fiscal year 1984 - u.s. national library of medicine · robert badovina •c natha bagbn y •...

Ulf Aass • Judy Abramowitz • Estelle Abrams • Carlana Acker • Randall Adams • Doralee Agayoff • Barbara Albright • AnnieAlbritton • Jerrold Alexander • Cynthia Allen • Michele Alsheimer • Andre Alston • Dorothy Anderson • John Anderson • JudyAnderson * Sharon Anderson • Marck Apolito • Marilyn Apolito • Duane Arenales • Karen Armstead • Richard Arnold • JulesAronson • Jack Arthur • Dorothy Atkinson • Niles Austin • lone Auston • Katarina Avnet • Clifford Bachrach • Joyce Backus •Robert Badovinac • Nathan Bagby • Manucher Bahrami • Evelyn Bain • Donna Baker • Marlene Baker • Richard Baker • StevenBaker • Esther Baldinger • Lynn Ballard • Paula Banks • Marquita Banner • Alvin Barnes • Gloria Barnes • Renee Barnes • BryanBarts • Ora Battle • Elizabeth Bauernschub • Alison Beatty • Karen Beauregard • Peggy Beavers • Melvin Beckelhimer • MarthaBeckham • Frances Beckwith • George Bell • Daniel Belsole • Audrey Belton • Davega Belton • Gracie Belton • Juliet BenEzra •Deborah Bennett • Harry Bennett • Wilma Bennice • Dennis Benson • Marian Beratan • Connie Bergsmith • Albert Berkowitz •Kevin Beverly • Barbara Bishop • Dennis Black • Lesterine Black • Heather Blondell • Cynthia Bolton • Judy Blumenthal • SharonBoone • Donald Borton • RuthBortz • Patricia Bosnia • Raymond Bowen • Nancy Bowman • LisaBoyd • Robin Boynton • ReginaBrailsford • Jeanne Brand • June Bray • Charles Bridgman • Dorothy Brincefield • Louisa Britten • Regina Broadhurst • ArthurBroering • Harriet Brooks • Elaine Brown • Michael Brown • Elsie Browne • Anita Bryant • Jane Bryant • Patricia Buchan •Donald Buckner • Theodore Burch • Sally Burke • Joan Burnside • Edward Burris • Frederick Buschmeyer • Brian Butler • SusanBuyer • James Cain • Edith Calhoun • Doreen Callahan • Caroline Camilo • Brian Campbell • Frank Cappiello • Daniel Carangi• Dawn Carlisle • Kenneth Carney • Amelia Carpenter • Victor Carr, Jr. • Anglique Carroll • Patricia Carson • Barbara Cassedy• James Cassedy • Kathleen Caswell • Theodore Catchings • Lois Chang • Karen Chappelear • Meredith Charak • Thelma Charen •fames Charuhas • Joseph Charuhas • Michael Chase • May Cheh • Gloria Chen • Robin Chivers • Chong Chung • Wanda Clarke •Darol Clausen • Peter Clepper • Carol Cofrancesco • Maxine Cohen • BodeCoker • Lois AnnColaianni • Annie Coleman • Phillip^oleman • Nelda Coligan • Kenneth Collins • Karin Colton • Eleanor Conger • Felicia Conner • Jean Carol Conner • Anna Cooke> John Cookson • Sandra Cooper • William Cooper • Michelle Cornish • Cheryl Corson • George Cosmides • Joseph Costa • Sandra^ostanzo • John Cox • Nancy Cox • Atsuko Craft • Paul Craig • Nancy Cray • Elizabeth Crichton • Madeline Crisci • Robert Cross» Joanne Crowley • Stephen Crowley • Donna Crump • Martin Cummings • Patricia Cunningham • Robert Curry • Stanley Cutting9 Beatrice D'Aguanno • Roger Dahlen • Veronica Dailey • Antoinette D'Amato • Michael Daniel • Mary Danner • Sara Davidson •

NATIONAL LIBRARY of MEDICINE

PROGRAMS and SERVICES

Fiscal Year 1984

Carolyn Davis • Chivon Davis • Richard Davis • Timothy Davis • ErvinDawson • Stephen Defreytas • Angel Demps • Kelly Desouza• RayDeyton • Wanda Deyton • Michael Diamond • Pamela Dickerson • Alexandra Dimitroff • Carol Ditzler • Donald Dodson •Sean Donohue • Margaret Donovan • Kathleen Doss • Tamas Doszkocs • Denise Drake • Alexander Draznowsky • Howard Drew •Steve Duarte • Walter Dudley • Judith Duff • Jeannette Duggan • Barbara Duke • Gale Dutcher • Daniel Eberly • MichelleEckebrecht • Jerry Edge • Jody Ehr • Ahmed El Hoshy • Leslie Elder • James Eubanks • Jeffrey Eubanks • Carol Evans • MichaelSwing • Mary Jean Fair • Eunice Fairchild • Maria Farkas • Dawn Farr • Tyrone Ferguson • Isabel Fine • Martha Fishel • BarbaraFisher • Elizabeth Fisher • Joseph Fitzgerald • Lawrence Fitzpatrick • Paul Floyd • Laura Foote • Derrick Ford • Linda Ford •ftelen Foster • Jane Fowler • Gloria Fox • George Franklin • Laurie Frazier • Reginald Frazier • Ernest Freeman • Dorothy Fried• Penny Friedenberg • Herbert Friedman • Richard Friedman • Dennis Fryback • Catherine Fuller • Machel Furchner • SeldaPutrowsky • Zelda Gafford • Steven Gaffney • Cynthia Gaines • Joseph Galassi • Saundra Galloway • Joseph Gantner • GeraldEarner • Susan Geddes • Anita Gerath • Miriam Gershfeld • Roger Gilkeson • Jo Lynn Gilliam • Tatia Gilstrap • Yvonne Glanze •Derak Glover • Fritz Gluckstein • James Goldsmith • Charles Goldstein • Filiberto Goodwill • Cealie Goodwin • Catherine Goolsby •Catherine Gordon • Zetherine Gore • Jeanne Goshorn • Raymond Gould • Madeleine Graitson • Elizabeth Weiss Grant • Gloria Grant» Kenneth Grant • Stella Graves • Lavell Green • Richard Gregg • Gerard Guthrie • Anh Ha • Carol Haberman • Marie Hahn •Harol Hairston • Katherine Hamil • Dorothy Hanks • Kathi Hanrahan • SirjaHantsoo • MaryHantzes • Steven Harab • Ellen Hardyrlowe • William Harless • Mary Harmon • Willie Harmon • Alvin Harris • James Harris • Maychel Harris • Thomas Harris • Lisarlarrison • Frances Hartman • Benjamin Hasan • Martha Hassler • Susan Hawk • Debra Hawkins • George Hazard • Arthur Hazes> Patricia Healy • Patricia Hearns • B. Earl Henderson • Sara Hensley • Michael Hepburn • Charles Herbert • Lowell Herbert •iverett Hewett •^Darlene Heyward • Gloria Heyward • Mary Higgins • Lisa Hill • Alice Hines • Christa Hoffmann • Carolyniolloway • Theodore Holloway • Rose Marie Holston • David Homer • Patricia Hopkins • Meredith Horan • John Home • Francesioward • Myrtis Howard • Tulane Howard • Vera Hudson • Helen Humes • Susanne Humphrey • Betsy Humphreys • Jennie Hunt> Rand Huntzinger • Ann Hurley • Joseph Hutchins • Kenneth Irvin • Deborah Jackson • Karlton Jackson • Shawn Jackson •Sherman Jackson • Silas Jackson • Alice Jacobs • Cynthia Jacobs • Robin James • Sharilynjee • Brenda Jefferson • David Jefferson

NATIONAL LIBRARY OF MEDICINE

OFFICEOF TH€

DIRECTOR*

OR. DONALD A. B. LINDBERG

OFFICEOF

ADMINISTRATION

KENNETH O.CARNEY

BOARD OF REGFNTS

OFFICE OF INQUIRIES«. PUBLICATIONS

MANAGEMENT

ROBERT B. MEHNERT

OFFICE OFCOMPUTER t

COMMUNICATIONSSYSTEMS

JOHN ANDERSON

1DIVISION OF

LIBRARY OPERATIONS * *

LOIS ANN COLAIANNI

REFERENCESERVICESDIVISION

JAMES CAIN (ACTO)

BIBLIOGRAPHICSERVICESDIVISION

SHELDON KOTZIN

TECHNICALSERVICESDIVISION

DUANEARENALESIACTOI

HISTORY OFMEDICINEDIVISIONDR. JOHN

PARAICANOOLA

'Deputy Director. Kent Smith, Dip Directortor Research & Education, Dr. Hirold M.

Schoolman; Attociate Director for Planning,Or. William Cooper (Actgl. Annum Directorfor International Programs, Vacant, Director olInformation Syltemi, John Anderion

"Include! Regional Medical Library Programand Medical Subject Heading! Section

DIVISION OFSPECIALIZED

INFORMATION SERVICES

OR. HENRY KISSMAN

BIOMEDICALINFORMATION

SERVICES BRANCH

DR.MELVINSMNN

BIOMEDICAL FILESIMPLEMENTATION

BRANCH

BRUNO VASTA

LISTER HILLNATIONAL CENTER FOR

BIOMEDICALCOMMUNICATIONS

EARL HENDERSON (ACTG)

COMMUNICATIONSENGINEERING

BRANCH

DR.OEOROETHOMA

COMPUTERSCIENCEBRANCH

JULES ARONSON

HEALTH PROFESSIONS APPLICATIONS BRANCH

DR. WARREN SEIBERT(ACTG)

INFORMATIONTECHNOLOGY

BRANCH

CHARLES GOLDSTEIN

AUDIOVISUALPROGRAM DEVELOP

ME NT BRANCH

JAMES MAIN (ACTO)

TRAINING «CONSULTATION

BRANCHDR. MICHAEL

WEISBERG

October 1984

This document was prepared by the National Library of Medicine for administrative purposes.Copies may be purchased from the National Technical Information Service (5285 Port Royal Road,Springfield, Virginia 22161).

Cover: The names of the approximately 600 employees who worked at the National Library ofMedicine during fiscal year 1984.

NATIONAL LIBRARY OF MEDICINE

PROGRAMS AND SERVICES

Fiscal Year 1984

October 1, 1983 - September 30, 1984

U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICESPublic Health Service

National Institutes of Health

National Library of MedicineBcthcsda, Maryland

January 1985

CONTENTS

Page

Preface vii

Policy and Direction 1Board of Regents 1Modernization of the Building 1Financial Resources 2Personnel 2

Awards JEqual Employment Opportunity 3Lobby Exhibits 4

Library Services and Operations 5Personnel and Training 5Planning and Management 5Collection Development 6

Selection 6Acquisitions 7

Collection Preservation and Maintenance 8Bibliographic Control 8

Thesaurus and Classification 9Cataloging 9Indexing 10

Network Services 11Publications 11Machine-Readable Databases 12Online Services 12Document Delivery 13RML Program 17

Onsite Services 17Reference and Research Services 17Public Tours 17Special Historical Programs 17Services to NIH and Other Agencies 19

Office of Information Systems 21MEDLARS III 21

Interim Projects 21Computer and Communications Systems 22Application Services Branch 22Systems Support Branch 22

Equipment 23Computer Services 23

in

IV

Page

Specialized Information Services 25Online Services 25Query Response Services 27Information Services to Other Agencies 27

Hazardous Substances Information Services 27Interagency Subcommittees 27

Lister Hill National Center for Biomedical Communications 29TIME 29Communications Engineering 30

Electronic Document Storage and Retrieval 30Computer Science 31

Automated Classification and Retrieval 31Advanced Computer Science Resource 31

Information Technology 31Distributed Information System 31The National Demonstration Center for Educational Technology.. 32Microprocessor Laboratory 32Processing Bibliographic Citations 33Electronic Mail 33

Audiovisual Program Development 33Projects 33Support Activities 34

Health Professions Applications 34Training and Consultation 34

Extramural Grants and Contracts 35Research Grants 36Medical Library Resource Grants 36

IAIMS Program 37Training Program 38Publication Grants 38Special Foreign Currency Program 39

International Programs 41International MEDLARS Agreements 41Collaboration with the Chinese Academy of Medical Sciences 41Collaboration with India 41Collaboration with the World Health Organization 41Collaboration with the Pan American Health Organization 42International Visitors 42

Appendices1. Staff Bibliography 432. Supported Publications 463. Board of Regents 514. Board of Scientific Counselors 525. Biomedical Library Review Committee 53

TablesPage

Table 1. Financial Resources and Allocations 2Table 2. Staff 3Table 3. Growth of the Collections 6Table 4. Acquisition Statistics 7Table 5. Cataloging Statistics 9Table 6. Bibliographic Services 11Table 7. Online Searches 14Table 8. Offline Searches 14Table 9. Circulation Statistics 15Table 10. Reference Services 18Table 11. History of Medicine Activities 18Table 12. Extramural Grant and Contract Programs 39Table 13. Non-U.S. MEDLARS Centers 42

FiguresPage

Figure 1. Domestic Online Users by Type 13Figure 2. Regional Medical Library Network 16

Preface

In my short time at the National Library of Medicine I have been impressedby the wisdom of the choices in program emphasis made by my predecessors.These decisions and the consistency with which the institution has pursued itschosen course have resulted in outstanding accomplishments. NLM's MEDLARSbibliographic database system, and the collections and procedures supporting it,provide the backbone worldwide for access to the biomedical scientific literature.A variety of NLM bibliographic products save enormous effort and cost in librariesthat utilize work already done here.

On the research side, NLM's commitment to support the investigation ofcom-puter-based programs to benefit information management and decision-making inAmerican health care institutions was clearly farsighted and correct. Now theseprograms are bearing fruit in advancing our understanding of human cognition,medical decision making, and practical interfaces to automated systems.

It is clear, of course, that this is a time of change. The successes of the pastare a source of pride but not a program for the next 20 years. NLM's greateststrength remains its excellent and devoted staff and the wise and faithful guidanceof its advisors—the Board of Regents, the Board of Scientific Counselors, and theBiomedical Library Review Committee. During the coming year we shall be draw-ing upon these strengths to formulate plans for NLM that will carry its invaluablework into the next century.

My most sincere thanks to all on the NLM staff and to the Library's manyfriends and advisors for so much help and goodwill in the past, and for the helpwe will need in the future.

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

VII

POLICY AND DIRECTIONKenneth C. CarneyExecutive Officer

Board of Regents

Perhaps the most important issue considered bythe Regents in FY 1984 (as it has been in recent years)was that of pricing NLM computer-based products andservices. A draft position paper was considered at theOctober 1983 meeting and gave rise to lively debate.Before it could be amended and reconsidered in Janu-ary, however, the Department of Health and HumanServices issued a report on the subject. The study ap-proved the present method for establishing and review-ing pricing policies and levels and it found that the cur-rent method of basing charges on the actual cost ofproviding access is reasonable. The study also conclud-ed that the present policy of differential pricing by typeof database and time of day is reasonable, but that thepossibility should be explored of expanding that policyto include charging different prices to different types ofusers (commercial and noncommercial, for example).The Regents were asked to study the question of differ-ential pricing for different categories of online usersand to report within 120 days to the Assistant Secre-tary for Health.

The Regents, at the January 1984 meeting, dis-cussed the Department's report and assigned to theBoard's Pricing Subcommittee the task of drafting a re-sponse. The Subcommittee convened an open meetingon March 26 at which representatives of various inter-ests in the private sector presented their views on theissue of differential pricing. As a result of its own delib-erations and of the opinions and testimony expressedat the open meeting, the Board of Regents, in May, ap-proved a report that concurred with the findings of theDepartment's study. While the Board rejected thenotion of differential pricing by type of domestic MED-LARS user, it recommended a modest increase in thecost of foreign access. This is based on the premisethat since foreign users do not support the generation

of MEDLARS databases through taxes, it is reasonableto impose on them a higher rate to reflect this fact. Inits report, the Board expressed concern that the Ameri-can public have rapid and easy access to biomedicalinformation, regardless of the source. In keeping withthat philosophy, the NLM was encouraged to work co-operatively with database producers in the privatesector to create linkages between databases, reduceproduction costs, and to otherwise facilitate access toall relevant health information.

Other subjects warranting the Regents' attentionthis year (in addition to their responsibility for review-ing grant actions) were the new subset policy (see page12), the Library's coverage of the medical behavorialsciences (page 6), MEDLARS III progress (page 21),and Integrated Academic Information ManagementSystems (page 37).

The terms of appointment expired for Dr. Gwen-dolyn S. Cruzat, Dr. William D. Mayer, and Dr.Charles E. Molnar. Dr. L. Thompson Bowles was elect-ed Chairman at the May meeting. A list of Regents is inAppendix 3.

Modernization of the Building

The renovation project for the National Library ofMedicine was completed in the spring of 1984. Theproject, which began in the summer of 1981, involvedmajor modifications to the Library building to accom-modate the many rapid changes in Library activitiesthat have taken place since the original construction ofthe building more than twenty years ago. The phasingof the project has been successful, allowing Libraryfunctions to proceed with a minimum of interruption toservices.

Besides making the work environment and publicareas more attractive, the renovation has resulted in aneffective fire and safety system for the protection of

1

Programs and Services, FY 1984

staff and the priceless collection and has increased theavailable stack space by approximately 20 percent.

Financial Resources

In FY 1984, the NLM had a total budget authorityof $50,220,000, including a supplemental transfer tooffset payraise costs. Table 1 displays the FY 1984budget authority plus reimbursements from other agen-cies, and the allocation of these resources by programactivity. The Department of Health and Human Serv-ices (DHHS) will begin FY 1985 operating under a con-tinuing resolution.

Personnel

Martin M. Cummings, M.D., retired on January 3,1984 as Director, National Library of Medicine. Hisdistinguished career in the Federal Government cov-ered a period of 40 years, the last 20 of which were ashead of the Library.

On October 11, 1984, Donald A.8. Lindberg,M.D. was sworn in as the nineteenth director of theNational Library of Medicine (NLM). Dr. Lindberg, apathologist and information scientist, was director ofthe Information Science Group and Professor of Pa-thology at the University of Missouri School of Medi-cine in Columbia. He is a pioneer in the use of com-puters in medicine, having founded at the University ofMissouri in 1963 one of the nation's first medical com-puter centers. His most recent research has been in ap-plying artificial intelligence techniques to the develop-ment of expert medical consulting systems. Dr. Lind-berg is familiar with the programs of NLM through his

Table 1Financial Resources and Allocations FY 1984(in thousands of dollars)

advisory roles on the- Library's Board of ScientificCounselors ,ind Uiomt'dic.il Library Review Committee.

William C. Cooper, Ph.D., was appointed Associ-ate Director for Extramural Programs in March 1984.Dr. Cooper has held the position of Acting AssociateDirector for EMP since 1982. He previously held theposition of Associate Director for Planning and is pres-ently acting in that capacity.

Lois Ann Colaianni was appointed Associate Di-rector for Library Operations in May 1984. Mrs. Co-laianni has been at NLM since January 1981, when shewas named Deputy Associate Director for Library Op-erations. She became Acting Associate Director in1982.

James C. Cain was appointed Deputy Chief of theLibrary's Reference Services Division in July 1984. Hehad previously served as Head of the Division's Circu-lation and Control Section.

Albert M. Berkowitz, Chief of the Reference Serv-ices Division, retired in August 1984. Mr. Berkowitzcame to the NLM in 1966 as Head of the Division'sLoan and Stack Section (now Circulation and Control).He became Deputy Chief of the Division in 1969, andChief in 1971.

Calvin H. Plimpton, M.D., was appointed NLMSpecial Assistant for International Programs in October1983. Dr. Plimpton is a former President of AmherstCollege (1960-1971) and SUNY Downstate MedicalCenter (1971-1979). He succeeded Dr. Mary Corningwho retired in August 1983.

Richard B. Friedman, M.D., resigned from his po-sition of Director, Lister Hill National Center for Bio-

Budget authority:Appropriation, NLMPayraise supplemental transfer.

Subtotal..Plus: Reimbursements.

$49,613607

50,2202,543

Total $52,763

Budget allocation:Medical Library Assistance $7,573Intramural Programs and Services 39,265

Library Operations (26,478)Lister Hill National Center for Biomedical Communications (8,200)Toxicology Information (4,587)

Direct Operations 1,775Program Management 4,150

Total $52,763

Policy and Direction

medical Communications in July 1984. Dr. Friedmanheld this position from March 1983. He has returnedto the University of Wisconsin as Vice Chairman of theDepartment of Medicine. B. Earl Henderson is current-ly Acting Director, LHNCBC.

B. Earl Henderson was appointed Deputy Direc-tor, Lister Hill National Center for Biomedical Commu-nications in October 1983.Mr. Henderson has beenwith the Lister Hill Center since 1972where he hasserved as Chief of the Communications EngineeringBranch since 1974.

George R. Thoma, Ph.D., was appointed Chief ofthe Communications Engineering Branch, Lister HillNational Center for Biomedical Communications inJan-uary 1984. Dr. Thoma has been a member of theLister Hill Center staff since 1974.

Betsy L. Humphreys was appointed Deputy Asso-ciate Director of Library Operations in August 1984.Since 1973 she has held a number of increasingly re-sponsible positions in NLM's Technical Services Divi-sion, becoming Chief of that Division in 1980.

Becky Lyon-Hartmann was appointed Coordinatorfor NLM's Regional Medical Library Program in January1984. Ms. Lyon-Hartmann previously was employedby the Veterans Administration, where she was Assist-ant for Network Development in the Central Office Li-brary Division.

The Library was saddened by the death, onAugust 21, of Stella Schehl, Principal Cataloger of theTechnical Services Division. Mrs. Schehl had workedfor the Library for almost 40 years.

Awards. Kent A. Smith received the Assistant Secretaryfor Health Award for ExceptionalAchievement.

