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U.S. Department of Health, Education, and WelfarePublic Health Service

National Institutes of Health

DHEW Publication No. (NIH) 75-256

CONTENTS

List of Tables 4Organization of the National Library of Medicine 5Board of Regents 6

I. POLICY AND DIRECTION 7

Board of Regents, 7Staffing Activities, 8Management of Financial Resources, 9Lister Hill Center Building,10Security, 10Awards and Honors, 10Copyright, 11Exhibits, 12Equal Employment Opportunity Activities, 12

II. LIBRARY SERVICES AND OPERATIONS.... 13

Bibliographic Services, 13MeSH Section, 14History of Medicine, 15Reference Services, 16Technical Services, 17Specialized Information Services, 19

III. ON-LINE RETRIEVAL SERVICES 21

MEDLINE, 21TOXLINE, 22Toxicology Data Retrieval, 23CAS Registry Numbers, 23Collaborative Activities, 24MEDLARS II, 24

IV. GRANTS FOR LIBRARY ASSISTANCE 25

Medical Library Assistance Act, 25Administration, 25Division of Biomedical Information Support, 25International Programs Division, 27

V. AUDIOVISUAL PROGRAMS 29

Clearinghouse, 29Evaluation and Acquisition,29Distribution, 29Workshops and Conferences, 30Advisory Services, 30Media Development, 31Publications, 32Audiovisual Productions, 32

VI. HEALTH COMMUNICATIONS RESEARCH .. 33

ATS-6,33Interact, 34Computer-Assisted Instruction Network, 35Other Projects, 36

VII. INTERNATIONAL ACTIVITIES 37

International MEDLARSCooperation, 37Pan American Health Organization, 38US/USSR Discussions, 38Exchange Programs and Services, 38Public Law 480 Program, 39International Organizations,39

LIST OF TABLES

Table 1. Personnel ceilings 9

Table 2. Financial resources and allocations 10

Table 3. Summary of bibliographic services 14

Table 4. History of medicineactivities 15

Table 5. Summary of circulation activities 16

Table 6. Summary of reference services 17

Table 7. Growth of collections 18

Table 8. Summary of acquisition statistics 18

Table 9. Summary of cataloging activities 18

Table 10. Bindingstatistics 18

Table 11. Summary of on-line searches 22

Table 12. Resource project grant allocation by network level 27

Table 13. Resource project grant allocation by objective 27

Table 14. Summary of NLM extramural programs 28

ORGANIZATION OF NATIONALLIBRARY OF MEDICINE

Office of AdministrationKENT A. SMITH

Ass't Director forAdministration

DIRECTORMARTIN M. CUMMINGS, M.D.

DEPUTY DIRECTORMELVIN S. DAY

Assistant DeputyDirector

HAROLD M. SCHOOLMAN. M.D.

Assistant Director forInternational Programs

MARY E. CORNING

Lister Hill National Center forBiomedical Communications

ALBERT FEINERDirector

Computer andCommunications Systems

DAVIS B. McCARNAssociate Director

Office of Inquiries andPublications Management

ROBERT B. MEHNERTChief

Library Operations

JOSEPH LEITER, Ph.D.Associate Director

Specialized InformationServices

HENRY M. KISSMAN, Ph.D.Associate Director

Extramural Programs

ERNEST M. ALLEN, Sc.D.Associate Director

National Medical AudiovisualCenter

GEORGE E. MITCHELL, D.M.D.Director

BOARD OF REGENTS

JOHN P. McGovERN, M.D., ChairmanProfessor and ChairmanDepartment of the History of SciencesGraduate School of Biomedical SciencesUniversity of Texas

SUSAN Y. CRAWFORD, Ph.D.Director, Archive-Library DepartmentAmerican Medical Association

BERNICE M. HETZNERProfessor of Library ScienceUniversity of Nebraska Medical Center

W.N.HUBBARD,JR.,M.D.President, The Upjohn Company

J. STANLEY MARSHALL, Ph.D.President, Florida State University

ANGELO M. MAY, M.D.Physician, San Francisco

JOSEPH F. VOLKER, D.D.S., Ph.D.President, University of AlabamaBirmingham

ETHEL WEINBERG, M.D.Associate DeanMedical College of Pennsylvania

Executive Secretary

MARTIN M. CUMMINGS, M.D.Director, National Library of Medicine

Ex Officio Members

JOHN D. CHASE, M.D.Chief Medical DirectorVeterans Administration

ELOISE E. CLARK, Ph.D.Division Director for Biologicaland Medical Sciences

National Science Foundation

VICE ADMIRAL DONALD L. CUSTISThe Surgeon GeneralDepartment of the Navy

S. PAUL EHRLICH, JR., M.D.Acting Surgeon GeneralU.S. Public Health Service

L. QUINCY MUMFORD, LL.D.The Librarian of Congress

LT. GENERAL ROBERT A. PATTERSONThe Surgeon GeneralDepartment of the Air Force

LT. GENERAL RICHARD R. TAYLORThe Surgeon GeneralDepartment of the Army

I. POLICY AND DIRECTIONBoard of Regents

On March 8, 1974, following Senate confirma-tion, President Nixon appointed Joseph F.Volker, D.D.S., Ph.D., President of the Univer-sity of Alabama, and Ethel Weinberg, M.D.,Associate Dean of the Medical College of Penn-sylvania, to four-year terms on the NLM Boardof Regents. The Board, which meets three timesa year, advises the Secretary of HEW on policymatters affecting the Library. Because theterms of John P. McGovern, M.D., and J.Stanley Marshall, Ph.D., expired in June 1974,the Board still stands at six appointed Regents,four less than the ten authorized by theNational Library of Medicine Act.

At the June 1974 meeting, the outgoing chair-man, Dr. McGo\ern, handed over the gavel tohis elected successor, W. \. Hubbard, Jr., M.D.Dr Hubbard is serving as chairman for thethird time, having been elected to that positionin 1965 and 1966 when serving his first term as aRegent. Dr. Hubbard, formerly dean of theUniversity of Michigan Medical School, is Presi-dent of the Upjohn Company.

The highlight of the June 1974 meeting was aspecial session of the Board to examine theNational Library of Medicine, past, present, andfuture. All Regents chairmen for the past ten\ears, with the exception of Drs. Normal Q.

Members of the Board of Regents, June 1974, from left, top row: Dr. Martin M. Cummings, Dr. Joseph F. Volker, Dr.W. N. Hubbard, Jr., Dr. Angelo M. May, Brig. Gen. George E. Reynolds; center row: Capt J. William Cox, Dr. JohnP. McGovern, Dr. J. Stanley Marshall; front row: Dr. Laurence V. Foye, Jr., Vice Adm. Donald L. Custis, Dr. SusanY. Crawford, Mrs. Bernice M. Hetzner, Dr. Ethel Weinberg, Col. Mims C. Aultman, Mr John G Lorenz.

Brill and Robert H . Ebert, attended Also pre-sent to make brief remarks about NLM's

"unwri t ten history" was Worth B. Daniels,M.n , first chairman of the Board (1957).

Former Chairmen of the NLM Board of Regents gathered at the Board's 48th meeting to discuss the Library's past,present, and future. From left to right: Dr. Barnes Woodhall, Mr. Alfred R. Zipf, Dr. John P. McGovern, NLM Direc-tor Dr. Martin M. Cummings, Dr. Worth B. Daniels, Dr. W. N. Hubbard, Jr., Dr. Stewart G. Wolf, Dr. William G.Anlyan, and Dr. Jack M. Layton.

Staffing ActivitiesPersonnel actions in FY 1974 numbered 834,

including 60 promotions, 121 separations(including resignations, retirements, andtransfers to other agencies), and 134 accessions.There were 34 employees enrolled in the NIHUpward Mobility College and four employeesparticipated in other upward mobility programsduring the year. A total of 320 requests fortraining were processed in FY 1974, including142 for courses at nongovernmental facilities,such as local universities, and 178 for trainingthrough agency and interagency programs.

In accordance with a governmentwideemployment reduction that occurred early inthe fiscal year, the NLM personnel ceiling wasreduced by 20 positions, from 466 to 446. NLM

appealed this reduction to the NIH Office of theDirector. In recognition of the need to sustainbasic library services and make modest begin-nings in the research and deve lopmentprograms, the NIH Director restored ten ofthese positions early in the fiscal year and tenmore later in the year, thus returning the end-of-year ceiling to the FY 1973 level of 466positions Major staff changes during the \earincluded the following:

In April 1974, James M Stengle, M D , wasnamed Deputy Director for Medical Affairs ofthe Lister Hill Center. He joined NLM afterserving in several branch chief positions in theNational Heart and Lung Institute.

Also in April, George Cosmides, Ph.D., wasappointed Deputy Associate Director forSpecialized In format ion Ser\ices. He had

previously been Director of the PharmacologyResearch Associate Training Program in theNational Institute of General Medical Sciences.

Mr. Joseph Gantner was appointed Chief ofthe Technical Services Division, LibraryOperations, in December 1973. He came to NLMfrom the State University of New York at StonyBrook, where he had been Associate Directorand Acting Director of Libraries. Mr. Gantnersucceeded Seymour I. Taine, who left theLibrary in July 1973 to take a position with theWorld Health Organizat ion in Geneva,Switzerland.

Joining Specialized Information Services inJune as Chief of the Technical Files Implemen-

tation Branch was Michael Oxman, Ph.D. Hewas previously with the NIH Division ofResearch Resources where he served as aProgram Officer in the Biotechnology ResourcesBranch.

Ernest M. Allen, Sc.D., Associate Director forExtramural Programs, officially retired fromFederal service in June 1974. However, Dr.Allen continues serving in that position under afull-time temporary appointment.

Others retiring in June 1974 were Norman P.Shumway, M.D., Head of the MeSH Section,Bibliographic Services Division, and LeonardKarel, Ph.D., pharmacologist, Office of theAssociate Director for Library Operations.

Table 1. Personnel CeilingsFY1973 FY1974 FY 1975*

Office of the DirectorOffice of Inquiries and Publications

ManagementOffice of AdministrationOffice of Computer and Communications

SystemsExtramural ProgramsLister Hill National Center for

Biomedical CommunicationsSpecialized Information ServicesNational Medical Audiovisual Center . . .Library Operations

TOTAL.

'Estimated

Management of Financial ResourcesIn January 1974 the President submitted to

Congress the Administration's budget for fiscalyear 1975. The amount requested for the NLMwas $27,738,000, an increase of almost $2 millionover the FY 1974 appropriation but nearly $1.5million less than the amount actually availablefor obligation in FY 1974. The reason for thewide divergence between appropriated andobligational levels was that in December 1973the Federal Courts ruled that the Administra-tion must release to the various agencies fundswhich had been impounded in the previous year;$3,338,000 were restored and made available forobligation by NLM in FY 1974.

In the spring of 1974, subcommittees of theHouse and Senate Appropriations Committeesheld hearings on NLM's FY 1975 budget request.Members of both subcommittees expressed con-

12

5430

1716103192

466

11

536

5127

2017100199

466

11

536

5127

2017100199

466

siderable interest in the progress of the pro-posed Lister Hill Center building. On June 27,1974, the House passed a bill including funds forthe NLM; the Senate had not yet taken action byyear's end. The House bill contained an increaseof $312,000 over the President's budget requestfor NLM, the additional funds to be used for"staff support."

The Library continued to experience the per-vasive effects of inflation in 1974, which, as inprevious years, were more extreme in thepublishing industry than in the Nation'seconomy as a whole. This had the dual effect ofincreasing the cost of literature acquisition tothe NLM and of forcing many small libraries tocurtail their own subscriptions to medical jour-nals and rely more heavily on the NLM and theRegional Medical Libraries for loans and otherservices.

Table 2. Financial Resources and AllocationsFiscal Year 1974

Amounts Available for ObligationAppropriation. NLM $26,871,000Plus: Unobligated Balance Brought Forward,

StartofFY 1974 3,365,000Pay Cost Supplements 458,000Earned Reimbursements 1,004,594

Less: Transfer of Funds to Departmental Management 36,000

Total 130,662,594

Amounts Obligated by Extramural Programs $ 7,689,000

Amounts Obligated for Direct OperationsLister Hill National Center for Biomedical Communications $ 2,931,000National Medical Audiovisual Center 4,518,000Office of Computer and Communications Systems 3,682,000Library Operations 5,632,000Toxicology Information Program 1,747,000Review and Approval of Grants 822,000Program Direction 3,497,000

Subtotal, Direct Operations $22,829,000

Total Obligations, NLM $30,518,000

Lister Hill Center Building

Under the specific authority of Public Law 90-456, the planning for the Lister Hill NationalCenter for Biomedical Communications facilitybegan in FY 1970. When built, the facility willhouse the staff of the Lister Hill Center, theNational Medical Audiovisual Center, Ex-tramural Programs, Specialized InformationServices, Office of Computer and Com-munications Systems, and certain componentsof Library Operations. This will make it possibleto use most of the NLM building for library ser-vices and stacks, purposes for which it wasdesigned. The new Lister Hill Center Building,to be located adjacent to the present Library,will be a ten-story tower with three under-ground levels.

