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On May 24-26, 2023, the Nobel Prize Summit entitled Truth, Trust, and Hope was convened as a hybrid event to examine misinformation and disinformation in the context of the broader information ecosystem, looking at the global impact of information technologies in nature and society. The summit brought together Nobel laureates, leading scientists, business leaders, writers, artists, and young innovators to share insights, challenges, and solutions relating to trust and information. With a positive narrative and the accelerating prevalence of artificial intelligence, big data, and other emerging information technologies, the summit explored the challenges and opportunities of democratization of knowledge and information and the erosion of trust. Held in Washington, DC and virtually, the 3-day summit attracted more than 700 in-person attendees and more than 10,000 online participants from more than 70 countries. Eleven Nobel laureates were actively engaged in the summit, and 32 partner organizations were involved, including breakout sessions and solution sessions. This publication summarizes the presentations, activities, and discussion of the summit.

The proper disposal of unused or expired prescription drugs, particularly controlled substances such as opioids, may help to prevent serious risk of nonmedical use or overdose. In June 2023, the National Academies Forum on Drug Discovery, Development, and Translation hosted a hybrid public workshop to examine the scientific merit and practical implementation of drug disposal options to remove opioid analgesics from the home. Workshop participants considered potential strategies for encouraging and assessing the development and efficacy of in-home drug disposal systems that support the public health goal of mitigating the risk of nonmedical use or overdose associated with opioids.

A National Academies committee was tasked with identifying essential health care services for women related to intimate partner violence (IPV) during steady state conditions, determining whether the essential health care services related to IPV differ during public health emergencies (PHEs), and identifying strategies to sustain access to those essential health care services during PHEs. This report, Essential Health Care Services Addressing Intimate Partner Violence, presents findings from research and deliberations and lays out recommendations for leaders of health care systems, federal agencies, health care providers, emergency planners, and those involved in IPV research.

"The committee and National Academies staff conducted an extensive literature search to identify sources pertaining to the epidemiology of LBW, as well as the diagnosis, prognosis, and treatment of disabilities resulting from being born LBW. The search included peer-reviewed scholarly articles from 2002 to 2022, with a focus on the United States, Canada, France, Norway, Sweden, and Denmark. Online databases used in the search include EMBASE, PubMed, ProQuest, and Scopus. Committee members and project staff identified additional relevant literature using traditional academic search methods and online searches. In addition to journal articles, the search included websites of the Centers for Disease Control and Prevention, the World Health Organization, and SSA. The committee also engaged in discussion with a panel of experts who work with families of LBW babies"--

Across multiple domains of science, engineering, and medicine, excitement is growing about the potential of digital twins to transform scientific research, industrial practices, and many aspects of daily life. A digital twin couples computational models with a physical counterpart to create a system that is dynamically updated through bidirectional data flows as conditions change. Going beyond traditional simulation and modeling, digital twins could enable improved medical decision-making at the individual patient level, predictions of future weather and climate conditions over longer timescales, and safer, more efficient engineering processes. However, many challenges remain before these applications can be realized.This report identifies the foundational research and resources needed to support the development of digital twin technologies. The report presents critical future research priorities and an interdisciplinary research agenda for the field, including how federal agencies and researchers across domains can best collaborate.

Before the COVID-19 pandemic, research demonstrated a significant impact of family caregiving responsibilities on the careers of professionals who work in science, technology, engineering, mathematics, and medicine (STEMM) - especially women. The COVID-19 pandemic increased public recognition of the challenges experienced by caregivers in STEMM fields and created a sense of urgency among many stakeholders. As part of the information-gathering stage of a forthcoming consensus study to address the barriers faced by caregivers, of all genders, in STEMM fields, the Committee on Policies and Practices for Supporting Family Caregivers Working in Science, Engineering, and Medicine organized two national symposia on February 27 and March 27, 2023. Scholars and leaders from a range of sectors convened to identify evidence-based interventions that can support the recruitment, retention, and advancement of caregivers in science, engineering, and medical fields. This publication summarizes the presentations and discussion of the symposia.

Despite calls to increase diversity throughout the engineering education enterprise and years of efforts by and collaborations between universities, K-12 schools, and professional societies and other education- or equity-related organizations, Black or African-American individuals, American Indian or Alaska Native individuals, and Hispanic or Latine individuals of any race do not participate in engineering education and occupations at parity, defined as the same proportions as their representation in the US population. To review current and past efforts and explore ways to progress to a more diverse engineering profession and reach parity in comparison to the US population, the National Academy of Engineering (NAE) convened a virtual 3-day workshop series on March 18, March 30, and April 20, 2022. Attendees considered existing collaborations between extramural initiatives that support engineering student success and universities seeking to recruit and retain these students in undergraduate and advanced engineering education. Participants also shared potential new approaches for enhancing coordination among the various levels of the engineering education system to reach parity. This publication summarizes the presentation and discussion of the workshop.

