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In the fall of 2010, the U.S. National Academies (consisting of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine) and the Russian Academy of Sciences (in cooperation with the Russian Academy of Medical Sciences and the Russian Academy of Agricultural Sciences) initiated a joint study of U.S.-Russian bilateral engagement in the biological sciences and biotechnology (hereinafter collectively referred to as bioengagement). The U.S. Department of State and the Russian Academy of Sciences provided support for the study. The academies established a joint committee of 12 leading scientists from the two countries to assess bioengagement activities since 1996 and to provide recommendations as to collaborative efforts in the near future. The Unique U.S.-Russian Relationship in Biological Science and Biotechnology: Recent Experience and Future Directions summarizes the principal conclusions and recommendations of the study.
The sequencing of the human genome and the identification of links between specific genetic variants and diseases have led to tremendous excitement over the potential of genomics to direct patient treatment toward more effective or less harmful interventions. Still, the use of whole genome sequencing challenges the traditional model of medical care where a test is ordered only when there is a clear indication for its use and a path for downstream clinical action is known. This has created a tension between experts who contend that using this information is premature and those who believe that having such information will empower health care providers and patients to make proactive decisions regarding lifestyle and treatment options. In addition, some stakeholders are concerned that genomic technologies will add costs to the health care system without providing commensurate benefits, and others think that health care costs could be reduced by identifying unnecessary or ineffective treatments. Economic models are frequently used to anticipate the costs and benefits of new health care technologies, policies, and regulations. Economic studies also have been used to examine much more specific issues, such as comparing the outcomes and cost effectiveness of two different drug treatments for the same condition. These kinds of analyses offer more than just predictions of future health care costs. They provide information that is valuable when implementing and using new technologies. Unfortunately, however, these economic assessments are often limited by a lack of data on which to base the examination. This particularly affects health economics, which includes many factors for which current methods are inadequate for assessing, such as personal utility, social utility, and patient preference. To understand better the health economic issues that may arise in the course of integrating genomic data into health care, the Roundtable on Translating Genomic-Based Research for Health hosted a workshop in Washington, DC, on July 17-18, 2012, that brought together economists, regulators, payers, biomedical researchers, patients, providers, and other stakeholders to discuss the many factors that may influence this implementation. The workshop was one of a series that the roundtable has held on this topic, but it was the first focused specifically on economic issues. The Economics of Genomic Medicine summarizes this workshop.
Genome-Based Diagnostics: Demonstrating Clinical Utility in Oncology is the summary of a workshop convened in May 2012 by the Roundtable on Translating Genomic-Based Research for Health and the Center for Medical Technology Policy of the Institute of Medicine to foster the identified need for further sustained dialogue between stakeholders regarding the clinical utility of molecular diagnostics. The workshop brought together a wide range of stakeholders, including patients, health care providers, policy makers, payers, diagnostic test developers, researchers, and guideline developers, to identify the challenges and opportunities in advancing the development and use of molecular diagnostic tests designed to guide the treatment and management of patients with cancer. The sequencing of the human genome has greatly accelerated the process of linking specific genetic variants with disease. These findings have yielded a rapidly increasing number of molecular diagnostic tests designed to guide disease treatment and management. Many of these tests are aimed at determining the best treatments for specific forms of cancer, making oncology a valuable testing ground for the use of molecular diagnostic tests in medicine in general. Nevertheless, many questions surround the clinical value of molecular diagnostic tests, and their acceptance by clinicians, payers, and patients has been unpredictable. A major limiting factor for the use of these tests has been the lack of clear evidence of clinical utility. Genome-Based Diagnostics assesses the evidentiary requirements for clinical utility of molecular diagnostics used to guide treatment decisions for patients with cancer; discusses methodologies related to demonstrating these evidentiary requirements that meet the needs of all stakeholders; and considers innovative, sustainable research collaborations for generating evidence of clinical utility involving multiple stakeholders.