Tentative working drawings were reviewed byNLM staff in March 1974 and comments wereforwarded to the architect, Carroll Associates ofPhiladelphia, for consideration in developingthe final working drawings. These are scheduledto be completed by January 1975. The projectwill be ready for issuance of invitation to bid onconstruction in FY 1975, pending the authoriza-tion of construction funds by Congress.

Security

During FY 1974 a complete review was madeof the Library's safety and security program.George P. Morse and Associates, consultants inprotection, conducted a survey and seminar onprotection at the National Library of Medicine.As a result of recommendations made by theconsulting firm and staff members of theLibrary, a new program of protection and safetywas established. Some of the elements of theprogram which were instituted during the yearinclude: development of an emergency evacua-tion plan; assignment to the Library of perma-nent guards and establishment of a specialguard force training program; improvement ofcontrol over the collection and other propertywith an improved pass system; and evaluationof the need for an automatic access controlsystem. A study of the feasibility of an im-proved fire protection system to safeguard thecollection was also completed.

Awards and HonorsNLM Director, Martin M. Cummings, M.D.,

was the recipient of a 1973 Rockefeller PublicService Award, one of the most prestigious

10

honors of its kind in the nation. Dr. Cummingswas cited for his leadership in the Library'sdevelopment of computerized bibliographicretrieval systems, and for the use of com-munications satellites in the transfer ofbiomedical information.

Princeton President William G. Bowen (left) presents theRockefeller Public Service Award to NLM Director Dr.Martin M. Cummings. Sponsor of the award is John D.Rockefeller, III (right).

Two NLM employees were named to receiveDHEW Superior Service Awards. Kent A.Smith, Assistant Director for Administration,cited for "exceptional competence as an ad-ministrator, unique and lasting contributions tothe management of NLM, and dedication to thehighest traditions of public service." Arthur J.Broering, Deputy Associate Director for Ex-tramural Programs, was honored for his "con-siderable contributions to the guidance anddevelopment of the NLM grant programs and tothe direction and growth of the RegionalMedical Library System."

Mrs. H. Rita Orr, Personnel ManagementSpecialist in the Office of Administration,received the NIH Equal Employment Oppor-tunity Award for 1974, the first time the awardhas been given. Mrs. Orr was recognized for her"success in working with NLM supervisors andeducational institutions which has helpedproduce an awareness of the capabilities andpotentialities of the young employee and for herrole as coordinator of the Stay-in-School andSummer Aide programs."

The f i f t h a n n u a l Regents Award fo rScholarship or Technical Achievement went toSharon L. Valley, Ph.D., pharmacologist in theOffice of the Associate Director for SpecializedInformation Services. Dr Valley was cited forher initiative and creativity in developing uni-que toxicology information products and ser-vices.

The Direc tor ' s A w a r d wen t to t h r e eemployees for their exceptional achievementsand contributions to the Library: Henry M.Kissman, Ph.D., Associate Director forSpecialized Information Services; Mary E Cor-ning, Assistant Director for InternationalPrograms; and Norman P. Shumway, M.D.,Chief, Medical Subject Headings (MeSH) Sec-tion, Bibliographic Services Division, LibraryOperations.

Copyright

On November 27. 1973, the U.S. Court ofClaims ruled that mak.ng single copies of jour-nal articles by NLM and the NIH library doesnot violate copyright la AS. The judgment was inresponse to a petition fi led on February 27,1968,by Williams & Wilkins against the FederalGovernment. The petition alleged that NLM andthe NIH library, by providing on inter-libraryloan single copies of journal articles for the useof health professionals, had infringed the jour-nal publisher's cop.\ right. The court's four tothree decision in favor of the Federal Govern-ment overturned Commissioner James F.Davis's preliminary report filed in February1972, \ \h ich had recon n ended in favor of theplaint i f f .

The court said that medical research wouldbuffe r if such photocop\,ng were banned since"the supply of reprints and hack numbers iswholly inadequate," and r, is "wholly unrealisticto expect scientific personnel to subscriberegularly to large r u r i h e r s of journals whichwould onh occasionally contain articles of in-terest to them." The court also rejected theplaint i f f ' s argument that he had suffered finan-cial loss because of l ibrary photocopying.

The plaintiff has appealed the decision of theCourt of Claims to the Supreme Court, whichhas agreed to hear the case. Arguments w i l l beheard in the fall of 1971, with a decision comingprobably in the spring </ 1975.

11

Exhibits

Two new exhibits were displayed in theLibrary's entrance foyer during the year. Thefirst, "The Artist and Medicine," contained avaried selection of prints and drawings present-ing artists' views on man's confrontation withsickness, pain, and death. The second,"Witchcraf t and Medic ine ," dealt wi thwitchcraft from the 15th through the 18th cen-turies, and included books and prints from thecollection of NLM's History of Medicine Divi-sion.

"Base Hospital," a lithograph by George Bellows (1882-1925), was one of the works displayed in the exhibit "TheArtist and Medicine."

Equal Employment OpportunityActivities

The Library has continued to follow the actionsteps and timetable contained in the 1973 Affir-mative Action Plan. Among the significantevents for FY 1974:

• The Director reaffirmed his commitment toproviding opportunities for employees byreestablishing the Administrative Traineeposition within the Office of Administra-tion. The last trainee in this position, Mr.Bryant Pegram, is now serving as Ad-ministrative Officer, Office of Computerand Communications Systems.

Within Library Operations, the AssociateDirector has been working with the EEOCommittee to establish an in-house trainingprogram for five library technicians in-terested in qualifying as librarians. Thist r a i n i n g w i l l g i v e e m p l o y e e s i nparaprofessional positions knowledge toassist them in performing their daily workand, at the same time, increase their up-ward mobility by preparing them to takethe Federal Librarian Examination.The NLM, in addition to increasing its par-ticipation in Project Stride, has also nowbegun to participate in Access, an upwardmobility cooperative work-study programinvolving alternating periods of full-timework and full-time college attendance. Theparticipants are students of local collegesand universities who are preparing for aprofessional career. This program is helpfulin bringing minority group members andwomen into professional positions at NIH.All college fees are paid under the program.However, the student earns a salary onljfor the time he is actually working at NIH.The NMAC EEO Committee has been in-strumental in developing a separate andcomprehensive Aff i rmnt ive Action Plan forNMAC.Elections were held for the new EEO Com-mittee in September. Subsequently, MsCecile Quintal, Serial Records and BindingSection, TSD, was appointed to chair theCommittee.Efforts to inform NLM employees about theEEO program were highlighted by the dis-t r ibut ion of an in format ive brochurep repa red by m e m b e r s of the Com-munications Subcommittee.In May 1974, an Upw ard Mobility Programsforum was conducted at NLM to educatesupervisors about these programs, in-cluding the on-campus Upward MobilityCollege.The NLM EEO Coordinator has been in-strumental in recruiting minorities andwomen for professional-level positions atthe Library. His office has also been engag-ed in developing a statistical profile of NLMemployees to aid in identifying areas of theLibrary where recruitment efforts shouldbe increased.

12

II. LIBRARY SERVICES AND OPERATIONS

The Library has continued to build resourcesto provide the necessary central back-up servicefor document delivery and bibliographic supportto the Regional Medical Library Network. In ad-dition, NLM is planning to develop and imple-ment a management information system whichwill use the existing MEDLINE, SERLINE, andCATLINE data bases to generate networkcontrolled document delivery systems which ul-timately will be fully integrated with thebibliographic retrieval system of the network.

An extension of the traditional interlibraryloan services as we now know them was the ini-tiation in FY 1974 of an experimental referralsystem between the National Library ofMedicine and the British Library Lending Divi-sion in Boston Spa, Yorkshire. This experimen-tal cooperative project—using the British Len-ding Library as backing for document deliveryneeds in the United States—is a resource shar-ing approach on an international level whichmay open a new extension of interlibrarycooperation.

NLM's involvement with the Library ofCongress' Cataloging in Publication Programwas expanded considerably during the fiscalyear. The preparation of cataloging data for ap-proximately 1,700 biomedical titles has almostdoubled last year's output. The National Libraryof Medicine plans to continue and increase itscontribution to this program.

As a result of cooperative programs with theLibrary of Congress, the Council on LibraryResources, and other major academic libraries,agreement has been reached on adopting amodification to the standard Library ofCongress MARC record format which enablesNLM and other libraries to make their machinereadable records compatible with MARCrecords generated by the Library of Congress.This development will make it possible toprovide a linkage with the Ohio College LibraryCenter which operates a large national libraryprocessing system and has the capability tomake NLM's cataloging data available tonetwork users.

NLM has also taken an active role in thedevelopment of a National Serials Data Base

called CONSER (ComerMon of Serials DataBases). This development in resource sharing\ \ i th in the libran community has evoked as anextension of the National Serials Data Program(NSDP), begun by the Library of Congress,NLM, and the National Agricultural Library

Numerous t ra ining programs, inc lud ingworkshops, seminars, and courses of severalweeks' duration were conducted b\ LibraryOperations to train l ib t a i i ans and informationspecialists in health sciences l ibrarianship, inindexing methods, and in the techniques of on-l ine bibliographic searching The LibraryAssociate Program, no\\ in its ninth year ofoperation, continued to prove popular \ \ i t h re-cent graduates of librai , -cience schools Fifty-f ix e candidates from H2 ^chooK Competed for thefour Associate positions a' NLM The new train-ing program will begin in September 1974 Theone-year associateship provides opportunit iesfor seminars, practical work experience, andproject assignments, as \ v e l l as formal presen-tations and individual ^tudv.

Training classes are held regularly at NLM for indexersand MEDLINE search analysts.

Bibliographic Services

During fiscal \ear I ' . iTl , 224,318 journal ar-ticles were indexed for \ I E D L \ R S TheBibliographic Services Division, under whosedirection all indexing i^ done, continued itsprimary funct ions o*' c x rd inat ing th is world-

1,'J

wide effort and of maintaining an intensivequality control review procedure. In addition, byyear-end, 25 percent of all indexing was per-formed by Division personnel.

Almost 225,000 journal articles were indexed in FY 1974.

More than 150 journal titles were added to thelist of those indexed for MEDLARS This wasmade possible as a result of the continuingreview of all journals indexed, and the subse-quent deletion of those whose quality haddeteriorated. By the end of the year a total of 2,-275 journal titles were being regularly indexed.

The day-to-day operation and management ofthe network of 235 libraries utilizing and offer-ing the Library's on-line services continued to bea major activity of the Division. On-goingpublication of the monthly NETWORK/MEDLARSTechnical Bulletin, generation of user manuals,and gathering and reporting of statistical dataon system usage are representative of BSD'snetwork management functions. In addition,five training courses on the operation of theLibrary's on-line systems were conducted underthe auspices of the Division; 67 medical li-brarians attended these courses.

Table 3. Summary of Bibliographic Services

FY1972 FY1973 PY1974

Articles IndexedNLMOther U.S. .Foreign . . .

TOTAL

MEDLINE Searches

Recurring Bibliographies

Journals Indexed f or Index Medicus

39,869 30,894 44,100120,739 74,276 74,00172,769 102,646 106,217

233,377 207,816 224,318

6,277 156,059 215,294

24 24 24

2,246 2,194

MeSH SectionIn view of the greatly expanded activities of

the Medical Subject Headings (MeSH) Sectionand its growing diversity of interactions outsidethe Bibliographic Services Division, anorganiza t iona l change in January 1974transferred the MeSH Section from the Divisionto the Office of the Associate Director forLibrary Operations.

Medical Subject Headings Section activity forthe year was concentrated on preparing for thetransition from MEDLARS I to MEDLARS II Thehierarchical organization of the subjectheadings was extensively reorganized to utilizethe capability of having a seven-level structurewhere only four levels were previously possible.

One hundred and seventy-five new terms wereadded to facilitate this change.

In November 1973, the MEDLARS I MeSH filewas closed to further additions or changes inorder to permit its conversion to MEDLARS IIformat. All subsequent additions and changeshave had to be held in abeyance awaiting theavailability of MEDLARS II input and filemaintenance capabilities. These were not yetavailable at the close of the fiscal year.

Extended meetings with subject experts fromthe National Institute qf Child Health andHuman Development and Karolinska Institutetin Stockholm, Sweden, have led to the develop-ment of many new terms and cross referencesconcerned with the biology of reproduction.

14

History of Medicine

The History of Medicine Division continued toincrease its resources for historical scholarshipduring the year. Three incunabula were addedto the collection: Jacopo da Forli, Expositiosuper primo Canonis Avicenne (Venice, 1495;Goff J-52); Joannes de Janduno, Questiones intres libros De nnima Aristotelis (Venice, 1488;Goff J-353); and Alexander of Aphrodisias, Deanima ex Aristotelis institutione (Brescia, 1495;Goff A-386). From later periods the Libraryadded a wide range of materials, from such fun-damental works in the history of science asFrancis Bacon's Instauratio magna (London,1620) and rarities such as the famous LeonhartF u c h s ' s Alle Kranckheyt der Augen(Strassburg, 1539), to 19thcentury Americanai n c l u d i n g an ephemera l "Circular andCatalogue" for Alden March's Practical Schoolfor Anatomy and Surgery in Albany, New York,1835. Additions to the modern manuscriptcollection included some 2,000 items relating tothe history of the Public Health Service fromDr. Ralph Chester Williams, the Archives ofAlpha Omega Alpha, and the papers of Dr.William Bean. Manuscript material was alsoreceived from Drs. Esmond R. Long, W. PalmerDearing, William S. Middleton, and ChaunceyD. Leake.