On May 23, 2023, the National Academies of Sciences, Engineering, and Medicine Board on Behavioral, Cognitive, and Sensory Sciences hosted a workshop titled Current Practices and Challenges for Identifying and Managing Suicide Risk Among Veterans in Non-Department of Veterans Affairs (VA) Healthcare Systems to explore the landscape of veteran health care and suicide risk; consider strategies to identify veterans who receive their health care outside of the VHA; and identify best practices for suicide risk identification and care for VA-purchased care in community and at non-VA entities. This proceedings presents a summary of the presentation and discussion of the workshop.

Health services research is "the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviors affect access to health care and the quality and cost of health care." Since the 1960s, health services research has provided the foundation for progress, effectiveness, and value in health care. Ironically, at a time in which appreciation has never been higher for both the need and potential from health services research, the political and financial support for sustenance and growth appear to be weakening. With funding support from AcademyHealth, the American Association of Colleges of Nursing, the American Board of Family Medicine, the American Society of Anesthesiologists, the Association of American Medical Colleges, the Federation of American Hospitals, and the Robert Wood Johnson Foundation, this National Academy of Medicine Special Publication identifies the range of issues that health services research must consider, address, and potentially overcome to transform the field to meet the needs of a 21st-century health care system. These issues are broad, multidisciplinary, and will require a coordinated effort to address--as well as dedicated and sustainable funding. Federal support for health services research has never been more critical. Now is a critical time for the field to articulate its priorities, demonstrate its utility, and transform to meet the needs of a 21st-century health care system. The physical and financial health of the nation is at stake.

Realizing the promise of digital technology will depend on the ability to share information across time and space from multiple devices, sources, systems, and organizations. The major barrier to progress is not technical; rather, it is in the failure of organizational demand and purchasing requirements. In contrast to many other industries, the purchasers of health care technologies have not marshaled their purchasing power to drive interoperability as a key requirement. Better procurement practices, supported by compatible interoperability platforms and architecture, will allow for better, safer patient care; reduced administrative workload for clinicians; protection from cybersecurity attacks; and significant financial savings across multiple markets. With funding support from the Gordon and Betty Moore Foundation, this National Academy of Medicine Special Publication represents a multi-stakeholder exploration of the path toward achieving large-scale interoperability through strategic acquisition of health information technology solutions and devices. In this publication, data exchanges over three environments are identified as critical to achieving interoperability: facility-to-facility (macro-tier); intra-facility (meso-tier); and at point-of-care (micro-tier). The publication further identifies the key characteristics of information exchange involved in health and health care, the nature of the requirements for functional interoperability in care processes, the mapping of those requirements into prevailing contracting practices, the specification of the steps necessary to achieve system-wide interoperability, and the proposal of a roadmap for using procurement specifications to engage those steps. The publication concludes with a series of checklists to be used by health care organizations and other stakeholders to accelerate progress in achieving system-wide interoperability.

On September 22, 2022, the National Academy of Sciences held a symposium entitled Endless Frontier 2022: Research and Higher Education Institutions for the Next 75 Years. The event was a follow up to a February 2020 NAS symposium convened to celebrate the 75th anniversary of the landmark report Science, the Endless Frontier. Building on the 2020 symposium and on lessons learned during the COVID-19 pandemic, the September 2022 symposium sought to generate tools, strategies, and actionable steps that people and institutions can implement to ensure that science and technology continue to serve the public good. The symposium was designed to progress from broad perspectives that encompass the entire science and technology enterprise to consideration of more specific issues. This proceedings summarizes the 2022 symposium.

"High energy density (HED) science has critical applications for society from fusion energy to sustaining the U.S. nuclear deterrent, while also contributing to broader scientific questions such as understanding planets and their origins. The next decade of HED science will be instrumental to growing our understanding and in the development of new technologies and processes. This report identifies key challenges and science questions for the field for the coming decade and proposes ways to address them"--

Antarctica and the Southern Ocean are important research locations for many scientific disciplines, including oceanography, biology, and astronomy. Because of its remoteness and the extreme and dangerous weather conditions in which researchers must operate, research in this region presents many unique challenges. New and improved technologies can make Antarctic research safer, more efficient, and capable of covering a greater spatial and temporal range, all while minimizing the costs and environmental impacts of this research. At the request of the National Science Foundation Office of Polar Programs, the Polar Research Board of the National Academies of Sciences, Engineering, and Medicine convened a workshop on May 3-5, 2022, to solicit broad community ideas regarding how technological developments can advance and expand Antarctic research and polar research more generally. Workshop participants discussed recent and potential technological breakthroughs, cross-cutting research themes, and how new technologies can facilitate broader, more diverse participation in Antarctic research. This publication summarizes the presentations and discussions of the workshop.

