NATIONAL LIBRAR OFY MEDICINE PROGRAMS &v SERVICE FYS …€¦ · Basic Research 46 User Suppor ant d Outreach 47 Extramural Programs 47 ... number of other accomplishment in FYs 199

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MEDICINE PROGRAMS 07/08/97

TITUTES OF H E A L T H

NATIONAL LIBRARY OF MEDICINE

PROGRAMS &v SERVICES FY 1996

Internet Grateful Med

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Internet Grateful Med V2.21a

NEW RELEASEThis version of Internet Grateful Med was released September 9, 1996. It can search inHealthSTAR, AIDSLINE, and PREMEDLINE in addition to MEDLINE. The default fileis MEDLINE. Select the "Search Other Files" action on the Search Screen to change to oneof the other files.

INTRODUCTIONInternet Grateful Med offers assisted searching in MEDLINE and other online databases ofthe U.S. National Library of Medicine (NLM). It was developed through the User AccessServices project of NLM's System Reinvention initiative. Internet Grateful Med can mapuser terms through NLM's Unified Medical Language System® (UMLS®) Mctathesaurus®to help users create, submit and refine searches in MEDLINE® and other MEDLARSdatabases.

USER ID AND PASSWORDSearching MEDLINE requires a valid MEDLARS user ID code and password.

User ID code:f Password:|•••••••••

APPLY ONLINE FOR A NEW NLM USER ACCOUNT (last updated June 18. 1996)

CHARGES TO USE INTERNET GRATEFUL MED (last updated July 19, 1996)

SEND QUESTIONS OR COMMENTS TO THE DEVELOPERS

HELPTEXTContext-sensitive help is available from many areas of the program. To invoke it, select thenearest information icon V]. To return from the help text, use the "Back" function of your

'F HEALTH AND HUMAN SERVICES

further information ahoul the programs described in thna(hnini\tKitive report / s available fioin.

Office of Pnhlu InformationNational Lihiarv of Medicine

MOO Ro<kville Pikellethesda, Ml) 208V4

e-Mail: puhlu

Cover: Inlcincl (ii.ncliil Mctl Homo I'.iyc (lui|i//igin nlin nih j:ov)

NATIONAL INSTITUTES OF HEALTH

NATIONAL LIBRARY OF MEDICINE

Programs and ServicesFiscal Year 1996

U.S. Department of Health and Human ServicesPublic Health ServiceHethesda, Maryland

National Library of Medicine Catalog in Publication

/ Nat ional Library of Medicine ( U S )675 \fa Nat ional Library ot Medicine programs and services --US6an 1977- -- Uethesda, Mel The l ibrary , 11978-

v i l l , portsReport covers f i s c a l yearContinues Nat ional l ibrary of Medicine (U S ) Programs and services Vols tor1977-78 issued as DHFW publication no ( N l l l )

78-256, etc , for 1979-80 as N l l l publicat ion no 80-256 etcVols for 1981-available from the National t e c h n i c a l Information Service

Springfield, VaISSN 0163-4569 = Nat ional 1ibrary of Medicine programs and services

1 Information Services - United Stales - periodicals 2 Libraries, Medical -United States - periodicals I T i t l e II Series D l l h W publ ica t ion no 80-256, etc

DISCRIMINATION PROHIBITED Under provisions of applicable public lawsenacted by Congress since 1964, no person in the United States shall, on the ground ofrace, color, nationalorigin, sex, or handicap, be excluded from participation in, be deniedthe benefits of, or be subjected to discrimination underany program or activity receivingFederal financial assistance. In addition, Executive Order 1 1 1 4 1 prohibits discrimina-tion on the basis of age by contractors and subcontractors in the performance of Federalcontracts Therefore, the National Library of Medicine must be operated in compliancewith these laws and executive order

Contents

Preface v

High Performance Computer and Communications Program 1Telemedicine 1Visible Human Project 2Internet Grateful Med 2Unified Medical Language System 3

Office of Health Information Programs Development 4NLM Long Range Plan 4International Programs 4Outreach 6

Library Operations 8Planning and Management 8Collection Development and Management 8Bibliographic Control 10Network Services 12Reference Services 13Document Delivery 14National Network of Libraries of Medicine 14Special Onsite Programs 15Customer Service Policy 16

Specialized Information Services 22TOXNET 22Databases Under ELHILL 23AIDS Services 24Other Programs 24

Lister Hill National Center for Biomedical Communications 26Computer Science Branch 26Communications Engineering Branch 29Cognitive Science Branch 34Audiovisual Program Development Branch 40

National Center for Biotechnology Information 43Database Building 43Database Access 44Basic Research 46User Support and Outreach 47Extramural Programs 47Biotechnology Information in the Future 47

Extramural Programs 48The Grant Programs 48Other Extramural Programs Activities 51Grant Review 51Divisional Operations 51Summary 52

111

Office of Computer and Communications Systems 53

Administration 57National Performance Review 57Financial Resources 57Personnel 58NLM Diversity Council 60Office of Equal Employment Opportunity 60

Index 74

NLM Organization Chart Inside back cover

Appendixes

1. Regional Medical Libraries 622. Board of Regents 633. Board of Scientific Counselors/LHC 644. Board of Scientific Counselors/NCBI 655. Biomedical Library Review Committee 666. Literature Selection Technical Review Committee 677. Extramural Programs Grants-FY 1996 68

Tables

Table 1. International MEDLARS Centers 7Table 2. Growth of Collections 17Table 3. Acquisition Statistics 17Table 4. Cataloging Statistics 18Table 5. Bibliographic Statistics 18Table 6. Circulation Statistics 18Table 7. Online Searches 19TableS. Off-line Searches 20Table 9. Reference Services 20Table 10. History of Medicine Activities 21Table 11. Extramural Grants and Contracts Program 52Table 12. Financial Resources and Allocations 58Table 13. Staff 60

IV

Preface

There were two signal events in Fiscal Year 1996 that led to an unusual amount of pressattention for the National Library of Medicine, the announcement in November 1995 of theVisible Human Female and the introduction ol the Internet Grateful Med in April 1996 (both inthe HPCC Chapter) A number of other accomplishments in FY 1996 are worth noting, however,including'

• Publishing two major reports—"Survey ol Online Customers" and "Outreach Activities ofthe National Library of Medicine: A Five-Year Review",

• Managing to keep MEDLINE operating during weeks of shutdown because of Federalfurloughs and bh//ards,

• Increasing to 140,000 the number of user codes for NLM's national online network,

• Introducing two new databases—SPACELINE, a space medicine database produced incooperation with the National Aeronautics and Space Administration, and HealthSTAR, amerging of two existing NLM databases into one file with 2.5 mil l ion records on health careadministration, planning, health services research, and clinical practice guidelines,

• Announcing a formal customer service policy that commits the Library to providing a highlevel of service to its customers (see page 16),

• Taking over from the Public Health Service two new programs: the PHS Historian's Officeand the bimonthly journal Public Health Reports;

• Awarding five-year contracts to eight insti tutions to serve as Regional Medical Libraries inthe National Network of Libraries of Medicine, and

• Three new Regents were appointed by the HHS Secretary in 1996 Ennqueta Bond, M.D.,Raymond J. Fonseca, D.M D , and John Gage. Steven J. Phillips, M.D., was electedChairman of the Board by his colleagues

For the success we continue to enjoy in meeting the information needs of healthprofessionals, I would l ike to thank the Library's hard-working staff, our friends andcollaborators in the National Network ol Libraries of Medicine, the experts who serve on theLibrary's various advisory Boards, and the American public who continue to support the Libraryand the National Institutesol Health with their tax dollars

Donald A. B. Lindberg, M.D.Director, NLM

HIGH PERFORMANCECOMPUTING ANDCOMMUNICATIONSPROGRAM

The High Performance Computing andCommunicalions in i t i a t ive is the rubric under whichIhc Library engages m several important technology-related programs Up un t i l January 1995, NLMdirector Donald A B. Lmdberg, M D , headed thecoordinating olfice for the HPCC multiagencyinitiative He had assumed that post m 1992 and heldit concurrently with his directorship ol the NLM InFY 1996 an Office ol High Perlormance Computingand Communications was created wi th in the ListerHil l Center Two ol thai Office's projccts-telemcdicme and Visible Human-arc described here,along with the Internet Gratclul Med and UMLS, twoprojects that cut across several NLM programs

Telemedicine

NLM's telemedicme program, coordinated bythe Lister Hil l Center's Office ol High PerlormanceComputing and Communications, is designed ( I ) toevaluate the impact ol (he National Informat ionInfrastructure (Ni l ) on health care, research, andpublic health, (2) to lest methods to preserve theprivacy of individual health data while also providingefficient access lor legitimate health care, research,and public health purposes, ,md (3) to assess theu t i l i t y of emerging health data standards m healthapplications ol advanced communications andcomputing technologies

NLM is the lead agency wi thin DHHS lor thegovernment's High Performance Computing andCommunications in i t i a t i ve and as such has a directinterest of the use and e f f e c t s of the Ni l on healthcare The growth of Ihc Ni l and the increasing accessto high-speed computers and communications byconsumers, health care providers, public healthprofessionals, and basic, c l in ica l , and health servicesresearchers is having a fundamenta l e lfecl on healthand human services throughout Ihe nation

Major research and evaluation issuesincluded in NLM's tclcmcdiune program arisingfrom the current and future impact of the Nil include( I ) the impact of telemedicme on the health caresystem as a whole and on cost, qual i ty , and access tocare lor specific populations, (2) the benefits ol

integrated access to practice guidelines, expertsystems, bibliographic databases, electronicpublications, and other knowledge-based informationfrom wi th in computer-based patient record systemsand other automated systems that support researchand practice, (3) the maintenance of patientconfidentiality as increasing amounts of electronichealth data arc transmitted via telecommunicationsduring health care and aggregated for importantpublic health and research purposes, and (4) thedevelopment of data standards and uniform practicesfor effective transmission, aggregation, andintegration ol health care, public health, and researchdata

The Library announced that it was funding 19telemedicme projects, affecting rural, inner-city, andsuburban areas, with a total budget of $42 millionThe 19 multi-year telemedicme projects, located in13 states and the District of Columbia, wi l l serve asmodels for. evaluating Ihc impact of telemedicme oncost, quality, and access to health care, assessingvarious approaches to ensuring Ihe confidentiality ofhealth data transmitted via electronic networks, andtesting emerging health data standards Each projectwil l review and apply recommendations Irom twoNational Academy of Sciences studies on criteria forevaluation of tclcmcdicmc and on best practices forensuring (he conf ident ia l i ty of electronic health dataNLM is the principal patron ol these studies

Telemedicme, is receiving increasingattention not only in remote areas where health careaccess is troublesome but also in urban and suburbanlocations Yet the benefits and costs of this blend olmedicine and digital technologies must be betterdemonstrated before today's cautious decision makersinvest significant f u n d s in its development NLMsponsored a study by the Institute ol Medicine (IOM)designed to develop a framework for evaluating thepatient care applications of tclcmcdicmcTelemeditine- A Guide to AlieningTelecommunu ation.s for Health Care identif iesmanagerial, technical, policy, legal, and humanfactors that must be taken into account in evaluating alelemcdicinc program The IOM appointed acommittee to review previous effor ts to establishevaluation frameworks and reports on results fromseveral completed studies of image transmission,consulting f rom remote locations, and otherleleincdicinc programs The committee alsoexamined basic elements of an evaluation andconsidered relevant issues of quality, accessibility,and cost ol health care

M Ackerman, Ph.D

Program* and Scrvues, FY

Visible Human Project

The Visible Human Project data sets arcdesigned to serve as a common rclcrcnce point forthe study ol human anatomy, as a sei ol commonpublic domain data lor testing medical imagingalgorithms, and as a test bed and model lor theconstruction of image libraries that can be accessedthrough networks. The Visible Human data sets arcbeing made available through a free licenseagreement with the NLM They are being distributedto licensees over the Internet at no cost, and on DATtape The data sets arc being applied to a wide rangeol educational, diagnostic, treatment planning, vir tualreality, artistic, mathematical and industrial uses byover 700 licensees in 26 countries The VisibleHuman Project has been featured in well over 800newspaper articles, news and science maga/mes, andradio and TV programs worldwide

NLM convened a public conference olVisible Human data sets license holders Theconference served as a lorum lor researchers anddevelopers to exchange information on theirapplications of the data sets and to share wi th NLMtheir successes and problems in using the data setsFilly papers were presented to over 250 attendees

The data sets are having their greatest cllecton health care and health education and thus benef i tthe general public The data sets are used as a normalreference and as an aid in the diagnostic processPrograms under development w i l l he used to educatepatients about the need for and purpose ol surgeryand other medical procedures as well as to penniiphysicians to plan surgery and radiation therapy. Theimages from the Visible Human data sets are used inseveral prototype virtual reality surgical simulators.Educational materials that make use ol the VisibleHuman data sets are beginning to be used by studentsfrom kindergarten to practicing health careprofessionals.

The data sets arc being used to form the basisof interactive games to entertain as well as toeducate Automobile manufacturers now includepassenger injury models based on Visible Humandata to their vehicle crash simulat ion models.Engineers and physicists arc creating models toquantify human exposures to various forms ofelectromagnetic radiation The data provided by theVisible Human data sets are being used bymathematicians as an application for what werepreviously only theoretical mapping theories Severalartists are using the data set as the basis lor newmulti-media art lorms

Phase two ol the Visible Human Project is toturn the data sets into an interactive digital imagelibrary As a pilot project, each object in each cioss-

scction ol the thorax is being idcntilied and labeledThe relationship of each object to the other objects inits cross-section and in the adjacent cross-sections isbeing cataloged. The extent of a single object whichspans several cross-sections must be noted In orderto accomplish this, information about buildinggeographic databases and databases associated withcomputer-aided draf t ing systems are being used asstarting points for development of this uniqueinteractive anatomical digital atlas

M Ackermun, Ph I)

Internet Grateful Med

The National Library of Medicine launched theInternet Grateful Mcd on April 16, 1996, at aconference on health-care applications of theinformation superhighway sponsored by the Friendsof the National Libraiy of Medicine The introductionol IGM was made by NLM Director Donald A BLindbcrg, M.D., Michael E DcBakey, M.D. (amember ol the NLM Board ol Regents), and SenatorBil l Frist (R-TN), a physician

The new system, which is the f i r s t major productof the NLM Reinvention In i t ia t ive , allows anyonewith access to the World Wide Web to search theMEDLINE database of 8 mil l ion journal articlereferences and abstracts It improves considerably onthe existing versions of Grateful Mcd (used primarilywith dial-up telephone networks) by affording muchgreater f lex ib i l i ty in using medical vocabulary(including terms from (he UMLS Metathcsaurus) andthe easy use of l imi t ing factors such as language, agegroup, and year of publication The Internet GratefulMcd allows users to sign up online and, because theInternet is global in nature, even health professionalsin other countries can |om the network

The system has extensive context-sensitiveonline help that can be displayed from nearly everypoint in the program. There is also a 20-slidehypertext introduction and system overview A 25-scgmcnt hypertext "New User's Survival Guide"leads the user step by step through a scries of actionsand searches that demonstrate the capabilities olInternet Gratelul Med An unusual "Analy/c Search"function oilers related terms from among manythousands of cross references

The instant appeal ol Internet Grateful Medresulted in a dramatic increase in the number otpersons using the Library's online network, andonline computer usage statistics arc repeatedly h i t t ingall-time highs The system received another boost inpopularity when Ann Landers printed a letter f romDr Michael E DcBakey praising the new systemThe Internet Gratelul Med was improved later in FY1996 by adding NLM's AIDS and health services

Hi%h Performance Computer and Communuatioii'i Program*

research duiubascs (including access lo clinicalpractice guidelines) to its searching capabilities, alsoadded was a direct link to the 60,000 Images from theHistory of Medicine More databases will be added inthe future

R Mehnert

Unified Medical Language System

The goal of the UMLS program is to helphealth professionals and researchers to retrieve andintegrate biomedical informat ion emanating Irom avariety ol electronic sources, including computer-based patient records, bibliographic databases, (actualdatabases, and expert systems To do this, it mustovercome obstacles ol language (various informationsources use various vocabularies), disparate searchprocedures, and wide distr ibution ol computer-basedinformation across the electronic landscape TheUMLS seeks to build "knowledge sources" that maybe used to develop interlaces by those creatingmedical information systems These knowledgesources map concepts and terms Irom many di f fe rentbiomedical vocabularies and classifications and alsoprovide machme-processablc descriptions ol thecontents ot health-related databases

FY 1996 marked the I Oth anniversary ol theUMLS project, which is directed by a mul t i -disciplinary team of NLM stall and involves medicalinformatics research groups across the United Slatesworking under competitively awarded contracts andgrants More than 700 UMLS users worldwidereceive annual editions ot the UMLS KnowledgeSources

Several improvements in distribution ol theUMLS Knowledge Sources occurred in 1996 Therelease dale was moved to early in the calendar yearto allow UMLS applications (hat use ihc MeSHterminology to have access (o the most cuirentedition A new Web-based front-end lo the UMLSKnowledge Source Server provides easy cross-

platform access lo the UMLS Knowledge Sources viathe Internet As a result, NLM ceased distribution olseparate Macintosh and DOS browser applicationslor the UMLS Mctathcsaurus

NLM continued to make major additions tothe Mctathesaurus, a database of concepts and termsfrom more than 30 vocabularies and classificationsThe 1996 edition incorporates additional sections olSNOMED International, more cancer terminologyIrom PDQ, and the German translation of McSHproduced by the International MEDLARS Center inthat country Through the collaboration ol severalInternational MEDLARS Centers, the Melathesaurusnow has MeSH terminology in English, French,German, Portuguese, and Spanish.

Users in commercial companies,universities, hospitals, libraries, and other researchinst i tut ions are applying the UMLS KnowledgeSources to a variety of mlormalion problems,including creation ol compute)-based patient records,l inking patient records lo related information inclinical practice guidelines and bibliographicdatabases, Web information retrieval, and naturallanguage processing NLM itself uses the UMLSMetathesaurus in the Internet Grateful Med interfaceto MEDLARS databases and in natural languageprocessing, indexing, and retrieval research

In FY 1996, NLM began a large-scalenational lest to determine the extent to which the1996 Mctathcsaurus and several planned additions toit cover the concepts and terms needed in U S healthdata applications. The test, which is co-sponsored bythe Agency for Health Care Policy and Research,uses a special Web-based interface to the UMLSKnowledge Source Server lo allow participation bygroups across the country The results, which wil l beavailable in 1997, wi l l assist NLM in sellingpriorities for UMLS development and should also behe lp fu l in developing appropriate strategics formoving toward a standard sel of vocabularies forU S. health data

H L Humphreys

OFFICE OF HEALTHINFORMATIONPROGRAMSDEVELOPMENTElliot R Siegel, Ph. I)

Director

Long Range Plan

In January 1985, NLM's Board ol Regentsundertook to develop a Long Range Plan to guide theLibrary in using its human, physical, and financialresources to fu l f i l l its mission This culminated in theadoption of a Plan by the Board of Regentscontaining goals, recommendations, and resourcerequirements, published in 1987. NLM continuallyexpands and updates the Plan, recent planning reportsprepared as supplements to the 1987 Plan containrecommendations on outreach to health professionals(1989), electronic imaging (1990), informationservices for toxicology and environmental health(1992), and the education and training of healthscience librarians (1995). The current planning effortis focusing on NLM's international programs

The Long Range Plan is integral to the dayto day management ol the Library Over the pasi 10years, NLM has successfully integrated its budgetand planning processes, so that the budget is "driven"by the Long Range Plan New init iat ives arcpresented in terms ol the Plan, and progress towardachievement ol recommendations is tracked Thisgives NLM a rational process for setting goals andobjectives and measuring program performance thatis built into the fabric ol Us management processes.

Planning Panel on International Program*

The NLM's International Piograms ,11 eintegral to the Library's responsibilities in biomcdicalinformation transfer. The U S. health communitydepends on NLM's information retrieval system toidentify the relevant information from the world'sbiomcdical literature and, in turn, the world healthcommunity shares the benefi ts of NLM's advancedinformation systems in meeting Us own lequiremenlsfor needed information

The Board of Regents approved theformation of a Long Range Planning Panel forNLM's international programs The purpose of thepanel is to advise NLM on the relative priority ol itsinternational activities and responsibilities, and toassist in the development ol appropriate strategies

consistent with the Library's statutory mission andavailability of resources It is expected that the panelwill meet three times in 1996-7, and will present itsfinal report to the Board for approval and inclusion inthe NLM Long Range Plan

Dr. Donald S Frednckson, former NIHDirector, has accepted the chairmanship of this panelDr. Frcdnckson is a distinguished physician andscientist who has been President of the Institute olMedicine and President and Chief Executive Officerol the Howard Hughes Medical Insti tute, amongmany other accomplishments and honors

The panel has 24 regular members and it isbeing advised by a number ol consultants in areassuch as health sciences librananship, electronicpublishing, and telecommunicationsThe Panel is being asked to tie Us considerations tothe following frame ol issues• What work ought NLM do overseas or with

other countries1'• Should NLM locus Us efforts on particular

countries or regions'• Should NLM locus its e f f o r t s on particular types

ol biomcdical information1'• Arc there particular communication methods or

strategics that should receive special attention''We seek to emerge at the end of three

meetings with useful maps to guide the Board olRegents in constructing its blueprints for the futureinternational roles of the Library

International Programs

While we plan lor the fu tu re of the NLMInternational Programs, activit ies continue in thepresent In FY 1996, NLM marked another year ofactivities with individual countries, internationalgovernment orgam/ations such as the World HealthOrgam/ation (WHO) and the Pan American HealthOrgam/ation (PAHO), and internationalnongovernmental orgam/adons such as theInternational Council lor Sc ien t i f i c and TechnicalInformat ion (ICSTI) NLM international activitiesalso included training loi colleagues I rum abroad, theNLM publication exchange program with 168libraries in 58 countries, and receiving numerousprofessional visitors f rom abroad

Country-io-Countr\Agreement',

ami Htlatcral

International MEDLARS CentersTo assist international health professionals

in accessing NLM Ml-.DLARS data bases, NLM hassigned Memoranda ol Understanding with partners in

Office of Health Information Program* Development

18 foreign countries und with two internationalorganisations (Table 1)

Twenty-seven representatives from 17 ofthese International MEDLARS Centers attended the1996 International MEDLARS Policy AdvisoryGroup at the NLM March 26-27, 1996 Technicalprograms on NLM System Reinvention,biotechnology information activities. InternetGrateful Med, and a demonstration of the VisibleHuman were presented to the group Issue panels onUnified Medical Language System and MeSHtranslations, regional medical bibliographies,outreach initiatives, access to Internet Grateful Medand the Internet, document delivery, and tclcmcdicineapplications provided important information to thegroup on NLM activities As Chair ol the LongRange Planning Panel on International Programs(LRP-IP), Dr Donald S Frednckson, NLM Scholarin Residence, NIH Director Emeritus, asked foradvice from IMPAG concerning what should NLMbe doing internationally in the next S to 10 years, andwhat contributions is NLM in a position to make tothe world's health The input received Irom theIMPAG provides important issues for considerationby the Long Range Planning Panel on InternationalPrograms (sec above)

Hong Kong

The signing ol a Memorandum olUnderstanding between the Chinese University olHong Kong (CUHK) and the National Library olMedicine (NLM) on March 26, 1996, designatedHong Kong as the 20lh International MEDLARSCenter The CUHK has already demonstratedsuccessfully from many hospitals, doctors' olliccs,and libraries how to use Grateful Med and theInternet to search NLM MEDLARS databases. TheHong Kong center wil l be the second foreign centerto access NLM's databases exclusively over theInternet using the Grateful Med software.

Israel

In an effort to provide foreign users withcost-savings and conveniences associated with apredictable charge for searching NLM's database, anexperimental arrangement has been undeitaken withthe Israel MEDLARS Center to purchase a block ofcodes and to market these among current andprospective individual users in the region with accessto the Internet. (The Egyptian MEDLARS Center hasbeen offered a similar opportunity.) The intent is togam needed international experience with theeconomics and dynamics of such competitive pricing

schemes that are proving to be very popular in theUS.

Newly Independent States

The NLM, with assistance from the U.S.Department of State, is helping medical scientist ofseveral newly independent stales of the former SovietUnion with access to biomcdical information. Themedical libraries of Belarus, Ukraine, Ka/akhslan,Krgygstan, U/bekistan, Lithuania, Latvia, andEstonia are being provided online access to NLM'sbiomedical databases as well as journal subscriptionsand intcrhbrary loans. By 1995, all libraries wereable to search NLM databases and to communicatewith colleagues at NLM and other participatinglibraries via e-mail

In 1996, an experiment in upgradingtelecommunications infrastructure was completed inLithuania that enabled both the Vilnius UniversityMedical Faculty and the Lithuanian National MedicalLibrary to use Internet services other than e-mail.Additional codes for MEDLARS access were givento branch medical libraries and researchers in certaincountries receiving U S support for collaborativeresearch projects. Every library has been conductingregular MEDLARS searches using the hardware andsoftware provided, with one exception, and journalshave been flowing to the central Asian republics fromthe American Association for the Advancement ofScience. Intcrhbrary loans have been moreproblematic and uneven, and the volume hasdepended on each country's infrastructure andestablished lines of communication with itscollaborating library in the U S. Additional journalsubscriptions arc being provided to supplementmterlibrary loans where appropriate Equipmentupgrades are being explored in cases where theremay be sufficient infrastructure to support them

Activities with International Organization*

PAHO

The Pan American Health Orgam/ation hasbeen an important collaborator with the NLM. In1988, Dr. Carlos Gamboa, working with colleaguesat the University ol Chile's School of Medicine,successfully devised BITNIS as a means to conductMEDLINE searches over high-speed computernetworks using Grateful Med. BITNIS is a gatewaysystem that imbeds a MEDLINE search within an e-mail packet envelope, thereby providing aninexpensive and fast search service in regions ol theworld where the cost of access by traditional

1'iograiiis and Servu es, FY

communications sysicins would he prohibit ive lormost health professionals During 19%, searcheswere performed Irom more than 40 countries, but thegoal remains one of migrating these users over tosysicms such as Internet Graiclul Med when ful lInternet capabilities arc in place

WHO

The National Library ol Medicine and theWorld Health Orgam/auon continue (heircooperative ef for t in the publication ol the Quartol\Hibliofiraphy of Majoi Tropual Diseases and theBibliography oj A(uie Diarrhoeal Diseases NLMprepares camera-ready copy Irom the MEDL1NEsystem, and WHO prints and distributes these tothousands of insti tutions in the developing countries

International Coumil for Stientiju and TechnicalInformation

Working with ICSTI, NLM is leading thedevelopment of a demonstration project intended toreduce existing technological and land barriers u> theHow of scientific and health-related in format ion overthe Internet lo developing regions ol the worldFocused in i t ia l ly in the eastern Cuibbean, theNLM/ICSTI effort will be carried out in conjunct ionwith a number of other international orgam/alions,including UNESCO, PAHO, the InternationalTelecommunications Union, and the United NationsDevelopment Programmes

International Meetings and Visitors

The Library continues to he a local point forvisitors ol the international community from a varietyol disciplines Many ol these visi tors iiie responsiblelor medical, sc ient i f ic or technical informat ion intheir own countries Visitors are o f f i c i a l l y leceivedand briefed on relevant aspects of NLM operationsand research. Among the visitors in 19% wererepresentatives from the fo l lowing countries

Argentina, Australia, Belarus, Bra:il. Bulgana,Canada, China. Czech Republic, Egypt, Ecuadoi,Estonia, France. Georgia, Gcnnan\, Hong Kong,Israel, Japan, Korea, iMtvia, Lithuania, Me\uo,Netherlands, Poland, Romania. Russia, South Afrit a.Sweden, Switzerland, Singapoie, Slovakia, Slovenia,Spain, Taiwan, Thailand, llkiaine. United Kingdom,Uruguay

Outreach

In the late f a l l ol 1995, NLM conducted arandom sample survey ol 2,500 online customersThe purpose of the survey was lo assess theavailabili ty ol end-user technology capable ofsupporting a transition from Gratefu l Med to newforms ol access and letneval , in particular InternetGralelul Med which was under development at thelime. The survey results indicated that about 70percent of the NLM's customers already had accessto the Internet, although the majori ty ol theseInternet-capable users were not accessing NLMdatabases via the Intemet In addition, according tothe survey results, Internet access is uneven,especially in rural areas and at hospitals More than athird of the rural useis and almost half of users athospitals reported that they did not have access to theInternet Similarly, about hall of users at rurallibraries did not have Internet access These resultsremlorce the need loi cont inuing special outreachefforts directed at improving access lor rural andhospital-based users and rural libraries

In FY 1996, NLM published the f i r s tcomprehensive and detailed assessment of (heoutreach e f f o r t s undciiakcn m collaboration with theeight regional medical libranes and the more than4,500 members ol the National Network ol Librariesol Medicine Published as a special supplement to theApril 1996 issue ol (he Bulletin o/ the MedualLibrary Association, (he icport highlights the priorityand importance ol outreach across all of NLM'sprograms

A newly developed outreach project is beingundertaken by the Regional Medical Library at theUniversity ol Washington The ellort is directedtoward belter understanding how to build sustainableand workable means loi Native American health careprovideis (and. by extension, other underservedcommunities) to access NLM and other biomedicalinformation resources A primary goal is to developmodels of the luc i l i lu to is lor and barriers to clfecliveaccess Model components may include geographicarea served, technologies, mtcgiaied infras t ructure ,extent ol use ol computeii/ed biomedical databases,t ra ining needs, ins t i tu t iona l participants,cultural/language lailois, and local leadership(actors The models may also provide the Irameworksfor evaluat ing progress toward sustainable andworkable access

Office of Health Information Programs Development

Table 1International MEDLARS Centers

COUNTRY CENTER

AUSTRALIA National Library of AustraliaCANADA Canada Institute for Scientific & Technical Information (CISTI)CHINA Institute of Medical Information, Chinese Academy of Medical

Sciences (CAMS)EGYPT Egyptian National Scientific & Technical Information Network,

(EINSTINET)FRANCE Institut National de la Sante et de la Recherche Medicale (INSERM)GERMANY Deutsches Institute for Medical Documentation and Information

(DIMDI)HONG KONG The Chinese University of Hong Kong (CUHK)INDIA National Informatics Center Planning CommissionISRAEL Hebrew University, Hadassah Medical School, Berman National

Medical LibraryITALY Ministry of Health, Istituto Superioredi SanitaJAPAN Japan Science and Technology Corporation (JST)KOREA Medical Library, Seoul National University, College of MedicineKUWAIT Ministry of Public Health, Kuwait Institute for Medical Specialization

(KIMS)MEXICO Centre Nacional de Informacion y Documentacion sobre Salud

(CENIDS)SOUTH AFRICA South African Medical Research CouncilSWEDEN Medical Information Center, Karolinska InstituteSWITZERLAND Documentation Service (DOKDI) of the Swiss Academy of Medical

Sciences (SAMS)UNITED KINGDOM The British Library*PAN AMERICAN HEALTH ORG Centra Latino Americano e de Caribe, Bibliotec Regional de Medicina

(BIREME)/PAHO*TAIWAN Science and Technology Information Center

*International/Intergovernmental Organizations

LIBRARY OPERATIONSLois Ann ColaianniAssociate Director

Library Operations (LO) provides the coreNLM services that improve access to hiomedical andhealth care information for health professionals andresearchers around the world The largest of NLM'sDivisions, LO acquires and preserves the biometlicalliterature, develops and maintains a biomcdicalthesaurus and a classification that arc widely used toorgan i/.c biomcdical information, indexes andcatalogs the materials acquired by the Library usingthis thesaurus and classification; distributes Nl.M'sauthoritative indexing and cataloging records online,in machine-readable form, and in publications,provides document delivery, reference, and researchassistance as a back-up to services available Iromother U S health sciences libraries, and coordinatesthe National Network of Libraries ol Medicine(NN/LM) which provides primary informationservices to U.S health prolessionals and researchers

The multidisciplmary LO staff alsomaintains an active research program in the history olmedicine, conducts research and evaluation related toLO programs and services, and directs or contributesactively to many NLM-wide ini t ia t ives LO's basicservices lonn the essential foundation lor Nl.M'sOutreach Program and lor NLM's biotechnology,AIDS, and health services research informationprograms

Planning and Management

Minimi/ ing the combined effects ol pait ialGovernment shut-downs, snow days, and theextended suspension of the MEDLINE data entrycontract became an important management challengeduring the past year Most FY 1996 LO productionand service figures are not comparable to those olprevious years due to these unusual disruptions Toreduce the Library's dependence on keyhoardmg as adata entry mechanism, LO is collaborating with otherNLM components to establish a robust OCR (opticalcharacter recognition) input stream for MEDLINEdata and to obtain electronic citation and abstract datadirect Irom publishers. Additional information aboutthese efforts appears in this and other chapters of thereport.