The National Nanotechnology Initiative (NNI) is a multiagency, multidisciplinary federal initiative comprising a collection of research programs and other activities funded by the participating agencies and linked by the vision of "a future in which the ability to understand and control matter at the nanoscale leads to a revolution in technology and industry that benefits society." As first stated in the 2004 NNI strategic plan, the participating agencies intend to make progress in realizing that vision by working toward four goals. Planning, coordination, and management of the NNI are carried out by the interagency Nanoscale Science, Engineering, and Technology (NSET) Subcommittee of the National Science and Technology Council (NSTC) Committee on Technology (CoT) with support from the National Nanotechnology Coordination Office (NNCO). Triennial Review of the National Nanotechnology Initiative is the latest National Research Council review of the NNI, an assessment called for by the 21st Century Nanotechnology Research and Development Act of 2003. The overall objective of the review is to make recommendations to the NSET Subcommittee and the NNCO that will improve the NNI's value for basic and applied research and for development of applications in nanotechnology that will provide economic, societal, and national security benefits to the United States. In its assessment, the committee found it important to understand in some detail--and to describe in its report--the NNI's structure and organization; how the NNI fits within the larger federal research enterprise, as well as how it can and should be organized for management purposes; and the initiative's various stakeholders and their roles with respect to research. Because technology transfer, one of the four NNI goals, is dependent on management and coordination, the committee chose to address the topic of technology transfer last, following its discussion of definitions of success and metrics for assessing progress toward achieving the four goals and management and coordination. Addressing its tasks in this order would, the committee hoped, better reflect the logic of its approach to review of the NNI. Triennial Review of the National Nanotechnology Initiative also provides concluding remarks in the last chapter.
The charge of the Army Research Laboratory Technical Assessment Board (ARLTAB) is to provide biennial assessments of the scientific and technical quality of the research, development, and analysis programs at the Army Research Laboratory (ARL). The ARLTAB is assisted by six panels, each of which focuses on the portion of the ARL program conducted by one of ARL's six directorates1. When requested to do so by ARL, the ARLTAB also examines work that cuts across the directorates. For example, during 2011-2012, ARL requested that the ARLTAB examine crosscutting work in the areas of autonomous systems and network science. The overall quality of ARL's technical staff and their work continues to be impressive. Staff continue to demonstrate clear, passionate mindfulness of the importance of transitioning technology to support immediate and longer-term Army needs. Their involvement with the wider scientific and engineering community continues to expand. Such continued involvement and collaboration are fundamentally important for ARL's scientific and technical activities and need to include the essential elements of peer review and interaction through publications and travel to attend professional meetings, including international professional meetings. In general, ARL is working very well within an appropriate research and development niche and has been demonstrating significant accomplishments, as exemplified in the following discussion, which also addresses opportunities and challenges.
Pharmaceutical companies, academic researchers, and government agencies such as the Food and Drug Administration and the National Institutes of Health all possess large quantities of clinical research data. If these data were shared more widely within and across sectors, the resulting research advances derived from data pooling and analysis could improve public health, enhance patient safety, and spur drug development. Data sharing can also increase public trust in clinical trials and conclusions derived from them by lending transparency to the clinical research process. Much of this information, however, is never shared. Retention of clinical research data by investigators and within organizations may represent lost opportunities in biomedical research. Despite the potential benefits that could be accrued from pooling and analysis of shared data, barriers to data sharing faced by researchers in industry include concerns about data mining, erroneous secondary analyses of data, and unwarranted litigation, as well as a desire to protect confidential commercial information. Academic partners face significant cultural barriers to sharing data and participating in longer term collaborative efforts that stem from a desire to protect intellectual autonomy and a career advancement system built on priority of publication and citation requirements. Some barriers, like the need to protect patient privacy, pre- sent challenges for both sectors. Looking ahead, there are also a number of technical challenges to be faced in analyzing potentially large and heterogeneous datasets. This public workshop focused on strategies to facilitate sharing of clinical research data in order to advance scientific knowledge and public health. While the workshop focused on sharing of data from preplanned interventional studies of human subjects, models and projects involving sharing of other clinical data types were considered to the extent that they provided lessons learned and best practices. The workshop objectives were to examine the benefits of sharing of clinical research data from all sectors and among these sectors, including, for example: benefits to the research and development enterprise and benefits to the analysis of safety and efficacy. Sharing Clinical Research Data: Workshop Summary identifies barriers and challenges to sharing clinical research data, explores strategies to address these barriers and challenges, including identifying priority actions and "low-hanging fruit" opportunities, and discusses strategies for using these potentially large datasets to facilitate scientific and public health advances.
