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Despite the integral contribution of oral health to general health status, it continues to be treated as a marginalized and less important practice of health care. Minimizing its importance begins with how U.S. dental professionals are educated. The National Academies Global Forum on Innovation in Health Professional Education held a public workshop in November 2022 to discuss definitions of community-engaged oral health and its application within, between, and across health professions. Discussions emphasized lifelong learning, the social determinants of health and community engagement, and the development of innovative approaches and models for oral health workforce education and training in a global context. This Proceedings of a Workshop summarizes the discussions held during the workshop.

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

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

"The COVID-19 pandemic spurred a rapid expansion of wastewater-based infectious disease surveillance systems to monitor and anticipate disease trends in communities.The Centers for Disease Control and Prevention (CDC) launched the National Wastewater Surveillance System in September 2020 to help coordinate and build upon those efforts. Produced at the request of CDC, this report reviews the usefulness of community-level wastewater surveillance during the pandemic and assesses its potential value for control and prevention of infectious diseases beyond COVID-19.Wastewater-based Disease Surveillance for Public Health Action concludes that wastewater surveillance is and will continue to be a valuable component of infectious disease management. This report presents a vision for a national wastewater surveillance system that would track multiple pathogens simultaneously and pivot quickly to detect emerging pathogens, and it offers recommendations to ensure that the system is flexible, equitable, and economically sustainable for informing public health actions. The report also recommends approaches to address ethical and privacy concerns and develop a more representative wastewater surveillance system. Predictable and sustained federal funding as well as ongoing coordination and collaboration among many partners will be critical to the effectiveness of efforts moving forward."--

"The Dietary Reference Intakes (DRIs) are a set of reference values that encompass a safe range of intake and provide recommended nutrient intakes for the United States and Canada. The DRIs for energy are used widely to provide guidance for maintaining energy balance on both an individual and group level.U.S. and Canadian governments asked the National Academies to convene an expert committee to examine available evidence and provide updated Estimated Energy Requirements (EERs) for their populations. The resulting report presents EER equations that provide a baseline for dietary planners and assessors who are estimating energy needs and monitoring energy balance to enhance the general health of individuals and populations."--

Carbon materials pervade many aspects of modern life, from fuels and building materials to consumer goods and commodity chemicals. Reaching net-zero emissions will require replacing existing fossil-carbon-based systems with circular-carbon economies that transform wastes like CO2 into useful materials. This report evaluates market opportunities and infrastructure needs to help decision makers better understand how carbon dioxide utilization can contribute to a net-zero emissions future.

Oil and natural gas represent more than 50 percent of the worldwide energy supply, with high energy demand driven by population growth and improving standards of living. Despite significant progress in reducing the amount of oil in the sea from consumption, exploration, transportation, and production, risks remain. This report, the fourth in a series, documents the current state-of-knowledge on inputs, fates and effects of oil in the sea, reflecting almost 20 additional years of research, including long-term effects from spills such as the Exxon Valdez and a decade-long boom in oil spill science research following the Deepwater Horizon oil spill. The report finds that land-based sources of oil are the biggest input of oil to the sea, far outweighing other sources, and it also notes that the effects of chronic inputs on the marine environment, such as land-based runoff, are very different than that from an acute input, such as a spill. Steps to prevent chronic land-based oil inputs include reducing gasoline vehicle usage, improving fuel efficiency, increasing usage of electric vehicles, replacing older vehicles. The report identifies research gaps and provides specific recommendations aimed at preventing future accidental spills and ensuring oil spill responders are equipped with the best response tools and information to limit oil's impact on the marine environment.

The Forum on Regenerative Medicine of the National Academies of Sciences, Engineering, and Medicine convened a two-day virtual public workshop to address knowledge gaps in the understanding of promising approaches to manipulate the immune system and/or the regenerative medicine product to improve outcomes of tissue repair and regeneration in patients. The workshop, titled Understanding the Role of the Immune System in Improving Tissue Regeneration, explored the role of the immune system in the success or failure of regenerative medicine therapies. Participants considered potential strategies to effectively prepare patients' immune systems to accept regenerative therapies and increase the likelihood of successful clinical outcomes and also discussed risks associated with modulating the immune system. This Proceedings of a Workshop highlights the presentations and discussions that occurred during the workshop.

