Consensus
Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities.
Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face.
Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends:
It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
288 pages
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6 x 9
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hardcover
ISBN Ebook: 0-309-58877-4
DOI:
https://doi.org/10.17226/11140
Institute of Medicine. 2005. Quality Through Collaboration: The Future of Rural Health. Washington, DC: The National Academies Press.
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Many existing highways were originally constructed without stormwater control facilities, prompting several state departments of transportation (DOTs) to retrofit these highway facilities with improved treatment and flow control systems. To implement watershed-based strategies more cost effectively, some DOTs have explored partnerships with third-party entities.
NCHRP Synthesis 654: Stormwater Retrofit Programs and Practices Through Third-Party Partnerships, from TRB's National Cooperative Highway Research Program, documents the varied approaches taken by state DOTs on stormwater retrofit partnerships with third parties.
104 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-99220-6
ISBN Ebook: 0-309-99221-4
DOI:
https://doi.org/10.17226/29106
National Academies of Sciences, Engineering, and Medicine. 2025. Stormwater Retrofit Programs and Practices Through Third-Party Partnerships. Washington, DC: The National Academies Press.
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Consensus
The U.S. Army Combat Capabilities Development Command (DEVCOM) Army Research Laboratory (ARL) is the U.S. Army's sole fundamental research laboratory focused on cutting-edge scientific discovery and technological innovations that offer great potential to strengthen the U.S. Army. The mission of ARL is to operationalize science for transformational overmatch in support of persistent Army modernization.
At the request of Army, this report examines the following four ARL competencies: biological and biotechnology sciences; network, cyber, and computational sciences; photonics, electronics, and quantum sciences; and sciences of extreme materials. The cross-cutting conclusions for the four competencies assessed in this report focus on encouraging a streamlined administrative approval process to enable conference attendance; creating bilateral forums with industry, academia, and government; continuing cross-pollination efforts through communication and collaboration; and increasing awareness of emerging computational methodologies.
144 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-73362-6
ISBN Ebook: 0-309-73363-4
DOI:
https://doi.org/10.17226/28878
National Academies of Sciences, Engineering, and Medicine. 2025. 2024 Assessment of the DEVCOM Army Research Laboratory. Washington, DC: The National Academies Press.
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Workshop_in_brief
The climate surrounding reproductive health research in the U.S. changes rapidly. The National Academies Standing Committee on Reproductive Health, Equity, and Society hosted a workshop in November 2024 to address the challenges and opportunities and their effects on research quality and quantity. This Proceedings of a Workshop-In Brief highlights the presentations and discussions that occurred at the workshop.
12 pages
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8.5 x 11
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ISBN Ebook: 0-309-99284-2
DOI:
https://doi.org/10.17226/29131
National Academies of Sciences, Engineering, and Medicine. 2025. Understanding the Barriers and Opportunities to Conducting Reproductive Health Research: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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State departments of transportation (DOTs) undertake numerous bridge replacements annually. Specific replacements present unique challenges among these projects due to location restrictions, mobility implications, design characteristics, and environmental constraints.
NCHRP Synthesis 645: Construction Strategies and Techniques for Planned Bridge Replacements in Complex Scenarios, from TRB's National Cooperative Highway Research Program, documents practices and decision-making used by state DOTs for planned bridge replacements in complex scenarios.
104 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-73403-7
ISBN Ebook: 0-309-73404-5
DOI:
https://doi.org/10.17226/29029
National Academies of Sciences, Engineering, and Medicine. 2025. Construction Strategies and Techniques for Planned Bridge Replacements in Complex Scenarios. Washington, DC: The National Academies Press.
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Consensus
When someone experiences the loss of a limb or severe facial disfigurement, one of their options may be vascularized composite allotransplantation (VCA), which transfers a graft containing multiple tissues transferred as a functional unit. Using VCA to restore the functionality and aesthetics of a lost upper limb or disfigured face is a profound and life-altering gift; however, the process and the decision to accept (or donate) a VCA graft is complex and deeply emotional. In addition to psychosocial considerations, a VCA recipient must commit to undergoing years of rigorous rehabilitation, have a robust support system in place, and accept and understand the risks of being on immunosuppressive drugs for the rest of their life. Despite VCA advances over the last 25 years, challenges remain, and the small number of recipients of face or hand transplants makes it difficult to generalize outcomes.
To address these challenges, the Department of Defense Reconstructive Transplant Research Program tasked a committee of the National Academies with developing principles and a framework for the standardization, assessment, and validation of protocols and standard operating procedures for face and hand transplantation. The resulting report offers guidance for the newly established Clinical Organization Network for Standardization of Reconstructive Transplantation (CONSORT), but it also includes specific recommendations to enable the larger VCA community to mature, advance, and thrive into the future.
