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A R Y O F M E D I C I N E

and ServicesFiscal Year 1990

Unified Medical Language System

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES'Public Health Service • National Institutes of Health

Further information about the programs described in thisadministrative report is available from:

Office of Public InformationNational Library of Medicine

8600 Rockville PikeBethesda, MD 20894

(301) 496-6308

Cover: The Unified Medical Language System "tree of knowledge": was designed byBecky Cagle of NLM's Lister Hill Center. Tree structures have been employed to elucidaterelationships among medical concepts at least since Francesco Torn" published "Fever Tree"in 1712. Trees are also a cardinal feature of NLM's Medical Subject Headings.

N A T I O N A L L I B R A R Y O F M E D I C I N E

Programand

Services

Fiscal Year1990

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES'Public Health Service • National Institutes of Health

National Library of Medicine Catalog in Publication

X National Library ol Medicine (U.S )

675.Ml National Library ol Medicine programs and services -US6an 1977- -- Hethesda, Md The Library, 11978-

v ill , ports

Report covers fiscal yearContinues: National Library ol Medicine (U.S ) Proclaim and services Vols for1977-78 issued as DIII-W publication , no (Nlll)

78-256, etc., for 1979-80 as Nlll publication , no 80-2%, etc'

Vols. for 1981-available from the National Technical Information Service,Springfield, Va

ISSN Ol6.Vi569 = National Library ol Medicine proclaim and services

1 Information Services - United States - periodicals 1 Libraries, Medical -United Slates - periodicals I Title II Series: DIII-W publication , no 80-256, etc.

1(1

CONTENTS

PagePreface v

Calendar of Events vi

Special Initiatives 1NLM Outreach Activities 1Unified Medical Language System™ 2Health Services Research 3Electronic Imaging 4National Center for Biotechnology Information 5

Library Operations 6Planning and Management 6Collection Development 6

(Selection and Collection Assessment, Acquisitions, Preservation)Bibliographic Control 8

(Thesaurus, Cataloging, Indexing)Network Services 10

(Publications, Machine-Readable Databases, Online Services,Reference Services, Document Delivery, Regional MedicalLibrary Program)

Special Onsite Programs 13(Tours and Briefings, Historical Programs, Associate Program)

Specialized Information Services 20SIS Databases Under ELHILL" 20AIDS 22TOXNET11 and Its Files 22Microcomputer Workstation 24User Support Service 24Other Programs 25

(Alternatives to Animal Testing, Biotechnology, Servicesto Other Agencies)

Lister Hill Center 26Computer Science Branch 26

(Expert Systems, Natural Language Systems,Machine Learning, MedlndEx)

Information Technology Branch 31(Online Reference Works, CD-ROM, AHCPR)

Communications Engineering Branch 32(EDDS, SAIL, ILL Via Facsimile, Image Archiving Software,LAN-Based Document Image Server, Machine-ReadableArchives, OCR Evaluation, Imaging)

Educational Technology Branch 36(Computer-Based Curriculum Delivery, Dermatology VisualDatabase, Library Growth Project, TLC)

Audiovisual Program Development Branch 38

National Center for Biotechnology Information 41Database Building and Enhancement 41Basic Research 42

IV

Communication 43Extramural Programs 43Biotechnology Information in the Future 43

Extramural Programs 45Research Grants 46Training 47Integrated Academic Information Management Systems 48Resource Grants 49Publication Grants 49National Reference Center for Bioethics 50Committee Activities 50

Office of Computer and Communications Systems 51Development Branch 51Applications Services Branch 52Systems Support Branch 52Computer Services Branch 53

International Programs 54International MEDLARS® Agreements 54Collaboration with WHO 54Special Foreign Currency Program 55International Meetings and Visitors 55

Administration 56Financial Resources 56Personnel 56Awards 56Equal Employment Opportunity 57

Appendices

1. Acronyms, Abbreviations, and Initialisms 592. Staff Bibliography 623. Extramural Programs-Supported Publications 654. Board of Regents 705. Board of Scientific Counselors/LHC 716. Board of Scientific Counselors/NCBI 727. Biomedical Library Review Committee 738. Literature Selection Technical Review Committee 75

TABLESPage

Table 1. Growth of Collections 15Table 2. Acquisitions Statistics 15Table 3. Cataloging Statistics 16Table 4. Bibliographic Services 16Table 5. Circulation Statistics 16Table 6. Online Searches 17Table 7. Offline Searches 18Table 8. Reference Services 19Table 9. Flistory of Medicine Activities 19Table 10. Extramural Grants and Contract Program 50Table 11. International MEDLARS Centers 55Table 12. Financial Resources and Allocations 56Table 13. Staff 58

PREFACE

This annual report, covering the activities of the National Library of Medicine duringthe first year of a new decade, reveals the maturing of a number of programs begunin earlier years. To mention just three examples: Grateful Med® and its effect onusage patterns of the Library's online databases, the first publicly available productsof the Unified Medical Language System, and the implementation at several majoruniversities of Integrated Academic Information Management Systems.

The 1986 Long Range Plan continues to be the lodestar guiding the Library. In 1989,the broad plan was updated in the area of "outreach," a concept that was introducedas the result of the ad hoc planning panel headed by Dr. Michael DeBakey. This yearanother planning panel recommended that the Library undertake a "VisibleHuman" project. Both of these additions to the Long Range Plan, enthusiasticallyendorsed by the NLM Board of Regents, are described in the section on SpecialInitiatives.

I would like to express the thanks of all of us at the National Library of Medicine toour partners throughout the Nation and around the world. Our collaboration meansthat never before have so many health professionals—in research, education, andhealthcare delivery—had such widespread access to the biomedical literature. Welook forward to continuing and expanding our mutual undertaking.

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

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

Kent A. SmithDeputy Director

Harold M. Schoolman, M.D.Deputy Dir. for Research

and Education

VI

CALENDAR OF EVENTS—FISCAL YEAR 1990

1989Oct-Dec: "Medicine and the Naturalist Tradition" (exhibit)Oct 24-26: Toxicology Information Program CommitteeOct 26-27: Board of Scientific Counselors (LHC)Nov 2-3: Biomedical Library ReviewCommitteeDec 5: General NLM toll-free number institutedDec 11-12: Toxicology Information Program Committee

7990Jan 18-19: Board of RegentsJan: "Electronic Imaging" planning panel report publishedFeb-Mar: History of cataract surgery exhibitFeb-Mar: 'To Your Health: An Exhibition of Posters"Feb 1-2: LiteratureSelection Technical Review CommitteeFeb 6: Visit by Education Secretary Lauro F. Cava/osFeb 7: Toxicology Information Program CommitteeFeb 8-12: Visit of Delegation from USSR's SoyuzmedinformMar 7-8: BiomedicalLibrary Review CommitteeMar 19:Teratology Information Users GroupMar 23: Demonstration of TRI database to Congressional staffApr-May: "The Surgeon at Work"—exhibit of paintingsby Dr. Joseph WilderApr 3: Visit of Polish Vice Minister of Health and delegationApr 20: Leiter Lecture: "Evolution of a Premier Information Center," Dr. Michael DcBakeyApr 23-24: "The Medicinal Muses" (symposium)May 3-4: Board of Scientific Counselors (LHC)May 12: NLM Director receives honorary degree from University of Missouri-ColumbiaJun-Aug: History of Experimental Embryology(exhibit)Jun 1: NLM-Agency for Health Care Policy and Research agreement in forceJun 2: MEDLINE™ updating becomes weeklyJun 7-8: Board of RegentsJun 8: Lectures on the history of embryologyJun 14-15 Literature Selection Technical Review CommitteeJun 18:Memorandum on medical information exchange signed by Soyu/medinform (USSR) and NLMJun 18-19: Toxicology Information Program CommitteeJun 27-28: Biomedical Library ReviewCommitteeJul 16: GenInfoIM Backbone Database announced at NCBI meetingof software developersAug 3: Board of Scientific Counselors (NCBI)Aug 9: Lecture by Dr. David Satcher, Meharry Medical College PresidentSep 13: CENDI Technical Forum on High Performance Computing/NetworkingSep 14: NCBI lecture series in ComputationalMolecular BiologySep 19:Taiwan becomes an International MEDLARS CenterSep 25: Outreach presentation to NLM staffSep 27-28: Board of Regents

1990 SPECIAL INITIATIVES

NLM Outreach Activities

In response to the recommendations contained inlast year's DeBakey planning panel report (ImprovingHealth Professionals' Access to Information) NLM hasbegun a wide variety of outreach activities.This has beenaided with funding of $3.8 million appropriated by theCongress in FY 1990.

The focus of these activities has been on improvingaccess by individualhealth professionals to NLM's infor-mation products and services, especially by personspresently unaff i l ia ted with an institution or who arelocated in rural or other medically under-served settings.Many of the latter locations are comprised of predomi-nantly minority populations.

A series of presentations on outreach was made tothe NLM staff on September 25,1990, in the Lister HillCenter Auditorium. Two days later, several of these pre-sentations were made to the Board of Regents.

The RML Network. Through special enhancements tothe existing RML contracts, NLM has funded demonstra-tion projects in 12 states to test varying means of increas-ing awareness of and access to NLM'sinformat ionproducts and services by heal th professionalslocated in underserved areas. Some of the projects are be-ing carried out directly by the RML; others involve theRML subcontracting with another network library. Workbegan in eight of these states as .1 direct result of newoutreach funding; a project was already under way infive states in the Pacific Northwest, but this project wasexpanded as a result of the new funds.

Another program, which was developed entirelywith new outreach funds, provides for small competitivecontracts awarded direct ly by NLM to networklibraries for the purpose of introducing online searchingvia Grateful Med to health professionals in rural and in-ner city areas. Thirty such contracts will be awarded bythe end of September, 1990, to network libraries fromHawaii to Maine. NLM will be assisting these libraries ina variety of ways during the projects, including provid-ing non-billed demonstration codes, application packetsand blocks of online codes, and tracking system usage aspart of the evaluation phase of each project.

Improving hospital access to national information sources.The new Information Access and Information SystemsGrants foster access to information resources andservices utili/ing today's computer and communicationstechnologies. For example, among some recentlyawarded Information Access Grants aimed at small- andmedium-size hospitals are those to two groups of health-related libraries in Eastern Kentucky to introduce Grate-ful Med and provide the concomitant end-user training.An Information Systems Grant, which is directed to-wards larger hospitals and medical centers, wasawarded to the University of Miami's medical center li-brary to assist in developing an AIDS information ser-vice for health professionals in Southeast Florida. Bothtypes of grants have significant outreach potential.

The IAIMS (Integrated Academic Information Man-agement Systems) Program assists health institutions toplan and develop computer and communication net-works that link and relate library systems with indi-v idual and ins t i tu t ional databases and informationfiles—inside and outside the organization—for applica-tions in patient care, research, education, and administra-tion. (For more on this subject, see the IAIMS section inthe Extramural Programs.)

Undergraduate Research Study Program. NLM has de-veloped an intramural Undergraduate Research StudyProgram to provide two-year scholarships and researchassignments in medical informatics for sophomore stu-dents majoring in electrical engineering, computer sci-ence, computer engineering, or physics at participatinghistorically black colleges and universities (HCBUs). Theprogram, scheduled to begin in late 1990, will select sev-eral schools (from nine HCBUs with engineering depart-ments) to collaborate with NLM for a five-year period.Participating students will complete two summer intern-ships at the Lister Hill Center and two academic yearassignments under thu guidance of their preceptors.

New information products and services. NLM hasincreased its efforts to obtain feedback from users andnon-users concerning the adequacy of its products andservices. Extensive studies are being undertaken in SouthTexas (in collaboration with the Health Sciences Libraryat the Univers i ty of Texas, San Antonio), and rural

Programs and Services, FY1990

Tennessee (in collaboration with Meharry Medical Col-lege) to identify impediments to use and strategies forimproving access among health professionals in geo-graphically isolated areas. The results of these studieswill provide important insights for the design of newproducts and services as called for in the OutreachReport.

Enhancements to existing products and services arealso proceeding. "Loansome Doc/7 a link between theGrateful Med user and a network library, is being testedin four western states. Using Loansome Doc, the healthprofessional will be able to electronically order docu-ments identified in an online search from a designatedDOCLINE® library. The system should be especiallyhelpful to health professionals who do not currentlyhave access to a medical library.

Publicity. Publicity activities are targeted both tohealth professionals and to general audiences. Amongthose for health professionals are the preparation of a kitfor "training Grateful Med trainers/7 including a plan-ning guide, suggested curriculum, pamphlets, slides andoverheads, and a videotape, to be used by medical librar-ians and others to train health professionals in the use ofGrateful Med; and a campaign to inform dental profes-sionals about the benefits of Grateful Med/MEDLINEsearching in their professional work. Other activities thattarget health professionals: a series of five Public ServiceAnnouncements being developed for professionaljour-nals; press releases on specialized subjects such as thatannouncing the new ChemID™ database; working withthe American Library Association on a videotape for up-dating librarians about the NLM7s services; the institu-tion of a toll-free number professionals may use to callthe NLM; and a continued high level of exhibiting atprofessional meetings.

Elliot R. Siegel, Ph.D., Ass't. Dir. for Planning andEvaluation; Susan Buyer Slater, Deputy Ass't. Dir.

Among outreach activities intended for generalaudiences: the widespread advertisement of the 54-pagepamphlet, "Health Hotlines/' available free from theNLM; support for a PBS series being produced byWNET (New York) on the future of medicine, a nation-ally distributed television news release on the ToxicChemical Release Inventory; general press releases onlectures and exhibits; and the production of a new film,"Pathways/7 and its translation into four foreign lan-guages for use with visiting groups.

E. R. Siegel

Unified Medical Language System

The UMLS project was initiated in 1986 as a long-term NLM research and development effort designed tofacilitate the retrieval and integration of informationfrom multiple machine-readable biomedicalinformationsources. The sources of interest include: descriptions ofthe biomedical literature, clinical records, databanks,knowledge-based systems, and directories of people andorganizations.

The variety of vocabularies and classifications usedin these different sources is a significant barrier to the useof machine-readable information by health professionalsand biomedical researchers and to the development ofeffective search interfaces to assist these users. TheUMLS approach assumes continued diversity in the ter-minology employed in different systems and by usersthemselves. The goal of the project is to develop prod-ucts that can facilitate the establishment of a conceptuallink between the user's question and relevant informa-tion in machine-readable form.

Participants in the UMLS project include an internalNLM research and development team, severalcontractors, and advice and input from professionalsocieties.

Knowledge Sources. In FY 1990, NLM released the ini-tial versions of the Metathesaurus™ and the SemanticNetwork, two machine-readable "Knowledge Sources"developed as part of the UMLS. The Knowledge Sourcesare designed primarily for use by system developers.They are meant to be consulted and used by search inter-face programs to interpret and refine user queries and tomap the user's terms to appropriate controlled vocabu-laries and classification schemes. The KnowledgeSources are also useful as reference tools for medical li-brarians, database builders, and other information pro-fessionals.

Meta-1™, the first version of the Metathesaurus, is adatabase of information about biomedical terms thatappear in several different controlled vocabularies and

Special Initiatives

classifications. It contains all terms from the 1990 MeSH"(NLM's Medical Subject Headings), and DSM-I1IR, theAmerican Psychiatric Association's Diagnostic andStatistical Manual of Mental Disorders, third edition,revised. It contains selected terms from several othersources, including the International Classificationof Dis-eases (9th edition, Clinical Modification) and the Libraryof Congress Subject Headings. Meta-1 preserves themeanings, hierarchical contexts, and relationshipsamong terms present in its source vocabularies, whileadding certain basic information about each term and es-tablishing new relationships between terms from differ-ent source vocabularies.

All concepts in Meta-1 have been assigned to one ormore of 131basic semantic types or categories, e.g., "Dis-ease or Syndrome," "Virus," "Medical Device," "Ha/-ardous Substance." The Semantic Network defines thesebasic types or categories and represents a variety of use-ful potential relationships among them, e.g., "Virus"causes "Disease or Syndrome."

The strategy for the development of UMLS compo-nents is to build successive approximations of the capa-bilities ultimately desired. Accordingly, Meta-1 and theSemantic Network provide relatively modest, althoughpotentially powerful, enhancements to existing machine-readable biomedical vocabularies and classifications.Additions in scope and complexity will be based onfeedback received from those who attempt to apply thesefirst versions to a variety of information problems. Whileit will probably always be necessary for system develop-ers to add some information of local importance to thesesources, the goal is centrally maintained knowledgesources that can reduce the cost and complexity of devel-oping medical information systems in various contexts.

Availability. To encourage the broadest possible ex-perimentation, NLM is providing copies of Meta-1 andthe Semantic Network under the terms of an experimen-tal agreement. Those who elect to receive the UMLSKnowledge Sources must provide feedback to NLM onhow the products are being used and on the ways inwhich they could be improved. Users of Meta-1 and thefirst version of the Semantic Network should be awarethat there may be substantial changes in the content orformat of subsequent editions.

The UMLS Knowledge Sources are availablein sev-eral file formats contained on two CD-ROMs; samplesets are availableon diskettes. In FY 1990, the Librarydistributed copies of the sample records, documentation,and experimental agreement to more than 100 institu-tions and individuals.

Fact Sheets on the Uni f ied Medical LanguageSystem and the two initial Knowledge Sources are avail-able from NLM's Office of Public Information.

B. L Humphreys

Health Services Research

In December 1989 Congress created a new agencywithin the Public Health Service: The Agency for HealthCare Policy and Research (AHCPR).This new agency isthe focal point in the Federal Government for health ser-vices research and the development of clinical practiceguidelines, expanding on the work of its predecessor, theNational Center for Health Services Research and HealthCare Technology Assessment.

The law that created AHCPR (P.L. 101-239) calls forthe new agency and NLM to work together to developand enhance information services in the field of healthservices research, encompassing health technology as-sessment and the development of practice guidelines. Asa result, the NLM and the AHCPR entered into aninteragency agreement in FY 1990. With funds trans-ferred from AHCPR, the Library has created a new Of-fice of Health Services Research Information in the PublicServices Division and is working to develop and enhanceits services in this important field.

A study recently begun by the Institute of Medicine,also funded by the AHCPR, will provide NLM with aclearer picture of the information needs of the users oftechnology assessment and related health services re-search studies, and of the new and enhanced servicesthat will be required to meet these needs.

The Library currently provides substantial, althoughpartial, coverage of health services research in its Medi-cal Subject Headings (MeSH) vocabulary, its collectionsof literature, and its indexing and cataloging of data-bases. Access to the health services research informationand literature now available at the Library is providedvia NLM's online and information services, publications,reference services, and document delivery services.

In response to the legislation that created theAHCPR, over the next few years NLM will review andenhance as necessary these products and services. In thisconnection, current activities include: review and revi-sion of MeSH terminology by a panel of subject expertsselected by NLM and AHCPR, expansion of the UMLSMetathesaurus in the field of health services research, re-examination of NLM's policies for acquisition and biblio-graphic control of technical report literature,enhancement of DIRLINE's™ coverage of organizationsinvolved in health services research and the develop-ment of practice guidelines, indexing of additional tech-nology assessment literature,research and developmenton online access to the full-text of AHCPR-approvedpractice guidelines, and the provision of special literaturesearches and document delivery assistance to theAHCPR panels charged with developing practiceguidelines.

B. L Humphreys

Programs and Services, FY 1990

Electronic Imaging

Much of what is known about biological form andfunction is best communicated by pictures. This was truein the time of Vesalius' carefully penned renderings ofhuman anatomy, and it now has added dimensions pro-vided by modern technologies that produce remarkablydetailed patient-specific medical images. The NLM haslong been the world leader in managing and providingaccess to the knowledge of medicine and biology, and inits printed document collections as well as in its histori-cal prints and photos and film collections there are un-counted millions of images. For as long as medicallibraries have existed, they have been repositories of pic-tures as well as words.

The perennial importance of pictures to biomedicinefinds new modes of expression in the era of digital elec-tronics: specialized large-memory graphics computersthat can quickly compute and display the millions ofpoints of light that comprise complicated images; high-resolution color video displays; optical disc and otherstorage media capable of storing billions of bits; andhigh-speed computer networks capable of moving elec-tronic image representations over long distances quickly.The rapid development of these enabling technologiesled the NLM's Long Range Planning panels in 1985-86 torecommend that the NLM "investigate the feasibility ofcreating digital image libraries" for purposes of medicaleducation.

In June 1988 the Library brought together represen-tatives from academic medical centers where three-di-mensional computer reconstruction of anatomic imageswas under development. When these pioneers of a newtechnology considered what the NLM might do in thisfield, they immediately and unanimously conceived aproject to build a digital image library that none of themhad the resources to individually create: a complete set ofx-y-z numerical coordinates representing the internaland external structure of an entire human being at milli-meter-level resolution. This "Visible Human" projectwould yield a computer data set of unprecedented detailand form the basis for a virtually unlimited number ofimage renderings of the human body. For, given the nu-merical coordinates of body structure, computer algo-rithms can be used to reconstruct an image from anyperspective, thus creating "living" images that can be ro-tated, viewed, and dissected like the physical objectsthey represent.

To develop in greater detail an overall role and strat-egy for the NLM in images, a planning panel was con-vened in 1989. This group of researchers, clinicians, andmedical educators was charged with answering impor-tant questions related to digital imaging and the NLM. Isthe time right to begin actually building and distributing

image collections in electronic format? Would such im-age collections, if available today or in the near future, beused sufficiently to justify the expense involved in theircreation and maintenance? Would a Visible Humanproject be a good start? If so, how should it be pursued?Were there other equally or more meritorious imagingprojects that the NLM might undertake?

The panel findings, as summari/.ed in a report re-leased in 1990, highlight a number of conclusions. Thefirst is that NLM should be involved in the creation,management, and distribution of digital image collec-tions as a natural component of the Library's mission toorganize and make available the scientific knowledge ofmedicine and biology. As a group, the panelists believedthat the relevant computer technologies are now, or willbe in a very few years, sufficiently powerful and eco-nomical to store, render, and display digital images ofreal value in clinical, research, and educationalapplica-tions.

They noted that the needs of each of these communi-ties differ. Teaching collections focus on the best andmost representative examples of normal and abnormalbiological structure. Researchers need tools and stan-dards by which they can manipulate, analy/e, and shareimaging data with one another. Clinical practice makeslimited use of normal images for comparison purposes,focusing primarily on the acquisition and managementof patient-specific images. All agreed that fundamentalresearch problems need to be addressed, such as the de-velopment of methods to identify and define biologicallyimportant objects within images, and the formats andstandards for optimal rendering, exchange, comparison,and editing of biomedical images. And all concurred thata future era in which NLM is positioned as a national re-source for digital images will depend upon high-band-width computer networks capable of transmissionspeeds thousands of times faster than the current com-mercially available networks that provide access toMEDLINE.

On the basis of these findings, the planning panelrecommended that the NLM should proceed with theVisible Human as a first project in digital image libraries.This would involve creating a digitized representation ofa human male and female, derived from carefully se-lected cadavers, including the image coordinates thatcorrespond to computed tomography, magnetic reso-nance imaging (MRI), and digitization of photographicsections—thin slices of the frozen cadavers.

Though the Visible Human would be of greatest useas an archetypal normal for computer-assisted medicaleducation applications, it would also serve as the center-piece for the development of technicalstandards for datarepresentation, communication, and image rendering. Inaddition, it would provide a substrate for research in the

Special Initiative*

fledgling field of "structural informatics," which seeks toorgani/e and relate the image-based knowledge of bio-medicine to conceptual, language-based understandingof biological form and function.

The findings of the Planning Panel on Electronic Im-aging were reviewed and enthusiastically approved bythe Board of Regents in the spring of 1990, and the panelrecommendations made a formal part of the NLM LongRange Plan. The closing months of FY 1990 saw the pub-lication of a Request for Proposals to begin the first phaseof building the Visible Human database; award of a re-search contract to undertake this first important step forthe Library of the future is planned for next year.