Table 2Staff, FY 1984 Full-Time Equivalents (FTEs)

Melvin L. Spann, Ph.D., received the NIH Direc-tor's Award.

NIH Merit Awards were presented to Dennis E.Black of the Office of Administration, and to Stella F.Schehl, Carolyn B. Tilley, and Judith A. Duff, all of theDivision of Library Operations.

Kent A. Smith, Deputy Director, Harold M.Schoolman, M.D., Deputy Director for Research andEducation, and Kenneth C. Carney, Executive Officerreceived the NLM Director's Award.

Martin M. Cummings, M.D., received the NLMRegents Special Award for Leadership and Accomplish-ment. He also was the recipient of the NIH EEO Spe-cial Achievement Award.

Dennis E. Black received a Certificate of Recogni-tion from the William A. Jump Memorial Foundationfor his noteworthy service in public administration.

Roger L. Cilkeson of the Office of Inquiries andPublications Management received the PHS SpecialRecognition Award.

Equal Employment Opportunity

Executive Order 11478 directs the Department ofHealth and Human Services and its constituent agen-cies to establish and maintain a continuing affirmativeaction (AA) program of equal employment opportunity(EEO) as an integral part of every aspect of personnelpolicy and practice in the employment, development,advancement, and treatment of employees.

The EEO calendar for 1984 included training formanagers, supervisors and employees to ensure anawareness of equal employment opportunity and af-firmative action. A series of films and a talk by the newDirector of NIH's Division of Equal Opportunity on

Program

Office of the DirectorOffice of Inquiries and Publications ManagementOffice of Administration .Office of Computer and Communications SystemsExtramural ProgramsLister Hill National Center for Biomedical CommunicationsSpecialized Information ServicesLibrary Operations .

TotalTotal FTE Usaae

FY1984

Full-TimePermanent

125

4659207629

222

469546

Other

101

1052

155

29

77


"EEO Directions at NIH," were the highlights of theyear. The film series gave rise to several lively discus-sion periods and afforded the opportunity for questionsand answers.

Lobby Exhibits

Three exhibits, prepared for the enjoyment andeducation of staff and library patrons, were mounted inthe Library's main lobby during the year.

The first, on display through January 1984, was aselection of work by one of America's foremost medi-cal illustrators, Frank Armitage. Mr. Armitage, whoworked with Walt Disney in the 1950s on a number ofhis animated motion pictures, has more recentlybecame known as a versatile medical illustrator whosework goes beyond literal representation. The NLM ex-hibit featured six large paintings depicting the retina inprogressive stages of modern abstraction, two worksshowing the artist's conception of the neuron junglesof the brain, and a number of sketches and paintingsrelated to surgery and the blood and nerve cells in thehand.

Another well known American medical illustrator'sart was featured in the next exhibit, "The Medical Artof Frank H. Netter, M.D." Dr. Netter's work related tothe artist's long association with the CIBA Pharmaceuti-cal Company, and items exhibited included more than50 watercolors illustrating human anatomy, embryolo-gy, physiology, and pathology in six body systems: res-piratory, excretory, circulatory, nervous, endocrine,and digestive. Also included were 20 paintings andthree sketches related to the artificial heart.

The third exhibit, on display from May to Octo-ber, was titled "Medical Incunabula and the Diffusionof Scientific Knowledge." Prepared by the Library'sHistory of Medicine Division, the exhibit featured morethan 50 works published between 1467 and 1500from the NLM collection, and included an illustratedbooklet on the history of medical incunabula.

A special exhibit (January-April 1984) in the lowerlobby of the Lister Hill Center depicted "medicinemen" of the world. The exhibit was lent to NLM byMidwest Medical of Afton, Minnesota, and featured aseries of color lithographs of witch doctors, shamans,acupuncturists, and medieval practitioners by artistJohn Doyle.

LIBRARY SERVICES AND OPERATIONSLois Ann ColaianniAssociate Director, Library Operations

Library Operations supports the basic mission ofthe National Library of Medicine through acquisitionand preservation of the world's biomedical literature;organization of this literature by cataloging, indexing,and bibliographical listing; dissemination of the result-ing authoritative bibliographic data in publications,online, and in other machine-readable formats; lendingor copying needed documents from the NLM collec-tion; provision of reference and research assistance tohealth professionals; and coordination of a nationalnetwork of health sciences libraries to improve bio-medical information services throughout the UnitedStates.

In this report, specific FY 1984 activities of the Li-brary Operations component are organized and de-scribed under functional headings rather than by orga-nizational unit as has been the practice in past annualreports. Viewing FY 1984 as a whole, at least fourmajor themes are discernable in the myriad of LibraryOperations' activities: (1) expansion of direct servicesto health professionals; (2) increased involvement innational bibliographic cooperation; (3) progress in thedevelopment of MEDLARS III and the transitional capa-bilities that lead toward it; and (4) efforts to improveaccess to NLM's rich resources in the history of medi-cine.

Personnel and Training

Library Operations' most important resource is itsdedicated and highly trained staff of over 250 librar-ians, technical information specialists, subject matterexperts, health sciences professionals, library techni-cians, and administrative support personnel. The staff isorganized into four operating divisions: BibliographicServices, Reference Services, Technical Services, andHistory of Medicine; plus the Medical Subject Head-ings Section; the Regional Medical Library Program

Office, and a small administrative unit in the office ofthe Associate Director.

Library Operations endeavors to improve its em-ployees' skills and potential through on-the-job andformal classroom training. In addition to staff trainingand development activities, Library Operations directsthe NLM Associate Program, which provides one yearof post-graduate training for library school graduateswith high potential in the health sciences library/infor-mation field. Six Associates, selected from 55 appli-cants, participated in the FY 1983/84 program. Thefirst five months of the program consists of a formalcurriculum which introduces the Associates to NLM'sprograms and services and is organized into nine broadfunctional modules. The remainder of the program isdevoted to individual projects. Each Associate workson two or three projects under the guidance of staffproject leaders. Associates also have the opportunityfor field experiences in other health sciences librariesand information organizations.

Planning and Management

In FY 1984, Library Operations continued the stra-tegic planning begun in FY 1983 by outlining the spe-cific tasks required to accomplish the plan's four majorobjectives for FY 1984-1988 and developing oper-ational plans for the first two years' tasks. Measurableprogress has been made toward achieving the four ob-jectives:

• to improve internal technical and bibliographicprocessing;

• to develop and implement programs that make iteasier to identify, locate, obtain, and use biomedi-cal information and literature;

• to develop and implement a program for the pres-ervation of the biomedical literature; and


• to ascertain the information needs and informa-tion-seeking behavior of health science profes-sionals and the history of medicine community, asa step toward improving Library Operations'products and services.

Achievements related to these objectives are high-lighted throughout this report. The year also saw sub-stantial progress toward automating personnel, budget,and other administrative data in order to support man-agement decisions within Library Operations.

The renovation of the Library building was com-pleted during FY 1984. All Library Operations staff arenow working in their permanent renovated quartersafter a series of temporary relocations. Staff coopera-tion assured that basic library services did not sufferduring the inevitable upheaval.

Collection Development

The History of Medicine Division (HMD) and theSelection and Acquisition Section and the SerialRecords Section of the Technical Services Division(TSD) share responsibility for development of the NLMcollection. HMD is responsible for building the pre-

Table 3Growth of Collections

1871 collection, the manuscript collection, and theprints and photographs collection. TSD selects, ac-quires, and processes all other post-1870 materials,which form the large majority of all acquisitions.

Selection. During FY 1984, work continued on a revi-sion of the Scope and Coverage Manual of the Na-tional Library of Medicine, which provides guidance tostaff in selecting material for the collection. Over 50NLM staff members, several consultants, and Dr. FayeAbdellah, Deputy Surgeon General, who is the NLMBoard of Regents liaison to the effort, have been in-volved in various aspects of this project. Several majorsubject areas in the current 1977 manual were exam-ined in depth and reworked to be responsive to recentchanges in biomedical research and to provide clearerguidance to selectors. In addition, the format of themanual has been redesigned to make it easier to use.The new edition of the manual will be available forpublic distribution in FY 1985.

In parallel with the revision of NLM's scope andcoverage manual, staff from NLM and the National Ag-ricultural Library (NAL) have been reviewing their poli-cies for collecting materials in veterinary science in an

Collection Previous Total(Sept. 1983)

Added inFY 1984 New Total

Book MaterialsMonographs:

Before 15001501-16001601-17001701-18001801-1870Americana1871-Present

Theses HMDPamphletsBound serial volumes....Volumes withdrawn

Total volumes.

Nonbook MaterialsMicroforms:

Reels of microfilmNumber of microfiche.

Total microforms..AudiovisualsPicturesManuscripts

5675,6329,88123,79139,5432,321

447,603281,585172,021713,565(26,904)

1,669,605

33,710122,150155,86040,63074,665

1,207,259

12637149436

9,7768

32,433(544)

41,935

91216,42817,3401,192459

33,024

5685,6589,91823,94039,5862,327

457,379281,593172,021745,998(27,448)

1,711,540

34,622138,578173,20041,82275,124

1,240,283

Library Services and Operations

effort to rationalize and clarify them. A joint statementon this issue will be distributed in late 1984, and infor-mation about NAL's guidelines for selecting veterinaryscience materials will be incorporated in the new edi-tion of NLM's scope and coverage manual.

During the year, researchers at Drexel University,working under contract to the Library, completed astudy of NLM's indexing coverage and monograph col-lection in the field of medical behavioral sciences. Thestudy has stimulated discussion of basic issues relatednot only to collection development and indexing cov-erage, but also to the scope of other services. A pres-entation and discussion of these issues took place atthe May 1984 Board of Regents meeting. As a follow-up, a small survey was designed by NLM staff to elicitopinions on the appropriate scope of five NLM activi-ties: (1) collection development; (2) cataloging; (3) in-dexing; (4) interlibrary loan and onsite use; and (5)preservation. Responses from NLM staff, th" RegionalMedical Library Directors, and a few medical librariansidentified by the Medical Library Association's MLA/NLM Liaison Committee will be compared to identifyareas of substantial agreement and disagreement.

Acquisitions. During FY 1984, 41,935 volumes wereadded to the NLM collection and more than 153,000books, serial issues, and audiovisual programs were re-ceived and processed. Among the more unusual andnotable additions to the historical collections were: acollection of Russian documents dated 1830-31 relat-ing to the cholera epidemic of those years and contain-ing official letters, orders, and regulations of the Minis-try of Internal Affairs; the case reports, diaries, andnotes of Drs. George and William Darrach, well-knownPhiladelphia physicians of the 19th century; a medicalstudent's notes from the lectures of Eli Ives, one of thefounders of the Yale Medical School; the papers ofMoses Shelesnyak, a prominent American physiologist;and Jean Fernel's De natural! parte medicinae libri

Table 4Acquisition Statistics

septem, Paris, 1542. Fernel was one of the mostfamous physicians in sixteenth century France and apopular professor at the University of Paris. His book isthe earliest work devoted to physiology and the first touse that term.

FY 1984 saw two significant changes in the fiscalcontrol of NLM's 2.3 million dollar literature budget. Itwas the first full year of use of the National Institutes ofHealth (NIH) automated delegated procurement systemfor processing literature invoices which allows NIH totrack payments more easily and ensure compliancewith the provisions of the federal Prompt Payment Act.Also, machine processing of automated serials invoicesfrom NLM's major subscription agents was fully imple-mented during the past year. This releases staff fromtedious line-by-line review of large serials invoices andallows them to concentrate on improving NLM's pro-gram for claiming lapsed subscriptions and missingissues.

The online serials check-in system implementedlast year improved in reliability during FY 1984 andwas linked with the new online indexing system whichbecame fully operational in January 1984. Data forissues to be indexed are passed from the check-insystem to the indexing system to form the basis for the"source" information in MEDLINE citations. The im-proved control and productivity provided by the onlinecheck-in system has reduced the need for offsitecheck-in services by subscription agents.

Additional improvements in serials processingwere realized with the development of new formattedvideo display screens for the addition and maintenanceof bibliographic, subscription, missing issue, and index-ing authority data. The screens permit greater input val-idation which decreases review time and improves thequality of data in the Master Serials System.

While these changes were made to current oper-ational systems, preparations for the implementation of

Acquisitions

Current serial titles receivedPublications processed

Serial pieces • •Other

TotalObligations ($) for

PublicationsIncluded for Rare Books

FY 1982

23,694

146,70822,342

169,050

2,618,99354,602

FY 1983

23,470

127,92725,479

153,406

* 1,861,48957,610

FY 1984

22,294

126,16727,456

15.3,623

2,390,42688,088

'Revised figure


MEDLARS III for collection development activities in-tensified. All records in the monograph in-process fileare being reviewed and upgraded or deleted as appro-priate in preparation for merging these records into theMEDLARS III master bibliographic file. As monographselection and acquisition will be one of two initial ap-plications to be brought under MEDLARS III, consider-able effort was devoted to the review of design specifi-cations for these activities and the development ofplans for the necessary file conversions scheduled forlate FY 1985.

Collection Preservation and MaintenanceCollection preservation and maintenance are pri-

marily the responsibility of the Circulation and Controland Audiovisual Resources Sections of the ReferenceServices Division (RSD), and of the History of Medi-cine Division (HMD), although the processing activitiesof other Library Operations' components also have animpact on preservation. RSD deals with the post-1870materials which include the bulk of the collection andalso the majority of the acidic paper that poses themost serious preservation problems. HMD manages theolder materials and special collections, such as rarebooks, prints and photographs, and manuscripts.

Preservation of the collection is one of the fourmajor objectives in Library Operations' strategic plan.An NLM Preservation Planning Team has been formedto assess the state of the collection, examine currentpreservation activities, and prepare a plan for the pres-ervation of the NLM collection. Research in electronicdocument storage and retrieval currently underway inthe Lister Hill National Center for Biomedical Commu-nications has significant preservation implications, andstaff from Center are collaborating with Library Oper-ations' staff to assist in the development of an optimumstrategy for preservation of the NLM collection. Thepreservation planning process is modeled on a self-study procedure developed by the Association for Re-search Libraries (ARL). NLM is working with ARL to setup the process and identify consultants to assist theTeam. The group's recommendations are expected inthe spring of 1985.

In the meantime, regular preservation and mainte-nance activities continued and several special projectsrelated to preservation and management of the collec-tion were completed. During FY 1984, 24,294 vol-umes were bound for the NLM collection and 296items were preserved on microfilm. The bindings for2,460 rare books were oiled and 1,100 pages weremended; 209 rare book volumes were restored or re-bound.

Additional compact shelving was purchased ac-cording to the Library's plan for providing space forcollection growth through the year 2004. The historical

film collection was moved into ,\ new film vault. Workwas begun on transferring historic ,il films to %" video-cassette format and moving NLM's prints and photo-graphs collection to acid-free folders.

Dust and dirt deposited on library materials duringthe renovation were removed under a special contractto clean the entire collection. A survey of the older se-rials to identify gaps and to determine the condition ofthe paper in the volumes was begun during thesummer. Data collection in the survey will be used inthe development of the preservation plan. The NLMDisaster Recovery Plan was revised, updated, and re-distributed to staff early in the fiscal year.

In an effort to assist preservation activities in thebiomedical library community as a whole, NLM madearrangements to have the 1984 Cumulated Index Me-dicus and all future cumulations printed on acid-freepaper.

Bibliographic Control

Responsibility for bibliographic control of the bio-medical literature and for the maintenance of the the-saurus and classification scheme used by NLM andother institutions to provide subject access to the bio-medical literature is shared among the Medical SubjectHeadings (MeSH) Section, Technical Services Division(TSD), History of Medicine Division (HMD), and theBibliographic Services Division (BSD). The MeSH Sec-tion maintains and updates the MeSH vocabulary; theCataloging Section, TSD, maintains the NLM classifica-tion scheme and provides authoritative cataloging forthe modern biomedical literature; the Index Section,BSD, indexes articles in selected serials in all fields ofbiomedicine; and HMD indexes articles and booksdealing with the history of medicine and catalogs pre-1871 materials. The Serial Records Section, TSD, alsoproduces a variety of tools which aid in the identifica-tion and use of the biomedical serial literature.

In addition to its regular bibliographic control re-sponsibilities, in FY 1984 Library Operations directed aTask Force to Identify Elements in Manuscripts in Elec-tronic Form Useful for Bibliographic Control andAccess as a part of the Electronic Manuscript Projectsponsored by the Association of American Publishersand the Council on Library Resources. The Task Force,which had broad representation from the library andinformation service community, submitted its reportand recommendations on March 30 as part of thelarger effort to develop a standard method of taggingelements in electronic manuscripts. The goal of theElectronic Manuscript Project is to facilitate use of theoriginal author's keystrokes in final publications and inthe production of information services that provideaccess to the published literature.

8


Thesaurus and Classification. In order to keep theMeSH thesaurus current with developments in medi-cine and trends in terminology, 159 headings wereadded to the vocabulary in FY 1984. Of these, 119were entirely new and 40 replaced deleted headings.An additional 81 headings were deleted also; most ofthese represented rarely mentioned chemicals andwere transferred from the regular MeSH to the chemi-cal subfile. This subfile grew by 3,427 records throughthe addition of chemical entities newly encountered inthe literature being indexed. A new edition of the print-ed version of the chemical subfile was published inNovember 1983.

During the past year, preliminary work began on aproject to develop a machine readable "table" torelate MeSH terms heavily used in cataloging to theirLibrary of Congress Subject Headings (LCSH) equiva-lents, and vice versa. When available, such a table canbe used to provide assistance to users searching cata-log files containing some records with LCSH and somerecords with MeSH terms. It can also help librarians touse cataloging copy which lacks the subject headingsnormally used in their libraries. In order to identifyproblem areas and policy issues to be resolved, allLCSH terms beginning with the letter A were reviewedand an attempt was made to map all those with bio-medical significance to equivalent MeSH terms. Basedon the information gathered during the effort, a plan isbeing developed to complete the intellectual mappingin FY 1985. Staff members also are considering theneed to store LCSH equivalents to MeSH terms, includ-ing main heading/subheading combinations, in devel-oping the final functional requirements for the MED-LARS III subject authority file.

Beginning with 1984 cataloging, NLM changed itspolicy for assigning classification numbers to newly cat-aloged nursing materials. The new policy states:

Classify works pertaining to clinical medicine writ-ten for nurses in the class number for the subject.Use the form subheading "nurses' instructions" tomodify MeSH terms assigned to these works.

This policy supersedes the previous practice of classify-ing materials on clinical medicine written for a nursing

Table 5Cataloging Statistics

audience in the WY (Nursing) schedule of the NationalLibrary of Medicine Classification, 4th edition, revised1981. The WY classification is now reserved for workswhich are actually about nursing. The new policyallows clinical materials written for nurses to be classi-fied according to the same general principle as materi-als written for other audiences. The form subheading"nurses' instructions" replaces "nursing texts" in orderto encompass audiovisual programs specifically ad-dressed to nurses.

Work is proceeding on plans to convert the auto-mated classification file to its MEDLARS III format andto link it to the MeSH file. Eventually, when this is ac-complished, it will be significantly easier to publish up-dated editions of the NLM Classification.

Cataloging. During FY 1984, NLM cataloged 17,859books, serials, audiovisual programs, and Cataloging inPublication galleys. A total of 11,592 items receivedfull cataloging; 6,267 items received limited cataloging.The Library continued to obtain cataloging assistancefor foreign language materials under contract andthrough an interagency agreement with the Library ofCongress (LC). A new contract action was initiated toobtain assistance in reviewing and upgrading Catalog-ing in Publication (CIP) records to full status when thepublished books are received. In all, 2,857 items inSpanish, French, Dutch, Norwegian, Swedish, and Rus-sian were cataloged by outside sources during theyear.

The contract to review frequently used records inNLM's name authority file for compliance to theAnglo-American Cataloging Rules second edition(AACR2), upgrade these records as necessary, andmaintain associated bibliographic records in CATLINEand AVLINE proceeded smoothly. With contract worknearly completed, 37,715 names have been reviewed;17,534 names have been upgraded; and an estimated71,000 CATLINE and AVLINE records maintained. Asa result, there is a single form of name access point formost names represented in the NLM catalog files. Thisassists users in searching for and retrieving works byparticular authors or corporate bodies.

Item FY 1982 FY 1983 FY 1984

Completed catalogingFullLimited

Total

10,80016,19026,990

11,3227,126

18,448

11,2436,267

17,510


Significant progress was made toward the goal ofachieving compatibility in descriptive cataloging pro-duced by the three national libraries. This will reducethe effort required by health sciences libraries to mergeNLM records with records produced by other catalog-ing sources. Since 1972, NLM has been cooperatingwith the Library of Congress (LC) to provide MeSHheadings and NLM classification data for inclusion inthe Cataloging in Publication copy for biomedicalbooks. Until very recently, however, NLM and LChave each produced descriptive cataloging independ-ently for these items. In March 1984, NLM and LCbegan a pilot project in which NLM provided LC withdescriptive cataloging for a portion of the biomedicalbooks receiving CIP treatment. Due to the success ofthis test, NLM will provide LC with descriptive catalog-ing, MeSH headings, and NLM class numbers for allbiomedical CIPs beginning in October 1984. LC willuse NLM descriptive records and add LC subject head-ings and classification numbers for publication in theCIP records.

In conjunction with the CIP pilot project, NLMalso expanded its contributions to the national NameAuthority Cooperation (NACO) file, which is main-tained at LC. NLM had been contributing all nameheadings associated with its serial cataloging and somepre-1871 books since July 1981. Beginning with calen-dar year 1985, all names associated with full catalogingrecords will be reconciled with the NACO file andadded to that file as appropriate. To reduce the dupli-cate keying now required by these cooperative efforts,NLM is investigating how to implement the Linked Sys-tems Protocol (currently being tested by LC, the Re-search Libraries Information Network, and the Wash-ington Library Network) in the MEDLARS III system.