Beginning with the development of the atomic bomb during World War II, the United States continued to build nuclear weapons throughout the Cold War. Thousands of people mined and milled uranium, conducted research on nuclear warfare, or worked in nuclear munitions factories around the country from the 1940s through the 1980s. Such work continues today, albeit to a smaller extent. The Department of Energy (DOE) is now responsible for overseeing those sites and facilities, many of which were, and continue to be, run by government contractors. The materials used at those sites were varied and ranged from the benign to the toxic and highly radioactive. Workers at DOE facilities often did not know the identity of the materials with which they worked and often were unaware of health risks related to their use. In many instances, the work was considered top secret, and employees were cautioned not to reveal any work-related information to family or others. Workers could be exposed to both radioactive and nonradioactive toxic substances for weeks or even years. Consequently, some of the workers have developed health problems and continue to have concerns about potential health effects of their exposures to occupational hazards during their employment in the nuclear weapons industry. In response to the concerns expressed by workers and their representatives, DOL asked the Institute of Medicine (IOM) to review the SEM database and its use of a particular database, Haz-Map, as the source of its toxic substance-occupational disease links. Accordingly, this IOM consensus report reflects careful consideration of its charge by the committee, and describes the strengths and shortcomings of both. To complete its task, IOM formed an ad hoc committee of experts in occupational medicine, toxicology, epidemiology, industrial hygiene, public health, and biostatistics to conduct an 18-month study to review the scientific rigor of the SEM database. The committee held two public meetings at which it heard from DOL Division of Energy Employee Occupational Illness Compensation (DEEOIC) representatives, the DOL contractor that developed the SEM database, the developer of the Haz-Map database, DOE worker advocacy groups, and several individual workers. The committee also submitted written questions to DOL to seek clarification of specific issues and received written responses from DEEOIC. The committee's report considers both the strengths and weaknesses of the SEM and the Haz-Map databases, recognizing that the latter was developed first and for a different purpose. The committee then discusses its findings and recommends improvements that could be made in both databases with a focus on enhancing the usability of SEM for both DOL claims examiners and for former DOE workers and their representatives. Review of the Department of Labor's Site Exposure Matrix Database summarizes the committee's findings.
The U.S. government supports programs to combat global HIV/AIDS through an initiative that is known as the President's Emergency Plan for AIDS Relief (PEPFAR). This initiative was originally authorized in the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 and focused on an emergency response to the HIV/AIDS pandemic to deliver lifesaving care and treatment in low- and middle-income countries (LMICs) with the highest burdens of disease. It was subsequently reauthorized in the Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (the Lantos-Hyde Act). Evaluation of PEPFAR makes recommendations for improving the U.S. government's bilateral programs as part of the U.S. response to global HIV/AIDS. The overall aim of this evaluation is a forward-looking approach to track and anticipate the evolution of the U.S. response to global HIV to be positioned to inform the ability of the U.S. government to address key issues under consideration at the time of the report release.
When, in late 2011, it became public knowledge that two research groups had submitted for publication manuscripts that reported on their work on mammalian transmissibility of a lethal H5N1 avian influenza strain, the information caused an international debate about the appropriateness and communication of the researchers' work, the risks associated with the work, partial or complete censorship of scientific publications, and dual-use research of concern in general. Recognizing that the H5N1 research is only the most recent scientific activity subject to widespread attention due to safety and security concerns, on May 1, 2012, the National Research Council's Committee on Science, Technology and Law, in conjunction with the Board on Life Sciences and the Institute of Medicine's Forum on Microbial Threats, convened a one-day public workshop for the purposes of 1) discussing the H5N1 controversy; 2) considering responses by the National Institute of Allergy and Infectious Diseases (NIAID), which had funded this research, the World Health Organization, the U.S. National Science Advisory Board for Biosecurity (NSABB), scientific publishers, and members of the international research community; and 3) providing a forum wherein the concerns and interests of the broader community of stakeholders, including policy makers, biosafety and biosecurity experts, non-governmental organizations, international organizations, and the general public might be articulated. Perspectives on Research with H5N1 Avian Influenza: Scientific Enquiry, Communication, Controversy summarizes the proceedings of the workshop.