D. R. Masys

National Center for BiotechnologyInformation

The National Center for Biotechnology Information(NCBI) was established by Public Law 100-607 in No-vember 1988 as a division of the National Library ofMedicine. The establishment of the NCBI reflects the im-portance of developing new information technologies toaid in the understanding of the molecular processes thatcontrol health and disease.

Basic Research. NCBI has had great success recruitingAmerican and foreign scientistsof international standingto work at NLM within the N1H Intramural Program.There are presently 25 senior scientists, postdoctoral fel-lows, and support staff working <it the NCBI. These sci-entists have backgrounds in medicine, molecularbiology, biochemistry, genetics, biophysics, structural bi-ology, computer science, and mathematics.

In the last year, NCBI scientists have developed newmathematical methods for assessing the statistical signifi-cance of molecular sequence features and have incorpo-rated these into a new fast algorithm for sequencesimilarity searches of protein and nucleic acid databases.The speed of these methods is crucial for strategies of

database exploration and for the discovery of new struc-tural similarities and functional associations of biologicalmacromolecules.

Recently, the identification of the gene product of thenewly discovered neurofibromatosis-1 gene as a GTPaseactivating protein was made at the NCBI through the useof these methods. These advanced analytical methodsare being applied by NCBI scientists in their own re-search as well as in collaboration with laboratories in theU.S. and Europe.

Database Building and Enhancement. NCBI, in collabo-ration with Library Operations, is creating a newbiosequence database, the Genlnfo Backbone. TheGenlnfo Backbone includes MEDLINE records that con-tain the sequence data, integrates DNA and amino acidsequence information,and maximizes the use of stan-dard nomenclature and gene names from off ic ia lsources. It is the first major database to be made availablein ASN.1 (Abstract Syntax Notation), an InternationalStandards Organi/ation data description language.These design features increase the power of the analysesmolecular biologists perform on sequence databases, andimprove the usefulness of Genlnfo as a foundation towhich the rapidly increasing number of specialized biol-ogy databases can be linked.

In a parallel effort, NCBI has created explicit defini-tions for biosequence objects using ASN.l. ASN.l will beused to provide a hardware- and software-independentversion of the information contained in the GenlnfoBackbone's relational database. NCBI has also built toolsfor producing ASN.l versions of the GenBank DNA se-quence database and the P1R amino acid sequence data-base. Other database producers are beginning to provideASN.l versions of their databases. NCBI plans to distrib-ute ASN.l versions of Genlnfo, as well as other sequencedatabases, on CD-ROMs along with information re-trieval and sequence searching tools for PC's and Macin-tosh computers.

D. /. Liprnan

LIBRARY OPERATIONS

Lois Ann ColaianniAssociate Director

NLM's Library Operations (LO) Division acquiresand preserves the world's biomedical literature; orga-nizes this literature through indexing and cataloging;disseminates NLM's authoritative bibliographic recordsin publications, online files, and machine-readable for-mats; lends or copies documents in the NLM collectionas a backup to the document delivery service providedby other U.S. biomedical libraries; provides referenceand research assistance to health professionals; and coor-dinates the Regional Medical Library Network, a nation-wide network of more than 3,000 U.S. health scienceslibraries. LO also conducts research and evaluation re-lated to its basic responsibilities and maintains an activeresearch program in the history of medicine.

More than 250 librarians, technical information spe-cialists, library technicians, subject matter experts, healthprofessionals, and administrative support personnelcarry out LO's programs and services. The LO staff is or-ganized in four main divisions: Bibliographic Services,Public Services, Technical Services, and History of Medi-cine; two smaller units: the Medical Subject HeadingsSection and the Regional Medical Library Program office;and a small administrative group in the Office of theAssociate Director.

Planning andManagement

LO develops its strategic and operational planswithin the framework of NLM's Long Range Plan, asaugmented by the reports of the special Panels convenedto expand and enhance particular segments of the basicNLM plan. Activities related to the NLM Long RangePlan, its supplementary Outreach Plan, and LO's opera-tional plan are described throughout this chapter.

In the FY 1990, LO staff members directed an NLM-wide effort to identify and implement a more cost-effec-tive electronic mail and file transfer system for usewithin the Library. Other administrative improvementsincluded the installation of additional PC-networking ca-pabilities for sharing administrative and production datawithin the Division.

Collection Development

Collection development includes: establishing andrevising literature selection policy, identifying andacquiring biomedical literature in all formats and

Right, Lois Ann Colaianni, Associate Dir. for LibraryOperations; Left, Betsy L. Humphreys, Deputy Asso. Dir.

languages, processing materials as they are received, as-sessing the effectiveness of the selection and acquisitionprocess, and maintaining and preserving the collection.The NLM collection now contains 1,957,389 printedbooks, journal volumes, theses, and pamphlets and2,728,388 nonprint items, including audiovisuals, soft-ware, microforms, prints, photographs, and manuscripts(table 1).

During FY 1990, LO completed an item by item in-ventory of the prints and photographs collection andeliminated many duplicate, poor-quality images fromthe collection. As a result, NLM's picture collection isnow known to contain 56,600 images, rather than the77,993 reported at the close of FY1989.

Selection and collection assessment. NLM staff mem-bers select materials for the NLM collection according tothe guidelines in the Collection Development Manual ofthe National Library of Medicine. The last general revi-sion of the Manual was completed in 1985. In keepingwith NLM's policy of conducting a general review andrevision of the Manual every 5 to 8 years, a plan has beenprepared for the next wholly new edition to be com-pleted in 1992. FY 1990 work on collection developmentpolicy included revised guidelines for animal welfare lit-erature, a draft policy statement on collection of elec-tronic formats, and a joint NLM/Library of Congressstatement on collecting the AIDS literature.

Library Operations

The Library has a continuing program to assess itssuccess in implementing collection development policiesand to examine how these policies serve the needs ofhealth professionals and researchers. In FY 1990,LO completed a comprehensive evaluation of NLM'sdermatology collection and began a similar evaluationofneurology. The results of the dermatology project indi-cated that NLM's collection is appropriately strong in alltime periods. Some work is needed to ensure consistentacquisition of materials issued by noncommercial pub-lishers. A review of general physics journals in NLM'scollection led to the cancellationof about $20,000 in sub-scriptions to titles that currently have little or no bio-medical content. NLM's collection of medical statisticswas also reviewed. In FY 1990, NLM participated in theNat ional Shelflist count, the American LibraryAssociation's periodic effort to provide comparativemeasurements of major U.S. research library collections.

Acquisitions. NLM added 40,637 volumes and159,744 other items (e.g., audiovisuals, microforms, soft-ware, pictures, manuscripts) to its collection in FY 1990(table 2). The Library staff processed 165,424 modernbooks, serial issues, audiovisuals, and software packages.NLM's historical collection was enhanced by the acquisi-tion of Lcktsii o Rabotc Glavni/kh Pishchevaritelnykh Zhelez(St. Petersburg, 1897) Ivan Pavlov's classic book on thephysiology of digestion. Other important additions tothe rare book collection included: Robert Thomas, Medi-cal Advice to tin1 Inhabitants of Warm Climates (Bahamas,1794), thought to be the only book printed in the Baha-mas in the eighteenth century; Dcr Vrouwen Natnere EndeComplexie (Antwerp, ca. 1520-1530), an extremely rareand early illustrated book on midwifery; Le Grand Herbier(Paris, ca. 1535), an herbal i l lustrated with over 300woodcuts; and a collection of 17th-19th century broad-sides and pamphlets on medicine in Mexico.

Significant items acquired for the manuscript, pic-ture, and historical audiovisual collections include: twoCivil War manuscripts, a medical journal for the U.S.brig Bo/7/0 and a prescription book for a regiment of NewHampshire volunteers; the papers of Dr. Marsden ScottBlois, a pioneer in the field of medical informatics; 220photographs of NIH activities donated by former NIHDirector Dr. Donald Fredrickson; a film on transfusionfeaturing Dr. Michael DeBakey; and five early Germanradiological fi lms.

In FY 1990, NLM negotiated lower service chargesfor serials subscriptions to reali/e a savings of about$40,000. A new online data entry system for creatingmonograph and audiovisual acquisitions records wasimplemented.

Collection preservation and maintenance. The Library'spreservation program includes: preserving and main-taining NLM's own collection, supporting the preserva-

tion of important biomedical literature not held by NLM,promoting the use of more permanent materials in newbiomedical publications, and investigating new technolo-gies for preservation of library materials. FY 1990 preser-vation activities affecting the NLM collection included:

• Microfilming 6.1 million pages of brittle booksand serial volumes. To allow the contractor tof i lm complete runs of serials, the Library bor-rowed 443 volumes missing from its own collec-tion from 37 different U.S. and foreign libraries.

• Storing microfilm masters in an undergroundoffsite facility to provide additional security inthe event of a disaster affecting the Librarybuilding.

• Establishing policies, procedures, and a new con-tract for producing service copy microformsneeded to fill interlibrary loan and purchase re-quests.

• Giving special conservation or preservation treat-ment to 268 rare books, manuscripts, and histori-cal films in NLM's collection.

• Purchasing new exhibit cases to provide a benignand secure display environment for items fromthe special collections.

• Awarding a new bindery preparation contractand completing work on an improved automatedsupport system for binding and recording issuesmissing from the NLM collection.

• Reviewing and revising the 20-year plan forshelving the NLM collection; NLM must acquireadditional compact shelving to accommodate theprojected growth in the size of the collection.

As part of NLM's National Preservation Plan, con-tracts for preserving important items not held by NLMwere awarded to: the Houston Academy of Medicine -Texas Medical Center Library for conservation and pres-ervation of some of the papers of Dr. Philip S. Hench(1896-1965), a recipient of the Nobel Prize for research onthe effects of corticosteroids on rheumatic diseases; theLibrary of Kirksville College of Osteopathic Medicine forconserving selected papers of Dr. Andrew Taylor Still,founder of the College; and Tufts University Health Sci-ences Library for microfilming four dentistry serials forwhich NLM has very incomplete or no holdings. NLMfunds 50 percent of the cost of the projects; the institu-tions receiving the contracts fund the balance of the cost.

The Library continues its campaign to promote theuse of acid-free paper in new publications as a means toreduce the growth of the preservation problem facinghealth sciences libraries. In FY 1990, NLM began flaggingin List of Journals Indexed in Index Medicus and the List ofSerials Indexed for Online Users those titles that are printedon acid-free paper and that also include a notice to thateffect. A total of 506 (17 percent) of Index Medicus titles

Programs and Services, FY1990

will have this flag in 1991. NLM staff members also di-rected the effort to revise the current American NationalStandard for Permanence of Paper (Z39.48-1984) to in-clude coated as well as uncoated papers. A revision in-corporating the results of a discussion draft will be votedon by the National Information Standards Organizationin FY 1991.

Peri L. Schuyler, Head, Medical Subject Headings Section

Bibliographic Control

NLM provides effective bibliographic control of thebiomedical literature by: maintaining and enhancing theMedical Subject Headings (MeSH) and the NLM classifi-cation scheme for the shelf arrangement of biomedical li-brary materials; cataloging biomedical publications in allformats; and indexing articles from selected biomedicaljournals.

Thesaurus. MeSH, the hierarchical thesaurus used incataloging, indexing, and searching NLM's online data-bases, currently includes 16,131 subject headings.MeSH's supplementary chemical file contains about57,400 additional terms, most of which are names ofchemicals. NLM staff members review, update, andmodify the terminology annually to ensure that MeSHkeeps pace with developments in biomedicine andchanges in the usage of biomedical terms. In FY 1990,308new MeSH main headings, 3 new subheadings, and1,239 new cross-references to existing terms were added.The vocabulary was expanded in several subject areas in-cluding AIDS, molecular biology, lymphomas, andretroviridae.

Other enhancements to MeSH included the elimina-tion of the distinction between major and minor head-ings in the vocabulary, the development of general"consider also" references (e.g., HEART consider alsoterms beginning with CARDIAC), and the creation of a

new publication type element to allow clearer distinc-tions between what an article is and what it is about.New "pre-explosions" were created to allow combinedsearching of all "adult" (i.e., adult, middle-aged, aged)and "child" (i.e., infant; infant, newborn; child; child, pre-school; adolescent) descriptors in MeSH. Pre-explosionswere also created to allow combined searching of sub-headings in certain categories, e.g., all the subheadingsfor therapies.

During FY 1990, MeSH staff members were alsoheavily involved in creating and reviewing key segmentsof the content of the first versions of the Metathesaurusand Semantic Network. A description of the UMLSproject appears in the Special Initiatives section of thisreport.

Cataloging. At NLM, the cataloging functionincludes: cataloging new works added to the Library'scollection, updating NLM's automated files of catalogingand name authority records, contributing NLM's cata-loging data to the national bibliographic apparatus, andmaintaining the NLM classification (used by health sci-ences libraries world-wide to assign shelving locations tocataloged items based on their subject content). In FY1990, NLM cataloged a total of 19,369 modern books,serials, nonprint items, and Cataloging-in-Publicationgalleys, using a combination of in-house staff, contrac-tors, and an interagency agreement with the Library ofCongress (table 3). The inventory of uncataloged bookswas reduced by 565 to a total of 7,303 items, most in lan-guages other than English.

Work continued on improving the bibliographiccontrol and access to NLM's retrospective holdings.Emilie Savage-Smith, Ph.D., a distinguished scholar inthe history of Arabic medicine, began a detailed reviewof NLM's Arabic manuscript holdings preparatory to theLibrary's creating machine-readable bibliographic andname authority records for these items. Dr. Savage-Smith's review has revealed that the previous project tolist these items overlooked some of the manuscripts thatwere bound together and misidentified others. NLM'scollection of Arabic manuscripts is therefore larger andmore significant than previously thought. Staff upgraded12,000 abbreviated records for items in NLM's picturecollection to a fuller format in conjunction with the jointLister Hill Center/LO project to develop an integratedautomated catalog and videodisc for the Library's his-torical pictures.

NLM intends to dispose of its name-title catalogcards and most of its shelf-list cards in early FY 1991. Thecards have been stored in the Library's basement since1985 when they were removed from public service. Inpreparation for the disposal of the card catalog, cardswere retrieved for approximately 30,000 theses and forbooks bound with other books that had not been con-verted to machine-readable form because they were not

Library Operations

in the shelf-list. Both categories of records will be con-verted to machine-readable form at a future date.

Substantial progress was made in implementing anew automated system for cataloging that distributesdata creation and validation tasks between PC worksta-tions and the mainframe computer. The data creationportion of the system was implemented for all in-housecatalogers in FY1990. It includes the ability to downloadname authority and bibliographic records from the Li-brary of Congress's online files for use as the basis ofNLM's cataloging and name authority records. In a re-lated development, a prototype of segments of the nameauthority portion of an expert cataloger system is underdevelopment. The tape of the machine-readable versionof the current NLM classification was mounted onlinefor staff use to support the continuing effort to revise theclassification. Procedures were drawn up for the revisionof the classification.

Left, Duane W. Arenales, Chief, Technical ServicesDivision; Right, Sally Sinn, Deputy Chief

Indexing. NLM's basic indexing operation involvesselecting the journals to be indexed, keyboarding de-scriptive information and abstracts from the articles to beindexed, indexing the content of the articles, reviewingthe accuracy of the keyboarding and indexing, and main-taining the citation databases to correct indexing errorsand to annotate citations to articles that have been re-tracted, corrected, or called into question by commentar-ies. Following a successful pilot test, NLM's indexingactivities have been expanded significantly to include de-scription of the characteristics of gene sequences pub-lished in journals indexed by the Library. These specialindexing data are incorporated into the products and ser-vices of NLM's National Center for Biotechnology Infor-mation.

The Literature Section Technical Review Committee(LSTRC) (Appendix 7) advises NLM on the selection ofjournals to be indexed in MEDLINE and Index Medicus.In FY 1990, the LSTRC reviewed 306 journals and gave71 of them a sufficiently high priority to warrant their

immediate addition to MEDLINE and Index Medicus. Af-ter reviewing reports prepared by professional associa-tions in the fields of dermatology, oncology, andepidemiology, the Committee recommended the selec-tion of 14 titles in these fields and the deselection of 19others. A LSTRC subcommittee completed writtenguidelines on the selection of titles to be indexed. A newmodule of the Library's Master Serials System wasimplemented to support the journal selection and reviewprocess. Staff also compared a sample of LSTRC evalua-tions of journals with citation impact factors for the samejournals.

About 391,000 indexed citations were added toMEDLINE during the year (table 4). NLM entered theauthors' abstracts into the database for the 70 percent ofthe articles that included them. MEDLARS indexing isdone by a combination of NLM staff, international MED-LARS centers, cooperating agencies such as the Ameri-can Dental Association, the American Journal ofNursing, and the American Hospital Association, andcommercial contractors. The NLM staff is responsible forquality review of all indexing.

In its continuing effort to alert users to data in bio-medical journals that have been identified as fraudulent,erroneous, or potentially flawed, NLM added informa-tion to MEDLARS databases about 14 retractions, 2,906published error notices, and 8,189 substantive commen-taries on previously indexed articles. The Library hasalso developed a procedure for announcing retractedmonographs or parts of monographs in CATLINE®.

Enhancements to automated support for indexingincluded the replacement of the terminals used byNLM's indexing contractors with more modern and reli-able hardware, the conversion of the last of the contrac-tor indexers to the online system, the acquisition of thefirst of the new PC workstations to be used by NLM in-dexers, and the beginning of an effort to modify the in-dexing system to accommodate the nonjournal citationsincluded in such files as BIOETHICSLINE® andHISTLINE®. In FY 1990 the Library contracted for two re-search projects related to indexing:

• William Hersh, M.D., will evaluate the relativeretrieval performance of AIDS meeting abstractsindexed by: 1) text words only, (2) text words incombination with MeSH headings assigned by aprogram that makes use of information in theUMLS Metathesaurus, and (3) textwords incombination with MeSH headings assigned byhuman indexers.

• Herner & Company will analyze data about howwell NLM's indexing covers the significant pointsin biotechnology articles as identified by re-searchers in the field. If the results of this studysuggest that the methodology used in this analy-sis can be adapted to other subjects, several clini-cal subjects will be examined in a similar fashion.

10 Programs and Services, FY1990

Network Services

NLM's direct services to local and remote usersinclude: disseminating authoritative bibliographic datain publications, machine-readable formats, and an onlineretrieval service; providing reference assistance in re-sponse to visitor, telephone, and written requests; pro-viding documents from the NLM collection to onsiteusers and to remote health professionals and researchersas a back-up to other U.S. libraries; and directing the Re-gional Medical Library Network, which attempts toequalize access to information for all U.S. health profes-sionals regardless of their geographic location or institu-tional affiliation. The expansion and enhancement ofthese traditional outreach activities are a critical part ofthe major outreach initiative recommended in the Boardof Regent's Outreach Panel's report and mandated andfunded by Congress (see Special Initiatives Section).

Publications. Despite the wide availability of its datain machine-readable databases and online services,NLM's publications continue to be an important vehiclefor worldwide distribution of the Library's authoritativeindexing and cataloging data and of information neededby users of NLM's online services. In FY 1990, NLM pro-duced more than 100 individual issues of some 27 recur-ring indexes and catalogs, ranging from comprehensivepublications such as Index Medicus® and the National Li-brary of Medicine Current Catalog to more specialized toolssuch as the AIDS Bibliography.

Publications introduced or substantially revised inFY 1990 included: Gratefully Yours, a newsletter aimed atindividual users who search NLM's databases online; the1984-1989 cumulation of the Bibliography of the History ofMedicine-, a reprint of the current edition of the NationalLibrary of Medicine Classification; the 2990 Medical SubjectHeadings Tree Structures to which special "tree annota-tions" were added; and the AIDS Bibliography, which wasexpanded to include citations from CATLINE® andAVLINE®.

A preliminary report of the results of the U.S.librarysurvey portion of the study of the current use of IndexMedicus and Abridged Index Medicus was prepared by theRegion 4 RML Office. Samples of Index Medicussubscribers in other countries are also being surveyed.The purpose of the study is to determine how theseproducts are used, when and why they are consulted inpreference to some machine-readable form of MEDLINE,and how they and NLM's electronic products can beenhanced to serve users better. The results will bepublished in FY 1991.

Machine-readable databases. To facilitate access to itsauthoritative data, NLM leases complete databases andsubsets of selected databases in machine-readable form.The licensees include commercial database vendors,other segments of the information industry, international

Sheldon Kotzin, Chief, Bibliographic Services Division;Lou Knecht, Deputy Chief

MEDLARS centers, and academic health science centers.These organizations then make NLM data availableonline or in CD-ROM products.

In FY 1990, the Library distributed more than 4,500tapes of various databases to domestic and internationallicensees. MEDLINE data are now available to licenseeson a weekly schedule. License agreements were estab-lished with 14 new organizations, bringing the totalnumber of agreements up to 87. At the end of the yearthere were 12 commercially available CD-ROM productscontaining MEDLARS data. Specific actions in FY1990included:

• Upgrading of AVLINE MARC tapes to conformto the current version of the MARC format and toallow distribution of MARC records for computersoftware.

• Revising the charges for MEDLARS data to be in-corporated on CD-ROMs to differentiate betweensingle and multiple use products and to ensuresimilar charges for similar use of MEDLARS datawhether on tape or CD-ROM.

• Distributing a quality assurance "self-test" in-cluding sample searches to licensees of full data-bases. This is part of NLM's effort to ensure thecurrency and accuracy of the MEDLARS dataprovided through other organizations and the ef-fectiveness of their retrieval programs.

• Improving the efficiency of the tape distributionprocess by contracting out the distribution ofsome databases.

• Developing a prototype expert system to assistwith pricing MEDLARS data.

Online services. NLM provides online access to 43databases, including the MEDLINE and TOXLINE®backfiles. In FY 1990, online users were connected to

Library Operations 11

NLM's system for a total of 333,685 hours and conducted4.8 million searches (tables 6 and 7). These figures do notreflect use of MEDLARS data on the computer systemsof other organizations that lease NLM files.

As a result of outreach efforts by NLM and the RMLNetwork libraries, the number of codes for use of NLM'sonline system continues its 5-year pattern of extremelyrapid growth. At the end of FY 1990, there were 39,758assigned codes, an increase of 28 percent from the end ofthe previous year. The special student code programcontinues to be popular and has been extended toCanada and, through Great Britain, to the Republic ofIreland. There are now 7,068 institutional and individualstudent codes. Individual users of NLM's online servicesnow outnumber institutional users and represent 52 per-cent of all domestic code holders.

Eighty-four percent of the individuals who receivednew codes in FY 1990 indicated an intention to use theGrateful Med microcomputer front-end package to ac-cess NLM's databases. Version 5.0 of Grateful Med forthe PC and Version 1 of Grateful Med for the AppleMacintosh microcomputer were issued in FY1990. A to-tal of 28,128 copies of Grateful Med (25,041 IBM PC ver-sions; 3,087 Macintosh) have been sold by the NationalTechnical Information Service since the package was in-troduced in March 1986. Purchasers receive new ver-sions at no additional cost as they become available.

In FY 1990, NLM produced demonstration disks forboth versions of Grateful Med. The disks simulate simplesearches and have order forms and code applicationforms that can be printed out, completed, and returnedto NLM. Improvements incorporated in Version 5.0ofthe PC Grateful Med included: additional MeSH infor-mation; an expanded citation review capability, allowingboth forward and backward browsing; easy incorpora-tion of MeSH terms suggested by the program into fol-low-up searches; and improved "set-up" features tosimplify telecommunications and trouble-shooting.

In addition to enhancing Grateful Med, NLM madeimprovements to MEDLARS databases, to the capabili-ties of ELHILL (the retrieval software used on NLM'smainframe computer system), and to the support mecha-nisms for NLM's online users. To make current informa-tion available more rapidly, the Library increased thefrequency of MEDLINE updates from biweekly toweekly. AIDSLINE®, a database of citations to the litera-ture about acquired immunodeficiency syndrome, wasfurther expanded to include abstracts from internationalAIDS conferences.The Author's Address is now retainedin new citations added to MEDLINE. The ELHILL re-trieval system was enhanced to permit online sorting ofcitations, automatic "EXPLODE" of all tree numbers towhich a MeSH term is assigned, and an increase in themaximum size of an index to a MEDLARS database.