The online cataloging system implemented in FY1983 continued to function well. This system repre-sents a transition to the MEDLARS III cataloging envi-ronment which will permit catalogers to upgrade ma-chine readable bibliographic records created during se-lection and acquisitions activities, thereby eliminatingthe redundant data creation necessitated by the currentsoftware. In preparing for the new system, a contractwas awarded to ensure that correct links exist betweenserial records in CATLINE (NLM's online database ofcataloging records for print materials) and the biblio-graphic module of the Master Serials System, so thatthe two files can be merged in the construction of theMEDLARS III bibliographic file. Cataloging will be oneof the first applications to bo switched to the MED-LARS Ml system, and staff have been heavily involvedin refining functional requirements, reviewing? designdocuments, and planning for conversion and imple-mentation.

Indexing. The consultants who advise NLM on the se-lection of literature for Index Medicus reviewed andrated 247 candidate journals for inclusion in Index Me-dicus. Of these, 61 were accepted for indexing. Theconsultants also reviewed currently indexed journals incardiology, anesthesiology, endocrinology, metabolism,nutrition, anatomy, cytology, embryology, histochem-istry, psychology, sociology, orthopedics, and rheuma-tology. Fifty-two of these journals were dropped eitherbecause they had ceased publication or were consid-ered to have limited value for Index Medicus users.The newly added journals publish more articles thanthose that were deleted, so the growth in the size ofthe Index is greater than would be expected by the netgrowth in journal titles alone. At the end of the yearthere were 2,695 titles being indexed for Index Medi-cus and a total of 3,688 titles represented in MEDLINE,the Health Planning and Administration files, and POP-LINE.

During FY 1984, 306,263 citations for indexed ar-ticles were added to various NLM databases. Of those,278,905 citations were published in Index Medicus.Abstracts were added to the MEDLINE file for 172,153articles or 62% of the citations added to that database.Beginning in January 1984, abstracts exceeding 250words have been truncated when added to the file.This limit is expanded to 400 words for abstracts fromarticles of 10 or more pages or from articles in thecore journals identified by the National Cancer Institutefor inclusion in the CANCEREXPRESS database. Ap-proximately 3% of the abstracts require truncation inthis fashion. Of the articles indexed for Index Medicusin FY 1984, 26% were indexed by NLM staff; 40% di-rectly by foreign MEDLARS centers or through arrange-ments made by them with U.S. commercial firms; and34% by NLM contractors.

Since January 1984, no more than ten authors'names have been included in a MEDLINE citation orlisted under the name of the first author in the AuthorSection of Index Medicus and other printed bibliogra-phies. Only the second through the tenth authors arecross-referenced to the first author, instead of the pre-vious unlimited number. This limitation was imposedbecause of the increasing number of articles with manyauthors listed. The largest number of authors encoun-tered to date is 162.

A new subject heading, Retraction of Publication,was introduced in 1984. This is used whenever a jour-nal publishes a retraction of an earlier article. The cita-tion of the retraction contains a reference to the origi-nal article, and the original citation is amended to callattention to the retraction.

Progress continues to be made in reducing thetime between receipt of journals at NLM and the ap-pearance of citations to them in Index Medicus. In the

10


Table 6Bibliographic Services

Services FY 1982 FY 1983 FY 1984

Total citations published*For Index Medicus

Recurring bibliographiesJournals indexed for Index MedicusAbstracts entered

282,950259,874

252,697

124,511

310,445284,856

242,709

149,851

306,263** 278,905

242,695

172,153

'Includes special list articles, audiotapes, and Health Administration citations."Includes 502 nonprint citations.

past year the Index Section continued to process 90%of the high priority journals, which account for over30% of all citations in Index Medicus, within 30 daysof receipt by NLM. Work will continue in the comingyear to reduce processing time to 60 days for all otherjournals that are indexed. The workflow within theIndex Section became more fully automated in January1984 when NLM in-house indexers began using a newonline indexing and management system. Developedwith support from the Office of Computer andCom-munications Systems (OCCS), the new system results infurther improvements in the currency and accuracy ofIndex Medicus and MEDLINE. It supports tracking ofIndex Medicus and Special List Journals through the in-dexing process, input typing of descriptive information,subject indexing, corrections and validations, and gen-eration of management statistics on the indexing work-load. Work will continue this year to extend online in-dexing to contract indexers; its extension to MEDLARSCenters overseas will be examined later.

Network Services

All organizational components in Library Oper-ations cooperate to provide services to health profes-sionals and health science libraries throughout theUnited States. BSD, HMD, RSD, TSD, and the MeSHSection are involved in the distribution of NLM's bibli-ographic data in publications, on machine-readabletapes, and through NLM's online services network.BSD manages NLM's online services network, includingtraining. HMD provides reference and research assist-ance and document delivery services to those needinginformation from the modern collections. The RegionalMedical Library (RML)office manages the contractswith the seven Regional Medical Libraries and providesnational coordination for the RML program. TSD sup-ports document delivery throughout the network bymaintaining SERHOLD, the national bibliographic serialholdings database. NLM filled 20,596 requests for ref-erence assistance from remote users in FY 1984, al-

though the majority of demand for network servicesoccurred in the other areas mentioned below.

Publications. In FY 1984, Library Operations pub-lished over 50 issues of serial publications, includingIndex Medicus, the National Library of Medicine Cur-rent Catalog, the National Library of Medicine Au-diovisuals Catalog, the Bibliography of the History ofMedicine, the various volumes of Medical SubjectHeadings, and several specialized recurring bibliogra-phies. Index Medicus, NLM's major index to biomedi-cal articles was distributed to more than 5,500 sub-scribers. Forty new published Literature Searches wereproduced on specific topics of current interest includ-ing Acquired Immunodeficiency Syndrome (AIDS), Alz-heimer's disease, and premenstrual syndrome. Morethan 85,000 copies of these bibliographies were dis-tributed by the library.

A new edition of the irregularly published Index ofNLM Serial Titles was prepared for distribution in thefall of 1984; the last edition was published in 1981.The first issue of Health Sciences Audiovisual, a quar-terly microfiche cumulation of all records in AVLINE,was published by the Government Printing Office. FY1984 was also the first year in which indexed citationsto audiovisual serials appeared as a separate section inthe NLM Audiovisua/s Catalog. Previously these cita-tions had been published by the Medical Library Asso-ciation in the Index of Audiovisual Serials in theHealth Sciences, which publication ceased at the endof 1983. There are plans to publish all CATLINErecords in microfiche in FY 1985.

An experimental videodisc of 1,000 pictures fromNLM's collection of some 75,000 prints and photo-graphs depicting medical subjects was produced byHMD in collaboration with the Lister Hill Center. The1,000 images were cataloged according to the Anglo-American Cataloging Rules, Second edition andGraphics Materials: Rules for Describing OriginalItems and Historical Collections and printed to accom-pany the videodisc. The pilot videodisc and accompa-

11


nying catalog will be distributed to selected sites forevaluation and comment.

Machine-Readable Databases. NLM makes its ownauthoritative bibliographic records available in a varietyof machine-readable databases and also cooperateswith other organizations to create and /or provideaccess to other biomedical information. By the end ofthe year 27 databases were available on NLM's onlineservices network. NLM regularly distributes tapes ofvarious NLM databases containing journal citations orthe Medical Subject Headings to 22 U.S. and foreigninstitutions. Six organizations receive NLM's catalogingrecords in USMARC format.

In FY 1984, NLM introduced an important newservice for domestic users—the availability of subsetsof the MEDLINE database. In the past, because of thesize of the NLM databases, tape distribution has beenlimited to organizations having major computer re-sources. With the development of sophisticated andrelatively low cost mini- and microcomputers, individ-ual users and organizations with smaller computers cannow set up local retrieval capabilities for files of sub-stantial size. To serve these users, NLM now offerssubsets of the MEDLINE database. Eventually, the Li-brary will offer "predetermined subsets," produced ac-cording to parameters set by NLM based upon the Li-brary's experience or advice of professional groups.Two options are presently available; "individualizedsubsets," specified by the subset requester and avail-able on annual subscription with monthly or quarterlyupdates; and "custom subsets," specified by the subsetrequester and provided on a one-time basis with noupdates. Subsets are currently distributed on magnetictape only; some subsets will be available on diskette inthe future. A policy statement covering the production,distribution, and use of subsets and a current price listwas published in August 1984.

NLM also significantly expanded the availability ofits cataloging records in FY 1984. An additional 33,846catalog records converted under the RetrospectiveConversion Contract completed during FY 1983 wereadded to the CATLINE file, bringing the total numberof CATLINE records to 562,034. During the year,NLM's limited cataloging records and its pre-1965 cat-aloging records became available in USMARC formatfor the first time. All CATLINE records are now avail-able in USMARC format. Progress was also madetoward the goal of distributing records for audiovisualmaterials in USMARC. Programs for converting theserecords are now being tested; distribution is plannedfor 1985.

Online Services. During FY 1984, the average month-ly connect hour usage of the MEDLARS system was19,122 hours, 11% higher than the average in FY

1983. Usage for the entire year was 229,463 connecthours. There are now 2,461 domestic institutions thatare online users of NLM's MEDLARS system. Morethan half of the domestic users are involved in directpatient care (Figure 1). Many additional users accessNLM's databases through other U.S. database vendorsand those foreign MEDLARS centers which mountcopies of certain NLM files.

A new method for determining charges for onlineuse of MEDLARS services was implemented on Octo-ber 1984. Online charges are now calculated by an al-gorithm which includes connect time, computer workunits, search statements, carriage returns, citations, andcharacters transmitted to the user's terminal. Under theprevious method, only connect time was considered.Communications charges are embedded in the chargefor connect time. The new algorithm does not penalizeusers with slower terminals, but charges according tothe amount of computer resources actually used to ful-fill each user's search requests.

After the introduction of the new online pricing al-gorithm, the Library added a new database, INFORM.While connected to INFORM, users may requestonline information, e.g., the NEWS or Online EX-PLAINS, which are descriptions of databases andsystem capabilities, with no charge being levied forcharacters. This was done to encourage online users toremain current with system developments.

NLM also introduced the INTROMED file in FY1984. INTROMED is a training database containing ap-proximately 20,000 citations extracted randomly fromthe MEDLINE database (1982 and 1983 publicationyears). There are no charges for citations or charactersprinted from INTROMED, which makes it approximate-ly 50% less expensive than the MEDLINE databases.Searchers who have recently attended a training classin searching the NLM system may wish to practice inINTROMED. Although it is useful as a training tool, itshould not be used for daily searching because it con-tains only a small fraction of the citations in the fullMEDLINE.

FY 1984 brought the addition of a new user-friendly version of the PDQ (Physicians' Data Query)file. This menu-driven file, developed by the NationalCancer Institute (NCI) in cooperation with NLM, is de-signed to permit health professionals to access informa-tion on the diagnosis and treatment of cancer, activeclinical protocols, and a directory of physicians and or-ganizations with a special interest in the care and treat-ment of cancer patients.

Enhancement of the bibliographic CANCERLIT filewith nonjournal citations also took place in late FY1984. NCI is now adding meeting abstracts and mono-graphic material to the regular monthly updates, which,for over a year, had consisted entirely of cancer-relat-

12


Figure 1

EDUCATION (296/120%)Include! Khouli of higher education

RESEARCH (228/9 3%)Rcscarih injlllunom, Includingfoundations, societies, associations^hiallh insurers

PATIENT CARE (1284/52 2%)Includes hospitals, cllnlci, ouipallenlfacilities & Individual health professionals

LEC-IS/REGULATORY (110/4 5%)Includes primarily government agencies

MISCELLANEOUS (22/0 9%)

GENERAL SERVICES (201/8 2%)Includes private firms engaged In Informationdissemination, publishers/media, law firms,trade and welfare associations

SCI/TECH SERVICES (320/13 0%)Includes private firms engaged in phar-maceutical*, health care supplies, chemicals/petroleum, energy/environment,computers/electronics

Domestic Online Users by TypeSeptember 1984

Total=2461

ed citations derived from MEDLINE. In addition, workhas begun on restructuring the CANCERLIT file. Thenew file will feature several new data elements, includ-ing MeSH headings and CAS Registry Numbers, and isexpected to be available in February 1985.

A total of 982 people received training in search-ing NLM databases in the 48 online classes held in FY1984. NLM staff conducted 20 classes at NLM and 7in other locations throughout the United States. UCLAand the University of Nebraska, two Regional MedicalLibraries which provide training in online searching ofthe MEDLARS databases under contract to NLM, spon-sored 21 classes in various locations.

NLM developed a new 6-hour online trainingcourse and associated training materials for health pro-fessionals who wish to search the MEDLARS system di-rectly. The first session was held at NLM on March 14.Additional courses were given by NLM and UCLA,sometimes in conjunction with meetings of health pro-fessional associations NLM also developed a specialclass to train health sciences librarians to provideMEDLARS training to health professionals. The firstclass was held for 140 librarians on September 20.

Document Delivery. NLM instituted a charge for filledinterlibrary loan requests effective in October 1984.Billing and collection of fees are handled through theNational Technical Information Service. Requests forloans dropped almost 33% to 142,464 for the year,presumably because of the new charge. NLM filled87% of the requests received. Throughput for handlingrequests remained very good, with 91% of filled re-quests processed within 4 days of receipt.

Interlibrary loan service for audiovisual materialswas expanded in April 1984, when all videocassettesin the NLM collection became available for loan. Atotal of 1,131 requests for audiovisual programs wasreceived during the year.

In order to provide more rapid service to reques-tors, NLM began to use the United Parcel Service forsending original items out on loan in March 1984. Thenew shipping method cuts two to ten days off deliverytime, depending on the location of the requestor.

Significant progress was made in providing auto-mated support to document delivery activities. SER-HOLD currently contains over 600,000 automatedholdings statements for 1,233 biomedical libraries. TheRegional Medical Libraries coordinate the gathering of

13


Table 7—^ •• f, •Online Searches

Database

AVLINEBIOETHICSCANCERLITCANCERPROJCATLINECHEMLINECLINPROTDIRECTORYDIRLINEEPILEPSYLINEEXPRESSHEALTHHISTLINEINFORMINTROMEDMEDLINE

MED80MED79MED77MED75MED71MED66

MESH VOCABULARYNAME AUTHORITYPDQPDQRSPOPLINERTECSSDILINESERLINESTORED SEARCHTDB (TOXICOLOGY DATA

BANK)TOXLINE

TOXBACK76TOXBACK74TOXBACK65

TOTAL

Table 8Offline Searches

Database

AVLINEBIOETHICSCANCERLITCANCERPROJCATLINE

CHEMLINE

CLINPROTDIRECTORY

DIRLINEEPILEPSYLINE

EXPRESSHEALTH

FY 1982

18,3763,409

42,3653,270

224,55946,375

1,753

1,607

70,7353,978

784,625

118,877

144,185

19,01610,618

16,48314,74117,77044,916

176

14,46668,768

8,864

1,679,932

r y 7982

336

5,38540

145

186

7

3,285

FY 1983

19,0504,047

45,7393,099

250,72940,880

3,166420

1,389326

1,08781,289

4,460

951,582

28,482193,796

67,47846,21130,14520,46916,528

7,124

18,65217,57818,61948,941

49

19,73767,381

11,651411

2,020,515

FY 1983

10418

5,09531

137

1471

13

207,147

FY 1984

11,3394,580

48,6641,797

156,91432,614

2,405840

2,446

1,76190,140

4,17347

7191,199,482

247,046

189,07790,64462,79945,50012,141

5,3224,7241,949

19,4868,512

25,97929,887

89

7,47075,190

2,88911,5188,246

2,406,389

FY 1984

32065

5,76610

333

20508

659,997

Database FY 1982 FY 1983 FY 1984

HISTLINE 11 3 9MEDLINE 36,666 26,771 26,628

MED80 25,803

MED79 44,817 8,972MED77 63,2(>7 35,906 29,610MED75 72,616 31,212 21,817MED72 56,646 8,413MED71 15,501 15,432MED69 42,094 5,966

MED66 30,374 14,166 10,462MESH VOCABULARY 18 6 8NAME AUTHORITY 1 0 0PDQ 1POPLINE 2,208 6,342 9,688RTECS 296 124 124SDILINE 178,774 197,762 218,110SERLINE 27 10 15TDB (TOXICOLOGY DATA

BANK) 238 117 103TOXLINE 21,798 18,591 17097

TOXBACK76 1 11TOXBACK74 6,204 4,410 2,261TOXBACK65 6,731 4,984 1,996

TOTAL 571,711 391,834 395,8(>6

holdings data for the database and provide it to NLMin machine-readable form The 1983 update of SER-HOLD was completed in early FY 1984. NLM pro-duced a variety of microform and hard copy union listsfrom the updated file, based on requests received fromthe Regional Medical Libraries. In early 1984, the datawere used to update the location symbols for majorbiomedical libraries in SERLINE and Health SciencesSerials, NLM's quarterly microfiche publication. The1984 SERHOLD update began m April 1984 and isscheduled for completion in October. Several unionlists have already been generated from the 1984 data.The contract to add NLM's serial title control numberto records in the CONSER database on OCLC ended mApril 1984. The addition of the numbers to the OCLCdatabase will make it possible for machine-readableholdings data from OCLC to be added to SERHOLD,after the programming for processing OCLC tapes iscompleted.

Although it is used to generate union lists, SER-HOLD was built primarily to support automated rout-ing of requests for articles in DOCLINE, NLM's auto-mated document request and referral system. DuringFY 1984, significant progress was made in developingan improved DOCLINE system suitable for use by allRML network libraries during the transition to MED-LARS III. As components of the system were complet-ed and tested, they were made available for testing

14


Table 9Circulation Statistics

Activity FY 1982 FY 1983* FY 1984

Requests Received:For Interlibrary LoanFor Readers

Requests Filled:For Interlibrary Loan

PhotocopyOriginal

For Audiovisual Loan**For Readers

Requests Unfilled:Interlibrary Loan

RejectedReferredReturned as Unavailable

Reader ServiceReturned as Unavailable

411,343226,991184,352

332,356175,657163,078

12,579

156,699

78,98751,33422,588

1,65227,094

27,653

395,957216,536179,421

332,478169,501159,583

9,9185,087

157,890

63,55241,94114,1673,718

24,056

21,611

358,654147,017211,637

299,6)11109,257102,723

6,5344,183

186,241

54,73733,57712,572

1,97519,030

25,160

'Revised to include audiovisual.* "Includes videocassettes loaned by the Audiovisual Resources Section and motion pictures circulated from an

off-site contract facility directly to individuals for educational use.

and use by the RMLs, which constitute the currentDOCLINE user group.

When available for broader use, DOCLINE willprovide the ability to create and edit interlibrary loanrequests online in real time, receive and update re-quests as a potential lender, and obtain real-time statusreports as both a lender and a borrower. Several auto-mated time-triggered actions will assure that requestsmove through the system in a timely manner. It will bepossible to transfer bibliographic data from MEDLINE,CATLINE, AVLINE, and the Master Serials System intorequests by keying only the appropriate record citationnumber and to enter shipping and billing addresses byentering only a short library identification number.Serial requests will be routed automatically based onSERHOLD data and a list of preferred loan sourcesprepared by each DOCLINE participant. The routingsystem was modelled after that in use in OCTANET,the automated serial request system developed by theMidcontinental Regional Medical Library System and

operated on the computer facility at Washington Uni-versity in St. Louis.

Additional network libraries will begin to useDOCLINE in early 1985. First, the resource librarieswill be brought on to the system region by region; theywill assist NLM staff in testing and stabilizing thesystem. In the second phase all network libraries willbecome participants, again a region at a time. Thephase-in period is expected to last 12 to 18 months.

An early test of the ability to link DOCLINE toother automated interlibrary loan systems was complet-ed successfully in January 1984, when procedureswere established for automatic transfer of unfilled re-quests from OCTANET to NLM's system.

In order to provide an improved interim documentrequest capability while DOCLINE availability is gradu-ally extended throughout the network, NLM is now ac-cepting interlibrary loan requests via electronic mail.

15


Figure 2.

REGIONAL MEDICAL LIBRARY NETWORK

Regional Medical Libraries

1 Greater Northeast Regional Medical LibraryNew York Academy of Medicine2 East 103rd StreetNew York, NY 10029States served: CT DE MA ME NH NJ NY PA Rl VT

Puerto Rico

2 Southeastern/Atlantic Regional Medical LibraryUniversity of MarylandHealth Sciences Library111 South Greene StreetBaltimore, MD 21201States served: AL FL GA MD MS NC SC TN VA

WV DC

3 Greater Midwest Regional Medical LibraryUniversity of IllinoisLibrary of the Health SciencesHealth Sciences CenterChicago, IL 60680States served: IA IL IN KY Ml MN ND OH SD Wl

4 Midcontinental Regional Medical LibraryUniversity of NebraskaMedical Center Library42nd and Dewey AvenueOmaha, NE 68105States served: CO KS MO NE UT WY

5 South Central Regional Medical LibraryUniversity of TexasHealth Science Center5323 Harry Hines Blvd.Dallas, TX 75235States served: AR LA NM OK TX

6 Pacific Northwest Regional Medical LibraryHealth Sciences LibraryUniversity of WashingtonSeattle, WA 98195Slates served: AK ID MT OR WA

7 Pacific Southwest Regional Medical LibraryUCLA Biomedical LibraryCenter for the Health SciencesLos Angeles, CA 90024States served: AZ CA HI NV

16


RML Program. The medical institutions currentlyunder contract with NLM to serve as Regional MedicalLibraries are listed in Figure 2. The current three-yearRegional Medical Library contracts emphasize outreachto health professionals, interlibrary loan of library mate-rials, resource sharing, online services, and training andconsultation—all aimed at improving access to biomed-ical information for the health professional. A basic na-tional goal is to provide health professionals whereverlocated with at least a minimum acceptable level of in-formation service. Each RML has identified under-served areas within its regional boundaries and is im-plementing programs to meet the information needs ofhealth professionals in these targeted areas.