The U.S. Army is working on a major science and technology development program to build the Strategic Long Range Cannon to fire a hypersonic projectile 1,000 miles. At the request of the Deputy Assistant Secretary of the Army for Research and Technology, the Committee on Assessing the Feasibility of the Strategic Long Range Cannon made recommendations for the U.S. Army in the following categories: organizational, operational, and technical demonstration development areas. This publication is the unclassified summary of the full, classified report.

The COVID-19 pandemic and overlapping global crises, including geopolitical conflict and climate change, have made achievement of the United Nations Sustainable Development Goals (SDGs) more challenging. The scientific community incre-singly recognizes the need to accelerate the adoption of evidence-based, scientifically-sound policies and actions to operationalize sustainable development. This report identifies key research priorities and possible actionable steps to operationalize sustainable development at the global and local levels. Although the scope of the challenges and opportunities are global with many research investigations and actions needed, Operationalizing Sustainable Development to Benefit People and the Planet presents research priorities and possible actionable steps for consideration by U.S. stakeholders.

Strategically moving communities and infrastructure--including homes and businesses--away from environmentally high-risk areas, such as vulnerable coastal regions, has been referred to as "managed retreat." Of all the ways humans respond to climate-related disasters, managed retreat has been one of the most controversial due to the difficulty inherent in identifying when, to where, by whom, and the processes by which such movement should take place. In 2021, the Gulf Research Program of the National Academies of Sciences, Engineering, and Medicine sponsored a two-year consensus study, Managed Retreat in the U.S. Gulf Coast Region, to learn about and respond to the unique challenges associated with managed retreat. As part of this study, the committee convened a series of three public workshops in 2022 in the Gulf Coast region to gather information for the consensus report. Each workshop focused on policy and practice considerations, research and data needs, and community engagement strategies. This proceedings recounts the first workshop in Houston and Port Arthur, Texas.

Electronic Health Records (EHRs) are used across a wide variety of activities in cancer care and cancer research, including communication among health care team members and patients, clinical documentation and treatment planning, patient safety and quality improvement, scheduling and billing, as well as clinical research and disease surveillance activities. On February 28 and March 1, 2022, the National Cancer Policy Forum and the Computer Science and Telecommunications Board of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to examine opportunities to improve patient care and outcomes through collaborations to enhance innovation in the development, implementation, and use of EHRs in oncology care, research, and surveillance. This Proceedings of a Workshop summarizes the presentations and discussions that took place at the workshop.

Patients diagnosed with Alzheimer's disease and related dementias (ADRD) rely on family members, their community, and the health care system for progressively increasing support over the course of their disease. These people receive care through a frequently siloed health care system across hospitals, nursing homes, ambulatory care settings, and long-term care settings, as well as community- and home-based care. As the number of people living with a diagnosis of ADRD continues to grow, so does the need to provide better support for these people and their caregivers. The National Institute on Aging (NIA) Division of Behavioral and Social Research suggests that organizational behavior change will be needed for health care systems to integrate all of the services and supports required to provide high-quality care for people with ADRD. NIA sponsored a workshop hosted by the National Academies of Sciences, Engineering, and Medicine to explore mechanisms to improve the quality of care for people living with ADRD and the potential of innovative payment models to incentivize health care systems to make the necessary systemic changes. The workshop convened a diverse array of experts in fields including nursing, geriatrics, health care economics, health care services research, quality measurement, social work, medical ethics, law, health care finance, and health care policy. This publication summarizes the presentation and discussion of the workshop.

The US Department of State, Bureau of International Narcotics and Law Enforcement (INL) provides assistance and supports capacity building for criminal justice systems and police organizations in approximately 90 countries. In order to support and inform that work, this report explores high-level corruption and its effects on police organizations, as well as strategies that police can use to effectively contribute to efforts to combat that corruption.