The NLM System Reinvention project,which is designed to replace the Library's outmodedlegacy systems with more flexible and maintainablesoftware that wil l help users and staff members do

their work more ef f ic ien t ly , continued to be a majorpriority. LO staff members assisted with final testingand release of Internet Grateful Mcd and final testingof Grateful Med for Windows and also testedpotential replacements lor NLM's underlyingretrieval system, ELHILL LO and OCCS selected acommercial integrated library system (ILS) that wi l lbe adapted to support many ol NLM's basic libraryfunctions and purchased Relais, a product originallydeveloped for the Canadian Institute of Scientific andTechnical Information, that wi l l be used to automateinternal operations related to the Library's documentdelivery service.

LO also continued work on re-engineeringits customer service activities A new NLM customerservice policy was announced and released on theLibrary's Web site in early 1996 To obtain a moreaccurate picture ol current customer service traffic,LO directed a projcu to collect and analy/e allcustomer inquiries leceived at service pointsthroughout NLM during a one-week period inDecember 1995 The data indicated that 92% ofcustomer inquiries were handled by the combinationol the Online Service Desk, the Reference Section,the Collection Access Section, and the NationalCenter for Biotechnology Information and that 84%of the customer transactions took 5 minutes or lessTo facilitate a more coordinated approach to handlingcustomer service inquiries and obtaining customerfeedback. LO has obtained the CustomerQ,commercial customer service support software, andthe Teloqucnt automated call distribution system

Like others engaged in orgam/mg andproviding access to biomedical information, LO isexamining how to manage the challenges andopportunities offered by the rapidly growing numberof electronic in fo rma t ion sources Specific projectsarc described elsewhere in this chapter

Collection Development and Management

Collection development entails establishingand updating selection policy, acquiring andprocessing relevant li terature in all formats andlanguages, and preserving the materials acquired Asof September 30, 1996, NLM owned 2,181,783printed books, journal volumes, theses, andpamphlets and 3,004,029 nonprmt items, includingaudiovisuals, computer software, microforms, prints,photographs, and manuscripts (Table 2)

Selection

LO staff members and their agents selectliterature lor the NLM collection based on guidelinespublished in the Colk'i non Development Manual of

Library Operation*

the National Library oj Medicine, which is revisedevery 5-7 years In between major revisions, LOdevelops more specific operational criteria for typesof material that are presenting selection challengesand for emerging subject areas In FY 1996, LOimplemented more detailed coverage guidelines forsome types of serials and audiovisuals. With theassistance of Lucretia W McClure, Librarian cmeritaof the University of Rochester Medical Center,coverage guidelines for annual reports, countymedical society bulletins, and state journals wereexamined, and recommendations developed for asystematic review of this material. Testing began oldraft criteria for selecting the electronic informationsources that will be described in NLM's databases,including AVLINE, DIRLINB, and the UMLSInlormation Sources Map NLM joined with theLibrary of Congress and the National AgriculturalLibrary to revise the |oml NLM/NAL/LC collectingstatement for human nutrition and made the jointcollecting statement lor veterinary medicine availableon NLM's Web site The national libraries issue jointstatements to clarify their collecting responsibilitiesin subject areas that arc partially covered by each ofthem.

LO conducts periodic collection assessmentstudies to determine how successfully it is applyingNLM collection guidelines In FY 1996, currentserial titles in sociology, social work, and counselingwere reviewed, and some subscriptions werecancelled as a result.

Acquisitions

In FY 1996, LO received and processed174,992 modern books, serial issues, audiovisuals,and software packages (Table 3) The Library'scollection grew by 37,553 volumes and 39,304 otheritems (e.g., audiovisuals, microforms, software,pictures, manuscripts) Among other interestinghistorical acquisitions, NLM acquired a number ofrare 16th century books including. l)i\.\ettumisVenarum Artiarumque Commennarium (Paris, 1526),the first separate editions ol Galen's treatises on thedissection of veins and arteries, nerves, and musclestranslated by Antomus Fortobus, Pierre Tolct'sFrench translation ol Galen's treatise on blood-letting,De la Raison de Cvrer per Euaiuation de Sang(Pans, 1584), Paedotrophiae (Pans, 1584), a firstedition of Scevolc dc Samlc-Marie's poem on thecare and feeding ol children. Joannes Gilmus' la.Antiquar. Arx Erat hie Quondam Domux Ext uhi &Hoxpita Virgo qua (Milan, 1508), a f i r s t edition ofwhat is probably the first printed book on hospitalhistory and management, about the 15th centuryOspedale Maggiore of Milan, a first edition of

Nicolas Monardcs' work on blood-letting, DeSecanda Vena Impleuriti inter Greco* et Arabex(Seville, 1539); and a first edition of Paracelsus' DeNatura Rerum IX Bucher. The Library alsoobtained several manuscripts of physicians whopracticed in America in the late 18th and early 19thcenturies the account book of a Revolutionary Warphysician, Joseph Fiskc, Jr. of Lexington,Massachusetts (1784-98, 1803); the two-volumemedical daybook of Nathaniel Swif t , a countrypractitioner in rural Massachusetts in the aftermath ofthe War of 1812, and the journal of an anonymousphysician working in the Adirondacks from 1827-33.William H. Hclfand continued his generosity to NLMby donating 149 historical postcards of hospitals anda collection of pharmaceutical handbooks, catalogs,and therapeutic manuals which provide excellentsource material for the study of late 19ih and early20th century medical practice and the development ofthe pharmaceutical industry

As a cost-saving measure, the Librarycanceled additional second copy subscriptions forjournals indexed in MEDLINE that arc not heavilyrequested by onsitc and oflsitc users. Effor ts toimprove acquisition channels for material fromEastern Europe and the former Soviet Republicsbegan to bear fruit. The automated system used tocreate and edit literature invoice records wasenhanced to improve the accuracy ol invoice dataOther improvements to existing automatedprocessing systems were held to a minimum as staffmembers worked on the procurement of thecommercial integrated library system that will serveas the platform for replacing existing legacy systems

Preservation and Collection Managemeni

Preservation and collection managementcover all activities that extend the life of NLM'sarchival collection of biomcdical literature and keepthat collection in good order. These activities include-binding incoming journal issues, microfilming brittlevolumes, providing conservation treatment for rareand unique items, maintaining appropriate storageprocedures, facilities, and conditions for all segmentsof the collection, and preventing and responding toemergencies that threaten library materials. NLMalso distributes preservation information to assistother libraries, explores the use of new technology topreserve library materials, and promotes the use ofmore permanent media in new biomedicalpublications. In May 1996, NLM's National Programfor the Preservation of the Biomedical Literaturereceived the Louise Darling Medal for DistinguishedAchievement in Collection Development m theHealth Sciences from the Medical Library

Program* and Services, h Y

AssociationIn FY 1996, LO hound 18,308 volumes,

microfilmed I 2 million brittle pages, and gaveconservation treatment to 250 items in the specialhistorical collections Substantial progress was madeon the project to ensure that there is archival qualitymicrofilm lor all brittle non-U S Index Medicustitles (The U.S titles were completed in FY 1995 ) Anew PC-based automated system manages and tracksmicrofilming production operations, since thesefunctions cannot be quickly addressed by the newILS software NLM will procure as part ol SyslcmReinvention

Much of the planned work to establish anonsite f a c i l i t y for minor hook repairs was completedThe revision ol the Disaster Recovery Plan is alsoproceeding A study of collection storage space needsshowed that, at current growth projections, NLM willhave space for its collection through the year 2014Since the rate of conversion to electronic publicationremains d i f f i cu l t to predict, the Library wi l l re-exammc its space needs in 2000.

In FY 1996, LO began distributingpreservation data in MARC lormat, thus greatlyenhancing access to information about what NLMhas preserved The Preservation Section alsoestablished a home page on NLM's Weh site loimprove dissemination ol preservation informat ion tohealth sciences libraries

Bibliographic Control

To help health professionals and researchersto iden t i fy relevant information w i t h i n (he world'sbiomedical literature, NLM develops the MedicalSubject Headings (MeSH) thesaurus lor use inindexing, cataloging, and online searching, l inks (histhesaurus to other biomedical vocabularies in theUnified Medical Language System (UMLS)Mctathesaurus, maintains the NLM Cla.\\ifuatwn lorsubject arrangement of books on library shelves; andproduces authoritative cataloging and indexingrecords for newly published or acquired books, seriallilies, audiovisuals, computer software, manuscripts,and journal articles

Thesaurus

The 1997 MeSH contains 18,531 mamsubject headings, 787 subheadings or qualifiers, 83publication types, and about 91,000 supplementaryrecords for chemicals and other substances. For 1997,LO s ta f f added 349 new mam headings, replaced 71mam headings with more current terminology, andcreated 1,019 new cross-references There werespecial efforts to improve terminology lor viruses and

virus diseases, dentistry, space medicine, and thehistory of medicine The enhancements to dentalterminology were based on recommendationsprepared by Dr. Colette Hochsicm, then an NLMAssociate, who analy/ed terms in vocabulariesprovided by the American Dental AssociationThirty-five new publication types and 15 newgeographic subheadings were established lor 1997 aspart ol a broader project to eliminate differences inthe use of MeSH in NLM cataloging and indexingThe goal ol this project is to remove barriers to effectcross-file retrieval by NLM's users

The MeSH Section manages the editing olthe content of the UMLS Mclathesaurus, which isreleased annually in January In FY 1996, most of theediting for the 1997 Melathesaurus was completedMore than 80,000 concepts and 124,000 terms wil l beadded to the Metalhcsaurus lor 1997, including theremainder of SNOMED International, the AmericanMedical Association's Current ProceduralTerminology (CPT), U>gnul Observations IdentifiersNames and Codes (LOINC), and about one third ofthe Read Thesaurus, which is used by the NationalHealth Service in (he United Kingdom. Theseadditions wil l improve the Metalhesaurus's alreadyconsiderable u t i l i ty as a source of controlledvocabulary for clinical in format ion systems and wil limprove the abili ty ol Internet Grateful Med andother search interfaces to map users' clinicalterminology to MeSH terms for better MEDLINEretrieval.

OCCS staff have begun development of anew MeSH maintenance system that will be built on(he Oracle relational database management softwarethat wi l l also underlie NLM's new integrated librarysystem The new MeSH system w i l l be based on afundamental data model (hat is similar to that of theUMLS Mctathesaurus to facil i tate an eventualintegration of the systems used to build and maintainMeSH and the Mctalhesaurus

The LO stall catalogs the literature acquiredby the Library both to alert users to what is availablefrom NLM and to provide cataloging records that canbe used by other libraiies, thus reducing the level ofe f f o r t required to orgam/e and manage librarycollections throughout the world Many healthsciences libraries also use MeSH and the NationalLibrary of Medicine Classification to catalogmaterials ol local interest lor which no NLMcataloging record is produced

In FY 1996, the Technical Services Divisioncataloged 20,365 modern books, serials, nonprmtitems, and cataloging-m-puhlicaiion (CIP) galleys,

10

Library Operaiions

using a combination ot m-house stall, contractors, unmicragency agreement with the Library ol Congress,and assistance Irom the International MEiDLARSCenter in China. There was a net reduction ol 1,663in the working inventory of uncataloged modernbooks. Samples of a range ol' electronic informationsources were cataloged as part of a project to developNLM policy lor bibliographic control of thesematerials The History of Medicine Divisioncataloged 351 rare books and began applying McSHheadings to pre-1801 works. Previously these itemsdid not receive subject cataloging

Images from the History of Medicine, theWeb-based image database and associated catalog forNLM's historical prints and photographs collection, isbeing moved from the prototype system developed inthe Lister Hi l l Center to a new production systembased on the integrated library system software that islikely to be a key part ol the NLM SystemReinvention project The new environment wi l lfaci l i ta te upgrading ol the picture catalog records, aswell as user access to the image database

Significant improvements in the distributionof NLM's machine-readable cataloging records aredescribed in the Network Services section of thischapter

Indexing

LO indexes more than 3,800 biomedicaljournals to help health professionals and researchersidentify articles on specilic topics, using acombination ol in-house staff, commercialcontractors, international MEDLARS centers, andcooperating organ i/at ions LO also annotates usindexed citations when previously indexed articlesare retracted, corrected, or challenged insubsequently published notices or commentaries LOstall' members assist the National Center forBiotechnology Informat ion (see NCB1chapter) byindexing gene sequences and editing author sequencesubmissions for incorporation into GenBank

The Literature Selection Technical ReviewCommittee (LSTRC- see Appendix 6 for members),an NIH-charlered committee, advises NLM about thejournals that should be indexed in MHDLINE, IndexMedicu.\, and other NLM databases In FY 1996, theLSTRC reviewed 395 journal titles and rated 77sufficiently highly for them to be added toMEDLINE. The LSTRC reviewed recommendationson journal coverage from professional societies in thefields of obstetrics and gynctology, psychiatry, thebehavioral sciences, and hematology and alsoconsidered the results ol a special review of journalsin the Chinese language As a lesult ol these reviews,

the LSTRC advised NLM to index 38 additionaljournals and to discontinue indexing 29 journals inthese areas

In FY 1996, NLM added 336,000 citationsto MEDLINE, an 18% decrease from FY 1995 due tothe impact of a two-month suspension of a newlyawarded data entry contract. The contract awardmade in January 1996 was protested by anunsuccessful bidder, and the Government ServicesAdministration eventually instructed NLM to reopenthe negotiations with both the winner and theprotestor in the competitive range. Both firmssubmitted revised proposals, and the second technicalreview yielded the same result as the first.

To mmimi/e the immediate impact of thesuspension, s tal l members throughout NLMvolunteered their services as emergency keyboardersand proofreaders, work began on a parallel OCRinput stream that wil l be developed into a productionoperation as insurance against f u tu r e disruptions tothe data entry operation, the exist ing project to obtainmachine-readable citation and abstract data frompublishers was accelerated, and, as soon as legallyable to do so, the Library purchased short-term dataentry and keyboarding support from a range ofoutside sources. The Index Section handled the largeand complex task of coordinating input from all thesesources and ensuring that contract indexers continuedto receive an adequate volume ol work The backlogthat developed during the suspension and itsaftermath should be cleared by early calendar 1997

LO, the Office of the Director, the ListerHil l Center, and the Off ice of Computer andCommunications Systems cooperated to establish abasic OCD (optical character recognition) operationat the Library that can be used to input abstractsAdditional research and development will continue inFY 1997 to produce software thai more correctlyinterprets the Greek letters, other special characters,and formulas that appear frequently in the journalsNLM indexes In an efloi l coordinated by theNational Center for Biotechnology Information (seeNCBI chapter), NLM received 3,816 usableelectronic citations and abstracts from publishers inFY 1996. The volume ol data received via thismechanism is expected to increase gradually over thenext several years

LO stall' membeis are directing orcontributing to several subprojects in the NextGeneration Indexing project, which wil l examinewhether more intensive use of automation canproduce comparable retrieval performance whilereducing the time and human resources needed toindex articles The Lister H i l l Center is directing thisNLM-wide e f f o r t

Programs and Servu c.s, FY 1996

Network Services

To improve access to current biomcclicalinformation, NLM disseminates its indexing undcataloging data online, in machine-readable formats,and in publications, answers requests lor referenceand research assistance from onsitc and remote users,delivers documents from the NLM collection as aback-up to services available from other libraries andsuppliers, and coordinates the National Network olLibraries ol Medicine (NN/LM) to cquali/e healthprofessionals' access to information irrespective oltheir geographic locations The goal of NLM'sOutreach Program is to l ink every U S healthprofessional to these services

Online Servu e.\

NLM's online users conducted about 7 4million searches in FY 1996 (Table 7) This figuredoes not include searches performed on the computersystems and CD-ROM products of the manyorgam/ations that lease data from NLM and probablyrepresents less than half of the total online use ol theLibrary's databases

At the end of FY 1996, 139,257 individualsand institutions held codes for searching the onlinedatabases available on NLM's systems, an increase ofabout 25,000 or 21% from FY 1995 Many new userslook advantage of a new online registration system,and the number of code applications submitted onpaper forms declined sharply Individuals Iromoutside the United Stales may now access NLM'ssystem directly, without applying through anInternational MEDLARS Center, i f they registeronline, use Internet Grateful Med, and pay via creditcard. Increasing numbers of U S users obtain onlineaccess through fixed-fee arrangements negotiated bytheir employing institutions There are 38 sucharrangements covering 200 different sites

Most of NLM's online users search via oneol the several versions ol Graielul Med, including (henew Internet Grateful Med thai was released in April1996 Any code holder wilh an appropriate WorldWide Web browser can point to NLM's Web sue anduse Internet Grateful Med, which employs the UMLSMctathcsaurus lo help users construct moresuccessful search strategies A new version olGrateful Mod for Windows was f u l l y tested in FY1996 and will be released in early FY 1997 Theresults of the FY 1996 survey of NLM's online users(see chapter on Health Information ProgramsDevelopment) indicate that the majority of theseusers are l ikely to switch to cither the Internet 01 theWindows version ol Grateful Med, allowing theLibrary to phase out the DOS version as planned lor

NLM System ReinventionIn FY 1996, the Library took steps to make

references to both newer and older journal articlesavailable online PREMEDLINE, a database ol in-process MEDLINE citations that have not yet beenproofread or indexed with MeSH headings, becamepublicly available in August 1996 This file has beenparticularly useful while NLM works to reduce thebacklog caused by the data entry contract suspensionLO and OCCS stall also completed most of the workto put 1964-65 Index Meduut, data online at NLM,using original MEDLARS data that had been retainedby DIMDI, the German MEDLARS CenterOLDMEDLINE wil l become available to the publicin early FY 1997, and NLM will proceed to work onmaking earlier data available as well Other importantchanges to NLM's online services included theOctober 1995 release ol SPACELINE, a spacemedicine and life sciences database produced byNLM and the National Aeronautic and SpaceAdministration, the April 1996 merger of theHEALTH and HSTAR databases to formHealthSTAR, the addition ol 14,000 references loitems not represented in other NLM databases toHISTLINE, and the enhancement of HSTAT withcross-file searching and many new ful l - textdocuments, including the 1995 revision of the Guideto Clinical Preventive Servile1!

FY 1996 was a transition year lor NLM'sonline services training (online) program for healthsciences librarians and other search intermediariesThe number of regional online training centers wasreduced from three to one—the New York Academyof Medicine—in April 1996 Work proceeded onrestructuring the "Fundamentals of MEDLARSSearching" class to rely more heavily on multimediaand computer-assisted instruction and to reduce itslength to two days The revised course will beintroduced in 1997. In FY 1996, NLM and theRegional training sites taught 45 online trainingcourses, including Fundamentals courses, speciali/edtraining modules, and MEDLARS updates, to a totalol 688 students

Machine-readable database*

To promote broad access to biomedicalinformation, NLM leases its databases in machine-readable lorm to commercial database vendors,international MEDLARS centers, universities, andother interested orgam/ations The licensees thenmake the data available online or in CD-ROMproducts In FY 1996, NLM distributed data fromone or more of us databases to 98 differentorgam/alions Although they pay lor a proportionalshare ol the cost of making MEDLARS data

12

Library Operation*

available in machine-readable torni, several licenseesare now offering free access to MEDLINE via theInternet, usually in conjunction with commercialadvertising or other services lor which there may be alee

LO continues to streamline its datadistribution procedures. In FY 1996, all mlormationrelated to licensing NLM data became available onthe NLM Web Site The Library developed a policythat permits people to download small amounts ofMEDLARS data for incorporation in their products atregular online service rates In 1997, orgam/alionswill be able to establish license agreements for McSHdata online via the Internet, and additional formats ofMeSH data will be available via tip In FY 1996, ftpdistribution of cataloging data was expanded toinclude weekly USMARC (MAchme-ReadablcCataloging) bibliographic record shipments and thetransfer of NLM name authority records to theLibrary of Congress. NLM completed the conversionol its USMARC distribution format to the newintegrated format The Library also began to includeNLM preservation microfilm informat ion in itsMARC records

Publications

NLM publishes some of its authoritativedata in printed publications, of which Index Medicusis the oldest and largest As NLM's primary clientelebecomes able to use alternative electronicdissemination mechanisms, the Library reviews andmodifies or eliminates specific printed publicationsthai have outlived their usefulness in that format Inkeeping with this strategy, NLM ceased publicationol Cumulated Abridged Index Medicu\ with the 1994edition, and will cease publishing Health Saence\Serials and the MeSH Supplementary Chemicals withtheir 1996 issues Print remains an attractive formalfor some products, however In FY 1996, NLMpublished A Shelflist of Islamu Medical Manuscriptsat the National Library of Meilume in printed formThis publication reflects ihe exiensivc scholarlyassislance previously provided by Emihe Savage-Smilh, Ph.D., Oxford University, which allowedHMD to prepare full cataloging records for thisimporlant group of historical materials

The Library continues to increase thenumber and types of publications available via theInternet. In FY 1996, LO played a key role in thereorganization and expansion ol NLM's public WorldWide Web site (www nlm nih gov) Since March1986, Internet users obtained more than 244,763copies of NLM publications—Irom fact sheets toextensive bibliographies and reports—using the Web

Current Bibliographies in Medicine is

available both m print and electronically. Its issuesaddress topics of current interest that may be difficultto search in NLM's databases or appear in theliterature of several multiple disciplines. Thebibliographies cover subjects important to specificprograms of NLM, NIH, and other Health andHuman Services agencies and are often produced inconjunction with NIH Consensus DevelopmentConferences or other special meetings. LO staffmembers collaborate with outside experts to produceeach bibliography FY 1996 additions to the seriesincluded Critical Pathways; The Role oj DietarySupplements jor Physically Active People,Confidentiality of Electronic Health Data, producedas an NLM contribution to the InterdepartmentalHealth Privacy Working Group and as backgroundfor a National Academy of Sciences study funded byNLM; and Public Health Informatics, one outgrowthof the meeting on "Making a Powerful Connectionthe Health of the Public and the National InformationInfrastructure" held at the Library in April 1995.

Reference Services

LO provides reference service and researchassistance to onsitc and remote users as a backup toservices available from other health sciences librariesin the National Network of Libraries of Medicine. InFY 1996, staff in the Reference Section, the NationalInformation Center on Health Services Research andHealth Care Technology (NICHSR), and the Historyof Medicine Division responded to 72,510 requestsfor reference assislance from onsite and remote users(Tables 9, 10) The number of inquiries received viathe Internet continues to grow

LO is heavily involved with expanding andorgam/mg the information on NLM's World WideWeb sue to better serve the Library's users andemployees. Notable LO additions to the Web siteincluded a pointer page for finding information onhealth and medical topics, a Preservation andCollection Management home page, the onlineSERHOLD Manual, a report on the use ol NLMdatabases in health services research, and extensiveinformation for researchers visiting the Library orusing NLM services from a distance. A newlyestablished Intranet also provides NLM staffmembers with ready access to administrative andtechnical information that helps them do their jobsmore elficiently In FY 1996, NLM's CD-ROMnetwork was upgraded and expanded to include morereference tools useful to onsitc users and staffmembers. The Reference Section also installedadditional software and equipment to help peoplewith disabilities to use onsitc services Among thenew tools provided lor those with disabilities are

13

l'nn;i<inn ami Servit n I-Y

speech synthesi/ers and adjustable heightworkstations lor wheelchair access

Document Delivery

LO provides copies ol documents l ioinNLM s comprehensive collection ol biomedicalliterature as a back-up to services available hornother NN/LM libraries and doeumenl suppliers Stal lalso retrieve documents Irom NLM's closed stackslor use by onsilc patrons In F;Y 1996, the Libiaryhandled 584,718 requests lor post-1911 documents(Table 6) and f i l l e d 5,289 lequests lot i tems l ioin (hehistorical and special collections ( I able 10)Inlerlibrary loan requests lor modern items mcieasedI per cent and onsile requests increased 4 per cent,despite the unusually large number ol days NI.M wasclosed Requests lor Internet delivery ol documentsincreased 51 per cent to a total ol 20,184 NLM f i l l e d64 per cent of the interl ibraiy loan lequesls i treceived, down 6 per cent Irom I-Y 1995 due to theimpact ol the shutdowns

Af te r a comparison ol deliveiy limes, theLibrary changed to Fedl'.x loi deliveiy ol books andaudiovisuals requested on mlcrhh ia iy loan I Inschange has improved deliveiy lime to west coastlibraries and reduced NLM stal l processing t imeBased on the results ol a cost study, NLM w i l l KIISCits ILL charges by $1 00 ellective October I , 1996

As part ol NLM System Reinvent ion, theRelais system has been purchased to piovideenhanced automated suppoil to the L i b i a i y s internaldocument delivery operations Relais w i l l hecustomi/ed to interact wi th other NLM systems andto accommodate NLM's unique requirements NLM sgoal is to deliver documents electronically w i t h i n 24hours ol receipt ol request The Relais system usesscanners instead ol photocopiers to captuie images olthe requested document (hat can then be sent to therequester by Ariel, electronic mail , lax, 01 postalmail The images wi l l not be retained by NLM LO'sdocument delivery procedures wi l l be modif ied tomake optimum use of Relais fea tures

At the close ol the f i sca l yeai 2,875 hbianeswere using DOCLINL, NLM's automated documentrequest and routing system These hbianes cntcied29 million document requests into DOCLINF. in FY1996, which is roughly equivalent to (he FY 1995tra l l i c Ninety-three per cent ol the icquests weiel i l led DOCLINB routes lequesls based on the I 4mi l l ion holdings statements loi 1,181 health scienceslibraries, primarily in the United Stales and CanadaDuring FY 1996, progress was made on improving(he procedures for updating SbRHOLD to ieducecontention with othci internal processing systems andto allow more Irequenl and less laboi-mlensive

holdings updatesIn I-Y 1996, NLM and the Regional Medical

Libranes stepped up ellorls to encourage DOCLINFparticipants to access the system via the Internet toreduce NLM telecommunications costs Twenty-sixpercent ol DOCLINh usage currently occurs via theInternet A numhei of changes weie made to theDOCLINL system to impiove its e l l i c iency Usersmay now print request numbers in bar code formatand specify additional delivery methods, such asInternet More DOCLINL- statistics are available toparticipants via I tp , and the Regional MedicalLibraries can update DOCLINL- participantinformat ion via (he Woild Wide Web

National Network of Libraries of Medicine

The purpose ol (he NN/LM is to provideU S health science practi t ioners, investigators,educatois, and admmisi ia to is w i t h t ime ly convenientaccess to biomedical and health in fo rma t ionlesouices The NN/LM strives to ensuie equal accessto up-to-date in fo rma t ion irrespective of the user'sgeographic location 01 inst i tut ional a l f i l ia t ion Thenetwoik has more than 4,500 membeis, i nc lud inghealth sciences l ibiancs ol eveiy si/e and typelocated throughout the count iy NLM s NN/LMO f f i c e oversees the network programs which arecoordinated and administered by Regional MedicalLibraries (RMLs) in eight geographical regions NewRML contracts lor 1996-2001 weie awarded in April1996 f o l l o w i n g a compet i t ive piocess that began inFY 1995 All ol the incumbent conliactors leceivednew awards (See Appendix I loi a l ist ol the R M L s )

The National In fo rmat ion Infras t ruc tureoilers the network new and exc i t ing opportunities toimprove in fo rmat ion seivices to health piofessionalsin 1996-2001 The RMI s aie mcieasmg their e f f o r t sto f a c i l i t a t e connec t iv i t y to the In t e rne t lor memberlibraries and health piolessionals and are using theInternet to develop innovat ive services I he NN/LMO f f i c e and the RMLs communicate legular ly via e-nuiil and audio-teleconference to ensuie that new andenhanced piograms and sei vices are piloted ind i l l e ien t icgions and i f successful , mtioduccdthroughout the country

The NN/LM piogram is a core componentol NLM's outreach i n i t i a t i v e I he RMLs and otheiNN/LM members have developed and implementedmany piojecls to leach out to underserved healthpiolcssionals in both uiial anil mnei -c i iy areas In arecent example, the l u s t special enhancement piojcctunder the new NN/LM contracts was awarded to thePacif ic Northwest RML to develop a model lorplanning and evaluat ing in fo rma t ion outreach inmmoi i ty communit ies I he project wi l l work wi th

14

Libran Operation',

evaluation specialists and gioups in the northwestconcerned with Native American health and willdevelop benchmarks and teM strategies lor improvingthe outcomes lor health information outreach

During the new conn act period, the RMLswill collaborate with the Centers lor Disease Controland Prevention and several NLM components toexpand outreach el forts to public healthprofessionals This e f fo r t , which will build on Ihepublic health outreach experience of Ihe RMLs in IheMiddle Atlantic, Greater Midwest, South Central, andPacific Northwest Regions, is another follow-on tothe meeting on public health and Ihe NationalInformation Inlrasiiucturc held at NLM in April1995

The RMLs conduct (he majority ol exhibitsand demonstrations of NLM's pioducts and servicesat health piolessional meetings around the countryNLM stalls the exhibits at the meetings in theWashington, DC aica and ai some distant meetingslocuscd on health services leseareh In I;Y 1996,NLM and NN/LM services were displayed at about82 exhibits at national, regional, and state associationmeetings across Ihe counliy

Special Onsitc Programs

In addition to releience and documentdelivery services, NLM o f f e i s a variety ol specialprograms and services to (hose who visit the Libiaryin Bethesda, including guided touis, hnelings onNLM's operations and new services, and historicalexhibits, seminars, and symposia The Libiary alsoconducts a I -year post-masiei's training program forlibrarians with potential loi leadership in healthinformation programs and services

I'ublii Toun and Hnefinx\

NLM attracts many domestic andinternational visitors interested biomedicalcommunication, information technology, healthsciences lihrananship. and the histoiy of medicineIn FY 1996, LO stall members conducted 127 tegulardaily tours lor a total ol 488 visitors The Of f ice olPublic Information (Off ice ol (he Director) arranged95 special group tours and briefings loi 1,779 visitorsand arranged a press conlerence in conjunction withthe public release ol Internet Grateful Med in April1996 (sec chapter on High Performance Computingand Communications)

llntorual

The Histoiy ol Medicine Division hosted aI -day conleience on "Medicine in the Indian Pnncely

Slates" on December 1, 1995 and a symposium,"Public Health, Demography, and AmericanMedicine", on May 22, 1996, in honor ol James HCasscdy's contributions to the NLM and to historicalscholarship. The symposium was co-sponsored by theWashington Society lor the History ol Medicine

HMD, the NLM l-.KO Office, and the NLMliKO Committee sponsored two historical lectures.livelynn M Hammonds, Assistant Professor olScience, Massachusetts Institute ol Technology, gavea talk on "Race, Gender, and AIDS An HistoricalPerspective" on February 29, 1996 This was themost lecent ol an annual series of NLM AfricanAmerican History Month lectures Mary Fissell ol theJohns Hopkins Institute ol (he History of Medicinediscussed "Vernacular Bodies Popular MedicalWorks lor Women" in NLM's first Women's HistoryMonth lecture on March 14, 1996 HMD alsoarranged for several historical seminars, including "InSearch ol Dr George Ii Burch and 2()th CenturyCardiology" by Vivian Burch Martin, "Louis PasteurScientific Method and lilhical Quandaries," byGerald L Geison, and "To the Book and to theLetter Lxhibilmg Books, Manuscripts, andDocuments" by Lou Stoiey

The HMD siall installed two historicalexhibits in the NLM lobby in FY 1996 "Disease andDeath in the Neighborhood. Medical Maps olWashington, DC , 1878 to 1909" and "ExtraordinaryObjects, Rxlraordmaiy Stones Celebrating the NLMCollections" S ta f f members also published theresults of then scholarship in a number of books,chapleis, articles, and leviews during the past year

NLM A >>',(>( Kite

The Lihraiy has a 1-year competitivetunning program that provides individuals with amaster's degree in library and information sciencewith an understanding ol NLM's programs andoperations, key issues facing health sciences libraries,and new information technologies, and of fers theman opportunity to develop and apply their skills byconducting special projects NLM Associates alsohave an opportunity to visit other national librariesand a range of health sciences libraries and to attendprofessional meetings Three Associates participatedin the program in 1995/1996, including one from theC/ech Republic Among the projects undertaken by(he 1995/96 Associates weie a study of potentialadditional sources of literature suitable lor theSPACEL1NI: database, the development of amechanism lor conducting comparative analyses ollesults leturned by different retrieval interfaces, andwork on two issues ol Current Hihlir>f>raphie\ inMcdit me

15

Programs and Services, h'Y 1996

The international Associate returned to workin her home country, and the two 1995/96 U.S.Associates accepted jobs at the National Institutes ofHealth Library and the Kevric Company. Four newU.S. Associates began the 1996/97 program inSeptember 1996. Effective in September, the NLM

Associates are part of a special educational programadministered on the Library's behalf by the OakRidge Institute for Science and Education and are nolonger directly employed by NLM. This change doesnot affect the scope and purpose of the Associateprogram.