The RML contracts continue to emphasize docu-ment delivery and resource sharing. Approximatelytwo million journal articles, book and audiovisual loansare provided annually to health professionals throughthe network, with the RMLs themselves filling about120,000 requests for library materials. NLM, asbackup, satisfies more than 140,000 requests annually.Six RMLs earmarked funds for strengthening regionalcollection resources to improve resource sharing andeach has developed a plan for accomplishing this.

All seven RMLs provide trained online searcherswith regional updates that cover changes to the NLMonline databases. In addition, RML staff demonstratethe NLM databases for local groups of health profes-sionals. Through the RMLs, the network also providestraining and consultation programs that improve serv-ice to health professionals by enhancing the skills of in-formation providers. Here the emphasis is on basictraining for non-professional library personnel andtraining in resource sharing activities such as interli-brary loan, consortia formation, and locator tool devel-opment. In FY 1984, the RMLs continued to shift train-ing and consultation programs from federal support toa cost recovery basis by imposing fees to cover a mini-mum of 50% of actual costs.

Onsite Services

The Reference Section, RSD, provides referenceand research assistance and obtains materials from theLibrary's general collections for onsite users. HMD pro-vides these same services for the smaller group of userswho come to use the historical and special collections.Library Operations staff also serve as guides for themajority of regularly scheduled public tours given atthe Library and provide special briefings to many for-eign and domestic visitors.

Reference and Research Services. Approximately26,000 people came to NLM to use the Library's serv-ices in FY 1984, 13% more than in FY 1983. Visitorsthis year requested that 211,637 items be retrieved

from NLM's closed stacks. This represents an 18% in-crease over the number of such requests made lastyear and for the first time surpassed the number of re-quests for materials in the NLM collection made by off-site users. Onsite users also asked 62,309 referencequestions, a 47% increase over last year's total. In all,3,739 online searches were performed on NLM data-bases for onsite users.

With the availability of a new Learning ResourceCenter and appropriate staffing for this facility, thenumber of onsite users of audiovisuals rose 107%.New, more convenient quarters also led to greateronsite use of NLM's extensive prints and photographscollection.

During FY 1984, CITE/MEDLINE, a prototype userfriendly interface to MEDLINE, was made available toonsite users. Onsite users also continued to use CITE/CATLINE, NLM's online catalog for printed materials.Walk-in patrons are now able to search for biomedicalbooks or journal articles using flexible natural languagesubject queries.

Public Tours. During FY 1984, 165 regular publictours were given to a total of 681 visitors. Of these,31% were students, interns, or residents; 24% were li-brarians or people otherwise associated with the infor-mation science field; 14% were health professionals;9% were NLM or NIH staff, 8% were foreign visitors;and 14% fell into other categories. Visitors in groupsaccounted for 31% of those toured. Another 550 visi-tors (40 groups) received special programs and toursarranged by the Office of Inquiries and PublicationsManagement (Office of the Director).

Special Historical Programs. NLM has announced anew visiting scholar program in the History of Medi-cine. Under this program, one recognized scholar willbe invited annually to spend from six to twelve monthsat the Library. Scholars will be expected to engage inresearch which will utilize the NLM historical collec-tions extensively. They will also be available for staffconsultation, for one or more public presentations, andfor assessing segments of the collections.

Beginning in FY 1984, HMD also initiated a publiclecture/film series on subjects related to the history ofmedicine with a showing of "Free Show Tonight," afilm about the old-time patent medicine shows. Aseries of seminars for HMD staff given by staff andother scholars who are using the NLM historical collec-tions in their research was also inaugurated.

The responsibilities of some HMD staff include re-search using NLM's rich historical collections. The re-sults of this research appeared in several publicationsduring the year.

17


Table. 10Reference Services

FY 1982 FY 1983 FY 1984

Reference SectionRequests by telephone 12,886 15,157 20,069Requests by mail 301 386 527Readers assisted 37,297 42,318 62,309

Total 50,484 57,861 82,905

Audiovisual Resources SectionRequests by telephone 2,123 2,473Requests by mail 2,300 1,579Readers assisted 220 383

Total 4,643 4,435

Total reference service 50,484 62,504 87,340

Reader Room users registered 22,078 23,096 26,273

Table 11History of Medicine Activities

FY 1982 FY 1983 FY 1984

Acquisitions

Books 248 253 271Modern manuscripts 91,953 46,313 33,024Prints and photographs 475 346 459

Processing

Titles cataloged 3,028 862 349Modern manuscripts cataloged 53,100 51,353 36,209Pictures cataloged 420 188 1,436Citations indexed 4,498 6,178 6,000Pages microfilmed 103,869 103,930 80,817

Public Service

Reference questions answered 2,421 2,378 2,659ILL and pay orders filled 2,515 2,575 2,118Reader requests filled 5,903 5,236 5,061Pictures supplied 2,427 2,209 2,627

18


Services to NIH and Other Agencies. The NationalInstitutes of Health (NIH) Library provides library andinformation services to NIH employees, but NLM staffdo provide special support to some NIH programs.RSD prepares Literature Searches for distribution to theparticipants in many of the NIH Consensus Develop-ment Conferences and provides Public Health Serviceofficials with up-to-date information on publicationsdealing with acquired immunodeficiency syndrome(AIDS), through special monthly supplements to thequarterly Literature Searches on AIDS. The NIH Libraryalso relies on NLM's Learning Resource Center to pro-vide audiovisual services to NIH employees. LibraryOperations staff also serve on advisory committees tothe NIH Library, as advisors to public information

clearinghouses operated by various institutes, and onspecial committees formed to address high priorityhealth issues.

RSD also responds rapidly to a variety of specialinformation requests from members of Congress, theSupreme Court, the Office of the President, the Secre-tary of the Department of Health and Human Services,and other federal agencies. Over 1,500 such requestswere received and processed in FY 1984; almost allwere filled in the same day.

The information services available to assist NLMemployees in performing their varied assignments wereimproved during FY 1984 when the reorganization ofRSD led to the assignment of a full-time professional Li-brary employee to head the Staff Library.

19

OFFICE OF INFORMATION SYSTEMSJohn E. AndersonDirector

MEDLARS III

The MEDLARS III contract was awarded onAugust 31, 1983 to Logicon, Inc. The design and im-plementation of MEDLARS III is taking place in threephases. The Phase I work includes the tasks: (1) to de-velop the overall system architecture that will supportthe total MEDLARS III system; (2) to acquire and installa database management system (DBMS); (3) to imple-ment applications that will support the cataloging andacquisition functions; and (4) to develop a pilot infor-mation retrieval language that will be used to test theoverall performance of the system. The target date forthe implementation of Phase I is fall of 1985.

Several significant changes have occurred in thePhase I contract as a result of the analysis and designthat has taken place to date. The first of these was thedecision to use the IBM PC/XT personal computer asthe basic workstation for internal MEDLARS III users inplace of more conventional terminals. The use of theIBM PC/XT provides several advantages to the user interms of more flexible screen formatting and better re-sponse time. The second major change was the selec-tion of the Model 204 DBMS in place of the systemthat was originally proposed. A number of importantelements have been so far completed by the contractorand reviewed by NLM. A Software Development Plan,which is the basic management document controllingthe development process, was completed and accept-ed by NLM during the first three months of the con-tract. A Requirements Specification, which documentsthe basic agreement between NLM and Logicon, wascompleted and accepted by NLM in April 1984. In ad-dition, Logicon has acquired and installed on the NLMcomputer the Model 204 DBMS, and has acquired andmade operational a full complement of hardware, soft-ware, and communications devices required to supportsoftware development and testing.

The design of the Phase I system is nearing com-pletion. The final design review by NLM will occur inOctober 1984. The programming of certain moduleshas been under way for some time and is expected tocontinue through April 1985. The remaining months ofthe contract will be devoted to acceptance testing,training, and system implementation. The current con-tract completion date for Phase I is September 30,1985.

Phase II of the system calls for the implementationof applications to support the indexing function, serialrecords processing, and subject authority control.Phase III will include the implementation of the interli-brary loan routing and control function, the informationretrieval system, and remaining collection managementactivities. Phases II and III are expected to be complet-ed during the following two years.

Interim Projects. In order to improve processing inseveral important areas prior to the implementation ofMEDLARS III, NLM has undertaken the development oftwo interim systems: indexing and interlibrary loan sup-port.

The interim indexing system became operationalin December 1983. This system provides completeonline input and control of indexing materials fromtheir check-in to their release for inclusion in MEDLINEand Index Medicus. Plans are under way to enlargethe scope of the online indexing system to include thework of contract indexers performed off-site.

Development to support an interim interlibraryloan routing and control system has been underway forseveral years. The first phase of this system providedautomated support for billing interlibrary loan users.The billing system was implemented in January 1984.The second phase of the system provides for onlineinput of interlibrary loans to NLM from the RegionalMedical Libraries. This phase of the system has been

21


operational since March 1984. The third phase of thesystem will provide online input of loan requests androuting of those requests to other libraries based onholdings data. This phase is expected to be operationalin early 1985.

Computer and Communications Systems

The Office of Computer and Communications Sys-tems (OCCS) provides data processing and data com-munications support for all elements of the Library. Ithas a critical supporting role for Library Operations aswell as Specialized Information Services. Computer an-alysts and programmers work closely with subject areaspecialists to determine their data processing require-ments and to convert these requirements into new orimproved data processing capabilities. OCCS providessystems and programming support for the MEDLARS IIsystem and is responsible for certain aspects of thetransition to the MEDLARS III system. Support for all ofNLM's production data processing is provided byOCCS on an IBM 3033 multiprocessor system andData General 230 and 350 minicomputer systems.

OCCS also provides support to our foreign MED-LARS partners. OCCS provides copies of the MEDLINEand other databases to six foreign centers and providescopies of the ELHILL retrieval system to three centers.The most recent, France, was converted this year froman online center to a combination online and tapecenter. OCCS installed the ELHILL retrieval system anddatabases in Valbonne, France for use by INSERM inAugust. This system will be made available to searchersin November 1984.

Application Services Branch

The Application Services Branch was organized inSeptember 1983 by merging the workloads and mostof the personnel from the MEDLARS Support Branchand the Application Support Branch. Prior to reorgani-zation, the programming staffs tended to specialize ineither INQUIRE stand-alone support or MEDLARS IIdatabases, individual workloads and responsibilitylevels tended to be uneven, and coordination of impor-tant projects was occasionally less than perfect. Thenew branch structure has permitted the Office of Com-puter and Communications Systems to cross-train pro-fessional staff in both the INQUIRE and MEDLARS IItools and techniques, to the point where all databasesand systems have both primary and secondary pro-grammer assignments. Internal programmer documen-tation has been improved and standardized to permitback-up programmers to solve problems that arise. Inaddition, the assignment of technical team leaders helpto insure that projects are kept ontrack and ontime.

Concurrent with the major reworking of assign-ments and organization, the branch output was main-

tained at a high level. Major MEDLINE databases weremaintained and made available to the public on sched-ule. All the TOXLINE and CHEMLINE files were rebuiltand the locator fields in CHEMLINE were aligned withthe new back file assignments in TOXLINE. Responsi-bility for the Automated Indexing Management Systems(AIMS) was accepted in the branch, and a new subsys-tem—BIBCHECK—was added to further automate andintegrate the work of the several Library Operationssections. A new field was added to the master serialssystem, sequence (SEQ) element, which had a majorrippling effect throughout the associated databases, andhas permitted serial holdings to be uniquely identifiedwithout losing any prior identifier used by other medi-cal libraries. We improved the processing of the serialholdings data from Regional Medical Libraries and willbe able to process their submissions in a fraction of th(>previous time, provide the source libraries with excep-tion reports, and create the SERHOLD database on ,1production basis. We have improved the flow of citalions from AIMS into HISTLINE so that redundantkeying by contractors is avoided and the citations arcavailable for editing online by NLM staff. Finally, programming staff has been assigned to develop the inter-library loan system under the direct supervision of theDevelopment Branch. A similar interchange of person-nel had been successful for AIMS development.

Systems Support Branch

During FY 1984 the Systems Support Branch provided all required support for NLM mainframe operat-ing systems and related software, provided training,and resolved user-reported problems and inquiriesMajor efforts this year were to take advantage of thecapacity of the 3033 system and to provide the neces-sary support for the MEDLARS III interim systems.

Notable activities of the Systems Support Branchduring FY 1984 include:

• Installation and maintenance of systems softwarepackages—MVS/SP—the current version of theIBM operating system that provides support forthe recently installed 3380 disk storage units aswell as increased system reliability and perform-ance.

• Installation and support of more than 100 soft-ware products for programmers, users, systemssupport staff, and computer operations specialists.

• Installation and support for the Model 204 DataBase Management System which is being used forMEDLARS III development. This system was in-stalled in addition to the INQUIRE/System whichhas been in use at NLM for a number of years.INQUIRE itself was enhanced with the installation

22

Offn c of Information Systems

of its Data Management Supervision in late FY1983 and became fully operational in FY 1984.At the present time the AIMS online indexingsystem and the National Canter Institute's PDQCancer Information System have been installedunder INQUIRE/DMS.

• Major tuning and continuing development of CO(Customer Information Control System) and theSeries/1 protocol converter. The increased use ofcomputer terminals by NLM professional staff re-quired an improved method of providing comput-er services. CICS provides control for database/data communications applications and will be oneof the critical building blocks for MEDLARS III.The protocol converter provides the ability forASCII terminals—those used throughout NLM—touse the vast library of 3270 applications and serv-ices available on the 3033 system. Those systemsare an important element in the MEDLARS III in-terim systems.

Equipment. In 1982, NLM installed its IBM 3033 mul-tiprocessor system to support the present MEDLARSsystem and services as the new capabilities of MED-LARS III are developed. In 1984, NLM completed itsupgrade to new technology IBM 3380 magnetic diskstorage. These units are much faster, more reliable, andhave greater capacity than any other drive availabletoday. As a result of this upgrade, NLM now has astorage capacity of some 60 billion bytes of storage—the equivalent of more than 18 million pages of infor-mation.

In lanuary 1984 a UMMI of OCCS specialists con-ducted a series of system simulations at the IBM Ra-leigh, North Carolina facility to project NLM's futurecomputational needs. The simulations were based onprojected workload growth and the anticipated impactof MEDLARS III. The results showed that the NLMprocessor's capacity will be reached in 1985. As aresult, initial planning for a new competitive procure-ment to replace the IBM 3033 multiprocessor systemwas started this year.

Computer Services

During this fiscal year, the Computer ServicesBranch maintained an extremely high level of oper-ational readiness. In FY 1984, with the advent ofonline indexing and the implementation of the NationalCancer Institute's PDQ cancer information database,systems reliability and availability became even morecritical. Service to both of these new online systems aswell as to MEDLINE users has been excellent, withMEDLINE response times remaining in the range of oneto two seconds.

On March 30, 1984, NLM awarded contracts toTelenet, Tymnet, and UNINET for data communica-tions services. These data communications networkcompanies will provide continued toll-free access tothe NLM systems for users of NLM databases. TheNLM policy of equal access for all users, which wasfirst implemented with TYMSHARE (now Tymnet) in1974 and supplemented later with Telenet, has nowbeen expanded to include UNINET access as well. Thenew contracts have increased the areas of local areatelephone access to NLM databases.

23

SPECIALIZED INFORMATION SERVICESHenry M. Kissman, Ph.D.Associate Director

The Toxicology Information Program (TIP), whichis the major responsibility of the Library's Division ofSpecialized Information Services (SIS), was establishedin 1967 in response to the 1966 President's ScienceAdvisory Committee report, "Handling of ToxicologicalInformation." The objectives of the Program are to: (1)create automated toxicology data banks, and (2) pro-vide toxicology information and data services.TIP offersthree major types of services: it provides online serv-ices, responds to queries, and supports other Govern-ment agencies in their information needs.

Online Services

TIP develops and maintains the NLM Chemicaland Toxicological Files, which are online, interactiveinformation and data retrieval services in toxicology.They include CHEMLINE, TOXLINE, RTECS, and theToxicology Data Bank. It is also responsible for DIR-LINE, an online information resources directory file.

CHEMLINE (Chemical Dictionary Online) is an onlinechemical dictionary and directory file. It allows usersto identify a chemical substance of interest, determinewhich NLM files contain information for that sub-stance, and aids in the formulation of an appropriatesearch strategy for these NLM files. As of August 1984,CHEMLINE contained records for 612,812 chemicalsubstances. It is updated bimonthly, and regenerated atleast once annually. In FY 1984, the average usage was279 connect hours per month.

During FY 1984, improvements continued to bemade in the CHEMLINE file. In April more than110,000 substance names from the RTECS, TDB, andMeSH files were added to CHEMLIME. It is now possi-ble to add chemical names, identified by NLM staff,that are of emerging biomedical interest but are notfound in current sources. An agreement was signedwith United States Pharmacopeia, Inc. (DSP) for the

use of their validated drug nomenclature in CHEM-LINE.

In order to learn more about the characteristics ofCHEMLINE users and their perceptions about the file, asurvey was begun of chemical information searchers incooperation with the NLM Operations ResearchCroup. In FY 1984, a questionnaire was designed andapproved by the Office of Management and Budget,and an analysis of the workflow necessary for imple-mentation of the survey was made. The survey andanalysis of the results will take place in early FY 1985.

TOXLINE (Toxicology Information Online) is an onlinebibliographic database covering the toxicological ef-fects of drugs and other chemicals. TOXLINE is updat-ed monthly and, including its backfiles, now encom-passes more than 1.4 million records from 1965 to thepresent. During FY 1984, online usage of TOXLINE andits backfiles was 10,650 hours.

New sources of information for enriching theTOXLINE file were evaluated. A "toxicology" subset ofCRISP, the NIH database of research grants awards,will be added to the RPRO) (Research Projects) subfileof TOXLINE in FY 1985, as will the National TechnicalInformation Service's Federal Research in Progressdatabase, FEDRIP. Selected portions of the HazardousMaterials Technical Center Bulletin, the InternationalLabor Organization bibliographic database, and asubset of the National Institute for Occupational Safetyand Health Technical Information Center database areexpected to be added to TOXLINE during FY 1985.

The TOXLINE files were regenerated in August1984. The records were redistributed: TOXLINE(1981-present), TOXBACK76 (1976-1980) and TOX-BACK65 (pre 1965-1975), and the language data ele-ment was modified to facilitate retrieval of non-Englishrecords.

25


RTECS (Registry of Toxic Effects of Chemical Sub-stances) is an online interactive database built andmaintained from data provided by the National Insti-tute for Occupational Safety and Health (NIOSH) Asof September 1984 it contained records for 68,386substances. Quarterly updates to the file provided in-creases both in the number of substances covered andin the scope of information relating to the toxicity ofchemical substances.

TDB (Toxicology Data Bank) is an online factual data-base describing chemical substances that may be haz-ardous and may have significant human exposure po-tential. Records in TDB include information on phar-macology and toxicology, manufacturing and use, envi-ronmental and occupational exposure, and chemicaland physical properties. Data are extracted from terti-ary sources such as monographs and handbooks, aswell as from the primary literature Completed recordsare evaluated by the TDB Peer Review Committee, agroup of toxicologists associated with the ToxicologyStudy Section of the NIH Division of Research Grants.The online file presently contains 4,112 records—ofwhich 4,077 are complete, and 35 are in processingOnline usage remained constant at approximately 200hours per month in FY 1984.

Considerable progress has been made in enhanc-ing the content and responsiveness of the TDB file. Anew record format was adopted, with more extensivecoverage in the areas of environmental pollution, safetyand handling, exposure standards and recommenda-tions, and other health and environmental effects.More than 3,000 records, many of which were updat-ed and enhanced, have been converted into the newformat.

The Remote Data Entry System, developed byNLM's Lister Hill Center, has been adapted for buildingthe TDB file. This minicomputer-based system permitsmulti-site, online, interactive construction of recordsthrough communication links installed between dataentry terminals and the host computer facility. Othersoftware modules have been implemented to provide:(1) computer conferencing for the peer-review process,(2) in-process control tracking of record building andreview; and (3) electronic mail/message sharing capa-bilities.

A new search/delivery system, which runs on thesame minicomputer used for file building and review,was designed. It provides more user-friendly access tothe data and greater flexibility in output options. Theenhanced TDB file will be tested in the fall of 1984and is scheduled to be available to domestic MEDLARSusers in the spring of 1985

DIRLINE (Directory of Information Resources Online),an online interactive directory which refers users to or-

ganizations and other sources of information in specificsubject areas, successfully completed its one-year ex-perimental period in August 1984 Currently, records inDIRLINE come from two sources the Library of Con-gress's National Referral Center (NRC) database, andthe National Health Information Clearinghouse (NHIC)database

The NRC component contains information about13,621 resource centers These centers include publicand private organizations, institutions, and groups andindividuals with specialized information in particularfields. Each record is updated by the NRC at leastevery two years.

The NHIC database, provided through an agree-ment with the Office of Disease Prevention and HealthPromotion of the Public Health Service, was added toDIRLINE in June 1984 Initially, the Office provided428 records, and has agreed to enhance DIRLINE byapproximately 1,000 records in FY 1985 NHIC con-tains references to organizations that provide informa-tion about various aspects of health and disease. Eachrecord in NHIC is updated at least once a year. DIR-LINE is updated quarterly

User support for the NLM Chemical and Toxico-logical Files continued to expand The manuals andpocket cards, designed to aid users in searching thefiles, were updated. The printed SAMPLER and audio-visual Files Overview, both of which introduce thenew or prospective user to the files, were revised. Aslide/script on the organization and management ofthe TIP was developed to be used in conjunction withthe existing TIP slide/script overview describing theProgram's products and services Instructional packagesconsisting of 35mm slides and lecture guides were de-veloped for each of the files, as well as the basic fea-tures of the ELHILL search system Courses were de-signed for a three-hour abbreviated end-user trainingprogram and a six-hour end-user training program. Theabbreviated end-user training course was given for thefirst time at the American Chemical Society meeting inPhiladelphia, PA, on August 16, 1984

An expanded exhibit program at professionalmeetings was started to acquaint potential users in theareas of c hemistry, toxicology, and environmentalhealth with the1 NLM Chemical and Toxicological Files.In the future, end-user training will be offered at pro-fessional meetings in conjunction with the exhibit pro-gram, and at governmental sites in the field.