The National Academy of Engineering's 2012 forum, "Educating Engineers: Preparing 21st Century Leaders in the Context of New Modes of Learning," opened with presentations by six speakers who looked at the future of engineering and engineering education from their perspectives as educators, administrators, entrepreneurs, and innovators. Each speaker focused on just one facet of a tremendously complex picture. Yet together they outlined a new vision for engineering education based on flexible, interactive, lifelong learning and the merge of activities long held to be distinct. This summary of a forum recaps the six speaker's presentations.
The Standing Committee on Defense Materials Manufacturing and Infrastructure (DMMI) conducted a workshop on July 23-24, 2012, to share information and gather perspectives on issues concerning Materials and Manufacturing Capabilities for Sustaining Defense Systems. This workshop, held at the headquarters building of the National Academies, 2101 Constitution Avenue N.W., Washington D.C., was conducted according to the procedures of the National Research Council (NRC) for a convening activity. That is, all workshop participants--including presenters, members of the DMMI standing committee, Reliance 21, invited guests, and visitors--spoke as individuals, and no overall findings, conclusions, or recommendations were developed during or as a result of the workshop. All statements and views summarized in this publication are attributable only to those individuals who expressed them. It is worth noting that the sponsor, Reliance 21, is a Department of Defense group of professionals that was established to enable the DOD science and technology (S&T) community to work together to enhance Defense S&T programs, eliminate unwarranted duplication, and strengthen cooperation among the military services and other DOD agencies. The DMMI standing committee named a workshop planning group to develop the workshop agenda and decide on invited guests and presenters, in accordance with the statement of task approved by the Governing Board of the NRC. The planning group also consulted with the Reliance 21 materials and processing community of interest. The presentations and discussions during the workshop are summarized sequentially in the main part of this report. As an aid to readers, nine themes have been identified by the author that recurred in multiple presentations and discussions. Materials and Manufacturing Capabilities for Sustaining Defense Systems: Summary of a Workshop explains these nine themes and summarizes the two day workshop.
In 2012, the Defense Intelligence Agency (DIA) approached the National Research Council's TIGER standing committee and asked it to develop a list of workshop topics to explore the impact of emerging science and technology. From the list of topics given to DIA, three were chosen to be developed by the Committee for Science and Technology Challenges to U.S. National Security Interests. The first in a series of three workshops was held on April 23-24, 2012. This report summarizes that first workshop which explored the phenomenon known as big data. The objective for the first workshop is given in the statement of task, which explains that that workshop will review emerging capabilities in large computational data to include speed, data fusion, use, and commodification of data used in decision making. The workshop will also review the subsequent increase in vulnerabilities over the capabilities gained and the significance to national security. The committee devised an agenda that helped the committee, sponsors, and workshop attendees probe issues of national security related to so-called big data, as well as gain understanding of potential related vulnerabilities. The workshop was used to gather data that is described in this report, which presents views expressed by individual workshop participants. Big Data: A Workshop Report is the first in a series of three workshops, held in early 2012 to further the ongoing engagement among the National Research Council's (NRC's) Technology Insight-Gauge, Evaluate, and Review (TIGER) Standing Committee, the scientific and technical intelligence (S&TI) community, and the consumers of S&TI products.
The Workshop on the Future of Antennas was the second of three workshops conducted by the National Research Council's Committee for Science and Technology Challenges to U. S. National Security Interests. The objectives of the workshop were to review trends in advanced antenna research and design, review trends in commercials and military use of advanced antennas that enable improved communication, data transfer, soldier health monitoring, and other overt and covert methods of standoff data collection. The first day's sessions, consisting of five presentations and discussions on antennas and wireless communications and control, were open to committee members, staff, guests, and members of the public. The second day was a data-gathering session addressing vulnerabilities, indicators, and observables; presentations and discussions during this session included classified material and were not open to the public. The committee's role was limited to planning and convening the workshop. This report is organized by topic in the order of presentation and discussion at the workshop. For Day 1 the topics were Future of Antennas, Commercial State of the Art of Wireless Communications and Control, Military State of the Art of Wireless Communications and Control, and Future Trends in Antenna Design and Wireless Communications and Control. For Day 2 the topics were Vulnerabilities of Ubiquitous Antennas, and Indicators and Observables, followed by a wrap-up discussion. Summary of a Workshop on the Future of Antennasdescribes what happened at the workshop.
