Bøger af National Academies Of Sciences Engineeri

Radiation exposure at low doses (below 100 milligray) or low-dose rates (less than 5 milligray per hour) occurs in a wide range of medical, industrial, military, and commercial settings. The effects of exposure at these levels are not fully understood, but there are long-standing concerns that such exposure could negatively affect human health. Although cancer has been linked to low-dose radiation exposure for decades, there is increasing evidence that low-dose radiation exposure may also be associated with cardiovascular disease, neurological disorders, immune dysfunction, and cataracts. Recent advances in research, new tools, and a coordinated multidisciplinary research program could help fill knowledge gaps about the health impacts of low-dose radiation exposures. This report calls for the development of a U.S. research program to study how low doses of radiation affect cancer, cardiovascular disease, neurological disorders, and other disease risks. Research should also better define the impacts of radiation doses, dose rates, types of radiation, and exposure duration. The report estimates $100 million annually for the next 15 years would be required to conduct epidemiological and biological research, and to establish an infrastructure for research.

"The US Global Change Research Program (USGCRP) is a collection of 13 Federal entities charged by law to assist the United States and the world to understand, assess, predict, and respond to human-induced and natural processes of global change. Global Change Research Needs and Opportunities for 2022-2031 advises the USGCRP on how best to meet its mandate in light of climate change impacts happening today and projected into the future. This report identifies critical climate change risks, research needed to support decision-making relevant to managing these risks, and opportunities for the USGCRP's participating agencies and other partners to advance these research priorities over the next decade." --

"Transplantation of a solid organ, such as a kidney, heart, or liver, is a lifesaving procedure and is sometimes the only viable treatment for patients experiencing end-stage organ failure as a result of illness or injury. A growing prevalence of solid organ diseases in the United States is contributing to more people needing a transplant and longer wait times on the national transplant waiting list. While transplantation can lengthen a person's life, the road to recovery is difficult and complex. Transplant recipients commonly experience considerable impairments related to health factors, medication side effects, organ rejection, or other setbacks that can cause functional limitations. A spectrum of services and supports can be beneficial to patient functioning and quality of life, but patient access is variable due to individual, system, and social factors. To gain an understanding of current scientific findings in the field of solid organ transplantation, the U.S. Social Security Administration asked the National Academies of Sciences, Engineering, and Medicine's Board on Health Care Services to organize a virtual public workshop to examine disability associated with organ transplantation. The workshop, held March 22-23, 2021, focused on kidney, heart, liver, and lung transplantation, and to a lesser extent intestine transplantation. Subject-matter experts presented on clinical aspects of post-transplantation recovery and described the implications for physical, cognitive, and psychosocial functioning in adults and children. This publication summarizes the presentations and panel discussions from the workshop." --

"Every year, significant amounts of expensive drugs are discarded. This is due in part to the growing number of prescription drugs that are administered in variable doses (rather than fixed or flat doses) based on a patient's weight or body size. Strict regulations and guidance generally prohibit or severely restrict the acceptable time frame for sharing medication from single-dose vials among patients, and so the unused amount will typically be discarded. Due to the current system for producing, administering, and paying for drugs in the United States, significant - but indeterminate - amounts of expensive prescription drugs are discarded each year. At the request of the Centers for Medicare & Medicaid Services, Medications in Single Dose Vials: Implications of Discarded Drugs explores the federal health care costs, safety, and quality concerns associated with discarded drugs that result from the weight-based dosing of medicines contained in single-dose vials."--

"A Research Strategy to Examine the Taxonomy of the Red Wolf provides independent guidance about taxonomic research on the red wolf, Canis rufus. Building from the 2019 report Evaluating the Taxonomic Status of the Mexican Gray Wolf and the Red Wolf, this report reviews and ranks research applications to determine the taxonomy of wild canid populations in southern Louisiana and other relevant locations. The report then develops a research strategy to examine the evolutionary relationships between ancient red wolves, the extant managed red wolf populations, and the unidentified canid populations." --