388 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-73108-9
ISBN Ebook: 0-309-73109-7
DOI:
https://doi.org/10.17226/28580
National Academies of Sciences, Engineering, and Medicine. 2025. Advancing Face and Hand Transplantation: Principles and Framework for Developing Standardized Protocols. Washington, DC: The National Academies Press.
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Consensus
The 8th Edition of Principles and Practices for a Federal Statistical Agency supports the essential role of relevant, credible, trusted, independent, and innovative government statistics. Since 1992, this report has described the characteristics of effective federal statistical agencies. Government statistics are widely used to inform decisions by policymakers, program administrators, businesses and other organizations, as well as households and the general public.
Principles and Practices is a concise tool to communicate the unique responsibilities of federal statistical agencies. It underscores the invaluable role that relevant, timely, accurate, and trustworthy government statistics play to inform the public and policymakers. Since 2001, an updated edition is released at the beginning of each presidential term.
This eighth edition retains the five principles and ten practices established in prior editions, including updated examples and extensive appendices to reflect the many and varied changes across the national statistical system that have occurred since the passage of the Foundations for Evidence-Based Policymaking Act of 2018 ("Evidence Act"), the CHIPS and Science Act, and implementing regulations.
240 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-72543-7
ISBN Ebook: 0-309-72544-5
DOI:
https://doi.org/10.17226/27934
National Academies of Sciences, Engineering, and Medicine. 2025. Principles and Practices for a Federal Statistical Agency: Eighth Edition. Washington, DC: The National Academies Press.
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Consensus
Formula is often the sole source of nutrition for many infants, making its safety and quality particularly critical. While most food laws and regulations apply to infant formulas, they are also subject to additional requirements and manufacturer regulations for certain quality factors. These include an assessment of protein quality and demonstration that the formula supports normal infant physical growth.
Per the Food and Drug Omnibus Reform Act of 2022, the U.S. Food and Drug Administration asked the National Academies to examine and report on the state of the science regarding methodologies for assessing the biological quality of protein in infant formula and the ability of infant formula to support normal physical growth. The committee's statement of task noted that its analysis should include the examination of current study designs and methods that could demonstrate quality factors have been met. The resulting report presents conclusions, recommendations, and areas of future research to improve standardized procedures for assessing protein quality in infant formula.
220 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-73521-1
ISBN Ebook: 0-309-73522-X
DOI:
https://doi.org/10.17226/29065
National Academies of Sciences, Engineering, and Medicine. 2025. Protein Quality and Growth Monitoring Studies: Quality Factor Requirements for Infant Formula. Washington, DC: The National Academies Press.
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Workshop
Glucagon-like peptide-1 receptor (GLP-1R) agonists, originally developed for type 2 diabetes patients and popularized by their ability to rapidly reduce body weight in patients with obesity, have recently received a lot of national attention. Repurposing GLP-1R agonists to treat some central nervous disorders is promising, but comparatively understudied. At a September 2024 workshop, the National Academies Forum on Neuroscience and Nervous System Disorders reviewed the current knowledge and research gaps about the mechanisms of action of GLP-1R agonists in the brain, and the evidence of their clinical efficacy for eating disorders, neurodegenerative diseases, substance use disorders, and pain.
118 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-73505-X
ISBN Ebook: 0-309-73506-8
DOI:
https://doi.org/10.17226/29061
National Academies of Sciences, Engineering, and Medicine. 2025. Examining Glucagon-Like Peptide-1 Receptor (GLP-1R) Agonists for Central Nervous System Disorders: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Open-book negotiations for determining construction pricing for transportation agencies can enhance cost certainty, optimize risk allocation, and ultimately lead to more efficient project delivery. In a survey of 42 state departments of transportation (DOTs), key insights arise in how agencies negotiate construction costs post-award, collaborate with independent cost estimators, and manage project contingencies. Additionally, case examples reveal the critical role of trust and transparency in ensuring fair and reasonable guaranteed maximum prices.
NCHRP Synthesis 653: Open-Book Pricing Practices for Construction Manager/General Contractor and Progressive Design-Build Projects, from TRB's National Cooperative Highway Research Program, explores the complexities of alternative project delivery methods for state DOTs, with a focus on transparency, risk management, and cost negotiation.
140 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-73576-9
ISBN Ebook: 0-309-73577-7
DOI:
https://doi.org/10.17226/29084
National Academies of Sciences, Engineering, and Medicine. 2025. Open-Book Pricing Practices for Construction Manager/General Contractor and Progressive Design-Build Projects. Washington, DC: The National Academies Press.