The oral history collection continued to beenriched by transcripts of interviews by Dr.Milton Senn relating to the child development

Dr. Faye G. Abdellah, Chief PHS Nurse Officer, and Dr.Anne Kibrick and Mrs. Margaret Walsh of the NationalLeague for Nursing, meet with Dr. Peter D. Olch, DeputyChief of the History of Medicine Division, to discuss es-tablishing a national repository of manuscript materialsrelated to the development of the American nursingprofession.

movement. A master index to the interviews,now totaling 83, is being prepared for thebenefit of interested readers.

During the year, over 4,000 books, manuscriptboxes, and oral history memoirs were providedto readers in the Library. Some 2,200 items werefurnished on interlibrary loan or in photocopyand nearly 1,900 photographs and slides weresupplied in answer to requests for pictorialmaterial. To improve access to the collection,and in anticipation of future publications, near-

Table 4. History of Medicine Activities

FY1972 FY1973 FY1974

AcquisitionsBooksModern manuscriptsOral history hoursPrints and photographs

ProcessingTitles catalogedModern manuscripts catalogedPictures indexedArticles indexedPages microfilmed

Public ServiceReference questions answered .ILL and pay orders filledReader requests filledPictures supplied

1,26536,325

43479

3,00220,362

5712,892

153,441

2,1131,8215,7841,888

936 1,14213,819 29,551

52 401,100 565

2,192 2,47345,890 20,900

526 3554,270 5,354

160,220 148,952

1,9362,1406,2781,782

1,8652,2334,0851,877

15

ly 2,500 books were cataloged. Librarypublications issuing from the History ofMedicine Division included issue number 7(1971) of the Bibliography of the History ofMedicine. In addition, staff members publishedseveral articles in professional and scholarlyjournals.

Reference Services

Over 27,000 requests for reference andbibliographic assistance and almost 180,000 re-quests received for interlibrary loans duringfiscal year 1974 added another notch to thesteady rise in service demand.

The continued growth of the journal collectionnecessitated the shifting of seven years'holdings of each current title from the A to theC level of the building, filling that area to"working capacity" (75 percent of its shelvingcapacity). The shift, which required threemonths to accomplish, served to open up thecurrent journal stacks on the A level, the area ofgreatest demand and activity.

The Division began a review of the security-classified government documents in its care,with the view to weeding out-of-scope items andrequesting declassification to promote wideruse.

The contract negotiated in fiscal year 1973 forarchival microfilming of certain portions of thecollection was renewed during 1974. The Libraryreceived almost 1,900,000 pages of material on

fi lm. In conjunction with this stepped-up preser-vation program, the Photoduplication Sectionundertook the in-house micropreservation film-ing of badly deteriorated items which could notsafely be sent out for contract filming. The pre-sent goal for in-house filming is one millionpages a year.

Toward the end of the year, the Divisionbegan testing access to computerized catalogdata using cathode ray terminals, for iden-tifying material cataloged since 1965. Thesystem (CATLINE) is searchable by author, title,or subject, and a variety of terminal types arebeing tested for public use in the catalog area.

An experimental referral system for in-terlibrary loan service was successfully in-stituted between the Library and the BritishLibrary Lending Division located in Boston Spa,Yorkshire. Loan requests which could not befilled at NLM were telexed to Britain andphotocopies of these articles were air mailedback for transmission to the requesting insti-tution. The experiment will continue into 1975.

Dr. Jaroslav Nemec of the reference staffcompiled an International Bibliography of theHistory of Legal Medicine, the first to appear onthis subject with world-wide coverage since1819. It is available through the U.S. Govern-ment Printing Office. Mrs. Joy Richmond, also amember of the reference staff, compiled and an-notated the Second Supplement to MedicalReference Works, 1679-1966. The work waspublished by the Medical Library Association.

Table 5. Summary of Circulation Activities

Number of Requests

Received

FY1971 FY1972 KY1973 FY1974

218,982 241,824 256,715 262.733

FilledFor readersBy interlibrary loan.

PhotocopyOrdinal

186,14483,585

102,55995,5597,000

UnfilledRejected and referredUnavailable

193,00972,892

120,117110,08110,036

194,34170,430

123,911114,228

9,683

205,89466,895

138,999126,68912,310

32,838 48,815 62,374 56,8399,273 10,558 12,228 14,082

23,565 38,257 50,146 42,757

16

Table 6. Summary of Reference Services

FY1971 FY1972 FY1973 FY1974

Requests by telephone .GovernmentNongovernment . ,

Requests by mail . . .Government . . .Nongovernment

Readers assisted . . . .Government . . .Nongovernment

TotalGovernment —Nongovernment .

Reading room users registered

10,0274,6635,374

1,391133

1,268

8,8683,2196,649

20,2868,006

12,281

11,6064,9226,683

1,570104

1,466

9,3473,3935,954

11,8034,5077,296

1,22963

1,166

11,1073,2077,900

22,422 24,1398,419 7,77714,003 16,362

13,3165,3977,919

1,398200

1,198

12,5944,3078,287

27,3089,90417,404

22,382 20,360 16,938 16,209

Technical Services

During the fiscal year 1974, CATLIKE (CatalogOn-Line) and SERLINE (Serials On-Line) be-came operational systems; both systems weredeveloped during FY 1973. In addition, an on-line Inprocess (INPROC) File and on-line InvoiceFile were designed and implemented during1974.

NLM's CATLINE contains full bibliographicdata for approximately 140,000 citations; it isupdated biweekly and is accessible throughNLM's MEDLINE user network, as is SERLINE.Machine readable cataloging has as a resultbecome available to MEDLINE users, providingsupport for a number of library activities suchas acquisitions, cataloging, reference, and in-terlibrary loan.

SERLINE provides direct and immediate accessto bibliographic and location data for some 6,000substantive serial titles held by 117 resourcelibraries in the Regional Medical LibraryNetwork. It has great potential as a tool for im-plementing and maintaining cooperative collec-tion assignments: SERLiNE's bibliographic andlocation data are continuously monitored, up-dated, and refined by the Library.

The on-line Inprocess File, developed and im-plemented during FY 1974, reflects the current

status of every item ordered, received, and inthe process of being cataloged by NLM or by acooperative cataloging partner; it is the controlpoint for all bibliographic records until catalog-ing is completed. INPROC contains approximately10,000 records. An on-line invoice file which con-trols, monitors, and regulates the flow of in-voices also produces regular managementreports on the status of items in the file. Thissystem provides for on-line input of data intothe file, capability for searching any invoice orvendor in the file, and production of up-to-datereports on the status of funds expended fromthe Division's literature budget.

Contractors were engaged for the followingtasks in FY 1974:• The preparation of approximately 15,000

volumes for shipment to the bindery.• The cataloging of some 2,425 SERLINE

titles for input into the CATLINE database, and the recataloging of 377 additionaljournal titles to conform to the AngloAmerican Rules before input intoCATLINE.

• Assistance in building the SERLINE database by adding publishers names, titleholdings, ISSN's, and locator codes for the117 medical libraries in the Regional Medi-cal Library Network which participate inSERLINE.

17

Table 7. Growth of Collections, FY1974Volumes Total Volumes

Added in Collections

Book MaterialBound Monographs

Prior to 1800 473 39,7101801-1913 687 90,5871914-present 11,937 269,896Bound issues 20,617 439,029Unbound issues (volumes) 2,108 48,056

Theses 325 340,585Pamphlets 61 171,989Total book material 36,158 1,399,852

Nonbook MaterialMicrofilms (archival) 4,226 17,520Microfiche 1,261 6,648Pictures 565 70,003Total nonbook material 6,052 94,171

Total book and nonbook material 42,210 1,494,023

Table 8. Summary of Acquisition StatisticsFY1972 FY1973 FY 1974

Serial RecordNew titles added 1,172 741 960Discontinued titles 201 86 105Current titles received 23,132 23,787 24,642

Publications ProcessedSerial pieces 87,995 100,930 93,371Other 20,323 20,548 16,148

Total 108,318 121,478 109.519

Obligations for Publications $430,000 $575.000 $689,740Included for rare books 79,583 118,133 101,769

Table 9. Summary of Cataloging ActivitiesFY1972 FY1973 FY 1974

Completed catalog 13,595 13,161 11,382

CataloK cards filed 105,236 112,716 134,190

Volumes shelf-listed 8,549 9,494 9,900

Table 10. Binding Statistics

FY1972 FY1973 FY 1974

Number of VolumesSend to binder 20,619 32,362 31,900Oblinations for bindinK $64,852 $114,787 $110,596

18

Specialized Information Services

The Library's Specialized Information Ser-vices administers the Toxicology InformationProgram(TIP)established in 1967 in response torecommendations by a President's Science Ad-visory Committee Panel. The Program's missionis: (1) to set up computer-based data banks oftoxicology information derived from the scien-t i f i c l i tera ture and f rom the f i les ofcollaborating governmental andnongovernmen-tal organizations; and (2) to provide toxicologyinformation and data services to the scientificcommunity. The Program provides services inthree modes: query response, publications, andon-line interactive informat ion retrievalsystems. The last is dealt with in the chapterOn-Line Retrieval Services.Query Response

During 1974, TIP continued to support theToxicology Information Response Center (TIRC)at the Oak Ridge National Laboratory. Duringthis period, some 350 comprehensive literaturesearches were carried out by TIRC in responseto requests from scientists and organizations.These searches covered all segments of tox-icology and resulted in bibliographies whichwere sent to the requesters. Bibliographies mayinclude computer printouts derived fromTOXLINE or MEDLINE searches as well as citationsand abstracts that are obtained through manualsearches of the conventional secondaryliterature sources.

The use of the $50 per search unit charge wascontinued to help defray portions of the totalcost of this service. The National Technical In-formation Service handled the billing and collec-tion functions for TIRC. In addition, some 20bibliographies completed by TIRC were publish-ed for sale through that agency. Steps weretaken to establish fo rma l interagencyagreements with other Federal organizationsfor literature search services from TIRC on afull direct cost recovery basis (i.e. $20/hour).For example, such an interagency agreementwas set up between NLM and the NationalCenter for Toxicological Research of the Foodand Drug Administration.Publications

The Toxicology Information Program con-tinued to support the preparation and publica-tion by Biological Abstracts of the secondaryjournal, Abstracts on Health Effects of En-

vironmental Pollutants. Twelve monthlypublications were issued, each containingcitations and abstracts for approximately athousand items. An Annual Cumulative Indexfor Volume 2 (1973) was prepared and publish-ed. Publication of the Toxicity Bibliography, aquarterly secondary journal containingcitations and MeSH terms for articles in thefield of toxicology, extracted from the MEDLARSdata base, was continued for the sixth year.

During the year, the following state-of-the-art reviews, sponsored by the Toxicology Infor-mation Program through the Toxicology Infor-mation Response Center, were published inselected scientific journals:

Health Hazards from Chemical Impurities:Chlorinated Dibenzodioxins andChlorinated Dibenzofurans by J. E. Huffand J. S. WassomE f f e c t s of Exposure to Micro-waves—Problems and Perspectives by S.M. MichaelsonProducts Marketed to Promote Growth inFood-Producing Animals: Steroid and Hor-mone Products by E. J. UmbergerAsbestos: World Concern, Involvement andLaissez-Faire by A. S. Mammons and J. E.HuffMycotoxins: Toxicity, Carcinogenicity andthe Influence of Various Nutritional Con-ditions by P. M. Newberne

UHEW Toxicofagy CommitteeEarly in the fiscal year, the HEW Assistant

Secretary for Health established a new Com-mittee to Coordinate Toxicology and RelatedPrograms throughout the Department. InJanuary 1974, a Toxicology Information Sub-committee was created. NLM's Toxicology In-formation Program was given the responsibilityfor coordinating the activities of the Subcom-mittee and for implementing the informationand data projects that the Subcommittee willsponsor. As a result of its first meeting inFebruary 1974, the Subcommittee has identifieda number of projects for implementation whenresources become available:1. A UHEW Toxicology InformationSystem—an on-line interactive retrieval file ongovernment supported research-in-progress intoxicology and related fields. The informationwould be extracted from the project report filesof the Smithsonian Science Information Ex-change.

19

2. Base Line Response in Laboratory AnimalsData Bank—The first step in this project—afeasibility study—is now in progress.

3. Roster of Toxicologi8t8—&r\ on-line retrievalfile and probably a printed directory of scien-tists active in toxicology and related areas.

4. Chemical File Support Services—NLM'scapability of processing files through the CAS

Name-Match system to obtain CAS RegistryNumbers (see On-Line Retrieval Services)would be made available to DHEW agencies viathe Subcommittee.5. Literature Support Services—Literaturesearch services, special bibliographies, andstate-of-the-art activities would be provided bythe Toxicology Information Response Center toDHEW agencies and the Subcommittee.