Customer Service Policy

The Library's Mission

The National Library of Medicine collects, organizes and disseminates the hiomedical literature of theworld in order to advance the medical and related sciences and to improve the public health. The Library serves as anational information resource for research, health care, the education of health professionals, and service activitiesof Federal and private agencies, organi/ations, inst i tut ions, and individuals.

The Scope of the NLM Collection

NLM's collection is intended to serve the information needs of U.S. health professionals, but access toinformation in the collection is available world wide. The Library comprehensively collects the world's substantivebiomedical publications to support its mission. Although the importance of consumer health information isrecognized, and the public may use the Library's information services, the Library docs not collect information thatis written for the public.

NLM's Customers

Our primary customers include: health science librarians and information specialists, health care providers,researchers, scholars and students, and historians.

Customer Service Values

• We will treat all of our customers with courtesy.• Our customers will be assisted by knowledgeable staff.• We will provide information and instructional materials to assist our customers in using our products and

services.• We will meet or exceed our established deadlines for providing customer service.• Periodically, we will assess our customers' needs and level of satisfaction with our service.

Customer Service Commitment

Our goal is to respond to your inquiry according to the following standards:

• If you call the Library using our 800 numbers, staff will be available to assist you during business hours. Ourbusiness hours will be prominently posted and noted in our brochures and through other information sources.

• If you mail or fax your request, you wil l be sent a response within ten working days after we receive yourinquiry.

• If you contact us via e-mail, you wil l be sent a response wi thin five working days alter we receive your inquiry.

If we cannot provide a full response within these time frames, you will receive confirmation that we receivedyour request, with an estimate of the delay before we can provide the full reply.

If you visit the Library, you will receive information on how to use our collections and services from staff inour Reading Rooms. Staff will be available to assist you during business hours, which will be prominently postedand noted in our brochures.

16

Library Operations

Table 2Growth of Collections

Collection

Book MaterialsMonographs:

Before 15001501-16001601-17001701-18001801-1870Americana1870-Present

Theses (historical)PamphletsBound serial volumesVolumes withdrawn

Total volumes

PreviousTotal

(9/30/95)FY1996 New Total

(9/30/96)

576..5,787..

10,120..24,441 ..41,106..

2,341 ..613,777..281,794..

....172,021..

.1,049,964..

... (57,697),

.2,144,230..

0..,6...4...5...

15...0...

, 15,322...0...0...

,22,361...(160).

. 37,553...

5765,793

10,12424,44641,121

2,341....629,099....281,794.... 172,021. 1,072,325

(57,857).2,181,783

Nonbook MaterialsMicroforms:

Total microforms 394,084 .Reels of microfilm 79,639 ,Number of microfiche 314,445 .

Audiovisuals 58,722.Computer software 776 .Pictures 56,601 .Manuscripts 2,454,542.

Total nonbook 2,964,725 .Total book and nonbook 5,108,955 .

. 37,222..

... 3,900..

. 33,322.,,..2,001.,

81.,0.,0.,

. 39,304.

. 76,857.

....431,30683,539

....347,76760,723

85756,601

. 2,454,542

. 3,004,029

. 5,185,812

Table 3Acquisition Statistics

Acquisitions

Serial titles receivedPublications processed:

Serial piecesOther

FY1994

....23,250.

FY1995

... 22,600,

FY1996

,...22,522

. 154,076.

...22,569.154,342.

.. 22,743.154,146..20,846

Total 176,645. 177,085 174,992

Obligations for:PublicationsIncluded for rare books.

.$4,456,480 $4,788,181...

..($207,575) ($189,527)..$5,102,058...($209,178)

17

Programs and Services, FY1996

Table 4Cataloging Statistics

FY 1994

Completed Cataloging 19,556 .

FY1995 FY1996

...22,232 20,365

Table 5Bibliographic Services

Services FY 1994 FY1995 FY1996

Citations published in MEDLINE 367,877 .For Index Medicus 351,958.

Recurring bibliographies 12 .Journals indexed for Index Medicus 3,127 .Abstracts entered 274,514 .

.392,354 322,825,374,907 309,038

6 63,093 3,205

.293,724 242,544

Table 6Circulation Statistics

Activity FY1994 FY1995 FY1996

Requests Received 539,988 573,541 584,738Inter-library Loan 324,670 345,428 347,992Onsite 215,318 228,113 236,746

Requests Filled: 410,453 424,169 410,732Intel-library Loan 229,949 245,078 227,810

Photocopy 217,627 231,993 215,461Original 10,864 11,384 10,814Audiovisual 1,458 1,701 1,535

Onsite 180,504 179,091 182,922

18

Library Operations

Table 7Online Searches*

DATABASES FY1994 FY1995 FY1996

AIDSDRUGS 1,288 1,453 1,240AIDSLINE 54,596 66,200 59,507AIDSTRIALS 2,319 3,148 2,203ALERT 2,027 3,062 3,244AVLINE 27,269 27,543 22,712BIOETHICS 15,075 15,248 14,352BIOTECHSEEK 725CANCERLIT 88,077 91,324 80,206CATLINE 363,805 390,067 382,321CCRIS 4,048 3,168 2,697CHEMID 10,608 9,970 9,151CHEMLINE 16,588 13,075 12,150DART 3,061 3,861 2,556DENTALPROJ 146 142 72DIRLINE 17,064 33,427 27,602DOCUSER 14,353 17,699 14,664EMIC 3,577 3,787 3,743EMICBACK 2,995 2,039 1,566ETICBACK 896 1,046 666GENETOX 1,808 1,913 2,935HEALTH 186,701 178,295 93,183HEALTHSTAR 76,857HISTLINE 4,374 6,806 6,577HSDB 35,767 30,296 24,947HSRPROJ 93 1,266 1,756HSTAR 27,789 41,670 27,263IRIS 21,453 17,593 15,870LOAN STATUS 14,495 19,939 21,304MEDLINE 4,989,911 5,262,329 5,414,712MeSH 37,221 38,058 39,138PDQ 23,794 20,303 17,404POPLINE 24,610 22,864 19,731PREMEDLINE 3,001REFLINE 42,518 39,984 33,541RTECS 14,685 13,808 12,159SDILINE 44,259 218,654 188,418SERLINE 418,162 633,615 664,265SPACELINE 1,507 3,119STORED SEARCH 336 108 162TOXLINE 69,944 71,631 66,761TOXLIT 11,766 11,074 9,954TRI 21,320 12,793 8,959TRIFACTS 577 511 441USERS 3,912 3,701 3,911YEAR86 2 4 0Total 6,625,774 7,334,981 7,397,020

*Beginning in FY 1995, figures include off-line searches.

19


Table 8Off-line Searches*

DATABASES FY 1994

AIDSLINE 1,710AVLINE 75BIOETHICS 5CANCERLIT 3,177CATLINE 504CHEMLINE 0DENTALPROJ 0HEALTH 9,943HISTLINE 6MEDLINE 3,733MeSH VOCABULARY FILE 0POPLINE 4,692SDILINE 210,612SERLINE 3TOXLINE 3,557TOXLIT 2,234

Total 240,251

*Off-line searches are no longer being counted separately.

Table 9Reference Services

Activity FY 1994 FY 1995 FY1996

Reference Section:Offsite requests 22,706 25,135 24,799Onsite requests 42,482 43,132 34,796

Total 65,188 68,267 59,595

20

Library Operations

Table 10History of Medicine Activities

Activity FY1994 FY1995 FY1996

Acquisitions:Books 126 154 188Modern manuscripts 193,725 184,000 163,500Prints and photographs 313 2,046 183Historical audiovisuals 61 147 108

Processing:Books cataloged 340 2,451 351Modern manuscriptsprocessed 0 0 0Pictures cataloged 1 0 0Citations indexed 3,697 2,510 1,363

Public Services:Reference questions answered 13,516 13,434 12,885Onsite requests filled 7,866 7,273 5,289

21

SPECIALIZEDINFORMATIONSERVICESMelvin Spann, Ph I)A.\wciate Director

The Division ol Speciah/cd Informat ionServices (SIS) has been increasingly responsive lodemands for up-to-date information in toxicology andenvironmental health and in HIV/AIDS Theevolution ol the Toxicology and EnvironmentalHealth Inlormation Program (TEHIP) has resulted inthe development ol new and easier methods lorinformation access and expanded sources As publicconcern with exposure lo environmental ha/ards hasgrown, SIS over the past three decades hasimplemented the use of state-ol-the-arl computer andcommunication technologies to meet concomitantdemand lor informat ion. Use of these newtechnologies has allowed the Division lo reachbeyond Us traditional user base and traditionalinformation products

The Division has created a World WideWeb server lo distribute informat ion moreeffectively, e f f ic ien t ly and al lowei cosl Thegraphical nature of the WWW allows the Division toprovide access lo additional types of in format ion aswell as to l ink information fac i l i t a t ing Us use.

We anticipate further expanding services inresponse to recommendations f rom the Ins t i tu te olMedicine's panel examining ways to improve theuti l i ly of ihc TEHIP databases The Division's AIDSactivities also continue to expand as the outreachprogram in HIV/AIDS connects wiih more of iheHistorically Black Colleges and Universi t ies andcommunity-based orgam/alions

TOXNET

The Toxicology Dala Network (TOXNET),the Library's networked microprocessoi system, hadtwo major developments in FY 1996 discontinuationol VAN access to TOXNET and implementation of anew version of the Remote Data Entry System(RDES) Searching TOXNET databases is mainlydone now through FTS 2()(X) and the InternetMembers of the Scient i f ic Review Panel now use Ihenew RDES software to do online commentary andreview of the Ha/ardous Substances Dala Bank(HSDB) In addition• A feasibility study to investigate mounting ihe

National Cancer Insiuuie's voluminous PHS-149

data (i e , chemical carcmogemcity studies) as anonline TOXNET database was completed

• Work continued on the fur ther enhancement andimplementation ol ihe Windows workstation lorbuilding and updating HSDB records

• Work also continued on researching alternativeconfigurations and costs lor possible newhardware and opei t i l ing system pla t forms for theTOXNET system

• More work has been done lo implement a f u l l yassociative graphical user interlace using theFORMS Software embedded in Ihe experimentalSIS server This wi l l f ac i l i t a t e literature searchesby users who also need to search ELHILLdatabases such as MliDLINE and TOXLINE

l)ataba.\e.\ undo TOXNET

The Hazardous Substances Data Bank (HSDB)continues to be the most h igh ly used data bank onTOXNET, averaging over I(),()(X) searches eachmonth Increased emphasis was placed on providingmore data on human toxicology and clinical medicinewithin HSDB, in keeping with the recommendationsol the Board of Regenis' Subcommittee on TEHIPAdditional recommendations are anticipated I mm theInst i tu te of Medicine I 'va lua t ion Study Changes tothe composition ol ihe Sc i en t i f i c Review Panel (SRP)arc being made to accommodate the anticipated s h i f tin content emphasis Newer sources ol relevant dalahave been added to maintain the currency lor the4,500 HSDB records Because ol increased s t a f fellorls, more records are being processed throughspecial enhancements, inc luding source updates Iromvarious peer-reviewed f i l e s These enhancements arebeing made possible by a cusiomi/ed Windows-based PC workstation wi th enhanced li le-buildingfeatures SRP mcmbcis, in collaboration with SISstal l are exploring new approaches lor datapresentation tor the HSDB metal records

The Toxic Chemical Release Inventory (TRI) seriesol liles now includes eight online files, TRIK7through TRI94 These f i l e s remain an importantresource for environmental release data and continueto attract new useis Mandated by the EmergencyPlanning and Community Right- lo-Know Act (TitleIII of the Superlund Amendments andReaulhon/aiion Act ol 1986), these EPA-sponsoreddatabases contain envuonmenta l release data to air,water, and soil lor almost 400 EPA-speciliedchemicals Starting wi th Ihe TRI91 file, the reportingfaci l i t ies were required to report source reduction andrecycling activities, in addition to environmentalreleases These additional reporting requirements

22

Specialized Information Servu e\

have considerably increased ihc si/c and complexityol the databases.

In spite ol (he additional data, the TRI94 filewas released in June, 1996 This relatively earlyrelease date was made possible by increasedTOXNET system elhciencies, and impiovemenis indata handling at the EPA KPA is planning to includeover 280 additional chemicals in 1996 and requiresubmissions from federal and military installationsAnother major change in TRI95 will be two versionsol the reporting form, a long and a short, requiringuni t record changes TRIFACTS, a companion file tothe TRI series, supplies users wi th informat ionrelated to health and ecological e l fects and the saletyand handling of the TRI chemicals These records aresupplied by EPA, who also funds the managementand maintenance ol the TRI files

The Chemical Carcinogenesis ResearchInformation System (CCRI.S) continues to be bu i l t ,maintained, and made publicly accessible on NLM'sTOXNET system This data hank is supported by theNational Cancer Insti tute and has grown to over7,3(K) records The chemical-specific data covers theareas ol carcmogenesis, mutagenesis, tumorpromotion, and tumor i n h i b i t i o n studies

The Integrated Risk Information System ( IRIS) ,EPA's official health risk assessment fi le, continuesto experience high usage on TOXNET. Beginningwith version 6 5, Grateful Med contains form screensto facil i tate the searching of IRIS by inexperiencedusers Creating a search mechanism wi th theTOXNET Concept Menus is also underconsideration IRIS now contains 666 chemicals

The GENE-TOX f i l e continues to be built andupdated directly on TOXNET by EPA scient i f ic s t a f fThis file contains peer-reviewed genetic toxicology(mutagemcity) studies lor about 3,()(X) chemicalsGENE-TOX receives a high level ol interest amongusers in other countries where mulagenesis is a factorin regulations

The Registry of Toxic Effects of ChemicalSubstances (RTECS) is a data bank based upon aNational Institute ol Occupational Safety and Health(NIOSH) file by the same name which NLM hasrestructured and made available for online searchingSIS continues to add new data to this f i l e as NIOSHmakes them available NIOSH has announced thatthe full RTECS will no longer be available as aprinted or microlichc product, so online access viaNLM is now even more important. RTECS containsinformation on over 135,000 chemicals

The Developmental and Reproductive Toxicology(DART) database now contains over 30,000 citationsfrom literature published since 1989 on agents thatmay cause birth defects This year, a significant effor twas made to add relevant technical reports to DARTRecords from DART are also added to TOXLINE ona quarterly basis DART is a continuation of theEnvironmental Teratology Information Centerbackfile (ETICBACK) database, which containsalmost 50,000 citations to literature published from1950-1989. ETICBACK citations are also found inTOXLINE. DART is funded by the EPA, theNational Inst i tute of Environmental Health Sciences,and the FDA's National Center for ToxicologicalResearch NLM provides funding and managementfor the project

The Environmental Mutagen Information Center(EMIC) database contains over 14,000 citations toliterature published since 1992 on agents that havebeen tested lor genotoxic activity A backfile forEMIC (EMICBACK) contains 70,000 citations to theliterature published from 1950-1991 Records fromEMICBACK are included in TOXLINE. Plans areunder way to add the records from the new EMICdatabase to TOXLINE as well EMIC is funded bythe EPA and the National Institute of EnvironmentalHealth Sciences and managed by NLM.

Databases under ELHILL

CHEMID (Chemical Identilication File) is an NLMonline chemical dictionary that contains 290,000records, primarily describing chemicals olbiomcdical and regulatory importance It alsocontains an important set of regulatory data,collectively known as SUPERLIST More than12,0(X) records are augmented with the name and anindication ol source for chemicals mentioned in oneor more of 33 lists, e g , the Department ofTransportation Ha/ardous Materials List and thePriority List of the Agency lor Toxic Substances andDisease Registry (ATSDR) These data allow users todetermine i l a chemical is mentioned on a given listand under what name as well as to search forchemical classes on these lists In FY 1996 new I liegeneration programs allowed more frequent updatesto ChcmID and thus more currency for users. Datasuch as Carcinogenic Status trom regulatory sourceswere added to the Classilicalion Code field and weremade searchable lor the lirst time During FY 1997,the number of lists in SUPERLIST should increase toover 35 and the file si/e ol ChemID wi l l grow to300,000 records, reflecting increasing coverage olhiomedical and regulatory sources

23

Program* and Services, FY 1996

CHEMLINE (Chemical Dictionary Online) is anonline chemical dictionary and directory file thatallows users to identify chemical substances vianomenclature and other identifiers, and to formulateoptimum search strategies for other NLM filesCHEMLINE is updated every two months andregenerated annually. The basic foundation ofCHEMLINE's data is supplied by the ChemicalAbstracts Service (CAS) from its Registry System,and this is augmented extensively by NLM withnonpropneiary data from a variety of sourcesCHEMLINE now contains 1,550,000 records onchemical substances. In 1996, efforts to use the newChemID Tile generation techniques for CHEMLINEwere studied, and analysis will continue into 1997.

TOXLINE (Toxicology Information Online) is anNLM online bibliographic retrieval service producedby merging "toxicology" subsets from some 18secondary sources. TOXLINE and its backfilc,TOXLINE65, contain data from sources that do notrequire royalty charges based on usage TheChemical Abstracts Service requires usage royalties,therefore, information from this source is used tocreate two separate online bibliographic Ilies,TOXLIT and TOXLIT65. The four databases in theTOXLINE family of services now contain over fourmillion records. Approximately 20,000 records arcadded with each monthly update During FY 1996,SIS added a new subfile from the Swedish NationalChemical Inspectorate's file, RISKLINE Wecontinue to explore ways that the Unified MedicalLanguage System can be utilised to accommodatevocabulary changes in TOXLINE subfiles

DIRLINE (Directory of Information ResourcesOnline) is NLM's online directory of organisations,databases, projects, and programs which focus onbiomedicme. These resources provide information tousers that may not be available from any other NLMdatabase. A new version of Health Hotline* (a listingof organizations from DIRLINE with toll-free phonenumbers) was produced which will also be availablethrough a simple search interface on the SIS HomePage.

AIDS Services

AIDSTRIALS and AIDSDRUGS are thedatabases generated as part of the Public HealthService's AIDS Clinical Trials Information Network.This year citations to published results of clinicaltrials started being added to the AIDSTRIALSrecords. This information, along with the citationnumber from AIDSLINE. facilitates access to resultinformation for users

NLM awarded 22 AIDS InformationOutreach Purchase Orders in FY 1996 Seven awardswere made to previous award recipients to allowthem to continue or expand successful projects. Theremaining 15 awards were for new projects NLM'scollaborative project with the Wheaton RegionalLibrary, Montgomery County, Maryland, hasprovided NLM with interesting information on theuse of NLM's resources and health information bythe general public. Very useful relationships havedeveloped between other local government agenciesand the library The introduction to the public ofaccess to the World Wide Web and training in how touse this capability has also been a very exciting partof this project

A new NLM AIDS home page wasdeveloped as part of the overall development of theSIS World Wide Web service In addition to accessto NLM's AIDS-rclaled databases and otherresources, NLM staff worked with the sponsors of theXI International Conference on AIDS to quicklycreate a database which debuted the day theconference started

Other Programs

Internet

The SIS World Wide Web Server began tooffer a greatly expanded panoply of data to Interne)users. Among the new offerings were chemicalstructures displays for substances in theAIDSDRUGS file, searching the abstracts of the XIConference on AIDS, new WWW versions of the SISdemo and slide overview packages which use thelatest JAVA script and frames capabilities of WWWbrowsers, and a conversion of all SIS Fact Sheets to ahypertext (HTML) format While the SIS TEHIP andAIDS Internet Gophers remain open to users,increasingly data from these sources are beingconverted to WWW format to allow use of the moreflexible graphical capabilities of the Web In 1997,additional searching capabilities wi l l be madeavailable on the SIS Server, including searchingHSDB chemicals by structure, substructure, andsimilarity, as well as searching DIRLINE records toallow public access to this useful collection ofinformation resources.

New WWW init iat ives to commence in FY1997 include the development of an operational Web-based user interface to access the TOXNET systemand a collaborative research participation programwith the Artificial Intelligence Group at theUniversity of An/ona to automatically generate a

24

Specialized Information Servn es

Toxicology and Environmental Health ConceptThesaurus from the TOXLINL- database

Outreach

SIS continues its support ol the ToxicologyInformation Outreach Project The objective of thisinitiative is to strengthen the capacity ol HistoricallyBlack Colleges and Universities (HBCUs) to trammedical and other health professionals in the use ofNLM's lexicological, environmental, occupationalhealth, and ha/ardous wastes information resouicesIn addition to providing workstations, training, andIrec online access to nine HBCUs participating in apilot training project, NLM has collaborated with theAgency for Toxic Substances and Disease Registry(ATSDR) to tram representatives from 57 additionalschools in the use of NLM's valuable onlineresources During the past Fiscal Year, one ol thetraining classes was hosted by Howard Universityand it included HBCUs from the Lower MississippiDelta This class was joint ly sponsored by ATSDR,NLM and the EPA's Environmental Justice Of f ice insupport of the Mississippi Delta Project During thepast year, new PC-based workstations were providedto the nine original participating HBCUs

SIS has also implemented an AIDSInformation Training component to the existingToxicology Information Outreach Project The goalof this project is to provide training in the use ofavailable information resources in HIV/AIDS forfacu l ty , s ta f f , students, and community providersassociated with the HBCUs NLM is working withthe National Association for Equal Opportunity inHigher Education (NAFEO) and the National AIDSMinority Information and Hducation Program to

identity participants A number of training classeswere held during the year, including one at HowardUniversity lor attendees at NAFEO's annualconference

User Support Computer-Based Activities

The mam locus of our computer-basedtraining activities over the past year was to develop ademonstration ol the TEHIP databases and a TEHIPslide presentation with access from the WWW TheTEHIP demonstration gives a brief description andseveral sample searches for each database. The slidepresentation covers the historical development of theprogram and the status of current projects Bothproducts are currently available on the SIS WWWserver and use the latest Java script and framescapabilities of Web browsers In addition, SIScompleted development of the introductory moduleol TOXICOLOGY TUTOR, a computer-basedtoxicology course The course was developed underTOOLBOOK for use in a Windows environmentCurrently, TOXICOLOGY TUTOR is being revisedlor release on the WWW

Alternatives to Animal Testing

SIS continued to compile and publishrclerences Irom the MEDLARS hies that wereidentified as relevant to methods or procedures whichcould be used to reduce, refine, or replace animals inbiomcdical research and toxicological testingRequests for these quarterly bibliographies haveincreased, as has the number of articles deemedrelevant to the f ie ld Bibliographies issued during thepast lour years are available through the SIS WWWserver and gopher

25

LISTER HILLNATIONAL CENTERFOR BIOMEDICALCOMMUNICATIONSHaroldM Schoolman, M I)Acting Director

The Lislcr Hill National Center lorBiomedical Communications (LHNCBC) wasestablished by a joint resolution of Congress in 1968An intramural research and dcvelopmcni division olthe NLM, LHNCBC research programs apply stale-ol-the-art computer and communicationstechnologies to the management ol biomedicalknowledge Such knowledge can take the lorm olimages, electronic signals, sounds and standardinformation LHNCBC programs create innovativemethods tor acquiring, storing, retrieving, analy/mg,communicating, and presenting the knowledge ot thelilc sciences

A Board of Scientific Counselors meets toreview the quality and contents ol the intramuralresearch programs within the Lister Hi l l Center TheBoard is composed of scientific and technical experts(see Appendix 5 for a list of members) who areprominent leaders in the fields ol medicine, computerscience, engineering, and health professionseducation

In FY 1996 a new orgam/ational elementwas added to the Lister Hil l Center the Oflice ofHigh Performance Computing and CommunicationsThis office includes the Library's HPPC-relalcdprograms that were originally part of the HPCCNational Coordinating Office when it was located atthe NLM The major activities ol that Office are inthe Chapter on High Performance Computing andCommunications

The Center is now composed of an Office olthe Director, the Office of High PcrlormanceComputing and Communications, and four branches• Computer Science Branch• Communications Engineering Branch• Cognitive Science Branch• Audiovisual Program Development Branch

The research and development programs ofthe LHNCBC fall into three categories• Computer and information science as applied to

the problems of Ihc Library, of Biomedicalresearch, and health care delivery,

• Biomedical image engineering, including imageacquisition, processing, storage, retrieval, and

communications, and• Use ol computer and image technologies for

health professions education

Computer Science Branch

Research projects of the Computer ScienceBranch concentrate on applying artificial intelligencetechniques to problems in the representation, retrievaland manipulation ol biomedical knowledge CSBprojects involve both basic and applied research insuch areas as expert systems, intelligent databasesystems, multimedia hypertext information delivery,machine learning, and machine-assisted indexing forinformation classification and retrieval The researchaddresses issues in knowledge representation,knowledge base structure, knowledge acquisition,and the human-machine interface for complexsystems Important components ol the researchinclude embedded intelligence systems whichcombine local reasoning with access to large-scalemainframe data banks, and multimediaknowledge-based systems with interactive videocapability

Branch stall members participate inindividual and team research projects Several areprincipals in the User Access Services project olNLM's System Reinvention program and in thedevelopment of the Metathcsaurus and theInformation Sources Map of NLM's Unified MedicalLanguage System initiative They participate in themedical informatics and information science researchcommunities and professional specialty societiesSeveral s t a f f members participate in the meetings ofthe Internet Engineering Task Force and theInternational World Wide Web ConlerenccCommittee Finally, rccogm/mg the importance ofaddressing the future of medical informatics byhelping to tram new researchers, Branch Chief DrLawrence Kmgsland and computer specialist MsMay Cheh co-direct the 8-wcek NIH elective inMedical Informatics for third- and fourth-yearmedical students each spring

User A(<fvj Servue\ Projett

The User Access Services Project appliestechniques of computer science, information science,artificial intelligence, and networked distributedcomputing to the problems of helping users gamaccess to the information m NLM's multimilhonrecord databases The members of this group underproject leader Dr Lawrence Kmgsland havedeveloped a new program for assisted searching inNLM's online databases over the World Wide WebInternet Grateful Mcd (IGM), an important

26

Luter Hill National Center Jor Btomedu al Communu aiion\

component of NLM's System Reinvention in i t ia t ive ,was released to the public in April 1996 IGM is anintelligent gateway system, designed to provideassisted searching to NLM's users with a consistent"look and feel" across multiple database systems asNLM's primary retrieval systems evolve Thegateway architecture has proven a successful meansol transparently connecting users to several d i f ferenttypes of retrieval systems while insulating them fromthe specifics of d i f fer ing command languages.