The Library continued its efforts to streamline proce-dures for assigning online codes and is preparing to ob-tain contract assistance for keying data for new onlinecodes and address changes. The test of flat-rate per-codeonline pricing was expanded to a total of five institu-tions.

The tremendous growth in the number of individualonline users has increased the number and altered thecharacter of calls received at NLM's online service desk.The Library now receives an average of more than 200service desk calls per day. Many additional requests forinformation or assistance are received via the GratefulMed Bulletin Board. As in past years, NLM analyzed ser-vice desk calls in general, and Grateful Med-related callsin particular, to identify major user problems and con-cerns.

As part of its increased emphasis on outreach, the Li-brary staff exhibited NLM's products and services andpresented short courses on searching via Grateful Med ata number of meetings of associations of health profes-sionals. Expanding on a program begun in FY 1989,NLM trained selected FASEB Summer Research Confer-ence attendees to demonstrate Grateful Med to their col-leagues at all such summer conferences held in 1990. Atotal of 915 librarians and other search intermediaries re-ceived basic or follow-up training in online searchingfrom staff at NLM or one of the three Regional MedicalLibraries that provide such training under contract to thelibrary.

Left, Eve-MarieLacroix, Chief, Public Services Division;Right, Martha Fishel, Deputy Chief

12 Programs and Services, FY1990

Reference services. NLM provides reference andresearch assistance to onsite users and to remote users asa back-up to the services of other U.S. health scienceslibraries. In FY 1990, the Library received 60,630 requestsfor reference assistance, 67 percent from onsite users, 31.7percent in telephone calls, and 1.3percent in letters (table8). A new telephone answering system implemented inFY 1990 has reduced considerably the number of callsreferred to reference staff by allowing callers to selectrecorded answers to frequently asked questions.

Service to onsite users and NLM staff was improvedsubstantially through the implementation of a CD-ROMnetwork that provides access from the same workstationto a variety of CD-ROM reference tools and toMEDSTATS, an expert system designed to help usersand staff locate the sources of answers to specific statisti-cal questions. Work was completed on the content of anautomated guide to the use of NLM's onsite services.The guide will be installed and evaluated in FY1991.

NLM's reference staff provide special literaturesearch service in support of the NIH Consensus Devel-opment Conferences. The searches prepared as back-ground for conference attendees are also published aspart of NLM's Current Bibliographies in Medicine.Among the topics covered in FY 1990 were: treatment ofearly-stage breast cancer; sleep disorders of older people;and cocaine, pregnancy and the newborn.

This year NLM began to provide extensive literaturesearch service to panels convened by the new Agency forHealth Care Policy and Research to develop clinical prac-tice guidelines. (See Special Initiatives Section). Segmentsof these literature searches will also be published in theCurrent Bibliographies in Medicine series.

Document delivery. NLM provides document deliveryservice to remote requesters as a back-up to the serviceprovided by other libraries in the Regional Medical Li-brary Network and also to onsite users who need itemsfrom NLM's closed stacks (table 5). In FY 1990, theLibrary received 258,421 interlibrary loan requests, 13percent more than in FY 1989. Seventy-one percent of therequests were filled; if requests for which the requestorwas unwilling to pay NLM's charge are removed fromthe calculation, 78 percent were filled. NLM received 81percent of its interlibrary loan requests via DOCLINE,NLM's automated document request and routing sys-tem. A total of 4,088 requests were received viatelefacsimile transfer; 2,619 of these were for materialsneeded for clinical emergencies and were processedwithin two hours.

In FY 1990, NLM issued a contract for assistance inretrieving items requested under interlibrary loan. Abacklog of requests for items from the historical collec-tions which had to be microfilmed before the requestswere filled was eliminated. LO, the Lister Hill Center,

and the Office of Computer and CommunicationsSystems are collaborating to test the combined use ofstored images of selected journal articles, DOCLINE, andtelefacsimile technology to allow NLM to fill some of itsinterlibrary loan requests without retrieving the physicalitems from its stacks. This project, known as the Systemfor Automated Interlibrary Loan (SAIL), is also describedin the Lister Hill Center Chapter.

A total of 1,977 libraries are current DOCLINE users.In FY1990, these libraries entered 1,877,754 requests intothe system; 93 percent were filled. DOCLINEnow routesserial requests based on more than 1,200,000 SERHOLD®records, representing the serial holdings of more than2,900 institutions. During the year DOCLINE wasenhanced to allow cancellation of requests, to increasethe number of simultaneous users accommodated, andto include a fax-only routing option.

Loansome Doc, a system that allows health profes-sionals to use Grateful Med to request copies of docu-ments from a specific library in the RML network, iscurrently undergoing testing in Region 7. Using theLoansome Doc software, Grateful Med creates a docu-ment request and uploads it to DOCLINEfor transmis-sion to the library that has agreed to serve the user. If thislibrary cannot provide the requested item, the request isrouted through DOCLINE to a library that can fill it. Ifthe results of the Region 7 test are positive, LoansomeDoc will become available to Grateful Med usersthroughout the country in FY1991.

Onsite users made 198,483 requests for documentsfrom the NLM stacks in FY 1990, 8 percent more than inthe previous year. Eighty-four percent of the requestswere filled, 82 percent within 30 minutes of receipt. Sincethe implementation of NLM's online patron registrationand request logging system in February 1988, 24,320people have registered to request documents onsite atthe Library.

Becky Lyon-Hartmann, RML Program Coordinator

Library Operations 13

Regional Medical Library Program. The purpose of theRegional Medical Library Network is to improve andequalize access to biomedical information in the UnitedStates by linking health professionals and researchers tothe information resources they need, regardless of theirgeographic location. There are 3,373 network membersincluding health sciences libraries of every size and typein all parts of the country. NUVTs Regional MedicalLibrary Program Office provides national coordinationof the network. The RML Program is a cornerstone ofNLM's outreach program and its services are being re-vised and enhanced as part of NLM's expanded outreachinitiative (see also Special Initiatives Section).

In each multistate region of the Network, NLM con-tracts with a distinguished medical library to coordinatenetwork members within the Region to provide docu-ment delivery, encourage resource sharing, support useof online services, and develop innovative outreach ser-vices to health professionals. The Regional Medical Li-braries are supported by more than 130 large ResourceLibraries, generally in medical schools, and many hospi-tal and special libraries, individually and in consortia.

FY 1990 was the last full year of the current 5-yearRML contracts and recompetition of new contracts is un-der way. Under the new contracts, the RML Networkwill be reconfigured from 7 to 8 regions, with the NewEngland states designated as the eighth region. The newcontracts, to be awarded in 1991, increase the role of theRMLs in outreach to individual health professionals, call-ing on them to serve as a "field force'' for NLM and itsproducts and services.

The role of the RMLs in outreach has expandedthrough several outreach enhancement projects. In addi-tion to established outreach projects being conductedthrough the RMLs in West Virginia and the PacificNorthwest, six new outreach enhancement projects werefunded this year. Some are being carried out directly byRML staff while others involve the RML workingthrough network libraries in the targeted areas. The sixnew projects are in Massachusetts, New York, WesternMaryland, Southern Iowa, Oklahoma, and North andSouth Dakota.

NLM has also increased its support of outreach ef-forts to specific network libraries by awarding 30 com-petitive contracts aimed at introducing Grateful Med tohealth professionals who are not currently affiliated witha medical library, and providing them with a link toinformation services from a health sciences library. Pro-posals were solicited from members of the RML Net-work in March 1990. The contracts, which range up to$25,000, were awarded to 17 hospitals and 13 academicinstitutions and associations. Overall management of thisoutreach effort will be handled by staff in NLM's RMLOffice.

The projects will target a wide range of health pro-fessionals in both rural and urban underserved areas andwill be based in 22 states and the District of Columbia.Training packets were sent by NLM to all recipients aswell as to the Regional Medical Libraries. The contracts,all of which have an evaluation component, will cover an18-month period ending in March 1992.

Right, Robert Mehnert, Chief, Office of PublicInformation (Office of the Director); Left, Roger Gilkeson,Deputy Chief

Special Onsite Programs.

In addition to the reference and document deliveryservices provided to onsite patrons, NLM offers a varietyof special programs and services to people who come tothe Library in Bethesda, including guided tours, brief-ings on NLM's services and operations, and historicalexhibits and symposia. NLM also sponsors a VisitingHistorical Scholar Program and conducts a one-yeartraining program for library school graduates withpotential for leadership roles in health sciences informa-tion.

Public tours and briefings. Each year NLM entertainsmany visitors from throughout the United States andaround the world. In FY 1990, LO staff members con-ducted 147 regular daily tours for a total of 413 visitors.The Office of Public Information (Office of the Director)arranged special tours and orientation programs for 127groups (1,354 visitors). NLM staff members alsoarranged special briefings on library programs andservices for many individual visitors.

Historical Programs. The FY 1990 Visiting HistoricalScholar was Diana Long, Ph.D. Each year a recognizedhistorical scholar is selected competitively to spend 6to 12 months at NLM to engage in research that will usethe Library's collections, to give one or more public pre-sentations, to assess segments of NLM's historical collec-tion and to consult with staff. Dr. Long used NLM's

14 Programs and Services, FY1990

collection to carry out research on the history of theIndex-Catalogues and early indexing policies at NLM.She presented a lecture on "The Index-Catalogues of theSurgeon-General's Library, 1880-1961: Indexers, Vocabu-laries, and Values/'

In FY 1990, the History of Medicine Division pre-pared several special exhibits, presentations, brochures,and other materials. With the aid of consultant WilliamHelfand and the NIH Medical Arts and PhotographyBranch, NLM prepared a traveling exhibit of publichealth posters from its collection. After an initial showingat NLM, the exhibit will appear at 10 museums andmedical libraries over the next 2 years. Also, major lobbyexhibits were prepared on natural history and its rela-tionship to medicine, experimental embryology, andpublic health in nineteenth century New York City.

The Library co-sponsored with the University ofMaryland a third medicine and the arts symposiumentitled "The Medicinal Muses: The Therapeutic Value ofthe Arts." Individual staff members continued their re-search using NLM's historical collections. Staff researchwas published in several publications and presented atinvited lectures throughout the year.

NLM Associate Program. The NLM Associate Pro-gram is a one-year competitive program that provideslibrary school graduates an opportunity to learn aboutNLM's operations, to gain a better understanding of thekey issues facing all health sciences libraries, to use newinformation technologies, and to develop their skills byconducting special projects. Projects undertaken by As-sociates in FY 1990 included a study of the feasibility ofusing search statements devised for accessing MED-LARS databases as a basis for searching non-NLM data-bases, an analysis of the subsequent publication injournals of work presented at AIDS-related meetings,and testing of optical scanners for use in converting

Left, John L. Parascandola, Ph.D., Chief, History ofMedicine Division; Right, Philip Teigen, Ph.D.,Deputy Chief

manuscript finding guides to machine-readable form.Associates also have an opportunity to visit the other na-tional libraries and various types of health sciences li-braries or information centers and to attend professionalmeetings. NLM staff members continue to attend por-tions of the Associates' formal curriculum.

Four Associates completed the 1990/90 program.Three have made career plans: One accepted a positionat NLM; one joined an academic medical library; andone joined a private information company. Four new As-sociates began the program in September 1990.

Library Operations 15

Table 1Growth of Collections

CollectionPrevious

Total(9/30/89)

FY 7990 New Total

Book MaterialsMonographs:

Before 1500 5711501-1600 5,7351601-1700 10,0441701-1800 24,3201801-1870 39,843Americana 2,3401870-Present 523,302

Theses (historical) 281,794Pamphlets 172,021Bound serial volumes 891,724Volumes withdrawn (34,942)

Total volumes 1,916,752

Nonbook MaterialsMicroforms:

Reels of microfilm 48,269Number of microfiche 223,871Total microforms 272,140

Audiovisuals 48,598Computer software 244Pictures' 55,958Manuscripts 2,191,704

0131342781

14,66500

25,917(92)

40,637

5,84614,88520,731

1,578268642

136,525

5715,748

10,05724,36239,921

2,341537,967281,794172,021917,641(35,034)

1,957,389

54,115238,756292,87150,176

51256,600

2,328,229

'1989 total adjusted based on retrospective conversion of prints and photographs collection

Table 2Acquisition Statistics

Acquisitions FY1988 FY1989 FY 1990

Serial titles receivedPublications processed:

Serial piecesOtherTotal

Obligations for:PublicationsIncluded for rare books.

20,726

133,22620,101

153,327

$3,495,123($156,446)

21,781

137,84918,382

156,231

$3,526,901($182,584)

21,557

144,35621,068

165,424

$3,632,746($203,559)

16 Programs and Services, FY 1990

Table 3Cataloging Statistics

Item

Completed CatalogingFullLimitedTotal

Table 4Bibliographic Services

Services

Citations published in MEDLINEFor Index Medicus

Recurring bibliographiesJournals indexed for Index MedicusAbstracts entered

Table 5Circulation Statistics

Activity

Requests Received:Interlibrary LoanReaders

Requests Filled:Interlibrary Loan

PhotocopyOriginalAudiovisual

Readers

Requests Unfilled:Interlibrary Loan

ReferredReturned

Reader ServiceReturned as unavailable

FV 1988

14,5675,721

20,288

FY1988

329,019313,963

282,855

197,674

FY 1988

415,137204,484210,653

316,508143,151131 870

9,8101,471

173,357

96,28361,3332,125

59,208

34,950

FYI989

11,9856,748

18,733

FY 1989

372,806352,206

262,888

233,707

FY1989

414,354227,841186,513

310,363158,840146,67910,7531,408

151,523

101,00969,0012,850

66,151

32,008

FV/990

12,0607,309

19,369

FV 7990

391,172363,890

282,973

275,000

FY7990

456,904258,421198,483

349,999183,950170,60512,0541,291

166049

106,90574,4713,431

71,040

32,434

Library Operation*

Table 6Online Searches

DATABASES

AIDSDRUGSAIDSLINEAIDSTRIALSAVLINEBIOETHICSCANCERLIT"CATL1NECCR1SCHEMIDCHEMLINE*CLINPROT"DARTIM

DB1R'M

DENTALPROJDIRLINEDOCUSEirEMICBACKETICBACKHEALTHH1STLINEHSDB1"INFORMINTROMED"1NTROTOXIRISLOAN STATUSMEDL1NE

MED86MED83MED80MED77MED75MED72MED71MED66

MESH VOCABULARY'NAME AUTHORITY'PDQPOPLINE*REFLINERTECS*-ELHILLRTECS-TOXNETSDILINE*SERLINE*STORED SEARCHTOXLINE*

TOXLINE65TOXLIT

TOXLIT65TRIYEAR86

Total

FY1988

2,977

11,9377,888

54,759160,129

2,894

24,9072,956

6,107973

121,589

4,13131,976

1464,955

43

1,895,591

526,338276,753140,99016,01875,51815,73164,42320,1583,120

44,82220,849

31,9672,703

13,693

38,95649,137

8368,398

24,1718,742

201

3,776,729

FY1989

4818,940

9511,9898,196

61,070157,783

3,060

24,6742,763

657121

7,2712,646

3311,316

128,6584,341

32,641115692—

—1,782,750

567,991492,092254,539

144,562

99,358

70,20220,5423,580

69,15822,53438,799

17,34639,81253,532

13071,1015,202

20,8777,087

12,1582

4,260,761

FY1990

24724,525

76812,8798,505

63,898158,293

2,9833,497

22,6832,4321,2441,942

2627,1203,3091,5171,627

136,6164,643

34,939127——

4,959211

2,058,301602,394402,341225,340132,976

91,601

68,37320,4483,179

69,68419,14041,902

16,30341,18555,038

10768,9119,962

15,5165,116

30,625655

4,478,323

Programs and Services, FY 1990

Table 7Offline Searches

DATABASES FY 1988 FY1989 FY1990

AIDSLINE 5AVLINE 208BIOETHICS 34CANCERLIT 3,726CATLINE 517CHEMLINE 4CLINPROT 3DIRLINE 2DOCUSERHEALTH 11,173HISTLINE 8MEDLINE 8,960

MED86MED83 13,862MED80 11,014MED77 7,332MED75 1,320MED72 3,141MED71 871MED66 2,757

MESH VOCABULARY 7POPLINE 5,337RTECS-TOXNET 3SDILINE 231,269SERLINE 3TOXLINE 15,474

TOXLINE65TOXLIT 366

TOXLIT65 312

Total 317,708

19112638

3,842558

111,516

66,1157,3808,8235,9713,830

2,440

1,5101

5,378

247,8126

12,73135

145119

1,29410325

3,654536

1040

10,9839

4,6305,9935,2113,5572,073

1,452

8381

5,107

229,62510

6,60876

5,497103

318,576 287,390

Library Operations 19

Table 8Reference Services

Activity FY 1988 FY1989 FY1990

Reference Section:Requests by telephoneRequests by mailIn-person requestsTotal

26,429743

48,93576,107

21,481985

39,37461340

19,222585

40,82360,630

Table 9History of Medicine Activities

Activity FY1988 FY 1989 FY1990

Acquisitions:Books 125Modem manuscripts 166,429Prints and photographs 214

Processing:Books cataloged 442Modem manuscripts processed* **Pictures cataloged 138Citations indexed 5,645Pages microfilmed 48,774

Public Services:Reference questions answered 10,077ILL and pay orders filled 3,607Reader requests filled 10,416Pictures supplied 6,642

127946,750

3,420

34648,001

05,479

27,140

10,2442,4068,3096,045

360128,088

642

232112,541

05,136

66^81

13,9823,5069,3585,872

Revised category.Figure not available

20

SPECIALIZED INFORMATIONSERVICES

Henry Kissman, Ph.D.Associate Director

Concern about the environment and the effects ofenvironmental pollutants on human health reached newheights in 1990. The twentieth anniversary of Earth Daywas celebrated in April with extensive fanfare world-wide. According to a recent Gallup Poll, a large majorityof Americans think that action is necessary in order toavoid major environmental disruptions. The need forinformation about the consequences for man and theenvironment of pollution by hazardous chemicals isgreat. NLM's Specialized Information Services Division(SIS), through its Toxicology Information Program, con-tinues to respond to that need with a variety of informa-tion services.

The NLM online files for which SIS has responsibil-ity are made available to the public through two com-puter systems—NLM's mainframe system, ELHILL, andTOXNET, a system specially built for the toxicology da-tabases. In FY 1990, SIS made major changes to its files inboth of these environments.

On the ELHILL side, SISintroduced a new, royalty-free, online chemical dictionary and directory file, calledChemID (Chemical Identification File). ChemID helpsusers identify chemical substances and formulate strate-gies to search other MEDLARS files. ChemID also con-tains a set of unique capabilities, collectively known asSUPERLIST, which provide the names and the source ofchemicals found on one or more of 16 Federal and Stategovernment lists having major regulatory or biomedicalimportance.

Health Hotlines, a publication derived from DIRLINE(Directory of Information Resources Online), was up-dated. This publication contains descriptions of organi-zations with toll-free telephone numbers that providehealth-related information and other services to the pub-lic. Health Hotlines is a very popular item; over 60,000copies have now been distributed.

In the TOXNET (Toxicology Data Network) system,the number of online databases was expanded to 10. The1988 reporting year data for the Toxic Chemical ReleaseInventory (TRI88) file has joined the 1987 data (TRW) asthe first two in a series of annual files operated by NLMfor the Environmental Protection Agency (EPA). Thesedata collections were required by the Emergency Plan-ning and Community Right-to-Know Act of 1986. Theyprovide the public with information about the release ofEPA-specified hazardous chemicals to the air, water,

Right, Henry M. Kissman, Ph.D., Associate Directorfor Specialized Information Services; Left, George J.Cosmides, Ph.D., Dep. Asso. Dir.

or land. The data are collected on an annual basis by theEPA from certain industrial facilities throughout thecountry.

DART (Developmental And Reproductive Toxicol-ogy) was made available to the public, as a newTOXNET bibliographic file. During the first year of op-eration, about 3,600 records are being added to cover theliterature published since 1989.

A joint two-year effort involving SISand NLM's Na-tional Center for Biotechnology Information is now un-der way for a total redesign of the TOXNET system in aRelational Database Management System (RDBMS)structure that can be operated within the Library.

Thus, through its computerized services, SIS strivesto provide information that will be used by professionalsand the public-at-large in making informed decisions onhow to protect the environment and preserve the publichealth.

SIS Databases under ELHILL

ChemID (Chemical Identification File) is a newonline chemical dictionary that covers primarily chemi-cals of biomedical and regulatory importance. Availableat normal MEDLARS rates without the royalty chargesrequired by CHEMLINE, ChemID allows users to searchby a variety of chemical and biological identifiers; to for-

Specialized Information Smriccs 21

mulate strategies for searching other MEDLARS files;and to locate other files on the ELHILL and TOXNETsystems, or external sources, which contain more infor-mation about the chemical in question. The first versionof ChemID, containing 180,000 records, was made avail-able on the ELHILL system in February 1990.

In July 1990, a new set of datii, collectively known asSUPERLIST, was added to the file. Over 5,600 recordswere augmented with the name and an indication ofsource for chemicals mentioned in one or more of 16 listsof regulatory or biomedical importance. Coverage in-cluded such lists as the Department of TransportationHazardous Materials List, the Ha/ardous Substances Re-portable Quantities (RQ) List, and the MassachusettsSubstance List. These new data allow users to determineif a certain chemical is mentioned on a given list and un-der what name; to search for chemical classes on theselists; and to show coverage overlap between lists. An-other nine lists are being processed into this f i le .SUPERLIST begins an important new link to the varietyof information sources which are of importance in creat-ing a Federal and State regulatory picture of a chemical.

CHEMLINE (Chemical Dictionary Online) allowsusers to identify chemical substances via nomenclatureand other identifiers, and to formulate optimum searchstrategies for other NLM files. Each chemical record haspointers to other files on the ELHILL and TOXNET sys-tems which contain information about that chemical sub-stance. CHEMLINE is updated every two months andregenerated annually. Most of CHEMLINE's data aresupplied by the Chemical Abstracts Service (CAS); usersmust pay CAS royalty fees to use CHEMLINE. Origi-nally made available in January 1974 with about 59,000records, the file now contains over 975,000 records ofchemical substances.

During FY 1990 the scope of coverage of theCHEMLINE file continued to increase. CHEMLINE nowcovers substances in the AIDSDRUGS file on ELHILL, aswell as the TRI, IRIS, DART, and EMICBACK files onTOXNET. For seekers of regulatory information, the datafrom the U.S. EnvironmentalProtection Agency's ToxicSubstances Control Act (TSCA) Inventory was updated,and new pointers were added for EINECS, the EuropeanInventory of Commercial Chemical Substances. Datafrom all sources contributing to CHEMLINE were up-dated and enhanced during the file regeneration of 1990.This included a major improvement in the indexingofthe molecular formula field, which makes comprehen-sive searching with these data easier and somewhat lessexpensive.

TOXLINE (Toxicology Information Online) is anonline bibliographic retrieval service produced by merg-ing "toxicology" subsets from some 17 secondarysources, including Biological Abstracts, GovernmentReports Announcement and Index (report literature),

International Pharmaceutical Abstracts, and MEDLINE.TOXLINE and its backfile, TOXL1NE65, contain datafrom sources which do not require royalty charges basedon usage.

Information from Chemical Abstracts Service (CAS),which requires usage royalties, is used for two otheronline bibliographic files, TOXLITand TOXLIT65. Thefour databases in the TOXLINE family of services nowcontain approximately 3 million records, more than aten-fold increase in the number of records sinceTOXLINE was first made available in September 1972.

The TOXLINE indexing vocabulary mapping projectwhich resulted in the addition of MeSH vocabulary toBiological Abstracts records added to TOXLINE sinceAugust 1985, is continuing. SIS staff developed a pro-gram that maps Biological Abstracts' Concept Codes andBiosystematic Codes to the MeSH vocabulary, and arecurrently working on the mapping of indexing terms forother TOXLINE components.

