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"A consensus study report of The National Academies of Sciences, Engineering, and Medicine."

"A Consensus Study Report of The National Academies of Sciences, Engineering, Medicine."

"Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. Effective cancer treatment approaches are also available and can reduce the morbidity and mortality due to cancer in low-resource areas. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds--on an individual or a societal basis--to cover health infrastructure and care costs. As a result, worse outcomes for patients with cancer are more common in low- and middle-income countries compared with high-income countries. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and this may undermine the effectiveness of care. Recognizing the challenges of providing cancer care in resource constrained settings, the National Academies of Sciences, Engineering, and Medicine developed a two- workshop series examining cancer care in low-resource communities, building on prior work of the National Academies. The first workshop, held in October 2015, focused on cancer prevention and early detection. The second workshop was held in November 2016, and focused on cancer treatment, palliative care, and survivorship care in low-resource areas. This publication summarizes the presentations and discussions of this workshop"--

Accessible and affordable housing can enable community living, maximize independence, and promote health for vulnerable populations. However, the United States faces a shortage of affordable and accessible housing for low-income older adults and individuals living with disabilities. This shortage is expected to grow over the coming years given the population shifts leading to greater numbers of older adults and of individuals living with disabilities. Housing is a social determinant of health and has direct effects on health outcomes, but this relationship has not been thoroughly investigated. In December 2016, the National Academies of Sciences, Engineering, and Medicine convened a public workshop to better understand the importance of affordable and accessible housing for older adults and people with disabilities, the barriers to providing this housing, the design principles for making housing accessible for these individuals, and the features of programs and policies that successfully provide affordable and accessible housing that supports community living for older adults and people with disabilities. This publication summarizes the presentations and discussions from the workshop.

"In September 2016, the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine trends and patterns in aging and factors related to healthy aging in the United States, with a focus on nutrition, and how nutrition can sustain and promote healthy aging, not just in late adulthood, but beginning in pregnancy and early childhood and extending throughout the lifespan. Participants discussed the role of nutrition in the aging process at various stages in life, changes in organ systems over the lifespan and changes that occur with age related to cognitive, brain, and mental health, and explored opportunities to move forward in promoting healthy aging in the United States. This publication summarizes the presentations and discussions from the workshop"--

The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults.

The future security, economic growth, and competitiveness of the United States depend on its capacity to innovate. Major sources of innovative capacity are the new knowledge and trained students generated by U.S. research universities. However, many of the complex technical and societal problems the United States faces cannot be addressed by the traditional model of individual university research groups headed by a single principal investigator. Instead, they can only be solved if researchers from multiple institutions and with diverse expertise combine their efforts. The National Science Foundation (NSF), among other federal agencies, began to explore the potential of such center-scale research programs in the 1970s and 1980s; in many ways, the NSF Engineering Research Center (ERC) program is its flagship program in this regard. The ERCs are "interdisciplinary, multi-institutional centers that join academia, industry, and government in partnership to produce transformational engineered systems and engineering graduates who are adept at innovation and primed for leadership in the global economy. To ensure that the ERCs continue to be a source of innovation, economic development, and educational excellence, A New Vision for Center-Based Engineering Research explores the future of center-based engineering research, the skills needed for effective center leadership, and opportunities to enhance engineering education through the centers.

"The State of the Science in the Field of Regenerative Medicine: Challenges of and Opportunities for Cellular Therapies: a Workshop, October 13, 2016, National Academy of Sciences Building, Room 125. 2101 Constitution Avenue, NW, Washington, DC 20148"--Page 87.

"A report of the National Academies of Sciences, Engineering, Medicine."