"Current von Neumann style computing is energy inefficient and bandwidth limited as information is physically shuttled via electrons between processor, short term non-volatile memory, and long-term storage. Biologically inspired neuromorphic computing, with its inherent autonomous learning capabilities and much lower power requirements based on analog processing, is seen as an avenue for overcoming these limitations. The development of nanoelectronic "memory resistors", or memristors, is essential to neuromorphic architectures as they allow logic-based elements for information processing to be combined directly with nonvolatile memory for efficient emulation of neurons and synapses found in the brain. Memristors are typically composed of a switchable material with nonlinear hysteretic behavior sandwiched between two conducting encoding elements. The design, dynamic control, scaling and fundamental understanding of these materials is essential for establishing memristive devices. To explore the state-of-the-art in the materials fundamentally underlying memristor technologies: their science, their mechanisms and their functional imperatives to realize neuromorphic computing machines, the National Academies of Sciences, Engineering, and Medicine's Board on Physics and Astronomy convened a workshop on February 28, 2020. This publication summarizes the presentation and discussion of the workshop." --

A widespread and rapid transition to a low-carbon energy system by 2050 is essential to keep pace with ambitious policy goals and avoid the worst consequences of climate change. Innovation is necessary to lower costs and improve performance of existing technologies and to develop new clean energy options that address challenges in harder-to-decarbonize sectors. To examine means by which the U.S. federal government can rise to this challenge, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop series "Enhancing Federal Clean Energy Innovation" on July 27 to August 7, 2020. The workshop featured timely, action-orientated assessments of how to strengthen development and penetration of new clean energy technologies. This publication summarizes the presentations and discussions that occurred over the course of the workshop.

In 2018, the National Academies of Sciences, Engineering, and Medicine issued an Interim Report evaluating the general viability of the U.S. Department of Energy's National Nuclear Security Administration's (DOE-NNSA's) conceptual plans for disposing of 34 metric tons (MT) of surplus plutonium in the Waste Isolation Pilot Plant (WIPP), a deep geologic repository near Carlsbad, New Mexico. It provided a preliminary assessment of the general viability of DOE-NNSA's conceptual plans, focused on some of the barriers to their implementation. This final report addresses the remaining issues and echoes the recommendations from the interim study.

From 1962 to 1971, the U.S. military sprayed herbicides over Vietnam to strip the thick jungle canopy that could conceal opposition forces, to destroy crops that those forces might depend on, and to clear tall grasses and bushes from the perimeters of US base camps and outlying fire-support bases. Mixtures of 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), picloram, and cacodylic acid made up the bulk of the herbicides sprayed. The main chemical mixture sprayed was Agent Orange, a 50:50 mixture of 2,4-D and 2,4,5-T. At the time of the spraying, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the most toxic form of dioxin, was an unintended contaminant generated during the production of 2,4,5-T and so was present in Agent Orange and some other formulations sprayed in Vietnam. Because of complaints from returning Vietnam veterans about their own health and that of their children combined with emerging toxicologic evidence of adverse effects of phenoxy herbicides and TCDD, the National Academies of Sciences, Engineering, and Medicine was asked to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange, other herbicides used in Vietnam, and the various components of those herbicides, including TCDD. Updated evaluations were conducted every two years to review newly available literature and draw conclusions from the overall evidence. Veterans and Agent Orange: Update 11 (2018) examines peer-reviewed scientific reports concerning associations between various health outcomes and exposure to TCDD and other chemicals in the herbicides used in Vietnam that were published between September 30, 2014, and December 31, 2017, and integrates this information with the previously established evidence database.