CITE (Current Information Transfer in English). TheCITE Online Public Access Catalog in the NLM Read-ing Room was enhanced to provide user-friendlyaccess to the MEDLINE medical journal literature data-base. Walk-in patrons of the National Library of Medi-cine are now able to search for biomedical books or

26

Specialized Information Services

journal articles using flexible natural language subjectqueries. The CITE systems utilizes a "closest match"search strategy, automatically displays suggested medi-cal subject headings, and shows retrieved documentsin a ranked sequence.

Query Response Services

Literature search and query response services intoxicology are provided by both TIP and the NLM-sponsored Toxicology Information Response Center(TIRO at the Oak Ridge National Laboratory in Tennes-see.

TIP is currently developing a Query Responseservice that closely parallels that of the NLM ReferenceServices Division. A policy instituting charges for serv-ices is under discussion. TIP continues to provide spe-cially requested searches on a non-routine basis.

TIRC products and services are provided on acost-recovery basis. Charges for literature searches atTIRC are $40 per hour for both domestic and foreignusers, with billing being handled by the National Tech-nical Information Service (NTIS). TIRC performed ap-proximately 400 full literature searches in FY 1984.Most of the search requests were from Federal agen-cies that have interagency agreements with NLM forinformation support from TIRC.

Information Services to Other Agencies

TIP provides information support to several Feder-al agencies. Current examples are the Agency for ToxicSubstances and Disease Registry, the National Toxicol-ogy Program, the Food and Drug Administration, theDepartment of the Army, and the National Institute forOccupational Safety and Health (NIOSH). Literaturesearches and related information services for theseagencies are provided by TIRC.

Hazardous Substances Information Services. Amajor effort of TIP during FY 1984 has been in supportof the Department's responsibilities under the Compre-hensive Environmental Response, Compensation andLiability Act of 1980 (CERCLA), also referred to as the"Superfund Act." These activities were initiated in late1982 and became fully operational in FY 1984. Theprimary objectives are to: (1) enhance the NLM Chem-ical and Toxicological Files with additional chemicalsubstance records and data pertinent to chemicalwaste dumps or accidental spills; and (2) improve in-formation dissemination capabilities for officials dealingwith hazardous chemicals—often in emergency or re-medial situations.

An interagency agreement with the Agency forToxic Substances and Disease Registry, signed on June28, 1983, was extended through FY 1984. TheAgency, formed under direction of the CERCLA, is the

lead agency for the Department of Health and HumanServices' Superfund activities, and is part of the Centersfor Disease Control in Atlanta.

While TOXLINE and CHEMLINE were enhancedto some extent for CERCLA purposes, the major part ofthe effort in FY 1984 was focused on enhancing theTDB. An effort was made to identify additional datasources to supplement the existing sources, especiallyin the areas of environmental effects and occupationalsafety. A workshop was held at NLM in spring 1984 tobetter identify sources and their utility for TDB pur-poses.

Since January 1983, NLM has directed the devel-opment of a stand-alone, microcomputer-based work-station—housed in a CODATA microcomputer—topermit rapid and convenient access to chemical, toxi-cological, and hazardous waste information for region-al and field personnel at the Centers for Disease Con-trol (CDC). The capabilities planned for this worksta-tion encompass most of the major functions of theChemical Substances Information Network (CSIN) (seebelow). Additional capabilities now under developmentinclude: (1) post-processing of retrieved data, (2)searching of local data files, (3) communicating withother workstations, and (4) communicating with region-al headquarters and field personnel via electronic mail/messaging. The first field workstation is being deployedto CDC for testing and evaluation.

In addition to the activities discussed above, NLMsupported the DHHS Hazardous Waste InformationEvaluation Subcommittee in selecting chemicals fortoxicity testing and incorporation of information intothe TDB, and conducted a feasibility study for the de-velopment of hazardous chemical profiles.

Interagency Subcommittees. As part of its collabora-tive work with other Federal agencies, TIP chairs theToxicology Information Subcommittee of the DHHSCommittee to Coordinate Environmental and RelatedPrograms, and the Chemical Substances InformationNetwork Subcommittee of the Interagency Toxic Sub-stances Data Committee. The former group sponsorsand monitors the following three projects which areoperated by TIP.

TOXLTIPs (Toxicology Testing-in-Progress) is amonthly publication that describes toxicity testing andrelated epidemiological studies reported voluntarily bygovernmental, industrial, and academic laboratories.Coverage of literature reports on animal testing alterna-tives was begun this year as a new feature. Each issuealso includes an alerting service entitled, "Methods ofTesting Chemicals for Biological Effects." TOX-TIPS ispublished monthly through NTIS and is available atannual subscription rates of $45 /domestic and $90/foreign. The number of subscriptions has remained

27


stable at approximately 625 worldwide. Contributionsto the publication were received chiefly from Federalagencies and some industrial testing programs.

Two TOXLINE components, Research Projects,carrying information on ongoing research in toxicology,and the Toxicology Document and Data Depository(TD3), with information about the report literature intoxicology, are also sponsored by the Subcommittee.

As the name indicates, the CSIN Subcommitteemonitors the activities of the interagency CSIN (Chemi-cal Substances Information Network) project which

provides integrated access to specified files on MED-LARS, the Chemical Information System, CAS ONLINE,and ORBIT. CSIN facilitates online searching through aminicomputer-based "gateway" system that functionsbetween the user's terminal and the target online fileshoused in government or commercial online systems. Ituses the preprogrammed search capabilities, SCRIPTS,which essentially perform the online search for theuser, and TRANFORMs, which reformat the output ofone search for use as input to another search. NLMhas supported the CSIN project since its inception.

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LISTER HILL NATIONAL CENTER FOR BIOMEDICALCOMMUNICATIONSEarl HendersonActing Director

In FY 1984, the Lister Hill National Center for Bio-medical Communications conducted reviews of all itsintramural research and development projects. The Di-rector asked senior researchers to develop documenta-tion for new research and development projects and tojustify major ongoing activities. This marked the begin-ning of a review process that included internal peerreview at the LHNCBC and review by the NLM'sBoard of Scientific Counselors (the members of theBoard are listed in Appendix 4). This effort helped inte-grate the programs and resources of the National Med-ical Audiovisual Center with the programs of theCenter by identifying research projects which could ex-ploit the personnel and research facilities of the newLister Hill Center. Potential research areas in computerassisted instruction, medical decision analysis, andhuman factors in information systems were definedand staff training and project development for themwas begun.

Among new activities in FY 1984 were a series ofmonthly seminars identified as "The Lister Hill CenterSeminars" which were held in the LHC auditorium.Both local and external experts in areas of increasinginterest to biomedical communications researchers dis-cussed their recent research projects. Some expertsand their topics were, Robert Williges, Ph.D., HumanFactors Design of Human Computer Dialogues; ArthurElstein, Ph.D., Physicians' Judgments About EstrogenReplacement Therapy: A Study of Clinical DecisionMaking; Dennis C. Fryback, Ph.D., Feedback Systemsfor Improving Clinical Judgment; George R. Thoma,Ph.D., Compression Techniques; Ms. May Cheh, Artifi-cial Intelligence: Problems in Knowledge Representa-tion; Mr. Charles Goldstein, Optical Disk Technologyand Library Information; Richard B. Friedman, M.D.,

Computer Simulation of the Patient Physician Encoun-ter.

In addition, Dr. Ben Shneiderman of the Universityof Maryland Computer Sciences Department presenteda seminar to LHNCBC and other NLM staff on Design-ing Interactive Computer Systems. The Center alsosponsored presentations on the Health Education Net-work and the Health Sciences Communication Associa-tion, when the officers of those organizations attendedconferences at LHC. An increased number of technicalseminars and demonstrations were presented by visit-ing faculty, commercial, and medical researchers.

In October 1983, Mr. Earl Henderson was select-ed as the Deputy Director of LHNCBC. He was for-merly the Chief of the Communications EngineeringBranch. In 1984, Dr. George Thoma was appointedChief of the Communications Engineering Branch. TheDirector of the Center, Dr. Richard B. Friedman,headed an effort to review and advise NLM manage-ment on office automation strategies for the Library.The effort culminated in new office automation for theNLM which is now being implemented.

The Director of the Lister Hill Center, Richard B.Friedman, M.D., left his position in July to return to theUniversity of Wisconsin Medical School. Mr. Earl Hen-erson was appointed Acting Director while a search fora successor is underway.

TIME

A major new project, known as Technological In-novations in Medical Education (TIME), was begun inthe first quarter of FY 1984. The project is directed byDr. William G. Harless and involves staff from severalLister Hill Center branches; thus, it is not reportedunder the branch headings which follow, but has itsown section in this report.

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The primary goal of the TIME project is to addressthe potential application of the new technologies of mi-croprocessor, interactive laser disc, and speech recog-nition to the education of medical students and medi-cal practitioners. The new technologies offer unprece-dented capabilities for interactive and visual presenta-tions of educational material. The TIME project is ex-ploring these capabilities by developing a series ofproblem-based, patient-related clinical simulations.

The educational methodology being developed bythe project for the simulations has been labeled "con-textual learning." This method assumes that optimallearning occurs when an interested, motivated studentis given the opportunity to observe and participate in arelevant, believable simulated situation.

Each TIME simulation provides an appropriatecontextual framework for acquiring medical knowledgeand learning clinical decision making. The simulationsare carefully designed to engage the user in the lifestory and health problems of the patient. Furthermore,they provide the user with effective educational materi-al (visual, audio, and textual) within the context of thepatient situation.

The first prototype TIME simulation to be devel-oped has been completed. The patient, Frank Hall, is a43-year-old male who arrives at the emergency roomcomplaining of weakness and abdominal pain followingan episode of vomiting blood two days earlier. TheFrank Hall simulation requires two videodiscs. Eachdisc contains a variety of scenes depicting the patient'scurrent experience in the hospital and significant pastexperiences (through flashbacks) which are related tohis present illness. Other scenes depict elements of thephysical exam and relevant diagnostic tests.

At the user's verbal request any scene on any discis immediately available. The user selects scenes in anyorder desired by speaking into the voice recognitionunit. Before using the simulation, the user trains thesystem to recognize more than fifty control words.About forty of these allow access to scenes concerningthe patient's medical condition and social situation.The remaining words (called system control words)enable the user to independently manage the interac-tive session or obtain help from the system.

The TIME program is designed to preclude theneed for either an on-site monitor or written user in-structions. At the conclusion of the interactive session,the user receives (evaluative graphic) feedback fromthe system describing the type, amount and order ofinformation gathered during the simulation.

This prototype simulation has been formally pre-sented to the senior NLM management, Lister HillCenter Staff, International Council of Scientific Unions-Abstracting Board, American Association of Colleges of

Pharmacy, and a variety of NLM visitors from both thepublic and private sectors.

A supplementary disc for the Frank Hall simulationis nearing completion. This prototype tutorial disc willdemonstrate further the possibilities for contextuallearning by providing the student with instruction inrelevant physical examination techniques and proce-dures within the context of the medical problem.

A second prototype TIME simulation is currentlybeing developed concerning a geriatric patient in anursing home situation. It is scheduled for completionduring the first quarter of FY 1985.

During FY 1985 additional simulations will be cre-ated. The TIME staff will evaluate the simulations anddevelop research paradigms to explore the relevantissues concerning the technological and educational in-novations. In addition, presentations will be made tointerested medical and educational agencies, institu-tions and societies; and manuscripts submitted for pub-lication to medical and educational professional jour-nals.

Communications Engineering

Electronic Document Storage and Retrieval (EDSR).The EDSR Program is an ongoing effort to design, de-velop, and evaluate a laboratory facility that will serveas an engineering prototype to electronically store, re-trieve, and display documents acquired by the LibraryIts long-term goal is to help introduce advanced tech-nology to aid the Library in fulfilling its missions in in-formation processing as well as to serve as a nation.ilarchive for biomedical literature. The development ofthe experimental system involves integrating variouscomponents such as a document capture subsystem,high density storage media, document display subsys-tem, and a system controller. The resulting engineeringprototype enables both technical and operation.il eval-uation to be done.

Document capture techniques are being exploredto scan electronically both loose-leaf and bound doc u-ments containing textual and graphic material Docu-ment storage in the prototype system is provided byhigh-density magnetic disks allowing about a thousandpages of storage, sufficient for preliminary experimenta-tion and documentation. This storage medium will laterserve as a buffer storage for an archival storage subsys-tem to be implemented by optical disk technology.Documents are retrieved and displayed at a resolutionof 200 points per inch in both softcopy (electronic dis-play) and hardcopy (paper) forms.

The first phase of the program is complete,namely, a prototype system to scan, store, retrieve,and display the exact images of paper documents. Thissystem is currently being used to demonstrate a poten-

30

Lister Hi/I Center

tial library application. First, a document image data-base was built from the title pages and tables of con-tents in cited books m a selected medical area. Thisdemonstration begins with performing a search on astandard NLM bibliographic database yielding a list ofcitations. For the citations of interest the image data-base may be commanded to rapidly deliver the corre-sponding exact document images. This is accomplishedby linking the bibliographic database on the Library'smainframe computer to the minicomputer that servesas the system controller in the EDSR prototype.

Among the program's next phases will be to de-velop an archival capacity by means of optical disktechnology. Also, the hardcopy output is to be upgrad-ed to allow plain paper output at a higher speed. Thepresent device has the disadvantage of requiring ex-pensive chemically treated paper and its slow speed isa deterrent to effective usage of the EDSR workstation.

The research effort will use the prototype systemas a test bed to evaluate and correct problems encoun-tered in capturing images, transferring images to stor-age media, retrieving and displaying images on outputdevices, and evaluating factors such as display imagequality, system reliability, maintainability, the man-ma-chine interface, and the utility of such a system to theNLM mission in information processing. Other researchprograms using the prototype system are being initiat-ed. These involve image data compression and omni-font text recognition.

Computer ScienceAutomated Classification and Retrieval. This new re-search program will investigate, develop, and evaluateinformation science, computational linguistics, and arti-ficial intelligence techniques which support the auto-mated classification and retrieval of biomedical litera-ture. The program will include projects in the areas ofnatural language understanding, knowledge representa-tion, and information retrieval. The goal of theseprojects is to explore their application to the develop-ment of automated systems for identifying, represent-ing, and retrieving relevant concepts and main ideasfrom printed documents. The Center is pursuing this asan intramural research program, but also seeks oppor-tunities to collaborate with other organizations that areconducting related research.

Two intramural research projects are being devel-oped. The first is defined as a matcher between queriesand a knowledge base. The second is defined as a nat-ural language understanding project.

A preliminary study explored the development ofsemantic grammars and frame structures to representinformation in a selected group of English language arti-cles about clinical drug treatment. The relevance of therepresentations, as well as other representations devel-

oped as part of the new projects, will be evaluatedwith respect to queries used by library patrons. A setof queries processed against various online retrievalsystems during 1983 was provided by the NIH Library(patron names were deleted prior to their release to theNLM) for such use.

Advanced Computer Science Resource (ACSR). TheComputer Science Branch, with the help of the Infor-mation Technology Branch, procured and installed theACSR system which consists of two VAX 11/780 sys-tems interconnected by an ethernet local area network.This system, which was installed in January 1984, re-placed two computer systems, a DEC 20/60 and aDEC POP 11 /60. One of the new systems is connect-ed to the ARPA/MILNET network. The ethernet, be-cause it uses the TCP/IP protocols, is also part of theARPA/MILNET network. As a consequence, eithersystem has the capability for exchanging mail or filesand for remote terminal connections with many sitesthroughout the United States. The ACSR runs under theBerkeley version of the UNIX operating system andsupports a variety of text editors, program develop-ment tools, graphics facilities, and languages and toolsapplicable to artificial intelligence.

The text editors, EMACS and VI, are full screentext editors and provide the capability of editing pro-grams and documents. EMACS, through its macro lan-guage feature (a lisp-like dialect), can be tailored to fita multitude of applications ranging from documentpreparation to program development. These editors to-gether with a collection of other programs provide anenvironment to develop and test programs in the lan-guages C, Fortran 77, Prolog, Interlisp, and Franzlisp.

The graphics facilities include a high resolutionlaser graphics printer, graphics terminals, and softwareto display graphics images on these devices.

The artificial intelligence languages and tools in-clude the languages Interlisp, Franzlisp, and Prolog;and the expert system building tools ACE, EMYCIN,and MRS.

Information TechnologyDistributed Information System (DIS). The DIS pro-gram encompasses several projects related to the effec-tive distribution (as opposed to centralization) of ad-vanced information systems technology. The projectsinclude:

• Interactive Information Management System(IIMS)

• Network Access Information Workstation

• Integration of an Extended MUMPS Languageunder UNIX

• Information Retrieval Testbed System

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The efforts of the Information Technology Branch havebeen related to the above projects and have benefitedfrom a collaborative program with NLM's SpecializedInformation Services in which the results have been ap-plied to operational systems. The 11 MS project is de-signed to produce a working model for testing anddemonstrating advanced information management andretrieval techniques which can be applied to full-textdatabases. The project has been built upon conceptsand code developed for previous Lister Hill Centerprojects including a Retrospective Data Entry Systemoriginally used for conversion of NLM's card catalog,electronic mail initially developed for the Integrated Li-brary System, and a Distributed Information DeliverySystem which demonstrated the microprocessor-baseddelivery of a full-text encyclopedic data base.

The Network Access Information Workstationproject is to develop a user-friendly microcomputerworkstation that can facilitate access to different onlineinformation sources. The workstation provides auto-matic logon to online databases, automated search se-quences (scripts), transformation of retrieved data tostandard formats, and transfer of data to a user's per-sonal filing system. The prototype has been basedupon a design for the Chemical Substances InformationNetwork which was originally implemented on a DECVAX 11/780. The workstation has brought the func-tionality of the VAX implementation to an inexpensivemulti-user microcomputer and in the process has pro-vided greater flexibility and ease of use. In collabora-tion with Specialized Information Services and theCouncil on Environmental Quality, a version of theworkstation that has been tailored for access to haz-ardous waste information will be field-evaluated by theCenters for Disease Control (CDC) in Atlanta. Theworkstation will form the hub for a network of portablecomputers that will be used by CDC personnel who re-spond on-site to chemical emergencies and who re-quire immediate and accurate information.

The third DIS project is the implementation of anextended MUMPS programming language environmentunder the UNIX operating system. MUMPS is one ofthe ANSI-standard languages and has been extensivelyused in biomedical computing applications. Two of thestrong points of the language are its interpretive natureand an embedded database management system,which are two features missing in UNIX. Since a signifi-cant amount of software, including the IIMS, has beendeveloped for NLM in a version of MUMPS, the trans-lation to a language that operates under a portable op-erating system such as UNIX would increase the avail-ability of this software and save the effort of recedingthese applications in another language. The InformationTechnology Branch has begun testing commercial im-plementations of MUMPS that exist under UNIX with a

view towards defining the functions necessary to pro-vide a translation of NLM software and an optimalMUMPS environment in UNIX.

The last activity within the DIS program, the Infor-mation Retrieval Testbed System, evolves from earlierwork in the area of natural-language queries and statis-tical retrieval techniques. As part of that effort, asystem called ANNOD (A Navigator of Natural Lan-guage Organized Data) was developed as a querysystem for the Hepatitis Knowledge Base. The objec-tive of the present effort is to create a testbed systemthat will enable evaluation of the performance of statis-tically based information retrieval systems. The basicset of component programs, including word stemming,thesaurus building, and ranking of retrieved output, hasbeen developed under the UNIX operating system andwill permit systematic testing of different retrieval strat-egies and dependencies on the types of databasessearched. The Toxicology Data Bank file has beenstored on an I DM database machine to facilitate themanagement of and access to a sample full-text data-base. The project also includes the investigation of bit-mapped display technology for window-based presen-tation of text.

The National Demonstration Center for EducationalTechnology. In 1984 a Lister Hill Center program wasinitiated to establish a National Demonstration Centerfor Educational Technology (NDC). This Center is toprovide an environment for, and demonstrate, state-of-the-art-technologies in health-sciences-oriented com-puter-based education. The Center will allow healthscience educators—faculty and researchers—to haveaccess to a spectrum of computer-based educationalmaterials. In addition to demonstrations, the NDC willserve as a laboratory for comparative studies and eval-uation of such materials. The NDC facilities will in-clude two demonstration areas and a conferenceroom; the latter to be linked electronically with theformer. Detailed plans have been drawn up for theNDC, to be implemented in FY 1985.

Microprocessor Laboratory. In recognition of the de-velopment, advances, and widespread utilization of mi-croprocessor technology, the Lister Hill Center desig-nated the space on the ninth floor as a microproces-sor-based research and development laboratory. Thismicroprocessor laboratory will provide space for corefacilities and research and development—movable par-titions allow the laboratory to be divided into as manyas eight separate areas. Planned core facilities include acommunications section, a software library/archivearea and a general purpose access area. The programstargeted for initial occupancy all involve computer-based education. The laboratory space will be reallo-cated to new programs as old programs are phased

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Lister Hill Center

out. Expected programs in artificial intelligence, distrib-uted database systems, and human interfaces will behoused in the laboratory in the future.

Processing of Bibliographic Citations. There is todaya large variety of online bibliographic citations servicedby various retrieval systems such as SDC, LockheedDIALOG, BRS, NLM's MEDLINE, etc. With the adventof micro- and personal computers, coupled with soft-ware programs such as ISI's SCIMATE, INSEARCH,etc., an increasing number of users are "downloading"citations in machine-readable form. These downloadedcitations are usually incorporated into personal biblio-graphic files and are often used as references in subse-quent publications. Unfortunately, there are no biblio-graphic citation standards and, hence, citation formatsdiffer between different databases and retrieval sys-tems. Under such circumstances, it is natural to ask if itwould be possible to machine process the citationsinto some common format, and then to provide aneasy means of formatting for different purposes.