The concept of utilizing big data to enable scientific discovery has generated tremendous excitement and investment from both private and public sectors over the past decade, and expectations continue to grow. Using big data analytics to identify complex patterns hidden inside volumes of data that have never been combined could accelerate the rate of scientific discovery and lead to the development of beneficial technologies and products. However, producing actionable scientific knowledge from such large, complex data sets requires statistical models that produce reliable inferences (NRC, 2013). Without careful consideration of the suitability of both available data and the statistical models applied, analysis of big data may result in misleading correlations and false discoveries, which can potentially undermine confidence in scientific research if the results are not reproducible. In June 2016 the National Academies of Sciences, Engineering, and Medicine convened a workshop to examine critical challenges and opportunities in performing scientific inference reliably when working with big data. Participants explored new methodologic developments that hold significant promise and potential research program areas for the future. This publication summarizes the presentations and discussions from the workshop.

"A consensus study report of the National Academies of Sciences, Engineering, Medicine."

The vitality of the innovation economy in the United States depends on the availability of a highly educated technical workforce. A key component of this workforce consists of engineers, engineering technicians, and engineering technologists. However, unlike the much better-known field of engineering, engineering technology (ET) is unfamiliar to most Americans and goes unmentioned in most policy discussions about the US technical workforce. Engineering Technology Education in the United States seeks to shed light on the status, role, and needs of ET education in the United States.

Most countries in the world use the International System of Units (also known as the metric system) for radiation measurements. The United States still uses a mix of SI and conventional units for radiation measurements, which means radiation professionals in the U.S. need to understand and make conversions between the two systems. Participants at this workshop discussed the need for the U.S. to adopt the SI, and, by doing so, standardize internationally the units for radiation measurements.

"A report of the National Academies of Sciences, Engineering, Medicine."

"The volume and complexity of information about individual patients is greatly increasing with use of electronic records and personal devices. Potential effects on medical product development in the context of this wealth of real-world data could be numerous and varied, ranging from the ability to determine both large-scale and patient-specific effects of treatments to the ability to assess how therapeutics affect patients' lives through measurement of lifestyle changes. In October 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop to facilitate dialogue among stakeholders about the opportunities and challenges for incorporating real-world evidence into all stages in the process for the generation and evaluation of therapeutics. Participants explored unmet stakeholder needs and opportunities to generate new kinds of evidence that meet those needs. This publication summarizes the presentations and discussions from the workshop"--

The National Academies of Sciences, Engineering, and Medicine's Army Research Laboratory Technical Assessment Board (ARLTAB) provides biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory (ARL), focusing on ballistics sciences, human sciences, information sciences, materials sciences, and mechanical sciences. This biennial report summarizes the findings of the ARLTAB from the reviews conducted by the panels in 2015 and 2016 and subsumes the 2015-2016 interim report.

The U.S. Global Change Research Program (USGCRP) is an interagency program, established by the Global Change Research Act (GCRA) of 1990, mandated by Congress to "assist the Nation and the world to understand, assess, predict, and respond to human-induced and natural processes of global change". Since the USGCRP began, scientific understanding of global change has increased and the information needs of the nation have changed dramatically. A better understanding of what is changing and why can help decision makers in the public and private sectors cope with ongoing change. Accomplishments of the U.S. Global Change Research Program highlights the growth of global change science in the quarter century that the USGCRP has been in existence, and documents some of its contributions to that growth through its primary functions of interagency planning and coordination, and of synthesis of research and practice to inform decision making.

Genome editing is a powerful new tool for making precise alterations to an organism's genetic material. Recent scientific advances have made genome editing more efficient, precise, and flexible than ever before. These advances have spurred an explosion of interest from around the globe in the possible ways in which genome editing can improve human health. The speed at which these technologies are being developed and applied has led many policymakers and stakeholders to express concern about whether appropriate systems are in place to govern these technologies and how and when the public should be engaged in these decisions.