To examine the potential role of companion animals as sentinels of relevant, shared environmental exposures that may affect human aging and cancer, the National Cancer Policy Forum held a workshop in collaboration with the Forum on Aging, Disability, and Independence and the Standing Committee on the Use of Emerging Science for Environmental Health Decisions to explore this promising and underutilized pathway for research. Presentations and panel discussions covered the current state of the science and pathways for accelerating research, along with opportunities and challenges for using this novel translational approach to exposure science to advance human health. This Proceedings of a Workshop outlines the presentations and discussions that occurred during the workshop.

Despite being preventable and curable since the middle of the twentieth century, tuberculosis (TB) has long persisted as the world's deadliest infectious disease, with the communities most devastated by TB among the poorest and most vulnerable in the world. Only about half of people with TB receive successful treatment each year. As the global threat of antimicrobial resistance continues to escalate, so do cases of drug-resistant TB, or TB that is resistant to various antibiotics that constitute standard treatment regimens. In response, the National Academies of Sciences, Engineering, and Medicine's Forum on Microbial Threats held a two-part virtual workshop on July 22 and September 14-16, 2021 titled Innovations for Tackling Tuberculosis in the Time of COVID-19. The aims of the workshop were to evaluate the current status of TB elimination, assess the effects of the COVID-19 pandemic on the global fight against TB, and examine technical and strategic innovations that could be leveraged to meet the United Nations High-Level Meeting on Tuberculosis targets in 2022 and The World Health Organization's END TB Strategy targets by 2030. This publication summarizes the presentations and discussions of the workshop.

Within the past decade an ever-growing number of New Space organizations have emerged that are unencumbered by legacy practices and constraints. By reimagining, creating, and continuously improving SmallSat space technology a new and growing space ecosystem is now in place that is capable of serving a broad stakeholder community of both traditional users and new or nontraditional users. Current commercial practices are expanding with capabilities including technology and business-driven applications that open the door to a broad and vibrant ecosystem offering a wide range of solutions capable of supporting a growing range of stakeholders. In parallel to traditional approaches, space infrastructure related to manufacturing, such as customized spacecraft buses, instruments, and sensors--including high-resolution imaging and radar systems rivaling the performance of traditional systems--are emerging in both growing volume and with constantly improving capability. On the operational commercial ground stations are now routinely available, as are data management and analytics including cloud computing for data access and archiving. Thus, if properly encouraged and nourished, a broadly capable ecosystem can emerge including new business opportunities for data fusion, analysis, and databuys, as well as ground/space communications that can equally benefit both traditional and nontraditional user communities. Leveraging Commercial Space for Earth and Ocean Remote Sensing assesses the feasibility and implications of creating and exploiting partnerships for developing, deploying, and operating a system of satellites and supporting infrastructure capable of sensing ocean, coastal, atmospheric, and hydrologic data of sufficient scientific quality to enable prediction models and to support near real time applications of national interest. This report identifies and describes promising options for such a system.

Intelligence analysts conduct these analyses every day, using decades of propriety tradecraft techniques and an arsenal of clandestine information gathering sources, but the resources available are not unlimited. Open source public opinion tools can provide timely and relatively inexpensive methods of understanding fast-moving conditions, acting as a force multiplier to help policymakers have a truly all-source understanding of complex events. By providing analysts with the best practices in survey methodology and nonsurvey methods for gathering data on public opinion, they will be armed with a clearer sense of important shifts in attitudes, elections, and unrest. In order to provide guidance to analysts on strategies for assessing public opinion, representatives from the intelligence community approached the National Academies of Sciences, Engineering, and Medicine to request preparation of a framework on Measuring and Analyzing Public Opinion. This analytic framework includes three layers of information. Layer 1 comprises four authored papers that review literature from various disciplines containing overview information as well as how the topic/situation of interest can enable better analysis across different situational constraints. Layer 2 is a distilled layer of information in the form of an authored summary of the four Layer 1 papers, both summarizing and describing key points. Finally, Layer 3 provides an even further distillation of the key concepts, in a one-page visual graphic, that displays key drivers from the work in Layers 1 and 2 to help the intended audience apply knowledge to the situation of interest.

Training police in the knowledge and skills necessary to support the rule of law and protect the public is a substantial component of the activities of international organizations that provide foreign assistance. Significant challenges with such training activities arise with the wide range of cultural, institutional, political, and social contexts across countries. In addition, foreign assistance donors often have to leverage programs and capacity in their own countries to provide training in partner countries, and there are many examples of training, including in the United States, that do not rely on the best scientific evidence of policing practices and training design. Studies have shown disconnects between the reported goals of training, notably that of protecting the population, and actual behaviors by police officers. These realities present a diversity of challenges and opportunities for foreign assistance donors and police training. At the request of the U.S. State Department's Bureau of International Narcotics and Law Enforcement Affairs, the Committee on Law and Justice of the National Academies of Sciences, Engineering, and Medicine examined scientific evidence and assessed research needs for effective policing in the context of the challenges above. This report, the second in a series of five, responds to the following questions: What are the core knowledge and skills needed for police to promote the rule of law and protect the population? What is known about mechanisms (e.g., basic and continuing education or other capacity building programs) for developing the core skills needed for police to promote the rule of law and protect the population?