The American Time Use Survey (ATUS), conducted by the Bureau of Labor Statistics, included a subjective well-being (SWB) module in 2010 and 2012. The module, funded by the National Institute on Aging (NIA), is being considered for inclusion in the ATUS for 2013. The National Research Council was asked to evaluate measures of self-reported well-being and offer guidance about their adoption in official government surveys. The charge for the study included an interim report to consider the usefulness of the ATUS SWB module, specifically the value of continuing it for at least one more wave. Among the key points raised in this report are the value, methodological benefits, and cost and effects on the ATUS and new opportunities. Research on subjective or self-reported well-being has been ongoing for several decades, with the past few years seeing an increased interest by some countries in using SWB measures to evaluate government policies and provide a broader assessment of the health of a society than is provided by such standard economic measures as gross domestic product. NIA asked the panel to prepare an interim report on the usefulness of the SWB module of the ATUS, with a view as to the utility of continuing the module in 2013. The Subjective Well-Being Module of the American Time Use Survey is intended to fulfill only one narrow aspect of the panel's broader task. It provides an overview of the ATUS and the SWB module, a brief discussion of research applications to date, and a preliminary assessment of the value of SWB module data. The panel's final report will address issues of whether research has advanced to the point that SWB measures-and which kinds of measures-should be regularly included in major surveys of official statistical agencies to help inform government economic and social policies.
Among the poorest and least developed regions in the world, sub-Saharan Africa has long faced a heavy burden of disease, with malaria, tuberculosis, and, more recently, HIV being among the most prominent contributors to that burden. Yet in most parts of Africa-and especially in those areas with the greatest health care needs-the data available to health planners to better understand and address these problems are extremely limited. The vast majority of Africans are born and will die without being recorded in any document or spearing in official statistics. With few exceptions, African countries have no civil registration systems in place and hence are unable to continuously generate vital statistics or to provide systematic information on patterns of cause of death, relying instead on periodic household-level surveys or intense and continuous monitoring of small demographic surveillance sites to provide a partial epidemiological and demographic profile of the population. In 1991 the Committee on Population of the National Academy of Sciences organized a workshop on the epidemiological transition in developing countries. The workshop brought together medical experts, epidemiologists, demographers, and other social scientists involved in research on the epidemiological transition in developing countries to discuss the nature of the ongoing transition, identify the most important contributors to the overall burden of disease, and discuss how such information could be used to assist policy makers in those countries to establish priorities with respect to the prevention and management of the main causes of ill health. This report summarizes the presentations and discussions from a workshop convened in October 2011 that featured invited speakers on the topic of epidemiological transition in sub-Saharan Africa. The workshop was organized by a National Research Council panel of experts in various aspects of the study of epidemiological transition and of sub-Saharan data sources. The Continuing Epidemiological Transition in Sub-Saharan Africa serves as a factual summary of what occurred at the workshop in October 2011.
SMART Vaccines--Strategic Multi-Attribute Ranking Tool for Vaccines--is a prioritization software tool developed by the Institute of Medicine that utilizes decision science and modeling to help inform choices among candidates for new vaccine development. A blueprint for this computer-based guide was presented in the 2012 report Ranking Vaccines: A Prioritization Framework: Phase I. Ranking Vaccines: A Prioritization Software Tool,Phase II extends the proof-of-concept presented in the Phase I report, which was based on multi-attribute utility theory. This report refines a beta version of the model developed in the Phase I report and presents its next iteration, SMART Vaccines 1.0. Ranking Vaccines: Phase II discusses the methods underlying the development, validation, and evaluation of SMART Vaccines 1.0. It also discusses how SMART Vaccines should--and, just as importantly, should not--be used. The report also offers ideas for future enhancements for SMART Vaccines as well as for ideas for expanded uses and considerations and possibilities for the future.