Tens of thousands of physicians have beenintroduced to Internet Grateful Mcd through outreachprograms of the National Network of Libraries olMedicine and professional specialty conferences suchas the annual conferences of the Radiological Societyof North American, the American College olPhysicians, and the American Medical InformaticsAssociation The program h.is been a considerablesuccess The ini t ia l version of Internet Gra te fu l Medsearched only m MliDLINIi A much-needed onlineself-registration process was added to the system inJune 1996. By the end of FY 1996, theself-registration system had been used by more than4,2(X) users from 52 countries to establish newindividual accounts for searching in NLM'sdatabases Searching m AIDSLINE-, HcalthSTAR,and the new PREMEDLINE database was added toInternet Grateful Med early m September 1996Internet Grateful Med won one of several FederalShowcase Site awards at the Federal WebmasterWorkshop in August, 1996

By the end of FY 1996, five months alter usrelease, usage ol the Internet Grateful Med seiverwas running at a rale of I 3 mi l l ion World Wide Webconnection requests from users at nearly 42,()(K)individual computers on the Internet each monthWeekdays m late September, the server handledabout 60,0(X) Web connections from users at nearly2,400 individual computers on the Internet each dayIn the aggregate, Internet Gra tefu l Med users madenearly 80,000 searches that month in MEDLINE orthe AIDSLINE, HcallhSTAR or PREMEDLINEdatabases.

During FY 1997, the Internet Gra te fu l Meddevelopment team w i l l add searching capability to anumber of additional NLM databases to the system.Linkages to additional systems wil l be expanded, andmeans of identifying and searching m multipledatabases from a single user query will be explored.

Expert Sy.\ti'm.\ Program

The objective ol the Expert SystemsProgram is to create computer systems that fac i l i ta teaccess to medical knowledge The Expert Systemsgroup has bui l t a multimedia expert system shell

called CTX, for Criteria Table Expert. This year,progress was made in the design and development ofa World Wide Web version of the system to allowWeb-based delivery of expert systems based on thecriteria table knowledge representation pioneered byNLM researchers.

The Expert Systems Program's flagshipresearch vehicle is the AI/RHEUM knowledge basedexpert system for diagnosis m rheumatology Thissystem was improved with the inclusion of additionalvideo images for physician education and new textdescriptions to provide physicians with expandedinformation resources at the conclusion of the systeminteraction Update of the system's disease knowledgebase has continued with the collaboration of expertrhcumatologists Dr H James Williams of theUniversity of Utah and Dr Balu Athreya of ThomasJefferson University.

The Expert Systems Program continues toparticipate in exploring and defining the issues ofevaluation of knowledge based systems. A 2-dayWorkshop on the Evaluation of Knowledge BasedSystems was held at NLM December 7-8, 1995. Theworkshop was co-sponsored by NLM and theNational Science Foundation, the Agency for HealthCare Policy and Research, and Microsoft Research

Unified Medical Language Sy.\tem Melathe!>auru>,

Each year more than 85% of the UMLSMctalhesaurus effort goes into creating the newrelease for the annual edition of the UMLSKnowledge Sources Developing the 1997Mctathesaurus, with a very significant advance incontent, was the main achievement of Dr WilliamHole's Mctathcsaurus production group this fiscalyear. The new Mclathcsaurus includes 331,756concepts (78,864 more than in 1996, a 31.2%increase) and 740,170 distinct names for theseconcepts (197,062 more, a 36.2%; increase). All arelinked to 827,362 entries in 35 vocabularies, thesauri,or classifications (an increase of 237,964 or 40.37%).

Major additions for 1997 included thecomplete Snomcd International, the complete AMACPT96, and the complete official ICD9-CMincluding ful ly specified names for the 5th digitICD9-CM terms. One third of the Read ClinicalClassification (the standard for medical coding in theUnited Kingdom) was also added.

Under NLM review and supervision, mostvocabulary inversion and insertion is done bycontractor Lexical Technology, Inc The majority olthe editing is done on remote client systems bycontractor Kcvric, Inc. Dr. William Hole and MsTammy Powell of the MeSH Section, LibraryOperations, arc project officers for these contractors.

27

Program* and Services, FY 1996

Major progress was made this year on theredesigned Metathesaurus Enhancement andMaintenance Environment software system("Memc2"). Initial complete server and clientversions were created and tested Final testing andswitchover to the new system is planned for spring1997. This system allows editors to perform editingactions at the same level at which editors think, ratherthan in unnecessarily complex detail It wi l l storeactions to allow analysis and the "do" and "undo" ofalgorithmic and human editing steps. It wil l addressfundamental limits of relational databasemanagement system (RDBMS) performanceencountered in use of the present system, and wil lform the basis for integrated editing of multiplevocabularies within a common environment Theserver side of Mcmc2 is being developed at LexicalTechnology, Inc. The client design and testing arcbeing done by NLM. Alternative RDBMSenvironments (including an Oracle version) arc beingbuilt and tested at NLM.

Unified Medical Language System InjormationSources Map

The UMLS Information Sources Map (ISM)is an attempt to develop a software environment thatwil l accept a biomcdical query, i den t i fy relevantnetwork-accessible information resources, iind(where possible and appropriate) connect to thoseresources and retrieve helpful information Theapproach to this problem is two-tiered, iden t i fyresources, then identify and retrieve informationwith in those resources Although progress has beenmade on both tiers, the f i r s t has received moreattention thus far Identif ication of resources followsthe classical library model: the nature and content ofeach resource is described by the equivalent of a cardcatalog entry (the ISM record).

FY 1996 was a busy year lor the ISMProject team (Dr R.PC Rodgers, Dr Kevin Scott,and Mr Lawrence Wright). Development work wasshifted into the new object-oriented Java language,which is well suited for World Wide Web-basedinformation systems. With the collaboration ofmedical librarians Ms. Betsy Humphreys and Ms.Jana Bradley, the ISM record structure and contentwas extensively revised ISM records wereinstantiated within a set of relational tables runningunder the Oracle database system The Oracledatabase was set up in such a way as to make itavailable to the UMLS Mctalhesaurus and the UMLSSemantic Network developers as well

A completely new version ol Sourcerer. theprototype ISM user interlace, was presented Thisnew prototype accepts natural language queries, then

employs tools developed by Dr Alan Aronson andMr. Thomas Rmdflcsch of the Cognitive SciencesBranch to identify phrases within the query andsubsequently to i d e n t i f y UMLS Mctalhesaurusconcepts within those phrases Concepts highlightedby the user arc then used to search the ISM databasefor relevant resources The ISM team created aninterface framework based on the Common ObjectBroker Request Architecture (CORBA) lor both theISM database and the UMLS Knowledge SourceServer, and began working with the other UMLScomponents to make this approach available to themas well

With the assistance ol Ms. BetsyHumphreys and her colleagues in the Division olLibrary Operations, real-world biomedical queriesfrom the NIH and from the Oregon Health SciencesUniversity were assembled as test sets to assist in thedesign and evaluation of Sourcerer Strategies weredeveloped for creating larger test sets.

With the collaboration ol the Corporationlor National Research Ini t ia t ives, an experimental"handle server" was established at NLM The handleserver will be used for experiments in the use ol theUniform Resource Name, an identifier attachedpermanently to an information object, in place ol theUniform Resource Locator ubiquiious in World WideWeb documents today

HyperDOC, the in i t ia l version ol NLM'sprincipal Web server and home page, was createdseveral years ago by Dr Rodgers This was one olthe first Web servers in the Federal government, andone of the more complex and interesting early Websues In FY 1996, Dr Rodgers helped to transitionthis system into a lull-fledged NLM serviceencompassing all divisions ol the Library Thisincluded recruitment of a new technical supportperson to work within NLM's Office ol Computerand Communications Systems Dr Rodgers alsomade public an online mult imedia version ol theIslamic Medicine exhibi t that was on view at NLM in1994. He was asked to advise the NIH-wide groupthat is now developing a Web-based system lordisseminating NIH's consumer health information

As a member of both the InternationalWorld Wide Web Conference Committee and thePans Program Committee, Dr Rodgers participatedin the Fi l th Internat ional World Wide WebConlerence in Pans, France May 4-12, 1996 At thatconference he orgam/ed and co-chaired an expertpanel t i t led "Multicasting & Real-Tune Applicationsand the F'uture of the Web " This was the f i r s tpresentation at a major international meeting to useInternei-based teleconferencing half the panelistsparticipated from four different sites in California,the other hal f were present in Paris Dr Rodgers

28

Lifter Hill National Center for Biomedual Commnni((itu>n\

chaired the session on visuuh/.alion applications atIhe Federal Webmaster's Workshop in August 1996and he made a presentation during this session aboutNLM's Visible Human Projeu

Full Text-Online Reference Work* (ORW) Project

Mr. Charles Goldstein, long-time Chief olthe Information Technology Branch (ITB), retiredfrom the Federal service during FY 1996 The staffand projects ol ITB were integrated into theComputer Science Branch. The primary efforts in theFull Text-Online Reference Works project during FY1996 focused on improving the Web-based client(and interlace) to the retrieval system by whichdocuments Irom the Health Services/TechnologyAssessment Text (HSTAT) collection are providedonline. In addition, eflorts were made to simplify theaddition of new data by revising the StandardGeneralised Markup Language (SGML) encodingrequirements and providing Document TypeDefinitions to the data providers tailored to the styleol report or document to be submitted

Approximately 10 megabytes ol newdatabases (exclusive of the graphics associated withthem) were added to HSTAT, a 20% increase in thesi/c ol the available online collection. These includeAgency for Health Care Policy and Research clinicalguidelines and NIH Consensus DevelopmentReports.

An agreement was made with the Center lorSubstance Abuse Treatment of the Substance Abuseand Mental Health Services Administration(SAMHSA/CSAT) to include then TreatmentImprovement Protocols in the collectionApproximately 90% ol the data received lor inclusionin HSTAT prior to FY 1996 has been modified totake advantage of the features of Hypertext MarkupLanguage 3.x, especially the ability to render tabulardata in a reasonable and relatively readable manner inthe Web browser

Machine Learning Project

As reported in NLM Programs and Service*in past years, the Lister Hill Center has beenexploring the application ol machine learningtechnology to biomcdical problems in an ac t iv i tyknow as the Machine Learning Project Theunderlying motivation lor this work arises Irom theexplosion of available biomedical mlormation andthe less well acknowledged explosion ol analyticaltools and techniques thai can be applied to themlormation

During FY 1996, the Machine LearningProject has entered into collaborations with

researchers around the world to apply machinelearning technology generally to problems ofbiomcdical significance Included in this work areapplications to predicting the lilespan olHIV-infectcd individuals, understanding proteinfolding, and new research in modeling of complexassemblies of neurons.

MedlndEx Project

Work continues on the MedlndEx Project,reported in previous years, the mam objective olwhich is to facilitate expert indexing The MedlndExProject develops and tests interactiveknowledge-based systems for computer-assistedindexing of medical literature currently indexed inMEDLINE using terms Irom the Medical SubjectHeadings thesaurus Another focus ol this research isto develop intelligent retrieval systems utili/.mg thesame representations and environment of theindexing system

In addition to the Indcxer Interlace currentlybeing developed, the MedlndEx System includessoftware designed to assist knowledge engineers inensuring a consistent, compact, and syntacticallycorrect knowledge base. An evaluation of the systemis in progress.

Medical Informatu v Training Program

The Medical Informatics Training Programwas established in February 1996 at the suggestion ofthe LHNCBC Board of Scientific Counselors. TheProgram develops, coordinates, and evaluatesmedical informatics t ra ining at LHNCBC It providesrecruitment and advising ol students, the matching olstudents with mentors and preceptors, and theadministrative support needed to bring students toNLM and provide stipends where appropriate

Opportunities arc provided for students atvarious stages m their careers. These trainingopportunities benefit both the students and the NLMresearchers, providing contact for NLM researcherswith bright young people interested in medicalinformatics

During FY 1996, the LHNCBC MedicalInformatics Training Program provided training tohigh school, college, medical school, post-M.D. andpostdoctoral students and to high school teachers anduniversity facul ty members

Communications Engineering Branch

The Communications Engineering Branchfocuses on R&D in image engineering andcommunications engineering Included are the

29

Program!, and Service*, FY

capture, .storage, processing, online retrieval,transmission and display of both biomcclicaldocuments and medical imagery Data types olinterest include bitmapped bitonal document images,digitucd color documents, digiti/cd x-rays, colorcryosection images from NLM's Visible Humancollection, and motion video Areas of activeinvestigation center on image compression, imageenhancement, image understanding, pseudo-grayscalerendition, image transmission and networksimplemented via asynchronous transfer mode (ATM)and satellite technologies, optical characterrecognition (OCR) and man-machine interface designapplied to automated data entry.

This applied R&D is motivated by NLM'smission-critical tasks such as document delivery,archiving, and automated data entry, as well as wideInternet access to mixed text/x-ray image databases,and future imaging applications in support of medicaleducational packages employing digm/edradiographic, anatomic, and other imageryInformation on Branch projects appear in our Webserver at http://archive.nlm.mh.gov

Automating Data Entry into MEDLINE

In response to a crisis in early 1996 in (hedata entry of citations and abstracts of medicaljournal articles for the MEDLINE database, theCommunications Engineering Branch developed asystem, temporarily code named MARS lor MedicalArticle Record System. MARS is designed to serveas an alternative to manual key boarding, thetraditional method of data entry followed for manyyears. MARS combines the kcyboardmg of citationdata which may appear in different areas of a journalissue with scanning and the automatic text conversionof abstracts which, i! kcyhoarded, proves very labor-intensive.

Designed to enter 500 records a day, MARSconsists of multiple workstations ol three typesscanner, reconciling, and keyboardcd citation entryIn addition, the system requires three servers: anetwork file server, an OCR server, and one to matchdouble keyboardcd citations In parallel with softwaredevelopment, we specified and acquired thehardware, designed a floor plan to ensure smoothwork flow, installed additional power, and laid (heEthernet cabling for LAN connection Allworkstations, networked via a LAN, are installed andoperating at the work site.

Briefly, the MARS system works as follows.The scanning operator scans the pages on which theabstracts appear, and /.ones the titles and abstracts,and the bitmapped TIFF files arc sent to the networkserver The OCR server performs text conversion on

these TIFF fi les , and produces text files ol theabstract and title. A citation entry operator keys in allthe citation fields in a template for the journal issueand each article, and a second operator repeats thisprocess for the same journal issue and articles. A"citation match" module in the matching servercompares the two ci tat ion entries, and produces a"citation difference" f i l e highlighting inconsistenciesA MATCH module in the server then matches thisdifference file and the OCR'ed abstract, correlatingthe two article title texts (one from the scanned pageand the other from the keyboarded citation). At thispoint, both the citation and the abstract arc availablefor reconciling (validation and proofing). Followingthis step, the completed record files arc sent to amodule in the NLM mainframe computer from whichthe files are later accessed by mdexers who add theappropriate descriptive information such as MedicalSubject Headings

One advantage of th is networked approachis that all three operator functions (scanning,reconciling and citation entry) can be doneconcurrently, so that a fixed sequence of operations isnot necessary For example, citations may bekeyboardcd before or a f te r abstracts arc convertedThe network server maintainsdirectories in which thescanned TIFF images, Ihc text abstract files, and thecitation files are all retained t i l l they are acted upon

Current work is focused on increasing thelevel of automation in ihc system Some incrementalimprovements have been made, for example, by. (a)modifying the scanning workstations to allow theoperators to enter journal issue identificationnumbers by barcode readers instead of keyboardentry, (b) providing on-screen tables containingGreek and special symbols, (c) providing a highhght-and-click capability to capitali/e or de-capilah/cwords or entire text l ines, and (d) changing icons,error messages, and buttons lor clarity

Research toward more comprehensiveautomation is planned through automated field entryby page segmentation software being developed byMr Daniel Lc and (he application of fieldreformatting and validation rules To iden t i fy thebottlenecks in the current system, Dr Susan Hauserand Mr. Lew Berman arc developing instrumentationcode to synchronise all workstations to provide acommon time-stamp origin, to create log files, extracttiming data from the log fi les and to analy/e therecorded data

DocView

As described in last year's NLM Programsand Service1!, this program aims to investigate therole ol advanced client software that provides access

30

Lister Hill National Center for Hiomedual Communu alums

lo, and facilitates delivery ol, bitmapped images ofbiomedical documents over the Internet WhileInternet transmission of documents has beenimplemented by systems such as Research LibrariesGroup's Ariel, now a popular way for libraries toexchange documents among themselves, there hasbeen less of a focus on .serving the end user. Ourdevelopment of DocVicw is centered on the end userreceiving bitmapped document images over theInternet from servers (Web, Gopher or FTP), orscanned and sent over the Internet by Ariel systemsThe DocView client software runs under any ol theversions of Microsoft Windows.

DocView is currently being beta tested loestablish the technical feasibility of easy and intuitivedocument delivery over the Internet Mr. FrankWalker, the principal designer of DocView, releasedthe seventh version of the DocView beta program lorthe final phase of the ongoing beta testing with over35 orgam/ations in nine countries.

DocView offers a number of functions,including the ability to receive documents at the enduser's desktop, forward the document (with orwithout added text), order a document, viewmonochrome images, process images (/.oom, scroll,etc.); insert an electronic bookmark; copy and pasteparts of a document, and manage folders orcollections of documents.

Investigation into DocView's performanceand usage relies partly on feedback from users (betatesters). User feedback is implemented by both abuilt-in Comments function as well as an electronicuser survey.

One new feature added in response lo userfeedback was an Adaptive CommunicationsAlgorithm In this design DocView automaticallymaintains a database of IP addresses of the ten mostrecent Ariel systems that have sent the userdocuments. When the user powers up DocView, thesystem uses this database to contact each of the Arielsystems and receives documents from any Ariel thathas documents in its queue for this particular userThree papers describing DocView were presented atthe 1994, 1995, and 1996 Integrated Online LibrarySystems (IOLS) meetings, and published in theirproceedings. The most recent references: (I) WalkerFL, Thoma GR Internet document access anddelivery. Proc. Ilih IOLS Meeting. Medford NJ.Learned Information, Inc. May 1996, pp. 107-16 (2)Thoma GR, Walker FL. Access to document imagesover the Internet. In1 Rada R, Ghaoui C, eds. MedicalMultimedia; Oxford UK: Intellect, 1995, 179-93.

Workstation for Interlibrary Loan (WILL)

As described in last year's NLM Programsand Services, the pilot System for AutomatedInterlibrary Loan (SAIL), after 4 1/2 years ofsuccessful operation, was discontinued. The projectevolved to a different design and produced a systemcalled WILL. WILL is a multifunctional integratedworkstation that delivers documents on demandWILL automatically retrieves ILL requests fromDOCLINE, parses the request into data fields,provides a GUI for the operator to scan requesteddocuments, and automatically delivers documentimages by all three delivery modes (print for mail,fax and Internet), and updates DOCLINE with status.The only process that cannot be automated is thephysical handling and scanning of the documents.

To investigate the role of WILL inmtcrlibrary loan services, a beta test was installed byDr. Susan Hauscr at the NIH Library. Between lateApril and the end of September 1996 over 119,500requests were automatically retrieved, sorted, andprinted out by WILL, and status of the requestsautomatically updated in the request routing systemDOCLINE Since the vast majority of the requestswere for photocopies of articles, for which theconventional photocopy machines were used sincethey arc faster than printers, the most fruitful role forWILL was the automatic retrieval of requests andupdating of status rather than the automated fax andInternet delivery of documents. However, over thistime period some documents were indeed scannedand delivered by these modes. The beta test willcontinue through the next fiscal year.

WILL was described in two internaltechnical reports issued by the Branch in early FY1996 These arc titled WILL Advances in themanagement of mterhbrary loan, and WILL. Designof a standalone WILL unit Dr. Thoma presentedtalks on WILL at the Computers in Librariesconference in Arlington, Va., in February 1996 andthe 11th Computers in Healthcare EducationSymposium in Philadelphia in April 1996. Anextended abstract was published: Thoma GR.Automating Medical Document Delivery Proc. lllhComputers in Healthcare Education Symposium,April 1996, pp 68-9.

lmaf>e Compression

This R&D activity was proposed on May 6,1996 by Dr. Thoma to the Board of Scientific

31

and Servit e\, FY IW6

Counselors as part of a project called linage Storageand Transmission Optimi/ddon The objective ol theImage Compression project is to conduct siudycommunications and compression techniques toaddress the storage and transmission ol the highlydata-intensive color cryosection image files Irom theVisible Human Project The investigation is directedtoward both a lossy as well as a lossless techniqueThe strategy is to store the data losslessly whileproviding access to it via the Internet at a lossmesscontrolled by the user.

The fundamental notion in designing thelossless compression technique is to exploit themterl'rame redundancy expected to exist in theimages, rectangulate and extract the region ol inteiesiand eliminate the background, and apply a losslesscompression technique such as Huffman coding

The approach considered lor the lossycompression work is to determine the "best" wavelettransform and optimum number of taps to decomposethe images followed by a suitable quanti/adontechnique, either scalar or vector Finally a losslesstechnique will be applied to the quanti/ed data

Following the May 6 presentation to theBoard of Scientific Counselors, and their stiongendorsement, an initial step was completed theestimate ol data compaction resulting fiom removalol the blue background This is an important issue loiboth lossy as well as lossless compression, butparticularly for the latter since it is not expected toyield a very high compression ratio The region olinterest was defined as the biological image segmentsas well as the fiduciary marks on each slice Thefiduciary marks, which are cross-sections ol two I-shaped cables and a plastic rod, appear .11 the sameplace with respect to the body on all slices, and areincluded because they can be used to register theslices The extraction method used is rcclangulationaround the selected areas rather than wavelengthdiscrimination as suggested by othei investigaiorsWe found wavelength discrimination to be unreliablesince the pixel values representing blue occur in aieasother than the background Rectangulation wasapplied to every tenth slice, i c , 180 out ol the 1870slices in the male dalaset. Since 10 slices represent Icm in the male body, the si/e ol the icciangulatcdsegments lor every tenth slices should be close to theaverage lor every slice The average si/e olrectangulatcd body segments was combined with thesi/e of the rectangulated fiduciary marks to give anapproximate CR for the entire datascl, which wascalculated to he 3 545 This means that any additionalcompression olfeied by eilhei lossy 01 losslessmethods would be increased by this multiplicativefactor

These items were discussed by Dr Thoma at

the NLM-sponsored Visible Human ProjectConference in a paper tilled "Image compressionapproaches lor (he Visible Human dalaset"

Communication!, Enguivennx Research

In light ol NLM's initiatives in telemedicine,we consider R&D in communications engineeringcrucial This research activity has included testing ofexperimental methods lor Internet file transmission,satellite tests conducted with (he University olCalifornia at San 1-rancisco using the NASAAdvanced Communications Technology Satellite,investigation ol use ol the World Wide Web lordissemination ol biomedical database information,and experiments using asynchronous transfer modetechnology over dedicated high-speedcommunications links

This work is focused on the optimi/ation olTCP/IP performance, both lor lile transfer and lotinteractive applications and includes experimentsboth on the Inteinet and on dedicatedcommunications links ol opportunity Anexperimental optimi/ation method (multisockeltransmission) developed in-house is beinginvestigated

Inlemet TCP lile tiansmission experimentswere conducted in 19% between NLM and theUniversity of An/ona, using both conventional FTPand the NLM multisockel method. Visible Humandigital color files (7 megabytes) were used in thiswork A similai experiment was conducted on adedicated T-l (1544 megabits/sec) Veiy SmallAperture Terminal (VSAT) link between NLM andthe University of California at San Francisco, theVSAT work also included experiments with an RFC1323 TCP implementation Results ol die work werereported at a workshop on the Visible Human project,conducted at the 1996 SPIH Medical Imagingconference in Newport Beach, C'A In both theInternet and VSAT work, a substantial transmissionrate improvement was measured by use ol themullisockel method and by use of RFC 1323 TCP

For evaluating performance over ouicommunications tesi-beds, we aie using the in-house-developed Medical Information RetrievalSystem (MIRS), which allows query and retrieval oftext and images Irom biomedical databases. MIRS isSun-workstation based and requires the installation ofMIRS client software The MIRS concept is beingextended by investigation into use ol the World WideWeb and new Java soflw.iic technology loibiomedicul information delivery on a laige class ofhardwaie platforms

Mr Long and Mr Michael Gill have begun to

Lister Hill National Center /or Riomedu til Conimiini«itions

evaluate ATM technology lor Visible Human anddigital x-ray image liansmission wi th theestablishment oi a DS-3 (45 megabits/sec) l ink hornNLM to the Texas Medical Center in HoustonExperiments are beginning on a second ATMconnection, which l inks NLM to the ATDNET, atOC-3 (155 megbils/sec) rates This connection alsomakes available to NLM use ol the NASA High DataRale Terminal at Goddard Space Flight Center, overwhich additional satellite-mediated experiments areplanned

Selected papers on the communicationsactivity include ( I ) Long LR Transmission olmedical images over wide area networksProceedings of the 1st Visible Human Con/eren<e,Bethesda, MD, October 7-9, 1996 (2) Long LR, Gi l lMG, Thoma GR High-speed satellite access tobio-medical text/image databases. Advanied DigitalLibraries '9f> Forum on Research and TeihnologvAdvames in Digital Libraries, Library ol Congress,Washington, DC, May 13-15, 1996 (3) Ba/ i l l TM,Huang HK, Thoma GR, Long LR, Gil l MJ Highspeed image transmission via a communicationssatellite Proi SPIE Medual Imaging '96, NewportBeach CA, p 337 (4) Long LR, Thoma GR Medicalimage database access via satellite Prtx ACTSResults Conjereme, NASA Lewis Reseaich Cenlei,Cleveland OH Sept 1995, VSAT section

Document Image Analysis

As described in last year's NLM Progiamsand Seivues. Mr Daniel Le developed an algorithmto delect the orientation (poi t rai t vs landscape) ol abinary page image Orientation detection is anessential preprocessing stage lor optical characterrecognition, skew detection or skew correction Inaddition, page orientation is crucial lor automateddocument data entry in which the contents ol aprinted document is lirst segmented into such regionsas headlines, author or t i t l e fields, text columns,graphics or footnotes NLM has applied to the U SPatent and Trademark Oil ice for a patent to protectthis invent ion

This research is descnbed in several papers inthe literature, most recently in Le DX, Thoma GR,Wechsler H Classif icat ion of binary documentimages into textual or non-textual data blocks usingneural network models Machine Vi.sion amiApplication^ Issue 8, 1995, 429-35.