20

III. ON-LINE RETRIEVAL SERVICES

This past year there was an emphasis on ac-tivity designed to smooth the changeover fromMEDLARS I to MEDLARS II so that there would be aminimum of disruption of NLM's network usercommunity. During the spring of 1974, a seriesof regional orientation workshops was con-ducted by senior NLM staff to introduce the newcapabilities and search techniques to staff of the235 MEDLINE Centers throughout the nation. Themonthly NETWORK-MEDLARS/Tec/mica/ Bulletinand the publication of new manuals and othermaterials have helped to keep NLM's networkusers informed of changes in the system and toprepare the users for the greater capabilitiesand versatility of NLM's new on-line services.

The number of MEDLINE Centers increasedfrom 178 to 235 in FY 1974. This expansion ofthe network was primarily through hospitallibraries which formed MEDLINE consortia, thusstimulating not only the sharing of on-line in-formation retrieval services, but stimulatingcooperation in other areas of library services aswell.

MEDLINE service is provided through a datacommunications network which allows accessthrough a local dataphone call in any of 50 ma-jor metropolitan areas across the nation. Thecommunications network also has a node inParis and is being used regularly by the InstitutNational de la Sante1 et de la RechercheMedicale, the British Library System in Lon-don, the World Health Organization in Geneva,and by fifteen Canadian Centers. Additionally,the MEDLINE service is operated from acomputer in Sweden and is accessed by remoteterminals in eight locations in Sweden and oneeach in Denmark, Finland, Norway, TheNetherlands, and Poland, thereby greatly ex-tending its availability. In the past, MEDLINEservice has been provided free of charge to usinginstitutions. The widespread acceptance ofMEDLINE and projections of its continued rapidgrowth strongly indicated a need to establishsome form of user charges for the two-fold pur-pose of establishing a degree of managementcontrol over the growth of the system and toprovide a suitable funding alternative. A charg-ing policy was begun on August 20, 1973. The

user cost is $6 per connect hour, plus 10$ perpage for off-line prints. The minimum chargefor a user institution is $12 per month.

In preparation for the MEDLARS II system, theMEDLINE file of journal article references wasconverted in the spring of 1974 to include allMEDLARS citations for the two-year periodbeginning January 1972 plus the current year.Thus, MEDLINE now provides access to articles inover 2,200 journals. Previously, MEDLINEcontained references to about 1,000 journals forthree years plus the current year. The newMEDLINE file contains about the same numberofcitations—some 500,000.

In addition to MEDLINE, the on-line data basesavailable at the end of the year included:

SDILINE (Selective Dissemination ofInformation On-Line)—a complete file of thenext month's Index Medicua citations availablefor test searching and current awareness ser-vices. References contained in SDILINE arealmost one month ahead of the Index Medicuapublication date.

CATLINE (Catalog On-Line)—a data basecontaining fu l l bibliographic data for allmaterials cataloged at NLM and appearing inthe NLM Current Catalog since 1965. It containsapproximately 130,000 references and is up-dated twice a month. CATLINE is used to supporta number of library activities ranging from ac-quisitions and cataloging to reference and in-terlibrary loan.

SERLINE (Serials On-Line)—provides on-lineaccess to the bibliographic data for some 6,000serial titles as well as identifying the librariesholding a given title. SERLINE is used primarilyfor interlibrary loan activity within theRegional Medical Library Network.

MEDFILE (MEDLINE File)—contains citationsfrom approximately 1200 journal titles indexedin Index Medicua from 1970 through 1973. Thisfile is available only on a limited time schedule(rather than daily as with MEDLINE). Althoughsearches may be performed on-line, the usermust await the arrival of his search in the formof an off-line print-out by mail.

COMPFILE (Complement File)—contains thecitations to journal articles indexed from 1970

21

through 1973 in Index Medicus but not includedin MEDFILE. Like MEDFILE, COMPFILE is availableonly on a limited time schedule and the usermust await the arrival of an off-line printout bymail. Using MEDFILE, COMPFILE, and MEDLINE it

is possible to search the entire Index Medicusdata base from 1970 to the present.

MEDFILE and COMPFILE are interim data basesthat will eventually be merged into a BACKFILE.

Table 11. Summary of FY 1974 On-Line SearchesFY 1973 FY 1974

M E D L I N E . .SDILINE . . .CATLING ..SERLINE . .BACKFILE*TOXLINE**

Total

Off-Urn-PrintHMEDLINESDILINEBACKKILE . . . .CATLINESERLINETOXLINE*** ..

Total

* BACKFILE includes COMPFILE and MEDFILE"Estimated; includes CHEMLINE

•"Since transition to NLM computer in April 1974.

TOXLINEDuring this year, the Toxicology Information

Program (TIP) continued to improve and expandthe on-line toxicology bibliographic retrievalservice, TOXLINE. The service provides thesubscriber with remote on-line access to a database consisting of over 320,000 bibliographicrecords, enriched with index terms or fullabstracts, from the scientific literature. Theydeal primarily with the toxicology/phar-macology of drugs, pesticides, industrialchemicals, environmental pollutants, andhazardous household chemicals. On-l ineretrieval from TOXLINE is based on free-textsearching; most words in titles, index fields, andabstracts can be searched for, singly or in com-bination.

The user community for TOXLINE grew to over105 organizations by the end of June 1974: 28academic, 52 industrial/commercial, 19 govern-ment, and 6 miscellaneous. The system usagereached a level of 350/hours per month. Ap-

141.73013,3631,601477

1,6516,000

164.822

40.1155,8651,611

9

47,600

178,98327,64645,7712,88010,13813,000

278,418

40,92413,86611,143382134

1,034

67,483

proximately 13,000 searches were completed byTOXLINE users during this year.

For reasons of greater operating efficiency,the decision was made to move TOXLINE from acontractor operated computer to NLM forparallel operations with the MEDLINE services.In this situation, TOXLINE is using the MEDLINEsoftware, ELHILL. The rather cumbersome taskof transforming the entire 300-million characterTOXLINE file to the ELHILL software system wasaccomplished on schedule and, since April 1974,the system has been operating effectively fromNLM. As a result of this transfer, it was possi-ble to lower user costs from $45 to $15 per ter-minal hour. Also, TOXLINE users had to betaught to use the ELHILL query language. To thisend, a series of short training classes were heldfor TOXLINE users and an interim User TrainingManual was prepared for these users. A morepermanent TOXLINE training and referencemanual is now being prepared for all TOXLINEusers. As new users are coming into the system,they are given three-day training courses taught

22

by NLM staff. The TOXLINE Technical Bulletin(formerly TOXLINE Newsletter) became theofficial organ for transmitting technical infor-mation about TOXLINE to its users. A TOXLINETechnical Management Group was created within-house staff to handle technical problems be-ing experienced by TOXLINE users. TOXLINE nowcontains the following bibliographic files:

1. Toxicity Bibliography—& MEDLARS subset,86,967 citations with MeSH terms, 1968-March 1974.2. Chemical Biological Activities — AChemical Abstracts Service (CAS) publicationand tape service with 169,383 abstracts andCAS Registry Numbers to identify com-pounds, 1965-March 1974.3. Abstracts on Health Effects of En-vironmental Pollutants—& BIOSIS publica-tion supported by NLM, with 24,428 indexedcitations or abstracts and CAS RegistryNumbers, 1972-Dec. 1973.4. Pesticide Abstracts (formerly HealthAspects of Pesticide Abstracts Bulletin)—anEnvironmental Protection Agency publica-tion, with 13,062 abstracts and CAS RegistryNumbers, 1966-Dec.1973.5. International Pharmaceutical Abstracts(IPA)—a publication and tape service of theAmerican Society of Hospital Pharmacistswith 20,574 abstracts, 1970 - March 1974.6. Hayes File—a collection of 10,043 citationsfor articles on the health effects of pesticides,1950-1966 (a p recu r so r to PesticideAbstracts).

CHEMLINE

Since January 1974, TOXLINE users had anauxiliary, on-line retrieval system for chemicalnomenclature information called the TOXLINEChemical Dictionary. In April 1974, NLMchanged the name of this file to CHEMLINE, andmade it available in ELHILL. CHEMLINE takes itscontents primarily from the Registry Files ofthe Chemical Abstracts Service (CAS). Throughthe active cooperation of both CAS and the Com-puter Sciences Division, Oak Ridge NationalLaboratory, TIP was able to access the massiveCAS Registry Nomenclature tape files—cover-ing some 2.6 million unique compoundsand over3.5 million names—and extract from them allrecords for compounds that are cited by CASRegistry Numbers in TOXLINE . This resulted in

a file of 60,000 CAS Registry Number recordscontaining CAS Registry Numbers, molecularformulae, and all names known to the CASsystem. Where available, certain other com-pound identifiers, such as Wiswesser LineNotations, are being added to the file. Theresults of a CHEMLINE search normally are usedin combination with other search terms for amore precise and complete search in TOXLINE.CHEMLINE is available to all TOXLINE users at$15/hour.

Toxicology Data RetrievalThe success of on-line bibliographic retrieval

systems suggests that the same technologycould be applied effectively to data retrieval.Plans were therefore made to adapt or buildseveral data banks in toxicology for retrieval inthe same software system (ELHILL). One of theon-line, interactive data retrieval files which TIPis constructing is the Product Composition Filewhich will contain up-to-date information onmanufacturers, usage, formulations, ChemicalAbstracts Service Registry Numbers, com-ponents, and lexicological properties of some10,000 commercial products sold in the UnitedStates.

Another on-line interactive data retrieval filewhich TIP is constructing is the Toxicology DataBank. This file will contain evaluated data asfound in a selected set of sources, such as text-books, criteria documents, reviews, or the filesof specialized information centers, on com-pounds known to be hazardous and to whichpopulations are exposed.

CAS Registry NumbersAs previously mentioned, TIP is intimately

involved in the construction of toxicology infor-matiori and data bases in which the identifica-tion of chemical substances is of great impor-tance. After careful evaluation of existingsystems, the decision was made to adopt theChemical Abstract Service Registry Numbers asthe unique identifiers of chemical substances inthese files. In order to facilitate this operation,TIP, in collaboration with CAS and the Com-puter Sciences Division, Oak Ridge NationalLaboratory (ORNL), modified and installed theCAS Name-Match system at ORNL.

The function of the CAS Name-Match systemis to compare a chemical name with the CAS

23

Registry Nomenclature File. If a match is made,the system will output the CAS RegistryNumber, molecular formula, and ChemicalAbstracts Index nomenclature (as well as othernames and synonyms known to the CASRegistry System) for the input name. Undercontractual arrangement with CAS, TIP ac-quired the CAS Name-Match system and thecorresponding Registry Files of CAS. Certaindesign modifications by TIP and ORNL staffsresulted in a free-standing (i.e., independent ofother modules of the CAS Registry System)Name-Match system. TIP now has permission touse the CAS Registry Nomenclature Files to up-date CHEMLINE and to perform Name-Matchactivities for NLM and certain other govern-ment agencies.

Collaborative Activities

During FY 1974 the National Library ofMedicine and the National Cancer Institute haveagreed to place cancer-related abstracts intodata bases residing in the NLM system and us-ing the NLM telecommunications network tomake the data available to cancer research in-stitutions. Under this arrangement the CancerChemotherapy Abstracts data base involving13,000 abstracts is now available. During FY1975, 18,700 abstracts previously published inCarcinogenesis Abstracts and 6,000 reports of

ongoing cancer research will be added to theNLM data base.

The Library continues its contractualarrangements with the State University of NewYork at Albany to provide a MEDLINE backup tothe existing system. This is especially importantin light of the significant increases in userdemands, and as an alternative in the event ofsystem failure at NLM.

MEDLARS II

During FY 1974, the MEDLARS II developmentproject neared completion. At the close of thefiscal year, the system had been used successful-ly to build a seven-level vocabulary file, a jour-nal file, and the current citation file. MEDLINEwas installed under ELHILL ill—the MEDLARS IIretrieval program—during June 1974. The en-tire MEDLARS II system is working satisfactorilyfor journal citation processing, including input,f i le generation, retrieval, and publicationprocessing.

Final delivery of all MEDLARS II softwaremodules and documentation is anticipated bythe end of August 1974 and acceptance by NLMcompleted by the end of September 1974. Atthat time MEDLARS II should be fullyoperational, allowing the removal of theHoneywell 800 system shortly thereafter.

24

IV. GRANTS FOR LIBRARY ASSISTANCE

Medical Library Assistance Act

The 93rd Congress extended the MedicalLibrary Assistance Act* for two years, through1976, with a provision that there would be anautomatic third year extension (FY 1977) ifCongress does not act to modify the legislation.There are several revisions to the MedicalLibrary Assistance Act. The new act con-solidates all program authorities except con-struction, which was repealed. Appropriationsof up to $17.5 million for fiscal year 1975 and $20million for fiscal year 1976 have been autho-rized. This lump sum appropriation createsmore flexibility in the use of funds as programpriorities change.

Administration

The Office of Extramural Programs of theNational Library of Medicine is responsible forthe administration of the Medical LibraryAssistance Act as extended, as well as theLibrary's Special Foreign Currency Programsponsored under Public Law 480, which providesfinancial support for a wide variety of foreignpublication projects.

The Division of Biomedical Information Sup-port is concerned only with the programsauthorized by the Medical Library AssistanceAct. The International Programs Division ad-ministers a publications program sponsored un-der Public Law 480, as well as a publicationsprogram authorized by the Medical LibraryAssistance Act.