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Transportation Insights 6: 7th International Conference on Women and Gender in Transportation presents the discussions and insights from a conference in Irvine, CA, from September 9 to 11, 2024.
87 pages
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8.5 x 11
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ISBN Ebook: 0-309-99261-3
DOI:
https://doi.org/10.17226/29126
National Academies of Sciences, Engineering, and Medicine. 2025. 7th International Conference on Women and Gender in Transportation. Washington, DC: The National Academies Press.
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This booklet, translated in Spanish here, provides key insights from Oil in the Sea IV: Inputs, Fates, and Effects, published in 2022, which benefited from significant advancements in scientific methods to detect the input and fates of oil in the sea, and from lessons learned from the Deepwater Horizon explosion and oil spill in 2010. Going beyond previous reports, Oil in the Sea IV includes analysis of human health impacts of oil in the sea, oil in the Arctic marine environment, and prevention and response efforts that can help to both reduce the amount of oil reaching the sea and minimize its effects. The booklet is meant to serve as a reference guide to all those involved in oil spill research and response. The English version can be found here.
88 pages
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6 x 9
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ISBN Ebook: 0-309-99263-X
DOI:
https://doi.org/10.17226/29127
National Academies of Sciences, Engineering, and Medicine. 2025. Oil in the Sea IV: Quick Guide for Practitioners and Researchers: Spanish Version. Washington, DC: The National Academies Press.
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Inspired by the National Academy of Sciences (NAS) building, which turned 100 in 2024, sixth-grade students at the Alain Locke School in West Philadelphia created the Promethean Sparks mural. The students collaborated with artist and educator Ben Volta to imagine how scientific imagery in the NAS building's Great Hall—from the Prometheus mural by Albert Herter and the golden dome by Hildreth Meière—might look if recreated in the twenty-first century. Their vibrant mural was exhibited alongside a timeline of the NAS building, which depicted the accomplishments of the Academy in the context of US and world events over the past century. The timeline was curated by Alana Quinn and Alexandra Briseno in consultation with historians Ruth Schwartz Cowan and Peter J. Westwick.
13 pages
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8.5 x 11
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ISBN Ebook: 0-309-99310-5
National Academy of Sciences. 2024. Promethean Sparks & NAS Building Timeline. Washington, DC: The National Academies Press.
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From February 15 through July 15, 2019, Cultural Programs of the National Academy of Sciences presented the exhibition Dornith Doherty: Archiving Eden. Since 2008, artist Dornith Doherty has traveled across five continents to document and poetically reflect on seed banking. This ongoing series blends traditional photography with X-ray images of seeds, created in collaboration with seed-bank scientists. Through these varied works, Doherty invites us to contemplate the beauty, dynamism, and fragility of plant life while highlighting crucial efforts to safeguard biodiversity—especially our essential food sources—against threats like blight, climate change, habitat loss, and unforeseen challenges. This exhibition catalog features essays by John Rohrbach, Senior Curator of Photographs, Amon Carter Museum of American Art, Fort Worth, Texas, and Katherine Ware, Curator of Photography, New Mexico Museum of Art, Santa Fe.
18 pages
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8.5 x 11
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ISBN Ebook: 0-309-99302-4
National Academy of Sciences. 2019. Dornith Doherty: Archiving Eden. Washington, DC: The National Academies Press.
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Nam_special_pub
The integration of large language models (LLMs) and generative artificial intelligence (AI) in health care holds the potential to transform the practice of medicine, the work and experiences of health care providers, and the health and well-being of patients. Generative AI can support clinical decision making and streamline workflows, promote patients and their support networks' engagement in care processes, and support clinical research.
However, successful and ethical implementation of generative AI requires careful consideration of the associated risks, particularly those concerning data privacy, bias, transparency, and infrastructure limitations.
Generative Artificial Intelligence in Health and Medicine: Opportunities and Responsibilities for Transformative Innovation explores the transformative potential of generative AI in health care, with a focus on its applications in clinical decision making, administrative efficiency, and patient engagement.
70 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-73369-3
ISBN Ebook: 0-309-73370-7
DOI:
https://doi.org/10.17226/28907
National Academy of Medicine. 2025. Generative Artificial Intelligence in Health and Medicine: Opportunities and Responsibilities for Transformative Innovation. Washington, DC: The National Academies Press.
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Consensus
In 2022, the U.S. Geological Survey (USGS) was directed by the U.S. Congress to conduct an assessment of the current state of knowledge concerning linkages between biodiversity and climate change in the United States, called the Biodiversity and Climate Change Assessment (BCCA). Recognizing that biodiversity and climate change span national and other jurisdictional borders, the USGS expanded the assessment to include all of North America, working in collaboration with Canada and Mexico.