During FY 1990 the TOXLINE files were regeneratedto add current MeSH indexing vocabulary to the portionderived from MEDLINE, and to update several othercomponents as well. One new subfile was added toTOXLINE, and another is under development and is ex-pected to be added in early 1991. The new FEDRIPsubfile expands the coverage of research reports in toxi-cology by obtaining information from Federal Research-In-Progress (FEDRIP), an NTIS resource covering mostlyFederally supported research projects. This new subfileallows TOXLINE to carry more than the Public HealthService-supported research projects in toxicology thathave already been covered by the CRISP subfile. Underdevelopment is the DART subfile, derived from a newdatabase on Developmental and Reproductive Toxicol-ogy, available on NLM's TOXNET system.

D I R L I N E (Directory of Information ResourcesOnline) is an online directory of organizations with infor-mation resources and subject expertise, that are willingto provide informationand assistance in response to in-quiries. This database assists MEDLARS users by pro-viding an alternative resource for information needs notmet by the usual bibliographic or factual databases.

DIRLINE is made up of 11 subfiles from suchsources as the National Referral Center database fromthe Library of Congress; the DHHS Office of DiseasePrevention and Health Promotion's National HealthInformation Center database; the National Center forEducation in Maternal and Child Health; the NationalInstitutes of Health directory of research resources; asubset of the National AIDS Information Clearinghousedatabase of national AIDS-related organizations; and theSelf-Help Clearinghouses, organizations collaboratingwith the Surgeon General's Initiative in Self-Help andPublic Health. The newest subfile, Health Care Technol-ogy Assessment (HCTA),was added in 1990. Most of the

22 Programs and Services, FY1990

organizations in this subfile conduct such assessmentsand produce reports of the results.

A contract to provide MeSH indexing for all therecords in DIRLINE was completed in 1990. The avail-ability of MeSH terms will facilitate online retrieval fromDIRLINE. Grateful Med 5.0 was programmed to includethe ability to use MeSH in order to search DIRLINE.

Health Hotlines, a booklet listing organizations inDIRLINE with toll-free telephone numbers, was updatedand redistributed in February 1990. This has been a verypopular and sought-after publication; over 60,000 copieshave been distributed to all sectors of the public, includ-ing libraries, health departments, newspapers, maga-zines, and private citizens.

Melvin L. Spann, Ph.D., Chief, Biomedical InformationServices Branch

AIDS

The Health Omnibus Programs Extension Act of1988 mandated the development of several AIDS-relatedinformation services, including a data bank on clinicaltrials and treatments. In response to that mandate, SISand OCCS have built two new MEDLARS databases,AIDSTRIALS and AIDSDRUGS. These databases, whichbecame publicly available at the end of last year, wereenhanced and improved during FY1990.

AIDSTRIALS contains descriptions of experimentalclinical trials of agents being tested for effectivenessagainst AIDS, HIV infection and AIDS-related opportu-nistic infections. This database was enhanced throughthe addition of indexing using Medical Subject Headings(MeSH). Trial categories were defined and added to thedatabase to improve retrieval. The format of the trial lo-cation information was improved to permit better selec-tion of trial sites.

AIDSDRUGS contains information about the agentsbeing tested in clinical trials; it was enhanced with theaddition of bibliographic references to allow users to findadditional relevant information about these experimentalagents. The AIDScomponent in DIRLINE was expandedfrom approximately 350 records to over 1,100 by the ad-dition of Federal and international organizations.

SIS staff participated in the Sixth International Con-ference on AIDS in San Francisco. A poster session waspresented highlighting the importance of information inthe fight against this epidemic. An exhibit displayed allof NLM's AIDS-related activities and gave visitors an op-portunity to search the online databases. Staff also par-ticipated in the Conference's Media Center to provideaccess to NLM's databases for representatives of thepress.

TOXNET and Its FILES

With funding authorized under the SuperfundAmendments and Reauthorization Act of 1986, SIS hasworked for several years on information activities for theAgency for Toxic Substances and Disease Registry(ATSDR). These activities include file building and thecreation of improved methods of access to informationresources for hazardous chemicals and emergency re-sponse. The continued development of the TOXNET sys-tem, the enhancement of the Hazardous Substances DataBank (HSDB), and the development of a microcomputerworkstation for chemical emergency response (see be-low) have been the predominant SIS activities under thiscollaboration.

During FY 1990, three new files were added to theTOXNET system, bringing the total to ten. They were:TRI88 (the Toxic Chemical Release Inventory's 1988 re-porting year data), IRIS (Integrated Risk Information Sys-tem), and DART (Developmental and ReproductiveToxicology). TOXNET's online usage increased substan-tially throughout the year. Usage of theTOXNET-to-ELHILL gateway, a transparent switching mechanismwhereby users can gain access to all other NLM files, hasalso set new usage records in 1990.

One of the major system-wide enhancements toTOXNET was the implementation of CROSSFILE search-ing and printing among certain chemically linked files,such as HSDB, RTECS, CCRIS, and IRIS, as well as theTRI files (TRI87, TRI88). CROSSFILEpermits users tosearch for and/or display data from multiple files simul-taneously; it can greatly improve search efficiency.

As TOXNET grows in size and usage, NLM is con-sidering some fundamental changes in the basic designof the system. A 1989 evaluation study recommendedthat the system be rewritten from MIIS, its current com-puter language, to the MUMPS language. MUMPS is

Specialized Information Services 23

available to operate on many hardware platforms includ-ing—potentially—the NLM mainframe computer. As aresult of this recommendation, a MIIS-to-MUMPS con-version of the total TOXNET system is now under way.When this is completed, the system will continue to beoperated for the next two years by a contractor.

In parallel with this contractor-based effort, the useof Relational Database Management System (RDBMS)technology is being explored for the cluster of files nowon TOXNET.This in-house effort was initiated becauseof expertise in RDBMS technology now available inNLM's National Center for BiotechnologyInformation.An RDBMS-based system could be operated in-house onNLM equipment. The new system is expected to beavailable in about two years.

The Hazardous Substances Data Bank (HSDB), animportant NLM file on the TOXNET system, experi-enced a substantial increase in usage in 1990. This file isco-supported, as a Superfund activity, by ATSDR. En-hancements this year included the addition of emer-gency medical treatment data supplied byMICROMEDEX, Inc. During this period, 325 chemicalrecords were peer-reviewed by the Scientific ReviewPanel (SRP), and over 560 records went through PublicSystem Updates. Hazard summaries are now being pre-pared, by in-house staff, for each peer-reviewed record;while environmental summaries are being prepared by acontractor. Staff-prepared toxicity summaries for peer-reviewed record will be added during the next year.

A special HSDB two-day planning retreat was heldin May 1990 to examine various alternatives for in-creased efficiency in building and reviewing this databank. Members of the SRP participated in this activity.

The Toxic Chemical Release Inventory (TRI) files(TRI87 and TRI88) quickly established themselves as im-portant information resources. TRI is mandated by theEmergency Planning and Community Right to KnowAct (Title III of the Superfund Amendments andReauthorization Act of 1986). These EPA-sponsored da-tabases contain environmental release data—to air, wa-ter, and soil—for 325 EPA-specified chemicals, with thenames and addresses of the industrial facilities reportingfor the years 1987 and 1988. Public interest and online us-age of these files have been high.

The TRI files incorporate several new TOXNET fea-tures designed specifically for them. The "novice"menus, allowing inexperienced users easy access, are be-ing enhanced to permit greater search flexibility. A SORTfeature now permits data to be arranged numerically oralphabetically by virtually any TRI data element.

The Chemical Carcinogenesis Research InformationSystem (CCRIS) is maintained on TOXNETby the Na-tional Cancer Institute.This data bank contains test re-sults from carcinogenicity, mutagenicity, and tumorpromotion studies. Tumor inhibition studies and addi-

tional negative mutagenicity studies were added in FY1990. CCRIS now contains more than 2,000 records.

During FY 1990, the Developmental And Reproduc-tive Toxicology (DART)database was made available onthe TOXNET system. DART contains about 3,600citations from 1989 and later to publications on agentsthat cause birth defects. Records in DART contain biblio-graphic citations, abstracts (when available), MedicalSubject Headings (MeSH), and the names and ChemicalAbstracts Services (CAS) Registry Numbers for allchemicals mentioned in the publications. Over half of therecords are derived from MEDLINE and supplementedwith additional chemical index terms. Additional recordsthat are not found in MEDLINE, such as meeting ab-stracts, articles from journals not indexed for MEDLINE,books, and technical reports, make up the remainder.Plans are under way also to add the records in DART toTOXLINE.

DART is a continuation of the Environmental Tera-tology Information Center Backfile (ETICBACK) data-base on TOXNET that was produced by the Departmentof Energy's Oak Ridge National Laboratory (ORNL).ETICBACK contains over 50,000 citations to literaturepublished from 1950-1989.

The Environmental Mutagen Information Center(EMIC) database is produced by ORNL and is managedby NLM. A backfile for EMIC (EMICBACK) has beenpublicly available through NLM'sTOXNETsystem sinceJune 1989. EMICBACK contains over 70,000 citations toliterature, published since 1950, on agents that have beentested for genotoxic activity.

Records in EMICBACK contains bibliographic cita-tions, EMIC special keywords, and the names and CASRegistry Numbers for all chemicals tested. Beginning inFY 1991, the EMIC database for literature since 1990 willbe built and maintained on the TOXNET system.

These four bibliographic databases on TOXNET arefunded by the Agency for Toxic Substances and DiseaseRegistry (ATSDR), the Environmental Protection Agency(EPA), and the National Institute of EnvironmentalHealth Sciences (NIEHS), and are operated by NLM.

IRIS (Integrated Risk Information System) is anothernew file which had its debut on TOXNETin 1990. IRIS isgenerated by the EPA and contains health risk and EPAregulatory information on over 400 chemicals. Healthrisk assessment data is provided for both carcinogenicand non-carcinogenic effects by oral and inhalationroutes of exposure. IRIS data, when combined with in-formation related to chemical exposure assessment, canhelp State and local regulatory agencies manage chemi-cal risks to the public.

The Registry of Toxic Effects of Chemical Substances(RTECS) is a data bank based upon a National Institutefor Occupational Safety and Health (NIOSH) file of thesame name which NLM has restructured and made

24 Programs and Services, FY1990

available for online searching on TOXNET. SIS continuesto add new data to this file as NIOSH makes them avail-able. This year, references to the National OccupationalExposure Survey and the National Occupational HazardSurvey, conducted by NIOSH, were added. In addition,SIS continues to enrich RTECS records that lack CASRegistry Numbers with these important identifiers.Sofar about 30,000 records have been so enhanced. RTECSnow contains over 100,000 records.

Bruno M. Vasta, Chief, Biomedical Files ImplementationBranch

Microcomputer Workstation

SIS, in conjunction with the ATSDR, has built a por-table, microcomputer-based workstation that providesinformation assistance to emergency response teamsworking on accidents involving hazardous chemicals.The operational prototype, known as ANSWER™ (an ac-ronym for ATSDR/NLM's Workstation for EmergencyResponse), consists of software modules designed to fa-cilitate easy access to information useful to emergencyresponse teams during emergencies.

The core modules of the Workstation are: a CD/ROM-based database containing information on bothhazard management and medical management; a spe-cialized database containing information gleaned fromprevious chemical emergencies; a modified version ofsoftware (Micro-CSIN)® that facilitates searching of di-verse remote online databases; a FAXcapability to trans-mit information to and from an emergency site; access toweather information from the National Weather Service;and a word processing capability for editing, sorting,merging, and transforming retrieved data files.

The Workstation has been made available for testingto 13 sites, including selected State health departmentsand several poison control centers.

User Support Services

User support for all its online files is an ongoing SISfunction. User Guides for the CHEMLINE, TOXLINE,RTECS, HSDB, CCRIS, and DIRLINE files are madeavailable as part of NLM's Online Services ReferenceManual. Guides for newer SIS files that are not yet cov-ered in the NLM manual are provided directly to systemusers on request or in training classes. In addition, a spe-cial reference manual and other training materials wereprepared for SISby the Oak Ridge Associated Universi-ties (ORAU). Updated fact sheets for all databases andother related activities are prepared routinely. SIS staffcontinued to provide training for the SISonline files bothas a part of the MEDLARStraining program and, forother users, at special training sessions and at profes-sional meetings.

Special training in the use of the toxicology files wasprovided in conjunction with the Agency for Toxic Sub-stances and Disease Registry to environmental healthspecialists from ATSDR and selected State agencies. Thisprogram is conducted under SIS direction by ORAU inOak Ridge, Tennessee. In FY 1990, the project was ex-panded, with a program designed to "train trainers'7—State health department representatives—who teach theuse of the NLM toxicology files back in their homeStates. To date, representatives from health agencies in40 States and two U.S. territories have been trained. Indi-viduals from eleven occupational health clinics and theseven organizational members of the American MinorityProfessional Health Schools have also taken this training.

During FY 1990 SIS developed ELHILL LEARN, amicrocomputer-based tutorial for the ELHILL search andretrieval software that supports the majority of the MED-LARS databases. It is intended as a precursor to theCHEMLEARN^, TOXLEARN™, and MEDTUTOR™microcomputer-based tutorials. While this tutorial is de-signed primarily for new ELHILL users, it can be used asa quick reference tool to reinforce or recall previouslylearned search procedures.

The MEDTUTOR and TOXLEARN tutorials wereupdated to reflect 1990 MeSH and other changes to theMEDLINE and TOXLINE databases. CHEMLEARN isbeing updated to include the new ChemID file and to re-flect any changes to the CHEMLINE file. These pro-grams provide an alternative or augmentation to formalclassroom training.

Additionally, the TIP Files Demo Disk was updatedto include all the files supported by the Toxicology Infor-mation Program. A new feature was added to allow theDemo Disk to run automatically without user-interac-tion. This should prove useful at exhibits and in readingrooms and libraries.

Specialized Information Services 25

Other Programs

Alternatives to animal testing. SIS staff have under-taken a number of projects related to alternatives to us-ing live vertebrates in biomedical research and testing.Quarterly annotated bibliographies are prepared by theOak Ridge National Laboratory under the direction ofSIS staff and are distributed to those requesting them.In addition, ILAR NEWS, a publication of the NationalResearch Council, announces the availability of thesequarterlies. Under an agreement with NLM, ILAR (Insti-tute of Laboratory Animal Research) also publishes an-nually concatenated versions of the NLM/ORNLquarterly bibliographies.

Biotechnology. The Directory of Biotechnology Infor-mation Resources (DBIR) was first offered in January1989 as an online file on TOXNET. It lists various re-sources available for use by the biotechnology and mo-lecular biology communities. DBIR is now offered to thepublic as a separate file on TOXNET and as a subset ofDIRLINE on the ELHILL system. The resources de-scribed include relevant databases and other electronicinformation services, organizations, collections and re-positories, publications, and sanctioned nomenclaturecommittees. During 1990, DBIR has grown to over 1,500records.

The Seminar Series in Biotechnology has been con-tinued, with these informative talks being videotapedand distributed to NLM's Regional Medical Librariesand to NLM-sponsored medical informatics training pro-grams.

Information services to other agencies. As described, SISprovided support to ATSDR by building, maintaining,and deploying computer-based information resourcessupportive of ATSDR's legislative mandates. These dataand information resources have proven to be of utility tothose who are concerned with the effects of chemical,biological, and physical agents on human health and theenvironment.

SIS provided leadership for the Subcommittee onInformation Coordination (SIC) of the HHS Committee

to Coordinate Environmental Health and Related Pro-grams (CCEHRP). Among the activities of this Subcom-mittee are the development of a DHHS Directory of RiskAssessment Projects, and an attempt to identify the infor-mation needs in environmental health epidemiology. SISalso represents NLM on CCEHRP's Subcommittees onEnvironmental Health Risk Assessment; HazardousWaste Information Evaluation; Testing and Test MethodValidation; and Research Needs.

SIS staff continued to represent the Library on theCongressionally mandated Interagency Task Force onEnvironmental Cancer and Heart and Lung Diseases andon the National Institute of Environmental Health Sci-ences' (NIEHS) Annual Review of Carcinogens (ARC)Working Group, which completed deliberations on thestructure and content of ARC 6 and 7. The Library alsocontinued to be involved with development of the Na-tional Toxicology Program (NTP) Annual Plan and Re-view of Current DHHS, Department of Energy, and EPAResearch Related to Toxicology.

Sidney Siegel, Ph.D., Chief, Office of HazardousSubstances Information

26

LISTER HILL NATIONAL CENTERFOR BIOMEDICAL COMMUNICATIONS

Daniel R. Masys, M.D.Director

The Lister Hill National Center for Biomedical Com-munications (LHNCBC) was established by a joint reso-lution of Congress in 1968. The Center serves as anintramural research and development division of the Na-tional Library of Medicine. LHNCBC research programsapply state-of-the-art computer and communicationstechnologies to the management of biomedical knowl-edge. Such knowledge can take the form of proceduralrules found in expert systems, information in biblio-graphic and factual databases, as well as signals, images,and sound. LHNCBCprograms create innovative meth-ods for acquiring, storing, retrieving, analyzing, commu-nicating, and presenting information to biomedicalresearchers and health care professionals.

A Board of Scientific Counselors meets to review thequality and contents of the intramural research programswithin the Lister Hill Center. The Board is composed ofscientific and technical experts (see Appendix 4 for a listof members) who are prominent leaders in the fields ofmedicine, computer science, engineering, and health pro-fessions education.

The Center is organized in five component branches:• Computer Science Branch• Information Technology Branch• Communications Engineering Branch• Educational Technology Branch• Audiovisual Program Development BranchThe research and development programs of the

LHNCBC fall into 3 categories:• Computer and information science as applied to

the problems of the Library, of biomedical re-search, and health care delivery;

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

• Use of computer and image technologies forhealth professions education.

Computer Science Branch

Research projects of the Computer ScienceBranch(CSB) concentrate on the application of artificial intelli-gence techniques to problems in the representation,retrieval, and manipulation of biomedical knowledge.CSB projects involve both basic and applied research insuch areas as expert systems, natural language systems,machine learning, and automated indexing for informa-

Left, Daniel R. Masys, M.D., Director, Lister Hill Center;Right, B. Earl Henderson, Deputy Director

tion classification and retrieval. Issues in knowledge rep-resentation, knowledge base structure, knowledge acqui-sition, the validation of automated consultant systems,the human-machine interface, the use of high-resolutiongraphics, interactive videodisc capability, and the linkingof knowledge-based systems to large-scale mainframedatabanks are important components of this research.

Branch staff members are involved in individual andteam research projects in various aspects of NLMprojects such as the Unified Medical Language Systeminitiative and in the medical informatics and informationscience research communities. Recognizing the impor-tance of addressing the future of medical informatics byhelping to train new researchers, Branch Chief LawrenceKingsland directs the 8-week annual NIH-sponsored"Medical Informatics" elective for third-year and fourth-year medical students.

Expert systems. Expert systems are computer pro-grams that combine knowledge of a particular subjectarea with inferencing mechanisms enabling them to usethis knowledge in problem-solving situations. An artifi-cial intelligence research program concentrating in ex-pert systems was established at LHNCBCin 1984. Theobjective of the Expert Systems Program is to facilitatecomputer-assisted access to knowledge. This knowledgemay reside in different forms, in different places, on dif-ferent media, with different structures and naming con-ventions.

Lister Hill National Center for Biomedical Communications 27

During FY 1990, the primary research projects of theExpert Systems Program included the AI/RHEUM con-sultant system in rheumatology, the rheumatology vid-eodisc image library, the CTX "criteria engine" shell andits family of Clipper-based tools, the medical expert sys-tems evaluation project, the AI/COAG hemostasis con-sultant system, and the COACH™ expert searchersystem.

The flagship project of the Expert Systems Programis the continuing development and evaluation of the AI/RHEUM expert consultant system. The AI/RHEUMknowledge base has been updated, extended, and linkedto the new rheumatology image library. Useful critiqueby advisory groups has resulted in improving thesystem's data entry process in preparation for testing inclinical settings in Utah and Missouri in FY 1991.

AI/RHEUM is the best known of a series of knowl-edge-based medical consultant systems using the criteriatable form of knowledge representation pioneered byNLM researchers. The power, simplicity, and flexibilityof this representation are augmented by a new expertsystem shell written at NLM for the development of cri-teria-based reasoning systems. The shell, called "CTX"for its use in criteria table expert systems, will reach beta-test phase in early FY 1991. CTX was deliberately de-signed to write dBASE III- and Clipper-compatible casedata files. It is extensible and maintainable, and poten-tially a very useful building block for integration intocomplex projects which need decision-support compo-nents.

The new shell allows direct coupling of video imagelibraries to expert systems. In the context ofAI/RHEUM,the user has immediate access to more than 6,300 still im-ages and 15 minutes of brief motion sequences on a vid-eodisc created to help users make accurate observations.Voice-over narration for the video motion sequences willbe the final stage in the production of NLM'srheumatology image library. Several software tools writ-ten as adjuncts to the CTX shell provide utilities assistingthe developer in handling multi-thousand-frame imagebanks and in automating the performance evaluation ofCTX-based consultant systems against benchmark sets oftest cases.

The shell, with its explicit multimedia links toknowledge sources in different forms in different places,even on different machines, is one focus of the overallExpert Systems Program goal of providing users with ac-cess to knowledge. Its unique combination of capabili-ties can help developers build consultant systems in anydomain which lends itself to the criteria form of knowl-edge representation.

The AI/COAG hemostasis consultant system,reported in prior years, became in FY 1990 the basis fora collaboration between LHNCBC's Expert Systems

Program and the Medical Informatics Program, and theDepartment of Laboratory Medicine at Yale University.Building on the AI/COAG knowledge base, the Yalegroups have produced a hemostasis advising system forin-house testing and potential distribution.

The COACH expert searcher system, the most recentof the Expert Systems Program projects, is now a run-ning prototype. It works with NLM's Grateful Med pro-gram to help improve retrieval from MEDLINE for userswho have gotten too little, too much, or poorly focusedsearch results. COACH will use the inference enginefrom CTX for reasoning in which it emulates some of theactions of an expert human searcher diagnosing and re-sponding to retrieval problems.

The interactive videodisc exhibit on "Artificial Intel-ligence in Medicine" completed a 3-year national tour inearly FY 1990 after being seen by nearly 3 million visi-tors. This exhibit, one component of a larger exhibitioncalled "The Age of Intelligent Machines," opened at theMuseum of Science in Boston in January 1987. It hasspent 3-month periods there and at such other institu-tions as the Franklin Institute in Philadelphia, the FortWorth Museum of Science and Industry in Texas, theCalifornia Museum of Science and Industry in Los Ange-les, and the Museum of Science and Industry in Chicago.

Dr. Kingsland of the Expert Systems Program servedagain in FY 1990 as coordinator for an 8-week NIH"Medical Informatics" elective for third-year and fourth-year medical students. Thirteen students from medicalschools across the U.S. completed the elective. Thecourse included a seminar series of 37 90-minute lec-tures, independent research projects under the directionof NIH preceptors, and oral and written presentations ofresearch results. Some of these extremely bright, highlymotivated students have made important contributionsto Expert Systems Program projects.

Lawrence C. Kingsland III, Ph.D., Chief, ComputerScience Branch

28 Programs and Services,FY 1990

Natural Language Systems. The Natural LanguageSystems (NLS) research program was established atLHNCBC in 1986. NLS research questions lie at the inter-section of the fields of computer science, information sci-ence, and linguistics. The research involves methods andapproaches used in all these fields, with the goal of de-veloping natural language processing systems that im-prove access to biomedical information in computerizeddatabases.

The primary focus of the NLS program continues tobe the development of SPECIALIST, an experimentalsystem for parsing, analyzing, and accessing biomedicaltext. The system is implemented in Quintus Prolog withsome supporting programs in C. It runs on Sun worksta-tions.