Both the Food and Drug Administration (FDA) and the National Institute for Occupational Safety and Health (NIOSH) have responsibilities for evaluating and regulating respiratory protective devices ("respirators") for health care workers. Respirators protect the user from respiratory hazards by either removing contaminants from the air (air-purifying respirators) or by supplying clean air from another source (air-supplying respirators). Respirators that are used in workplaces in the United States must be approved by NIOSH and meet standards and test results specified by regulation. Respirators used by health care workers are air-purifying respirators that generally fall into three types: (1) disposable particulate filtering facepiece respirators (also termed N95s); (2) elastomeric respirators, also known as reusable respirators because they use a replaceable filter; or (3) powered air-purifying air respirators. To provide input to NIOSH and FDA and to discuss potential next steps to integrate the two agencies' processes to certify and approve N95 respirators for use in health care settings, a workshop was held by the National Academies of Sciences, Engineering, and Medicine in August 2016. The workshop was focused on exploring the strengths and limitations of several current test methods for N95 respirators as well as identifying ongoing research and research needs. This publication summarizes the presentations and discussions from the workshop.

Note: This is the French translation of Recent Fertility Trends in Sub-Saharan Africa. Fertility rates and population growth influence economic development. The marked declines in fertility seen in some developing nations have been accompanied by slowing population growth, which in turn provided a window of opportunity for rapid economic growth. For many sub-Saharan African nations, this window has not yet opened because fertility rates have not declined as rapidly there as elsewhere. Fertility rates in many sub-Saharan African countries are high: the total rate for the region is estimated to be 5.1 births per woman, and rates that had begun to decline in many countries in the region have stalled. High rates of fertility in these countries are likely to contribute to continued rapid population growth: the United Nations projects that the region's population will increase by 1.2 billion by 2050, the highest growth among the regions for which there are projections. In June 2015, the Committee on Population organized a workshop to explore fertility trends and the factors that have influenced them. The workshop committee was asked to explore history and trends related to fertility, proximate determinants and other influences, the status and impact of family planning programs, and prospects for further reducing fertility rates. This study will help donors, researchers, and policy makers better understand the factors that may explain the slow pace of fertility decline in this region, and develop methods to improve family planning in sub-Saharan Africa.

"The National Academies of Sciences, Engineering, Medicine."

This is the fourth in a series of five letter reports that provide an independent review of the more than 30 evidence reports that NASA has compiled on human health risks for long-duration and exploration spaceflights.This letter report reviews eight evidence reports and examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input.

"Cyber-physical systems (CPS) are 'engineered systems that are built from, and depend upon, the seamless integration of computational algorithms and physical components.' CPS can be small and closed, such as an artificial pancreas, or very large, complex, and interconnected, such as a regional energy grid. CPS engineering focuses on managing inter- dependencies and impact of physical aspects on cyber aspects, and vice versa. With the development of low-cost sensing, powerful embedded system hardware, and widely deployed communication networks, the reliance on CPS for system functionality has dramatically increased. These technical developments in combination with the creation of a workforce skilled in engineering CPS will allow the deployment of increasingly capable, adaptable, and trustworthy systems"--

"The penetration of solid-state lighting (SSL) has increased dramatically since the publication of the National Research Council (NRC) report Assessment of Advanced Solid-State Lighting in 2013. The Committee on Assessment of Solid-State Lighting, Phase 2 has been surprised by this rapid adoption and the accompanying diversity of applications of SSL, which has been driven largely by the dramatic decline in the retail price of lamps and luminaires, and recognition of the unique qualities of the light emitting diode (LED) light source. Improvements in lamp performance, the introduction of innovative applications, improved compatibility of lamps with controls, and the integration of LED lamps in systems have all contributed to this rapid acceptance. Examples of exploiting the special characteristics of SSL are the introduction to steerable headlamps in cars, the use of spectral control to prevent lighting-induced damage to artwork, and more efficient and controllable street lighting. Accompanying this growth in the SSL market has been the rapid decline of compact fluorescent lamps (CFLs) from retail shelves"--Preface, page vii.