Division of Biomedical InformationSupport

Five funding mechanisms are available to theDivision of Biomedical Information Support, allof which aid the Division in promoting theprogrammatic interests of the National Libraryof Medicine.Training grants for medical librarians andhealth information personnel have been un-usually productive in this respect. Although the

"These MLAA provisions were signed into law July 23,1974, as Public Law 93-353, Title II.

In a program funded by NLM grant, medical librarians(such as the one at the left of the picture) accompanyteaching physicians and medical students on rounds inhospitals linked with the University of ConnecticutHealth Center. The librarians later supply readingmaterial related to what they have seen and heard onrounds.

Library was unable to accept applications fornew training grants in FY 1974, the support ofseventeen training grants and one fellowshipwas continued under the terms of the phaseoutrequirements.Research grants are available to investigators inthe broad area of biomedical communicationsfor the testing of hypotheses, the systematicdevelopment of the tested concept, and the op-portunity to demonstrate the activity to otherinterested parties.Special Scientific Project awards are availableto mature scientists so they may devote theirfull attention to the preparation of a monographor treatise on a broad health topic. In addition tothe state of the art in the particular area of theauthor's competence, the manuscript would in-clude future projections based on the author'sknowledge of the topic as well as the social,political, and economic ramifications of the sub-ject. The resultant book would be of interest notonly to the author's scientific peers andcolleagues but also to health planners,politicians, sociologists, and economists who areconcerned with health problems and health caredelivery.Contracts are used as the mechanism of supportfor the day-to-day operation of the RegionalMedical Library network.Resource grants support projects directly or in-directly related to the development of the RML

25

network. The scope of a project may be limitedto the primary constituency of the library orcould involve an outreach to the larger com-munity. A grant to a local library makes thatlibrary a more active and effective participantin that region. Many of the grants, while givento an individual library, involve activities andservices extending beyond its immediate con-stituency. This subregional activity hasprogressively increased over the years until, inFY 1974, three-fourths of a million dollars wasawarded to libraries for these purposes.

These five types of awards collectively sup-port four program areas that are identified asmajor objectives of the National Library ofMedicine.

1. Medical Libraries and LibrarianshipSeveral groups of investigators, withNLM support, have been testing,developing, and demonstrating the use ofthe computer in automating variouslibrary activities, such as serials control,circulation, acquisitions, and other dataprocessing activities. In another project,which interfaces a medical school librarywith a state-wide area health educationcenter program, resource materials andother assistance are provided by thegrantee to various community hospitals.Another grant is assessing the needs forthe continuing education of medicallibrarians and developing an integratedplan to meet these needs.The above examples are of projectsstudying various facets of libraries andlibrarianship. In addition to these, 50 im-provement grants were awarded in FY1974. These grants, averaging less than$3,000 each, are given to small hospitallibraries to improve their basic holdings.While these grants are of primary im-portance to the local hospital, they im-pact directly on the Regional MedicalLibrary network. The local hospitals areable to have available the most common-ly utilized books and journals, thus ob-viating interlibrary loans of thesematerials.

2. BiomedicalInformation Science and Ser-vicesExamples in this category includenomenclature projects sponsored byprofessional societies to formulate stan-

dard terminology and classification fortheir subject areas. Another project isconcerned with the development of anautomated program to select, from alarge data base, information related to aspecific disease. These subsets may beobtained by utilizing clinical signs as in-dex and search terms. This system isoriented to the clinician user, a new ap-proach.Over one million dollars was expended inFY 1974 in the support of biomedical in-formation science and services. Thisamount is a five-fold increase over thelevel of support in this area four yearsago and is indicative of the priority theLibrary places on biomedical com-munications.

3. Education and Knowledge TransferOne project in this area supports thetesting and evaluation of instructionalmaterials prior to publication. Studentand faculty members evaluate thematerial in draft form and provide feed-back information to the author who thenincorporates th i s in to the f i na lmanuscript. This procedure ensures am u c h i m p r o v e d f i n a l ed i t ion ofworkbooks, self-instructional and self-testing books, atlases, and othermaterials. Other grants have been madeto medical libraries to provide referenceservices to community hospitals within alocal area, state, or region.

4. History of MedicineTwo projects in the history of medicinewill illustrate the nature of this supportprogram. The first concerns Tran-sylvania University in Lexington, Ken-tucky, the first medical school in theUnited States west of the Appalachianmountains. In operation from 1800 to1859, the Transylvania library contains aunique collection of well-preserved early19th century medical texts. Under thegrant, a catalog of this collection will bep u b l i s h e d , m a k i n g th is valuablehistorical resource more widely knownamong medical historians.The second project is centered at thePennsylvania Hospital in Philadelphia,the oldest public hospital in the UnitedStates. Founded in 1751, its library has

26

served practitioners since that time andcontains unique archival materials ofmajor importance. This material is beinginventoried and a catalog will be pub-lished to coincide with the U.S. bicenten-nial celebration.

International Programs Division

The publications support programs ad-ministered by the International Programs Divi-sion facilitate the dissemination of scientific in-formation important to medical progress andthe public health. Carried out both within theUnited States, through the Publication GrantProgram, and abroad (PL 480 program) withspecial U.S.-owned foreign currencies in Poland,Israel, Tunisia, Yugoslavia,India, and Pakistan,these selective programs continue to producestudies useful to U.S. scientists, educators, andhealth practitioners. The PL 480 program isdescribed in the chapter on International Ac-tivities.

The domestic Publication Grant Programprovides support for biomedical publications of

a nonprofit nature, including critical reviewsand monographs in health fields; secondaryliterature tools (bibliographies, atlases, guides,etc.); publications in library science, biomedicalcommunication, and information science; tem-porary support for serial publications to developinnovative approaches to periodical informationpackaging; research and translations in thehistory of medicine; the translation and publica-tion of foreign biomedical monographs; and thepublication of the proceedings of internationalsymposia and conferences related to U.S. healthneeds.

A total of 32 Publication Grants was fundedduring FY 1974, 15 of which were new awards.Among the new awards were a project for thepreparation and publication of a comprehensiveatlas on the pathology of tropical diseases and acritical review on advances made in the trainingof allied health personnel.

During FY 1974, 23 books, periodicals, andjournal articles were published with supportfrom publication grant awards in prior years.These are listed in Appendix 3.

Table 12. Resource Project Grant Allocation by Network Level*

Network Levels

LocalSubregionalRegional

Total

1971

$343,514242,985270,559

$857,058

1972

$1,239,595363,222218,312

$1,821,129

1973

$1,587,919617,206220,035

$2,425,160

1974

$1,443,442747,999297,888

$2,489,329

'Includes support for Regional Medical Libraries

Table 13. Resource Project Grant Allocation by Objective*

Objectives 1971 1972 1973 1974

Medical libraries and librar-ianship $549,108 $1.608,036 $1,641,234 $1,066,082

Biomedical informa-tion services 53,867 245,202 351,286 712,400

Education and knowl-edge transfer 402,505 441,407 579,624 773,529

History of medicine 18,404 64,268 61,942 105,250

Total $1,023,884 $2,358,913 $2,634,086 $2,657,261

'Includes support for Regional Medical Libraries

27

Table 14. Summary of NLM Extramural Programs

ActiveNew Grants & Projects

Awards Contracts CompletedProgram FY1974 June 30,1974 FY1974

Research 5 27 5Resource 85 156 139Training & Fellowships 2 18 1Special Scientific Projects 1 3 1Publication 17 29 12Special Foreign Currency* 31 70 34Regional Medical Library — 10 —

Total 141 313 192

*See International Activities

28

V. AUDIOVISUAL PROGRAMS

"A most b e a u t i f u l demonst ra t ion ofpartnership" was the way one Regent at theMarch 1974 Board of Regents meeting describedthe ongoing successful cooperative programbetween the Library's National MedicalAudiovisual Center (NMAC) and nationalprofessional societies to evaluate audiovisual in-structional materials in biomedicine. Othersignificant progress during FY 1974 includedthe beginning of an evaluation project to assessNMAC's film and videotape distribution system,increasing the number of self-instructional un-its available through the U.S. Government FilmSales Program, final production of films andstudy manuals of 15 modules on restorative den-tistry, and design for a multimedia LearningResource Center to be constructed at NMAC inAtlanta.

Clearinghouse

In the effort to develop an automated database of information on nonprint instructionalmaterials relevant to professional education inmedicine, dentistry, and allied health sciences,approximately 22,000 citations to instructionalmaterials have been entered into an in-houseworking file to provide raw data on audiovisualsavailable for peer review and evaluation. Actionwas taken to obtain professionally writtenabstracts and acquire catalog information onapproximately 2,800 audiovisuals to be enteredinto the clearinghouse data base; these entrieswill ultimately be retrievable via an on-linecomputer system.

Evaluation and Acquisition

Evaluation procedures and criteria for assess-ing items to be entered in the clearinghousewere standardized in FY 1974. Through the con-tractual agreement between the NationalLibrary of Medicine, the Association ofAmerican Medical Colleges, and the AmericanAssociation of Dental Schools, about 150 itemsin a variety of mediated formats are scheduledfor peer review every three weeks. NMAC ac-quires the instructional materials on loan andprepares them for the peer-review process.

Specialists in education, audiovisualproduction,and content then screen and evaluate thematerials for design, quality, and content ade-quacy. The results of the review are tabulatedand recommendations made for input of theitems into the clearinghouse. Items that receiveacceptable ratings and are not nationallyavailable are acquired by NMAC for distribu-tion. During FY 1974, 110 new titles were ac-quired.

A major evaluation project to assess the filmand videotape distribution system of NMACwas begun under a contract with ABTAssociates, Cambridge, Massachusetts.Preliminary results obtained from a question-naire survey of users of the system indicatedthat:

1. Both the film distribution and videotapeduplication programs are used primarilyfor t e a c h i n g p u r p o s e s by aheterogeneous population of biomedicaleducators.

2. Audiovisuals ordered from NMACreceive heavy exposure and serve as avaluable resource for the needs ofbiomedical educators.

3. Clients of NMAC are well satisfied withthe service they receive.

4. Audience interest and enhancement ofthe educational process are perceived byNMAC audiovisual users to be at highlevels.

5. An analysis of the NMAC distributionoperation indicated a very favorablebenefit/cost ratio.

Distribution

Over 56,000 requests for film loans were filledduring FY 1974. The development of the collec-tion toward professionally oriented materialscontinued with the addition of 110 peer-reviewed titles and the withdrawal of 88 titles(2,450 prints) directed to lay audiences. As ex-pected, statistics reflected a definite increase inthe percentage of professional health scienceusers as opposed to lay users.

Over 3,300 videotape programs wereduplicated from the Center's collection of

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master instructional videotapes, and furnishedto schools requesting them.

There were 21 new self-instructional teachingpackages added to the collection presentlyavailable for sale through the U.S. GovernmentFilm Sales Program. The titles are:

Single ConceptUnits:

Gross AnatomySeries:

Nuclear MedicineSeries:

Pediatric Ambula-tory Series:

Introduction toCongenital HeartDisease Series:

Closed Chest Tube Thor-acotomy

Left Ventricle Catheteri-zation

The Femoral TriangleThe Scapular RegionPosterior Compartment ofthe Forearm

Liver ScanningFocused Collimators

Acute Asthmatic AttackFebrile Convulsions

Part 3—Common AcyanoticLesions

Part 4—Common CyanoticLesions

Part 5—The Large Ven-tricular Septal Defect inInfancy

Introduction to Mam-mography

Mammography TechniqueBreast Diseases: Their Im-portance in Your DailyPractice

Immune Complexes andDisease

Disorders of the Stomachand Duodenum

Flail Chest with Hemo-pneumothorax

Workshops and ConferencesA total of 815 participants from the

biomedical community attended 20 workshopsessions conducted by NMAC staff and visitingfaculty in Atlanta and nine field locations.Titles of these workshops were:Management of Learning Resources, Design of

MammographySeries:

Basic PathologySeries:

Instructional Media, Television in the MedicalEnvironment, Evaluation of InstructionalMaterials in Medical Education, Graphics inHealth Sciences Education, Learning Spaces,Symposium on Ins t ruc t iona l Technology,Anatomy Workshop, and Workshop for NursePhysiologists.

The Center was host to the Fourth AnnualConference of Directors of Biomedical Com-munication on January 28-29, 1974. TheConference was attended by 59 directors and 15observers from health science schools andrelated organizations. The decision was made toorganize the group formally, and a bylaw com-mittee was elected with Dr. Horace Hartsell,University of Texas Medical Center, DentalBranch at Houston, as Chairman.

Advisory ServicesNMAC staff conducted surveys or site visits

at the following institutions: seven communitycolleges on the islands of Hawaii, Kaui, Maui,and Oahu; University of Arkansas MedicalCenter, Little Rock; University of New Mexico,School of Medicine, Albuquerque; DownstateMedical Center, SUNY, Brooklyn; Long Island-Jewish Hillside Medical Center, New HydePark; New Children's Hospital of Philadelphia;University of Alabama, College of CommunityHealth Sciences, Tuscaloosa; University of UtahMedical Center, Salt Lake City; University ofMaryland School of Nurs ing , Baltimore;Meharry Medical College, Nashville (2 visits);Johns Hopkins School of Medicine, Baltimore;State Universityof New York, Buffalo (2 visits);University of Miami Medical School; Universityof Alabama, Birmingham;Saint Louis Universi-ty, School of Medicine.