The parsing system, based on principles oflinguisticanalysis, includes a lexicon together with rules of mor-phology, syntax, and semantics. The system is designedto capture the regularities of general English as well asthe specialized nature of biomedical text. The lexicon, acentral part of the system, incorporates general Englishlexical items as well as items specific to the domain ofbiomedicine. Each lexical entry encodes syntactic and se-mantic information.Syntactic information includes infor-mation about the syntacticcategory, or part of speech;inflectional variants; allowable complements; and allow-able transformations.The semantic information includesinformation for logical interpretation.

The building of an adequate lexicon for a naturallanguage processing system is one of the most time-con-suming and labor intensive aspects of such a system. Forthat reason, a separate lexicon development project wasinitiated during FY 1990. This project involves the effortsof several highly qualified individualswho will useLEXTOOL, an interactive menu-based lexicon buildingtool, to add many thousands of entries to the SPECIAL-IST lexicon. Terminology from the UMLS Metathesauruswill also be added to the system. Both activities are ex-pected to result in a significantly augmented lexicon bythe end of the year.

The syntactic and semantic components of the SPE-CIALIST parser are based on the Definite Clause Gram-mar formalism. The grammar includes context-freephrase structure rules and context-sensitiverestrictionsthat constrain the structures actually built. The parsercurrently gives a 2-level output as it analyzes sentences.The first level is a parse tree showing the detailed con-stituent structure of the sentence. The second level is arepresentation which more clearly shows its logicalstructure.

Knowledge of the relevant domain is a necessarycomponent of a natural language processing system.This knowledge must be in such a form that a computer-ized system can interpret it and reason with it. Work car-ried out under the UMLSproject has direct implications

for this aspect of the SPECIALIST system. Recent UMLSefforts have included enhancing the MeSH indexing vo-cabulary by making explicit the implicit relationships be-tween the terms in the hierarchy; the development of aMetathesaurus of biomedical concepts; and the develop-ment of a semantic network for these concepts.

The labeling of relationshipsbetween "parent" and"child" terms in selected portions of the MeSH vocabu-lary was carried out by subject matter experts. The NLSgroup developed a menu-based tool called MESHL1NKto facilitate this work. MESH LINK presents the expertuser with a child and parent MeSH pair and prompts theuser to choose from the available set of about 30relation-ships. The tool steps the user through terms in a MeSHsub-tree, providing access both to the MeSH definitionand to definitions in a medical dictionary.

The Metathesaurus is the central vocabulary tool ofthe UMLS. It contains information about specific bio-medical concepts, including their representation andcontext(s) in a variety of controlled vocabularies. Meta-1,the first version of the Metathesaurus, incorporates all ofthe MeSH terminology and selected vocabulary fromother sources. Each concept in Meta-1 is assigned to atleast one of the semantic types available in the accompa-nying UMLS Semantic Network.

The purpose of the Semantic Network is to provide aconsistent categorization of all concepts represented inthe UMLS Metathesaurusand a set of useful relation-ships between these concepts. All information about spe-cif ic concepts is found in the Metathesaurus. Thenetwork provides information about the set of basic se-mantic types, or categories, which may be assigned tothese concepts. The first release of the SemanticNetworkincludes 131 semantic types. Major groupings have beenestablished for organisms, anatomical structures, biologicfunction, chemicals, events, physical objects, and con-cepts or ideas. In addition, a set of potentially useful non-hierarchical relationships between the types has beenidentified. These include relations such as "causes,""process of," "property of," "uses," and "treats."

A major NLS effort during FY 1991 will be the con-tinued development of the Semantic Network. This willinvolve the testing and evaluation of the network itself aswell as the development of application systems for link-ing this knowledge source to the information stored inMeta-1. Programs to facilitate intelligent traversal of thenetwork will be designed and implemented. The net-work and the large number of concepts to which seman-tic types have been assigned will then be tested asa source of domain knowledge for the SPECIALISTsystem.

Machine Learning Project. A new research project be-gan at LHNCBC in 1989 to investigatethe subfield of ar-tificial intelligenceknown as machine learning. The fieldencompasses a wide v.iriety of mechanisms for creating

Lister Hill National Center for Biomedical Communication* 29

computer programs that improve their performancewith use The objective of this project is to develop andapply methods by which programs can automatically ac-quire knowledge and put it to work

The underlying motivation for this work anses fromthe explosion of available biomedical information andthe less well acknowledged explosion of theanalyticaltools and techniques applied to that information. NLM,having long recognized the need for automated assis-tance in gaining access to this valuable corpus of knowl-edge, has supplied the community with a wide variety ofdatabases. However, dramatic improvements in auto-mated knowledge manipulation, analysis, and inferencewill be necessary if we are to take full advantage both ofthe anticipated exponential growth of biomedical dataand of the increasingly evident interrelationships amongpreviously disparate information sources

Programs like expert systems have already movedfrom the manipulation of information toward the ma-nipulation of knowledge The goal of the Machine Learn-ing Project is to create computer programs that not onlymanipulate knowledge but also can acquire it them-selves Ideally, a researcher or clinician with a questionshould be able to have a machine learning program iden-tify where to find relevant information, retrieve that in-formation (possibly from multiple data sources), andanaly/e and assemble the information into a complete,accurate, and comprehensible response

Machine learning research may also help transcendthe traditional computer interaction of a user issuingcommands and a program responding In a world ofrapidly advancing knowledge, programs will have to domore than retrieve information when asked; they willhave to manage information retrieval and inference overtime Once a user has specified a question of interest, amachine learning program should be able to continu-ously and intelligently track evolving knowledge sourcesfor potentially relevant information It should then auto-matically assemble and analy/e that information andpresent it to the questioner These visions are the drivingforce behind the LHNCBCMachine Learning Project

Currently, machine learning technologies focus pri-marily on inducing concept definitions from externallyspecified datasets The project endeavors to advance sig-nificantly the state of the art in machinelearning, pursu-ing the vision by creating a computationally tractabletheory of how to use diverse sources of knowledge andto deploy diverse (and complex) analytical tools in pur-suit of explicitly stated goals This approach, calledknowledge acquisition planning, is in an early stage ofdevelopment Although achievingthe vision describedabove is clearly a long-term goal that will require funda-mental advances in basic computer science, the processof developing the theory and implementing prototypeshas already produced some useful results

The primary testbed for research in knowledge ac-quisition planning at LHNCBC is a program that selectsand manages the use of computerized analytical toolsand database searchers to achieve specific goals. This ex-perimental program, INVESTIGATOR, operates by se-lecting other programs such as statistical analysispackages and database search engines, which can be ap-plied to achieve its human-provided knowledge acquisi-tion goals Each program INVESTIGATOR deploys musthave an internal representation describing the precondi-tions for its execution, the data formats it requires, its ex-pected outputs, how long it takes to run, and so forth.From this information, INVESTIGATOR'S planningmechanism can select the appropriate tools and data-bases to accomplish a variety of tasks.

INVESTIGATOR has been programmed to use sev-eral computenzed analyticaltools and to plan to acquireknowledge in several different domains. The analyticaltools include inductive category formation, heuristicBayesian classification, marker-passing intersectionsearch, analysis of variance, random sampling, and back-propagation trained artificial neural networks. The data-bases INVESTIGATOR has accessed include MEDLINE,Genlnfo, the Protein Information Resource, BrookhavenNational Laboratory's Protein Databank of crystallo-graphic structure information, and others Results ofINVESTIGATOR-managed knowledge acquisition planshave addressed questions in diverse domains includingearly Eukaryotic evolution, classification of the structuralelements of proteins, and changes in protein conforma-tion after point mutations

Our research in knowledge acquisition planning hasthe potential for high payoff in improving the capabili-ties of machine learning systems in general. Current ma-chine learning technology is fundamentally limited bythe computational complexity of exploring the space ofhypotheses compatible with a set of data. The knowl-edge acquisition planning approach provides importantconstraints on the space of hypotheses which must besearched, using the specific goals of the learning systemto focus computation on the available methods and datamost likely to lead to answers to its questions Thismethod of using the content of desired knowledge toconstrain the search space may result in significantimprovement in the performance of machine learningsystems

The general problem of selecting and coordinatingdiverse and complex sources of knowledge touches onmany open questions in cognitive science The onlyavailable models for designing systems that might ac-complish these tasks are human beings A significantcomponent of the project's research, therefore, is theanalysis of human subjects as they acquire knowledgeMachine learning project staff work with biomedicalresearchers to gather data on how people manage

30 Programs and Services, f-Y 1990

knowledge acquisition tasks Protocols of researchers us-ing computer tools and devising retrieval and analysisstrategies have been gathered and analy/ed to provideinsight into this complex cognitive process.

Results from these experiments have led to the iden-tification of connections between attentional phenomenain cognitive and social psychology and computationalcomplexity considerations m the design of machinelearning systems. Potential implications of this researchfor the understanding of human cognitive phenomenaare also being pursued. The machine learning researchprogram places a strong emphasis on the use of cogni-tive models in the design of artificial intelligence sys-tems.

Building artificial intelligence systems generallyrequires gathering extensive data about how people dothe task to be mechani/ed. This informationcomes in theform of interviews, think-aloud protocols, interactiveproblem-solving sessions, and other verbal interactions.Traditionally, the informationgathered is painstakinglytranscribed and the transcripts are then analyzed by aknowledge engineer. To eliminate the transcription step,the staff of the Machine Learning Project designed theAudio Knowledge Acquisition Tool (AKAT) for digitallyrecording audio onto an optical disk and building anextensive set of indices into the information.

Points or passages of the audio can be marked andannotated, and the annotations can be grouped or orga-nized into a hierarchy. The user can hear the original au-dio segment on speakers or headphones by simplypointing to an annotation with a mouse pointing device.This software tool both obviates the need for transcrip-tion and retains the original audio in easily accessibleform, preserving potentially valuable nonverbal informa-tion such as pauses or "hmmm" sounds. A prototype ofthe AKAT tool running on Macintosh computers is in thealpha-testing stage, with versions in use at NLM and atexternal test sites.

MedlndEx Project. The objective of the MedlndExProject is to develop and test interactive knowledge-based systems for computer-assisted MEDL1NE index-ing using MeSH. By encoding the indexing scheme in aknowledge base (KB)and using it to assist indexers, thesystem is designed to facilitate "expert indexing"—in-dexing consistent with published indexing tools uponwhich indexers currently depend Published indexingtools are unable to provide this type of interactive assis-tance.

The MedlndEx (Medical Indexing Expert) System iswritten in a frame language, a type of object-orientedlanguage where objects, known as frames, are used forrepresenting concepts. In a frame, a concept (the framename) is described as a list of pairs of slots and values. Aslot is a relation; a value is another frame name that com-pletes the relationship, for example "Heart LOCATION

Thorax." Frame descriptions contain both this detailedfactual knowledge and procedural knowledge. Specifi-cally, slots contain both values and executable proce-dures tha t enable the system to assist indexersinteractively Just as slots link frame concepts with val-ues (other frame concepts), facets l ink slots with theseprocedures.

An important relation in the KB is known as "mher-its-from," which links the entire KB into a single classifi-cation Inheritance, whereby lower-level f ramesautomatically assume descriptions of higher-level framesto which they are linked by this inherits-from relation,achieves a number of important KB functions. These in-clude maintaining consistency of the KB, detecting re-dundancy in the KB, and simplifying algorithms foraccessing frames based on these explicit hierarchicalpaths from higher-level frames to lower-level frames.

Human indexers, with system guidance and helpfrom the KB, create for each document indexed a set ofindexing frames patterned after KB frames These index-ing frames are descriptions of instances of KB frames.These instances correspond to objects, events, proce-dures, and other specific descriptions as discussed indocuments being indexed. Each indexing frame is linkedto its corresponding KB frame by the same inherits-fromrelation used for linking frames in the KB classification.Indexing frames inherit slots from these KB frames, andsince KB frames includeexecutableprocedures (indexingrules), the indexingsystem can give help specific to theconcept being indexed

Indexing assistance includes offering slot names asprompts for indexers to consider indexable aspects of adocument, validating indexers' input, prescribing or sug-gesting slot values based on KB rules, and showing hier-archical KB displays for browsing permissible values forthe current slot. The KB contains rules both for creatingand fi l l ing indexing frames and for generating in thebackground conventional MeSH indexing terms at thelevel of expert indexing This output can be used to com-pare the system to conventional indexing, and wouldprovide actual MEDL1NE indexing for current retrievalsystems.

Indexing frame output, which consists of a networkof linked frames, would describe a document more pre-cisely than conventional indexing.Project staff are there-fore investigatingframe databases for retrieval.The useof this knowledge-based system as a front-end for an in-telligent searching assistant by guiding searchers in cre-ating query frames, is also being explored

Recent project developments have included the cre-ation of a KB manager to assist knowledge engineers inensuring a consistent, compact, and syntactically correctKB. This software uses the inheritancefeature of framelanguages and special scripts employing menu and cutand paste interfaces. Additional enhancements are the

Lister Hill National Center for Biomedical Communications 31

graphical display of hierarchies and the creation offrames in batch mode. New developments in the indexerinterface program include the detection of inconsisten-cies in previously stored indexing frames; system sug-gestion of specific terms; the retention of canceled framesfor possible reuse; caching for quick access to large hier-archies; and regular-expression searching and other im-provements in the browsing of hierarchical displays. Aword-level aliasing technique has been developed to per-mit truncation of individual words in a term, which thenwould be recognized by the system as lead-in vocabu-lary for frame terms.

The KBhas been significantly augmented with about1000 new frames. Existing frames have been edited usingthe advanced features of the new KB manager. As anexperiment, the Art and Architecture Thesaurus (AAT),received on diskette, was loaded into the MedlndEx Sys-tem and a demonstration prototype developed for usingthis AAT KBin indexing a journal in this domain. A 250-page technical report on the MedlndEx System (NLM-LHC-90-03), titled "The MedlndEx System: Research onInteractive Knowledge-Based Indexing and KnowledgeManagement/' by Susanne M. Humphrey, leader of theMedlndEx Project, and De-Chih Chien, was completedin July 1990 for distribution by NTIS (Publication No.PB90-234964/AS).

Charles M. Goldstein, Chief, Information TechnologyBranch

Information Technology Branch

The Information Technology Branch (ITB) pursuesapplied R&D in computer and information science witha current emphasis on full-text publication and retrieval.Areas of activity include development of generalizedwindowing interfaces across multiple platforms, object-oriented retrieval systems encompassing both text andgraphic objects, editing workstations for manuscriptpreparation, computer-based publication, and CD-ROMtechnology. Within these programs many areas of

applied computer science must be addressed, includingportability, object-oriented programming, multi-process-ing, client/server distributed processing models, and ad-vanced memory management.

Online Reference Works. The Online Reference Works(ORW) seeks to enhance and improve 1) the extensiveand valuable body of information to be found in pub-lished medical reference works, and 2) the scholarly pro-cess of text creation and maintenance by establishingcomplementary online versions of the published works.An ancillary objective of the program has been to create aprototype "scholar's workstation" that can serve as anintegrated information resource for both the creation andthe retrieval of online reference works. The platform forresearch in this program has been an experimental textretrieval system known as IRx™ (Information RetrievalExperiment). IRx supports Natural Language Query(NLQ) searching of full-text databases providing aranked output of search results to the user. It also allowsthe explicit use of Boolean combinations of terms whererequired or preferred.

Mendelian Inheritance in Man (MIM) by Dr. Victor A.McKusick was the first online reference work imple-mented under IRx in collaboration with Dr.McKusickand the Welch Library, Johns Hopkins University (JHU).OMIM, the online version of MIM under IRx, is pres-ently available from JHU via dial-up access and Telenetto an international community of biotechnology re-searchers. MIM, along with many other biotechnologydatabases, is also available under IRx to NIH researchersfrom the NLM's National Center for Biotechnology In-formation (NCBI). Terminal access to IRx is via standardterminals, IBMPC-compatible computers, and sophisti-cated Sun Workstations.

In 1989, a new collaborative effort with JHU was ini-tiated to explore the requirements of a reference text ofmore generalized structure than MIM. This effort is be-ing based on Principals of Ambulatory Medicine (PAM),Drs. Barker, Burton, and Zieve, editors. The characteris-tics of PAM that recommend it as a research prototypeinclude: multi-author (over 60), multi-editor (3), hierar-chical text (105 chapters), tables, line-drawings, and im-ages. In 1990, the three editors utilized specializedediting workstations to prepare for a third edition ofPAM. The online, full-text retrieval of more generalizedreference works such as PAM dictated the need for acomplete redesign of IRx.This resulted in the design ofan object-oriented version of IRx called IRx.2.

CD-ROM Program. NLM has a growing need to dis-seminate large full-text databases and/or digitized im-ages and/or digitized audio in a number of programareas and across multiple platforms such as MS-DOS,Macintosh, and Sun/Unix. CD-ROM represents a uniquestorage medium for the dissemination of such informa-tion. Its salient features include a nominal computer

32 Programs and Services, FY 1990

storage of 600 Mbytes per side and a duplication cost ofless than $2 per disk in large quantities. The effective uti-lization of CD-ROM, however, is encumbered by an ac-cess time much slower than magnetic hard disks. Thisimpacts the response to the user of search software ac-cessing data on a CD-ROM and, hence, requires specialconsideration in design and implementationof such ap-plications.

In 1990, ITB established a laboratory for CD-ROMdevelopment and began to establish technical expertisein CD-ROM design and pre-mastering. The primarylaboratory tool is a CD-ROM Pre-mastering and Simula-tion Workstation that will allow the formatting of tapesfor mastering and the simulation of CD-ROM applica-tions even prior to mastering. Two UMLS CD-ROMdisks were produced this year, one with a MacintoshHyperCard application and the other with a series ofASCII files relating to UMLS.

AHCPR Program. In the pursuance of its mission, thenew Agency for Health Care Policy and Research(AHCPR) has a requirement for an online, full-text re-trieval system. The NLM has a specific Congressionalmandate to support AHCPR in the development of astate-of-the-art capability for online full-text retrieval.Based on previous full-text retrieval work (e.g., IRx), ITBhas undertaken the task of developing and establishingan operational capability in support of the AHCPR re-quirements. Present plans call for the development of anonline full-text system based on both natural languageand Boolean search queries. The retrieval system shallinitially reside on a computer located within theLHNCBC laboratories. Terminal access will be availablevia standard ASCII terminals, personal computers, andworkstations supporting a number of standard Graphi-cal User Interfaces. Communications access will beavailable via dial-up telephones and existing networks(Internet, Telenet, Tymnet).

The initial text chosen for the development of fulltext retrieval capabilities suitable for AHCPR require-ments is Guide to Clinical Preventive Services, An As-sessment of the Effectiveness of 169 Interventions. Acopy of the photocomposition tapes of the text was ob-tained from the publishers, Williams & Wilkens. Thetext, which was parsed and entered into IRx for testing,will also be used to evaluate other full-text retrievalsystems.

Communications Engineering Branch

The focus of this research area is the capture, storage,processing, online retrieval, transmission, and display ofbiomedical documents and medical imagery. Ongoingactivities include image compression, image enhance-ment, image understanding, pseudo-grayscale rendition,image transmission and networks, omnifont text recogni-

tion, and man-machineinterface design. An example ofcurrent research is an investigation of advanced tech-niques in electronic imaging to address the problem ofpreserving and accessing the biomedical collection. Inaddition, research into imaging techniques that supportmedical educational packages employing digitized ra-diographic, dermatological, and other imagery is also be-ing pursued.

Electronic Document Delivery System. Following thecompletion of a long-term program named ElectronicDocument Storage and Retrieval(EDSR), the Branch un-dertook to develop an electronic imaging system fordocument delivery. The motivation for the EDSR pro-gram was the preservation of the biomedical collection inelectronic bitmapped form on optical disk media.

In summary, research in EDSR yielded several prod-ucts: (a) a detailed hardware design on a system and asubsystem basis; (b) a complete software package in Cand assembly languages to implement the three stagesofdocument conversion, as well as rapid and random im-age retrieval from local and remote optical disks; (c) acost analysis; and (d) a throughput performance analysisapplicable to a scaled-up version of the prototype sys-tem. These findings were presented to the LHNCBCBoard of Scientific Counselors in May 1989, accompaniedby a three-volume final report entitled "Document Pres-ervation by Electronic Imaging" (available through theNational Technical Information Service). This researchhas resulted in over a dozen papers published in theelectronic imaging literature.

Component technologies developed in the EDSRprogram allowed the development of the EDDS proto-type. The objective of the EDDS program is to demon-strate in prototype form a system for direct documentaccess and delivery, i.e., a system that allows a remoteuser equipped with a Document Request Workstation(DRW) to perform a search of MEDLINE via GRATE-FUL MED, directly access an electronic store of docu-ment images, and receive the document images throughfax, mail, or local pickup. The user's DRW consists of af-fordable, off-the-shelf components, such as an IBM-ATcompatible microcomputer and a standard fax machine.It also requires special in-house-developed software. Atpresent, we have demonstrated the third-generationEDDS system and will plan to use it as a testbed toevaluate the role of such a system for local area docu-ment delivery. The results of work in this area appear inthe Proceedingsof the American Society for InformationScience.

System for Automated Interlibrary Loan (SAIL). In lightof the successful outcome of the EDSR program fordocument preservation, and the potential for electronicdocument delivery demonstrated by the EDDS proto-type, a new program was begun involvingboth elec-tronic document preservation and delivery to support

Lister Hill National Center for Biomedical Communications 33

George R. Thoma, Ph.D., Chief, CommunicationsEngineering Branch

the NLM's interlibrary loan (ILL) service. Thismultiphase effort involves: 1) The creation of an elec-tronic document image store on WORM-type opticaldisks; the images are of selected journals in the NLM col-lection that are to be preserved. 2) The development andimplementation of a Document Storage, Retrieval, andTransmission (DSRT) system that is linked to NLM'sDOCLINE system used to request documents. 3) Em-ploying this system to fill a portion of the ILL requestsarriving at NLM. A number of engineering studies weredone in support of SAIL development and the library'sILL activity. Among these are the following:

Interlibrary loans via facsimile. This study focused onthe impact of introducing fax in NLM's ILL service to re-place conventional mail as the method of document de-livery. First, performance data was collected for bothadvanced fax machines and conventional machines, theformer equipped with internal hard disks enabling storeand forward capability. Then, mathematical modelswere developed to relate various decision measures suchas the number of machines required and costs to the frac-tion of the ILL load to be served via fax. The modelsyielded families of curves that served as decision toolsleading to the acquisition of specific machines and theoperational strategy to be followed. The final report(June 1990) is available through the National TechnicalInformation Service.

Image archiving software: Engineering tradeoff study.The tradeoffs were evaluated between recently availablecommercial software and ARCHIV, the in-house-devel-oped software for archiving and retrieving documentimage files to and from WORM media over a LAN. Thiseffort is consistent with NLM's objective to incorporateinto its systems commercial products that follow indus-try standards. The study focused on speed, storage over-head, compatibility issues, system flexibility, datasecurity and software development issues. The studyconcluded that the in-house ARCHIV software would

store and retrieve files from WORM disks at a rate abouttwice as fast as the commercial software, and, because ofthe way it stores file access data, would store about 5 per-cent more image files. However, these advantages areoffset by the greater level of compatibility, flexibility,data security, and ease of use afforded by the commer-cial software. The commercial software is being inte-grated into current system development efforts andmore complete tests of its performance are planned.

LAN-based document image server: Performance evalua-tion. Recognizing the general lack of quantitative perfor-mance information for systems combining WORMdrives and LANs for image file distribution, a study wasperformed in which the laboratory's prototype systemfor document image distribution was used to simulate asystem with several users. The objective of the study wasto predict the performance of a practical multi-user sys-tem. A database of document images, whose compressedfile size distribution is representative of a cross section ofNLM documents, was stored on WORM platters at theImage Server Workstation (ISW). An Image RetrievalWorkstation (IRW), capable of expanding and displayingdocument images, retrieved images from the server overan Ethernet LAN using an NLM-developed protocol. Re-trieval times and reliability were measured at theIRWand at the ISW while auxiliary workstations simulatedlarger scale conditions by providing varying loads to theEthernet and to the ISW.

