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While technologies are clearly instrumental in transitioning away from fossil fuel-based energy and toward a decarbonized economy, decisions about which technologies are prioritized, how they are implemented, and the policies that drive these changes will have profound effects on people and communities, with important implications for equity, jobs, environmental and energy justice, health, and more. The National Academies of Sciences, Engineering, and Medicine Committee on Accelerating Decarbonization in the United States: Technology, Policy, and Societal Dimensions was tasked with assessing the broad range of technological, policy, and societal dimensions of decarbonizing the U.S. economy. The committee produced a 2021 report that provides the U.S. government with a roadmap of equitable and robust decarbonization policies. The next report of the committee will address the broader range of policy actors who play a role in equitable energy transition. To inform its deliberations, the committee hosted a 1-day workshop on July 26, 2022 to discuss critical issues of equity and justice during the energy transition. The goal of the workshop, titled Pathways to an Equitable and Just Transition: Principles, Best Practices, and Inclusive Stakeholder Engagement, was to move beyond energy technologies and elicit ideas and insights to inform the development of principles, best practices, and actionable recommendations for a broad range of policy actors and stakeholders in order to fully operationalize equity, justice, and inclusion. This publication summarizes the presentations and discussion of the workshop.

The mission of the Roundtable on Black Men and Black Women in Science, Engineering, and Medicine at the National Academies of Sciences, Engineering, and Medicine is to advance discussions on the barriers and opportunities encountered by Black students and professionals as they navigate the pathways from K-12 and postsecondary education to careers in science, engineering, and medicine (SEM) and highlight promising practices for increasing the representation, retention, and inclusiveness of Black men and Black women in SEM. This proceedings serves as a summary of the presentations and discussions from a capstone workshop, held virtually on December 6 and 7, 2021, to review how anti-Black racism had permeated across the topics covered by the Roundtable over the previous 2 years.

Sunscreens and a variety of other products contain chemical ultraviolet (UV) filters that absorb or block the sun's radiation and thereby help mitigate harms to human skin from the sun. The 2022 NASEM report Review of Fate, Exposure, and Effects of Sunscreens in Aquatic Environments and Implications for Sunscreen Usage and Human Health called on the EPA to conduct an ecological risk assessment of UV filters to characterize the possible risks to aquatic ecosystems and the species that live in them. However, the 2022 report also identified a number of knowledge gaps and research barriers that may limit understanding of those ecological risks. To share progress and identify opportunities to further address gaps and barriers, NASEM hosted a workshop in Washington, D.C., on January 23-24, 2023, entitled Workshop to Advance Research on Understanding Environmental Effects of UV Filters in Sunscreens. Through a series of prepared talks, panel discussions, and structured breakout discussions, participants examined the 2022 report and its management context; explored data needs and analytical challenges relevant to the development of accurate toxicity metrics for UV filters; and suggested opportunities to improve and standardize toxicity testing for these chemicals. These proceedings has been prepared by the workshop rapporteur as a factual summary of what occurred at the workshop.

Consequences of natural disasters and the COVID-19 pandemic have taken a cumulative toll on the health and well-being of people in the Gulf of Mexico region. Long-standing societal challenges related to racism, poverty, education, housing, and underemployment are compounding the trauma, leading to chronic stress for many Gulf residents. The Committee on Progress Toward Human Health and Community Resilience in the Gulf of Mexico Region new report, Advancing Health and Community Resilience in the Gulf of Mexico Region: A Roadmap for Progress, explores key challenges and priorities in Gulf states, including Alabama, Florida, Louisiana, Mississippi, and Texas and evaluates recent progress. The report also makes recommendations for closing critical gaps and implementing transformative approaches that focus on the diverse needs and experiences of people who live and work in the Gulf region.