At the request of USGS, the National Academies of Sciences, Engineering, and Medicine conducted an independent peer review of the first order draft of the BCCA chapters, beginning concurrent with the public comment period that took place in fall 2024. The review evaluates whether the draft chapters adequately and transparently assess the relevant scientific literature and evidence, address the most pressing issues of biodiversity and climate change, and communicate findings in policy-relevant language accessible to a broad audience.
74 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-72355-8
ISBN Ebook: 0-309-72356-6
DOI:
https://doi.org/10.17226/27796
National Academies of Sciences, Engineering, and Medicine. 2025. Biodiversity and Climate Change Assessment: Review of Draft Chapters. Washington, DC: The National Academies Press.
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Nam_special_pub
Since its founding, the Center for Medicare & Medicaid Innovation (CMMI) has tested more than 50 alternative payment models reaching more than 28 million patients across 528,000 health care providers and plans, yielding invaluable insights on the implementation of models to achieve better care, better health, and lower costs. On the other hand, many basic lessons learned are lessons unapplied. U.S. population health outcomes lag behind its highly economically developed peers and our health system is still firmly entrenched in the fee-for-service payment system that rewards service volume.
This Special Publication suggests six key priority actions for CMMI centered on signaling, mapping, measuring, modeling, partnering, and demonstrating. These priority actions, coupled with implementation considerations that focus on meaningful and continuous engagement, intersectionality and diversity, and expanding CMMI activities and impact, are intended to assist in aligning, supporting, and informing the implementation of CMMI’s Strategic Refresh.
145 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-69235-0
ISBN Ebook: 0-309-69236-9
DOI:
https://doi.org/10.17226/26675
National Academy of Medicine. 2025. Catalyzing Innovative Health System Transformation: An Opportunity Agenda for the Center for Medicare & Medicaid Innovation. Washington, DC: The National Academies Press.
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Cyber technologies underpin every facet of the economy and are critical for national security. Cyber and cyber-enabled systems are rapidly growing in both complexity and scale, and - despite significant progress - are outpacing the capacity to keep them safe, secure, and resilient to disruptions. Cyber hard problems - unsolved technical and research problems for which progress toward solution would have a significant impact on the practical security of cyber systems - are frequently caused or sustained by human or societal factors and misaligned incentives. These in turn are exacerbated by the continuing tremendous growth in the production and use of cyber technologies and their resulting near ubiquity in societally important systems and institutions.
This report builds off of the Cyber Hard Problem List originally developed for the Department of Homeland Security in 1996. Cyber Hard Problems reviews that original list, then provides an update by identifying and describing current key hard problems for cyber resiliency. This report explores each of the identified problems, and then proposes ways to use the list to enhance community-wide coordination of research and development activities.
136 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-73489-4
ISBN Ebook: 0-309-73490-8
DOI:
https://doi.org/10.17226/29056
National Academies of Sciences, Engineering, and Medicine. 2025. Cyber Hard Problems: Focused Steps Toward a Resilient Digital Future. Washington, DC: The National Academies Press.
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Postdoctoral scholars are particularly vulnerable to sexual harassment because of their early career stage, a lack of clear institutional policies, and dyadic relationships with their advisors, among other factors. Recent surveys and listening sessions have reiterated this issue, indicating that workplace bullying, harassment, and discrimination are chief concerns to postdoctoral scholars and that power imbalances are a cross-cutting theme contributing to harassment, bullying, and questionable behaviors by mentors and principal investigators. It is within environments of generalized disrespect and incivility that much sexual harassment occurs.
This issue paper builds on the findings and recommendations in the 2018 report Sexual Harassment of Women: Climate, Culture, and Consequences in Academic Sciences, Engineering, and Medicine by providing more information related to implementing the report’s recommendation to diffuse the hierarchical and dependent relationships between faculty and their trainees (e.g., students, postdoctoral fellows, residents). Through this paper, individual scholars, higher education leaders, and practitioners from the Action Collaborative’s Response Working Group describe key institutional considerations and challenges in supporting postdoctoral scholars experiencing sexual harassment in higher education.
84 pages
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8.5 x 11
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ISBN Ebook: 0-309-73295-6
DOI:
https://doi.org/10.17226/28852
Gary, S., A. Allison, S. Burton, C. Cuthbert-Martinez, L. J. McKown, and S. Rankin. 2025. Considerations for Supporting Postdoctoral Scholars Experiencing Sexual Harassment in Higher Education: Issue Paper. Washington, DC: The National Academies Press.
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