both U.S. and global populations. This report identifies the highest priorities for research in the Southern Ocean and nearshore and coastal Antarctica, as well as gaps in current capabilities to support this research. Global sea level rise, heat and carbon budgets, and changing ecosystems are the three highest-priority science drivers for research in the region. To address those drivers and maintain a robust U.S. research presence in this vitally important region, investments are needed in the U.S. Antarctic program and its research platforms, including the development of new technologies and the replacement of aging icebreaking research vessels. Additionally, the U.S. should strengthen relationships with other nations'Antarctic programs that can help support these essential science drivers.

The United States is experiencing a decline in life expectancy despite high health care spending due to a multitude of factors, including the COVID-19 pandemic, opioid epidemic, high burden of chronic disease, and systemic and structural inequities. A response proportional to this crisis is required. Valuing America's Health: Aligning Financing to Reward Better Health and Well-Being explores opportunities to transform the current health and health care system to one that promotes whole person and whole population health. The publication emphasizes the need for a bold vision and sustainable financing strategies to prioritize health and well-being for all. Authors of the publication highlight the importance of building a movement to prioritize health, repairing systemic failures, holding stakeholders accountable, controlling health care costs, incentivizing health promotion, adopting collaborative financing and policy-making approaches, and empowering individuals and communities in health decision-making. The way is clear; what is needed now is the will to move forward. Learn more about how to ensure our nation's health and health care system can support optimal health for all.

In September 2023, the Committee on Population at the National Academies of Sciences, Engineering, and Medicine held a workshop, Developing an Agenda for Population Aging and Social Research in Low- and Middle-Income Countries (LMICs). The explicit goal of the workshop was to identify the most promising directions for behavioral and social research and data infrastructure investments for studying life-course health, aging, and Alzheimers disease and Alzheimers disease and related dementias in LMICs. This publication summarizes the presentation and discussion of the workshop.

Approximately 3.6 million live births occur every year in the United States. Between 8 and 9 percent of infants are born with low birth weight (LBW), defined by the medical community as less than 2,500 grams or 5.5 pounds at birth. While most infants born with LBW are not impacted by severe developmental disabilities or major or multiple health conditions, research indicates that these infants often do experience elevated rates of mild to moderate chronic health conditions that have meaningful functional impacts throughout an individuals life course. The Social Security Administration (SSA) asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to provide an overview of the current status of the identification, treatment, and prognosis of LBW babies, including trends in survivability, in the U.S. population under age 1 year. SSA also asked the committee to provide information on the short- and long-term functional outcomes associated with and the most common conditions related to LBW, available treatments and services, and other considerations. The resulting report, Low Birth Weight Babies and Disability, presents the committees conclusions.

Smart manufacturing technologies - from advanced sensors to new computing capabilities - have the potential to greatly improve the productivity, energy efficiency, and sustainability of the U.S. manufacturing sector. Successfully implementing these technologies is essential for ensuring U.S. competitiveness and providing new job opportunities for the U.S. workforce. Options for a National Plan for Smart Manufacturing explores promising technologies transforming the manufacturing sector and identifies the research and resources needed to accelerate smart manufacturing adoption industry wide. This report also identifies critical needs for education and workforce development for smart manufacturing and makes actionable recommendations to support and train the next-generation manufacturing workforce.

The National Academies National Cancer Policy Forum hosted a Summer 2022 workshop to explore the current state of knowledge regarding risk factors for cancer and best practices for cancer prevention and risk reduction interventions. Speakers reviewed the current evidence base, examined best practices and innovative approaches for clinic- and population-based cancer prevention, and discussed strategies to promote effective communication about cancer prevention. This Proceedings of a Workshop summarizes the discussions held during the workshop. This workshop is the second in a series examining policy issues in cancer prevention and cancer screening. The first workshop, which took place in 2020, focused on advancing the development and implementation of effective, high-quality cancer screening.

Schools, workplaces, businesses, and even homes are places where someone could be subjected to particulate matter (PM) – a mixture of solid particles and liquid droplets found in the air. PM is a ubiquitous pollutant comprising a complex and ever-changing combination of chemicals, dust, and biologic materials such as allergens. Of special concern is fine particulate matter (PM2.5), PM with a diameter of 2.5 microns (<0.0001 inch) or smaller. Fine PM is small enough to penetrate deep into the respiratory system, and the smallest fraction of it, ultrafine particles (UFPs), or particles with diameters less than 0.1 micron, can exert neurotoxic effects on the brain. Overwhelming evidence exists that exposure to PM2.5 of outdoor origin is associated with a range of adverse health effects, including cardiovascular, pulmonary, neurological and psychiatric, and endocrine disorders as well as poor birth outcomes, with the burden of these effects falling more heavily on underserved and marginalized communities. Health Risks of Indoor Exposure to Fine Particulate Matter and Practical Mitigation Solutions explores the state-of the-science on the health risks of exposure to fine particulate matter indoors along with engineering solutions and interventions to reduce risks of exposure to it, including practical mitigation strategies. This report offers recommendations to reduce population exposure to PM2.5, to reduce health impacts on susceptible populations including the elderly, young children, and those with pre-existing conditions, and to address important knowledge gaps.