The Hanford Nuclear Reservation in Washington state, which produced plutonium for nuclear weapons from 1944-1987, is the site of the largest and most complex nuclear cleanup challenge in the United States. The U.S. Department of Energy's Office of Environmental Management (DOE-EM) is responsible for managing the cleanup of the radioactive and other hazardous wastes stored in 177 underground tanks at the site. DOE plans to use vitrification, or immobilization in glass waste forms, for all of the high-level radioactive waste at Hanford. However, because the volume of "low-activity waste" exceeds DOEs capacity limits for vitrification, DOE must decide how to treat the remaining "supplemental low-activity waste" (SLAW) so that it can be safely disposed in a near-surface disposal site. To help inform its decision, DOE contracted with a Federally Funded Research and Development Center (FFRDC), led by Savannah River National Laboratory, to analyze and report its findings about three potential alternative technologies. At the request of Congress, the National Academies reviewed the FFRDC report in terms of its value for decision making and how well it meets various Congressional requirements related to Hanford cleanup. The review concludes that the FFRDC report is overall very strong, provides a useful framework for evaluating the technology options, and is responsive to guidance from the first National Academies review. The framework provides for structured side-by-side comparisons, using relevant criteria, of a limited number of alternatives for managing SLAW. Recommendations for strengthening the report include estimating a lifecycle cost profile for constructing and operating each alternative, and providing more in-depth discussion on potential challenges that may need to be addressed in obtaining the necessary various regulatory approvals.

Land-grant colleges and universities play a crucial role in addressing the complex challenges facing the U.S. agricultural system and global food security. Multidisciplinary collaboration involving a diversity of land-grant institutions has the potential to accelerate scientific progress on those challenges. However, historical and current funding disparities have prevented Historically Black Colleges and Universities and Tribal Colleges and Universities from being full partners in multi-institutional collaborations. This report, produced by request of the U.S. Department of Agriculture National Institute of Food and Agriculture acting on a congressional directive, examines how enhanced cooperation across the land-grant system could deepen and expand the impact of its agricultural work, which is critical to address evolving industry and environmental challenges, as well as demands from consumers. The report concludes that many investigators are unaware of potential partners with complementary expertise across the system. The report states that adopting a culture of collaboration could improve the coordination in the land-grant system. Key report recommendations include improving systems and incentives for facilitating academic partnerships, providing dedicated support for collaboration across the land-grant system, and enhancing outreach strategies for communicating about the beneficial outcomes of collaborative research.

Emerging real-time data sources, together with innovative data science techniques and methods - including artificial intelligence and machine learning - can help inform upstream suicide prevention efforts. Select social media platforms have proactively deployed these methods to identify individual platform users at high risk for suicide, and in some cases may activate local law enforcement, if needed, to prevent imminent suicide. To explore the current scope of activities, benefits, and risks of leveraging innovative data science techniques to help inform upstream suicide prevention at the individual and population level, the Forum on Mental Health and Substance Use Disorders of the National Academies of Sciences, Engineering, and Medicine convened a virtual workshop series consisting of three webinars held on April 28, May 12, and June 30, 2022. This Proceedings highlights presentations and discussions from the workshop.

Scholars, policymakers, and the public view police legitimacy and community trust in the police alike as essential components of an effective police organization. An extensive network of international and regional organizations, bilateral donors, international financial institutions, and civil society organizations aims to work with governments to improve policing practices and enhance police legitimacy. 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. At the request of INL, the Committee on Law and Justice of the National Academies of Sciences, Engineering, and Medicine convened an ad hoc committee to review, assess, and reach consensus on existing evidence on policing institutions, police practices and capacities, and police legitimacy in the international context. The committee produced five reports, addressing questions of interest to INL and the State Department. Developing Policing Practices that Build Legitimacy, the fourth in this series, responds to the question: What policing practices build community trust and legitimacy in countries with low-to-moderate criminal justice sector capacity? This report focuses on the concept of legitimacy and ways of building legitimacy to foster this kind of trust and expectations.

The staggering number of deaths and emergency department visits caused by firearm injuries has only grown with time. Costs associated with firearm related injuries amount to over a billion dollars annually in the United States alone, not including physician charges and postdischarge costs. To address this epidemic, in April of 2022, the National Academies of Sciences, Engineering, and Medicine's Board on Population Health and Public Health Practice, in collaboration with Northwell Heath and the PEACE Initiative, brought together firearm injury prevention thought leaders to explore how health systems can integrate interventions for firearm injury prevention into routine care for the purpose of improving the health of patients and communities. The workshop speakers discussed strategies for firearm injury and mortality prevention and its integration into routine care. Speakers also explored facilitators and barriers to implementation strategies, and how health systems might work to overcome those barriers.