The persistent trends in suicide necessitate action among mental health care providers and payers, researchers, and community leaders. Health care settings provide an important opportunity for suicide intervention and prevention, but they cannot yet fully manage suicide risk because of a lack of training, knowledge gaps, and reimbursement challenges. School, workplace, and community-based interventions can help reduce the incidence of suicidal behavior, as can better access to care and reduced access to lethal means of suicide. To better understand the strategies to improve access to effective interventions to prevent suicide, the Forum on Mental Health and Substance Use Disorders at the National Academies of Sciences, Engineering, and Medicine hosted a two-part virtual public workshop, Strategies and Interventions to Reduce Suicide, on June 22, 2021, and July 28, 2021. The first webinar examined the scope of the public health problem, discussed implementation of effective approaches for suicide prevention care, and addressed known barriers to health care access. The second webinar focused on building 9-8-8, the new nationwide emergency number designated to the National Suicide Prevention Lifeline. Participants discussed current crisis systems, gaps, challenges, and needs for marginalized populations. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshops.

The COVID-19 pandemic has led to dramatic adjustments in cancer care delivery and cancer research. To examine these changes, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop, Innovation in Cancer Care and Cancer Research in the Context of the COVID-19 Pandemic, in July 2021. Workshop speakers considered the lessons learned from these adaptations in order to improve the delivery of high-quality cancer care and the conduct of cancer clinical trials in the post-pandemic era. This Proceedings of a Workshop highlights presentations and discussions from the workshop.

Academic preparation is critical to increase Black representation in Science, Engineering, and Medicine, but so, too, are such interrelated factors as providing mentoring and role models in sufficient numbers, adequately funding school and community support services, and analyzing the intentional and unintentional consequences of a range of policies and practices. To address these issues, the Roundtable on Black Men and Black Women of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop on September 2 and 3, 2020. Titled "Educational Pathways for Blacks in Science, Engineering, and Medicine: Exploring Barriers and Possible Interventions," the workshop provided a platform to explore challenges and opportunities, beginning in the earliest years of life through K-12 schooling, undergraduate and postgraduate education, and into the workforce. Presenters throughout the workshop provided perspectives from research and from their own experiences to discuss the need for systemic solutions inside and outside of formal education institutions. This publication summarizes the presentation and discussion of the workshop.

A virtual workshop series titled Approaches to Assessing Intake of Food and Dietary Supplements in Pregnant Women and Children 2 to 11 Years of Age was convened in May, 2021 by the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine. The four-day workshop series explored the evidence on methodological approaches to assessing intake of food and dietary supplements in pregnant women and children 2 to 11 years of age. Obtaining reliable and valid dietary intake information for these population groups is particularly difficult - in pregnancy, rapid changes in nutrient needs and dietary intakes occur, and in young children, much of dietary intake is consumed outside the home and is often misreported by the children or their proxy reporters. To advance the quality of the science in these areas, the workshop had four goals: identify the suite of current methods used in dietary assessments, including food and dietary supplements, in pregnant women and children 2 to 11 years of age; identify the methodological challenges and opportunities in improving current methods; explore methodologies in other disciplines and their application in dietary assessments in those populations; and discuss factors to consider when implementing dietary assessment tools in those populations. This publication summarizes the presentations and discussions of the workshop series.

During the past 25 years, the U.S. National Academies of Sciences, Engineering, and Medicine, in collaboration with the Russian Academy of Sciences, have carried out a wide variety of activities to improve understanding of the challenges in containing and reducing ethnic conflicts, violent extremism, and terrorism. Roots and Trajectories of Violent Extremism and Terrorism provides an overview of this cross-ocean program, which has involved American and Russian scientists, engineers, and medical professionals from a large number of government agencies, leading research institutions, think tanks, educational institutions, analytical centers, and consulting and commercial firms in the two countries. This report highlights challenges addressed by the academies over many years that remain of current interest as the U.S., Russian, and other governments continue to cope with old and new forms of aggression that threaten the livelihood of populations at home and abroad.