Digital X-ray Imaging Pro/e< is

These projects have been described in NLMProgram* and Services in previous years One ol theprojects named DXPNET lor Digital X-rav Prototype

Network serves as a vehicle to address engineeringgoals while creating an archive ol digili/edradiographic images accessible over the Internet. Anini t ia l prototype Slandardi/ed Reading Workstation(SRW) was developed on a Sun 4/260 platform, withimage display on both the standard Sun monitor and ahigh resolution Megascan monitor. Mr. Rodney Longand colleagues have completed all planned funct ionslor the workstation They have completed systemtests and debugged the software As a result, the basicfunctional capability of the system to collect readingsis available, and U is well-positioned to move to thefield-test level

This implementation includes (hefunc t iona l i ty required to create stand groups forwhich modules were designed lor the duplication ofimages for QC, the inclusion of gold standard imagesand the randomi/ation of images for the readers Forthe reading groups, three software modules wereimplemented one each for the technician, medicalconsultant and medical adjudicator, the three types ofreviewers envisioned doing the standardi/edreadings Region-of-mleresl funct ions for /.oommgand histogram cquah/ation have also beencompleted, but these routines are general enough toaccommodate other image processing functionsAnother func t ion being developed for the SRW is anonline radiological atlas that a reader can reler towhile leading the cervical and lumbar images

To increase the e f f ec t ive image access anddelivery speed, the storage system has been expandedbeyond the optical jukebox to include a SunSparcarray RAID system controlled by a Sun Spare20 A performance study was done to identify theRAID level optimum lor this data collection, and waspublished Hauscr SE, Berman LE. Thoma GR. Is thebang worth the buck' A RAID performance studyProt 5th NASA Goddard Conjereme on MU.S.SStorage Ssslems and Technologies NASA Pub No3340, Sept 1996, 131-40

As an extension ol the DXPNET work, ourNational Center for Health Statistics collaboratorshave proposed a fu tu re pro|ect to read I(),0(K) handsand knees x-ray images from the third NHANESsurvey A key issue here is the scan density (spatialicsolut ion) required to read this class of x-rays whendigili/ed We have completed the design ol aworkstation to i den t i fy the optimum resolutionrequired The idea is to use a few score images froma study on the Puna Indians as a way to establishresolution requirements lor the large NHANES IIIcollection The Puna Indian x-ray images have beendigiti/ed at three d i f f e r e n t spatial resolutions 2000 x1634, 3000 x 2400 and 3000 x 4900. The sollwarewill display these images on the high resolutionmonitor, allow subject experts to examine these and

33

Programs and Service*. AT

record interpretations. This workstation wil l hecompleted in 1997

While the SRW and related systems weredeveloped specifically for the DXPNET project,another project was motivated by (he potentiallywidespread interest in the heretofore inaccessible x-rays from NHANES. This project focused on thedevelopment of a prototype system named MIRS(Medical Information Retrieval System), designed toenable general access via Internet to the mixedtext/image database consisting ol NHANBS IIcollateral data and the x-ray images MIRS isdeveloped on a Sun Spare 10 platform and uses X-Wmdows and TAE Plus lor interface development.Access to the data is by SQL query, and the data isorganised in an Illustra DBMS An anticipated betatest of MIRS wil l demonstrate access to theintegrated database consisting ol the images, thestandardized readings, and the correspondingNHANES collateral data (demographic, bloodchemistry lab data, medical questionnaire data, etc )Although beta testing of MIRS wil l be done ovci theInternet, ATM, as well as over the ACTS satellitelink, it was demonstrated at the Department of Healthand Human Services in Washington D C and at theMaryland Governor's Technology Showcase inBaltimore in 1996 Recent references to our design olMIRS arc (I) Thoma GR, Bcrman LE, Long LRInternet access to a biomcdical text/x-ray imagedatabank Prot 19th International Online MeetingOxford UK. Learned Information Europe Ltd , 1995,429-35. (2) Thoma GR, Long LR, Berman LI< Aclient/server system for Internet access to biomcdicaltext/image databanks. Computerized MedicalImaging and Graphics (1996), 20 4, 259-68

To increase widespread acceptance of MIRSin the future, we are designing a platform-independent Web-based MIRS system using the SunSpare-based system design as a foundat ion The newdesign, written entirely in Java, provides input heldvalidation; simple query formulating capability toautomatically generate sql queries, multithreadedimage download and display capability enablingmultiple images to be retrieved and displayedsimultaneously; and support lor Web-based databaseaccess using Java Database Connectivity An earlyversion of this system has been demonstrated, asnoted earlier

Visible Embryo Project

The goal of this project, now completed, wasthe development of a Web-based distribution systemfor the embryo images and associated text from theworld-famous Carnegie Embryo Collection housed atthe Armed Forces Institute of Pathology (AFIP). Mr

Lew Berman led the development e f fo r t and alphaand beta test phases. The beta test group consisted ol38 participants from a wide range of disciplinesmedical researchers, students, NIH staff, anddatabase suppliers Following the lest phases, wetransilioned the Visible hmbryo Web site in June1996 to a Silicon Graphics machine at AFIP Theproject was funded by the National Institute of ChildHealth and Human Development

Engineering Ltihoratorie \

The R&D conducted by the CommunicationsEngineering Branch relies on two laboratories whichare designed, equipped, and maintained by theBranch The Document Imaging Laboratory supportsthe DocVicw, WILL, and Document Image Analysisprojects The Image Processing Laboratory supportsthe investigation of image processing techniques forboth grayscale and coloi biomcdical imagery at highresolution As described in last year's NLMProgram* and Services, both laboratories containhigh-end workstations and a variety of Ethernet,Token Ring, and other network connections

Cognitive Science Branch

The Cognitive Science Branch (CgSB)conducts research and development in learning andinformat ion technologies CgSB stal l participate inthe health professions education, computer andinformation sciences, and medical informaticscommunities. The branch maintains a World WideWeb server (wwwcgsb.nlm nih gov) that providesinformation relevant to health professions educationand information technologies The server featuresinformation about CgSB icsearch projects, resources,and monographs and provides l inks to related Websites

Research staff have developed a variety oftutorials on Internet-based resources and distancelearning which arc also available on (he server TheCgSB Web site is updated regularly and new featurescontinue to be added

Re\vanh in Learning

The Learning Center lor Interactive Technology

The Learning Center for InteractiveTechnology showcases a wide range ol computer-based information and educational technologiesrepresenting stand-alone, local area networked, andwide area networked applications in the healthsciences More than 10,000 individuals representing ahighly diverse population of health professionals and

34

Lister Hill National Center for Hinmedu al Communication \

students have visited the Center since us inception in1984 The f i l ty-plus groups visiting The LearningCenter in 1996 included university presidents,international health leaders, business representatives,loreign exchange students, medical and nursinginformatics students, students f rom local elementaryand high schools, and Elder Hostel members (citi/cns65 years and older)

Visitors this year were especially interested inhow to use the Internet and the World Wide Web toImd and provide health-related in format ion Stallprovided demonstrations ol new and emerging onlinetechnologies and used the CgSB Web site to pomlvisitors to a variety of online multimedia educationalresources in medicine Staff also provided m-dcplhindividual and group consultations on how to createonline multimedia resources and demonstratedexemplary distance learning applications availableover the Internet f rom various health sciencesinst i tut ions

Continuing collaborations and outreach activitiesby Learning Center s t a l l ' dur ing 1996 included sevenprofessional presentations and publ ishing iwo revisedtechnology monographs and one original tutorialStaff also presented eight tutorials on "Introduction tothe Internet and World Wide Web RadiologyResources" and nine tutorials on "DevelopingResources lor World Wide Web and RSNAElectronic Journal (RSNA liJ)" to more than 600health professionals at the Radiological Society ofNorth America Annual 1996 Meeting Incollaboration with other NLM programs, TheLearning Center also served as the setting loroutreach activities in which several teachers andstudents completed practicums to meet therequirements ol (heir respective internships

Distributed Learning Environments

The purpose of the Distributed LearningEnvironments project is to investigate, demonstrate,and evaluate various in fo rma t ion and communicationtechnologies for distributed learning Emergingtelecommunications and computer-mediatedtechnologies, especially those based on the conceptsol distributed computing architectures andclientAcrvcr computing systems, can expand andenhance learning experiences and opportunities bymaking them available anyplace, anytime. These newtechnologies and conceptual frameworks oiler a newenvironment for developing and delivering learningexperiences, one that is dccentrali/ed and emphasi/eslearning over teaching The major objective of thisproject is to iden t i fy the potential ol thesetechnologies and concepts to provide enricheddistance learning experiences in the health

professionsProject efforts focus on developing

innovative means for delivering online distancelearning integrating telecommunications, the Internetand the World Wide Web Project staff collaborateclosely with health science institutions and othergovernment programs involved in distance learning.Applications will exemplify collaborative authorshipof learning resources by developers, the collaborativeuse ol these resources by faculty, resourcesharing/exchange by both facu l ty and developers, andcooperative learning by students Developers, users,and resources that reside at different sites will beinterconnected by emerging communicationtechnologies

In 1996, a review of the literature ondistributed learning environments, distance learning,and collaborative learning was completed As a resultof this review, staff made seven presentations ondistributed learning in the health professions alregional and national conferences and published onejournal paper. Additionally, an ongoing assessmentol current and emerging telecommunications andcomputer-mediated technologies was initialedCollaborations arc ongoing with health scienceinstitutions and other government distance learningprograms.

Digital Microscopy System Project

In 1994 the Digital Microscopy System(DMS) project set aboul attempting to determine Iheparameters that govern the indexing of a library olmedical photomicrographs so that eventually alibrary of such materials can be available to medicalpractitioners, researchers, and students via the WorldWide Web In particular, Ihc project intended todetermine whether, as had been suggested by theLHNCBC Board of Scientific Counselors, suchimages can be described using the concepts found inthe UMLS Metathesaurus

A well-delmcd sub-set of the universe olsuch images was chosen lor the tasks DMS had inhand a set of prostate photomicrographs that wererecorded in analog formal by another LHNCBCproject and had access to an expert consultant ingcnilo-urmary (GU) cytology, also as a result of workon the previous project

During the 1994-95 period an expert panel offour GU pathologists indexed a series ol 51 prostateslides. They worked independently and supplied toNLM keywords (index terms) to describe mor-phology, a diagnosis, and a written slide descriptionThe results indicated that although they alwaysagreed on the diagnosis, they frequently usedd i f f e r e n t words to describe the slides

Programs andSi'rvne\, hY I99f>

morphologically Furlhcr, only about ft(>'# ol thelerm.s used could be mapped to the 1995 version ol(he UMLS Mctathcsaurus Use ol the analog images(resident on a videodisc) proved to be cumbersomeand so in mid-1995 one of the consultants came toNLM to record a lew prostate images in digitallonnai

Three s ign i f i can t developments came in HY1996 First, DMS installed a WWW server on one olits computers providing potential mdexers with thecapability of having on a single screen aphotomicrograph and the input screen lor theMctalhesaurus The server may be accessed throughthe CgSB Web site Access to the indexing researchpage is restricted but a password may he obtained bycontacting the project o f f i c e r via the email l i nk on theDMS home page

Second, a collaborative effor t was initiatedwith the Department ol Pathology at the Univers i tyof Pittsburgh and WWW pages were developed (hatpermit mdcxers to see images stored on the DMSWeb server and enter keywords and diagnoses Thetwelve images that were captured at NLM in 1995have now been indexed by six paihologists operatingremotely Irom Ann Arbor, Baltimore, Denver andPittsburgh The index terms entered into thePittsburgh database have been submitted to theNLM/AHCPR Large Scale Vocabulary Test and thedata are just now being analy/ed Even before theanalysis is complete, cursory examination indicatesthat well over 90% ol the terms are recogm/ecl bywhat will be the next edition of the Mclalhcsauius

Third, DMS has developed a WWW pagethat wil l give mdexers access to the images and acontrolled vocabulary (Mctathesaurus concepts)During early 1997 the team ol mdexers will re-indexthe test set of images using the controlled vocabularyand inlcr-mdexer variabilities can then be studied

Research in Information Te<.hnol<>xie\

Natural Language Systems Program

The Natural Language Systems (NLS)research team is concerned with investigating thecontributions that natural language processingtechniques can make to the task of mediatingbetween the language of users and the language olthe databases they attempt to access The success!ulintegration of these techniques with othersophisticated retrieval strategics has the potential ofcontributing to the resolution ol some of the mostd i f f i c u l t problems laced by health professionals asthey attempt to access biomcdical information incomputcri/.cd form.

The locus ol NLS work is the development ol

SPECIALIST, an experimental natural languageprocessing system lor the biomedical domain TheSPECIALIST system includes several modules whichare based on the maior components of naturallanguage—lexicon, morphology, syntax, andsemantics The morphological component isconcerned with the slruciuie ol words and the rules olword formation The syntactic component treats theconstituent structure ol phrases and sentences, andthe semantic component is concerned with meaning,with emphasis on the domain of discourse All threerely heavily on the lexical component which encodesthe information specific to the lexical items in thelanguage

An ongoing and fundamental aspect of NLSresearch is the evaluation ol the eflcctivcness olnatural language processing in the context olmlormation retrieval NLS staff regularly conductexperiments using the SPECIALIST system andUMLS knowledge to assess incrementalimprovements in retrieval effect iveness It is atestable hypothesis that methods such as those underdevelopment by the NLS group, which depend onextensive l inguistic and domain knowledge, providean advantage over methods which do not have accessto such knowledge

Lexical Systems Project

The Lexical Systems Project brings togetherseveral activities centered around lexical issues,including development and maintenance of theSPECIALIST lexicon and the lexical toolsdistributedwith the UMLS as well as a project to exploit thoseresources lor text analysis The volume of textavailable in electronic form is increasingexponentially Text processing algorithms exploitingthe lexicon and lexical tools can be used inexperiments companng word-based andconcept-based retrieval algorithms

The SPECIALIST Lexicon

A major component ol the Lexical Systemsproject is the SPECIALIST lexicon, a large syntacticlexicon ol medical Icimmology containing over1()(),(M)() lexical items Lexical items are collectedinto uni t records containing morphological, syntactic,and spelling information about each itemMorphological information includes l u l l inflectionalinformation for each lexical item A database olderivational relationships is also maintained with thelexicon Morphological and spelling informat ion isimportant tor matching of lexical items and forms amajor part of the capability ol the lexical toolsSyntactic informat ion includes sequencing

LiMer Hill National Center fur Biomedical Cummnnii ution\

informaiion lor adjectives and complement patternsfor verbs. Verb complement information is central toanalysis of sentence structure. A recent experimenton the lexicon coverage of MEDLINE text showedthat the lexicon was able to account for 95% of theword-tokens in a random sample of MEDLINEabstracts

The lexicon has been bui l t and maintained byNLS staff together with several expert consultantsTools have been developed to facilitate lexiconbuilding and to ensure the consistency of the lexicalentries, Lcxtool, the original lexicon building toolwritten in Prolog, has recently been replaced by aWeb-based tool called LexBuild. Both tools enforce acomplete and consistent form for lexical entries, andprovide users wi th a menu-based approach toentering lexical informat ion A "lexicon grammar"specifying the correct form of lexical records assuresthat lexical records created by the tools are correctlylormed The f i r s t large-scale e f fo r t in lexiconbuilding was in 1990 when l ive expert consultantsworked off-site using government supplied computerequipment and software to expand the lexicon. Thiseffort brought the lexicon to over 40,000 lexicalrecords In 1994, when the lexicon was first releasedas one ol the UMLS Knowledge sources it containedapproximately 64,000 lexical records Anothersuccessful lexicon building project in 1995 increasedthe si/.e of the lexicon to over 80,000 items

An ongoing lexicon building project hasbrought the lexicon to its current si/c Two lexiconconsultants arc working o f f - s i t e with (he Web-basedtool, LexBuild New lexical records are downloadedto NLM via the Internet biweekly This project isscheduled to continue un t i l April 1998 Each ol thelexicon bui lding projects has emphasi/cd qual i tycontrol and correction ol errors in the exis t inglexicon as well as growth of ihe lexicon The cuirente f f o r t has concentiated on icrms from the UMLSMclalhesaurus that have been assigned lexical tagsIn the future, lexical tags wil l be removed from theMclathcsaurus and the lexicon wil l carry thatinformation Both consultants are professionall inguists with broad knowledge of the issues involvedin lexicon coding and pievious experience asconsultants in previous SPECIALIST lexiconbuilding projects.

Lexical Tools

The lexical tools are designed to help usersabstract away from certain sorts of lexical variation.Retrieval and matching tasks of ten require some wayto ignore variation. The three tools Ivg, norm, andwordmd offer this sort of capability Lvg uses theSPECIALIST lexicon, and associated databases

along with a set of heuristic rules to allow users toabstract away from alphabetic case, word order,variations in punctuation, spelling variation,inflection, and derivation. Lvg offers methods (calledflows) which can combine these functions to produceindexes with varying degrees of aggressiveness withrespect to the matching ol terms. Essentially usersuse Ivg io create the index keys for the terms theywish to search Using Ivg again with the same flowsgives the users the capability of matching termsthrough the index in a way that abstracts away fromthe sorts of lexical variation (hey wish to ignoreNorm encapsulates one ol the flows ol Ivg and isused in the UMLS Melathesaurus to create thenormali/cd string index together with wordmd tocreate the normali/.ed word indexes

Modular Text Processing System

The Lexical Systems group is developing atext analysis system based on the SPECIALISTlexicon and the lexical tools The system is modularin design in order to allow for f lexible use andcontinuous revision. The modules arc servers whichwil l be available to a variety of clients for a variety ofuses Interchangeable versions of particular modulesshould facilitate experiments to improve the systemThe system wil l consist of several modules atokcm/cr module to analy/c text into tokens andlabel them, a sentence identification module toanaly/e text into sentences; a lexical look-up moduleto find lexical items in the text; a preprocessormodule to i d e n t i f y items m the text that do not occurin the lexicon but have types recogm/.able from theirform; and a parser module to assign phrase structureto the sentences of the text. A structured text analysismodule is also planned This module wil l deal withstructured text such as text with SGML markup,MEDLINE record structure or other structured texttypes Preliminary versions of each module, with theexception of the preprocessor module, have beencreated in a pilot project.

The tokcni/.cr and sentence iden t i f i e rmodules of this early version use regular expressionsto break text into tokens and sentences and to iden t i fythe type ol each token. The pattern used to i d e n t i f ysentence breaks was selected after some preliminaryempirical studies of sentence breaks in MEDLINEtext. The lexical look-up module uses a BerkeleyDBMS database Mult i- token lexical items(multi-word terms) are retrievable by their first tokenso the lexical look-up module can detect multipletoken lexical items without combinatorial explosionLexical look-up currently uses a strategy of f indingthe longest left anchored match to cover a span oftext

37

Pn>Riam\ ami Service1,, f-'Y

The design ol (he parser modulo is intendedto be strongly bused on the syntactic informationencoded in the SPECIALIST lexicon The structureol sentences is determined in large part by thecomplement patterns of the verbs thai occur in them.Alter consideration ol several grammar paradigms,Catcgonal Grammar was chosen as a grammaticalsystem thai expresses th is lexically based approach tosentence structure The lexical record lor each lexicalitem wil l be translated into a categonal grammarcategory symbol which expresses how thai lexicalitem combines with other lexical items and phrases toform a larger phrase In the preliminary version of thesystem Ihc place ol ihe Catcgonal Grammar Parser isbeing held by a simple phrase extraction programThis program extracts phrases containing nouns andtheir pre-modifiers An early application ol Ihe lexiprocessing system will be to test ihe hypothesis that(he SPECIALIST lexicon encodes s u f f i c i e n tin fo rmat ion for parsing a good portion ol medicalEnglish text

Semantic Knowledge Representation Project

The Semantic Knowledge RepresentationProject was reccndy initiated in order to developprograms to provide usable semantic representationol biomedical free text by bui lding on the resouicescurrently available in the Uni f i ed Medical LanguageSystem (UMLS) Ideally, digital libraries of thefuture will provide "deep semantic interoperability,"that is, "the abili ty ol a user to access, consistentlyand coherently, similar ((hough autonomouslydefined and managed) classes ol digital objects andservices, distributed across heterogeneousrepositories" (Lynch and Garcia-Molma 1995) Anumber of challenges must be met before deepsemantic interoperability becomes possible, a majoraspect ol achieving this goal is reliable representationol the knowledge contained m text A richerrepresenladon wil l be required than is currentlyavailable This project is a lirst step toward providingsuch a representation for biomedical text It is alsohoped that the results ol (he project wi l l be applicableto automatic indexing m support ol enhancedinformation retrieval e f fec t iveness

As an example ol the type ol representationunder development, ( I b ) contains (he semanticpropositions which represent some ol the knowledgecontained in the text in ( l a )

( l a ) We u\ed hemujiltralitm to treat a patient witlidigoxin overdose tomplitated h) refractoryhyperkalemut

( I b ) Hemoliltration-TREATS-Overdose

Digoxm-CAUSl'.S-OvcrdoseOvcrdosc-OCCURSJN-PalientsHypcrkalemia-COMPLICATES-Overdosc

Each ol the propositions in ( I b ) has apredicate (in upper case) which is a relation from theUMLS Semantic Network Each of the arguments is aconcept from (he UMLS Meiathesaurus

A leprcsenlation such as that given in ( I b )could serve as a prime candidate lor the automaticindexing of free text II this could be reliably andaccurately imposed on free text, olher applications,such as question answering, retrieval of images, andguided browsing would be possible Knowledgemining applications, such as gathering informationfrom coinpuicn/cd pat ient records, would also befeasible

The Semantic Knowledge RepresentationProject relics on exislmg resources, especially theUMLS Knowledge Sources and the SPECIALISTnatural language processing lools The Parser(supported by the SPhCIALIST lexicon) providessyntactic analysis. MetaMap (supported bySPECIALIST lexical lools) maps syntacticallyanaly/ed text to Metalhesaurus concepts Theprogram ScmRep ihen uses the synlaclic structureand the UMLS knowledge 10 map to the SemanticNetwork, thereby providing propositions as semanticconceptual structure as shown in ( I b ) The Parser andMetaMap (wilh supporting resources) are currentlybeing used in several research projects They serve asa natural language froni-end for the Sourcererprototype which accesses the UMLS Informat ionSources Map They also support research in Ihe NextGeneration Indexing project

Evaluation is a central concern in this projectEffectiveness is based on Ihc number of propositionsretrieved In this context. 100% recall indicates thatall the propositions expressed m the text beingprocessed were produced by the program, and 100%precision indicates that only those propositions wereproduced. Achieving such a level of performance isunrcahstically ambitious given the current stale ofknowledge concerning natural language processingIncreasing precision by e l iminat ing incorrectinterpretations is currently being addressedPreliminary error analysis indicates that incorrectsemantic interpretations t a i l into three classes, thosedue to lexical considerations (ambiguity andsynonymy), those due to the rules which map tromtext to Semantic Network relationships, and thosedue to the process of identi lymg the arguments olSemantic Network iclationships The currentprecision rale may be ncai 70%, which is quite goodlor natural language processing ol free text, but it ishoped that the enhancements being undertaken wil l

LiMer Hill National Center foi Biomedicul Communi<ati(in\

significantly increase ihi.s raleCurrent research focuses on enhancing two

programs, MctaMap and SemRcp, which are centralto the semantic interpretation process. Two importantaspects of enhancing MetaMap arc improving thetreatment of ahbreviatory expressions and dealingwith ambiguous mappings, since both phenomenacontribute to lexical ambiguity, which is an importantsource ol error Increased coverage ol abbreviatoryexpressions in medical text is needed. However, theambiguity inherent in such expressions must beresolved. One aspect of resolving this ambiguity is todiscover abbreviations expanded in the text, since, i lthe correct expansion is ident i f ied , these are notambiguous Methods tor disambigualmg other typesol abbreviatory expressions have to be soughtAmbiguous mappings (ol non-abbrevialoryexpressions) arise lor various reasons and detractfrom the reliability ol the f i n a l semanticinterpretation One solution to this problem is the useof a statistical technique (Hidden Markov Model) toresolve ambiguity on the basis of the semantic typesassociated with the mappings Other solutions need tobe explored

In improving SemRep, the rules which maplinguist ic structures to relations in the SemanticNetwork need to be expanded A semiautomaticmethod for discovering such rules, based on patternsof semantic types occurring in sentences inbiomedical text, is being developed. The methods ofargument ident i f icat ion during the semanticinterpretation process need to be improved Oneaspect of this improvement is .1 more rigorous use olinformation for the complement structuie ol verbsand nommali/ations found in the lexicon. Anothergoal is to expand the ident i f ica t ion of coordinatenoun phrases

Umjied Medital Language S^.Mcni Proivt. t

UMLS Knowledge Source Server

The NLS group has designed andimplemented the UMLS Knowledge Source Serverlor accessing informat ion stored in (he UMLSKnowledge Sources The server provides f lexibleaccess to the UMLS data over the Internet Thesystem has three client interfaces a World Wide Webinterface, an application programming interlace(API), and a command-line interface TheKnowledge Source Server allows the user to requestinformation about particular concepts in theMetathcsaurus, including, for example, attributessuch as the concept's def in i t ion , us semantic types,(he concepts that are related to it, etc It also allowsthe user to request informat ion about the attributes

themselves, lor example, by asking for all theconcepts that have been assigned to a particularsemantic type, or by asking lor all the terms that havea particular lexical tag.

The implementation of the Semantic Networkmodule in the server computes the relationshipsbetween semantic types using the inheritanceproperty of the network type hierarchies Informat ionin the network can be queried in terms of thesemantic types and the relationships between them.The Information Sources Map module gives usersaccess to descriptions ol each of the databasescatalogued in the Information Sources Map and alsoallows them to see sample records for each of thedatabases. The SPECIALIST lexicon can besearched, and syntactic and morphologicalinformation about the lexical item will be displayed.The lexicon also forms the basis for the lexicalroutines and the normali/ed indexes that are used inthe Metathesaurus look up procedures

The World Wide Web interface to theKnowledge Source Server allows users to browse andexplore the data and to sec how those data arcorgam/.ed in the UMLS. The command-line interfaceis best suited for batch processing Researchers cansubmit a list of terms to the server to see il they canbe found in (he UMLS, and i l so, what attributes thematching concepts may have They can also f i l t e r theresults, for example, by retrieving only thosematching concepts that have a particular semantictype. The API allows developers at remote sites toembed calls in their application programs to theKnowledge Source Server, thereby accessing theUMLS data directly over the Internet

NLM/AHCPR Large Scale Vocabulary Test

During 1996 the NLM and the Agency lorHealth Care Policy and Research (AHCPR)sponsored a lest to determine the extent to which acombination of exist ing health-related terminologiescovers the vocabulary needed in health informationsystems The lest vocabularies arc those 30 that wererepresented in the 1996 release of the Mclalhcsaurustogether with three planned addit ions- the portions olSNOMED International not already in the UMLS, theRead Clinical Classification, and the LogicalObservations, Identifiers, Names, and Codes system.The NLS group designed and implemented aspeciah/ed application interlace to the UMLSKnowledge Source Server for use in the Large ScaleVocabulary Test Participants all over the countryused the Web-based system over five months andsubmitted more than 40,000 terms to the system Thedata arc currently being analysed and results areexpected to be available in the spring of 1997

39

eintl Scivi< i",. I-Y

Next Generation Indexing Project

The objective of the Nexl GenerationIndexing (NGI) project is to investigate methodswhereby automated indexing methods partially orcompletely substitute lor current indexing practices.The project will be considered a success if methodscan be designed and implemented that result inretrieval performance that is equal to or better thanretrieval of citations based on index terms assignedby humans

Human indexing is an expensive andlabor-intensive activity The total costs ol indexing atNLM include data entry, NLM stall indexing andrevising, contract indexing, equipment, andtelecommunications costs Indexers are highly trainedindividuals, not only m MEDLINli indexing practice,but also in one or several ol the subject domainscovered by the MEDLINE database. II automatedmethods can be successfully developed andimplemented, the project wi l l have an importantimpact on NLM's abil i ty to continue to providehigh-quali ty services to its constituents Secondanly,but also importantly, the project should contributesignificantly to mlormation science research. Asmore and more documents become available melectronic form, and as more and more orgam/alionsdevelop "digital libraries" for their collections,automated techniques lor accessing the informationare required It is not possible to index eachdocument by hand, and new methods must bedeveloped. The research products and publications olthe NGI project should contribute positively to theinformation science and digital libraries researchcommunities

CgSB Branch Chiel, Dr. Alexa McCray, isoverall coordinator ol the project in collaborationwith Dr. Nancy Wright, head ol NLM's IndexSection. Project work during 1996 has involved anumber of activities. Existing information retrieval( IR) research projects at the NLM were identihed,project leaders were invited to join the NGI team, andexisting research tools were ident i f ied loi project useThese include the UMLS Knowledge Source Seivei,(he Natural Language Systems lexical tools, theNCBI neighboring algorithms, and associativeindexing algorithms developed as a |omi projectbetween SIS and OCCS The Center's U n i xcomputer, which is cui rent ly being upgraded to anUltra Enterprise 4000, serves as a shared computerenvironment for the NGI project

The Next Generation Indexing project wi l lprovide NLM with an opportunity to investigate thedesign and implementation ol automated indexingmethods that will part ial ly or completely replace

current practices, as well as the cost savings that wi l lbe obtained from these automated methods Theproject should also be considered an opportunity toexamine some of the present assumptions about thecontents of MEDLINl: and existing indexingpolicies, and to deleiinme their relative costs andcontinuing value to cuirent and f u t u r e generations olMEDLINE users.

Audiovisual Program Development Branch

The Audiovisual Program DevelopmentBranch (APDB) conducts media developmentactivities with three specific objectives As its mosts ignif icant elforl, the branch supports the Lister Hi l lCenter's research, development, and demonstrationprojects with h igh-qual i ty video, audio, and graphicmaterials l;rom i n i t i a l project concept, throughimplementation wi th image preservation, transfer anddisplay, to project evaluation and reporting, all formsand formats ol imaging are produced.

Consultation and materials development arealso provided by the Branch lor the NLM'seducational and inhumat ion programs With themission requirement ol the Library to includeeffective outreach act ivi t ies , the support that theBranch provides to these programs continues toincrease From optical media technologies toleleconlerence support, the graphics, video, and audiomaterials requirement has increased m quant i ty anddivers i f ied m formal

The third aiea ol concentration is thedevelopment of technical improvements includingissues such as image resolution, color l ideli ly, mediatransportability, media storage, and imagecommunication In addition to techniquedevelopment by the s t a l l , the f a c i l i t i e s and hardwaresystems must reflect state-ol-thc-art standards in avery rapidly changing f i e l d High resolution video isa development area being explored that represents thefu tu re for improved electronic image quali tyMultimedia systems and techniques, visuah/alion,and networked media aie being puisued loi theeducational and cost advantages that they o i le rThree dimensional computer graphics, animationtechniques, and photorealistic rendering methodshave changed (he tools and products of the graphicsartists in the Branch. Digital video and imagecompression techniques aie central to piojecls beingpursued to improve image storage andcommunication With all ol the technologies beingbrought together in the development and supportprojects ol the Blanch, the central core expertiseremains the creative, a i l i s t i c , communication ski l ls olthe s t a f f

40

Lister Hill National Center for Hiomedical Communications

Visible Human Project

A videotape, "The Visible Humans-A SlcpToward Tomorrow" was completed in March 1996.Taping was done at several locations including theUniversity ol Colorado Health Sciences Center,Denver, where they videotaped actual imaging andsectioning activity over two years In addition totelling the history of the project, the tape locuses onthe applications ol the datasels by NLM licensees.More than 200 copies ol the tape have beendistributed to date The Branch also designed the newVisible Human Web site to provide backgroundinformation on the project as well as actual sampleimages Iroin the data set. It also provides l inks toother web sites that contain applications developedusing the data set.

The Visible Male and Visible Female 35mmand 70mm films arc now being stored at NLM Theyare kept in a dim storage environment withcontrolled temperature and humidi ty The Visiblehemale 35mm original negative films have beenassembled on composite reels in sequence and areready lor duplication To produce viewable copies, aninterpositivc, and a duplicate negative were printedso that a positive film transparency is available forscreening.

The enure 70 mm Visible Human male wasscanned using the Kodak 5057 custom designedscanner The decision was made to scan the original70 mm for the database to provide the highestresolution images wi th the most accurate colorreproduction The him was scanned at a resolution ol4096 x 5568 with a pixel dimension ol 144mm perpixel. There are 1878 images. The images werereviewed lor quality to delect any errors or artilactsand the frames with correctable artifacts were cleanedand rescanncd.

In collaboration with Dr Gary Hack,Professor at the Baltimore College of Surgery,University of Maryland, a method to visuali/c theSphenomandibulans muscle, and the Dura-posteriorcapitis minor muscle connection using the VisibleHuman data set was developed. This was done usingthe 2-D and 3-D visuah/ation tools in ANALYZErunning on a Silicon Graphics workstation

An interactive brain atlas wasdeveloped to be presented at the Visible HumanConlcrencc in October 1996 It is a SuperCard basedleaching program that runs on a Macintosh platform.It includes MR and CT scans of the head as well ascorresponding cryosections f rom the Visible HumanMale data set

Cervical Cancer Project-Screening for Life

This is an instructional program to promotethe early detection ol cervical cancer. Topics includerisk factors, incidence and mortality charts, screeningand laboratory procedures, pathology, and theBethesda Reporting System. In collaboration with theNational Cancer Institute, the program was originallydesigned as an interactive videodisc. In 1993, theprogram was redesigned lor the Compact Disc-interactive format including a modem dial up toNCI's PDQ cancer information database. APDB isnow in the process of beta-testing a complete Webversion that includes all the text, graphics, and videoclips from the original program. Intended for generalpractitioners, internists, nurses and other healthprofessionals who provide cervical cancer screeningservices, the NCI's International Cancer InformationCenter will make it available as part of its web sue.

Making Medical Science Visible

This videotape documents the graduate-leveltraining required lor the production of successfulvisuals for medicine and science. In an effort tohighlight the process of training students to becomebiomcdical visuali/.crs, the class of 1995 from theDepartment of Art as Applied to Medicine at theJohns Hopkins University School of Medicine wasclosely followed during their graduate trainingDuring the 2-year project, a variety of activities werevideotaped, including medical illustration techniques,project critiques and evaluations, academic courses,anatomical dissection and instruction, laboratoryresearch, surgical procedures, and interviews. Thef ina l 28-mmute tape is an effort to feature both thescientific and artistic training required to provideaccurate and instructive visuals for science andmedicine, both for the medical community and thepublic.