Injury and death from use of excessive force by police officers remain a common concern in countries across the globe. Despite local, national, and international attempts to legislate and provide guidance for police use of force, there continue to be global accounts of excessive force by law enforcement. Reports of officer-involved killings, injuries to citizens, and attempts to control protests and demonstrations with chemical irritants, rubber bullets, and sometimes shooting into crowds with live ammunition frequently appear in the press worldwide. However, reliable data on and accounting for these incidents are both lacking. A large network of international and regional organizations, bilateral donors, international financial institutions, and civil society organizations aim to work with governments to improve policing practices and reduce police use of excessive force. As a part of that network, the U.S. Department of State, through its Bureau of International Narcotics and Law Enforcement Affairs (INL), provides foreign assistance to and supports capacity building for criminal justice systems and police organizations in approximately 90 countries. Like many donors, it strives to direct its resources to the most effective approaches to achieve its mission. Policies and Practices to Minimize Police Use of Force Internationally, the third in a series of five reports produced for INL, addresses what policies and practices for police use of force are effective in promoting the rule of law and protecting the population (including the officers themselves). This report looks at what is known about effective practices and their implementation and identifies promising actions to be taken by international donors in their efforts to strengthen the effectiveness of law enforcement agencies.

The U.S. Social Security Administration (SSA) administers the Social Security Disability Insurance program and the Supplemental Security Income program. As part of their process, immune system disorders are evaluated under Listing of Impairments 14.00 for adults and 114.00 for children. At the request of the SSA, the National Academies of Sciences, Engineering, and Medicine assembled a committee to review selected conditions related to the immune system. In particular, the SSA was interested in the current status of the diagnosis, treatment, and prognosis of immune system disorders including systemic lupus erythematosus (SLE), scleroderma, polymyositis, Sjögren's syndrome/disease, and inflammatory arthritis. This report provides an overview of the current status of the diagnosis, treatment, and prognosis of these immune system disorders in the U.S. population and the relative levels of functional limitation typically associated with them, common treatments, and other considerations.

People spend the vast majority of their time inside their homes and other indoor environments where they are exposed to a wide range of chemicals from building materials, furnishings, occupants, cooking, consumer products, and other sources. Despite research to date, very little is known about how exposures to indoor chemicals across complex chemical phases and pathways affect human health. The COVID-19 pandemic has only increased public awareness of indoor environments and shed light on the many outstanding questions about how best to manage chemicals indoors. This report identifies gaps in current research and understanding of indoor chemistry and new approaches that can be applied to measure, manage, and limit chemical exposures. Why Indoor Chemistry Matters calls for further research about the chemical transformations that can occur indoors, pathways and timing of indoor chemical exposure, and the cumulative and long-term impacts of exposure on human health. Research priorities should consider factors that contribute to measurable environmental health disparities that affect vulnerable populations, such as the age, location, and condition of buildings that can alter exposures to indoor chemicals.

"Although artificial intelligence (AI) has many potential benefits, it has also been shown to suffer from a number of challenges for successful performance in complex real-world environments such as military operations, including brittleness, perceptual limitations, hidden biases, and lack of a model of causation important for understanding and predicting future events. These limitations mean that AI will remain inadequate for operating on its own in many complex and novel situations for the foreseeable future, and that AI will need to be carefully managed by humans to achieve their desired utility. Human-AI Teaming: State-of-the-Art and Research Needs examines the factors that are relevant to the design and implementation of AI systems with respect to human operations. This report provides an overview of the state of research on human-AI teaming to determine gaps and future research priorities and explores critical human-systems integration issues for achieving optimal performance." -- Provided by publisher

The United States is a major producer of plastics and in 2016, generated more plastic waste by weight and per capita than any other nation. Reckoning with the U.S. Role in Global Ocean Plastic Waste calls for a national strategy by the end of 2022 to reduce the nation's contribution to global ocean plastic waste at every step - from production to its entry into the environment - including by substantially reducing U.S. solid waste generation.

