National Academies of Sciences, Engineering, and Medicine

That is the NCA4 Federal Steering Committee and several rounds of technical and policy review by the thirteen federal agencies of the USGCRP.

An expert external peer review of the whole report was performed by an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine, NASEM.

Additional information on the development of this assessment can be found in Appendix One, Report Development Process.

Sources used in this report.

Treatment of uncertainties, risk framing, confidence, and likelihood.

Risk framing.

In March 2016, NASEM convened a workshop characterizing risk in climate change assessments to assist NCA4 authors in their analyses of climate-related risks across the United States.

To help ensure consistency and readability across chapters, USGCRP developed guidance on communicating the risks and opportunities that climate change presents, including the treatment of scientific uncertainties.

And it's not my narrative.

It's, you know, the National Academies of Sciences convened an expert panel.

They came together and they concluded that if you look across all these studies, the associations are often nonexistent, sometimes they're positive, sometimes they're negative.

And so there's this massive gap between the big effects that we believe technology has on the mental health of young people and what we can actually see in the data so far.

And I just ran an evaluation of those models.

Well, first of all, the change from NRC to NASEM, so NRC 2001 to NASEM 2021, I think was a huge leap.

It was a huge... uh step forward uh but we need to understand that as you mentioned there's a huge variability um so overall the models are doing okay both the i did evaluate both the calf and the heifer model so pre-win and post-win models they are doing okay so the cccs are usually between 0.4 and 0.5 so cccs evaluate both accuracy and precision at the same time um But we do have, like for calves, for instance, we are having biases for starter intake, which is something that we are really interested in, about 0.4, 0.6 kilograms, so 600 grams per day.

That's pretty high still.

Now, why did these attorneys general call on Congress and other federal agencies to defund the National Academy of Sciences? They claim that the organization has used taxpayer dollars to produce reports that are specifically designed to support plaintiffs in climate lawsuits against energy companies.

In the letter signed by the attorneys general, they said that to end grants to an organization, NASEM, that uses taxpayer money to prop up litigation theories that have been rejected by courts from Maryland to Mississippi to California.

So in other words, this is your taxpayer dollar.

Again, first of all, I contend that the National Academy of Sciences, Engineering, and Medicine doesn't legally exist because Congress is not authorized to spend money to promote the National Academy of Sciences, Engineering, or Medicine.

NCA4 Volume II was thoroughly reviewed by external experts and the general public, as well as the federal government, that is, the NCA4 Federal Steering Committee and several rounds of technical and policy review by the thirteen federal agencies of the USGCRP.

An expert external peer review of the whole report was performed by an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine, NASEM.

Additional information on the development of this assessment can be found in Appendix One: Report Development Process.

Sources used in this report.

Treatment of uncertainties, risk framing, confidence, and likelihood.

Risk framing.

In March twenty sixteen, NASEM convened a workshop characterizing risk in climate change assessments to assist NCA4 authors in their analyses of climate-related risks across the United States.

To help ensure consistency and readability across chapters, USGCRP developed guidance on communicating the risks and opportunities that climate change presents, including the treatment of scientific uncertainties.

Maybe I'll just ask you to step back and describe the landscape of pediatric subspecialty training and subspecialty practice that exists now and that you think led to this change being developed.

So the rationale for this change goes back in part to a 2023 report from the National Academies of Science, Engineering, and Medicine on the future of graduate medical education in the U.S. That report states that physician training in the U.S. is not aligned with the needs of the population, and specifically with regard to primary care, access to health care in rural areas, and behavioral health.

And when we look at what that means for pediatric subspecialties, the report essentially says that the current system structurally underproduces and also misplaces pediatric subspecialists, and a disproportionate number practice in large academic centers and urban areas.

So we have a mismatch between the number of physicians going into pediatric subspecialties and where and how they're practicing and the needs of the children in the U.S. And additionally, a report on child health needs and the pediatric GI workforce specifically was published by some of our NASPGAN colleagues in 2024.

They are common, astonishingly common.

Harvard astronomer David Charbonneau, who co-chaired the National Academies of Sciences, Engineering and Medicines Committee on Exoplanet Science Strategy, summarised the conclusion in terms that left little room for ambiguity.

At least one in every four stars has a planet that is roughly the same size as Earth, rocky in composition and orbiting at the right temperature for liquid water.

These were not speculative projections.

Right now, we don't have a lot of evidence that they do help.

A report that's now a couple of years old was put together by the National Academies of Science, Medicine, and Engineering, looking at all of the available marijuana-related literature that was available at that time.

And basically, it was hard to find a positive study for most things, right? It was good for like if you had cancer and you had no appetite, it was very effective.

For a closed angle glaucoma, it was very effective.

NCA4 Volume Two was thoroughly reviewed by external experts and the general public, as well as the federal government, that is, the NCA4 Federal Steering Committee and several rounds of technical and policy review by the thirteen federal agencies of the USGCRP.

An expert external peer review of the whole report was performed by an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine, NASEM.

Additional information on the development of this assessment can be found in Appendix One, Report Development Process.

Sources used in this report.

Treatment of uncertainties, risk framing, confidence, and likelihood.

Risk framing.

In March 2016, NASEM convened a workshop characterizing risk in climate change assessments to assist NCA4 authors in their analyses of climate-related risks across the United States.

To help ensure consistency and readability across chapters, USGCRP developed guidance on communicating the risks and opportunities that climate change presents, including the treatment of scientific uncertainties.

severe constipation with fecal impaction, painful diverticulitis flares, admissions that are entirely preventable and entirely downstream of a fiber intake running at a fraction of what the body actually needs.

So how much fiber do you actually need? Total dietary fiber needs are set by the National Academies and they scale with age and sex.

The official adequate intake sits at 38 grams a day for men under 50, dropping to 30 grams after 50, and 25 grams a day for women under 50. dropping to 21 after 50.

In practice, I round that up slightly and tell my male patients to aim for 40 grams of total fiber a day and my female patients to aim for 30 because national dietary surveys consistently show the average American eating well under half of even the lower official target.