Facilities planningassistance was provided to20 institutions including schools of medicine,dentistry, osteopathy, podiatry, nursing, andallied health. In-house consultations on specificproblems in the area of facilities planning wereprovided to 101 institutions during the year.

Post-survey assessments were conducted atMayo Medical School and Clinic, University ofOklahoma Health Science Center, and StanfordUniversity Medical Center. A review of theassessment profiles indicates that NMAC ef-forts to stimulate and improve biomedical com-munication programs in these institutions havebeen h igh ly effect ive. Mayo adopted all

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recommendations in the initial survey reportwith the following results: all media operationshave been centralized under a director; majorproduction and service capabilities have beendeveloped, including a Learning Center with afull-time librarian; several classrooms weremodified for multimedia presentations.

Direct problem-oriented consultation servicesrelating to educational technology and instruc-tional media development were provided on 88occasions for 170 representatives of 21 schools ofmedicine, seven schools of dentistry, threeschools of nursing, eight schools of allied health,five national or international organizations, and28 teaching hospitals and other health scienceinstitutions.

Designs are nearing completion for a mul-timedia Learning Resource Center to be con-structed at the Clifton Road (Atlanta) facilityfor demonstration purposes, and for use byvisiting faculty and medical librarians. It willalso serve as a proving ground where NMACstaff can test new ideas in learning space con-figuration and in audiovisual media manage-ment. Furniture and equipment are on order,and the new unit is scheduled to begin operationin FY 1975.

Media Development

During FY 1974 the Center completed fourmotion pictures, 15 television productions, andnine slide/tape sets.

Continuing emphasis was placed on the teamapproach to instructional media development,

Dr. Shields Warren, noted pathologist, and Dr. JohnBowers, President of Alpha Omega Alpha, prepare for avideotaping session at NMAC.

with each team consisting of a subject matterspecialist, an education specialist, and anaudiovisual specialist. The method is being usedfor in-house productions and taught inworkshops for health science faculty. Informa-tion on this procedure is contained in "A TeamApproach to Developing an Audiovisual SingleConcept Unit," by M. L. Brooke, R. W. Bell, andM. J. Oppenheimer, published in the PhysiologyTeacher, Vol. 3, No. 3, 1974.

Modifications based on field tests and finalproduction of films and study manuals are near-ing completion for Project ACORDE (A Consor-tium on Restorative Dentistry Education). Pilotversions of these units have been validated withstudents and approved by 53 dental schools. Thematerials will be made available through theU.S. Government Film Sales Program.

Three additional modules are nearing comple-tion in the film series on Family OrientedMaternity Care by the Nurse Clinician,developed with the School of Nursing, EmoryUniversity: "Labor," "Delivery," and "TheNeonate." Another series being developedcooperatively with the same school is titled"Behaviorally Speaking." Each module in theseries of eight will consist of a film and a studymanual.

Major accomplishments in television for FY1974 include the completion of 10 additionalvideotapes in the "Leaders in AmericanMedicine" series, produced in cooperation withthe medical honor society Alpha Omega Alpha.NMAC is also supplying television support tothe experimental satellite ATS-6 in cooperationwith the Veterans Administration Division ofMedicine and Surgery, Learning Resources Of-fice of Academic Affairs. Working with FACT(Foundation for the Advancement of Com-munications Technology) the Center is fur-nishing a variety of production services in thepreparation of videotapes for transmission tohealth science professions.

The recent acquisitionof sophisticated equip-ment including color cameras, switchingdevices, and t ime-base correctors willsignificantly augment NMAC's televisioncapability.

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Publications

The publications program begun last yearcontinued during FY 1974. Monographs No. 3,No. 4, and No. 5 were published: Organizing aBiological Photographic Unit, Financing aBiomedical Communication Program, and AMedical Television Center. Monograph No. 6,Operating a Learning Resource Center, is inprinting. Two case studies were also published:Cooperative Sharing of Audiovisual Materials,and Establishing a Learning Resource Center ina Medical Library.

Audiovisual Productions—FY 1974

Motion Pictures

The Autonomic Nervous System—An Overview

What's New in Medical Education

Clinical Evaluation of the Hip

Initial Assessment and Management of Burns

Slide Series

Hepatic Excretory Function: Jaundice

How to Design an Effective MeasuringInstrument

Congenital Heart DiseasePart III: Common Acyanotic LesionsPart IV: Common Cyanotic LesionsPart V: The Large Ventricular

Septal Defect in Infancy

Team Dentistry

Perinatal Assessment of Maturation

Febrile Seizures

Hypoglycemia of the Newborn (revision)

Television Projects

Leaders in American Medicine (series)Dr. Howard C. TaylorDr. Maxwell M. WintrobeDr. George W. CornerDr. John Enders, Dr. Frederick RobbinsDr. Karl MeyerDr. Grace A. GoldsmithDr. George L. EngelDr. Cecil WatsonDr. Emil HolmanDr. Helen Taussig

Cardiac Physical Assessment

Closed Chest Tube Thoracotomy—Tracheostomy and Thoracentesis

Autopsy Dissection Techniques

Adult Physical Assessment

Pediatric Physical Assessment

Filmstrips

Accidentes Del Transito

Dengue Fever

Dengue

La Historia Clinica

La Jeringuilla Hipodermica

La Pipeta

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VI. HEALTH COMMUNICATIONSRESEARCH

NLM's research and development component,the Lister Hill National Center for BiomedicalCommunication, manages a number of projectsto apply modern technology to the problems ofbiomedical information transfer. Because of alack of in-house technical facilities, the principalimplementation method is the research con-tract. The Lister Hill Center uses its funds todevelop, test, and evaluate prototype networksrather than operate such networks. At suchtimes as they show promise of becoming self-sustaining, or have provided all necessary data,the Center withdraws support to free funds fornew projects. The Lister Hill Center is engagedin the following projects:

Application Technology Satellite-6

(ATS-6)On the 30th of May, 1974, the ATS-6 left its

launching pad at Cape Canaveral, passed fromthe control of Kennedy Space Center to that ofHouston, and headed towards its temporaryparking place in synchronous equatorial orbit,22,235 miles above the Galapagos Islands.

ATS-6 is the world's largest and most power-ful communications satellite, weighing 3,080

pounds. It will beam messages down to "giantfootprints" on Earth, about 1,000 miles long by300 miles wide. Two high-powered transmitterswill bounce signals off its 30-foot diameterantenna, sending a television signal accom-panied by four voice channels to as many as 144receivers on the ground. Because of thesatellite's power, the ground antenna receiversare inexpensive, small, and made of fiberglass.The 144 receivers will be installed either direct-ly, each servicing a single set in a hospital,clinic, school, or community facility, or they willbe tied in with public broadcasting microwaveor cable systems already operating in Alaska,the Rocky Mountain states, and Appalachia.

ATS-6 will be available for experiments by anumber of Federal, state, and regional agenciesuntil May 1975. Then it will be moved to anequatorial position above East Africa where itwill be visible to the Indian subcontinent. Fromthere it will transmit programs on occupationalskills, increasing food production, family plan-ning, health and hygiene, and teacher trainingto a network of some 5,000 low cost communityreceivers in Indian villages.

The Lister Hill Nat iona l Center forBiomedica l C o m m u n i c a t i o n s has been

Earl Henderson, Chief of the Lister Hill Center's Communications Engineering Branch, watches liftoff of the ATS-6.The satellite was launched into orbit from Cape Canaveral on top of an Air Force Titan III-C rocket on May 30, 1974.

33

designated as the focal point for coordinatingthe DHEW health experiments over the ATS-6.Support is also provided by the HealthResources Administration and the Health Ser-vices Administration. These experiments willdetermine whether health care in remote areascan be improved by (1) telemedicine, and (2) byhealth education to train physicians whose un-dergraduate experiences are gained in ruralAmerica.

The telemedicineexperiments, which will con-tinue the work begun in Alaska with ATS-1 (seeNLM Programs and Services: FY1973), will beconducted at five Alaska sites equipped totransmit and receive video, voice, physiologicalinformation, and record data. Medics and healthaides at two village clinics will present patientsto viewing physicians at the Public Health Ser-vice Hospital at Tanana. Consultation withspecialists will be available by satellite fromFairbanks and from the Alaska Native MedicalCenter at Anchorage. Patient medical recordswill be retrieved via ATS-1 from the IndianHealth Service's Health Information Systemcomputer in Tucson, Arizona.

The health education experiment, involving ac o n s o r t i u m of the fou r W A M I states(Washington, Alaska, Montana and Idaho), is intwo parts—basic sciences and clinical medicine.Instruction in the basic sciences will involvefaculty at the Universityof Washington (whichhas the only medical school in the WAMI area)in Seattle and students and faculty at theUniversity of Alaska in Fairbanks. There will befull two-way voice and video interaction forclasses in basic sciences, administrative con-ferencing, counseling, and computer-aided in-struction and evaluation of student perfor-mance. Lectures, demonstrat ions, andclassroom experiments will originate from bothsites.

The experimenters hope to show that learningvia satellite is fully as effective as learning in a"normal" classroom environment.It will be im-portant to learn if the new technology is accep-table to the remote students and to the facultyat both sites.

The part of the health education experimentdealing with clinical medicine will involve third-and fourth-year medical students studying un-der clinicians in Omak in central Washington.

The students will present patients by video andvoice transmissions to the medical faculty of theUniversity of Washington in Seattle. In additionto student presentations, the cliniciansat Omakwill choose patients under their regular carewho have problems on which they wish con-sultation.

These experiments in clinical medicine willtrain students in preparing case studies and willalso permit a careful evaluation of the students'knowledge and ability in the actual care ofpatients seen in practice. Clinicians at Omakwill receive a valuable experience in continuingmedical education;the patients seen will benefitfrom the consultation with the specialists inSeattle.

Much of rural America suffers from a seriousdoctor shortage. There is evidence that youngdoctors often choose to practice where they havereceived their clinical training. A system whichsupports the development of first rate clinicaltraining in rural settings could work to en-courage new physicians to enter rural practice.

Interact

Reported in previous years' NLM Programsand Services, the New Hampshire/VermontMedical Interactive Television Network("Interact," as it's now called) consists of seveninstitutions in the two states linked together bya mountaintop microwave network. The hub ofthe network is the Dartmouth Medical Center inHanover, New Hampshire. Three of the in-stitutions on the network, all within a 20-mileline-of-sight radius of the tower on Mt.Ascutney in New Hampshire, are served by aspecial mobile unit that carries microwavetransmitting and receiving equipment, and TVcameras and monitors.

With live two-way voice and video com-munication, the network has become a regularworking tool for the medical and allied healthpersonnel at the seven locations. Each week, airtime is allotted to such programs as grandrounds, speech therapy, conferences inneurology and neurosurgery, psychiatric con-sultations, and courses for nurses. DuringJanuary of 1974, for example, the stations wereon the air for a total of 278 hours, with in-dividual users totaling 2,078 viewer hours.

A management consulting firm was retained

34

during 1973 to evaluate the impact, coat-effectiveness, and potential for self-sufficiencyof the network. Their report* shows that in-teractive television is an effective medium forproviding educational and other services in arural medical setting—that indeed, for formaleducational purposes the television can be aseffective as comparable classroom instruction.Also, the network may be of high value inpromoting "best medical practice" by affirmingpractitioner judgments on case managementand by encouraging the more widespread adop-tion of new practices already introduced to therural medical community.

The study disclosed that different types ofusers get different benefits from the network.The medical centers use the network as a vehiclefor service delivery and for faculty sharing. Thelocal community hospitals derive status andneeded information as participants in thenetwork. They also feel that they gain the goodwill of the medical centers and have easy accessto continuing education for their staffs. Generalpractitioners find that the network offers thema low key, job relevant "break," and an oppor-tunity to test their ideas with colleagues atother institutions. Specialists, on the otherhand, welcome the network.as an opportunity tomaintain contact with physicians at other in-stitutions.

Nurses, who have had more formal coursesoffered over the network, find that it offersthem both knowledge and certification.

The first period of operation and constructionof this network, from July 1970 through the fallof 1973, was devoted to exploring the uses andbenefits of interactive television in a remote,rural area. The next two years will be devotedto testing the hypothesis that these uses andservices can demonstrate cost benefits, to thepoint where they will assume a substantialportion of the costs of providing these com-munication links.

Computer Assisted InstructionNetwork

Since July 1972, the Lister Hill Center hasbeen coordinating an experiment to foster theinterinstitutional sharing of computer assistedinstruction (CAI) resources among medicalschools, hospitals, and other health relatedorganizations (see NLM Programs and Servicesfor FY 1972 and FY 1973). Three centers of

biomedical CAI expertise were put on-line via anationwide commercial time-sharing com-munications network. The three centers areMassachusetts General Hospital, Ohio StateUniversity College of Medicine and, untilFebruary of 1974, the University of Illinois atthe Medical Center, Chicago. In 1974, some, butnot all, of the UIMC programs were transferredto the Ohio State University computer so thatthey will continue to be available. The com-munications network is that of TYMSHARE,Inc.