In this brilliant, multi-layered conclusion to the Unbound trilogy, Emma Townsend journeys to Paris and discovers her own choices echoed within the labyrinthine love story The Phantom of the Opera . . . Senior year in Paris means dazzling architecture, gorgeous cafs, and a hefty workload. But no matter how busy her days, Emma Townsend misses her Coast Guard boyfriend, Gray. That lonely ache might explain the unsettling whispers Emma hears in the school's empty corridors, and the flickering images in her room's antique mirror. Her foreboding only increases as she reads Gaston Leroux's The Phantom of the Opera and becomes lost in the gothic masterpiece. When Gray goes missing during a rescue at sea, Emma refuses to believe the worst. In her strange waking dreams, Gray is very much alive, drawing Emma into a mysterious otherworld beyond her mirror. Friends worry that she's losing her grip on reality. Emma half wonders if they're right. . . and if her own story will end in a way she never envisioned. . . Praise for Eve Marie Mont's Unbound series Richly satisfying. . . a smart and rewarding ode to literature. -- Kirkus on A Breath of Eyre (starred review) Exceptional and unique. . . A breath of fresh air for hungry readers looking for that special touch that makes a book stand out from the rest of the pack. -- The New York Journal of Books on A Breath of Eyre A delightful story that makes classic literature appealing and relevant to today's teens. . . terrific. --VOYA on A Touch of Scarlet
Hot shape-shifters and even hotter passion. -- New York Times bestselling author Gena Showalter Livy Kowalski has no time for idiots. When you shapeshift into a honey badger, getting through life's irritants is a finely honed skill. Until she gets stuck housing her nutso cousin and dealing with her dad's untimely and unexplained demise. That's where Vic Barinov comes in--or his house does. Vic can't step outside without coming back to find Livy devouring his honey stash and getting the TV remote sticky. It gets his animal instincts all riled up. But he'll have to woo her at high speed: all hell is breaking loose, and Livy is leading the charge. . .
Deep in the heart of Texas, the firefighters are hotter, sexier, and totally out of control. . . Singe Stephen is an adrenaline junkie. And then he meets Julia and her sexy curves. He's on fire with the need for her, a Texas-sized blaze that jumps from one to five alarms the moment their lips touch. . . Smolder Marcus lost everything--his wife, his family, his business. Then nearly his life fighting fires. But out of the ashes he found something that never stopped burning. And this time he won't let go. . . Spark Childhood friends Talia and Dylan have been putting out fires as long as they've been in denial about their feelings. But one night everything changes, a fire's lit, and it's too hot to ever go out. . . Fans of heated contemporary romance will surrender to the seductive spell of author Lynn LaFleur. --Genre Go Round Reviews This book contains adult content
The quaint Midwestern town of Serenity is about to hit the small screen. Brandy Borne and her dramatically ditzy mother, Vivian, will be starring in Antique Sleuths, a reality TV show based on the duos antiquarian adventures--and their troubling talent for solving deadly crimes. What better shooting set than a creepy old house, the site of a 60-year-old unsolved axe murder?The location is perfect until Bruce Spring, the shows producer, meets a fatal axe-ident, mortally mauled just like the homes previous owner. The first suspect on the chopping block seems typecast for the role of killer--he was found at the scene of the attack, clutching a stained axe. But as Brandy and Vivian chop around for clues, plenty of other suspects stick out their necks. . . It seems the shows cameraman clashed with Bruce--could he be the culprit? What about the acrimony between Andrew, the harried homeowner, and Bruce, whose dirt-digging documentary all but accused Andrew of the original unsolved crime? And whos driving that blood-red Toyota that keeps making unscripted cameo appearances? If Brandy and Vivian are going to get to the bottom of this mystery, theyll have to be extra careful not to wind up on the cutting room floor--in pieces Dont miss Brandy Bornes tips on antiques "One of the funniest cozy series going. " --"Ellery Queen Mystery Magazine"
An innocent Beauty. A fearsome Beast. A dangerous passion. Mystery and speculation surround "the Dark Prince," a sorcerer who dwells in a kingdom cursed by endless winter. Though shunned by all, Prince Stellan secretly crusades against a zombie plague unleashed by his tyrannical father against the Five Lands. But only an alliance with Aldebaran will provide the support he needs to eradicate the plague once and for all Clarysa, daughter of the Aldebaran king, struggles under the weight of her role as princess. She yearns for adventure, but her father prefers to keep his youngest daughter safe within the palace walls. During one of her rare sanctioned trips beyond the walls of the castle, Clarysa comes face to face with the answer to her prayers. She's heard the tales of Stellan's dangerous nature. She knows a romance with him is forbidden. But one smoldering glance draws her deep into a world of dark magic and sensuous rapture. CONTENT WARNING: Magic, mayhem, and epic snowfall. A Lyrical Press Fantasy Romance | Once Upon