Utilizing the powerful text analysis and manipula-tion tools available in the UNIX operation system onthe Lister Hill Center's VAX 11/780 minicomputers,programs were developed to process journal and pro-ceedings citations into a common format and to pro-vide a means of creating different reference formats.These programs are presently being documented forpublication. It is expected that programs such as thesewill be part of a growing collection of computer-basedtools available to all scholars in the future.

Electronic Mail. The Information Technology Branchdeveloped an electronic mail system in the languageMIIS as part of the Integrated Library System (ILS) pro-gram (which terminated at the end of 1983). The mailsystem design introduced many innovations includingthe retention and categorization of messages to form apersonal information database for users. Followingcompletion of the ILS program, the electronic mailsystem has been used in the Distributed InformationSystem (DIS) program to provide communication be-tween the peer review committee members and thestaff of NLM's Specialized Information Services.

Audiovisual Program DevelopmentThe Audiovisual Program Development Branch

(APDB) applies current and emerging video communi-cation technologies and audiovisual techniques toLister Hill Center research, development, and demon-stration projects and to the educational, research, andinformation transfer needs of the health sciences com-munity.

In order to carry out its program goals, the Hr.inchbegan a long-term updating of the Lister Hill Centervideo and audio production facility. This will allow it to

continue to support the premastering of materials fornew videodisc projects, and to include in these proto-type materials the visual techiques consistent with cur-rent computer based educational objectives. This yearthe Branch emphasized updating the editing systems,with future plans to upgrade the audio production,video-graphics, and still recording systems.

Projects. Two medical simulations were produced asvideotape premasters for optical videodisc/microcom-puter programmed demonstrations in the TIME series(described earlier in this chapter). Experienced theaterperformers were recorded in both studio settings andon remote locations. Music, special effects, narration,and electronically generated graphics were integratedwith live action and still frames for mastering onto mul-tiple optical videodiscs.

An experimental videodisc was produced for theHistory of Medicine Division Prints and PhotographsCollection, using more than 1,000 selected visualsfrom that collection. A number of collaborating healthsciences institutions will test the feasibility of using thevideodisc and accompanying written materials as ameans of selecting prints or photographs for researchor educational purposes by medical professionals, au-thors, publishers, teachers, students, and library pa-trons.

In another activity, several hundred carefully se-lected color slides of skin disorders were electronicallyrecorded, to be assembled on videodisc for a "der-matologic diagnosis" project. Responsive to microcom-puter programming, the demonstration visual databasewill be tested in medical education settings to evaluateits utility as a teaching/learning tool and as an aid indiagnostic decision making.

Working with Dr. Frank Allen, Department ofMedicine, George Washington University School ofMedicine, the Branch's staff used video microscopes tocontinue to record materials from Dr. Allen's extensivecollection of histology slides. When properly indexedand enhanced with electronically generated graphicdescriptors and visual aids, a "Microanatomy DataBank Videodisc" will be developed. The disc will beinterfaced with microcomputer programming to createinteractive audiovisual learning units.

Two videotapes were produced, in collaborationwith the National Institutes of Health and the Food andDrug Administration, as units in a training series for re-searchers and health sciences administrators on the sig-nificance, the historical development, and the federalguidelines and regulations pertaining to the protectionof human subjects involved in medical research experi-ments.

Selected l>ram sections, plus 4" X 5" and 8" X10" color transparencies from the Armed Forces Insti-

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tute of Pathology's Dr. Yakovlev Brain Section Collec-ton were recorded on both videotape and 35mmmotion picture film. This experiment is designed to as-certain (1) if optical videodisc recording provides suffi-cient resolution for cataloging and analyzing brain sec-tions, and (2) to determine whether photographiccopies can be used in the videodisc production proc-ess, rather than actual brain sections.

Support Activities. The Branch's Graphics and StillPhotography Labs continue to provide visual informa-tion materials in support of approved audiovisual de-velopment projects and to other elements of the Li-brary. The Branch's graphic artists are helping to test acomputer graphics system as a step toward upgradingthe presentation graphics support provided to the Li-brary. The Branch also provides projection, audio re-cording, and other audiovisual support to meetingsscheduled in the Lister Hill Center Auditorium andother NLM facilities by the Office of Training FacilitiesCoordination.

Health Professions Applications

The principal activities of the Health ProfessionsApplications Branch this year were: 1) the continuationand extension of the microscopy-pathology videodisctesting, which now includes 35 test sites in U.S. andCanadian medical schools, technical support to theparticipating sites, and the evaluation of data from thesites; 2) the continuing development of similar proto-type videodisc projects in radiology and in suicide as-sessment, planned as collaborations with other govern-ment and non-government organizations; 3) the devel-opment of a prototype videodisc and database in der-matologic diagnosis; 4) the continuing roles in planningand evaluating the Lister Hill Center and Office forProtection from Research Risks (NIH) materials devel-opment project; 5) directing two evolving projects innursing history, one in cooperation with the PublicHealth Service nursing community and the other withFreedmen's Hospital alumnae; 6) the completion of a

study and analysis of user responses to NLM's audio-visual loan program services; 7) completion of work onNLM's Scope and Coverage Task Force, resulting inrecommendations about the collecting of medical be-havioral science materials; and 8) the securing of thelong-delayed approval by the Office of Managementand Budget of the selection-acquisition study, a con-tract project at the University of Iowa.

The Branch's staff participated in a series of orga-nizational development meetings with consultants fromTricom, Inc., an organizational consulting firm. Theseefforts resulted in a jointly prepared staff working paperthat included a new mission statement for the Branch;a compilation of the staff's credentials, interests, andwork experiences; and brief descriptions of about 30ongoing or suggested staff projects. These efforts con-tributed to improved cooperation among HPAB staff.As a follow-up to these meetings, staff prepared andsubmitted several preliminary proposals for review.These included proposed projects on test item bankingin health professions education, applications of clinicaldecision analysis, uses of videodisc technology inhealth professions education, health professionals' in-formation-seeking behaviors, and a history of medicalcomputer-based education.

Training And Consultation

The Training and Consultation Branch continuedits programs in support of the effective use of micro-computer and audiovisual technologies in the healthprofessions. Information resources for health profes-sionals were developed in the areas of microcomputerand videodisc applications in medical education and inselecting microcomputer authoring systems. TheBranch staff participated with the Information Technol-ogy Branch staff and consultants to establish a NationalDemonstration Center in Educational Technology.

The Training and Consultation Branch providedmore than 400 in-house consultations to health profes-sional teachers, researchers, and administrators.

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EXTRAMURAL GRANTS AND CONTRACTSWilliam C. Cooper, Ph.D.Associate Director, Extramural Programs

The National Library of Medicine's ExtramuralPrograms, authorized by the Medical Library Assist-ance Act (MLAA) of 1965 and extensions, provide avariety of assistance opportunities, through grants-in-aid and contracts, to the health science information,biomedical communication, and medical informaticscommunities. Awards have assisted authors and schol-ars, researchers and academicians, librarians andmedia experts, computer scientists and linguists, andinformation network and systems architects; collective-ly their global objectives have helped in the preserva-tion of health knowledge and in the expeditious utiliza-tion of such knowledge. Funded projects range frominformation resource improvement for the libraries ofrural hospitals to historical writings on significant healthtopics to the initial stages of developing integrated aca-demic information management systems with vast im-plications for the basic fabric of how heterogeneous in-formation is accumulated, stored, retrieved and amal-gamated in multi-faceted health conglomerates. Re-gional Medical Library contract activities, also author-ized by the MLAA, are described in the chapter, Li-brary Services and Operations.

The authorizing legislative language of the MLAAhas remained substantially unchanged since the PublicLaw was enacted almost twenty years ago; however,the implementation of this flexible law has consistentlyreflected the juxtaposition of contemporary health sci-ence information needs and the rapidly evolving tech-nologies through which these needs can be best ad-dressed.

Ten years ago this report described the ExtramuralProgram interests and provided examples of the year'saccomplishments for the $7.6 million expended underthe MLAA authorities. It is noted that the only explicitstatement relative to automation technology in the FY1974 report—indeed the only use of the word "com-puter"—is in the descriptive sentence, "Several groups

of investigators, with NLM support, have been testing,developing, and demonstrating the use of the computerin automating various library activities. . . . " A decadelater, the current report also describes grant programmechanisms and examples of MLAA awards for the$7.5 million obligated during the year, but closer ex-amination of the context of this support reveals a quitedifferent dynamic. In FY 1984, more than 67% of thegrant dollars expended were for activities directly de-pendent on the availability and the capability of thecomputer.

MLAA sponsored research, the initially disappoint-ing weak link of the 1965 Law's provisions (accordingto a 1971 analysis by NLM Director Cummings) hascome of age through opportunities afforded by com-puter technologies; the same, forward-looking objec-tive of the 1974 awards for "testing, developing anddemonstrating the use of the computer in automatingvarious library activities" has become the prerequisitefor this generation's new Resource Grant Initiative (seelAIMs); and NLM's new 1984 training awards nowfocus exclusively on advanced training of promisingpost-doctoral scientists for research careers in medicalinformatics (computers-in-medicine). Given the perva-siveness of the computer, it would be unusual if thesetrends were any less evident in the descriptive data forrecent NLM assistance awards. It is said, however, that"the mode by which the inevitable comes to pass iseffort" and less directive effort on NLM's part mighthave cast a somewhat different FY 1984 ExtramuralPrograms report.

MLAA appropriations for fiscal years 1974 and1984 were almost identical. Even though some of theintervening years provided larger spending levels, theannual average for MLAA funds for the decade wasless than $8.25 million. In addition, since FY 1981 theExtramural Programs have operated on a year to yearreauthorization provided by annual appropriation acts

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rather than by specific multi-year renewals of theMLAA Public Law. In regard to the recent years' ap-propriation levels, as well as postponements of theMLAA renewal, it should be noted that in neither in-stance were actions, or lack of actions, in any way at-tributable to concerns about the progress, results, orcontinued need of the MLAA programs. As is often thecase with complex, omnibus legislative bills, involvingappropriations and statutory authorities for a number ofbureaus and institutes, final action on noncontroversialparts of the bills depend on resolution of the whole.

Currently, a 3-year extension of the MLAA au-thorities is pending joint congressional committeeaction and the proposed authorization levels, if real-ized, would provide the initial steps toward an im-proved extramural assistance operation.

Research Grants

Ever expanding medical knowledge and changingdimensions of health care delivery raise challengingquestions about managing health information effective-ly. Scientific investigations of these questions are spon-sored by NLM's research awards. This research attractsworkers in many disciplines. The questions studied in-clude the organization of medical knowledge, econom-ic and social issues of information service, analyses ofmedical bibliography as a mirror of scientific activity,and assessments of the scientific literature in terms ofits validity and reliability.

At Mount Sinai School of Medicine in New YorkCity, for example, reports of controlled clinical trialsare analyzed to determine how valid the trial proce-dures are. The published trial reports are also com-pared against those which have not been published tosee whether they reflect different scientific methods.The long-term goal is to derive standards for clinicaltrial reports which investigators, their sponsors, andscientific journal editors will find helpful.

At Case Western Reserve University in Cleveland,the usage of medical libraries has been surveyed in astudy which combines usage statistics with data on in-formation service costs. The study results are comple-mented by a similar assessment of information eco-nomics in general academic libraries, sponsored by theNational Science Foundation.

Within recent years, exciting advances in the com-puter sciences, together with new discoveries in thecognitive, behavioral, and linguistic sciences, suggestinnovative possibilities for bringing relevant knowledgedirectly to bear on clinical activities. In 1978, the Na-tional Library of Medicine convened a distinguishedtask force to consider these developments as a possibleresearch focus. The task force recommendations led toa research program initiative entitled "medical informa-tics." Over a 5-year period, it has been possible to

support fundamental studies on computerized reason-ing via artificial intelligence, on the nature of clinicalthought processes in medical decision-making, and onthe attributes of medical language. Related studies con-cern retrieval of information from graphic images andmathematical models of medical problem-solving. Ex-amples of the broad scope of medical informaticsprojects follow.

At Stanford University, research into computerizedrepresentation of medical knowledge has yielded acomputer program that represents and assesses treat-ment planning for cancer patients.

At Latter Day Saints Hospital in Salt Lake City,computer-based logic is being studied for diagnosis andtreatment of coronary artery disease. The resulting pro-gram will be available to practitioners through a localcomputerized hospital information system.

Growing interest in medical informatics as a re-search field is one indication of the program's success,but the challenging issues involved require additionalexperienced investigators. This program uses differentkinds of grants to foster career growth in medical infor-matics. Besides the usual investigator-initiated researchgrants, there are New Investigator Research Awardsand Research Career Development Awards for promis-ing younger scientists. The program stresses fundamen-tal work on utilization of knowledge, but the researchsupported must necessarily take place in a health con-text. Where appropriate, NLM collaborates with otherFederal programs, at NIH and elsewhere, to supportresearch projects of mutual interest.

Recent publications resulting from NLM grant sup-port are included in Appendix 2.

Medical Library Resource Grants

The objective of this grant program is to assisthealth science libraries by increasing their resourcesand expanding their service capabilities. Medical Li-brary Resource Grants are of two types: The ResourceImprovement Grant assists single institutions and con-sortia in developing basic collections. The ResourceProject Grant is directed toward established health sci-ence libraries and enables them to undertake new serv-ices or expand existing ones. Libraries of various orga-nizations involved in health education, research, andpatient care are eligible to apply.

In FY 1984, 16 new Resource ImprovementGrants were awarded; seven were to single institutionsand nine to consortia serving some 66 members.

Among the nine Resource Project Grants awardedin FY 1984, two were for statewide networks and onefor a local network. Computer-based information sys-tems will be installed in the medical libraries of theMedical University of South Carolina and the Universi-

36

Extramural Grants and Contracts

ty of South Carolina. In subsequent years the systemwill be extended to the libraries of the Area HealthEducation Centers and to other library consortiathroughout the state of South Carolina. In the State ofWashington, a coordinator will assist in developinghealth sciences libraries and in creating a statewidenetwork. Such a network will strengthen resources andservices in existing libraries and will provide newaccess points to health information for currently un-served health professionals. A grant to the library ofCornell University Medical College in New York Citywill support the installation of a computer-based libraryinformation system. In the second year, the system willbe extended to three affiliated hospital libraries.

Two grants have been made to permit health sci-ence libraries to provide audiovisual services. At Mai-monides Medical Center in Brooklyn, Resource ProjectGrant funds will establish a learning resource centerwithin the library. In northern Maine, a regionallyshared audiovisual collection will be established to ac-commodate the continuing education and inservicetraining needs in seven small hospitals in AroostookCounty.

Two institutions will be introducing new servicesto patrons which go beyond the traditional libraryroles. A Resource Project Grant awarded to the Uni-versity of Maryland in Baltimore will assist in providingfaculty with direct access to reference, online searches,photocopy, and interlibrary loan services via an elec-tronic mail link with the Health Sciences Library. At theDahlgren Memorial Library of Georgetown UniversityMedical Center, a Library Computer Information Serv-ice will be established to provide a learning laboratoryenvironment where students, faculty, and staff mayobtain guidance in the use of microcomputers and indatabase development.

Two Resource Project Grants will assist in thepreservation and organization of special collections.Ross A. McFarland is considered one of the foundingfathers of the study of human factors in aviation. Hispersonal collection in aerospace medicine and humanfactors engineering, held at Wright State University,Dayton, Ohio, will be made available to the scholarlycommunity. W. Horsley Gantt was the only Americanto have studied with Pavlov for an extended period.He then pioneered Pavlovian theory and methodologyin the United States. The objective of this grant is topreserve and organize his papers so that they will beaccessible to historical scholars, clinicians, and medicalscientists.

IAIMS Programs. The NLM-supported study by theAssociation of American Medical Colleges, "AcademicInformation in the Academic Health Sciences Center:Roles for the Library in Information Management,"

identified the need for academic health sciences cen-ters and hospitals to take immediate steps to use newinformation technologies to facilitate the flow of re-corded biomedical knowledge throughout the institu-tion in as direct and useful a form as possible. Thestudy recommended the development of prototypenetwork systems as well as programs that encouragethe rapid integration of information technologies in thelearning and practice of the health professions.

In response to the study's recommendations, NLMlaunched a program to support the development of In-tegrated Academic Information Management Systems(IAIMS). The IAIMS concept is to use computer andcommunications technologies to bring together oper-ational and academic information in support of healthresearch, education, patient care, and management.NLM's foremost activity in this area is support of stra-tegic planning for the development of integrated infor-mation systems in academic health science centers.The next phases in sequence are to develop models inwhich IAIMS concepts resulting from the plan aretested on a small scale, followed by the implementa-tion phase of full-scale development based on success-ful modelling of critical plan elements.

NLM's initial response to the AAMC report was tosolicit proposals for IAIMS strategic planning activity inaccord with specific steps recommended in the report.In September 1983, contracts were awarded for IAIMSplanning to Columbia University, Georgetown Universi-ty, the University of Maryland, and the University ofUtah. These contractors, guided by NLM's contract re-quirements and and specifications, began the strategicplanning process for health sciences information man-agement through a series of self-studies to assess thetechnological capabilities, potentials, and needs of theirown institutions and to define the academic informa-tion management system accordingly. These contractswill end in June 1985. Another IAIMS planning con-tract was awarded in January 1984 to the OregonHealth Sciences University in response to congressionalinterest stimulated by the AAMC report and by a per-ceived need to test the IAIMS concept in the state ofOregon.

NLM subsequently announced the availability ofIAIMS grants as a part of the Medical Library ResourceProject Grant program for FY 1984. Utilizing the grantmechanism for support recognizes the advantages ofsupporting IAIMS planning operations which are institu-tionally unique and therefore institution-initiated. Thefirst two awards under the IAIMS grant program weremade in June 1984 to the University of CincinnatiMedical Center and the Baylor College of Medicine.

37


Training ProgramResearch issues in the health information and

health computer sciences call for highly trained, cre-ative talent, able to articulate medicine with computersand health care with information science. There is aparticular need in academic medicine for a new disci-pline—health information or health computer science.Through its training program, NLM provides grants forresearch career training in this field of medical informa-tics.

In 1984, five awards were made in this newHealth Computer Sciences Research Training program.Each site offers an excellent setting for didactic instruc-tion; involvement in major, ongoing health computerscience studies; and opportunities for work in ad-vanced information science research. Subsequent totheir training period, these newly trained investigatorswill contribute to the growth of science by their studiesof the role of knowledge in professional life, by analy-ses of the social structures for managing knowledge,and by advancing the frontiers of the computer sci-ences for organizing, retrieving, and utilizing healthknowledge. Twenty-two postdoctoral trainees are au-thorized for this year.

The five training sites and Directors are:

Marsden S. Blois M.D., Ph.D.University of California, San FranciscoSchool of MedicineSan Francisco, CA94143

Lael Gatewood, Ph.D.University of MinnesotaSchool of MedicineMinneapolis, MN 55455

Robert R. Greenes, M.D., Ph.D.School of Public HealthHarvard UniversityBoston, MA 02115

Stephen G. Pauker, M.D.Tufts-New England

Medical Center HospitalBoston, MA 02111

Edward H. Shortliffe, MD., Ph.D.Stanford UniversitySchool of MedicineStanford, CA 94305

Publication GrantsBiomedical scientific publication grants facilitate

the dissemination of health information important tomedical progress. The domestic Publication Grant Pro-gram provides selective support for not-for-profit bio-medical publications, including critical reviews and

monographs in health fields; publications in library andinformation science and in biomedical communication;temporary support for periodical publications; studiesin the history of medicine; translations of current for-eign biomedical monographs; proceedings of symposiarelated to U.S. health needs; and secondary literaturetools in the health sciences (such as annotated bibliog-raphies, catalogs, and atlases).

Together with its complementary activity, the Spe-cial Foreign Currency Program, the Publication GrantProgram assists the advancement of the medical sci-ences and aids in the dissemination and exchange ofscientific and other information important to theprogress of medicine and health.

During FY 1984, 20 publication grants wereawarded, totaling $623,151. Of these, 9 were newawards, including one for a comprehensive inventoryby the American Hospital Associationof machine-read-able data files containing U.S. health care data since1970. The continuing emphasis in this program uponhigh-quality, but low-cost, projects that are scheduledfor early publication was reflected in the averageamount of a publication grant in FY 1984—approxi-mately $23,000 in direct costs.

Among the 25 studies received in FY 1984* whichhad been supported earlier by the Publication GrantProgram was a monograph on Simulation of InfectiousDisease Epidemics, by Eugene Ackerman, Lila R. Elve-back and John P. Fox (Springfield, Illinois: Charles C.Thomas, 1984), in which the authors present mathe-matical models for examining the behavior of patho-genic agents in human populations. Their study is ex-pected to contribute to the improvement of the publichealth control of infectious diseases. Another significantvolume published this year is a reference source for re-searchers of craniofacial development, depicting themammalian species most widely used in medical re-search: The Postnatal Development of the Rat Skull,by Melvyn J. Baer, James F. Bosma, and James L. Ack-erman (Ann Arbor, Michigan: The University of Michi-gan Press, 1983). Also completed this year with grantsupport was a historical study on Morgagni (1682-1771), recognized as one of the founders of modernpathology. This collection of the records of one hun-dred of his most interesting consultations makes avail-able for the first time in English an important resourcein the history of clinical medicine: The Clinical Consul-tations of Ciambattista Morgagni: The Edition ofEnrico Benassi (1935). Translated and Revised by Saul

•See Appendix 2 for a complete listing of books, periodi-cals and journal articles received in FY 1984 resulting fromNLM Extramural Program Grants and Special Foreign Curren-cy Awards.