Over 80 institutions (primarily medicalschools) have used the network for a variety ofpurposes. These include: introducing CAI oncampuses; integrating available materials intothe curriculum; using the network as a supple-ment to other forms of training; using thematerial as a remedial tool; stimulating localCAI activities; and encouraging broader facultyuse of the variety of educational resourcesavailable. User institutions have been en-couraged to prepare "educational material useand evaluation plans" and to submit evaluativereports, which are shared with the others.About 70 percent of the CAI network's currentuse is by medical students. The remainder of thetime is used primarily by physicians, nurses andallied health personnel. Total usages have rang-ed as high as 2,800 hours a month. An houraverages out to include 2.5 teaching sessions.Since there is a tendency for several students togroup around the terminals and to interact asvigorously with each other as with theprograms, it is probably conservative to es-timate that the network has provided over 15,-000 interactive teaching sessions per month.

Until February 1974, the Lister Hill Centerabsorbed most of the costs of the network. Userswere required to provide suitable terminals, paytelephone charges to the nearest network con-nection point, and assume the cost of thenecessary faculty time for administering theprogram. Starting February 1, 1974, users wererequired to pay $2.50 per connect hour; after

•Molly K Hageboeck and Leon J Rosenberg IntrmctweTrlemimm A Study oj Itx EfJvctiwnuM an a Medical Educa-turn Keiumrre HI th<- Huml Northeast Practical Concepts,Inc Washington. D C Nov 1973 Available from NationalTechnical Information Service, Springfield, Va , 22121, asPB 225172/6AS for $1025 in hard copy or $2.25 inmicrofiche

35

July 1, 1974, the charges rise to $5.00 per con-nect hour. These charges defray a portion of thetotal communications costs and do not reflectthe computer and administrative costs paid tothe several CAI centers. The remaining costs,about $13 per hour, will be borne by the ListerHill Center for the duration of this phase of theexperiment, which will be concluded May 30,1975.

The network has demonstrated that schoolsare interested in sharing CAI materials for avariety of purposes; however, the presenttechnical implementation of the network is toocostly for the long run. Therefore, the Center isexploring alternative distribution methods,some of which may well involve an initialcapital expenditure on the part of the using in-stitutions, but which will result in substantiallyreduced operating costs. Computer languagetranslation to permit wider distribution ofmaterials, language standardization, and theuse of minicomputers at local nodes or even atthe campus end of the network, are all beingstudied. The goal is to encourage the exchange ofeducational materials prepared on other cam-puses while, at the same time, encouraging localinstitutions to maintain greater control in localmodification of materials, encouraging localauthoring, and keeping records of individualstudent performance out of central nationalcomputers. The Lister Hill Center will alsomaintain an active interest in the broaderproblems of resource sharing including: evalua-tion methodologies, content development issuessuch as copyright and author incentives, andhelping faculty members learn how to use thesenew materials effectively.

Other Projects

A series of experiments in biomedical com-munications in the Pacific Basin using the ATS-1 satellite was concluded in August 1973. TheUniversity of Hawaii utilized the PEACESAT(Pan-Pacific Education and Communication Ex-periments by Satellite) experimental systemmade up of eleven satellite groundterminals innine Pacific nations or jurisdictions. A largebody of data was gathered identifying key in-dividuals and agencies in the Pacific Basin andanalyzing their needs for biomedical com-munications. Pilot demonstrations were con-ducted via satellite in administrative planning,diagnostic consul t ing, research, patientreferrals, and training. Follow-on pilot healthinformation systems are planned for the area,including a network for the exchange of librarymaterials.

Also concluded in FY 1974 was a two and one-half year study supported by the Lister HillCenter to evaluate the effectiveness of in-dividual access to audiotapes and 35mm slidematerial in freshman medical education atGeorge Washington University. Students couldborrow tapes of lectures (in either regular or"compressed speech" mode) and slide-tapeprograms in such subjects as histology, em-bryology, and neuroanatomy. Among the con-clusions of the study were that the audiotapedmaterials were a significant support to learningfor about 25 percent of the students and that 67percent of these students considered theprograms to be "very effective."

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VII. INTERNATIONAL ACTIVITIES

International MEDLARSCooperation

During this fiscal year the eight internationalbilateral quid-pro-quo agreements concerningMEDLARS have been renegotiated. The firststep in this process was the second meeting ofthe International MEDLARS Policy AdvisoryGroup. The meeting reviewed the nature ofMEDLARS II/MEDLINE in terms of substantiveand technical considerations; the schedule ofNLM implementation; implications for non-U.S.centers; and alternate technical choices for thefuture. Particular emphasis was placed on anexamination of the nature of future agreementsbased on operating experience and policy con-siderations.

Special discussions were held on the otherNLM on-line data bases: CATLINE (mono-graphs), SERLINE (serials), and TOXLINE(toxicology); review of journal coverage inMEDLARS/MEDLINE; assessment of the status ofon-line systems and networking; interchange ofinformation and people; technical cooperationand coordination; elimination of duplicate ef-fort; and extension of services to other coun-tries.

The major policy conclusion reached duringthe deliberations was that future cooperationshould continue on the basis of a bilateral quid-pro-quo mechanism.

The alternatives available to the non-U.S.centers under the new MEDLARS agreements,with the selections made by the centers, are:

Tapes Germany, JapanTapes + Software.. Australia, SwedenOn-Line Access — France, Canada, WHOCombination of Tapes

plus On-LineAccess United Kingdom

Other actions and conclusions resulting fromthis Policy Meeting were: NLM requestedsuggestions for the development of inter-national guidelines and criteria for journalselection and a list of journals based on thesecriteria; there should be an increase in the in-

terchange of information and people; the exten-sion of services beyond national boundaries is amatter of joint decision by the centers, with theknowledge and concurrence of the NationalLibrary of Medicine; the role of the WorldHealth Organization will be primarily service toits technical staff, technical commissions, and todeveloping countries.

Attendees at this policy level meeting in-cluded:

AUSTRALIA ..

CANADA

FRANCE

Mr. W.D. RichardsonAssistant Director Gen-eral, National Libraryof Australia

Dr. Jack E. BrownNational Science LibrarianNational Science LibraryNational Research Council

Mr. A. FonrojetDirector, Administrationand Finance, INSERM

Mr. H. TheiselFederal Ministry forYouth, Family Affairs& Health

Professor S. BergstromRektor, KarolinskaInstitutet

Dr. H. HookwayChief Executive, TheBritish Library Board

WHO Dr. T. Fulop, ActingDirector, Health Man-power DevelopmentWorld Health Organ-ization

plus Directors of the MEDLARS centers programand technical officials. NLM was represented byMary E. Corning, Melvin S. Day, and Davis B.McCarn.

GERMANY

SWEDEN

UNITED KING-DOM

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Pan American Health Organization US/USSR Discussions

The NLM continued its technical consultationand backstopping for the Pan American HealthOrganization Regional Library of Medicine inSao Paulo, Brazil (BIREME). An agreementwas signed in January 1973 between the AtomicEnergy Institute of Brazil, the Pan AmericanHealth Organization, and the National Libraryof Medicine for experimental use of MEDLINE inBrazil by BIREME for the provision of com-puterized bibliographic information services.

This MEDLINE experiment involves: the NLMwhich provides the data base, the computerprogram, and the training; the Atomic EnergyInstitute of the University of Sao Paulo, whichis providing the computer time and operators;and BIREME for the provision of services. Theoperations are funded by the United NationsDevelopment Fund. The results of this ex-perimental project will determine how andwhen PAHO will be ready to enter into a quid-pro-quo arrangement with NLM similar to ex-isting ones.

The overall objective of BIREME is todevelop a degree of Latin self-sufficiency, notonly in terms of BIREME itself, but in thestrengthening of biomedical informat ionresources at national levels. BIREME hasbecome a model activity which is being ex-a m i n e d b y o t h e r n a t i o n s a n d o t h e rorganizations to determine its feasibility forapplication in other areas of the world.

A delegation of physicians and medical scientists fromthe Peoples Republic of China visited NLM on November7, 1973. Dr. C. P. Li, formerly on the staff of NIH, showsthe collection of ginseng materials he recently broughtback from a visit to the Peoples Republic, with membersof the delegation and Miss Mary Corning and Dr. PeterOlch of the NLM staff looking on.

Professor Yurii P. Lisitsyn, M.D., Director ofthe Ail-Union Research Institute for Medicaland Medical-Technical Information, Ministry ofHealth, USSR, (VNIIMI) visited NLM at therequest of Minister of Health Petrovsky and un-der the auspices of the US/USSR Agreement forCooperation in the Field of Medical Science andPublic Health.

A joint communique issued in September 1973by the Secretary of the U.S. Department ofHealth, Education, and Welfare and the USSRMinister of Health included the statement that:

"The Secretary and the Minister alsoagreed . . . to examine the possibility of shar-ing th rough compute r t e rmina l s andotherwise the information assembled by theU.S. National Library of Medicine and theUSSR Institute of Medical Information."Discussions with Professor Lisitsyn included:

MEDLARS/MEDLINE, unauthorized republicationin the USSR of Index Medicus; vocabularydevelopment and indexing; exchange of medicalliterature; and exchange of persons. These wereall areas to be explored further by the Soviets.

With particular reference to the MEDLARScomputer system, the USSR does not at thistime have the computer hardware necessary tooperate a system such as NLM's. A direct com-munication linkage between VNIIMI and theNLM computer in Bethesda would requiresizable USSR expenditures to sustain thetransmission linkage. Hence, this area ofUS/USSR biomedical cooperation is more ap-propriate in the long-range future. Any suchcollaboration would be consistent with the quid-pro-quo arrangements which NLM has withother countries.

Exchange Program and Services

NLM now has some 895 exchange partners in85 countries throughout the world. Under thesearrangements, the Library receives muchmaterial which otherwise would be difficult toobtain.

NLM continues to provide services to develop-ing countries under a special arrangement withthe U.S. Agency for International Development(AID). Under this program, we provide annuallyapproximately 20,000 services to 48 developingcountries throughout the world. These services

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meet a demonstrated need for those countrieswhere modern medical information is un-available because of inadequate libraryfacilities, collection, and staff. These servicescover interlibrary loans, reference requests,MEDLINE searches, subscriptions to IndexMedicua, Abridged Index Medicua, and CurrentCatalog. The subject matter extends through allelements of health—research, education, anddelivery of health care. The geographic distribu-tion is approximately 51 percent to LatinAmerica, 42 percent to the Near East, 4 percentto the Far East, and 3 percent to Africa. Thesedata do not reflect total or absolute needs, butare reflections of actual requirements. In fact,our modest AID/NLM program is not able torespond totally to the existing inadequacies.

Public Law 480ProgramThe Library's Special Foreign Currency

Program, in support of the research andpublication of scholarly projects in the healthsciences, numbered 136 active projects in sevencountries during fiscal year 1974. Twenty ofthese were new awards. Almost 68 percent ofthis program is carried out in Israel and Poland,with relatively few NLM projects active inYugoslavia, Tunisia, Egypt, India, andPakistan. During September 1973, two membersof the NLM Board of Regents, Dr. W.N. Hub-bard, Jr., and Dr. Jack Layton, and the Chief ofNLM's International Programs Division, Dr.Jeanne Brand, made a site visit to Israel andPoland to evaluate the Library's programs inthose countries. The Regents noted the benefitsto U.S. science of NLM's support for criticalreviews and monographs prepared by first-ranking scientists in countries with markedlydifferent scientific settings, perspectives, andopportunities.

IsraelAlthough the Government's Public Law 480

program in Israel has been phased out, theLibrary's program in support of critical reviewsin Israel will continue under a three-year awardin FY 1974 from the U.S.-Israel BinationalScience Foundation to the Israel Journal ofMedical Sciences. Fifty-four NLM collaborativeprojects were active in Israel during FY 1974,eleven of which were new projects. The majoritywere critical reviews of biomedical research and

practice, and proceedings of major internationalsymposia in special health fields.

PolandWith the signing of the Memorandum of

Understanding for Collaboration in the HealthSciences in 1973 by the U.S. Department ofHealth, Education, and Welfare and theMinistry of Health and Social Welfare ofPoland, certain areas of health research weresingled out with a view of achieving greaterresults from a concentration of efforts. InMarch 1974 these fields of emphasis were re-vised by mutual agreement and now include sixbroad areas: occupational and environmentalhealth, rehabilitation, neurological and psy-chiatric disorders, health problems related tofood and drugs, infectious diseases and the im-mune system, and the planning, delivery, andevaluation of health services. The Library spon-sored the preparation of monographs in Polandin five of the six priority areas during FY 1974.

Appendix 4 lists twenty books and journal ar-ticles which were published during FY 1974 as aresult of NLM foreign currency awards made inprior years.

International OrganizationsNLM has varying degrees of involvement with

a number of international organizations, bothgovernmental and nongovernmental, scientificand nonscientific in character.