Cardiac Embryology/Visible Embryo Web Site

The desktop, interactive version of theCardiac Embryology Project was successfullyconverted to a Cardiac Embryology Web site.Existing digital assets were repurposcd andsupplemented with additional graphics, text, andanimation, taking advantage of the interactiveeducational possibilities of the World Wide Web.The approach to the Web site design was based onmaintaining the streamlined organisation of theoriginal program, the user feedback from the Visible

41

Programs and Services, FY 1996

Embryo alpha and beta tests, and current issues insuccessful Web design. The site offers a richeducational experience to the user and delivers avaluable dataset of histological human embryonicimages, 3-dimensional models, instructionalanimations and supporting text, and bibliographicreference. The program was tested extensively byresearchers, anatomists, pathologists, and othersbefore release. The Web site has been included in theHopkins LectureLinks Project.

Office of the Public Health Service Historian

The Office of the Public Health ServiceHistorian became a pan of APDB as of October I ,1995. Created in 1992 in the Office of the AssistantSecretary for Health, the Historian's Office wastransferred to the Library as part of the 1995reorganization of the Department. One of the majorprojects of the Office in FY 1996 was thedevelopment of a 6-room exhibit titled "Doctors atthe Gate: the United Stales Public Health Service atEllis Island," which was on display at the Ellis IslandImmigration Museum from May 24 through July 31.A laser videodisc containing a portion of the 1936PHS film, "The Work of the Public Health Service"was prepared by APDS for the exhibit .

The office also assisted in planningcommemorative activities for the 50th anniversariesof the Centers for Disease Control and Prevention,the Division of Nursing, and the National MentalHealth Act of 1946, and the 25th anniversary of theNational Institute on Occupational Safety and Health.Planning of the PHS Bicentennial in 1998 was also asignificant effort of the Office this fiscal year. Staffcarried out research, delivered lectures, and publishedpapers on various aspects of PHS history, in additionto editing the "PHS Chronicles" historical scries inPublic Health Reports. Other responsibilitiesincluded answering historical queries from a varietyof sources and working to preserve PHS documentsand artifacts of historical significance such asmaterials from the now closed Saint Elizabeth'sHospital Museum.

Educational and Information Program Support

At the request of the MEDLARSManagement Section, APDB produced two newtraining videotapes to be used in the MEDLARStraining classes conducted at NLM and the regionalcenters. The tapes, which replace those made 10years ago, are Getting Started...a MEDLARSOverview and Getting Started...the MeSHVocabulary.

A videotape describing the major NLMprograms and activities was produced by APDB. Thisis an update of the Pathways videotape and is titledYour Key to Medical Knowledge. The revisedprogram was reviewed by the Board of Regents at theJanuary 1996 meeting. The recommended contentchanges were made and a new narration track wasrecorded and a new title background was created. Thefinished program was also revised to include asegment on Internet Grateful Med. Open caption andforeign language versions including Spanish,Chinese, Japanese, and Russian were produced, andcopies were made for distribution by NLM PublicInformation Office.

Mapping the Geographical History ofWashington, a 15-minute videotape was designed andproduced by APDB for inclusion in the History ofMedicine Division lobby exhibit, "Death and Diseasein the Neighborhood: Medical Maps of Washington,1878-1909." The tape was transferred to a laservideodisc and ran in the exhibit from January throughJune. The program was shown more than 4,800 timesduring this period. Also, APDB produced two laservideodiscs for the HMD exhibit, "Emotions &Disease" which opened in the NLM lobby in October1996.

Audiovisual Support ActivitiesThe branch continues to upgrade the

equipment used to support meetings held in the ListerHill Center Auditorium and the NLM Board ofRegents Room. APDB also provides preventivemaintenance for audiovisual recording, playback andprojection equipment used in other meeting roomsthroughout the Library.

42

NATIONAL CENTERFOR BIOTECHNOLOGYINFORMATIONDavid Lipman, M.D.Director

The National Center lor BiotechnologyInformation (NCBI) was established by Public Law100-607 in November, 1988, as a division of theNational Library of Medicine The establishment ofthe NCBI reflects the importance of informationscience and computer technology in theunderstanding of the molecular processes that controlhealth and disease. The Center has been given theresponsibility to:

• Create automated systems for storing andanaly/.mg knowledge about molecular biology,biochemistry, and genetics,

• Perform research into advanced methods ofcomputer-based information processing foranalyzing the structure and function ofbiologically important molecules andcompounds,

• Facilitate the use of databases and software bybiotechnology researchers and medical carepersonnel, and

• Coordinate el forts to gather biotechnologyinformation worldwide

There arc presently 55 senior scientists,postdoctoral fellows, and support staff working at theNCBI. These scientists have backgrounds inmedicine, molecular biology, biochemistry, genetics,biophysics, structural biology, computer andinformation science, and mathematics

NCBI programs arc divided into three areas (1 )creation and distribution ol sequence databases,primarily GenBank; (2) basic research incomputational molecular biology; and, (3)dissemination and support of molecular biologydatabases, software, and services. Within each ofthese areas, NCBI has established a network ofnational and international collaborations and alsoclosely coordinates its activities with other NLMdivisions. NCBI integrates data from NLM databasessuch as MEDLINE into specialized data resources forthe molecular biology community.

Database Building

GenBank - The NIH Sequence Database

NCBI is responsible for all phases ofGenBank production, support, and distribution.GenBank is the NIH genetic sequence database, aninternational database that collects all known DNAsequence, and a critical research tool in the analysisand discovery of gene function.

The database contains over 1,021,000sequences, nearly 594,000 of which are human. Over465,000 sequences were added during the year, a46% increase in the size of the database, with thenumber of human sequences representing almost halfof that increase. Two divisions were added toGenBank to accommodate the past two year's growthin human sequences, which is the result of large-scalehuman cDNA sequencing projects. The GenomeSurvey Sequence (GSS) division contains randomsingle pass read genome survey sequences and othertypes of sequences that will be used as a frameworkfor the mapping and sequencing of completegenomes; the High Throughput Genome (HTG)division contains genomic sequences that arcproduced by high-throughput sequencing projects.

The total genome sequences are nowavailable for representative species from threedomains of lifc-Archaca, Bacteria, and Eucaryotcs.For example, the ful l sequences for the bacteriaEschenchia coh, Haemophihus influence, andMycoplasma pneumomac are in GenBank. Otherorganisms for which there was substantial growth inthe number of GenBank records are Mus musculus(house mouse), Cacnorhabditis elcgans (aroundworm), and human immunodeficiency virustype 1 (HIV-1). Sequences from these organismshave provided valuable clues for understanding thefunctioning of human genes.

NCBI produces GenBank from thousands ofsequence records submitted directly from authorsprior to publication and, to a lesser degree, fromextracting sequences from publications. Indexcrswith specialty training in molecular biology createthese records and apply rigorous quality controlprocedures on the data. As a final step, senior NCBIscientists review the records for accuracy ofbiological information Improving the biologicalaccuracy of submitted data and correcting existingentries arc high priorities for the GenBank team. Newreleases of GenBank arc made every two months,daily updates arc made available via the Internet andthe WWW.

Programs and Services, f-'Y 1996

Comprehensive coverage of all sequencedau, proiem as well as DNA, is provided byGcnBank along with the corresponding MEDLINEbibliographic information, including abstracts. NLMhas expanded its journal coverage to include alljournals that regularly contain sequence data even ifthey are in nonmedical domains, e.g., appliedbiotechnology. GenBank is a key component in anintegrated sequence database system that NCBI hasdeveloped m order to serve as a single,comprehensive source of all known DNA and proteinsequence information. The integrated database offersresearchers the capability to perform seamlesssearching across all available data including theMEDLINE abstracts linked to the sequence data.

An international collaboration with theEMBL Data Library at Hmxton Hall, UK, and theDNA Database of Japan in Mishima facilitates theexchange of sequence data worldwide through ashared automated system of daily updates Othercooperative arrangements, such as with the U.SPatent & Trademark Office for sequences hornissued patents, augment the data collection el fortsand ensure the comprehensiveness of the database

Other Specialized Databases

NCBI was particularly active this year in thedesign, implementation, and distribution of newdatabases and software tools for the molecularbiology community. Access to the Online MendclianInheritance in Man (OMIM), Johns Hopkms'sdatabase of genetic disorders, was moved to NCBI'sWWW page with MEDLINE links via the Enire/service. A WWW page was also created for theHuman/Mouse Homology Map, created by RonaldDeBry and Michael Seldm, Duke University. TheSaccharomyces cerevisiae (yeast) database, a productof Stanford's DNA Sequencing and TechnologyCenter, was added to the BLAST database suite forsequence similarity searching. New NCBI databasesinclude the Molecular Modeling Database (MMDB)of 3-dimensional protein structures, incorporated intoWWW Entrez with a structure-viewing program; andthe Unique Human Gene Sequence Collection(UmGene), which organizes human GenBanksequences into "clusters" that represent distinctgenes.

The Expressed Sequence Tags database(dbEST) and the Sequence Tagged Sites database(dbSTS) both more than doubled in si/,c during FY1996. dbEST, which collects the growing number ofgene fragments obtained through cDNA sequencing,contains over 677,000 sequences, 70% of which arehuman. A significant number of the remainder arcMus musculus (house mouse) sequences. dbSTS

contains sequence and mapping data for over 47,000short genomic landmark sequences. Both dbEST anddbSTS are available for public queries via theInternet.

The NCBI taxonomy group, now composedof four specialists, designed and implemented aTaxonomy Browser on the WWW that contains thenames of all organisms represented in the geneticdatabases with at least one nucleotidc or proteinsequence. There are links directly from the browserto MEDLINE abstracts that describe new organismsThe source organism for each GcnBank submission isautomatically checked against the Taxonomydatabase, and if not listed, is added by one of the stafftaxonomists The international collaborators, EMBLand DDBJ, have accepted NCBI's Taxonomydatabase as the standard classification, and EMBLhas initiated procedures for their mdexers to use thedatabase and consult with NCBI laxonomists.

The Taxonomy database contained about25,000 organisms in FY 1996, and 500 neworganisms are added monthly Some 50 internationalmolecular biologists and taxonomisls serve ascurators and provide expert review and consultationfor the task of building and maintaining a current andconsistent phylogenetic classification andnomenclature for the source organisms in thesequence databases

Database Access

Entrez Retrieval System

The major database retrieval system atNCBI is Entrez, a search system for nuclcotide andprotein sequence databases and related MEDLINEcitations. Using network or WWW versions, userscan search gigabytes of sequence and literature datausing techniques that are fast and easy to use. A keyfeature of the system is (he concept of "neighboring,"which permits a user lo locate related references orsequences by asking foi all papers or sequences thatresemble a given paper or sequence. The ability totraverse the literature and molecular sequences vianeighbors and links provides a very powerful yetintuitive way of accessing the data

Entrees design permits incorporatingadditional linked databases without changes m theuser interface WWW tinlre/, now provides graphicalviews of nucleotide and protein sequences and accessto the NCBI Genomes database, which containsgraphical views of sequences and chromosome mapsA new structure viewer, Cn3D, was integrated intoNetwork Entree. In response to requests Irom the usercommunity, a function (hat allows large numbers of

44

National Center for Biotechnology Information

sequences to be downloaded, called Batch Enirc/.,was added lo WWW Enlre/

The CD-ROM version of Eintre/ wasdiscontinued in August 1996 after results of a usersurvey confirmed the Icasibilily of networkalternatives. Network Enlre/ usage has decreased byhalf, but use of the WWW version has grown by twoand one-half times, reflecting the general trend ofWWW usage ol NCBI's services

Other Network Service.1,

The BLAST sequence searching server isone ol NCBI's most heavily used services and itsusage continues to grow ut u lasl pace BLASTcompares a user's unknown sequence against thedatabase of all known sequences lo determine likelymalches. Sequence similarities lound by BLASThave been critical in several gene discoveries.Hundreds of major sequencing centers and researchinstitutions around the country use this soltware totransmit a query sequence from their local computerover the Internet network lo a BLAST server runningon a computer ai ihe NCBI In a lew seconds, theBLAST server compares ihe user's sequence loseveral hundred thousand known sequences anddetermines the closest matches A new nclworkBLAST application, called PowerBlasl, was designedlor automated analysis ol gcnomic sequences

Each day more than 20,000 sequencesearches arc performed, with users submitting (heirrequests through e-mail, server/client programs, andihe World Wide Web The e-mail service has a publickey encryption option to guarantee the confidentialityof user data as it traverses the public networksThrough significant improvements to the BLASTsoftware, which processes queries as lasl as 1.6seconds per search, and continued upgrades ofhardware, NCBI has been able to accommodate theincreasing number ol sues using ihe BLAST serviceGenome research is highly dependent on thisresource

NCBI's electronic mail servers, RETRIEVEand QUERY, are used to retrieve records Iromseveral sequence databases, including GenBank,EMBL, Swiss-Prot, and PIR, by sending a mailmessage containing a text query to Ihe server Anyuser in the world with e-mail access can submit aquery to the servers and have an answer returnedwithin minutes More than 1,000 queries are handleddaily by the Retrieve and Query servers.

NCBI continued to make significantimprovemenls lo the GenBank submission process inFY 1996 Sequin, a new sland-alone soliwaresubmission tool, was released in May andrclmemcnls continued throughout the year. Sequin is

capable of handling simple submissions that contain asingle, short, mRNA sequence, as well as complexsubmissions containing long sequences, multipleannotations, segmented sets of DNA, or phylogenelicand population studies. Extensive documentation isavailable on the World Wide Web, and versions forMacintosh, PC/Windows, and UNIX computers canbe downloaded to the user's workstation. In us secondyear of use, the Bankll submission lool available onthe World Wide Web continues to be ihe mostpopular submission lool, with nearly 80% ofsubmissions entering GenBank via this route.

Overall, usage of NCBI's World Wide Webservices, first introduced in December 1993,continues to expand as more services arc added. Inaddition lo Sequin, the Taxonomy browser, and newversions ol BLAST, Enlre/., Bankll, iwo olhcr WWWapplications were introduced These arc OrfFmder(Open Reading Frame Finder), a graphical analysislool that finds all open reading frames in a user'ssequence; and VacMan, which is software loranaly/.mg mfccl iv i ty dala from animal trialsInformation about NCBI, its databases and services,data submission and update, and individual scientists'research projects is readily available, as well as anever-increasing number ol search tools. The WWWserver provides capabilities for Enlre/ and BLASTsearches and submission by Banklt. Many otherWWW servers have links lo the NCBI server toconduct searches and obtain the latest GenBankrecords. Al ihe end of FY 1996, NCBI's site wasaveraging over 300,000 accesses daily.

GenBank is also distributed over the Internetthrough the standard File Transfer Protocol (FTP)program. Many large commercial and academic sitesmaintain a local copy of GenBank Every twomonths, 500 sites download new full releases ofGenBank, and daily, 120 sites download the updalcs.Fifty-five additional databases of molecular biologydata arc distributed as par! of the NCBI DalaRepository lo over 1,000 sues daily

NCBI uses a nclwork of Unix-basedsymmetric multiprocessor servers to provide Internet-based public search services such as BLAST andEntrc/ During FY 1996 ihe NCBI added a 20-processor Silicon Graphics (SGI) system dedicated toBLAST services. In addition, other SGI servers thatsupport public services as well as basic research wereupgraded lo newer and more powerful CPUs. NewSun Microsystems servers were acquired lo supportthe PubMcd project, a major new experimentalversion of Entrc/ thai will include all of MEDLINEwilh l inks lo full-lexl journal silcs A Sun server lhalsupports Enlre/ search services and a second thatsupports bimonthly GenBank releases were also

45


upgraded to faster CPUs Two Windows NT serverswere also acquired and installed.

The servers are supplemented by Unixworkstations, PCs and Apple desktop systems thatare used for database and software development,research applications and data analysis, user servicessupport, us well as conventional office andadministrative applications.

Equally important as building databases formolecular sequence information is the ability toaccess and retrieve the information using automatedsystems. The NCBI software toolkit conceptaddresses this need by creating software modules thatprovide a set of high-level functions to assistdevelopers in building application software Amongthese tools arc a Portable Core Library of functions inthe C language that facilitate writing software fordifferent hardware platforms and operating systems,and AsnLib, a collection of routines for handlingASN.I data and developing ASN.I applications. TheASN.l (Abstract Syntax Notation) tool is anInternational Standards Organisation data descriptionlanguage that provides a mechanism for defining andstructuring data as well as a set of programdefinitions that can interact with databases structuredin ASN.I .

NCBI's adoption of ASN I for databaseoutput has several advantages for users as well asdevelopers. The data definitions in ASN I forbiological objects enable the representation undstructuring of complex biological data in data f i l e swithout the need for a specific database managementsystem. Manipulation of the complex objects isperformed through the ASN. I software tools that arefreely distributed to the biology community. Thus,complicated analysis programs can be readilyconstructed from pre-existing sets of modular tools,saving considerable time and programming e f f o r t

Basic Research

Basic research is at the core of NCBI'smission. The Computational Biology and InformationEngineering Branches at the NCBI are comprised ofa mullidisciplmary group of scientists who carry outresearch on fundamental biomcdical questions ai themolecular level by developing and utih/mgmathematical, statistical and other computationalmethods. The approach is both theoretical andapplied. These two lines of research are mutual lyreinforcing and complementary. The basic researchhas led to new practical methods and the applicationof these methods has opened new areas of research

There have been a variety of applied andtheoretical studies of biologically important

molecules and their funct ion, as well as continueddevelopment and improvement of algorithms andstatistics for their analysis. This work has included astudy of the infection kinetics of HIV, and thedevelopment of an mlectivity assay; a modificationof the BLAST programs to produce gappedalignments, and the description of refined statisticsfor their assessment, an analysis of the native statesof random peptidcs; and the development of aBaycsian model and algorithm for multiple localalignment Macromolccular sequence analysisprograms have been applied to investigate hisloncs,helicases, acomtasc proteins, FAD-bmding domains,lyso/.ymc-likc virulence factors, mitochondria!proteins, eukaryotic developmental proteins, and toidentify a domain common to the human breastcancer gene, BRCAI.

This year genome-scale projects havebecome a staple of Computational Biology Branchresearch. They have involved the creation andpublication of a gene map for the human genome, anintegrated linkage map for E coli, and a genetic mapof Salmonella typhimunum; the molecular cloning ofHepatitis G virus, and comparative metabolic andevolutionary analyses based upon completeprokaryotic genomes Other projects have includedthe development of the Molecular ModelingDatabase (MMDB) for the analysis of proteinstructure, and its integration into the WWW Enlrc/system; the evaluation of threading methods forsequence-structure comparison; phylogcneticanalyses of pleurostom.itid ciliates and tnchomonads,and the theoretical and experimental study ofdocument retrieval methods.

The intramural group is engaged in some 29projects, many of which involve collaborations withNIH and other research laboratories The work isreviewed by a Board ol Scientif ic Counselors ofdistinguished extramural scientists (see Appendix 4for list of members). The high caliber of the work hasbeen evidenced by the number ol peer-reviewedpublications, some 60 in FY 1996. and the requestsfor outside collaborations und invitat ions for talks atinternational meetings

The Visitors Program continues to hesuccessful in bringing members of the scientificcommunity to the NCBI to engage in collaborativeresearch with the Computational Biology Branch aswell us joint activities in database design andimplementation with the Information EngineeringBranch. This program, administered in conjunctionwith Oak Ridge Associated Universities, facilitatedvisits by 43 individual senior researchers (his pastyear

46

National Center for Biotechnology Information

User Support and Outreach

As part of its mandate to facilitate the use ofdatabases and software by the biology community,NCBI maintains a user support group with broadexperience in handling biology and medicalinformation. The primary focus of this group is tosupport the particular services that NCBI offers by e-mail, phone, and fax. NCBI has extended its outreachto the library science community by invitedpresentations and workshops on biotechnologyinformation topics.

As the number of database services andnumber of users has increased, the scope of usersupport services has also expanded. NCBI staff in theInformation Resources Branch, with contractorsupport, provide responses to queries for informationand assistance. The three main areas of user supportinclude: information about GenBank and relatedmolecular biology database services and datasubmission; technical assistance for submission ofnew GenBank data and revision of existing records;and technical assistance with Entrez and other dataretrieval services. Most responses are immediate andnearly all answers or information are provided within24 hours of receipt of a message. Likewise, authorswho submit their sequences to GenBank arefurnished with accession numbers for publicationwithin 24 hours.

To increase awareness of NCBI and itsprograms, NCBI staff participate in exhibits,seminars, workshops, and courses, both nationallyand internationally. In FY 1996 NCBI staffedexhibits at scientific society meetings, including theAmerican Society for Biochemistry and MolecularBiology; American Society for Cell Biology;Biophysical Society; Experimental Biology;American Society for Microbiology; AmericanSociety of Human Genetics; and the Medical LibraryAssociation. Additional exhibits were staffed at morespecialized meetings, including the Yeast Geneticsand Molecular Biology Meeting, Bioinformatics andGenome Research, Tuskegee University Conferenceon the Human Genome Project, and GenomeProject-Commercial Applications.

In addition, senior NCBI membersparticipated as faculty at courses sponsored by theAmerican Association for Cancer Research; theWorld Health Organisation; Johns Hopkins School ofMedicine; George Mason University's Institute forComputational Sciences and Informatics; TheJackson Laboratory; NLM/Marine Biological

Laboratory; the International Center for GeneticEngineering & Biotechnology (Trieste, Italy).

Three issues of a newsletter were distributedto a mailing list of 25,000 biologists and institutions,and new Fact Sheets on programs and services weredistributed at all public forums where NCBI wasrepresented. More than 300 NIH and extramuralscientists' accounts are supported through onlineaccess to 20 databases under the IRX system.

The NCBI also participates in an advisoryand collaborative role with other governmentagencies such as the Patent and Trademark Officeand the Department of Agriculture on programsinvolving biotechnology information. Within theNIH, the NCBI coordinates with other institutes andparticularly with the National Human GenomeResearch Institute on databases and informaticsprograms that impact information exchange on anational level.

Extramural Programs

The NLM's Extramural Program (a separatedivision of NLM) offers a program of grants forcomputer analysis of molecular biology data. A widevariety of work in computational biology has beensupported through the program including methodsand algorithms for sequence analysis, structure andfunction prediction, new machine architectures andspecialized databases. Postdoctoral training in thecross-disciplinary areas of biology, medicine, andcomputer science is also funded through the NLM'sinformatics fellowship program.

Biotechnology Information in the Future

The explosive growth in the fields ofgenetics and molecular biology reinforces the need tobuild and maintain a strong infrastructure ofinformation support. NCBI continues to be engagedin developing and employing new methods fordisseminating knowledge to the biomedicalcommunity. Based on a core of advanced intramuralresearch in several areas of computational biology,NCBI rapidly addresses the evolving informaticsneeds for genome research with state-of-the-artsoftware and databases. Genomic informationresources such as NCBI have repeatedlydemonstrated their value as indispensable discoverytools for basic research. The value of these resourceswill only continue to grow as they support thebreakthroughs in basic research and provide us withbetter understanding and treatment of human disease.

47

Extramural ProgramsMilton Corn, M.D.Acting Associate Director

The Extramural Programs Division (EP) ofNLM continues to receive its budget under twodifferent authorizing acts, the Medical LibraryAssistance Act (unique to NLM), and Public HealthLaw 301 (which covers all of NIH). The funds arcexpended as grants-in-aid to the extramuralcommunity in support of the goals of the NationalLibrary of Medicine. Review and award proceduresconform to NIH policies.

Summary budget figures for FY 1996(andFY 1995 and 1994 for comparison purposes) arepresented in Table 11. Appendix 5 contains the rosterof the Biomedical Library Review Committee.Appendix 7 lists grants awarded in FY 1996.

The Grant Programs

EP issues grants in several categories forwhich the motif in general is medical informatics:• Resource (for Information Management)• Training• Research (and Research Resources)• Publication• Educational Technology• SBIR/STTR• Other

These categories are used to organizediscussion of EP activities for this report.

Resource

The "Resource" grants described in thissection are intended to strengthen the informationmanagement infrastructure of the grantee, and,therefore, provide significantly less overheadcompensation to the grantee insti tution than doresearch grants. The four increasingly complexresource programs described below are designed toaddress needs of the broad spectrum of Americanhealth care organizations.

Internet Connections Grants (MLAA)

This program provides relatively smallgrants to health organizations that wish to make aninitial Internet connection, or to broaden internalaccess to a connection already in place. To qualify,institutions must already have some local areanetwork (LAN)capacity. The health science libraryusually has a key role in the Internet connection

grants, primarily in training new users. These grantsare available in two forms: $30,000 to singleinstitutions and $50,000 to those extending theirconnection to other sites. Grant funds support costsfor router/gateway equipment and associatedconnection hardware, installation and leasing ofcommunication circuits to connect to an Internetprovider, and membership fees to a provider.

A Request for Applications issued inFebruary 1996 resulted in 115 applications. A 2-stagereview was utilized with an initial Special ReviewCommittee recommending 45 applications for furtherconsideration. In FY 1996 available funds permittedfunding of 26 Internet Connection Grants with themajority going to hospitals; the 8 collaborativeInternet Connection projects increase the totalnumber of beneficiaries to nearly 60.

Information Access Grants (MLAA)

Information Access Grants provide $12,000for single institutions and $12,000 per member forconsortia to purchase basic computer andcommunications equipment to access NLM's GratefulMed, DOCLINE, and Loansome Doc services. Fundscan also be used towards the installation of anintegrated library system. Internet Access is usuallyincorporated into these projects. To foster NLM'songoing Outreach Init iative, the grants supportconsortia in remote, rural areas where outlyinginstitutions can network with a larger site equippedwith back-up collections and library staff. FY 1996awards were all to consortia.

Information Systems Grants (MLAA)

Information Systems Grants, which range upto $ 150,000 per year for I to 3 years, are targeted forlarger health institutions such as teaching hospitalsand medical schools. Projects support computer andcommunications networking, integration, andconnectivity and must include the library as aparticipating partner. Internet capabilities are againemphasized by NLM as highly desirable. Grant fundsmay cover personnel, equipment, software,communications expenses, travel, and supplies. ThreeInformation Systems Grants were awarded in FY1996

IAIMS Grants (MLAA)

Integrated Advanced InformationManagement Systems (IAIMS), the most ambitiousof the resource grants, are institution-wide computernetworks that l ink and relate library systems with avariety of individual and institutional databases and

48

Extramural Programs

information files, within and external to theinstitution, for patient care, research, education, andadministration. Resource grants are made to assistmedical centers and health science organizations inplanning and implementing projects that will lead toan IAIMS. The goal of the program is to createorganizational mechanisms within health scienceinstitutions to manage more effectively theknowledge of medicine, and to provide for a systemof comprehensive, direct information access forhealth professionals.

NLM provides gram support for (I) aninstitution-wide planning phase where support maybe for up to $150,000 per year for I or 2 years, and(2) an operation phase in which IAIMS plans areimplemented. Operation phase grants may be for upto $500,000 per year for 5 years, or for $550,000 peryear if support of an IAIMS apprenticeship option isapproved. There were six new planning and oneimplementation award in FY 1996.

Training and Fellowships (MLAA)

Training in Informatics

Realizing the potential of computers andtelecommunication for managing health careinformation requires investigators able to addressfundamental problems of knowledge representation,decision support, and human-computer interlace.NLM remains the principal support nationally forresearch training in the fields of medical informatics.Special tracks are available for those who wish toconcentrate in the informatics of biotechnology,nursing, radiation oncology, or dentistry. Tocomplement the training of researchers, NLM nowalso offers training opportunities for health careprofessionals who want to apply the knowledge andtechnology of this field to some area of interest.

NLM provides three mechanisms of supportfor its training activities. Five-year institutionaltraining grants, the largest type, currently supportapproximately 100 trainees, and produce 25-30informatics scientists each year. During 1996 theseprograms and others were reviewed as part of acompetitive review process which resulted in adecision to continue funding of the existing programsand to fund two more.

Individual informatics research fellowshipsarc available to those who wunt research trainingsimilar to that received at the institutional trainingsites but at a site of their choosing. Individual appliedinformatics fellowships arc available to individualswho want to learn informatics techniques andtechnology for application to their currentprofessional specialties.

Education of Health Sciences Librarians

In early 1995 NLM, as a one-time initiative,issued a Request for Applications (RFA) for PlanningGrants for Education and Training of Health SciencesLibrarians to provide further planning for educationin four areas identified by the NLM Planning Panelon the Education and Training of Health SciencesLibrarians:• evolving role for health sciences librarians;• professional education programs;• lifelong learning programs; and• recruitment including minorities.

Twenty-one applications were received andseven awards were made: Welch Medical Library ofThe Johns Hopkins University, Baltimore, MD;Graduate School of Library and Information Science,University of Illinois, Champaign, IL; School ofLibrary and Information Science, University ofMissouri, Columbia, MO; School of Information andLibrary Science, University of North Carolina,Chapel Hill , NC; School of Library and InformationScience, University of Pittsburgh, Pittsburgh, PA;College of Library and Information Science,University of South Carolina, Columbia, SC; andEskind Biomedical Library, Vanderbilt University,Nashville, TN.

Reports from these awardees are expected inthe spring of 1997. NLM will consider follow-upoptions after reviewing the reports.

Training of Minorities

NLM is participating in an NIH-widcfellowship program aimed at encouraging under-represented minorities into research careers, andsupported one fellow pursing an MD/Ph.D. combineddegree at Harvard Medical School in FY 1996.

Research (and Resource Resources)

Research grants are made through a varietyof PHS 301 mechanisms, including individualresearch projects, cooperative agreements, researchresource grants and others.

Medical Informatics

NLM's medical informatics research grantssponsor the investigation of basic and appliedmedical knowledge issues that arise at theintersection of biomedicine, computer science, andhuman behavioral sciences. This year NLM receivedpermission to participate in several programssponsored by the Office of the Director, NIH. Five

49

Programs and Services, AT

applications altogether benefited from theseprograms, genetically called "ShannonAwards."These included three young investigators atYale, Vanderbilt, and Massachusetts GeneralHospital.

NLM initiated 15 new individualinformatics research projects in FY 1996. Five wereShannon Awards, five were the standard investigator-initialed research project grants, and five were FirstIndependent Research Support Transition Awards.

A major NLM effort has been the ongoingcollaboration with the Agency for Health Care Policyand Research to support research and development ofElectronic Medical Record Systems (EMRS).AHCPR sponsored a general meeting for theawardees and their colleagues in April, and NLMfollowed with one in November. NLM staffencouraged, and attended, meetings of severalsmaller working groups. These groups, one in theBoston area, and the other dispersed among thewestern slates, are addressing such issues as securepatient data transmission extraction of aggregatedpatient data from disparate files, and problem listmanagers.