The South Asia region presents a confluence of major climate impacts and key security issues. From a weather and climate standpoint, the region experiences a wide range of hazards, such as the recent heatwaves, droughts, storms, and floods that have upended the lives and livelihoods of millions of people. From a demographic and socioeconomic standpoint, the region is experiencing rapid transformations and progress, even as fundamental challenges such as poverty and inequality persist. From a security standpoint, the region is the setting for a range of social and political dynamics that impact U.S. interests, including conflict at national and subnational levels; regional rivalries; and the imprint of global geopolitics. On October 26-27, 2022, the National Academies of Sciences, Engineering, and Medicine, under the auspices of the National Academies Climate Security Roundtable, convened a workshop to explore climate security in South Asia. Over two days, workshop participants considered some of the underlying climate, development, and geopolitical dynamics at play in the South Asia region; explored a set of historical case studies and future scenarios for climate change and security in South Asia; and they considered the available tools for analysis and forecasting climate-related risks. This publication summarizes the presentations and discussion of the workshop.

In 2016, the National Science Foundation (NSF) established a five-year program on Understanding the Rules of Life (URoL) to identify generalizable rules that govern biological systems at micro and macro levels. At the request of NSF, the National Academies of Sciences, Engineering, and Medicine convened a series of workshops to explore the achievements of the URoL program. Presenters and participants discussed integration of multi-disciplinary, systems-level approaches, broader implications for studying highly complex systems, future scientific questions and future societal needs, and the production of generalizable rules that apply to different fields and scales. This publication summarizes the presentation and discussion of the workshop.

As part of its core mission, the U.S. Environmental Protection Agency (EPA) is tasked with assessing the hazards and risks to human health from exposure to pollutants. While some pollutants are well studied, there are little or no data on the potential health effects for many thousands of chemicals that can make their way into the environment, such as PFAS. EPA still relies on laboratory mammalian studies as the foundation of most human health risk assessments, which are limited by high costs, long timelines, and other concerns. New approach methods (NAMs) in toxicology, for example new in vivo and in vitro strategies and computational systems biology, offer opportunities to inform timely decision-making when no data are available from laboratory mammalian toxicity tests or epidemiological studies. NAMs may also help inform efforts to protect susceptible and vulnerable populations by characterizing subtle health perturbations, better encompassing genetic diversity, and accounting for nonchemical stressors. While the promise and need for NAMs is clear, many barriers to their use remain. This report aims to bridge the gap between the potential of NAMs and their practical application in human health risk assessment. Building Confidence in New Evidence Streams for Human Health Risk Assessment draws lessons learned from laboratory mammalian toxicity tests to help inform approaches for building scientific confidence in NAMs and for incorporating such data into risk assessment and decision-making. Overall, the report recommendations aim to ensure a seamless handoff from the evaluation of NAM-based testing strategies in the laboratory to the incorporation of NAM data into modern, systematic-review-based risk assessments.

Governments, philanthropic organizations, and private industry fund human health and medical research. Various funding sources might bias research so that the results are more favorable to their agents. Funders may influence investigative scope, specific questions posed, experimental design, and principal investigator appointments. Reporting, analysis, dissemination, and communication and data availability, reanalysis, and replication can also experience bias from a funding source. To explore structures, processes, and principles to ensure high-quality health research independent of sponsor influence, the National Academies Board on Population Health and Public Health Practice and the Board on Health Sciences Policy hosted a public virtual workshop in December 2022 that examined the sources of funding for health research and evidence on whether they influence the quality and outcomes of resulting health research. The workshop also discussed models, process, and principles used to protect the independence and quality of research. This Proceedings summarizes the discussions held during the workshop.

Alternative protein sources, which can be derived from plant and animal cells or created by precision fermentation, can have health, environmental, socio-economic, and ethical impacts. With a variety of types of alternative proteins being developed and available on the market, consumers, regulatory agencies, manufacturers, and researchers are faced with many different considerations. The National Academies Food Forum hosted a workshop that took a multi-sector approach to explore the state of the science on alternative protein sources as they relate to issues around diet quality, nutrition, and sustainability. The workshop also examined how alternative protein food processing innovations can be balanced in a way that optimizes nutritional content, affordability, and accessibility. This Proceedings of a Workshop summarizes the discussions held during the workshop.