Using science to improve science communication -- The complexities of communicating science -- The nature of science-related public controversies -- Communicating science in a complex, competitive communication environment -- Building the knowledge base for effective science communication -- References -- Appendix A: Agendas of public meetings -- Appendix B: Biographical sketches of Committee members and staff.

The Department of Homeland Security's (DHS's) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system. In response to the cancellation announcement, Congress asked the Government Accountability Office (GAO) to conduct a review of the program and the proposed system enhancements that would have been incorporated in BioWatch Gen-3. However, Mike Walter, BioWatch Program manager, Office of Health Affairs, DHS, said that DHS did not agree with all of GAO's characterizations of the BioWatch program efforts described in this review. In response to this, DHS requested that the National Academies of Sciences, Engineering, and Medicine conduct a workshop to further explore the findings of the 2015 GAO report and discuss the impact these findings may have with regard to the future development of the technical capabilities of the BioWatch program. Workshop participants also discussed existing and possible collaborations between BioWatch, public health laboratories, and other stakeholders that could contribute to the enhancement of biosurveillance capabilities at the federal, state, and local levels. This publication summarizes the presentations and discussions from the workshop.

"The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop"--

On January 20, 2015, President Obama announced the Precision Medicine Initiative (PMI) in his State of the Union address. The PMI, by developing new approaches for detecting, measuring, and analyzing a wide range of biomedical information including molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters, is intended to enable a new era of medicine in which researchers, providers, and patients work together to develop individualized care. Part of this effort included the creation of a national, large-scale research participant group, or cohort. The PMI Cohort Program is aimed at extending precision medicine to many diseases, including both rare and common diseases such as diabetes, heart disease, Alzheimer's disease, obesity, and mental illnesses such as depression, bipolar disorder, and schizophrenia, by building a national research cohort of 1 million or more U.S. participants. An important challenge to assembling the PMI Cohort will be to reach individuals who are socioeconomically disadvantaged. Individuals who are socioeconomically disadvantaged have lower health literacy; often belong to racial, ethnic, and minority communities; and are often less likely to participate in research studies and biorepositories. To explore possible strategies and messaging designs, the Roundtable on Health Literacy formed an ad hoc committee charged with planning and conducting a 1-day public workshop on the intersection of health literacy and precision medicine. The workshop participants discussed a variety of topics including an overview of precision medicine and its potential, the relevance of health literacy to the success of precision medicine efforts, and perspectives and understanding of different groups, such as health care providers, consumers, and insurers. This publication summarizes the presentations and discussions from the workshop.

"The Air Force (USAF) has continuously sought to improve the speed with which it develops new capabilities to accomplish its various missions in air, space, and cyberspace. Historically, innovation has been a key part of USAF strategy, and operating within an adversary's OODA loop (observe, orient, decide, act) is part of Air Force DNA. This includes the ability to deploy technological innovations faster than do our adversaries. The Air Force faces adversaries with the potential to operate within the USAF's OODA loop, and some of these adversaries are already deploying innovations faster than the USAF. The Role of Experimentation Campaigns in the Air Force Innovation Life Cycle examines the current state of innovation and experimentation in the Air Force and best practices in innovation and experimentation in industry and other government agencies. This report also explores organizational changes needed to eliminate the barriers that deter innovation and experimentation and makes recommendations for the successful implementation of robust innovation and experimentation by the Air Force"--Publisher's description.

In July 2016 The National Academies of Sciences, Engineering, and Medicine convened a workshop with the goal of bringing together industrial and organizational (I-O) psychologists, experts on personnel selection and testing, forensic scientists, and other researchers whose work has a nexus with workforce needs in the forensic science field with a focus on pattern evidence. Participants reviewed the current status of selection and training of forensic scientists who specialize in pattern evidence and discussed how tools used in I-O psychology to understand elements of a task and measure aptitude and performance could address challenges in the pattern evidence domain of the forensic sciences. This publication summarizes the presentations and discussions from the workshop.