The image server was found to perform in accor-dance with a standard and mathematically describedmodel of queuing theory. Thus, this model can be usedto extrapolate from the measured data to other cases.Also, if components of the image retrieval system aremodified to improve performance, two basic measure-ments will suffice to predict server performance undermost conditions. The study concluded that the currentsystem would be able to support from five to eight work-stations simultaneously with acceptable response times.It also determined that an image retrieval applicationcould share an Ethernet LAN with other applicationswith little impact on the performance of either. Finally, itconcluded that the speed of file retrieval from opticaldisks is significantly improved when the subsystem in-terface includes a large data buffer. Papers describingthis work appear in the proceedings of IEEE conferences.

Machine-Readable Archives in Biomedicine (MRAB).This program exploits advanced technologies becomingavailable in modular form and builds on previous NLMwork in electronic imaging. The goal is to build a proto-type system for a machine-readable archive.

While the EDSR program addressed the problem ofefficiently converting the paper documents to electronicbitmapped image form for purposes of permanent stor-age, the access to the stored material remains at the im-age level. Although this level of access is certainly faster

34 Programs and Services, FY 1990

and more convenient than that availablewith paper andfilm archives, electronic imaging offers the potential forfar greater access than merely to the image. It allows thecreation of vast machine-readable text/image databasesin very compact space (the equivalent of 350,000 to400,000 document pages on a single disk, or about 50million pages on a 128-disk jukebox), the capacity of rap-idly and randomly navigating through this store, theability to apply library processing (indexing and catalog-ing) to parts of the older literature,and the capability toaccess this store remotely.

In May 1989, the LHNCBC presented to the Board ofScientific Counselors the outline of a program to investi-gate the technologies involved in the creation of a ma-chine-readable archive. There are several considerationssupporting such a program, some of which are presentedbelow:

• This program will demonstrate the potential formaking the biomedical l i teratureavailable incompact and accessible electronic form.

• It would support certain objectives of the nationalpreservation effort in biomedicine spearheadedby the NLM. Medical libraries would not need toreplace their brittle documents with thousands ofreels of microf i lm. Furthermore, their userswould be better served by the access to both bib-liographic pointers and content.

• It would enable far greater access to the older bio-medical literature than available today.

• The availability of the older material in machine-readable form will allow it to be indexed andcataloged to levels that are more sophisticatedand useful than at present.

• It would permit research into historic terms cor-responding to modern medical vocabularies.

Making documents machine-readable,in principle,is a result of applying optical character recognition(OCR) technology, which in some form has been com-mercially available for several years. At the low end ofthe cost range, there are desktop OCR devices that ad-equately handle typewritten, uniformly spaced materialsuch as office correspondence. At the high end, there aredevices that do omnifont recognition for typeset, propor-tionately spaced material such as books and journals.However, none can adequately meet all of the followingconditions: bound documents, fragile paper, materialwith poor print to paper contrast, and compound docu-ments with intermixed text and graphics where it is re-quired to save these di f ferent data types in a formsuitable for display in the original format. For the mate-rial under consideration here, all of these factors hold.

The MRAB program intends to address the problemby: (a) developing a prototype system to demonstrate thefeasibility of creating, maintaining, and accessing amachine-readable archive of documents, (b) using this

prototype as a testbed to answer questions concerningthe process of creating this archive, (c) evaluatingthe roleof such an archive at the NLM,and (d) defining the tech-nical specifications for an operational system. Current ac-tivities in MRAB include evaluationsof commercial OCRdevices and investigation of artificial neural networks astcx)ls for image segmentation.

OCR evaluation studies. Performance evaluationswere conducted with an in-house system built around aCalera OCR engine as well as an off-site Kurzweil 5100system. The material tested included the Index-Catalogand journals representative of those indexed forMEDLINE. The performance criteria included conver-sion error rate and conversion time. Current work is indeveloping a database structure to incorporate selectedportions of the scanned material with minimal operatorintervention, and a prototype database managementsystem.

Imaging projects. Image Segmentation Using ArtificialNeural Networks. A particular implementation of an ar-t i f ic ia l neural network ( A N N )model, the back errorpropagation paradigm, was explored as a tool for auto-matic segmentation of document images. The paradigmis known for its ability to "learn" to classify data. Twoapproaches were tried, both using unprocessed docu-ment image data generated in the lab. In one approach,the image was divided into tiles. The network then deter-mined if the image data w i th in the t i le was text ornontext. In the other approach, histograms of the totalnumbers of black bits in vertical columns across the pageimage and in horizontal rows down the page were gen-erated. These histograms were presented to the net-work, which then determined the location of the edges ofthe text. Error rates for both approaches ranged from 5 to25 percent, encouraging enough to pursue additionalstudy. Future efforts will focus on methods to reprocessimage data to extract features that are more representa-tive of each image data class.

Biomedical Digital Image Processing (BDIP). This isa program to develop and evaluateimproved techniquesto capture, store, and display medical images for com-puter-based educational systems. Biomedical images ofinterest include both multiple gray-levelimages (e.g., ra-diographs) and high-resolution color (e.g., dermatologicslides). Other images of interest include monochromeand color material from NLM's historicalcollection. Theresults of research in this area are reported in the Pro-ceedings of the Society of Photo-Optical InstrumentationEngineers and similar publications.

Digital Color Imagingfor Dermatology. A study wasundertaken to determine the level of image compressionacceptable for images used to teach dermatology. Datafor this study was taken at the 1989 convention of theAmerican Academy of Dermatology. This forum af-forded access to a large number of expert participants.

Lister Hill National Center for Bivmcdical 35

The results of the study <ire reported in the ProceedingsoftheSPIE, vol. 1232.

The research showed unequivocally that dermatolo-gists can identify skin lesion morphology from imagescompressed to about KM with a Hadamard transform-based algorithm as well as they can from the original35mm slide It also showed that , although compressionratios of about 20 1 and 30-1 did not degrade perfor-mance except in one case, subjective opinions indicatethat these compression ratios result in images of slightlydegraded qua l i ty The images were digiti/.ed at1000x1000 pixels over a 35mm slide with 5 bits for eachof the red, green, and blue color components. Selection ofthe images was based on a previous study involving 91second year medical students 1 his study indicated nostatistically significant difference in morphology recogni-tion performance between 35mm slides anduncompressed electronic versions

Image Compression Techniques Evaluation. A studywas undertaken to compare the performance of aHadamard transform-based image compression algo-rithm with a discrete cosine tr.insform-based algorithm.35mm slides of four morphologic types of skin lesionswere digiti/.ed at 1000x1000pixels with 8 bits for each ofthe red, green, and blue color components. Using the dis-crete cosine transform (DCT) algorithm, the resulting im-age files were compressed at compression ratios of about7 1, 28-1, and 70 1 The original scans and the decom-pressed files were written to a 35mm film recorder. To-gether with the original photo slides, the slides resultingfrom digital images were evaluated in a study of mor-phology recognition and image quality assessment. Onthe strength of the rating of image quality by 15 derma-tologists, we conclude that the use of DCT-based com-pression yields acceptable performance for skin lesionimages Image quality evaluation does not correlate sig-nificantly with level of compression. The results of thisstudy will be published in the Proceedings of the SPIE'sMedical Imaging V Conference Future work in the areaof image compression wil l include the evaluation of ahigh-speed nondestructive algorithm applied to radio-graphs.

Image Classification via Artificial NeuralNetworks.To evaluate artificial neural net technology and its appli-cability to image classification problems, several experi-ments have been undertaken In the first, an artificialneural network characten/ed as feed-forward, restrictedcoulomb energy, has been trained to classify feature vec-tors derived from fine needle aspirates taken from hu-man breasts Each vector consists of elements whichrepresent cytology features such as si/.e uniformity orshape uniformity. Using 369 vectors as a training set and101 different vectors as a test set, the system accuratelyclassifies each test case as either malignant or benign.

Performance of the system is compared with another al-gorithm that is based on a nonconvex piecewise linearmodel. The comparison shows that the neural net per-forms as well as the piecewise linear model while exhib-iting features that have no reported counterpart in thepiecewise linear model. These features include the abilityto report uncertainty or indecision, to distinguish be-tween more than two classes (up to 255) and to includeother new or different information without extensive re-training. The details of this experiment are reported inAnalytical ami Quantitative Cytology and Histology, 2 July1990

The same artificial neural network has been trainedto classify feature vectors derived from skin lesion im-ages Each vector consists of 18 elements which representrelative color characteristics.The digiti/ed images arefirst segmented and then processed to obtain appropriatecolor metrics. A set of 217 vectors is partitioned intotraining and test sets from 90 percent training and 10 per-cent testing to 10 percent trainingand 90 percent testing.Performance of the net will be compared with the perfor-mance of an artificial intelligence (AI) expert system. TheAI system has user defined if-then-else rules to catego-n/e vectors while the neural model does not employ thismechanism. This experiment is still in progress.

Digital X-ray Prototype (DXP) Workstation. NLM iscollaborating with the National Center for Health Statis-tics (NCHS) and the National Institute of Arthritis, Mus-culoskeletal and Skin Diseases (NIAMS), which have aprogram for the digiti/ation of x-ray film to support theNational Health and Nutr i t ion Examination Surveys(NHANES). The existing collection consists of about17,000 images; the image set currently being acquiredwill augment this collection by an additional 20,000 im-ages.

The Communications Engineering Branch is partici-pating in this program by integrating and testing a pro-totype low-cost workstation that provides access to thisimage collection. Ini t ial design of the workstation, in-cluding test software, was done in the radiology depart-ment of UCLA's medical school. This organization also isunder contract to NCHS to digiti/e the existing collectionof 17,000 films NLM involvement includes assemblyand test of the hardware components and developing anextensive software system. The purpose of the softwareis to link the image collection with the NHANES database and then build a user interface to form an effectiveresearch tool Thus far, the hardware components havebeen integrated and tested The first batch of digiti/edimages will be compared with the original films by a ra-diologist.

Preliminary observations suggest that the test soft-ware supplied by UCLA may not be adequate for effec-tive qual i ty verification This software crops,

36 Programs and Services, FY1990

subsamples, and quantifies images in order to fit theminto the available display memory. Improvements tothese programs have been suggested to UCLA and arealso being studied here. A histogram analysis of asample from the first batch of digitized images also sug-gests that the electronic system's full dynamic range isnot being utilized. This assessment has been submittedto the digitizing laboratory at UCLA to determinewhether improvements are feasible.

The software component of this project is both themost challenging and the most potentially useful. Thekey to success will be to identify and satisfy user needs.The software will make the image database accessible. Itwill allow the retrieval of classes of images based uponuser-supplied search terms. The NHANES database con-tains all of the information on each participant; the x-rayimages are just one element of a unit record. The idealsystem will have the entire NHANES database search-able online so that all possible search criteria are avail-able. Local retrieval of images and other health statisticscould be achieved through remote searching of the data-base. If the NHANES database is not available online,then an alternative search mechanism will be devisedbased on a subset of the database.

The test phase of this project will be initiated by pub-lishing the features of the facility and inviting researchersto make use of it. The user interface will include softwarethat collects user evaluations. These evaluations will beused to design improvements in both hardware andsoftware.

Michael J. Ackerman, Ph.D., Chief, EducationalTechnology Branch

Educational Technology Branch

Computer-based Curriculum Delivery Systems (CCDS).The goal of CCDS is to produce and test experimentalhealth professions curricula that are delivered throughthe use of interactive technology.

The first CCDS prototype curriculum for Basic Medi-cal Pathology was offered to U.S. medical schools in June1983, when two programs on a two-sided videodisc werecompleted. Since that time the field-testing network hasgrown from 12 to 102 schools that have tested not onlythe pathology curriculum but also prototype curricula inmental health (Teenage Depression and Suicide Risk As-sessment) and in orthopedics. In the beginning therewere 12 student work stations. By the end of FY 1990there were at least 400. There are now 82 health profes-sions schools in the U.S., Canada, Europe, SoutheastAsia, and Puerto Rico involved in the pathology project.

The Basic Medical Pathology is the largest and mostextensive of the CCDS projects. In FY 1990 three newvideodiscs were mastered ("Cellular Accumulations,""Cellular Alterations and Adaptations," and "Cell Injuryand Cell Death"). The last two are new editions of thefirst two programs issued in 1983. The second editionbrings these two programs up to standards used since1985, e.g., single-frame slide banks in addition to the"mini-lectures," professional narration, and dBASE data-bases for each videodisc. These three programs completethe production phase of the project.

During FY 1990 CCDS also produced a new enginefor the delivery of the pathology programs which is pro-grammed in CLIPPER with data (content and studentperformance information) stored in relational database(dBASE) files. This new engine was made necessary bythe size and increased complexity of the content and per-formance tracking routines.

By the end of the year CCDS had furnished to thetest sites over 900videodiscs and diskettes containing re-vised code for the pathology delivery engine and associ-ated files. The impact of the pathology project can, inpart, be judged on the basis of the rapid adoption of itsproducts and the following data:

• Over 4,000 student evaluations of the programshave been received. On a scale of 1 to 5, studentsrated the programs 4+ as a learning experience.

• Comparison of pre- and post-test scores of thosestudents not passing the pre-test show that stu-dents master the material in about one-third theamount of time devoted to it by traditional cur-riculum delivery systems.

• At least three schools have canceled all lectureson topics covered by CCDS lessons and othershave reduced lecture time and made the CCDSlessons a required part of the course.

CCDS staff, in collaboration with a guest investiga-tor in the laboratory, completed two new orthopedic pro-totype programs for use at the 1990 annual meeting ofthe American Academy of Orthopaedic Surgeons(AAOS). The new programs were a "repurposing" of the1984 Level I videodisc on anatomy of the knee. Thesenew programs, and others to be developed in the same

Lister Hill National Center for Biomedical Communications 37

series, are under consideration for use in a large orthope-dic residency program. The new programs correlatemagnetic resonance and anatomic images of normal andabnormal human knees. CCDS has again been asked toparticipate in the AAOS annual meeting.

The Adolescent Depression and Suicide Risk Assess-ment videodisc program continues to be used in severalschools, both as required curriculumand as an enrich-ment tool. The U.S. Navy has decided to adapt the pro-gram to its CAMUS system. The program is nowdistributed by the National Audiovisual Center (NAC).The original pressing of the videodisc was sold out andNAC re-mastered the videodisc in 1989.

Dermatology visual database project. A research reviewby the LHNCBC Board of Scientific Counselors (BOSC)recently noted four significant contributions of thisproject. First, it establishes technical requirements for anelectronic imaging system necessary to display images oftissue at quality equivalent to that of photography. Sec-ond, it collects a large-scale image library valuable formedical education. Third, it represents a model collabo-ration within the Lister Hill Center and with academicinvestigators and users outside the government. Fourth,it develops a model for the continuing evaluation of edu-cational technology.

In response to recommendations of the BOSC, inves-tigations of image quality emphasized dynamic range re-quirements. Experimental design was expanded toassess aesthetic judgments of image quality as well as ob-jective performance in morphology recognition. Findingsto date suggest that film scan resolution of 2000 dpi vs1000 dpi does not offer a substantial improvement in im-age quality measured by either objective performance orsubjective assessment. The use of 24-bit vs. 15-bit colordoes enhance aesthetic judgments of image quality, al-though no difference in morphology recognition perfor-mance was noted. Images scanned in 24-bit color depthcan be optimized to an 8-bit color palette with minimalaesthetic compromise and possibly minimal impact onobjective performance. We have tested algorithms for filecompression (Hadamard and discrete cosine transform)and found that files can be compressed to approximately10:1 without any notable difference in either aesthetic rat-ing or morphology recognition performance, and thatthe latter is not affected until file compression exceeds30:1.

In collaboration with the Sulzberger Institute forDermatologic Education, Dr. Robert Schosser, an aca-demic dermatologist and biological photographer fromthe University of Arkansas, has provided a collection ofphotographic slides to test image transfer to both film(microform and intemegative) and electronic (high defi-nition analog and digital) archival media. The results ofthese studies in progress will be used to develop photo-graphic standards for collection of a large-scale image

database with the support of the American Academy ofDermatology.

Collaboration with the Sulzberger Institute has alsoresulted in mutual efforts in evaluating educational tech-nologies. Formative evaluation of the interactive videotutorial on melanoma at the Medical College of Virginiaresulted in positive student response to the tutorial con-tent and the interactive learning method, but revealedtechnical deficiencies in the IBM Infowindows hardwareand software. The Sulzberger Institute is supporting revi-sion of the tutorial to support online collection of studentperformance data. Several NLM staff members met withSulzberger Institute subcommittees on electronic textand image archiving to provide requested technical con-sultation.

Library growth project. The Library Growth Project'smajor accomplishment of the year was the completionand publication of a sequel to the 1987 Research LibraryTrends . . . report. The new report, RLT-II, analyzestrends in 35 academic research libraries (seven Canadianand 28 U.S.), libraries that are generally smaller and"younger" than the 58 studied earlier. All are membersof the Association of Research Libraries and their trendsshow two groups that behave similarly:the 35 libraries'expenditures have been increasing at an annual rate neareight percent; for both groups, the 1970's were a timeofdeclining collection growth rates and few staff increases;both also experienced a brief period of recovery duringthe early 1980's; and both show that, over a long run, theaverage collection has managed to double in less than 20years, in spite of repeated recent declines in growth rate.

The proportion of expenditures devoted to salariesand wages has also declined, although gradually, and itnow approaches 50 percent, while the proportion de-voted to materials acquisition (and binding) has in-creased from a customary level near 33 percent to a levelthat may soon exceed 40percent, an increase that prob-ably results from the libraries' efforts to counteract in-creasing materials prices and control the continuingdecline of growth rates. However, in light of the fact thatexpenditure increases have regularly outpaced or at leastmatched increases in the Consumer Price Index (see be-low), that half of total expenditures is for salaries andwages, and that only about 1 /5 of the total is for serials,it is very doubtful that serials price increases, "inflation,"or "austerity" are sufficient to account for the slackeninggrowth that libraries have experienced during most ofthe last 18 or 20 years.

Some estimates developed from results in bothTrends studies are these: since 1951, collections have in-creased by a factor of 4.2, staff size by a factor of 3.1 or3.2, entering professional salaries by a factor of 7.9, totalexpenditures by a factor of 32 (salary and wage expendi-tures by a factor of 30), and the Consumer Price Index bya factor of 5.0. Also, the 108 academic libraries that are

38 Programs and Services, FY1990

ARL's core membership represent current total expendi-tures of $1.3 billion, of which about $475 million is spentto acquire materials; this total will exceed $2.6 billion be-fore the year 2000; and the average entering professionalsalary in that year is likely to be $36-38,000 (it is now$22,000; in 1951 it was $2790).

The Learning Center For Interactive Technology (TLC).The TLC is a "hands-on" laboratory for medical educa-tors, researchers, and scientists. Visitors can explore thecomparative applications and various uses of interactiveeducational technology in the health sciences.

The Learning Center consists of two components: 1)a central facility where various microcomputer and inter-active video information and educational technologiesare demonstrated, reviewed, and evaluated; and 2) aTraining Facility with 6 microcomputer workstations forteaching about interactive technology.

A total of 72 interactive health science programs aredisplayed at 22 demonstration carrels. An additional 32programs are obtainable on request. Large group dem-onstrations are presented from a carrel configured forvideo/data projection and are also conducted in thetraining facility. Programs include applications repre-senting patient management problems, tutorials, evalua-tion, visual data bases, and information retrieval.

In FY 1990 The Learning Center staff provided over350 demonstrations and hands-on experience for 925visitors. This brings the number of visitors to 3,463 sincethe TLC opened in March 1985. Center staff also con-ducted demonstrations and exhibits in conjunction withseven national association meetings. An additional fourworkshops and seminars were conducted at health pro-fessional institutions. The first in-house 3-day tutorial onVideodisc Repurposing was also held. TLChosted threeseries of invitational seminars for nurses from severalFederal health agencies. Two series were on interactivetechnologies, including hardware and software, for edu-cational and performance assessment purposes. Thethird addressed technologies involved in authoring sys-tems, expert systems and artificial intelligence, andemerging interactive technologies.

In FY 1990 the TLC Training Facility conducted 46classes, providing training for 322 NLM staff. In addi-tion, 13 software demonstrations were presented to 256attendees.

The TLC Monograph series was expanded to fourtitles with the publication of Computer-Eased Education inNursing by Susan M. Sparks, Ph.D. and Interactive Tech-nology by Eldon J. Ullmer, Ph.D. An innovative video-tape "sampler" of available interactive technology wasproduced. It is soon to become available on videodisc.

In February 1989, E.T.Net (EducationalTechnologyNetwork) came online through a local Bethesda tele-phone number and in May 1989 became availablethrough Telenet. Access via the Internet is scheduled

for the fall of 1990. E.T.Net is an online computerconferencing system specially designed to facilitateonline discussions. Its purpose is to link electronicallydevelopers and users of interactive technology in healthcare education. One of the problems facing health scienceeducators is a lack of information on interactivecourseware: What is available and where it can be ob-tained? Which of it is useful? What needs to be devel-oped? E.T.Net is designed to alleviate this problem byenhancing communications among developers and usersof health science interactive courseware. Users of E.T.Netare able to share: software, hardware, and videodisc re-views; information on courseware and videodiscs thatare available, under development, or need to be devel-oped; and new applications of interactive hardware tohealth science education.

E.T.Net is open to professionals engaged in eitherthe development or use of interactive technology inhealth science education. E.T.Net is available at no cost,24 hours a day, 7 days a week, 365 days a year. Since itsdebut in February 1989, 815 health professionals haveregistered as E.T.Net users, including colleagues inCanada, Europe, South Africa, and Australia. A pocketE.T.Net Quick Reference Guide may be requested fromthe Learning Center for Interactive Technology. E.T.Nethas been demonstrated at several professional associa-tion meetings.

James S. Main, Chief, Audiovisual ProgramDevelopment Branch

Audiovisual Program DevelopmentBranch(APDB)

The APDB applies current and emerging video com-munications technologies and audiovisual techniques toLister Hill Center research, development, and demon-stration projects and to the information needs of thehealth sciences community. The APDB operates a video-disc premastering facility employing state-of-the-artvideo, graphics and audio systems to produce high

Lister Hill National Center for Hiomedical Communications 39

quali ty and creative materials for the LHNCBC's re-search and demonstration projects and for the NLM'seducational and information programs.

Technical issues such as image quality, resolution,color fidelity, image repeatability, generation loss, film tovideo transfer, transportability of images to differenttechnology platforms, and image file management pro-vide the framework against which new projects are ac-cepted or initiated. For that reason, the premasteringfacilities must be upgraded continuously and new gen-eration equipment integrated with proven systems.

As digital video continues to have impact on thegeneration, storage, and delivery of image materials, thepremastering facility was upgraded with the addition ofa D-2 format, composite digital recorder and a digitalspecial effects system. These systems will allow a newlevel of quality in recording and playback of materials,and a more dynamic presentation of images for medicaleducational materials. Improved graphics generationand offline editing capability should provide more effi-cient and better quality productions for all of the Branchprojects.

APDB completed the photography and the film-to-video transfer for the History of Medicine Prints andPhotographs Collection videodisc project. DuringFY1990, the entire collection of more than 55,000 imageswas transferred to the premaster videotape. SeveralDRAW (Direct Read After Write) videodiscs were thenmade and are being used to verify the accuracy of cata-loging and the completeness of the image capture, beforefinal laser videodiscs of the entire collection are mas-tered.

A D-2 (d ig i t a l ) edit master videotape of theRheumatology Image Library visuals was created, andan optical videodisc was produced, as a comparative testof premastering methods using traditional analog versusdigital recording technologies. The consensus of techni-cal and content personnel provided additional evidencefor the movement toward digital video techniques forimproved image quality.

In collaboration with the University of Arkansas forMedical Sciences, several hundred dermatology slides,made under differing lighting conditions and using vari-ous film stocks, were transferred to a newly introduced35mm color negative filmstock. These images were thentransferred to video using transfer techniques developedin collaboration with private industry in a joint researchproject. This procedure was designed both to evaluatethe technical aspects of image transfer and the human in-terface of medical experts wi th the transfer system,which wil l be used in various stages of videodiscpremaster productions.