The Hanford Nuclear Reservation in the state of Washington produced about two-thirds of the nations plutonium for nuclear weapons from 1944 until the last reactor was shut down in 1987. The U.S. Department of Energy Office of Environmental Management (DOE-EM) manages the ongoing clean-up at Hanford and has built a plant to convert the high-level radioactive waste into a glass form (vitrification) for safe disposal. However, decisions remain about how best to treat and dispose of the low-level waste at Hanford, which comprises over 90% of the volume of waste. To inform its decision, DOE contracted with key Federally Funded Research and Development Centers (FFRDC), led by Savannah River National Laboratory, to carry out an analysis. This final in a trilogy of reports from the National Academies reviews the FFRDC third report released in January 2023. The review finds that the FFRDC team made a strong technical case that converting the supplemental low-level waste from the vitrification process to a grout form (like cement) is the best option in terms of cost-effectiveness and timeliness, and that off-site disposal of that grout is a valid option as it will be away from potable water. The FFRDC provided a useful framework to help decision-makers understand the issues and trade-offs of the disposal options and did an excellent job of isolating specific factual considerations that can be analyzed, often quantified, and compared with each other. The FFRDC chose to provide a purely technical analysis that excluded analysis of two important factors to be considered - securing regulatory permissions and public acceptance - treating them, for now, as uncertainties. Looking ahead, the DOE faces many uncertainties and should emphasize flexibility in its overall approach, allowing for multiple, redundant options and pathways, as well as the ability to change over time.

One of the major challenges in materials science today is developing materials that can survive and function in extreme environments, such as the high-radiation environments found in a fission or fusion reactor or the ultra-high temperature experienced by a hypervelocity vessel or a spacecraft traveling through Earths atmosphere on its return to the planets surface. What is needed to discover such materials was the topic of a 2-day workshop held at the National Academies of Sciences, Engineering, and Medicine on October 5-6, 2022. That workshop, titled Materials in Extreme Environments: New Monitoring Tools and Data-Driven Approaches, brought together an international collection of experts on the testing and measurement of materials in extreme environments and on discovering and developing new materials. This Proceedings of a Workshop recaps the presentations and discussions that took place during the 2 days of the workshop.

The National Academies Board on Mathematical Sciences and Analytics and Board on Infrastructure and the Constructed Environment convened a 3-day public workshop on July 13, 20, and 27, 2022, to explore state-of-the-art analytical tools that could advance urban sustainability through improved prioritization of public works projects. Invited speakers included people working in urban sustainability, city planning, local public and private infrastructure, asset management, and infrastructure investment; city officials and utility officials; and statisticians, data scientists, mathematicians, economists, computer scientists, and artificial intelligence/machine learning experts. Presentations and workshop discussions provided insights into new research areas that have the potential to advance urban sustainability in public works planning, as well as the barriers to their adoption. This publication summarizes the presentation and discussion of the workshop.

Many young children in the United States are thriving and have access to the conditions and resources they need to grow up healthy. However, a substantial number of young children face more challenging conditions such as: poverty; food insecurity; exposure to violence; and inadequate access to health care, well-funded quality schools, and mental health care. In many cases, the historical origins of unequal access to crucial supports for children's physical, emotional, and cognitive development are rooted in policies that intentionally segregated and limited various populations' access to resources and create opportunity gaps that intertwine and compound to affect academic, health, and economic outcomes over an individual's life course and across generations. Closing the Opportunity Gap for Young Children, identifies and describes the causes, costs, and effects of the opportunity gap in young children and explores how disparities in access to quality educational experiences, health care, and positive developmental experiences from birth through age eight intersect with key academic, health, and economic outcomes. The report identifies drivers of these gaps in three key domains--education, mental health, and physical health--and offers recommendations for policy makers for addressing these gaps so that all children in the United States have the opportunity to thrive. In addition, the report offers a detailed set of recommendations for policy makers, practitioners, community organizations, and philanthropic organizations to reduce opportunity gaps in education, health, and social-emotional development.

Over the last three decades, there have been fundamental shifts in the electricity system, including the growing adoption of clean distributed generation energy technologies such as rooftop solar. Net metering, which compensates customers for excess energy they contribute to the grid, has been instrumental in supporting the integration of these systems into the grid, but these policies may need to change to better address future needs. The Role of Net Metering in the Evolving Electricity System explores the medium-to-long term impacts of net metering on the electricity grid and customers. This report evaluates how net metering guidelines should evolve to support a decarbonized, equitable, and resilient electricity system.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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