NLM also participates with 15 otherorganizations in the Human Brain Project, whichseeks innovative methods for discovering andmanaging increasingly complex information in theneurosciences. For example, NLM awarded aresearch grant to Dr. Douglas M. Bowden ofWashington University who plans to integrate a widerange of data on human and primate ncuroanatomy ina computerized Brain Information ManagementSystem.

Biotechnology Informatics

The techniques of informatics areindispensable tools for handling the complex datagenerated by molecular biology research. NLMcontinues to provide research grants for informaticsprojects in the area of biotechnology informatics. Arelated problem concerns the development andmaintenance of the myriad electronic databases onwhich researchers increasingly rely, and for which noother source of support has yet been identified.

Publication Grants

The Publication Grant Program providesshort-term financial support for selected not-for-profit, biomedical scientific publications. Studiesprepared or published under this NLM programinclude critical reviews or monographs on specialareas of medical research and practice; research

monographs in the history of medicine and the lifesciences; writings on medical informatics, healthinformation science and biotechnology information;and, in certain cases, secondary literature tools andscientifically significant symposia. Resources inrecent years have been used principally for history ofmedicine projects, but projects involving electronicpublishing, video productions, and other media werealso supported. The program has an informalself-imposed ceiling on direct costs per grant of$25,000. The three new awards made in FY 1996 arclisted in Appendix 7.

Educational Technology

NLM's grant support for educationaltechnology development is generally restricted tocomputer/telecommunication projects thatincorporate strong research and evaluativecomponents. Because (he Library's support funds forthis area arc small, those who seek funding foreducational technologies have been urged to focustheir work on some specific area of medicine whichmight attract funding from one of the largerInstitutes.

SBIR/SBTT(PHS30I)

All NIH research grant programs, includingNLM's, by Congressional mandate allocate a fixedpercentage of available funds every year to SmallBusiness Innovation Research (SBIR) grants. Theseprojects may involve a Phase I grant for productdesign, and a Phase II grant for testing andprototyping. This year, NLM's allocation wasawarded to Dr. John Nelson of Nelson InformationSystems in Chevy Chase, Maryland for work on areprint service for internists based on 10 corejournals. This award was the final one of a 2-ycarproject period and included participation by two otherNIH Institutes.

NLM also participates in the other mandatedfund allocation program, Small Business TechnologyTransfer, but generally it contributes its smallallocation to other NIH institutes, as it did this year.

Other Grants

Conference Grants

Support for conferences and workshops isintended to help scientific communities identifyresearch needs, share results, and prepare forproductive new work. No conference grants wereawarded in FY96.

50

Extramural Programs

Biomedical Ethics

Ethical issues in health care and researchproduce an enormous literature. This literature comesfrom law, medicine, public health, and government.The National Center for Bioethics Literature atGeorgetown University continues to offer invaluableresources and guidance for workers in this area. AnExtramural Programs contract maintains the Center.A complementary contract from Library Operationssupports an indexing activity that contributes toBIOETHICSLINE, one of NLM's MEDLARSdatabases.

Other Extramural Programs Activities

HPCC and Outreach

The Outreach and the HPCC initiatives ofNLM arc elements of the formal grant programs, andare being met more ful ly since revision of theresource programs, the continued success of theConnections program, and the Electronic MedicalRecord System cooperative grants.

Minority Support

The Information Access Grant awarded tothe University of Texas Health Science Center at SanAntonio includes several institutional membersserving significant Hispanic populations.

Grant Review

First Level Peer Review

The Biomedical Library Review Committee(BLRC) is NLM's ini t ia l review group for evaluatingthe scientific and technical merit of grantapplications. The BLRC has expertise germane to thespecific program areas: library, informatics, andbiotechnology. The committee met three times in FY1996 and reviewed 87 applications, 62 of which werescored and continued in the review process. A rosterof the Committee is in Appendix 5. The roster andother items relating to grant applications and,therefore, of interest to potential applicants are inNLM's World Wide Web site.(www.nlm.nih.gov/ep/extramural.html)

In FY 1996 NLM and the other NIH instituteswere granted authority to establish Special EmphasisPanels (SEP). The authority permits the creation ofinitial review groups whose expertise is focused on aparticular group of applications, for example, theInstitutional Advanced Information Management

Systems (IAIMS) program. Such one-lime reviewpanels arc also useful for evaluating individualfellowship applications, and applications havingsubstantial involvement of regular BLRC members.Meetings of the Panels, like BLRC meetings, areregularly announced in the Federal Register. Theutilization of Special Emphasis Panels replaces thepreviously used ad hoc review groups.

Second Level Review

A second level of review is performed bythe Board of Regents, which meets three times a year,approximately three months after the BiomedicalLibrary Review Committee. The Board concernsitself with the congruence of grant applications withthe NLM's mission and with the policy aspects of theapplications. The Extramural ProgramsSubcommittee of the Board reviews in depth"Special" grant applications such as those in whichthe recommended amount of financial support islarge; when at least two members of the init ial reviewgroup have dissented from the majority; where apolicy issue is identified; and those from a foreigninstitution. The Subcommittee makes itsrecommendations to the full Board.

Review Reform

The National Institutes of Health isparticipating in the President's "ReinventingGovernment" initiative. A portion of this activity hasbeen the establishment of a Peer Review OversightGroup (PROG) charged with coordinating,evaluating, and making policy recommendations forall peer review conducted at NIH. Items currentlyunder consideration include the use of three specificcriteria (significance, approach, and feasibility) witheach criterion being scored; the use of an 8-pointrating scale; and revision of the scoring system sothat the better the grant, the higher the priority scorenumber. The Oversight Group is continuing to meetand will consider input from the applicantcommunity. Formal recommendations arc expectedi n F Y 1997.

Divisional Operations

The operating budget was adequate forindicated site visits, and maintaining the Division'sactivities. EP incorporated the new NIH streamlininginitiatives in timekeeping and procurement. Mr.Dwight Mowery, Grants Management Specialist andMs. Tracy Graves, Grants Clerk joined the Division.

51


Summary

NLM's Extramural Programs, like almost allextramural grant divisions at NIH, regrets that not allapplications of good quality can be funded, but thegrants which can be made are furthering NLM goals

in most key areas. However, support for developingthe educational technology of informatics remainsuncomfortably small, and, most importantly, we havenot yet expanded the informatics research budgetcommensurate with the increase in informaticsscientists produced by our training programs.

Table 11Extramural Grant and Contract Program(dollars in thousands)

Category FY1994No.

Resource projects 38 5,150IAIMS (10) (3,115)Access (2) (80)Systems (9) (1,283)Connections (17) (672)

Research 53 12,436Medical informatics projects (19) (5,681)Medical informatics resourceBiotechnology (13) (3,776)Cooperative agreements (3) (1,008)Career awards (16) (1,725)Library science (2) (246)

Training 19 4,372Institutional (10) (3,980)Fellowship (9) (392)

Publications 8 239

Bioethics 1 400

SBIR/STTR 2 145

Regional Medical Library 8 5,678

NIH Tap

Totals: 129 $28,420

FY1995No.

54(7)

(11)(10)(26)

16

5,421(2,231)

(772)(1,438)

(980)

64 13,680(25) (5,966)

(21) (4,390)(6) (2,002)

(11) d,138)(1) (184)

25 5,072(16) (4,676)(9) (396)

513

1 416

1 191

8 5,545

169 $30,838

FY1996No.

53(10)(5)

(12)(26)

64(22)(1)

(19)(5)

(16)(1)

12

1

1

8

158

5,754(3,011)

(476)(1,387)

(880)

14,817(4,433)(1,419)(5,264)(1,872)(1,638)

(191)

19 4,501(10) (4,178)(9) (323)

327

458

196

6,283

849

$33,185

52

Office of Computer andCommunications SystemsFernando BurbanoDirector

Grateful Med

This year was another successful year forGrateful Med. As in years past, a record number ofGrateful Med searches were performed. The Internetcontinues to be the access method of choice, and theGrateful Med dial-up modem users were successfullytransitioned from Telenet, Tymnet, and CompuServeto AT&T's FTS2000 Packet Switch Service Network.Updates for both the PC DOS version and Macintoshversion of Grateful Med were distributed and aWindows version was completed.

During FY 1996 a new record of over fivemillion Grateful Med ELHILL searches wereperformed. The number of Grateful Med searcherscontinues to increase, comprising over 80 percent ofall ELHILL searchers. Also, the use of the Internet byGrateful Med patrons continues to grow. Currently,over 60 percent of all Grateful Med sessions reachNLM via the Internet. This is a 20 percent increasefrom last year. It is anticipated that the increasedInternet usage will also facilitate the electronicdistribution of future software updates anddocumentation. In fact, Grateful Med beta testersalready use NLM's anonymous ftp server fordownloading test programs and future Grateful Medfor Windows users will be able to download softwareand a User's Guide from NLM's World Wide Website.

A transition from the Value AddedNetworks (VANs) to AT&T's FTS2000 PacketSwitch Service was completed this year. GratefulMed now supports only Internet, FTS2000, directdial, or Canadian Datapac communications.Extensive testing and hardware upgrades wereperformed to insure a smooth move to FTS2000. Afew problems did occur, but the majority of themconsisted of user setup/configuration errors.

Grateful Med for Windows Version 1.0 wascompleted this year. The results from user responsecards show that 19,000 users want the Windowsversion while only 700 users want to remain DOSusers. The program disks and User's Guides are beingproduced by the National Technical InformationService and will be distributed in January 1997.

Both the PC DOS Version 6.7 update andthe Macintosh Version 2.3 update were distributed in1996. They contained the 1996 MESH files as well as

new communication scripts for FTS2000, newMEDLINE and 'older material' coverage, andHSRPROJ and SPACELINE database search screens.Over 12,000 Macintosh and 52,000 PC DOS updateswere mailed out.

A contract action to provide support forGrateful Med development and maintenance wascompleted this year. A multiple award was made toAAC Associates, Inc., and Taj Technologies, Inc.AAC was an incumbent contractor while this will beTaj Technologies ini t ia l contract with NLM.

LAN Support

• In December 1995 a new dedicated T3 (45Mbps) line was installed and became active. This lineupgraded NLM's connections to the BBN Planetnetwork for the Internet from the previous Tl (1.54Mbps) circuit.• A SONET Ring loop was installed by BellAtlantic in the spring of 1996. This connection goesfrom the Bell Atlantic facilities (Rockville, Md.)through the existing NIH conduit facilities on campusto Buildings 12 and 10 and back to Bell Atlantic.This SONET Ring brings a reliable, high-speed fibrenetworking capability to the NLM and NIH. NLM'sT3 was converted to this ring in June 1996.• A LAN superserver (Nctframe) was procuredand the process of converting users from desktopservers to the superserver was started.• GROUPWISE calendaring became operational.

TESS

TESS (Technical Services System)integrates various functions of the Technical ServicesDivision with emphasis on the cataloging processes.It is a client/server application with the majordatabases residing on the IBM mainframe and theediting of records on PC workstations. Thecommunication subsystems are based on the TCP/IPprotocols making TESS operable over both LocalArea Networks and the Internet. The system controlsthe creation and maintenance of bibliographic andname authority records for NLM. NLM distributesthis data to ELHILL and to subscribers of USMARCrecords.

Ini t ial releases of TESS provided for thecreation and maintenance of original cataloging,followed by a framework for the integration ofacquisition and cataloging activities. Next, authoritycontrol for the cataloging function was integrated intoTESS. This release also included the capability tocreate and maintain the name authority file.

Early releases of TESS included theconversion of the entire CATLINE/AVLINE files to

53

Programs and Services, FY I9V6

be supported within the TESS environment. TESSwas enhanced to support all file maintenanceactivities of CATLINE/AVLINE, and to support allcataloging distribution activities, principally thedistribution of catalog records in MARC format toMARC subscribers.

Another effort was a modification of thedatabases and software to comply with the USMARCstandard for Format Integration Phase I. A basic Z39client was established to permit FTP transfer of datafrom the Library of Congress. Software was alsodeveloped to allow the batch loading of USMARCdata tapes from outside sources

During FY 1996 software was developed forthe batch uploading of NLM preservation data I rumInquire DBMS Tiles. The databases and softwarewere also modified further to comply with theUSMARC standard for Formal Integration Phase II.Software was also developed to output the NameAuthority data in USMARC record formats.

Information Systems Laboratory (ISL)

The Information Systems Laboratory wascreated as a core facility to modernise and utilize theemerging technology domains ol distributedprocessing, open systems, high speed networks, andworldwide connectivity and service provision. Anearly software product, TC_COMM, has been widelyused for TCP/IP communications within otherproduction systems such as TESS, Locator/CMS, andthe Z39.50 server.

The ISL has supported the development andimplementation of Locator, the NLM public accesscatalog; NLMPUBS, the anonymous FTP serviceproviding online copies of NLM technicalpublications; the NLM Gopher, and Implement, umeta-DBMS toolkit designed to address the specialproblems of bibliographic data storage and retrievalThe ISL also supported developments for remotecataloguing and indexing activities.

The ISL is continuing to introduce opensystems computers and work-stations to supportoperational requirements. Efforts continue toredesign existing systems and develop new systemsto use multiplatform open system servers, TCP/IPcommunications and Internet connectivity. TheInternet has now become a major domestic andinternational access pathway.

During FY 1996 the Information SysiemsLaboratory continued to provide system support forUnix-based applications and services. Several Unix-based production systems now depend upon ISLhardware and software in order to support public useraccess to NLM data. Performance and operationalanalyses resulted in several applications being

changed to more appropriate hardwareconfigurations. An important consideration was todevelop system support architectures without anysingle points of failure and substantive strides weremade.

A major support area was the developmentand support of NLM's World Wide Web serverBased on the HyperDOC server originally developedin the Lister Hill Center, the WWW server has beenrestructured, reformatted, and re-implemented as anoperational facility.

NLM LOCATOR

OCCS developed a prototype Online PublicAccess Catalog (OPAC) which became a full-scaledevelopment effort The operational system, namedNLM Locator, was made available over the Internetand its usage continues to grow NLM Locatorprovides direct access to the NLM collectionsthrough the ELHILL databases CATLINE(monographs), AVLINE (audiovisual), SERLINE(serials), and DIRLINE (information resources). Thisproject was OCCS's initial Unix-based client/serverdevelopment effort, and the development team waschallenged to acquire skills in new technologies. Thecomplete project included mastering new skills innew computer hardware, system software,networking, programming languages, and a numberof uti l i ty tools.

One of the important concepts of theclient/server architecture is the ability to adapt tochange without reengincenng the application. NLMLocator utilizes a workstation client communicatingwith function servers which in turn communicatewith a data server. The client workstations in theReading Room arc DOS PC's, while Internet userslog in as VT-IOO terminal sessions to a Unix clientprocess executing in the (unction servers Thefunction servers arc Sun computer systems runningthe Unix operating system. Having multiple functionservers permits reliability as well as additionalcapacity, should usage require it. If necessary,another function server could be added withoutsoftware modification The data server is the NLMmainframe computer u t i l i z ing the ELHILL retrievalsystem No changes to the legacy systems wererequired to implement Locator.

The system continues to function well andcomments received via the electronic mail featurehave been most complimentary. Reading Room andNLM staff usage has stabili/ed. Internet usagecontinues to grow.

The second phase of the project was toprovide circulation control and collectionmanagement features for a combined system the

54

Office of Computer and Communications, Systems

LOCATOR/Colleclion Management Systems(Locator/CMS). It provides online patron registration,availability data, status information, requests forlibrary materials, and a great number of managementreports lo the Public Services Division The ELHILLretrieval agent subsystem was converted to C++ andit now shares much of this code with the Z39 50server, although both systems run on separate Unixservers.

Z39.50 Server

The project to make MEDLINE available toInternet clients via the Z39.50 protocol consists of anELHILL retrieval agent, a Z39.50 protocol enginethat delivers MEDLINE information over the Internetin Z39.50 formal, and a subsystem for dynamicallyconverting ELHILL data into Z39.50 formats TheZ39.50 formats delivered include SimpleUnstructured Text Record Syntax (SUTRS) andMARC, which is the most widely used Z39.50format.

The ELHILL retrieval agent supports simplesearching and full Boolean searching. It is written inC++ and it runs under the Solaris operating system ona Sun computer. The Z39 50 protocol engine iswritten in C and also runs on the same Sun computer.

MEDLARS Self Registration/Code SpoolingProject

New development ef lor ts combined all userauthority data from the ELHILL UUSF, theINQUIRE Users database, the TOXNET User File,the PDQ system, the bil l ing system, and the centralcomputer into one Consolidated User AuthoritySystem (CUADS) Software and online panels werewritten to allow individual and mass changes to thisfile and to permute these changes to theabove-mentioned data sources Changes made byusers of any of NLM's Information Retrieval Services(ELHILL, PDQ, and TOXNET) are nowelectronically transmitted to the others without thenecessity of making the changes individually to each.This new software also allows for the addition ofindividual User ID's, definitions (and capabilities) ofsubscriptions, and the addition of (or mass changesto) groups of codes belonging to a subscription WEBservers have been written for the central computersystem in support ol MEDLARS Sell Registration,User ID/Subscription maintenance, and codespooling.

The billing system has been changed toallow transmission of data to the National TechnicalInformation Service via FTP as an interim step totransmission via the newly developed Batch

Transmission File (BTF) which was developed forthe inter-system transmission. Tools have been builtfor the Code Spooler which will allow institutions tocome lo the NLM for MEDLARS informationretrieval service (Internei Grateful Med) without theneed of distributing individual User ID's Beta-testingwill be conducted with one or more of iheseinstitutions in the near future.

FY 1996 saw the implementation of a newI/O Subsystem with shared caching between iheELHILL servers which have halved the response limelo 80 milliseconds taking advantage of ihe new IBM9672/R52 Central Computer Syslem and allowing forthe support of about 400 simultaneous users andrapid response for Ihe growing Internet Grateful Med(IGM) system. These changes should allow for afive- lo len-fold growih of IGM.

Upgrades

The 3090/300J computer system wasupgraded to an IBM 9672/R52 in March 1996. Thisupgrade increased the "raw" processing capacity(CPU MIPS) by 38 percent, while retaining the samenewer, more reliable technology. The disk storagesystem was upgraded in September 1996. Thisupgrade replaces older, less reliable technology withnewer, more reliable technology. The operatingsystem and related components (TCP/IP, etc.) wereupgraded in July 1996. This upgrade applied majormaintenance and capacity improvements to thesystem

MEDLARS databases

• Health and HSTAR databases were combinedmlo HealthSTAR and a backfile (HealthStar75).Currently HealthSlar75 coniams 1,731,986 recordswith coverage from 1975-1989. HealthSTARcontains 1,174,164 records from 1976 through 9612(entry monlh).• PREMEDLINE was created as a newMEDLARS database to allow access to citationswhile they are being indexed i.e., prior to their entryinto the MEDLINE database The database is updateddaily.• HISTLINE was reorganized lo allow belleraccess to old records. Work has begun on anOLDMED file for citations prior to 1966. Thisdatabase will contain citations with a date olpublication prior lo 1966

Citation Maintenance

• Development of maintenance systems forSPACELINE and HealthSTAR databases was

55


completed. This involved the creation of software topermit importing and processing data from NASAand the Emergency Care Research Institute inaddition to accessing the NLM online databases formaintenance purposes.• The BIOETHICS maintenance system nowallows records to be imported from other databases.• Development of the CHEMLINE RecordMaintenance System (CRMS) was completed. Thissystem will provide for the creation and maintenanceof the MEDLARS CHEMLINE data dictionaryrecords.• The INDX65 system for data entry andmaintenance of Index Medicus 1965 data wasdeveloped and implemented.

Automated Indexing Management System

An online INVOICE system using aCustomer Information Control System interface tothe Database Management System INQUIRE wasdeveloped and installed. This system provides fordata entry/maintenance of invoice data received atNLM. Programs were written to process journalissue data encoded in the Standard GeneralizedMarkup Language (SGML). This data was providedto the NLM's National Center for BiotechnologyInformation by various publishers.

A Local Area Network-based system wascreated to provide data entry/maintenance of journalissue data.

The system provides for linking of keyed associatedarticle data to scanned/optical character recognitionabstract data. The data are then placed in theMEDLARS input streams for indexing.

DOCLINE and Loansome Doc

• Plans have begun for installing the RELAISsystem at NLM. RELAIS is a fully automatedintelligent document order processing and deliverysystem that will streamline the processing ofinterlibrary loans at NLM. A prototype workstationhas been designed and tested and the workflowdocuments were finalized. DOCLINE and Locatorhave begun to transfer requests to RELAIS.Modifications to the LEND module in DOCLINE arecomplete for new delivery methods-fax, Ariel,printer and e-mail. NLM is expecting a spring 1997installation of the system.

• A World Wide Web interface for updatingDOCUSER records was installed. DOCUSER is thedatabase containing data related to users of theDOCLINE system.• Access to HealthSTAR, HealthSTAR75 andPREMEDLINE was provided.• An interface to add foreign addresses, comments,and Internet addresses for electronic delivery wasadded to Loansome Doc and Grateful Medprocessing.

56

ADMINISTRATIONExecutive OfficerDonald C. Pappke

National Performance Review

In response to the Administration's NationalPerformance Review, NLM continued to be activelyinvolved in streamlining efforts and the Library'ssystems re-engineering initiative under its role as areinvention laboratory.

Streamlining

Overall, the NLM met its downsizing goalsfor FY 1996 and continues to work toward meetingfuture targets. The NLM closed FY 1996 with 575full-time equivalents (FTE). Our ceiling for FY 1997is 571 FTE.

In an NIH-wide streamlining effort to reducesupport positions, several Competitive ServiceCenters have been established. NLM's Office ofAcquisition Management became an NIHCompetitive Acquisitions Service Center last yearand provided procurement support for a selectedgroup of contracts from other NIH components.

A number of important delegations ofauthority in the acquisitions area were redelegated toNLM's Chief Contracting Officer. Also, numerouspersonnel delegations of authority were granted to allNIH components by the NIH Office of HumanResources Management.

Systems Reinvention Project

Clearly, one of our most important andhighly visible efforts in support of the NationalPerformance Review is the NLM's Systems Re-engineering Initiative. The NLM is a designated"Reinvention Laboratory" and the theme of this highpriority effort is to reinvent the Library's informationsystems, to move to a more flexible, powerful, andmaintainable computer system that will improveinternal processing and provide innovative services tooutside users. Making our services even moreresponsive to customers and to the nation's healthinformation needs with fewer staff resources will be a

most significant accomplishment. The NLM SystemReinvention project made progress in several areas inFY 1996:

• Integrated Library System (ILS). The ILS teamcompleted a detailed definition of systemrequirements and system evaluation criteria anda survey of candidate ILS products. NLM plansto use the NIH Image World contract, early inFY 1997, to engage a library systems integratorto design and build the required system.

• Document Delivery System. A contract wasawarded to Network Systems Inc. in June 1996to install their document delivery system, Relais.Relais will streamline NLM's document deliveryprocess, eliminating much of the current manualeffort and making it much more efficient totransmit document images electronically. Thesystem is scheduled to be fully operational byJune 1997.

• Internet Grateful Med (IGM). This World WideWeb service provides easy access to several ofNLM's databases. The initial release in the springof 1996 offered MEDLINE searching. Version2.2, released in September 1996, added access toPREMEDLINE, HealthSTAR and AIDSLINE.Many more databases will be added in thecoming months. IGM has proven to be verypopular with the public. By August 1996, IGMwas accounting for a quarter of the individualswho searched MEDLINE or other NLMdatabases during the month.

• Grateful Med for Windows. This newly designedversion of Grateful Med, which provides accessto MEDLINE, underwent extensive beta testingin 1996. User reaction to the product has beenvery favorable. A production Version 1.0 will bedistributed to active users of the current DOSversion of Grateful Med in January 1997.

Financial Resources

In FY 1996, the Library had a totalappropriation of $140,563,000. Table 12 displays theFY 1996 budget authority plus reimbursements fromother agencies, and the allocation of these resourcesby program activity.

57


Table 12Financial Resources and Allocations, FY 1996(dollars in thousands)

Budget Authority:Appropriation, NLM

Plus: Reimbursements

TOTAL

..$140,56313,283

.$153,846

Budget Allocation:Extramural Programs $ 33,285Intramural Programs 112,925

Library Operations (61,772)Lister Hill National Center for

Biomedical Communications (34,306)National Center for Biotechnology

Information (9,858)Toxicology Information (6,989)

Research Management and Support 7,636

TOTAL .$153,846

The 1996 appropriation language authorizedthe Library to use personal services contracts andprovided that $4.0 million be available without fiscalyear limitations. These authorities are key elementsof NLM's system reinvention initiative.

Personnel

We are sad to report that the NationalLibrary of Medicine lost a long-time friend and co-worker this year. Richard T. West, Chief of theOffice of Program Planning and Evaluation,Extramural Programs, died unexpectedly at his homeon October 1, 1996. Mr. West had been with theLibrary for some 25 years and will be greatly missed.

Appointments

In November 1995, Donald C. Poppke wasappointed as NLM's new Executive Officer. Mr.Poppke was formerly the Executive Officer of theNational Center for Nursing Research, NIH, andbefore coming to NLM he was the Chief of thePublic Health Branch in the Office of the HHSAssistant Secretary for Management and Budget. Hereceived a B.S. degree in biological sciences fromWashington and Lee University and an M.S. degreein the technology of management from AmericanUniversity. As Executive Officer, Mr. Poppke isresponsible for planning and directing the

administrative management functions of the Libraryincluding financial, personnel, and contractsmanagement, administrative services, andmanagement analysis and legislation.

In February 1996, the Library made its firstappointment under the Silvio Conte SeniorBiomedical Research Service (SBRS), a new careerpathway for outstanding basic science and clinicalresearchers at the NIH. The SBRS, comparable to theSenior Executive Service, is designed for scientistsactively engaged in research. James M. Ostell, Ph.D.,with the National Center for BiotechnologyInformation (NCBI) is the first NLM employeeselected for a Senior Biomedical Research Serviceposition. Dr. Ostell has made original and importantindependent contributions to biomedical research inthe new field of bioinformatics. He has conceived,designed, built, and delivered molecular biologysystems in a broader, more unified and biologicallyrational way than has ever been before.

Also in February, Kathleen GardnerCravedi joined the NLM as a Special Expert with theOffice of Public Information. Prior to joining NLM,Ms. Cravedi worked as Director of Public Policy ofthe Health Foundation for Hospice and Homecare inWashington, D.C. and served as Deputy ExecutiveDirector of the Alliance for Aging, also inWashington, D.C. As a Special Expert with OPI, Ms.Cravedi will develop public information andoutreach-related strategies.

In March, Robert Ploger was selected toreceive a Fellowship under the new TechnicalIntramural Research Training Award (IRTA)program. This new program is designed to producehighly trained support professionals capable ofperforming the latest advanced techniques in alaboratory. Mr. Ploger, who will be working withNCBI staff, will gain experience in the use of UNIXoperating system, programming in the computerlanguage C, and database management using theSYBASE relational database system. He will workon biomedical sequence databases used for mappingthe human and other genomes, as well as foridentifying, isolating and sequencing genes ofbiological and medical interest.

In April, Aaron Marchler-Bauer, Ph.D. wasappointed as an NCBI Visiting Fellow. He receivedhis Ph.D. in biochemistry from the University ofVienna. Dr. Bauer has extensive experience inprotein threading, an area that demands considerablesoftware skills, and in applied structural analysis. AtNCBI, Dr. Bauer will work on software development

58

Administration

lor the NCBI macromolecular structure database andon independent research projects in the urea olprotein threading und structure comparison Hisresearch wil l allow NCBI to further developcomparative analysis tools that make use of 3-Dstructure information.

In June, Stewart J Nelson, M I) wasappointed head ol the Medical Subject HeadingsSection (MeSH), Library Operations Dr Nelsonreceived his medical degree from the State Universityof New York, Downstatc Medical Center. Prior lojoining the Library, Dr. Nelson practiced and taughtgeneral internal medicine at the Medical College olGeorgia and at the State University ol New Yoik atStony Brook In addition, he worked as a consultantlo Lexical Technology, Inc , where he collaborated inthe development ol the UMLS Metathesaurus Dr.Nelson is a Fellow of the American College ofPhysicians

In July, Shih-HMn Yang was selected loreceive a Prcdoctoral Intramural Research TrainingAward (IRTA) Fellowship with the NCBI. Mr Yangwill learn the techniques involved in using computersto help solve some ol the information problems thatarise in scientific research He wil l collaborate withscientists at NCBI who aie working on themacromolecular structure database and the Enlrc/Genomes Project.

Also in July, Mark Alan Her\hkovitz, Pti.Dreceived a Postdoctoral Intramural Research TrainingAward (IRTA) Fellowship from the NCBI DrHershkoviu received his Ph D in botany from theUniversity of Cal ifornia Before his appointment withNCBI, Dr Hershkovit/ served as a PostdoctoralScientist at the Smithsonian Inst i tut ion. Laboratoiy ofMolecular Systemalics While at the NCBI, Dr.Hershkovit/ 's research wil l include the analysis ofthe taxonomy ol species in GenBank, the advancingof systcmatics of angiosperms, caryophylles, andorgamsmal evolution at the molecular level

Award'.\

The NLM Board ol Regents Award forScholarship or Technical Achievement was awardedto three individuals Wen-Min Kao, M LS. loroutstanding intellectual und editorial contributions lothe f i f t h edition of the National Lihrar\ of MedicineCluMijication, and lo Mark S Roguikt, Ml), PH.D.and Gregory I) Sihuler, Phi) lor technicalachievement in producing the human transcript map,a compilation and synthesis ol the current slate ofknowledge in human gene mapping

The Frank B. Rogers Award recogm/esemployees who have made significant contributionsto ihe Library's fundamental operational programsand services The recipient of the 1996 award wasJoseph W. Hutchin.\, Office of Computer andCommunications Systems, for his exceptionalcontributions that have significantly improvedNLM's indexing, database access, and documentdelivery functions.