Since 1944, the National Research Council (NRC) has published seven editions of the Nutrient Requirements of Beef Cattle. This reference has guided nutritionists and other professionals in academia and the cattle and feed industries in developing and implementing nutritional and feeding programs for beef cattle. The cattle industry has undergone considerable changes since the seventh revised edition was published in 2000 and some of the requirements and recommendations set forth at that time are no longer relevant or appropriate. The eighth revised edition of the Nutrient Requirements of Beef Cattle builds on the previous editions. A great deal of new research has been published during the past 14 years and there is a large amount of new information for many nutrients. In addition to a thorough and current evaluation of the literature on the energy and nutrient requirements of beef in all stages of life, this volume includes new information about phosphorus and sulfur contents; a review of nutritional and feeding strategies to minimize nutrient losses in manure and reduce greenhouse gas production; a discussion of the effect of feeding on the nutritional quality and food safety of beef; new information about nutrient metabolism and utilization; new information on feed additives that alter rumen metabolism and postabsorptive metabolism; and future areas of needed research. The tables of feed ingredient composition are significantly updated. Nutrient Requirements of Beef Cattle represents a comprehensive review of the most recent information available on beef cattle nutrition and ingredient composition that will allow efficient, profitable, and environmentally conscious beef production.

Sediments, ice, corals, and trees are just some of the natural storehouses of information that help tell the complicated history of Earth's climate. Paleoclimate researchers use these "proxies," in combination with numerical models, to gain understanding of the magnitudes, rates, and drivers of past climate variability with the goal of informing understanding of current and future change in Earth's climate system. The Paleo Perspectives on Climate Change (P2C2) program of the National Science Foundation (NSF) has advanced paleoclimate research through proxy development, data-model comparisons, and synthesis work, and has facilitated interdisciplinary collaboration that has contributed to the growth of the field. This new publication highlights discussions at a June 2021 workshop that focused on identifying potential future paleoclimate research directions to further advance understanding of past climate and better inform the public and decision makers about the expected future.

Widely available, trustworthy government statistics are essential for policy makers and program administrators at all levels of government, for private sector decision makers, for researchers, and for the media and the public. In the United States, principal statistical agencies as well as units and programs in many other agencies produce various key statistics in areas ranging from the science and engineering enterprise to education and economic welfare. Official statistics are often the result of complex data collection, processing, and estimation methods. These methods can be challenging for agencies to document and for users to understand. At the request of the National Center for Science and Engineering Statistics (NCSES), this report studies issues of documentation and archiving of NCSES statistical data products in order to enable NCSES to enhance the transparency and reproducibility of the agency's statistics and facilitate improvement of the statistical program workflow processes of the agency and its contractors. Transparency in Statistical Information for the National Center for Science and Engineering Statistics and All Federal Statistical Agencies also explores how NCSES could work with other federal statistical agencies to facilitate the adoption of currently available documentation and archiving standards and tools.

"Quantum concepts hold the potential to enable significant advances in sensing and imaging technologies that could be vital to the study of biological systems. The workshop Quantum Science Concepts in Enhancing Sensing and Imaging Technologies: Applications for Biology, held online March 8-10, 2021, was organized to examine the research and development needs to advance biological applications of quantum technology. Hosted by the National Academies of Sciences, Engineering, and Medicine, the event brought together experts working on state-of-the-art, quantum-enabled technologies and scientists who are interested in applying these technologies to biological systems. Through talks, panels, and discussions, the workshop facilitated a better understanding of the current and future biological applications of quantum-enabled technologies in fields such as microbiology, molecular biology, cell biology, plant science, mycology, and many others. This publication summarizes the presentation and discussion of the workshop." --

"The National Academies Roundtable on Aligning Incentives for Open Science, established in 2019, has taken on an important role in addressing issues with open science. The roundtable convenes critical stakeholders to discuss the effectiveness of current incentives for adopting open science practices, current barriers of all types, and ways to move forward in order to align reward structures and institutional values. The Roundtable convened a virtual public workshop on fostering open science practices on November 5, 2020. The broad goal of the workshop was to identify paths to growing the nascent coalition of stakeholders committed to reenvisioning credit/reward systems (e.g., academic hiring, tenure and promotion, and grants)to fully incentivize open science practices. The workshop explored the information and resource needs of researchers, research institutions, government agencies, philanthropies, professional societies, and other stakeholders interested in further supporting and implementing open science practices. This publication summarizes the presentations and discussion of the workshop."--