What happens undercover, stays under covers. Jessica Hartley is looking for answers surrounding the mysterious car accident that nearly claimed the life of her best friend. She's willing to risk it all, even her fledgling business, to find the person responsible and bring them to justice. Nate Steele is more than willing to help Jessica, but for reasons all his own. He's been watching the infamous Maxwell Office Solutions for some time now, convinced there's more going on than meets the eye. When his chief issues a cease and desist order yet again, Nate has no choice but to accept inexperienced Jessica as an undercover partner outside the letter of the law. Will Jessica and Nate be able to flush out Maxwell's elusive villain, or will their growing attraction for each other sabotage their undercover ploy? Motives aren't always what they seem when Jessica finds herself armed with Steele. CONTENT WARNING: Beware drool-worthy men in uniform, touchy-feely coworkers, and vindictive ex-girlfriends.
Nervous system diseases and disorders are highly prevalent and substantially contribute to the overall disease burden. Despite significant information provided by the use of animal models in the understanding of the biology of nervous system disorders and the development of therapeutics; limitations have also been identified. Treatment options that are high in efficacy and low in side effects are still lacking for many diseases and, in some cases are nonexistent. A particular problem in drug development is the high rate of attrition in Phase II and III clinical trials. Why do many therapeutics show promise in preclinical animal models but then fail to elicit predicted effects when tested in humans? On March 28 and 29, 2012, the Institute of Medicine Forum on Neuroscience and Nervous System Disorders convened the workshop "Improving Translation of Animal Models for Nervous System Disorders" to discuss potential opportunities for maximizing the translation of new therapies from animal models to clinical practice. The primary focus of the workshop was to examine mechanisms for increasing the efficiency of translational neuroscience research through discussions about how and when to use animal models most effectively and then best approaches for the interpretation of the data collected. Specifically, the workshop objectives were to: discuss key issues that contribute to poor translation of animal models in nervous system disorders, examine case studies that highlight successes and failures in the development and application of animal models, consider strategies to increase the scientific rigor of preclinical efficacy testing, explore the benefits and challenges to developing standardized animal and behavioral models. Improving the Utility and Translation of Animal Models for Nervous System Disorders: Workshop Summary also identifies methods to facilitate development of corresponding animal and clinical endpoints, indentifies methods that would maximize bidirectional translation between basic and clinical research and determines the next steps that will be critical for improvement of the development and testing of animal models of disorders of the nervous system.
The National Institute of Standards and Technology (NIST)--recognizing that information and insights gained through continual examination of practices for organizational assessment are useful for decision makers at organizations across the deferral, industrial, academic, and national laboratory sectors-recently requested that the National Research Council (NRC) organize a panel to review best practices in assessment of research and development (R&D) organizations. In response, the NRC established the Panel for Review of Best Practices in Assessment of Research and Development Organizations. The panel was charged to consider means of assessing the following in a manner that satisfies the requirements of NIST to perform effective assessments but also identifies assessment methods that can be applied selectively to other R&D organizations. These methods include: technical merit and quality of the science and engineering work, the adequacy of the resources available to support high-quality work, the effectiveness of the agency's delivery of the services and products required to fulfill its goals, the degree to which the agency's current and planned R&D portfolio supports its mission, as well as the agency's flexibility to respond to changing economic, political, social and technological contexts. As one means of data gathering, among others that the panel is performing toward development of a final report of its findings, the panel organized a planning committee for a workshop on best practices in assessment of R&D organizations. Best Practices in Assessment of Research and Development Organizations: Summary of a Workshop reviews the workshop conducted at the Keck Center of the National Academies in Washington, D.C., on March 19, 2012.
The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families' economic security or their income available for other basic needs. In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families' disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel's recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM. The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies - whether part of the ACA or other policies - are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.
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