The NIH Director's Award was presented totwo employees this year: Michael J. Ackerman, Ph.l)and Lawrence C. Ktngsland, HI, Ph.D. Dr Ackermanwas rccogni/.cd for his leadership of the VisibleHuman project, culminating in the release to thescientific community ol two immense dalaselsrepresenting a 3-dimcnsional male and female. DrKmgsland was rccogm/ed for his leadership increating, testing, and implementing the InternetGrateful Mcd software thai is revolutiom/ing howMEDLINE is searched by health professionalsaround the world

The NLM Director's Award, presented inrecognition ol exceptional contributions to the NLMmission, was awarded to two employees Joseph PFitzgerald, Lister Hil l National Center forBiomcdical Communications, and David J. Lipman,M D., National Center for BiotechnologyInformation Mr. Fit/gcrald was rccogni/.ed for hisexceptional contributions to the mission of the NLMthrough the creative application of his artistic talentDr Lipman was rccogni/.ed for contributions ofinestimable value to the research mission of theLibrary and for leading the National Center forBiotechnology Information lo internationalprominence

The NIH Merit Award was presented toseven employees Fernando Burhano, Office ofCompulei and Communications Systems, PandoriaL King, Office of Administration; Pamela A.Meredith, Division of Library Operations; Patricia S.Page, Office of Administration, Edmund J. Syed,Lister Hi l l National Center for BiomedicalCommunications; Cheryl E White, Division ofSpeciali/cd Information Services, and posthumously,lo Ruhard T West, Division of ExtramuralPrograms Mr. Burbano was recogm/cd for hisefforts m sustaining the NLM computer operations atpeak efficiency during furloughs, bli/,/.ards, and otherexigencies Ms. King was recogm/ed for herexceptional dedication and excellence in providingpersonnel support services to the Library. Ms.Meredith was rccogm/cd for exceptional leadershipand achievement in providing effective reference


services for NLM's Reading Room patrons andcustomers worldwide. Ms. Page was recognized forexceptional management and effective administrationof the contracting function at the NLM. Mr. Syed wasrecognized for creative excellence while serving assoftware architect, principal system designer, andlead programmer for the Internet Grateful Med. Ms.White was recognized for exceptional achievement inproducing documentation for SIS databases andeffectively using the new medium of the Internet todistribute information. Mr. West was recognized fordedicated nurturing of NLM's Integrated AdvancedInformation Management System grant program tonational renown as a facilitator of unified informationsystems at medical centers.

The NIH Purchasing Award was presentedto Liem T. Nguyen for demonstrating outstandingleadership and resourcefulness in support of theNLM's small purchases activities.

Table 13Staff, FY 1996 Full-Time Equivalents

Full-TimePermanent

Other

Office of the Director 14 6Office of Public Information 6 2Office of Administration 50 8Office of Computer and

Communications Systems 53 6Extramural Programs 13 5Lister Hill National Center

for Biomedical Communications? 1 6National Center for Biotechnology

Information 22 11Specialized Information Services ..28 2Library Operations 234 38

TOTAL 491 .84

TOTAL FTEs 575

NLM Diversity CouncilCassandra Allen (Chair)Public Services Division

In July 1996, under the leadership of theNLM Director, the Library became the firstcomponent of the National Institutes of Health toestablish a Diversity Council. The purpose of theCouncil is to provide advice to the Director to ensurethe NLM, its staff and programs reflect the breadth

and richness of character of the society we serve andthat everyone within the organization has theopportunity to reach his or her fullest potential.

The 11-member Council meets on a regularschedule and is mapping out a plan of action for thecoming year. The Council embodies the value ofbringing all voices to one table to discuss similarissues in a single advisory body.

Office of Equal Employment OpportunityDavid NashNLM EEO Manager

In FY 1996, NLM identified areas of under-representation in the composition of its staff,especially Hispanic and Native Americans. The NLMmade special efforts to cooperate with suchorganizations as the Association of American IndianPhysicians and the InterAmerican College ofPhysician and Surgeons about current NLM jobvacancies and other opportunities at the Library.There were exhibits and health information seminarsat meetings and conferences emphasizing healthissues affecting Hispanic and Native Americans.Several large groups of Hispanic high school andcollege students have toured the Library in the pastyear.

In working with African Americans, NLM'sEEO Manager attended and exhibited at suchconferences as the National Association for EqualOpportunity in Higher Education, composed of the117 Historically Black Colleges and Universities. Healso attended minority training seminars sponsoredby the National Medical Association, National UrbanLeague, National Association for the Advancementof Colored People, National Association of HealthServices Executives, Symposium on CareerOpportunities in Biomedical and Public HealthSciences, and Blacks In Government.

NLM has begun to explore developing aspecial outreach program with Largo Senior HighSchool, a predominantly African American School inMaryland. This school has a four-year biotechnologymedical career track program designed to trainstudents who are seeking careers in the medical andbiotechnology fields. Working with senior staff of theNational Center for Biotechnology Information, aseries of tours and presentations of NLM'sbiotechnology programs and facilities wereconducted.

NLM's EEO Manager became trained anddesignated as a Federal mediator in the AlternativeDispute Resolution (ADR) program. The objective ofthe ADR program is to improve the resolution rate ofEEO-related complaints, especially those that arebeyond the scope of EEO laws and regulations. The

60

Administration

training has allowed the EEO Manager theopportunity to provide the NLM Director and staff

with expert guidance and alternatives in addressingand resolvingemployee-related concerns.

61

Appendix 1: Regional Medical Libraries in theNational Network of Libraries of Medicine

MIDDLE ATLANTIC REGIONThe New York Academy of Medicine1216 Fifth AvenueNew York, NY 10029(212)876-8763 FAX (212) 534-7042States served: DE, NJ, NY, PA

SOUTHEASTERN/ATLANTIC REGIONUniversity of Maryland at BaltimoreHealth Sciences Library1 1 1 South Greene StreetBaltimore, MD 21201-1583(410) 706-2855 FAX (410) 706-0099States served: AL, FL, GA, MD, MS, NC,SC, TN, VA, WV, DC, VI, PR

GREATER MIDWEST REGIONUniversity of Illinois at ChicagoLibrary of the Health SciencesP.O. Box 7509Chicago, IL 60680(312)996-2464 FAX (312) 996-2226States served: IA, IL, IN, KY, MI, MN,ND, OH, SD, WI

MIDCONTINENTAL REGIONUniversity of Nebraska Medical CenterLeon S. McGoogan Library of Medicine600 South 42nd StreetOmaha, NE 68198-6706(402) 559-4326 FAX (402) 559-5482States served: CO, KS, MO, NE, UT, WY

SOUTH CENTRAL REGIONHouston Academy of Medicine-Texas Medical

Center Library1133 M.D. Anderson BoulevardHouston, TX 77030(713) 790-7053 FAX (713) 790-7030States served: AR, LA, NM, OK, TX

PACIFIC NORTHWEST REGIONUniversity of WashingtonHealth Sciences Center LibraryBox 357155Seattle, WA 98195(206) 543-8262 FAX (206) 543-2469States served: AK, ID, MT, OR, WA

PACIFIC SOUTHWEST REGIONUniversity of California, Los AngelesLouise Darling Biomedical Library10833 LcContc AvenueLos Angeles, CA 90024-1798(310) 825-1200 FAX (310) 825-5389States served. AZ, CA, HI, NV and U.S.Pacific Territories

NEW ENGLAND REGIONUniversity of Connecticut Health CenterLyman Maynard Slowe Library263 Farmington AvenueFarmington, CT 06030-4003(203) 679-4500 FAX (203) 679-1305States served: CT, MA, ME, NH, RI, VT

62

Appendix 2: Board of RegentsThe NLM Board of Regents meets three times a year to consider Library issues and make recommendations to theSecretary of Health and Human Services on matters affecting the Library.

Appointed Members:

PHILLIPS, Steven J., M.D.Senior Heart SurgeonMercy Hospital Medical CenterDes Moines, IA

ALBRIGHT, Tenley E., MDTwo Commonwealth Avc.Boston, MA

BALL, Marion, Ed.D.Vice President for Information SciencesUniversity of Maryland at BaltimoreBaltimore, MD

BOND, Enriqueta, M.D.President, Burroughs Wellcome FundDurham, NC

CORTEZ, Edwin M., Ph.D.Asso. Professor, School of Library andInformation ScienceUniversity of WisconsinMadison, WI

DeBAKEY, Michael E., MDChancellorBaylor College of MedicineHouston, TX

FONSECA, Raymond J., D.M.D.Dean, School of Dental MedicineUniversity of PennsylvaniaPhiladelphia, PA

FULLER, Sherrilynnc, Ph.D.Director, Health Sciences LibraryUniversity of WashingtonSeattle, WA

GAGE, JohnDirector, Science OfficeSun Microsystems Computer Corp.Mountain View, CA

NOLAN, George H., MDDirector, Department of Obstetrics and GynccologyHenry Ford HospitalDetroit, MI

Ex Offlcio Members:

Librarian of Congress

Surgeon GeneralPublic Health Service

Surgeon GeneralDepartment of the Air Force

Surgeon GeneralDepartment of the Navy

Surgeon GeneralDepartment of the Army

Under Secretary for HealthDepartment of Veterans Affairs

Assistant Director for Biological SciencesNational Science Foundation

DirectorNational Agricultural Library

DeanUniformed Services Universityof the Health Sciences

63

Appendix 3: Board of Scientific Counselors/Lister Hill Center

The Board of Scientific Counselors meets periodically to review and make recommendations on the Library'sintramural research and development programs.

Members:

MITCHELL, Joyce A., Ph.D. (Chair)Director, Medical InformaticsUniversity of Missouri-ColumbiaColumbia, MO

BRINKLEY, James F., M.D., Ph.D.Research Assistant ProfessorDepartment of Biological StructureUniversity of WashingtonSeattle, WA

BUCHANAN, Bruce G., Ph.D.Professor of Computer ScienceUniversity of PittsburghPittsburgh, PA

KAHN, Michael G., M.D., Ph.D.Assistant Professor of MedicineDivision of Medical InformaticsWashington UniversitySt. Louis, MO

WILKERSON, LuAnn, Ed.D.Director, Center for Educational DevelopmentUCLA School of MedicineLos Angeles, CA

64

Appendix 4: Board of Scientific Counselors/National Center for Biotechnology Information

The National Center for Biotechnology Information Board of Scientific Counselors meets periodically to review andmake recommendations on the Library's biotechnology-related programs.

Members:

ROBERTS, Richard J., Ph.D.Research DirectorNew England BiolabsBeverly, MA

BUETOW, Kenneth H., Ph.D.Fox Chase Cancer CenterPhiladelphia, PA

FITZGERALD, Paula, M.D., Ph.D.Senior Research FellowDepartment of Biophysical ChemistryMerck Sharp & DohmeRahway, NJ

PACE, Norman R., Ph.D.Distinguished Professor of BiologyIndiana UniversityBloomington, IN

SCHLICK, Tamar, Ph.D.Associate ProfessorChemistry DepartmentNew York UniversityNew York, NY

WILLIAMS, Myra N., Ph.D.Vice President, Information TechnologyGlaxo Research InstituteResearch Triangle Park, NC 27709

ZAMUDIO, CarlosDirector, Bioinformatics and EngineeringSequana TherapeuticsLa Jolla, CA 92037

65

Appendix 5: Biomedical Library Review CommitteeThe Biomedical Library Review Committee meets three times a year to review applications for grants under theMedical Library Assistance Act.

Members:

BUNTING, Alison (Chair)Associate University Librarian for ScienceLouise Darling Biomedical LibraryUniversity of CaliforniaLos Angeles, CA

ALLMAN, Robert M., M.D.Professor of RadiologyUniv. of Maryland School of MedicineBaltimore, MD

BROADNAX, LavondaAutomation Operations CoordinatorLibrary of CongressWashington, DC

BROERING, Naomi C.Director, Biomedical Info. Resource CenterDahlgren Memorial LibraryGeorgetown University Medical CenterWashington, D.C.

CLEVELAND, Ana D., Ph.D.Professor of Information ScienceSchool of Library and Information SciencesUniversity of North TexasDemon, TX

FRIEDMAN, Richard B., M.D.Medical DirectorWaianae Comprehensive Health CenterWaianac, HI

HOLST, RuthDirector, Library ServicesColumbia HospitalMilwaukee, WI

IYENGAR, S. Sitharama, Ph.D.Professor and Chairman of Computer ScienceLouisiana State UniversityBaton Rouge, LA

KULIKOWSKI, Casimir A., Ph.D.Professor of Computer ScienceRutgers UniversityNew Brunswick, NJ

MAVROVOUNIOTIS, Michael L., Ph.D.Associate ProfessorChemical Engineering DepartmentNorthwestern UniversityEvanston, IL

MODEL, Peter, Ph.D.Professor of BiochemistryRockefeller UniversityNew York, NY

MOLHOLT, Pat A.Assistant Vice PresidentColumbia University Health SciencesNew York, NY

RANKIN, Jocelyn A., Ph.D.Professor of Library Science andDirector, Medical Library and Learning

Resources CenterSchool of MedicineMercer UniversityMacon, GA

RINDFLEISCH, ThomasDirector, MCAMIS/SSRGStanford UniversityStanford, CA

ROSSE, Cornelius M. M.D., D. Sc.Professor and ChairmanDepartment of Biological StructureSchool of MedicineUniversity of WashingtonSeattle, WA

SEARLS. David B., Ph.D.Research Associate ProfessorDepartment of GeneticsUniversity of PennsylvaniaSchool of MedicinePhiladelphia, PA

TANG, Paul C., M.D.Medical Director, Information SystemsNorthwestern Memorial HospitalChicago, IL

VRIES, John K. M.D.Assoc. Vice Chancellor for Medical InformaticsUniversity of Pittsburgh Medical CenterPittsburgh, PA

66

Appendix 6: Literature Selection Technical ReviewCommittee

The Literature Selection Technical Review Committee meets three times a year to select journals for indexing inIndex Medicus and MEDLINE.

Members:

COLON, Angel Rafael Jr., M.D. (Chair)Professor of PediatricsGeorgetown Univ. School of MedicineWashington D.C.

ALTAMORE, Rita Ann, M.D., M.P.H.Senior LecturerDepartment of Health ServicesUniversity of WashingtonSeattle, WA

CABELLO, Felipe C, M.D.Dept. of Microbiology and ImmunologyNew York Medical CollegeNew York, NY

CLEVER, Linda Hawcs, M.D.Chair, Dept. of Occupational HealthCalifornia Pacific Medical CenterSan Francisco, CA 94120

MAKINEN, Ruth H.Head, Technical ServicesUniversity of MinnesotaBio-Medical LibraryMinneapolis, MN

MATHIEU, Alix, M.D.Professor of AnesthesiaUniversity of CincinnatiCollege of MedicineCincinnati, OH

PINCUS, Harold A., M.D.Director, Office of ResearchAmerican Psychiatric AssociationWashington, DC

ROLETT, Ellis L, M.D.Professor of MedicineDartmouth-Hitchcock Medical CenterLebanon, NH

STRICKLAND, Ora Lea, Ph.D.Professor, School of NursingEmory UniversityAtlanta, GA

THOMAS, John A., Ph.D.Vice President for Academic AffairsUniversity of Texas Health Science CenterSan Antonio, TX

WHITE, Charles A., M.D.Professor and Head EmeritusDepartment of Obstetrics and GynecologySchool of MedicineLouisiana State UniversityNew Orleans, LA

67

APPENDIX 7: Extramural Programs Grants - FY 1996Awards preceded by an "*" are first year, or competing awards, all others are continuation of awards made in prioryears.

Fellowships

Informatics Research Fellowships

*Ambrosino, Richard $43,684University of PittsburghImproving decision-support systems withdomain knowledge

Carter, Alexandre R. $32,998Harvard UniversityMinority predoctoral fellowshipprogram-NIGMS

Kogelnik, Andreas M. $14,508EmoryUniversityMitochondria! genetics information system

*SooHoo, KENT, Jr. $17,569University of California San FranciscoContent based indexing for medical imagemanagement

Zimmerman, Diane E.$31,600Rutgers the State University, New BrunswickProtein NMR spectra using artificialintelligence

Applied informatics Fellowships

Bradley, Johanna R. $55,600National Library of MedicineCreation, access and use of networked healthinformation

Gray, Paul A., Jr. $48,171DukeUniversityDeveloping patient outcomes from clinicalobservations

Legler, James D. $28,000University of Texas, San AntonioHealth Science CenterAssessment of city wide childhoodimmunization database

*Weiner, Mark G. 50,696University of PennsylvaniaHealth service research workstation

Internet Connections Grants

*Bailey, Nora J. $28,849

Sacred Heart Hospital of Pensacola, PL*Certo, Tindara J $50,000

Fayetteville AHEC, NCInternet access for rural health professionals

*Cook, Nedra J. $29,062Fort Sanders Regional Medical Center, TN

*Cullander, Christopher $22,943University of California, San FranciscoInternet access at affiliated hospitals

*Dujsik, Gerald $30,000Illinois College of Optometry

*Dyer, David W. $ 17,436Masonic Medical Research Laboratory, Inc. NYFull internet access for the MMRL

*Ervin, Frank R. $30,000Mcleod Regional Medical Center, SCMRMC Internet access to the Pee Dee

*Grimaldi, Deborah J. $32,310Doctors Community Hospital, MD

*Hamblin, Garth M. $49,298Bartlctt Memorial Hospital, AKAccess for rural health services in SE Alaska

*Hirsch, Marga R. $29,594Pennsylvania College of Podiatric Medicine

*Hunt, Ronald D. $30,000Harvard University NE Regional PrimateResearch Center

*Lynch, John T. $49,916Connecticut Hospital AssociationConnecting CT healthcare institutions to theInternet

*Montgomery, James B. $31,602Central State Hospital, VA

*Murry, Carol $50,000Ke Ola O Hawai'i, Inc., HICommunity partnershipshealthnet

*Norcross, Natalie $28,924Tuality Healthcare, Inc., OR

*Palmore, Jonathon D. $28,300Community Memorial Hospital, VAHealthcenter Internet connection

*Romanoski, Frank T. $19,986Memorial Health Alliance, Mount Holly NJ

*Roth, Juanita J. $30,000Southwest Missouri State UniversityCampus Internet expansion

68

*Shatzkin, Nance $30,000St. Luke's Roosevelt Hospital Center, NY

*Smith, Brian D. $28,900St. James Mercy Hospital, NY

•Thomas, Karen K. $26,850Assn. Women's Health/Obstetric/Neonatal, DC

*West, DeeW. $30,000Northern California Cancer Center

•Wirth, Pamela R. $50,000Susquehanna Health System

*Worley, Sandra $48,104Midwestern University,IL

*Zajac, Rosalie V. $49,136Good Samaritan Hospital, OH

•Ziegler, Judith E. $28,481Crozer-Key stone Health System, PA

Integrated Advanced Information Systems(IAIMS)

Phase I Grants

*Curry, David S. $134,487University of Iowa

*Frisse,Mark E. $134,954Washington University, MO

•Gardner, Reed M. $89,668LDS Hospital, UT

•Larson, Paul F. $134,924University of Medicine & Dentistry of NJ

•Mitchell, Joyce A. $550,000University of Missouri at Columbia

•Niland, Joyce C. $149,964City of Hope National Medical Center, CA

*Sokol, Robert J. $149.688Wayne State University,MI

IAIMS, Phase II

Fuller, Sherrilynne $549,998University of Washington, WACreating the UWHSC integrated informationinfrastructure

Paton, John A. $546.067Yale University, CTIAIMS implementation at Yale

Stead, William W. $571,500Vanderbilt University, TNFast track provision of IAIMS

Library Information Science Research Grant

Sievert, Maryellen C. $191,460

University of Missouri, ColumbiaRetrieval from full-text medical databases

Publication Grants

Baldwin, Peter $34,818University of California, Los AngelesState intervention against contagious disease

Barr, Bcrnadine C. $25,000Stanford University, CASpare children-subjects in research, 1900-1945

Carmichael, Ann G. $8,087Indiana University, BloomingtonHistory of state registration of causes of death

Faden, Ruth R. $33,000Johns Hopkins University, MDEthics & allocation-foundations of Americanhealth care

Funk.CarlaJ. $4,050Medical Library AssociationHistory of the MLA

Hast, Malcolm H. $35,405Northwestern University, ILAnnotated translation of Vesalius's Fabrica

Leys, Ruth $25,000Johns Hopkins University, MDWestern concepts of psychic trauma, 1875-1995

•Micale, Mark Stephen $18,000Individual award, CTHistory of psychiatric classification from

HippocratesRettig, Richard A. $43,960

Rand Corporation, CAPublic policy and the treatment of kidney failure

•Rosse, Cornelius $33,153University of Washington, WAInteractive atlas of thoracic viscera

Sievert, Maryellen C. $26,801University of Missouri, ColumbiaMissouri thesaurus of medical informaticsterminology

•Tracy, Sarah W. $39,701Rutgers the State University, NJMedicalization of alcoholism in America, 1870to 1920

Information Access Grants

•Bowden, Virginia M. 120,418University of Texas, San AntonioMedical Internet South Texas (MIST)

Bulgarelli, Nancy T. $54,570William Beaumont Hospital, MITachia electronic information access for ruralhospitals

•Pittman, Jan M. $102,046

69

Three Rivers AHEC, GAThree rivers triad project

*Richwine, Margaret $92,419Indiana & Purdue Universities at IndianapolisInternet library services for medical education

•White, Billie S. $106,937Mercy Medical Center, CARural northern CA medical internet connection

Information Systems Grants

Adams, Mignon S. $54,920Philadelphia College of Pharmacy, PAElectronic pharmacy library

*De Bord, William J. $52,625Morehead State University, KYHealth sciences information data l ink

Dennis, Sharon E. $166,939University of UtahModel multimedia support center for the healthscience

"Jones, Michael O. $146,544University of California, Los AngelesComputerized archive of American traditionalmedicine

Hagen, Michael D. $67,132University of KentuckyInformation for medical students in ruralsettings

•Kingsbury, David T. $95,544Johns Hopkins University, MDInternet based imagebase for medical education

Messerlc, Judith R. $116,922Harvard University, MACreation of a knowledge laboratory

Oppenheim, Roberta A. $149,969Forsyth Dental Center, MAOral health sciences information system

(OHSIS)•Scott, Ursula D. $134,725

Baylor Research Institute, TXBaylorlink

Self, Phyllis C. $143,022Virginia Commonwealth UniversityDrug information automated library (DIAL)

Seltzer, Ada M. $83,410University of Mississippi Medical CenterHealth sciences information network

Troutman, William G. $174,661University of New Mexico, AlbuquerqueInteractive medical information system in NM

Research Training in Medical Informatics

Clayton, Paul D. $219,022Columbia University, NY

Cooper, Gregory F. $317,840University of Pittsburgh

Downs, Stephen M. $392,388University of North Carolina, Chapel Hill

Gatewood, Lael C. $502,337University of Minnesota

Gorry, G. Anthony $281,180Rice University, TX

Greenes, Robert A. $1,191,502Harvard university, MA

Miller, Perry L. $259,458Yale University, CT

Mitchell, Joyce A. $317,213University of Missouri, Columbia

Shortliffe, Edward H. $537,196Stanford University, CA

Spackman, Kent $159,672Oregon Health Sciences University

Biotechnology FIRST Awards

Altman, Russ B. $104,141Stanford University, CAModeling and computing with uncertainstructures

Goldstein, Richard A. $102,770University of Michigan, Ann ArborComputational approaches to protein structureprediction

Karp, Peter D. $102,286SRI International, CABiological knowledge-base management system

Wu, Cathy H. $95,089University of Texas, TylerClassification neural networks for genomeresearch

Biotechnology Research Grants

•Altman, Russ B. $324,757Stanford University, CARepresenting biological data for molecularmodeling

Brutlag, Douglas L. $210,310Stanford University, CAMultiple representations of biological sequences

Davison, Daniel B. $175,339University of Houston, TXMultiple sequence alignment server andalgorithm development

Hardison, Ross C. $212,398Pennsylvania State University

70

Network server for electronic genetic analysis*Miller, Webb C. $393,494

Pennsylvania State UniversitySoftware for analyzing biosequence data

*Myers, Eugene W. Jr. $155,214University of ArizonaEfficient software for the analysis ofbiosequences

Pearson, William R. $255,637University of Virginia, CharlottesvillcComparison of protein sequences and structures

Biotechnology Resource Grants

*Jurka, Jerzy W. $244,203Genetic Information Research Institute, CARepbase--a database of repetitive sequences

Ledley, Robert S. $1,090,179National Biomedical Research Foundation, DCProtein information resource

*Markley, John L. $446,305University of Wisconsin, MadisonBiological magnetic resonance data bank

*Pagon, Roberta A. $150,330Children's Hospital and Medical Center, WAHelix--a directory of medical geneticslaboratories

Roberts, Richard J. $162,032New England Biolabs, Inc., MARebase-the restriction enzyme database

Smith, Temple F. $840,262Boston UniversityBiomolecular engineering research center

Electronic Medical Records Systems CooperativeAgreements

Barnetl, Guy O. $444,053Massachusetts General HospitalPoint of care computer-based ambulatorypatient record

Chute, Christopher G. $ 100,000Mayo Foundation, MNMulti-institutional testbed for clinicalvocabulary(co-funded with another agency)

Cimino, James J. $400,934Columbia University, NYControlled vocabulary in primary careelectronic records

Hersh, William R. $283,557Oregon Health SciencesUniversityVocabulary and text data extraction from theEMR

Kahn, Michael G. $233,246Washington University, MOAutomated tools to support health servicesresearch

Kohane, Isaac S. $287,176Children's Hospital, MA

Multiplatform internet access to multimedia EMRsSafran, Charles $123,448

Beth Israel Hospital, MASharing paperless records among providernetworks(co-funded with another agency)

Medical Informatics FIRST/Career AwardsCooper, Gregory F. $99,157

University of PittsburghStructuring medical knowledge-probabilisticinference

Friedman, Carol $109,392Queens College, NYIntegrated medical text processing system

Gorman, Paul Northrop $99,107Oregon Health Sciences UniversityAssessment of information seeking in primarycare

Hripcsak, George $106,829Columbia University, NYLinking knowledge-based systems to clinicaldatabases

Johnson, Stephen B. $107,858Columbia University, NYAccess to medical information through naturallanguage

Kahn, Michael G. $116,557Washington University, MOTime and context in medical databases

"LangloU, Curtis P. $109,512University of PennsylvaniaComputer-based explanation methods fordecision models

Lehmann, Harold P. $109,527Johns Hopkins University, MDformalizing the notion of clinical significance

Lenert, Leslie A. $112,700Stanford University, CAComputer interpretation of free-text data

*Rutledge, Geoffrey W. $ 124,384Beth Israel Hospital, MAAdvanced computer methods for ICU care

*Shahar, Yuval $104,035Stanford University, CAKnowledge based temporal abstraction ofclinical data

Sitlig, Dean F. $96,608Brigham and Women's Hospital, MAIntelligent real time information synthesis for

71

monitorsSonnenberg, Frank A. $65,880

University of Medicine & Dentistry of NJKnowledge management for clinical decisionanalysis

*Tong, David A. $94,532University of OklahomaModel-based interpretation of intracardiacelectrograms

Yang, Yiming $131,529Carnegie-Mellon University, PALLSF mapping for indexing and retrieval ofMEDLINE

Medical Informatics Research Grants

Begg, Colin B. $90,614Sloan-Kettering Institute for Cancer Research,NYMeta-analysis methodology for diagnostic testevaluation

*Bowden, Douglas M. $178,795University of Washington, WASpatial/symbolic brain information managementsystem

Brinkley, James F. $95,456University of Washington, WAStructural information framework for brainmapping(co-funded with another NIH institute)

*Chute, Christopher G. $176,155Mayo Foundation, MNLatent semantic indexing in support of dataretrieval

Elstein, Arthur S. $187,807University of Illinois at ChicagoEffect of decision support systems on clinicalreasoning

E/querra, Norberto F. $239,847Georgia Tech Research CorporationKnowledge-based system for cardiac imageinterpretation

Friedman, Charles P. $178,690University of North Carolina, Chapel HillInformation and cognition in medical education

Goldbaum, Michael H. $245,750University of California, San DiegoStructured analysis of the retina

Hay ward, Robert S. $115,370McMaster University,CanadaEvaluation of a database of practice guidelineabstracts

*Jaffe, Carl C. $231,240Yale university, CTIndexing image databases for motion similarity

retrievalJelliffe, Roger W. $431,187

University of California, Los AngelesNew decision supports and databases for drugdosage

"Lang, Walter P. $151,529University of Michigan, Ann ArborMEDLINE and computer conferencing bydentists

Letovsky, Stanley I. $83,590Johns Hopkins University, MDSpatially oriented database for digital brainimages(co-funded with another NIH institute)

Muscn, Mark A. $479,180Stanford University,CASoftware architecture for guideline directedtherapy

Patil, Ramesh S. $254,544University of Southern CaliforniaClinical management of critical illness using AI

Sahni, Sartaj K. $279,223University of FloridaAlgorithms for compression and registration ofbrain MRI

Selker, Harry P. $283,005New England Medical Center, MANew mathematical models for medical events

•Shiftman, Richard N. $100,000Yale University, CTKnowledge processing for clinical practiceguidelines

Toga, Arthur W. $208,743University of California, Los AngelesDigital representation and visualization ofhuman brain

Webber, Bonnie L. $224,960University of PennsylvaniaEffective information delivery to clinicalpersonnel

Widman, Lawrence E. $172,974University of Oklahoma Health Sciences CenterKnowledge-based interpretation of cardiacarrhythmias

Medical Informatics Resource Grants

Balas, E. Andrew $94,897University of Missouri, ColumbiaMela-analysis of clinical information servicetrials

*Giuse, Dario A. $100,000Vanderbilt University, TNImproving knowledge acquisition for medicaldiagnosis

72

*Ho, Bruce K. $100,000University of California, Los Angelesfast browsing of pacs image archive via network

Shortliffe, Edward H. $ 1,419,125Stanford University, CACenter for advanced medical informatics

Small Business Innovative Research(SBIR)/Small Business Technology Transfer Grants(STTR)

Nelson, John M. $380,198Nelson Information Systems, Inc., MDAdvanced pilot study of a journal managementsystem

Jimison, Holly B. $14,000Levernois & Associates, Inc., ORMultimedia tool enhancing informed consent(co-funded with another NIH institute)

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Index

Agency tor Health Care Policy and Research 3, 39, 50Agency (or Toxic Substances and Disease Registry 2 ?, 25AI/RHEUM 27AIDS Clinical Trials Information Network 24AIDS Services 24AIDSLINE 27Animal Testing 25Ann Landers 2Applied informatics fellowships 49Appropriation 57Ariel 14ASN 1 46Associate Program 15Audiovisual Program Development Branch 40AVLINE 9, 5?, 54Awards 59

BBanklt 45Bibliographic Control 10BIOETHICSLINE 51Biomedical ethics 51Biomcdical Library Review Committee 51Biotechnology informatics 50BITNIS 5BLAST 44Board of Regents 4, 51Board of Scientific Counselors 26, 46Bulletin of the Medical Library Association 6

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