Government organizations include the UnitedNations; the UN specialized agencies which havea health or scientific orientation such as theWorld Health Organization (and PAHO) and theUnited Nations Education, Scientific, andCultural Organization; economic organizationssuch as the Organization for Economic Coopera-tion and Development. Melvin S. Day, NLMDeputy Director, is the U.S. Member of theUNESCO/UNISIST Advisory Committee of theU.N. Environmental Program InternationalReferral Service, and Chairman of theOrganization for Economic Cooperation andDevelopment (OECD) Environmental Informa-tion Panel. Dr. Martin M. Cummings, NLMDirector, is serving as a special consultant to theWorld Health Organization in its developmentof a broad program plan in biomedical com-munications. Miss Corning represented theDirector at the meeting of the PAHO ScientificAdvisory Committee for its Regional Library of

39

Medicine which serves as the policy body forBIREME.

The NLM is a member of the InternationalCouncil of Scientific Unions Abstracting Board(ICSU AB). Representing the Library at the1973 meetings were Dr. Cummings and MissCorning. Topics discussed included the activitiesof the member unions and member services, theinternational serials data system, UNISIST, the

ICSU AB reference manual, and development ofbibliographic standards.

A paper was presented on The Hole of theUnited States Government in InformationTransfer by Miss Corning as part of a panel in-cluding Jacques Michel, Comte National deDocumentation Scientifique et Technique(CNIDST), and John C. Gray, Office for Scien-tific and Technical Information (OSTI).

40

Appendix 1

FY 1974 Publications Available from GPO

Number Printed forSale (per issue)

Abridged Index Medicus 4,700Bibliography of the History of Medicine 3,000Cumulated Abridged Index Medicus 2,000Cumulated Index Medicus 5,000Current Bibliography of Epidemiology (Annual) 750Current Bibliography of Epidemiology (Monthly) 1,000Index Medicus 9,200International Bibliography of the History of Legal Medicine 1,500List of Journals Indexed in Index Medicus 3,500Medical Subject Headings 10,000Monthly Bibliography of Medical Reviews 1,100NLM Current Catalog (Annual) 1,600NLM Current Catalog (Quarterly) 1,600National Medical Audiovisual Center Catalog 12,500A Profile of the U.S. Public Health Service 1,000Selected References on Environmental Quality as It Relates to Health 1,000Toxicity Bibliography 850

Appendix 2

Staff Bibliography

The following represent published articles or chapters of larger works byNational Library of Medicine authors in fiscal year 1974:

Brooke, M. L., Bell, R. W., and Oppenheimer, M. J.: A team approach todeveloping an audiovisual single-concept instructional unit. The PhysiologyTeacher. 3: 8-13, 1974.

Cassedy, J. H.: Edwin Oakes Jordan. In Dictionary of Scientific Biography.New York: Scribner's, Vol. 7, 1973, pp. 170-171.

Corning, M. E.: The role of the United States Government in informationtransfer. In Proceedings of the Full Board Meeting, International Council ofScientific Unions Abstracting Board. London, July 1973, pp. 87-120.

Day, M. S.: Computer-based retrieval services at the National Library ofMedicine. Federation Proceedings. 33: 1717-1718, 1974.

Day, M. S.: Restoring the library ecology through networks. In Kent, A. (Ed.):Resource Sharing in Libraries: Why. How. Next Action Steps. New York:MarcelDekker, Inc., 1974, pp. 259-265.

Krivatsy, P.: Nicola Massa's Liber de Morbo Gallico—dated 1507 but printedin 1527. J. Hi»t. Med. 29: 230-233, April 1974.

Krivatsy, P.: Erasmus' medical milieu. Bull. Hist. Med. 47: 113-154, 1973.McCarn, D.B.: Network—or all hang separately. In Lancaster, F. W. (Ed.):

Proceedings of the 1978 Clinic on Library Applications of Data Processing:Networking and Other Forms of Cooperation. Urbana-Champaign, Illinois,University of Illinois, Graduate School of Library Science, 1973, pp. 1-8.

McCarn, D.B.: A medical information network and constraints on networking.

41

In Greenberger, Martin (Ed.): Networks for Research and Education: SharingComjniter and Information Resources Nationwide. Cambridge, Massachusetts:MIT Press, 1974, pp. 338-344.

McCarn, D. B. and Leiter, J.: On-line services in medicineand beyond. Science.181: 318-324, 1973.

Nemec, J.: International Bibliography of the History of Legal Medicine.Bethesda, Maryland: National Library of Medicine, 1973, 224 pp.

Richmond, J. S., comp.: Medical Reference Works 1679-1966; a SelectedBibliography. Suppl. 2, 1969-1972. Chicago: Medical Library Association, 1973,174 pp.

Schoolman, H. M.: The copyright war. The library. Current Medical Dialog. 41:233-234, 1974.

Waserman, M. J.: Dr. Zuriel Waterman, an itinerant surgeon in theRevolutionary era. Proc. Am. Phil. Soc. 117: 338-403, 1973.

Wooster, H. and Lewis, J. F.: Utilization of the Lister Hill Center computerassisted instructional experimental network. Comput. Med. 3 (9): UnpagedSpecial Report, September 1973.

Wooster, H. and Lewis, J. F.: Distribution of computer-assisted instructionalmaterials in biomedicine through the Lister Hill Center experimental network.Comput. Biol. Med. 3: 319-323, 1973.

Appendix 3

Grant Supported Publications

Altschul, Siri von Reis. Drugs and Foods from Little Known Plants. Notes inHarvard University Herbaria. Cambridge: Harvard University Press, 1973,xii, 366 pp.

Chester, Edward M. The Ocular Fundus in Systemic Diseases. Cleveland, Ohio,Case Western Reserve University, 1973, 244 pp.

Dayhoff, Margaret 0., ed. Atlas of Protein Sequence and Structure, vol. 5,Supplement I. National Biomedical Research Foundation, GeorgetownUniversity Medical Center, Washington, D. C., 1973, 114 pp.

Protein Segment Dictionary. National Biomedical Research Founda-tion, Georgetown University Medical Center, Washington, D. C., 1973.

Forbes, Thomas R. Medical supplies for prisoners in 1675. Bulletin of the NewYork Academy of Medicine, 2d series, vol. 49, no. 7, 1973, pp. 592-593.

London coroners' inquests for 1590. Journal of the History Medicineand Allied Sciences, vol. 28, no. 4, Oct. 1973, pp. 376-386.

Greenbaum, Louis S. "Jean-Sylvain Bailly, the Baron de Bretuil and the fournew hospitals of Paris," Clio Medica, vol. 8, no. 4, 1973, pp. 261-284.

Howard, R. Palmer and Gideon, Rose C. The beginning of medical organizationin Oklahoma, 1889-1893. Journal of the Oklahoma State Medical Association,vol. 67, no. 2, February 1974, pp. 43-54.

Index-Catalogue of Medical and Veterinary Zoology, Special Publication No. 3,Ticks and Tickboume Diseases, U. S. Government Printing Office, Washing-ton, D. C., 1974.

International Journal of Systematic Bacteriology. Official Organ of theAssociation of Microbiological Societies, vol. 23, nos. 3-4, July-October, 1973.

Journal of Medical Entomology. Honolulu, Hawaii: B. P. Bishop Museum,Entomology Department, vol. 11, no. 1, March 28, 1974, pp. 1-45.

Kerker, Ann E. and Murphy, Henry T. Comparative and Veterinary Medicine;

42

A Guide to the Resource Literature. Madison, Wis.: The University of Wis-consin Press, 1973, 308 pp.

Medi-Kwoc Index. An Index to the Published Proceedings of Conferences andSymposia on Biomedicine. St, Louis; Washington University School of Medi-cine Library, vol. 1, no. 3, 1973; vol. 2, no. 2, 1974.

Nomina Histologica, Revision of the 1970 Leningrad version. Federation ofAmerican Societies for Experimental Biology. Bethesda, Md., July, 1973,56 pp.

Siegel, Rudolph. Galen on Psychology, Psychopathology, and Function andDiseases of the Nervous System. Basel: Karger, 1973, 310 pp.

Smith, Hobart M. and Smith, Rozella B. Synopsis of the Herpetofauna ofMexico. Vol. II: Analysis of the Literature Exclusive of the Mexican Axolotl.Augusta, West Va.: Eric Lundberg, 1973, 367 pp.

Smith, Rozella B., and Smith, Hobart M. Nominal taxa of recent amphib-ians and reptiles, I Gymnopliona. Transactions of the Kansas Academy ofScience, vol. 75, no. 1, 1972, pp. 52-99.

Smith, Hobart M.; Sinelnik, George; Fawcett, James D.; and Jones, RichardE. A survey of the chronology of ovulation in anoline lizard genera. Ibid, vol.75, no. 2, 1972, pp. 107-120.

Smith, William 0. The development of American medical research and theinfluence of John D. Rockefeller. Journal of the Oklahoma, State MedicalAssociation, vol. 67, no. 4, April 1974, pp. 146-155.

Sollers-Riedel, H. Cumulative bibliography 1953-1972. Parasites, predators,viruses and related agents. Mosquito News; Journal of the American Mos-quito Control Association, vol. 33, no. 2, 1973, pp. 301-17.

Literature references to mosquitoes and mosquito-borne diseases.Part II. Mosquito News; Journal of the American Mosquito Control Associa-tion, vol. 33, no. 2, 1973, and following.

Swindler, D. R., and Wood, Charles D. An Atlas of Primate Gross Anatomy:Baboon, Chimpanzee and Man. Seattle, University of Washington Press,1973, 370 pp.

Warren, Kenneth S. Schistosomiasis: The Evolution of a Medical Literature:Selected Abstracts and Citations, 1852-1972. Cambridge, Mass., The Mas-sachusetts Institute of Technology, 1973, 1073 pp.

Appendix 4

PL-480 Supported Publications

Bachrach, Uriel. Function of Naturally Occurring Polyamines. New York:Academic Press, 1973, 211 pp.

Becker, Yechiel. The Agent of Trachoma (Monographs in Virology, vol. 7).Basel, Switzerland: S. Karger, 1974, 99 pp.

Beutner, E. H., Chorzelski, T. P., Bean, S. F., and Jordan, R. E. (eds.). 7ra-mnnoi>athologi/ of the Skin: Labeled Antibody Studies. Stroudsburg, Pa.:Dowden, Hutchinson and Ross, 1973, 461 pp.

Blum, J. J., and Lubliner, J. Biophysics of flaggelar motility. Annual Reviewof Biophysics <ind Bioengineering, vol. 2, 1973, pp. 181-219.

Bogatyrev, I. D. Morbidity of Urban Populations and Standards of Thera-peutic-Prophultictic Care. Translated by E. Adelson and N. Kaner. Jeru-salem: Israel Program for Scientific Translations. New York: The American

43

Public Health Association, 1974, 401 pp.Carmon, Amiram; Gutman, Yehuda; and Werman, Robert (eds.). The neural

basis of memory and learning. Pharmacological aspects of brain research.Israel Journal of Medical Sciences, supplement to vol. 9, 1973, 124 pp.

Eliakim, M. (ed.). International symposium on hepatotoxicity. Israel Journalof Medical Sciences, vol. 10, no. 4, April 1974, pp. 285-461.

Gatt, Shimon. Inhibitors of enzymes of phospholipid and sphingolipid metab-olism. Metabolic Inhibitors, vol. 4, New York: Academic Press, 1973, pp. 349-387.

Gatt, Shimon and Barenholz, Yechezkel.Enzymes of complex lipid metabolism.Annual Review of Biochemistry, vol. 42, 1972, pp. 61-90.

Gedalia, Itzhak, and Zipkin, I. The Role of Fluoride in Bone Structure. St.Louis, Mo.: Warren H. Green, 1973, 40 pp.

Jeras, J. and Tivadar, I. Epilepsies in Children. Hanover, New Hampshire:The University Press of New England, 1973, 143 pp.

Kahlbaum, K. L. Catatonia. Translated by Y. Levij, and T. Pridan, Jerusalem:Israel Program for Scientific Translations. Baltimore, Md.: The JohnsHopkins University Press, 1973, 102 pp.

Lis, Halina, and Sharon, Nathan The biochemistry of plant lectins (phyto-hemagglutinins). Annual Review of Biochemistry, vol. 42, 1973, pp. 541-574.

Padan, Etana, and Shilo, Moshe. Cyanophages—viruses attacking blue-greenalgae. Bacteriological Reviews, September 1973, pp. 343-370.

Polish Research Guide. Warsaw: Polish Scientific Publishers, 1974, 638 pp.Prywes, Moshe and Helevi, H. S. (eds.). Proceedings of the Batsheva seminar

on health administration and health economics. Israel Journal of MedicalSciences, vol. 10. nos. 1-2, January-February 1974, 179 pp.

Rabinowitz, David and Merrimee, Thomas J. Isolated human growth hormonedeficiency and related disorders. Israel Journal of Medical Sciences, vol. 9,Nos. 11-12, November-December 1973, pp. 1599-1657.

Ramot, Brach (ed.). Genetic polymorphisms and diseases in man. IsraelJournal of Medical Sciences, vol. 9, nos. 9-10, September-October 1973, pp.1129-1533.

Razin, Shmuel. Physiology of mycoplasmas. Advances in Microbial Phyai-olofia, vol. 8, 1973, pp. 1-80.

Yoffey, Joseph M. Bone Marrow in Hypoxia and Rebound. Springfield,Illinois: Charles C. Thomas, 1973, 276 pp.

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U.S. Department of Health, Education, and WelfarePublic Health Service

National Institutes of Health

DHEW Publication No. (NIH) 75-256