Late in the fiscal year, APDB began designing a col-laborative project with the National Cancer Institute inwhich a large number of video, audio, text, and com-

puter graphic materials will be employed in the produc-tion of an interactive education program on CervicalCancer Screening. The goal will be to create program ma-terials that will be transportable to a wide variety of tech-nology platforms and to analog and digital media, toaddress the educational needs of several health sciencesprofessional audiences and the lay public.

APDB also continued to support the Library's Con-gressionally mandated outreach, educational, and infor-mationactivities:

• Four additional presentations by biotechnologyexperts were videotaped, edited, and made avail-able to the Library's distribution system in theBiotechnology Seminar Series. These includedtwo presentations given at the national meetingof the American Medical Informatics Association.

• Three more interviews with scientists at N1Hwere videotaped and edited in conjunction withthe Association of Neurological Surgeons.

• Two short versions of "Pathways...," a 17-minuteprogram on the impact of NLM programs on thehealth of the public were produced. Russian,Japanese, Chinese, Spanish and open-captionedEnglish versions of the 9-minute videotape weresubsequently produced.

• In conjunction with the Center's EducationalTechnology Branch, APDB continued to produceand edit a series of short videotapes on the manyinteractive videodisc programs housed in TheLearning Center. To be titled "Interactive Tech-nology Sampler," these premaster videotapes willbe used to create Level II and Level III opticalvideodiscs.

• The Branch was responsible for coordinating,producing, and editing the premaster videotapefor "Computers in Medical Research," anInfowindows interactive videodisc program, aspart of an NIH Clinical Center exhibit.

• In cooperation with Dr. Robert Hilfer of TempleUniversity, a number of fi lms and videotapeswere edited and converted to videodisc format,for use in an NLM lobby exhibit, "The Emergenceof Exper imenta l Embryology in the UnitedStates."

• Six presentations for a "Medicinal Muses" Sym-posium, held in the Lister Hill Center Audito-rium were videotaped, edited, and entered intothe NLM distributionsystem.

• Five videotapes were edited, with titles and vi-sual effects added, for NLM use in a nationalCODATA meeting.

• Several NLM program videotapes were editedfor use by Library representatives at this year'snational MLA meeting.

40 Programs and Services, FY1990

• The latest Joseph Leiter Lecture, given by Dr.Michael Debakey in the Center's Auditorium,was videotaped, edited, and entered into theLibrary's distribution system.

• Two NLM-sponsored lectures on embryology,presented in conjunction with the earlier men-tioned exhibit, were videotaped, edited, and en-tered into to the Library's History of MedicineDivision collection.

• Ten satellite teleconferences on a range of bio-medical subjects were downlinked and fed to at-tendees in the LHC Auditorium or to otherlocations on the NIH campus as part of theBranch's teleconferencingconsultation and coor-dination role.

APDB's Graphic and Still Photography Laboratoriescontinue to provide presentation, publication, and ex-hibit materials for the Library. The graphic artists are effi-ciently generating presentation slides and publicationmaterials through the creative use of computer worksta-tions and graphics software. The Still Photography Labo-ratory has made comparable improvements in the use offilm processors, lighting, and camera equipment. TheBranch also provides total video, audio, and projectionsupport for scientific and educational meetings in theLister Hill Center Auditoriumand the NLM Board ofRegents Room.

NATIONAL CENTER FORBIOTECHNOLOGY INFORMATIONDavid Lipman, M.D.Director

The National Center for Biotechnology Information(NCBI) was established by Public Law 100-607 in No-vember 1988 as a division of the National Library ofMedicine. The establishment of the NCBI reflects the im-portance of developing new information technologies toaid in the understanding of the molecular processes thatcontrol health and disease. The Center has been giventhe responsibility to:

• Create automated systems for storing and analyz-ing knowledge about molecular biology, bio-chemistry, and genetics;

• Perform research into advanced methods of com-puter-based information processing for analyzingthe structure and function of biologically impor-tant molecules and compounds;

• Facilitate the use of databases and software bybiotechnology researchers and medical care per-sonnel; and

• Coordinate efforts to gather biotechnology infor-mation worldwide.

There are presently 25 senior scientists, postdoctoralfellows, and support staff working at the NCBI. Thesescientists have backgrounds in medicine, molecular biol-ogy, biochemistry, genetics, biophysics, structural biol-ogy, computer science, and mathematics.

The establishment of the NCBI serves to strengthen anumber of ongoing NLM projects, and provides re-sources for new programs. Current NCBI projects are di-vided into three areas: (1)building new databases andenhancing existing ones which involve genomic informa-tion; this includes NLM-developed databases and extra-mural support for other research information resources;(2) improved information retrieval and analysis tech-niques for genomic databases; and (3) communication,which includes sponsorship of meetings, workshops,and tutorials on what might broadly be termed computa-tional biology. Within each of these three program areasthere are a number of ongoing projects.

Database Building and Enhancement

NCBI, in collaboration with Library Operations, iscreating a new biosequence database, the Genlnfo Back-bone. The Genlnfo Backbone includes the MEDLINErecords that correspond to the sequence data extractedfrom the literature, integrates DNA and amino acid se-quence information, and maximizes the use of standard

David J. Lipman, M.D., Director, National Center forBiotechnology Information

nomenclature and gene names from official sources. It isthe first major database to be made available in ASN.l(Abstract Syntax Notation), an International StandardsOrganization data description language. These designfeatures increase the power of the analyses molecular bi-ologists perform on sequence databases, and improvethe usefulness of Genlnfo as a foundation to which therapidly increasing number of specialized biology data-bases can be linked.

NCBI has designed and implemented a relationaldatabase and sophisticated data entry system for build-ing the database from the scientific literature. Specializedsequence indexers—members of the Library Operationsstaff with advanced training in biological disciplines—are responsible for identifying and annotating sequencedata from the indexed literature. The work sequence:

• NLM indexers identify articles containing se-quence data as part of normal MEDLINE pro-cessing;

• Corresponding MEDLINE records are loadedinto NCBI's relational database;

• Journal issues are scanned by sequence indexers;• Indexers select appropriate sequences for inclu-

sion into database and add annotation into rela-tional database;

• Copies of selected articles are sent out for contractkey-boarding of sequence data;

• For sequences with complex sequence features,indexers add annotation in a second pass to thekeyboarded sequence data.

42 Programs and Services, FY1990

In a parallel effort, NCBI has created explicit defini-tions for biosequence objects using ASN.l. ASN.l will beused to provide a hardware- and software-independentversion of the information contained in the GenlnfoBackbone's relational database. NCBI has also built toolsfor producing ASN.l versions of the GenBank DNAsequence database and the Protein IdentificationResource (PIR) amino acid sequence database. Other da-tabase producers, such as Dr. Amos Bairoch, Universityof Geneva, the creator of the Swiss-Prot amino acidsequence database, are beginning to provide ASN.l ver-sions of their databases. NCBI will soon distribute ASN.lversions of Genlnfo, as well as other sequence databases,on CD-ROMs along with information retrieval andsequence searching tools for PC's and Macintosh com-puters.

The NLM, in conjunction with other NIH institutesand the National Science Foundation, also providesfunding for databanks that are major resources for bio-logical research, including GenBank, the PIR, and theProtein DataBank at Brookhaven National Laboratory.The NLM, through an interagency agreement, is work-ing with NSF on a database initiative to help support thedesign and the development of biological databases andto foster interdisciplinary projects in biology and com-puter science. /

James M. Ostell, Ph.D., Chief, Information EngineeringBranch

Software toolkit. A major mandate of the NCBI is todevelop new tools and systems for information retrievaland analysis. The mere accumulation of new data can befutile unless scientists are able to retrieve and analyze itusing convenient and powerful software tools. NCBIsoftware development efforts have been directed to de-veloping computer programs that are modular, easilyadaptable to other systems, useful in the near term onpresent machines but also flexible enough to accommo-date future advances in software engineering and hard-ware design. The creation of a software environment that

divides large, complex systems into small independentpieces, which still act in concert, is at the cutting edge ofsoftware development. We are exchanging ideas and at-tempting to coordinate our efforts with other agenciesand industry-sponsored groups such as Lawrence Berke-ley Laboratories and the Object Management Group ofthe Open Systems Foundation, who are also addressingthese issues in their areas.

The first tool to come out of this project is the Soft-ware Toolbox User Interface, which will allow scientiststo implement quickly newly developed algorithms asuser-friendly programs. The interface is graphical andhigh-level. For example, applications that require theuser to pick from a set of choices can offer either a radiobutton group, menu choice set, or scrolling list box. Theinterface, which currently exists on the Macintosh, willbe portable among the computers most often found inbiological laboratories and computer science depart-ments, allowing the same application program to runvirtually unchanged on the Macintosh, IBM PC underMicrosoft Windows, and Unix workstations under OSF/Motif. The object-oriented internal design of the interfaceallows any number of objects to be created at run-time,and the interface automatically positions these objects onthe screen. Major changes to the user interface of an ap-plication during program development can thus bemade quickly and easily.

NCBI is also using this highly modular approach inbuilding the infrastructure for its online retrieval system.For sequence searching and comparison, a new, veryrapid search tool named BLAST has been implementedas a network-based retrieval system. A number of re-search groups around the country have been providedwith preliminary versions of this software which enablesthem to transmit a query sequence from their local com-puter over the Internet network to a BLAST server run-ning on a computer at the NCBI. In a few seconds, theBLAST server executes the user's query and returns theresults to the client program for viewing by the user. TheBLAST network service will not only provide sequenceanalysis but will be an important entry point for retrievalof related information for both the Sequence Backboneand MEDLINE databases

Basic Research

NCBI has a strong multidisciplinary group of in-house scientists carrying out research on fundamentalbiomedical problems at the molecular level using math-ematical and computational methods, and the theoryand technology of the methods themselves. These twostrands are mutually reinforcing: the drive to make andsubstantiate new discoveries in biomedical science givesa rich stimulus, urgency and direction to the develop-ment of new methods.

National Center for Biotechnology Information 43

In the last year, NCBI scientists have developed newmathematical methods for assessing the statistical signifi-cance of molecular sequence features (in collaborationwith Stanford University) and have incorporated theseinto a new fast algorithm for sequence similarity searchesof protein and nucleic acid databases (in collaborationwith Pennsylvania State University and the UniversityofArizona). New methods for searching for 3-way align-ments have been added. The speed of these methods iscrucial for strategies of database exploration and for thediscovery of new structural similarities and functionalassociations of biological macromolecules.

These discoveries, including the identification of theneurofibromatosis-1 gene product as a GTPase activatingprotein, are already being made frequently by NCBI sci-entists, in some cases in collaboration with scientists inother institutions. Rapid and sophisticated retrieval tech-niques for acquiring the information from the biomedicalliterature, using NLM and other databases, is also impor-tant for these discoveries.

Other basic research carried out at NCBI in the lastyear includes a new statistical analysis of errors in DNAsequences, global analysis and characterization of thelarge set of proteins represented in sequence databasesfor features such as repeats, improvements to the vectormethod for text retrieval, and mathematical modeling ofthe binding of CD4 to the gp!20 molecule of HIV.

Communication

As part of its mandate to support the developmentof new information technologies of relevance to biologyand genetics, the NCBI has been a leader in sponsoringforums for the exchange of information among leadingscientists from the fields of computer science and biol-ogy. The NCBI has sponsored the NLM BiotechnologyLecture Series, an international symposium and work-shop "Macromolecules, Genes, and Computers/' a seriesof workshops on databases for E. coli as a model organ-ism, and a workshop on viral nomenclature. Under theauspices of the National Academy of Sciences, a Work-shop on Computer Science in Molecular Biology Re-search was held in May to foster greater understandingand interest among computer scientists in the problemsand opportunities in computational molecular biology. Ameeting in July, focused on the design and implementa-tion of the NCBFs Genlnfo Sequence database for soft-ware developers, was attended by 120 representatives ofgovernment, commercial, and academic softwaregroups. NCBI is organizing a course for NIH intramuralscientists, to be offered in the fall of 1990, on the theoryand practice of sequence analysis.

In addition to meetings, information disseminationis being provided by the Genlnfo Data Repository, a net-work-based service for distributing software and data-

bases produced by the NCBI as well as by outsidegroups. The NCBI also participates in an advisory rolewith other government agencies such as the Patent andTrademark Office and the Department of Agriculture onprograms involving biotechnology information. Withinthe NIH, the NCBI coordinates with the National Insti-tute for General Medical Sciences and the National Cen-ter for Human Genome Research on databases andinformatics programs that impact information exchangeon a national level.

Dennis A. Benson, Ph.D., Chief, Information ResourcesBranch

Extramural Programs

The NLM's extramural division has a program ofgrants for computer analysis of molecular biology data.Its scope is broad and includes research into methodsand algorithms for improving the efficiency of informa-tion retrieval and improving the efficiency ofanalyticaloperations which are computationally intensive. Re-search applications to develop expert systems for anno-tating and linking databases are encouraged, as areproposals for work on algorithms for structure and func-tion prediction. Software development for newer ma-chine architectures is within the scope of the program aswell, including molecular analysis by neural net tech-niques and multiprocessor programming. Postdoctoraltraining in the cross-disciplinary areas of biology, medi-cine, and computer science is also supported through theNLM's informatics fellowship program.

Biotechnology Information in the Future• In the area of information resources, the NCBI

will use contract and cooperative agreements tosupport key molecular biology databanks lo-cated around the country. The contents ofthese databanks will be available through theNLM via networks, and will also be available onvarious physical media to researchers and value-added resellers.

44 Programs and Services, FY 1990

The NCBI is developing standards for inter-change of sequence, genetic, and physical mapdata as well as computerized tools for distributeddata entry and annotation by investigators.The NCBI will sponsor research in universitiesand industry to develop new methods of infor-mation representation and retrieval from factualdatabases of biological information.A parallel ef-fort will be conducted in the intramural laborato-ries of the NCBI.The design of such databanks and their resultingutility will, of necessity, need to follow scientifictrends in research. The stimulus to maintainstate-of-the-art systems will come from an intra-mural and extramural program supporting scien-tific discovery.

Intramural research activities will be comple-mented by a visiting scientist program and anactive extramural grant program. Fertile areas forsuch research in the next decade will include mo-lecular sequence-to-structure prediction anddetermination of biologic similarityby expert sys-tem techniques. In addition, the NCBI is sponsor-ing informatics workshops and short courses, toinstruct molecular biologists and medicalresearchers in the use of advanced computerizedmethods of data analysis.

EXTRAMURAL PROGRAMS

Milton Corn, M.D.Acting Associate Director

45

The Extramural Programs Division provides supportto the health science community in the biomedical areasfor which the National Library of Medicine takes particu-lar responsibility. NLM support for extramural programsstems from two sources, the Medical Library AssistanceAct of 1965 and its extensions, and from Section 301 ofthe Public Health Service Act as amended.

The dual basis of the funding sources as well as thehistoric mission of the Library explain the eclectic varietyof the funded projects for which the Division takes re-sponsibility, and for which an overview may be helpfulin explaining Division activities.

The Research Grants Section of this report summa-rizes some recent activities in the area of basic and ap-plied information science. The application of computersto biomedical information storage and retrieval has revo-lutionized the operations of biomedical libraries and hasengendered the useful term, medical informatics, to de-scribe the theory and practice of providing informationaccurately and usefully to health workers. This at a timewhen the volume of biomedical information is growingat a rate that threatens our ability to keep track of whatwe know, and to use what we do know most efficiently.

Our training efforts also merit specific description.Training of competent professionals in medicalinformatics must remain an important goal of the Divi-sion. This new field needs scientists who can exploit theenormous potential for improvement in health deliverywhich medical informatics is capable of providing.Merging information science with the peculiar complexi-ties of modern health care and research poses complexproblems whose solution will depend on well-trainedspecialists. NLM supports both institutional training pro-grams and a fellowship program (initiated in 1989 andstill in an early evolutionary phase).

The NLM's Integrated Academic Information Man-agement Systems (IAIMS) program addresses the insuffi-ciently appreciated but vital issue of integrating usefullythe myriad information systems which have sprung upat most of our medical centers. These systems are useful,to be sure, but all too often are unrelated, isolated, andvery far from taking advantage of the synergism that canbe realized by linking the various academic informationsystems present in our health centers, including thelibrary, research material, academic administration infor-mation, medical education, and hospital informationsystems (particularly patient records.)

Left, Milton Corn, M.D., Acting Associate Director forExtramural Programs; Right, Richard T. West, Chief,Office of Program Planning and Evaluation, EP

Medical Library Resource Grants have been an es-sential element of the Division's activities for years. It isclearly an NLM mission to make biomedical informationeasily available to health professionals. This emphasiswas heightened last year when the NLM adopted out-reach as a major new initiative. As recommended lastyear by the Board of Regents' Outreach Planning Panel,the outreach program involves a number of extramuralresponsibilities, including professional training, IAIMS,and improving access to national biomedical informationby hospital libraries and physicians.

Improvement of access by physicians to medical in-formation was specifically addressed by an amendmentof the Resource Grant Program designed to expand theability of hospital libraries, particularly in rural orunderserved areas, to establish facile contact with the na-tional biomedical library system.

Grants in support of publications have little to dowith medical informaticsbut are a time-honored, impor-tant commitment by the Division to the scholarly activi-ties which lie at the heart of libraries everywhere.

The support provided for the bioethics center is self-explanatory, as is the section on the Division's committeeactivities. Resource information is summarized in thetable.

Regional Medical Library support, as authorized bythe Medical Library Assistance Act, is described in thechapter on Library Operations. The Special ForeignCurrency Program, administered by the Extramural

46 Programs and Services, FY 1990

Programs' InternationalPrograms Branch, is describedelsewhere in this document under InternationalPrograms.

Research Grants

NLM continued its programs of grant assistance forresearch on health knowledge issues. Enhancing knowl-edge utilization by exploiting computer and communica-tion sciences raises numerous difficult ies at thetheoretical and practical level. To resolve these problems,NLM offers grant support in three separate but relatedareas. The first two, medical informatics and biotechnol-ogy information, are supported under the general NIHresearch authority, Public Law 301. Research in the healthlibrary information sciences is authorized by the MedicalLibrary Assistance Act, as amended.

Medical informatics is an interdisciplinary fieldwhich combines medical specialty knowledge with theinformation and computer sciences, computational lin-guistics, and cognitive sciences, among others. For over10 years, NLM has sponsored investigators who havepublished impressive contributions to a growing medicalinformatics literature. Partly in consequence, there is agrowing appreciation for this field in academic medicine.Learning how to manage information is increasingly per-ceived as an essential skill for the health professional.

Among the new project grants awarded this year aretwo investigations that have to do with artificial intelli-gence in medicine methodology while addressing clini-cal information problems related to AIDS. At StanfordUniversity, Dr. Mark Musen is developing computersoftware tools and techniques that will foster creationand dissemination of protocol guidelines in ways thatcan be easily incorporated into larger, computer-basedprotocol management systems. His work is one of sev-eral parallel medical computer science activities atStanford. His goal is to develop methods for computer-aided design of new clinical protocols, so that investiga-tors can better define the expected efficacy and toxicity oftherapeutic agents for AIDS.

At the Robert Wood Johnson Medical School(University of Medicine and Dentistry of New Jersey),Dr. Frank Sonnenberg is designing a computer-basedconsultative assistance system for clinicians faced withcomplex choices among diagnostic and therapeutic op-tions. A computer program, employing artificial intelli-gence techniques, will eventually automate thegeneration of decision models and analysis of these mod-els to produce appropriate recommendations. Theproject focuses on evaluating pulmonary infiltrates inAIDS patients. This increasingly significant clinical prob-lem involves high risks for individual patients and abewildering array of options for clinicians, with manycomplex trade-offs.

It was also possible this year to renew support forfundamental work on artificial intelligence in medicineat the Massachusetts Instituteof Technology. The investi-gator, Professor Peter Szolovits, and his colleagues havepioneered in work on basic knowledge representationproblems. Together with collaborators such as Dr.Stephen Pauker at Tufts/New England Medical Center,they successfully join artificial intelligence methodolo-gies with medical decision science.

Biotechnology information research is supported toinvestigate effective methodologies for organizing andanalyzing data about molecular control of life processes.Relevant problems include design and management oflarge-scale databases, more powerful methods to retrieveinformation from multiple factual databases, and generalpattern matching algorithms for biological sequences.Recognizing that major advances in molecular biologywill depend in large part on successful resolution ofknowledge and information issues, NLM published aformal request for applications and in 1989 set aside onemillion dollars for new starts in this vitally importantinformatics research area. NLM's special interest in thisarea continued in 1990.

In this area, there was some falling off this year inthe number of applications received and, consequently,the number of highly ranked proposals was smaller still.This trend doubtless reflects the difficulty, at this com-paratively early stage, of bringingtogether molecular bi-ologists and computer scientists in projects of mutualinterest.

The need for conveniently available information,however, continues in the molecular biology community.One response is in a recently funded project directed byProfessor Ronny Woodruff of BowlingGreen State Uni-versity. He will develop computer-based methods forupdating, printing, and mailing stock listings of Dros-ophila species and mutants to the researchcommunity.Professor Woodruff will bring a methodological exacti-tude to this project that will assure its credibilityevery-where; his computer database has a potential forgrowing into a sophisticated and versatile knowledge re-source.

Research in the health library and information sci-ences is authorized by the Medical Library AssistanceAct. It is generally agreed that traditional informationdisciplines must continue to evolve; their services are es-sential to the health community.The bibliographicrecord remains not only the source for current medicalknowledge, it constitutes the underlying archival struc-ture of modern science. Continuing work on analysis ofretrieval systems, following an intensivecompetitive re-view, is consistent with earlier project support on biblio-graphic retrieval.

In this area it was possible to award one project thisyear which continues the evaluation and comparison of

47

Grateful Med and other systems in providing drug infor-mation to community pharmacists and pharmacy stu-dents. A related aim is to investigate attitudes of usersregarding computerized access, demands on users' time,and, in general, compatibility of computers, as presentlydeveloped, in the day-to-day collaboration of pharma-cists and clinicians. The geographic area is rural WestVirginia, so this project represents one of several effortsto determine the usefulness of Grateful Med as an out-reach program to comparatively isolated communities.The investigator, Marie Abate, is an Associate Professorat the School of Pharmacy of West Virginia University.

During this year of varied research grant programactivities, several challenging problem areas were identi-fied. One is the difficulty of an effective joining of forcesbetween graduate school and medical school. Establish-ing an intellectual alliance that can lead to a scientificallyinteresting proposal in a medical context is difficult atbest; interdisciplinary collaboration makes heavy de-mands on investigators' time. Because most of the re-search proposals addressed to NLM involve eventualclinical application, questions of validation and evalua-tion are major review criteria, but applicants seldom sat-isfy evaluation concerns fully. NLM's reviewers will giveattention to this issue in the coming year with a view toproviding appropriate criteria and guidance.

For the young investigator, success with the grant re-view process is a major hurdle, even though the First In-dependent Research Support and Transition (FIRST)award is an assistance mechanism created just for thisgroup. Through a variety of tutorial methods, NLM, andmany of the senior investigators it supports, are attempt-ing to help young scientists marshal evidence specificallyand persuasively in grant applications. The problem isnot one of language or "grantsmanship," but rather oneof understanding the committee dynamic of peer review.

Gratifyingly, NLM was able to continue its supportfor many investigators initially funded in earlier years.The number of grant-related publications and presenta-tions is encouraging. In a recent book, Medical Informatics,Computer Applications in Health Care, four NLM awardeesbring together a large number of carefully written chap-ters on all aspects of computer applications in health careinformation management. For those who wonder whatthis field is about, this book provides an answer in ex-haustive detail.