38

Extramural Grants and Contracts

Jarcho, with new preface and supplements. (Boston:The Francis A. Countway Library of Medicine, 1984.)

Special Foreign Currency Program

Authorized originally under Public Law 480, theSpecial Foreign Currency Program is today a valuablesupplement to the domestic Publication Grant Programin the preparation and publication of biomedical stud-ies useful to the U.S. health professions. The oldest ofthe Library's extramural support activities, the P.L. 480Program is not funded in U.S. dollars, but with U.S.-owned foreign currencies which accrue in certaincountries abroad from the sale of surplus U.S. agricul-tural products. During FY 1984, NLM's Special ForeignCurrency Program funded projects in Poland, Yugo-slavia, Egypt, India, and Pakistan.

Administered jointly with the Publication GrantProgram by the International Programs Branch, the P.L.480 Program in FY 1984 sponsored 68 active projects,totaling $1,084,939 U.S. equivalent dollars. Almost 60percent of the program was carried out in India, about25 percent in Poland and the remaining projects inEgypt, Israel, Pakistan, and Yugoslavia.

About half of the awards supported the prepara-tion of scholarly research monographs and the transla-tion and publication of classics in the history of medi-cine. Another fourth of the program funded the prepa-ration and publication of critical reviews and biomedi-cal monographs identifying the status of research andpractice in various health fields and emerging trends

Table 12Extramural Grant and Contract Programs

for future developments. The program also supportedthe translation and publication of current foreign lan-guage biomedical studies, as well as several bibliogra-phies.

Among the other new projects activated in thePublic Law 480 Program in FY 1984 was the publica-tion of an English-language translation of Kharitonovaand Leonov's Omsk Hemorrhagic Fever, a Russianstudy described as a "benchmark work" in the identifi-cation of Omsk hemorrhagic fever as a waterborne in-fectious agent. The use of P.L. 480 funding for theprinting costs of two significant historical translations,prepared by eminent U.S. scholars under the Publica-tion Grant Program, extended the resources for NLM'sscientific publication activities: Johannes Mueller andthe Nineteenth-Century Origins of Tumor CellTheory, edited and translated by Dr. L.J. Rather; andVincenzo Chiarugi, On Insanity and Its Classification,translated and edited by Dr. George Mora.

Among the books received in FY 1984 were acritical review by the late Polish hematologist, Dr.Maria Wazewska-Czyzewska, on Erythrokinetics, asurvey of the quantitative, dynamic study of in vivoproduction and destruction of erythrocytes; Boris E.Kotliar's Neural Mechanism of Conditioning, translat-ed in Tunisia and published in Yugoslavia; and K.V. Su-dakov's Emotional Stress and Hypertension, a reviewof the relationship between emotional stress reactionsand cardiovascular disorders, with particular referenceto hypertension.

Category

Total

FY 7982 FY 1983 FY 1984

ResearchResource ProjectsResource ImprovementTrainingSpecial Scientific Projects . .Regional Medical Libraries (contracts)Publications. .

(31)(14)(25)( 9)( 2)( 9)(20)

$2,574520551930

222,399

504

(29)(11)(29)( 9)( 1)( 7)(19)

$2,782575636733

342,300

440

(29)(16)(22)

(9)

( 7)(20)

$2,399•1,114

614786

2,000587

(110) $7,500 (105) $7,500 (103) $7,500

Note: Figures in parentheses refer to number of projects.•Includes IAIMS Projects (2) $134

39

INTERNATIONAL PROGRAMSCalvin H. Plimpton, M.D.Special Assistant for International Programs

The International programs of the National Libraryof Medicine are a natural extension of NLM's domesticresponsibilities and illustrate the impact of a nationalresource on international communications.

International MEDLARS AgreementsThe National Library of Medicine currently has

MEDLARS agreements with partners in 13 foreigncountries and with the Pan American Health Organiza-tion in Brazil (BIREME). (See Table 13.) A technicalmeeting followed by an International MEDLARS PolicyAdvisory Group (IMPAG) meeting will be held in Be-thesda, Maryland in November 1984. Major topics tobe discussed are progress in MEDLARS III (the NationalLibrary of Medicine's third major automation improve-ment and development program), pricing of NLM serv-ices, downloading and vending, future trends vis-a-visfile merging, impact of electronic publishing, quality fil-ters and other output options, and scope and coveragein relation to other databases.

Collaboration with the Chinese Academyof Medical Sciences

The Chinese Academy of Medical Sciences, Insti-tute of Medical Information, continues to show in-creased interest in setting up a MEDLARS Center in thePeople's Republic of China. Attempts are being madethrough correspondence to arrange proper computercompatibility with NLM. In the interim, NLM continuesto provide Selective Dissemination of Information (SDI)searches to the Chinese Academy of Medical Sciences.It is hoped all problems will be resolved in the nearfuture so that NLM may begin to send MEDLARStapes.

Collaboration with IndiaIndia has shown an interest in sharing advances in

science and technology. As a result, the NLM sent a

delegation of three to India in February to discuss thepossibility of setting up a MEDLARS Center in NewDelhi. It was agreed by the NLM and the Indian Coun-cil of Medical Research and the National PlanningCommission that the main base of the service shouldbe in the National Informatics Center with terminals atthe National Medical Library as well as other locationsto be later designated. Negotiations between NLM andthe various Indian agencies are underway.

Collaboration with the World HealthOrganization

The National Library of Medicine and the WorldHealth Organization Special Program for Research andTraining in Tropical Diseases continued to cooperate inthe publication of the Quarterly Bibliography of MajorTropical Diseases. NLM prepares camera-ready copywhich WHO prints and distributes to 6,000 institutionsin the developing countries. The bibliography is pre-pared from the MEDLINE system and covers diseasesidentified by WHO for special attention—filariasis,leishmaniasis, leprosy, malaria, schistosomiasis, andtrypanosomiasis.

NLM has begun its third year of collaboration withthe WHO programs for control of diarrhea! diseases topublish a recurring Bibliography of Acute Diarrhea/Diseases. The same arrangement, whereby NLM pro-duces camera-ready copy from MEDLINE and WHOprints and distributes the publication, is used for bothrecurring bibliographies.

NLM and WHO continued the collaborative ar-rangement to provide photocopies of journal articles torequesters in developing countries of the WHO Re-gions of Africa, Eastern Mediterranean, and South EastAsia. Under the arrangement, WHO supports one indi-vidual who is in residence at NLM to provide this serv-ice. The activity is essential but it can only respondpartially to the existing biomedical and health informa-

41


tion needs of developing countries. Some 18,000 pho-tocopies of articles have been provided to developingcountries since this arrangement began October 1,1979.

Collaboration with the Pan AmericanHealth Organization

The National Library of Medicine and the PanAmerican Health Organization continued to cooperateto publish a recurring Bibliography of Respiratory In-fections in Children. This bibliography is drawn fromthe contents of the MEDLINE system with NLM provid-ing PAHO with camera-ready copy which PAHOprints and distributes.

International Visitors

In FY 1984, the National Library of Medicine re-ceived international visitors from Austria, Australia,Benin, Brazil, Bulgaria, Canada, People's Republic of

Table 13Non-U.S. MEDLARS Centers

China, Republic of China, Colombia, Costa Rica,Cyprus, Denmark, Egypt, Finland, France, Germany,Guyana, Guatemala, Haiti, Honduras, India, Indonesia,Italy, Jamaica, Japan, Korea, Lebanon, Nigeria, Roma-nia, Saudi Arabia, Spain, Sweden, Switzerland, Tunisia,Turkey, Yugoslavia, United Kingdom, and Venezuela.The visitors represented developed and developingcountries throughout the world and were provided de-tailed discussions by NLM staff on activities of mutualinterest. Formal delegations were received from Ger-many, Japan, Romania, People's Republic of China,France, Saudi Arabia and Italy. Topics of general inter-est included biomedical and health information pro-grams, medical research and education, library science,setting up new libraries, and research and develop-ment.

In addition, the National Library of Medicine pro-vided specialized training to several individuals fromvarious countries during the past year.

Tapes Tapes/software Online NLM

GermanyJapanSwitzerland

AustraliaPAHOSwedenFrance*

CanadaColombiaItalyKuwaitMexicoSouth AfricaUnited Kingdom

•Online NLM also

42

APPENDIX 1: STAFF BIBLIOGRAPHY

The following works were published by National Li-brary of Medicine staff in FY 1984:

Benson, D.A., Gottlieb, A., and Vasta, B.M.:Microcomputer-based information workstation (ab-stract). American Chemical Society Abstracts Bulletin36(1): 14, 1984.

Bernstein, L.M., Siegel, E.R., and Sneiderman,C.A.: Computer retrieval and analysis of gastroenterol-ogy literature. Frontiers of Gastrointestinal Research 7:147-185, 1984.

Bernstein, L.M. and Williamson, R.E.:Testing of anatural language retrieval system for a full text knowl-edge base, journal of the American Society for Infor-mation Science 35(4): 235-247, 1984.

Burnside, J., Craig, P.M., and Cuthrie, G.T.: NLM-CHEMSORT: an algorithm and computer program forsorting chemical names. Journal of Chemical Informa-tion and Computer Sciences 24(1): 39-41, 1984.

Cassedy, J.H.: American Medicine and StatisticalThinking, 7600-7560. Cambridge, Mass., HarvardUniversity Press, 1984, 306 pp.

Cassedy, J.H.: Highlights in the Development ofMedical History in the United States: Materials froman Exhibit. Bethesda, Md., National Library of Medi-cine, 1984, 30 pp.

Cassedy, J.H.: Review of This Land, This South:An Environmental History by Albert E. Cowdrey. Bul-letin of the History of Medicine 58(3): 444-445,1984.

Colaianni, L.: Administration of personnel. In Brad-ley, J., (Ed.): Hospital Library Management. Chicago,III., Medical Library Association, 1983, pp. 229-243.

Colaianni, L.: President's page, Phyllis S. Mirsky,1984/85. Bulletin of the Medical Library Association.72(3): 316-318, 1984.

Cookson, ).: A demonstration database for docu-ment images. In Andre Duerinckx, et al. (Eds.): Pro-ceedings of the IEEE Computer Society International

Symposium on Medical Images and Icons. SilverSpring, Md., IEEE Computer Society Press, 1984, pp.30-38.

Craig, P.N.: QSAR-origins and present status: anhistorical perspective. Drug Information Journal 18:123-130, 1984.

Doszkocs, T.E.: Automatic vocabulary mapping inonline searching. International Classification 10(2):78-83, 1983.

Doszkocs, T.E.: CITE NLM: natural-languagesearching in an online catalog. Information Technolo-gy 2(4): 364-80, 1983.

Friedman, R.B.: The academic medical center.Journal of Medical Education 59: 539-546, 1984.

Friedman, R.B.: Myths about computers and medi-cine. Cornell University Medical College AlumniQuarterly 47(2): 2-10, September 1984.

Friedman, R.B.: Selecting a personal computer.MEDCOMP 1(1): 60-71, 1983.

Friedman, R.B., Entine, S., Carbone, P.: Experiencewith an automated cancer protocol surveillancesystem. American Journal of Clinical Oncology 6:583-592, 1983.

Goldstein, C.M.: Computer-based information stor-age technologies. Annual Review of Information Sci-ence and Technology (ARIST) 19: 65-96, 1984.

Goldstein, CM.: Storage technology: present andfuture. Microcomputers for Information Management:An International Journal for Library and InformationService 1(2): 79-94, 1984.

Humphrey, S.M.: Current awareness in biomedicalcomputing by searching MEDLINE at NLM. SICBIONewsletter 6(4): 21-32, 1984.

Humphrey, S.M.: File maintenance of MeSH head-ings in MEDLINE. Journal of the American Society forInformation Science 35(1): 34-44, 1984.

43


Humphreys, B.L. Cataloging: general consider-ations and descriptive cataloging. In Darling, L,Bishop, D., and Colaianni, L.A. (Eds.): Handbook ofMedical Library Practice, Fourth Edition, Vol. II. Chica-go, III., Medical Library Association, 1983, pp. 183-251.

Kenton, D.: The development of a more equitablemethod of billing for online services. Online 8(5): 13-17, 1984.

Krivatsy, P.: Medical Incunabula and the Diffu-sion of Scientific Knowledge: Incunabula in the Na-tional Library of Medicine. Bethesda, Md., National Li-brary of Medicine, 1984, 14 pp.

Locatis, C. and Atkinson, F.: Media and Technolo-gy for Education and Training. Columbus, Ohio,Charles E. Merrill, 1984.

McHale, C.C.: MEDOC: index to U.S. Govern-ment publications in the medical and health sciences.Microform Review 12(4): 289-90, 1983.

Mehnert, R.B.: National Library of Medicine. InEhresman, j. (Ed.): The Bowker Annual of Library &Book Trade Information. New York, R.R. Bowker,1984, pp. 135-138.

Merriam, M.S. and Thoma, G.R.: An interactivevideodisc for visitor information. In Williams, M.E. andThomas, H.H. (Comps.): Proceedings of the Fifth Na-tional Online Meeting, New York, April 10-12, 1984.Medford, N.J., Learned Information, Inc., 1984, pp.195-206.

Page, N.P. and Kissman, H.M.: On-line sourcesfor toxicology and safety data. In Bennett, G. and Ber-nard, H. (Eds.): Proceedings of the National Confer-ence and Exhibition on Hazardous Wastes and Envi-ronmental Emergencies (Toxicology & Health), Hous-ton, Texas March 12-14, 1984. Silver Spring, Md.,Hazardous Materials Control Research Institute, 1984,pp. 409-412.

Parascandola, J.: John j. Abel and the founding ofASPET. The Pharmacologist 26: 37-40, 1984.

Parascandola, J.: Review of A Bio-Bibliography forthe History of Biochemical Sciences Since 1800 byJoseph S. Fruton. Bulletin of the History of Medicine58: 281, 1984.

Parascandola, J.: Review of History of ClinicalChemistry by Johannes Buttner. Pharmacy in History26: 163-164, 1984.

Pomeroy, E. and Toothman, JP: Medical Applica-tions Microcomputer Software. Springfield, Va., Na-tional Technical Information Service, 1983, 22 pp.

Pomeroy, E. and Toothman, JP: Videodisc andMedical Education. Springfield, Va., National TechnicalInformation Service, 1983, 8 pp.

Price, D.: Video Bulletin Board: A MicrocomputerBased Information Distribution System. Springfield,Va., National Technical Information Service, 1984, 34PP-

Schoolman, H.M.: Overwhelmed and underpre-pared: the clinician and medical information. Update:Computers in Medicine 2(4): 20-23, 1984.

Siegel, E.R., Kameen, K., Sinn, S.K., and Weise,F.O.: A comparative evaluation of the technical per-formance and user acceptance of two prototype onlinecatalog systems. Information Technology and Libraries3(1): 35-46, 1984.

Smith, K.A.: National Library of Medicine. ALAYearbook 8:188, 1983.

Smith, K.A.: Review of The Information Dilemmaby Harry M. Kibirige. FLC Newsletter, pp. 6-7, August1984.

Sneiderman, C.A.: Keeping up with the literatureof family practice: a bibliometric approach. FamilyPractice Research Journal 3: 12-23, 1983.

Sparks, S.M.: Computerized access to clinicalnursing literature on AIDS. Topics in Clinical Nursing6(2): 79-82, July 1984.

Sparks, S.M.: The National Library of Medicine'sbibliographic databases: tools for nursing research.Image: The Journal of Nursing Scholarship 16(1): 24-27, 1984.

Suthasinekul, S.: Making information computer ac-cessible: why and how? In Proceedings of the 2ndAnnual Conference of the American Association forMedical Systems and Informatics, Baltimore, Md., Oc-tober 21-23, 1983, pp. 184-186.

Suthasinekul, S., Walker, F.L., Cookson, J., Rashi-dian, M., Thoma, G.R.: A prototype system for elec-tronic document image storage and retrieval. In Pro-ceedings of the 1st International Electronic ImagingExposition and Conference, Boston, Mass., September10-13, 1984, pp. 174-177.

Thoma, G.R., Grier, R., Merriam, S., and Leonard,W.: Videodisc Premastering Facility: Technical Evalua-tion Springfield, Va., National Technical InformationService, 1984, 145 pp.

Thoma, G.R.: Premastering: a critical step in vid-eodisc development. Proceeding of the American So-ciety for Information Science 20: 41-47, 1983.

Toothman, JP and Sylver, S.: Design of interactivevideo computer-assisted instruction. In Proceedings of

44

Staff Bibliography

the American Association for Medical Systems and In-formatics 1984 pp. 255-257.

Vasta, B.M. and Kissman, H.M.: Toxicology DataBank (TDB)—peer review augmentation via computerconferencing (abstract). American Chemical SocietyAbstracts Bulletin 36(1): 13, 1984.

Walker, F.L. and Thoma, F.R.: An experimentalsystem to link citation retrieval to document image dis-play. Proceedings of the 23rd Annual Technical Sym-posium of the Washington, D. C. Chapter of the Asso-ciation for Computing Machinery, June 28, 1984, pp.D.3.1—12.

Waserman, M.: An important John Shaw Billingsfind. Bulletin of the Medical Library Association 72%;23-25, 1984.

Waserman, M. and Clausen, C.: Index to Bulletinof the History of Medicine, T933-1982, Baltimore,Md., Johns Hopkins University Press, 1983, 195 pp.

Waserman, M.: Review of A Catalogue of theManuscripts and Archives of the Library of the Col-lege of Physicians of Philadelphia by Rudolf Hirsch(Ed.) Transactions and Studies of the College of Physi-cians of Philadelphia. Series V(5): 385-387, 1983.

Waserman, M: Review of Quetzalcoatl and theIrony of Empire: Myths and Prophecies in the AztecTradition by David Carrasco.Journal of the History ofMedicine and Allied Sciences 38: 481, 1983.

Williamson, E.: ANNOD: A Navigator of NaturalLanguage Organized Textual Data. Bethesda, Md.,Knowledge Systems, Inc., 1984, 30 pp.

Williamson, E.: Experience with and Plans for Ex-tending an Interactive Text Management System. Be-thesda, Md., Knowledge Systems, Inc., 1984.

Woods, J.W.: Optical videodiscs and computers inlife science education. Computers in Life Science Edu-cation 1(4): 25-28, 1984.

45

APPENDIX 2: SUPPORTED PUBLICATIONS*

Ackerman, D.L., et al.: The Lithium Index: An in-novative approach to consultation by computer. Amer-ican Journal of Psychiatry 141:415-417, 1984.

Ackerman, E., Elveback, L.R. and Fox, J.P.: Simu-lation of Infectious Disease Epidemics. Springfield, Illi-nois, Charles C. Thomas, 1984, 202 pp.

Ackerman, E.B.: Medical care in the countrysidenear Paris, 1800-1914. Annals of the New YorkAcademy of Sciences 412: 1-18, 1983.

An Atlas of Ixodid Tick Ultrastructure. Edited byYu. S. Balashov, Zoological Institute, USSR Academy ofSciences, Nauka Publishers, Leningrad Department,Leningrad, 1979. Translated by Alexander S. Raikhel.English Publication Edited by Alexander S. Raikhel andHarry Hoogstraal. College Park, Maryland, Entomologi-cal Society of America, 1982, 289 pp.

Baer, M.J., Bosma, J.F. and Ackerman, J.L.: ThePostnatal Development of the Rat Skull. Ann Arbor,Michigan, The University of Michigan Press, 1983, 432PP.

Bauer, T.W., et al.: Prognostic factors in patientswith Stage 1, estrogen receptor-negative carcinoma ofthe breast: A clinicopathologic study. Cancer 52:1423-1431, 1983.

Beck, J.R. and Pauker, S.C.: The Markov processin medical prognosis. Medical Decision Making 3:419-458, 1983.

Blum, R.L.: Discovery, confirmation, and incorpo-ration of causal relationships from a large time-orientedclinical data base: The RX Project. Computers and Bio-medical Research 15: 164-187, 1982.

Bowden, V.M., Comeaux, E.A. and Eakin, D.:Evaluation of the TALON Cooperative AcquisitionsProgram for Monographs. Bulletin of the Medical Li-brary Association 72: 241-250, 1984.

•Includes 1983/84 supported publications and publishedworks resulting from research grants (not previously listed).

Boyce, B.R., et al.: A drill and practice programfor online retrieval. Journal of the American Societyfor Information Science 35: 129-134, 1984.

Brandon, D.: SAVE Consortium: Audio VisualCatalog 1984. Schenectady, N.Y., Ellis Hospital, 1984,170 pp.

Chalmers, T.C., et al.: Bias in treatment assignmentin controlled clinical trials. The New England Journalof Medicine 309: 1358-1361, 1983.

Chi, E.C., et al.: Relational data base modelling offree-text medical narrative. Medical Informatics 8:209-223, 1983.

Cleveland, D.B. and Cleveland, A.D.: Depth of in-dexing using a non-Boolean searching model. Interna-tional Forum on Information and Documentation 8:10-13, 1983.

Cleveland, D.B., Cleveland, A.D. and Wise, O.B.:Less than full-text indexing using a non-Boolean search-ing model. Journal of the American Society for Infor-mation Science 35: 19-28, 1984.

The Clinical Consultations of Ciambattista Mor-gagni: The Edition of Enrico Benassi (1935). Translatedand Revised by Saul Jarcho, with new preface and sup-plements. Boston, The Francis A. Countway Library ofMedicine, 1984, 450 pp. (Distributed by the UniversityPress of Virginia, Charlottesville).

De la Monte, S.M., Moore, C.W. and Hutchins,G.M.: Patterned distribution of metastases from malig-nant melanoma in humans. Cancer Research 43:3427-3433, 1983.

: Nonrandom distribution of metastases inneuroblastic tumors: Cancer 52: 915-925, 1983.

: Endocrine organ metastases from breastcarcinoma. American Journal of Pathology 114: 131-136, 1984.