Indigenous communities experience higher risks for suicide compared to the general U.S. population, with suicide as the second-leading cause of death among Indigenous children and young adults in North America. To reduce this trend, it is essential for prevention and intervention efforts to build on scientific evidence; cultural and local knowledge; and the best community, family, and institutional practices to reduce risk and increase protection. The Forum on Mental Health and Substance Use Disorders and the Forum for Children's Well-Being at the National Academies of Sciences, Engineering, and Medicine convened a three-part virtual public workshop on April 26, 2022, May 13, 2022, and June 10, 2022, to examine suicide risk and protective factors in Indigenous populations, discuss culturally appropriate and effective suicide prevention policies and programs, explore existing data systems and how data can be used for tracking suicide rates, and consider opportunities for action. This Proceedings highlights presentations and discussions from the workshop.

An estimated 10 percent of children in the United States are living with disabilities, including a disproportionate number of children living in poverty and children of marginalized racial and ethnic groups. During the pandemic, children with disabilities suffered disproportionately compared to their peers without disabilities. To learn more about what policies and practices might be sustained or implemented beyond the pandemic to support children with disabilities and their families, the Board on Children, Youth, and Families hosted a workshop on June 13-15, 2022. Workshop presenters included service providers, researchers, government leaders, youth with disabilities, and caregivers of children and youth with disabilities. In this workshop, practices were identified that could improve the system of care for children with disabilities as well as improve access to services for underserved and marginalized populations.

Adolescence is a crucial period of life for the prevention of substance use disorders. Research has shown that early intervention can significantly reduce rates of substance use disorder in adulthood. To learn more about effective family-focused interventions in primary care settings for preventing substance use disorder, the National Academies of Sciences, Engineering, and Medicine hosted a workshop on May 5-6, 2022. The proceedings from that workshop explores existing efforts to incorporate family-focused interventions into state health care policies. It also examines barriers to implementing such interventions as well as lessons learned from successful efforts to scale up these interventions.

The onset of COVID-19 pandemic and inundation of the U.S. health care system emphasized infrastructural and health professional education vulnerabilities. A planning committee of the National Academies of Sciences, Engineering, and Medicine Global Forum on Innovation in Health Professional Education conducted a series of public workshops in the fall of 2021 to explore whether students and trainees should be viewed as members of the health workforce, particular in times of emergency as was experienced during the COVID-19 public health crisis. The planning committee gathered educators, students, administrators, and health professionals to share ideas, experiences, and data to strategize expansion of learning opportunities for medical trainees and enhancement of medical preparedness to unforeseen crises without compromising the quality of patient care. The workshops explored issues such as identifying evidence on value-added roles for students to serve in the delivery of care and in a public health capacity, and balancing the role of learners as consumers (tuition payers) and not licensed providers versus members of the health workforce. This Proceedings highlights presentations and discussions from the workshop.

The Intelligence Community Studies Board of the National Academies of Sciences, Engineering, and Medicine convened a 2-day virtual workshop on December 17 and 21, 2021, to explore insights from world-class experts and technologists familiar with the extensive range of issues associated with anticipating rare events--those characterized by a very low probability of occurring--of major significance. Over the course of the 2-day workshop, the speakers discussed analytical methods, computational advances, data sources, and risk assessment approaches for anticipating rare events, including natural disasters, pandemics, anthropogenic threats, and widespread technological change. This proceedings is a factual summary of the presentations and discussion of the workshop.

U.S. leadership in technology innovation is central to our nation's interests, including its security, economic prosperity, and quality of life. Our nation has created a science and technology ecosystem that fosters innovation, risk taking, and the discovery of new ideas that lead to new technologies through robust collaborations across and within academia, industry, and government, and our research and development enterprise has attracted the best and brightest scientists, engineers, and entrepreneurs from around the world. The quality and openness of our research enterprise have been the basis of our global leadership in technological innovation, which has brought enormous advantages to our national interests. In today's rapidly changing landscapes of technology and competition, however, the assumption that the United States will continue to hold a dominant competitive position by depending primarily on its historical approach of identifying specific and narrow technology areas requiring controls or restrictions is not valid. Further challenging that approach is the proliferation of highly integrated and globally shared platforms that power and enable most modern technology applications. To review the protection of technologies that have strategic importance for national security in an era of openness and competition, Protecting U.S. Technological Advantage considers policies and practices related to the production and commercialization of research in domains critical to national security. This report makes recommendations for changes to technology protection policies and practices that reflect the current realities of how technologies are developed and incorporated into new products and processes.