Global advances in medicine, food, water, energy, microelectronics, communications, defense, and other important sectors of the economy are increasingly driven by discoveries in nanoscience and the development of nanotechnologies. Engaging the nanoscience and technology community in the crafting of national priorities, developing novel approaches for translating fundamental discovery to a technology readiness level appropriate for venture/industry funding, increasing domestic student interest in nanoscience to expand the workforce pipeline, and exploring new ways of coordinating the work of the National Nanotechnology Initiative (NNI) are all imperatives if the United States is to fully reap the societal benefits of nanotechnology. A Quadrennial Review of the National Nanotechnology Initiative provides a framework for a redesign of the NNI and its coordination with the goal of achieving a U.S. resurgence in nanotechnology. This report makes recommendations to improve the value of the NNI's research and development strategy and portfolio to the economic prosperity and national security of the United States.

The United States has long made substantial investments in clinical research with the goal of improving the health and well-being of our nation. There is no doubt that these investments have contributed significantly to treating and preventing disease and extending human life. Nevertheless, clinical research faces a critical shortcoming. Currently, large swaths of the U.S. population, and those that often face the greatest health challenges, are less able to benefit from these discoveries because they are not adequately represented in clinical research studies. While progress has been made with representation of white women in clinical trials and clinical research, there has been little progress in the last three decades to increase participation of racial and ethnic minority population groups. This underrepresentation is compounding health disparities, with serious consequences for underrepresented groups and for the nation. At the request of Congress, Improving Representation in Clinical Trials and Research: Building Research Equity for Women and Underrepresented Groups identifies policies, procedures, programs, or projects aimed at increasing the inclusion of these groups in clinical research and the specific strategies used by those conducting clinical trials and clinical and translational research to improve diversity and inclusion. This report models the potential economic benefits of full inclusion of men, women, and racial and ethnic groups in clinical research and highlights new programs and interventions in medical centers and other clinical settings designed to increase participation.

The Office of the Assistant Secretary for Planning and Evaluation (ASPE), in partnership with other agencies and divisions of the United States Department of Health and Human Services, coordinates a portfolio of projects that build data capacity for conducting patient-centered outcomes research (PCOR). PCOR focuses on producing scientific evidence on the effectiveness of prevention and treatment options to inform the health care decisions of patients, families, and health care providers, taking into consideration the preferences, values, and questions patients face when making health care choices. ASPE asked the National Academies to appoint a consensus study committee to identify issues critical to the continued development of the data infrastructure for PCOR. Building Data Capacity for Patient-Centered Outcomes Research contains findings and conclusions in the areas that could benefit from being prioritized as part of ASPE's work, and offers input on strengthening the overall framework for building the data infrastructure over the coming years. The committee authoring this report also issued three interim reports, which summarized discussions from three workshops, and are included as appendices in the final report.

New research in psychology, neuroscience, cognitive science, and other fields is published every day, but the gap between what is known and the capacity to act on that knowledge has never been larger. Scholars and nonscholars alike face the problem of how to organize knowledge and to integrate new observations with what is already known. Ontologies - formal, explicit specifications of the meaning of the concepts and entities that scientists study - provide a way to address these and other challenges, and thus to accelerate progress in behavioral research and its application. Ontologies help researchers precisely define behavioral phenomena and how they relate to each other and reliably classify them. They help researchers identify the inconsistent use of definitions, labels, and measures and provide the basis for sharing knowledge across diverse approaches and methodologies. Although ontologies are an ancient idea, modern researchers rely on them to codify research terms and findings in computer-readable formats and work with large datasets and computer-based analytic techniques. Ontologies in the Behavioral Sciences: Accelerating Research and the Spread of Knowledge describes how ontologies support science and its application to real-world problems. This report details how ontologies function, how they can be engineered to better support the behavioral sciences, and the resources needed to sustain their development and use to help ensure the maximum benefit from investment in behavioral science research.

This midcourse report provides an initial assessment of how the process used to develop the Dietary Guidelines for Americans, 2020-2025 (DGA) compares to the recommendations in the 2017 National Academies report on redesigning the process for establishing the DGA. It also assesses the criteria and processes for including the scientific studies used to develop the guidelines. The scope of this study was to address the process and not the content of the guidelines.