The National Academies Roundtable on Population Health Improvement hosted a workshop in February 2022, A Population Health Workforce to Meet 21st Century Challenges and Opportunities. The event, building upon the proceedings from their March 2019 workshop, Dialogue about the Workforce for Population Health Improvement, was further informed by the ongoing COVID-19 pandemic, the effects of climate change, and recent attention to and expenditure on the public health workforce. Workshop discussions explored the scope of work and work settings for public health and population health workers; the state of the workforce including attrition and gaps in specific roles and disciplines; and challenges to training, recruiting, and retaining workers. This Proceedings of a Workshop summarizes the presentations and discussions held during the workshop.

The transition to renewable energy has spurred many efforts to scale up the U.S. portfolio of efficient clean energy resources, including the development of offshore wind farms. The Nantucket Shoals region off the coast of Massachusetts is the first large scale wind farm installation under development in U.S. waters. To ensure Nantucket Shoals region offshore wind energy installations are being planned, constructed, and developed in an environmentally responsible way, the Bureau of Ocean Energy Management (BOEM) asked the National Academies to evaluate the potential for offshore wind farms in the Nantucket Shoals region to affect oceanic physical processes, and, in turn, how those hydrodynamic alterations might affect local to regional ecosystems. Of particular interest to BOEM are the potential effects of hydrodynamic changes on zooplankton productivity and aggregations, which may affect foraging for the critically endangered North Atlantic right whale. This report found the impacts of offshore wind projects on the North Atlantic right whale and the availability of their prey in the Nantucket Shoals region will likely be difficult to distinguish from the significant impacts of climate change and other influences on the ecosystem. Further study and monitoring of the oceanography and ecology of the Nantucket Shoals region is needed to fully understand the impact of future wind farms. This report recommends the Bureau of Ocean Energy Management, the National Oceanic and Atmospheric Administration, and others should promote observational studies and modeling that will advance understanding of potential hydrodynamic effects and their consequent impacts on ecology in the Nantucket Shoals region during all phases of wind energy development.

Since 1959, the National Institute of Standards and Technology (NIST) has annually commissioned the National Academies of Sciences, Engineering, and Medicine to assess its various measurements and standards laboratories. This report appraises the Physical Measurement Laboratory (PML), assessing four divisions of PML situated at the NIST Boulder campus: the Applied Physics Division, the Time and Frequency Division, the Quantum Electromagnetics Division, and the Quantum Physics Division. The report compares the caliber of research at PML with similar international programs to determine whether programs adequately align with its objectives; assesses the range of scientific and technical expertise available within PML; considers the budget, facilities, equipment, and Human Resources to bolster PML technical endeavors and contribute to the fulfillment of its goals; and assesses the efficacy of PML methods for disseminating the products of its work.

Despite advances over the past several decades, the clinical trials enterprise has struggled to meet the needs of an increasingly diverse U.S. population. To help address this issue, a 2023 National Academies workshop sought to identify the expertise and disciplines needed to achieve the aspirations for a transformed clinical trials enterprise by 2030 and enable a workforce that can better support the evolving needs of drug R&D - one that is resilient, culturally aware, anti-racist, and interdisciplinary. The workshop, hosted by the Forum on Drug Discovery, Development, and Translation and Roundtable on Black Men and Black Women in Science, Engineering, and Medicine explored strategies to bolster workforce capacity and challenges and opportunities associated with supporting the next-generation drug R&D workforce.

Addressing climate change is essential and possible, and it offers a host of benefits - from better public health to new economic opportunities. The United States has a historic opportunity to lead the way in decarbonization by transforming its current energy system to one with net-zero emissions of carbon dioxide. Recent legislation has set the nation on the path to reach its goal of net zero by 2050 in order to avoid the worst consequences of climate change. However, even if implemented as designed, current policy will get the United States only part of the way to its net-zero goal. Accelerating Decarbonization in the United States provides a comprehensive set of actionable recommendations to help policymakers achieve a just and equitable energy transition over the next decade and beyond, including policy, technology, and societal dimensions. This report addresses federal and subnational policy needs to overcome implementation barriers and gaps with a focus on energy justice, workforce development, public health, and public engagement. The report also presents a suite of recommendations for the electricity, transportation, built environment, industrial, fossil fuels, land use, and finance sectors.