: Estrogen and progesterone receptors inprediction of metastatic behavior of breast carcinoma.The American Journal of Medicine 76: 11-17, 1984.

46

Supported Publications

De la Monte, S.M., et al.: Midzonal necrosis as apattern of hepatocellular injury after shock. Castroen-terologyB6: 627-631, 1984.

Detweiler, O.K.: Electrocardiographic monitoringin toxicological studies: Principles and interpretations.In: Spitzer, J.J.(Ed.) Myocardial Injury. N.Y., PlenumPublishing Corporation, 1983, pp. 579-606.

Doe, Janet: Interview by Estelle Brodman, 20 July1977. Oral history interview, Medical Library Associa-tion, Chicago.

Doubilet, P. and Abrams, H.L.: The cost of under-utilization: Percutaneous transluminal angioplasty forperipheral vascular disease. New England Journal ofMedicine 310: 95-102, 1984.

Duda, R.O. and Shortliffe, E.H.: Expert sytems re-search. Science 220: 261-268, 1983.

Elstein, A.S., et al.: Medical decisions in perspec-tive: Applied research in cognitive psychology. Per-spectives in Biology and Medicine 26: 486-501,1983.

First, M.B., et al.: LOCALIZE: Computer-assistedlocalization of peripheral nervous system lesions. Com-puters and Biomedical Research 15: 525-543, 1982.

Friedman, C, et al.: Computer structuring of free-text patient data. In: Dayhoff, R. E. (Ed.) Proceedingsof the Seventh Annual Symposium on Computer Ap-plications in Medical Care. Silver Spring, Maryland,IEEE Computer Society, 1983, pp. 688-691.

Grishman, R., Hirschman, L. and Friedman, C.:Natural language interfaces using limited semantic in-formation. In: Horecky, J. (Ed.) Proceedings of theNinth International Conference on ComputationalLinguistics. New York, North-Holland Publishing Co.,1982, pp. 89-94.

: Isolating domain dependencies in naturallanguage interfaces. In: Proceedings of the Conferenceon Applied Natural Language Processing. SantaMonica, California, 1983, pp. 46-53.

Hall, T.S.: Spallanzani on matter and life: Withnotes on the influence of Descartes. In: Bernard), W.and La Vergata, A. (Eds.) Lazzaro Spallanzani e la Bio-logia del Settecento. Florence, Leo S. Olschki, 1982,pp. 67-82.

: Critical notes on the neurology and neur-oembryology of Rene Descartes: 1596-1650. In:Cowan, W.M., Studies in Developmental Neurobio-logy: Essays in Honor of Viktor Hamburger. N.Y.,Oxford University Press, 1981, pp. 436-445.

Hannaway, C.C.: The regulation of remedies ineighteenth century France. Histoire Des Sciences Me-dicates XVII: 265-269, 1982.

Hirschman, L. and Sager, N. Automatic informa-tion formatting of a medical sublanguage. In: Kittredge,R. and Lehrberger, J. (Eds.) Sublanguage: Studies ofLanguage in Restricted Semantic Domains. Berlin,Walter de Cruyter & Company, 1982, pp. 27-80.

Holmes, M.M., et al.: Factors affecting laboratoryutilization in clinical practice. Medical DecisionMaking 2; 471-482, 1982.

Holtzman, C.B., et al.: Physicians' judgmentsabout estrogen replacement therapy for menopausalwomen. Obstetrics & Cynecology 63: 303-311, 1984.

Horowitz, C.L., Jackson, J.D. and Bleich, H.L.: Pa-perChase: Self-service bibliographic retrieval. The Jour-nal of the American Medical Association 250: 2494-2499, 1983.

Jefferson, J.W., Creist, J. H. and Ackerman, D.L.:Lithium Encyclopedia for Clinical Practice. Washing-ton, D.C., American Psychiatric Press, Inc., 1983, 319PP-

Jefferson, J.W.: Lithium and affective disorder inthe elderly. Comprehensive Psychiatry 24: 166-178,1983.

Kantor, P.B.: Cost and usage of health sciences li-braries: Economic aspects. Bulletin of the Medical Li-brary Association 72: 274-286, 1984.

Katz, J.: The Silent World of Doctor and Patient.New York, The Free Press, Macmillan, Inc., 1984, 263PP.

Kirschenbaum, D.M.: A compilation of amino acidanalyses of protein. XVIII. Residues per thousand resi-dues—5. Applied Biochemistry and Biotechnology 8:315-368, 1983.

: Molar absorptivity and A "<leni values forproteins at selected wavelengths of the ultraviolet andvisible regions—XXIII. Applied Biochemistry and Bio-technology 9: 187-205, 1984.

Kotliar, B.E.: Weinberger, N.M. (Ed.) NeuralMechanism of Conditioning. Translated in Tunisia.Printed in Belgrade, Yugoslavia by the NOLIT Publish-ing House. Elmsford, N.Y., Pergamon Press, Inc., 1983,248 pp.

Krieg, N.R. (Ed.): Sergey's Manual of SystematicBacteriology, Volume 7. Baltimore, Williams & Wil-kins, 1984, 964pp.

Langlotz, C.P. and Shortliffe, E.H.: Adapting a con-sultation system to critique user plans. InternationalJournal of Man-Machine Studies 19: 479-496, 1983.

Lieber, E.: Galen in Hebrew: The transmission ofGalen's works in the medieval Islamic world. In:Nutton, V. (Ed.) Calen: Problems and Prospects.

47


London, Wellcome Institute of the History of Medicine,1981, pp. 167-186.

:Galen: Physician as philosopher; Maimon-ides: Philosopher as physician. Bulletin of the Historyof Medicine 53: 268-285, 1979.

Lyman, M., et al.: Automated case review of acutebacterial meningitis of ciiildhood. In: van Bemmel, J.H.,Ball, M.J. and Wigertz, O. (Eds.) Proceedings of theFourth World Conference on Medical Informatics,New York, North-Holland Publishing Co., 1983, pp.790-793.

Manning, P.R., et al.: Self-Directed LearningProject. Norris Medical Library, The University ofSouthern California, School of Medicine, November1983, 128pp.

Marcus, R.S.: An experimental comparison of theeffectiveness of computers and humans as search inter-mediaries, journal of the American Society for Infor-mation Science 34: 381-404, 1983.

Marsh, E. and Sager, N.: Analysis and processingof compact text. In: Horecky, J. (Ed.) Proceedings ofthe Ninth International Conference on ComputationalLinguistics. New York, North-Holland Publishing Co.,1982, pp. 201-206.

Marsh, E.: Utilizing domain-specific informationfor processing compact text. In: Proceedings of theConference on Applied Natural Language Processing.Santa Monica, California, 1983, pp. 99-103.

Marshall, Mary Louise: Interview by Estelle Brod-man, September and October 1977. Oral history inter-view, Medical Library Association, Chicago.

McDonnell, P.J., Toye, P.A. and Hutchins, C.M.;Primary pulmonary hypertension and cirrhosis: Arethey related? American Review of Respiratory Disease127:437-441, 1983.

Messer, J., et al.: Association of adrenocorticoster-oid therapy and peptic ulcer disease. The New Eng-land Journal of Medicine 309: 21-24, 1983.

Miller, P.L.: Critiquing anesthetic management:The "ATTENDING" computer system. Anesthesiology58: 362-369, 1983.

: Medical plan-analysis by computer. In:van Bemmel, J.H., Ball, M.J. and Wigertz, O. (Eds.)Proceedings of the Fourth World Conference onMedical Informatics. New York, North-Holland Pub-lishing Co., 1983, pp. 593-596.

: ATTENDING: Critiquing a physician'smanagement plan. IEEE Transactions on Pattern Analy-sis and Machine Intelligence 5: 449-461, 1983.

: A heuristic approach to risk in computer-assisted anesthetic management. In: Proceedings of the

International Symposium on Computers in Anesthesiaand Intensive Care. Rotterdam, 1983, p. 118.

: Critiquing as a modality for computeradvice in medical management and work-up. In: Day-hoff, R.E. (Ed.) Proceedings of the Seventh AnnualSymposium on Computer Applications in MedicalCare. Silver Spring, Maryland, IEEE Computer Society,1983, pp. 842-843.

Miller, P.L., et al.: ATTENDING: Tutorial use of anexpert system. In: Proceedings of the InternationalSymposium on Computers in Anesthesia and IntensiveCare. Rotterdam, 1983, p. 64.

Miller, P.L. and Black, H.R.: Medical plan-analysisand the management of essential hypertension. In: Pro-ceedings of the AAMSI Second Annual Conference.Baltimore, October 1983, pp. 72-74.

: HT-ATTENDING: Critiquing the pharma-cologic management of essential hypertension. In: Day-hoff, R.E. (Ed.) Proceedings on the Seventh AnnualSymposium on Computer Applications in MedicalCare. Silver Spring, Maryland, IEEE Computer Society,1983, pp. 824-827.

: Medical plan-analysis by computer: Cri-tiquing the pharmacologic management of essential hy-pertension. Computers and Biomedical Research 17:38-54, 1984.

Miller, R.A.: lnternist-1/Caduceus: Problemsfacing expert consultant programs. Methods of Infor-mation in Medicine 23: 9-14, 1984.

Miller, R.A., Kapoor, W.N. and Peterson J.: Theuse of relational databases as a tool for conductingclinical studies. In: Dayhoff, R.E. (Ed.) Proceedings ofthe Seventh Annual Symposium on Computer Appli-cations in Medical Care. Silver Spring, Maryland, IEEEComputer Society, 1983, pp. 705-708.

Moore, G.W. and Hutchins, G.M.: Consistencyversus completeness in medical decision-making: Ex-emplar of 155 patients autopsied after coronary arterybypass graft surgery. Medical Informatics 8: 197-207,1983.

Moore, G.W., Hutchins, G.M. and Miller, R.E.:Strategies for searching medical natural language text.American Journal of Pathology 115: 36-41, 1984.

Myers, J.D.: Artificial intelligence and medicaleducation. The Medical Journal 18: 193-202, 1983.

Myers, J.D., Pople, H.E. and Miller, R.A.: CADU-CEUS: A computerized diagnostic consultation systemin internal medicine. In: Proceedings of the SixthAnnual Symposium on Computer Applications inMedical Care. Silver Spring, Maryland, IEEE ComputerSociety, 1982, pp. 44-47.

48

Supported Publications

Nomina Histologica. Second Edition. Prepared bythe International Anatomical Nomenclature Committee.In: Nomina Anatomica. Fifth Edition, Baltimore, Wil-liams & Wilkins, 1983, 38 pp. + ix.

Northup, D.E., et al.: Characteristicsof clinical in-formation-searching: Investigation using critical incidenttechnique. Journal of Medical Education 58: 873-881,1983.

Northup, D.E. and Umland, B.E.: Searching ForInformation—A Self-Directed Learning Guide. Prob-lem 7: Diagnosis and Treatment: Hirsutism. Albuquer-que, Medical Center Library, University of NewMexico, 1983, 367 pp.

: Searching for Information—A Self-Direct-ed Learning Guide. Problem 2: Subacute Bacterial En-docarditis. Albuquerque, Medical Center Library, Uni-versity of New Mexico, 1983, 393 pp.

: Searching for Information—A Self-Direct-ed Learning Guide. Problem 4: Drug Side Effects. Al-buquerque, Medical Center Library, University of NewMexico, 1984, 329 pp.

Northup, D.E. and Bowermaster, J.P.: Searchingfor Information—A Self-Directed Learning Guide.Problem 7: Psychosocial: An Irresistible Impulse toSteal. Albuquerque, Medical Center Library, Universityof New Mexico, 1984, 328 pp.

: Searching for Information—A Self-Direct-ed Learning Guide. Problem 9: Patient Education:Multiple Sclerosis. Albuquerque, Medical Center Li-brary, University of New Mexico, 1984, 325 pp.

Nugent, A.: Fit for work: The introduction of phys-ical examinations in industry. Bulletin of the History ofMedicine 57: 578-595, 1983.

Parascandola, J.: Reflections on the history ofpharmacology. Pharmacy in History 22: 131-140,1980.

Parascandola, J. and Swann, J.: Development ofpharmacology in American schools of pharmacy. Phar-macy in History 25: 95-115, 1983.

: Charles Homes Herty and the effort to es-tablish an institute for drug research in post World WarI America. In: Parascandola, J. and Whorton, J. (Eds.)Chemistry and Modern Society: Historical Essays inHonor of Aaron /. Ihde. Washington, D.C., AmericanChemical Society, 1983, pp. 85-103.

Parascandola, J. and Keeney, E.: Sources in theHistory of American Pharmacology. Madison, Wiscon-sin, American Institute of the History of Pharmacy,1983, 55 pp.

Patterson, K.D.: The influenza epidemic of 1918-19 in the Cold Coast. Journal of African History 24:485-502, 1983.

Politser, P.: Decision analysis and clinical judg-ment: A re-evaluation. Medical Decision Making 1:361-389, 1981.

: Reliability, decision rules, and the value ofrepeated tests. Medical Decision Making 2: 48-68,1982.

Postell, William D. Interview by Estelle Brodman,29 October 1977. Oral history interview, Medical Li-brary Association, Chicago.

Ravitch, M.M., et al.: A chart audit study of thereferral of obese patients to endocrinologists. MedicalDecision Making 3: 69-79, 1983.

Riede, U. and Moore, C.W.: Quantitative patholo-gy by means of symbolic logic. CRC Critical Reviewsin Toxicology 11: 279-332, 1983.

Roberts, J.: Matching MARC to a picture collec-tion: Development of a computer format for medical il-lustrations. Information Processing & Management 19:131-139, 1983.

Rothert, M.L., et al.: Differences in medical refer-ral decisions for obesity among family practitioners,general internists, and gynecologists. Medical Care 22:42-55, 1984.

Sager, N., et al.: Relational database design forcomputer-analyzed medical narrative. In: Blum, B.I.(Ed.) Proceedings of the Sixth Annual Symposium onComputer Applications in Medical Care. Silver Spring,Maryland, IEEE Computer Society, 1982, pp. 797-804.

Sager, N., et al.: Data model for natural languageinformation. ACM-SICART Newsletter 86: 51, 1983.

Sager, N. and Wong, R.: Developing a databasefrom free-text clinical data. Journal of Clinical Com-puting 11: 184-194, 1983.

Sager, N. and Kosaka, M.: A database of literatureorganized by relations. In: Dayhoff, R.E.(Ed.) Proceed-ings of the Seventh Annual Symposium on ComputerApplications in Medical Care. Silver Spring, Maryland,IEEE Computer Society, 1983, pp. 692-695.

Savitt, T.L.: The education of black physicians atShaw University, 1882-1918. In: Crow, J.J. and Hatley,F.J. (Eds.), Black Americans in North Carolina and theSouth. Chapel Hill, North Carolina, The University ofNorth Carolina Press, 1984, pp. 160-188.

Shortliffe, E.H. and Fagan, L.M.: Modeling themedical decision-making process. In: Gravenstein, J.S.,Newbower, R.S., Ream, A.K. and Smith, N.T. (Eds.) An

49


Integrated Approach to Monitoring. Woburn, Massa-chusetts, Butterworth Publishers, 1983, pp. 183-200.

Sudakov, K.V. Emotional Stress and Arterial Hy-pertension: Review of Experimental Data. Translatedin Pakistan. Samuel A. Corson, Scientific TranslationEditor; Elizabeth O'Leary Corson, Associate Editor.Printed in New Delhi, India: Amerind Publishing Co.Pvt. Ltd., 1983, 88 pp. (Distributed by the NationalTechnical Information Service, Springfield, VA).

Taine, Seymour Irving. Interview by Carol H. Feni-chel. 4 October 1982. Oral history interview, MedicalLibrary Association, Chicago.

Trendelenburg, F: From My Joyful Days of Youth,A Memoir, with a Preface by Cuenter B. Risse. Trans-lated in Tunisia. Printed in Cairo, Egypt, by the Al-Ahram Publishing House, 1984, 289 pp. (Distributedby the National Technical Information Service).

Undersea Medical Society (Compl.). Key Docu-ments of the Biomedical Aspects of Deep-Sea Diving:Selected from the World's Literature 1608-1982. Vol.I-V. Bethesda, Maryland, Undersea Medical Society,1983.

Walters, L. (Ed.): Bibliography of Bioethics.Volume 9. N.Y., The Free Press, 1983, 346 pp.

Warner, J.H.: A southern medical reform: Themeaning of the antebellum argument for southern med-

ical education. Bulletin of the History of Medicine 57:364-381, 1983.

Wazewska-Czyzewska, M.: Erythrokinetics: Ra-dioisotopic Methods of Investigation and Mathemati-cal Approach. Warsaw, Poland: Foreign Scientific Pub-lications Department of the National Center for Scien-tific, Technical and Economic Information, 1983, 221pp. (Distributed by the National Technical InformationService).

Whorton, J.C.: "Physiologic Optimism": HoraceFletcher and hygienic ideology in progressive America.Bulletin of the History of Medicine 55: 59-87, 1981.

Yamamoto, W.S.: Information systems approachto integrated responses in the respiratory controlsystem. Annals of Biomedical Engineering 11: 349-360, 1983.

Yamamoto, W.S. and Wolff, P.G.: On the identifi-cation of verbs in computer programs of physiologicalmodels. Computers and Biomedical Research 17:175-184, 1984.

Periodical Publication

The Behavioral and Brain Sciences, N.Y., Cam-bridge University Press, Vol. 6, No. 3, September1983, and following issues.

50

APPENDIX 3: BOARD OF REGENTS

The NLM Board of Regents meets three times a year to consider Library issues and policies and make recom-mendations to the Secretary of Health and Human Services on matters affecting the Library.

Appointed Members:

L. Thompson Bowles, M.D., Ph.D. (chairman)Dean for Academic AffairsGeorge Washington University

Lois E. DeBakey, Ph.D.Professor of Scientific CommunicationsBaylor College of Medicine

Shirley EchelmanDirectorAssociation of Research Libraries

Charles C. Edwards, M.D.PresidentScripps Clinic and Research Foundation

Russell L. FenwickSenior Vice PresidentBank of America

Albert E. Cunn, M.D.Medical DirectorM.D. Anderson Hospital and Tumor Institute

John K. LopezExecutive Vice PresidentMedicalelectrographic Sciences

David O. Moline, D.D.S.Asst. Professor of DentistryUniversity of Iowa

Grant V. Rodkey, M.D.Associate Clinical Professor of SurgeryHarvard Medical School

Eugene A. Stead, Jr., M.D.Professor Emeritus of MedicineDuke University

Ex Officio Members:

Librarian of Congress

Surgeon GeneralPublic Health Service

Surgeon GeneralDepartment of the Air Force

Surgeon GeneralDepartment of the Army

Surgeon GeneralDepartment of the Navy

Chief Medical DirectorVeterans Administration

Assistant Director for Biological, Behavioral, and SocialSciences

National Science Foundation

51

APPENDIX 4: BOARD OF SCIENTIFIC COUNSELORS

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

Members:

Morris F. Collen, M.D.ConsultantPermanente Medical Group

Samuel J. Dwyer III, Ph.D.Director of Diagnostic Imaging and Radiological

SciencesUniversity of Kansas Medical Center

Leonard D. Fenninger, M.D.Vice PresidentAmerican Medical Association

Susan J. Crobe, Ph.D.Cal Project DirectorUniversity of Texas at Austin

Casimir A. Kulikowski, Ph.D.Professor of Computer ScienceRutgers University

Stephen G. Pauker, M.D. (chairman)Professor of MedicineTufts University School of Medicine

Mitchell W. Spellman, M.D.Dean for Medical ServicesHarvard University Medical School

M. Lucius Walker, Ph.D.Dean, School of EngineeringHoward University

52

APPENDIX 5: BIOMEDICAL LIBRARY REVIEWCOMMITTEE

The Biomedical Library Review Committee meets three times a year to review applications for grants underthe Medical Library Assistance Act.

Members:

Ellen Altman, Ph.D.Director, Graduate Library SchoolUniversity of Arizona

C. Michael Brooks, Ed.D.Director, Dept. of PsychiatryUniv. of Alabama School Medicine

Lauro F. Cavazos, Ph.D. (chairman)PresidentTexas Tech University Health Sciences Center

Rachael GoldsteinHealth Sciences LibrarianColumbia University

G. Anthony Gorry, Ph.D.Vice President for Institutional DevelopmentBaylor College of Medicine

Robert A. Greenes, M.D., Ph.D.Department of RadiologyBrigham & Women's HospitalBoston, Mass.

Lillian Haddock, M.D.Dean for Academic AffairsSchool of MedicineUniversity of Puerto Rico

Virginia HoltzDirector, Health Sciences LibrariesUniv. of Wisconsin-Madison

Mary M. HorresBiomedical LibrarianUniv. of Cal., San Diego

Donna P. JohnsonDirector, Resource CenterAbbott Northwestern HospitalMinneapolis, Minn.

Randolph A. Miller, M.D.Associate Professor of MedicineUniversity of Pittsburgh

Miranda L. Pao, Ph.D.Asso. Prof, of Library ScienceCase Western Reserve University

Donald F. Pochyly, M.D.Section Chief, Medical ServiceVeterans Administration Hosp.Hines, Illinois

Henry Riecken, Ph.D.Prof, of Behavioral SciencesUniv. of Pa. School of Medicine

Homer R. Warner, M.D., Ph.D.Chairman, Dept. of Medical Biophysics and ComputingUniv. of Utah School of Medicine

53

DISCRIMINATION PROHIBITED: Under provMont of applicablepublic laws enacted by Congress since 1964, no person In the UnitedStates shall, on the ground of race, color, national origin, sex, or handi-cap, be excluded from participation in, be denied the benefits of, orbe subjected to discrimination under any program or activity receivingFederal financial assistance. In addition. Executive Order 11141 pro-hibits discrimination on the basis of age by contractors and subcon-tractors In the performance of Federal contracts. Therefore, the Na-tional Library of Medicine must be operated in compliance with theselaws and executive order.

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