Training

The NLM continues its support of research trainingin the fields of medical informatics and biotechnologyinformation. It is clear that these disciplines go beyondthe use of the computer as a computational tool andextend into the process of knowledge representation,storage, retrieval, and manipulation to support inferen-

Roger Dahlen, Ph.D., Chief, Biomedical InformationSupport Branch

tial reasoning, and to rationalize decision making in thehealth sciences. There remains a need for qualified, tal-ented investigators, well equipped to address fundamen-tal issues in the use of computers and automatedinformation systems in health care, health professionseducation, and biomedical research. These investigatorswill contribute to the growth of science by their studiesof knowledge management and by advancing the fron-tiers of the computer sciences for organizing, retrieving,and utilizing health knowledge. NLM also intends to fos-ter medical informatics and biotechnology informationas growing disciplines with an appropriate place in aca-demic medicine. It is expected that the trainees will be-come able, cross-disciplinary translators, taking thecomputer sciences to all of biomedicine.

Support is in the form of institutional training grantswhich supported 48 postdoctoral and 21 predoctoraltrainees in 1990. The seven currently supported trainingsites are listed below. In addition to the institutionaltraining grants, NLM supported 5 individual fellows.The current fellows are receiving their research trainingat the University of Utah, Columbia University-Presbyte-rian Hospital, University of Washington, Yale Univer-sity, and Cold Spring Harbor Laboratories.

Institutional training grantees:

1. HarvardMedical SchoolBrigham and Women's HospitalMassachusetts General HospitalRobert A. Greenes, M.D., Ph.D., Director

Major research emphases are computer-based deci-sion support systems, modeling of physician decisionmaking, representation and structure of medical knowl-edge, application of information technology to medicaleducation, database and data analysis systems, computergraphics, and the development and evaluation of digitalimaging systems.

48 s mid Services, FY 7990

2. University of MinnesotaLael Gatewood, Ph.D., Director

The focus of this interdisciplinary program is to pro-vide training in cognitive, information, and computersciences. Current research includes physician decisionmaking, diagnostic classification, nurse decision making,electronic communications for health professionals, phy-sician training, and health information systems.

3. New England Medical CenterDartmouth College of MedicineStephen G. Pauker, M.D., Director

This research training program emphasizes clinicaldecision making, artificial intelligence approaches to thestructure and use of medical knowledge, and clinicalcognition. The program emphasis is on research experi-ence rather than on preparing for an additionalgraduatedegree, although that option is available.

4. University of PittsburghRandolph A. Miller, M.D., Director

Operating under the Intelligent Systems Program atthe University of Pittsburgh, this program uses the fac-ulty and services of the following: the School of Medi-cine, the Graduate School of Business, the Department ofComputer Science, and the InterdisciplinaryDepartmentof Information Science.

5. Stanford UniversityEdward H. Shortliffe, M.D., Ph.D., Director

This formal program in medical informatics offersMasters and Ph.D. degrees to individuals with a careercommitment to this field. The specialized curriculum fo-cuses on the development of a new generation of re-searchers with a commitment to developing practical,computer-based solutions to problems in the optimalmanagement of biomedical knowledge.

6. Washington University (St.Louis)Charles E. Molnar, Sc.D., Director

The development of skills in basic techniques ofinformatics and experience in applying these techniquesin a biomedical setting are inseparable goals of this pro-gram. Specific research opportunities for trainees areavailable from a wide range of options represented bythe research of the core faculty and of a much largergroup of participating faculty.

7. Yale UniversityPerry L. Miller, M.D., Ph.D., Director

This training program will prepare individualsforcareers in medical informatics research. The programwill include both postdoctoral and predoctoral training.In addition to multidisciplinary research opportunities,the program will also offer didactic experiences.

IAIMS

Integrated Academic Information Management Sys-tems (IAIMS) are institution-wide computer networksthat link and relate library systems with a variety of indi-vidual and institutional databases and information filesfor patient care, research, education, and administration.Resource grants have been made to assist medical cen-ters and health science institutionsin planning and de-velopment projects that will lead to the implementationof IAIMS. The goal is to create organi/ational mecha-nisms within health institutions to manage more effec-tively the knowledge of medicine, and to provide for asystem of comprehensive information access.

NLM has provided grant support for (1) institution-wide IAIMS planning and policy analysis, (2) model de-velopment and testing, and (3) implementationoffull-scale IAIMS projects.

Some of the functions undertaken by grantees dur-ing planning include preparing a 10-year strategic planfor the institution, developing an institutional informa-tion policy, assessing the technological capabilitiesof theinstitution, and defining information management needsand requirements. From these activities an IAIMS plan iscreated to serve as the guide for the second phase ofactivity, model development.

During FY 1990, IAIMS Phase 1 planning projectswere active at Dartmouth Medical School, Rhode IslandHospital, the University of Michigan, and the Universityof Pittsburgh. Additionally, new IAIMS planning grantswere awarded to Tufts University School of Medicineand the University of Washington.

After planning, Phase II projects support testingIAIMS models on a small scale in research, education,and/or patient care areas. During FY 1990, Phase I Igrants were active at the universities of Cincinnati, Mary-land, and Utah. A new Phase II project was begun with agrant to the American College of Obstetricians and Gy-necologists.

Two new grant awards to assist in the ful l imple-mentation of an institution-wide IAIMS (Phase I I I ) weremade to the Baylor College of Medicine and DukeUni-versity. These awardees joined Columbia University andGeorgetown Universi ty who received continuat ionawards in FY 1990 for their second year of the five-yearPhase HI activity.

In an lAIMS-related activity, an NLM contract wasin its second year at the Oregon Health Sciences Univer-sity (OHSU) to implement a Biomedical InformationCommunications Center (BICC) to serve the University,the State, and the northwest region of the country. Pri-mary activities over this five-year contract will includeestablishing a BICC organization and staff, developingcampus telecommunications, appointing training faculty,implementing an automated l ibrary information

Extramural Programs 49

resources system, developing Infonet and a RegionalRe-sources System and Network, creating a medicalinformatics curriculum for OHSU, and developing re-search programs in health informatics and in technology.

Resource Grants

FY1990 witnessed the implementation of the revital-ized Resource Grant Program with the award of 11 Infor-mation Access Grants and 3 Information Systems Grants.Information Access Grants, available to individual insti-tutions as well as consortia of health-related institutions,assist in providing access to information resources andservices utilizing computer and communications tech-nologies. Information Systems Grants, which also utilizecomputer and communication technologies, are intendedto encourage networking, connectivity, and integrationdirected towards developing an information infrastruc-ture.

Four institutions receiving Information AccessGrants to acquire CD-ROM capabilities are CentralMaine Medical Center in Lewiston, Columbia Hospitalin Milwaukee, Miami Children's Hospital in Rorida, andStamford Hospital in Connecticut. Odessa MemorialHospital in Washington received an Information AccessGrant to introduce Grateful Med to its staff. Three Infor-mation Access Grants were awarded to consortia ofhealth-related institutions to offer access to GratefulMed: the North Idaho Health Information Networkthrough the Kootenai Medical Center in Coeur D'Alene;the Eastern Kentucky Health Science Information Net-work based at Morehead State University; and theAHEC Mountain Information Access Cooperative head-quartered in Hazard, Kentucky. The Northeastern Con-sortium for Health Information (Boston) receivedInformation Access funds to compile a union list ofmonographs, and the University of North Dakota plansto use Information Access funds to expand the stateonline network to include the hospital/clinic libraryholdings. The University of Nebraska's medical center li-brary received an Information Access Grant on behalf ofhealth-related libraries in the Greater Omaha area to de-velop a plan for introducing end-user searching and de-livering documents.

Information Systems Grants were awarded to: 1)Yale University to install a full-text database manage-ment system to integrate Current Contents, thepreclinical curriculum syllabus, and a drug informationdatabase; 2) University of Miami to develop the South-east Florida AIDS Information Network; and 3) Cleve-land Medical Library Association for the Ohio Networkof Medical History Collections to develop a system tocatalog artifacts.

Four grants were awarded under the auspices ofthe former Medical Library Resource Grant Program.

A Medical Library Resource Project was awarded to theUniversity of Texas Health Science Center at San Anto-nio on behalf of the 21 members of the Friends of(Georgetown University's) Library Information Systemto provide a model of system planning and developmentfor automated library systems. Medical LibraryResourceImprovement Grants were awarded to: ValleyChildren's Hospital (Fresno, CA), Mercy Hospital(Janesville, WI), and the Laurel Highlands Health Sci-ences Library Consortium (Johnstown, PA).

Arthur Broering, Dep. Asso. Director forExtramuralPrograms; Jeanne L. Brand, Ph.D., Chief, InternationalPrograms Branch

Publication Grants

The Publication Grant Program provides selectiveshort-term financial support for not-for-profit, biomedi-cal scientific publications. Studies prepared and/or pub-lished under this NLM program include critical reviewsor monographs on special areas of medical research andpractice; secondary literature tools (such as annotatedbibliographies, atlases and catalogs); research mono-graphs in the history of medicine; publications on medi-cal informatics, health information science andbiotechnology; pilot or temporary support for secondaryperiodicals; and the proceedings of scientifically signifi-cant symposia related to U.S. health needs.

The Publication Grant Program is supplemented byNLM's Special Foreign Currency Program, authorizedunder Public Law 480. (The Special Foreign CurrencyProgram is described in the chapter on International Pro-grams.) Both publication support programs aid in thedissemination of biomedical information important to anunderstanding of progress in medicine and the healthsciences.

During FY 1990 NLM awarded 17 PublicationGrants totaling $390,377. Of these, 10 were new awards.This small grant program has a current annual ceiling ondirect costs per grant of $25,000. The average grantawarded in FY 1990, including both direct and indirectcosts, was under $23,000.

50 Programs and Services, FY1990

Among the books published in FY 1990 fundedthrough the Publication Grant Program was a compre-hensive study of the history of public health services inthe United States, John Duffy's The Sanitarians (Urbana,IL: University of Illinois Press, 1990). No similar modernvolume on the history of public health is in existence andthe work is expected to become a classic in the field.

Another notable work received in FY 1990 was thefourth and last installment of the current version of "TheGenome of Drosophila Melanogaster" issued by theDrosophila Information Service of the University ofCalifornia at San Diego. This project, which lists anddescribes all known genetic variations known in Dros-ophila, is an updated version of a fundamental referencework last published in 1968, Genetic Variations ofDrosophila Melanogaster. The revision is an important toolfor designing and interpreting genetic experiments withDrosophila. (A list of supported publicationsreceived in FY 1990 is in Appendix 2.)

National Reference Center for BioethicsThis year NLM renewed its support for a specialized

center at Georgetown University.The National Refer-ence Center for Bioethics has been supported by NLM bya variety of mechanisms for many years. The Centerfunctions in association with a bibliographic database onthe literature of bioethics, now funded by a contract withNLM. The Center collects, organizes, and disseminates awide range of written materials in the broad field of bio-ethics. Over the years, the Center has drawn widespreadpraise for its high level of service and operation. TheCenter and its related bibliography, available electroni-cally on NLM's BIOETHICSLINE, provide valuable in-formation to the entire country at a time when ethical,moral, and legal issues concerning health care and bio-medical research constantly increase. The Center is also a

Table 10Extramural Grant and Contract Program (dollars in thousands)

major reference source for undergraduate colleges every-where. The decision to renew support for the Center wasbased, in part, on an extremely favorable endorsementby a distinguished expert panel.

Highlights of Committee ActivitiesNLM's scientific merit peer review group—the Bio-

medical Library Review Committee (BLRC)—was ex-panded to 21 members in 1989 from its previous 15,adding experts in molecular biology information. Duringits regular three meetings in FY 1990, the BLRC reviewed121 applications of which 95 were approved. The Com-mittee operates as a "flexible" review group; i.e., it iscomposed of three standing subcommittees, consisting ofseven members each: Medical Library Resource Sub-committee, Medical Informatics Subcommittee, andBiotechnology Information Subcommittee. The subcom-mittees consider research applications in medical libraryprojects, medical informatics, and biotechnology infor-mation respectively.

The final peer review of applications is performed bythe Board of Regents, which meets three times a year ap-proximately four months after the Biomedical LibraryReview Committee. One of the Board's subcommittees,the Extramural Programs Subcommittee, comes togetherthe day before the full Board for the review of "special"grant applications. Examples of "specials" include appli-cations for which the recommended amount of financialsupport is unusually large, when at least two membersof the scientific merit review group dissented from themajority of either approval or disapproval, whena policy issue has been identified, and when an applica-tion is from a foreign institution. The ExtramuralPrograms Subcommittee makes recommendations to thefull Board.

Category

ResearchResource projectsResource improvementTrainingFellowshipsRegional Medical LibrariesPublications'

(IAIMS projects")(Med. info, research)(Biotech, research)

FY1988No. $

40158807

12(9)

(25)(7)

$5,8573,474

1142,619

02,330

330(2,822)(3,865)(1,000)

FYNo.

45149737

13(9)

(26)(14)

1989$

$7,6663,487

1292,537

992,569

346(2,962)(4,008)(2.747)

FY1990No. $

471515757

16(8)

(24)(17)

$11,3434,492

5192,886

1893,772

390(3,821)(6,030)(4.179)

Totals:. 90 $14,724 98 $16,833 112 $23,591

*Includes one Special Scientific Project**Includes both IAIMS resource and research projects

51

OFFICE OF COMPUTER ANDCOMMUNICATIONS SYSTEMSJohn AndersonDirector, Information Systems

The Office of Computer and CommunicationsSystems (OCCS) provides information processing capa-bility to meet NLM needs and, in so doing, determinesand meets the data processing and data communicationrequirements for: (1) disseminating biomedical informa-tion to thousands of institutional and individual healthprofessionals around the nation and world; (2) operatingthe world's largest library in a single technical area—bio-medicine; (3) providing MIS (Management InformationSystem) services, including office automation, to NLM.

OCCS: (1) implements computer and communica-tion systems using cutting-edge technology and state-of-the-art techniques; (2) analyzes, plans, and providesreal-time, online, around-the-clock information servicesfor increasingly sophisticated users; (3) schedules andcontrols the maintenance and publication of dozens ofdatabases, each measured in billions of bytes (charac-ters); (4) operates a modern computer center of fully re-dundant, fail safe hardware and software; (5) conductsperformance measurement and capacity planning forcomputer hardware, operating systems, database man-agement systems, transaction processors, etc.; and (6)produces data and software for distribution to twodozen international search centers.

The organization of OCCS is a direct reflectionofthese responsibilities. Computer and communicationsystems are:

• developed and implemented by the Develop-ment Branch

• enhanced and maintained by the Application Ser-vices Branch

• executed on computers under operating systemcontrol by the Systems Support Branch

• provided as an around-the-clock service by theComputer Services Branch

Development Branch

The Development Branch is responsible for analyz-ing, designing, and implementing computer-based sys-tems to support NLM's library processing requirements.Development activities during the past year include theimplementation of a major subsystem of MEDLARS III,expansion of Grateful Med support, enhancements to

Right, John Anderson, Director, Information Systems;Left, Aaron Navarro, Ph.D. Dep. Dir. for Development;Center, Harry D. Bennett, Dep. Dir. for Operations

DOCLINE, development of Loansome Doc, and exten-sions to the local area network services.

The Technical Services System (TESS) is being devel-oped to perform two functions for NLM's TechnicalServices Division: the Cataloging Front-End (CAFE) sub-system and the Selection and Acquisition (SAAS) Sub-system. TESS is a distributed processing system thatintegrates mainframe computer, personal computer(workstation), database, and local area network (LAN)technologies.

The CAFE subsystem was successfully implementedin September 1989. SAAS was developed using theCAFE software as a foundation and was implemented inthe fall of 1990. The two subsystems will not only sharethe same architecture, but also much applications soft-ware. The basic approach is to develop a common set ofsystem functions that drive the mainframe, database,LAN, and workstation, and then use them to constructthe specific application functions.

The scope and coverage of Grateful Med continue togrow. New versions for both the PC (version 5.0) and theApple Macintosh (version 1.5) have been released, and aUnix-based version is in the design stage. More than 2million searches will be performed via Grateful Med thisyear by over 25,000 registered owners of the software.

52 Programs and Servian, FY 1990

Existing support contracts are expected to be renegoti-ated in the coming year.

The functionality and utilization of DOCLINE alsocontinue to grow. Approximately1.9 million interlibraryloan requests were processed by nearly 2000 libraries inFY 1990. The abili ty to CANCEL a request has beenadded, as that of handling FAX requests. System perfor-mance has been improved through a variety of hardwareand software changes.

A major Development Branch effort has resulted inthe pilot implementation of Loansome Doc, which pro-vides an interface between Grateful Med and DOCLINE.This interface will enable the Grateful Med user to orderjournal articles electronically from a DOCLINE libraryduring a Grateful Med session.

As the processing power at NLM staff and patronworkstations continues to increase, greater requirementsare placed on internal communications in terms ofthroughput and volumes of data traffic. NLM Local AreaNetworks (LANs) continue to be enhanced in order tokeep pace with demands to share and transfer informa-tion among diverse systems. An extensive broadbandcable system throughout NLM links workstations withservers and other processing resources using the NovellNetware operating system. Workstations can access in-ternal hosts through gateways or direct links, and otherLANs or wide area networks, such as the NLM Ethernet,are accessible by bridges or gateways. These communica-tions facilities form an integrated network that supportsoffice automation, electronic mail, distributed applica-tions, and data processing activities.

Applications Services BranchThe Applications Services Branch (ASB) of OCCS

supports the various NLM programs and serves as thenucleus of all automated programming support services.In FY 1990:

• A new database, ChemID, described in the Spe-cialized Information Services chapter, becameoperational.

• Weekly updating of the MEDLINE databasewent into effect.

• New generations of software for some majorAutomated Indexing Management System(AIMS) subsystems became operational. The sub-systems affected are INDEXING (the applicationof NLM controlled thesaurus keywords), LSTRC(Literature Selection Technical Review Commit-tee), and BINDING (preparation of journals, etc.for binding).

• The NLM Machine Readable Catalog (MARC)software was updated to process CATLINE andAVLINE data according to the 1987 U.S. MARC(release 15) specifications.

• Many software enhancements were made to theModel 204 DBMS based MeSH system.

• A prototype Bioethics Citation MaintenanceSys-tem was completed. This software is PC-basedand will provide for individual citation mainte-nance. It is planned for production in FY 1991.

• Major enhancements were made to the ClassMaintenance software for NLM bibliographicdata. The new funct ions make it possible tochange MeSH minor descriptors to major de-scriptors, to create subheading pre-explodes, tocreate MeSH heading fragments, and to createtitle fragments.

Systems Support Branch

The Systems Support Branch is responsible for hard-ware analysis, system software, and data communica-tions. The current NLM production configuration is anIBM 3084-Q with MVS/XA (multiple virtual systems/extended architecture), TCAM, and VTAM. An IBM3081-K is used for system testing and development. Athird system, an IBM9370-60 with VM (virtual machine)is used for PROFS (the Professional Office System).

During FY 1990, storage capacity was expanded andthe reliability of the IBM 3084 system was improved.Accomplishments for the year include:

• An increase in online storage capacity to 260billion bytes.

• Expanded use of STC 4305 and Memorex 6890solid state disks.

• Provision of systems software for the 3084, theIBM 3380-K disk storage and 3990 controller, theSTC and Memorex solid-state disks, the Xeroxand IBM printers, and the IBM 9370 PROFSsystem.

• Support of more than 100 software products usedby programmers, users, and systems supportstaff.

• Operating systems support and communicationsconnectivity for new terminals throughout theNLM.

• Development and distribution of procedures andstatus information for the mainframe system.

• Program changes to system software as requiredby ELHILL and other applications softwaredevelopment.

Office of Computer and Communications Systems 53

Left to Right: Melvin Beckelhimer, Chief, Systems SupportBr.; William Hagarty, Chief, Computer Services Br.;Robert Kicklighter, Chief, Applications Services Br.; JohnCox, Chief, Development Br.

Computer Services Branch

The Computer Services Branch (CSB) provides dataprocessing services and support for subscribers andusers of the Library through the use of the three main-frame computer systems described above.

Operational support is provided around the clock,seven days a week, with computer operator coverage forall weekends and governmental holidays, as most sub-scribers, both domestic and foreign, continue to use theonline system.

The peripheral equipment attached to the IBM 3084mainframe consists of 220 direct access storage deviceswith a total online storage capacity of approximately260billion characters of data. In addition, there are 14 mag-netic tape drives, 6 IBM3420's, and 8 IBM3480's, whichare used in filling subscribers7 requests for copies of theMEDLARS database files.

In FY 1990, the CSB created and mailed more than5,200 magnetic tapes containing MEDLARS andTOXNET database files to domestic and foreign sub-scribers. Also installed are many telecommunicationsunits to provide easy and quick access, worldwide, to themain MEDLARS database files.

Annual printed output exceeds 22 million pages or989 million lines of local printing on the high-speed,fan-fold, and cut-sheet laser printers and high-speed impactprinters attached to the IBM3084 mainframe system. An-other 550,000 pages or 38 million lines are printedthrough the use of remote printers.

54

INTERNATIONAL PROGRAMS

Richard K. C. Hsieh, Dr. P.H.Director, International Programs

The National Library of Medicine plays an impor-tant role in making vital biomedical information avail-able to health scientists and clinicians around the world.

During the past year NLM continued its bilateral co-operative MEDLARS agreements with individual coun-tries, its cooperation with international governmentorganizations such as the World Health Organization(WHO) and the Pan American Health Organization(PAHO), and international nongovernmental organiza-tions such as the International Council for Scientific andTechnical Information (ICSTI).

The Special Foreign Currency Program was active inthe support of critical reviews and history of medicineprojects. Other NLM international activities includedtraining for colleagues from abroad, the NLM publica-tion exchange program (with 173 institutions in 51 coun-tries), as well as receiving numerous professional visitorsfrom abroad.

International MEDLARS Agreements

The Library has MEDLARS agreements with part-ners in 15foreign countries and with two internationalorganizations (Table 11).

The Indian National Informatics Center is continu-ing its efforts to set up a tape center in New Delhi to pro-vide MEDLARS services to health professionals in India.NLM will soon conduct a test with NIC to determinewhether the search software to be used by NIC can accu-rately retrieve citations from MEDLARS databases.

The Library, in collaboration with the American In-stitute in Taiwan and the Coordinating Council forNorth American Affairs, has reached an agreement forthe Science and Technology Information Center (STIC) inTaipei to become a new International MEDLARS Centerto provide MEDLARS service to health professionals inTaiwan. STIC has successfully demonstrated the use ofGrateful Med (GM) for MEDLINE access and will soonbe helping health personnel in the use of GM.

The other international organization with whichNLM has a MEDLARS agreement is the Pan AmericanHealth Organization. In 1989, PAHO amended its leas-ing agreement with NLM to provide online access toMEDLARS databases from Argentina, Chile, Jamaica,and Costa Rica, and soon access will be available to evenmore Latin American countries.

Richard K.C. Hsieh, Dr.P.H., Director for InternationalPrograms

Another collaborative project with PAHO and theUniversity of Chile is the development of a gateway sys-tem named BITNIS. This new system makes it possiblefor health professionals to conduct MEDLINE searchesin Argentina, Chile, Mexico, and Venezuela. AMEDLINE search through BITNIS is initiated by usingGrateful Med on a personal computer. The search com-mands created by Grateful Med are transmitted to NLMthrough the BITNET network. The search results ob-tained from the NLM computer are transmitted back tothe originator through BITNET and Grateful Med is usedagain to edit and present search results. The objective ofthe BITNIS project is to provide NLM's MEDLINE tohealth professionals in all Latin American countrieswhere the high cost of international communication ser-vices inhibits normal access.

Collaboration with WHO

NLM and the World Health Organization (WHO)continue to cooperate in the publication of the QuarterlyBibliography of Major Tropical Diseases and the Bibliographyof Acute Diarrhoeal Diseases. NLM prepares camera-readycopy from the MEDLINE system, and WHO prints anddistributes these to thousands of institutions in the devel-oping countries. Also, NLM provides MEDLINE bibliog-raphies in camera-ready form to PAHO, and PAHOprints and distributes these in the Bibliography of Respira-tory Infections in Children.

International Programs 55

NLM and WHO also continued a collaborativeinter-library loan arrangement in which photocopies ofjournal articles are provided to WHOreferred requestorsat a reduced rate. Library resources in developing coun-tries are usually insufficient and the need for biomedicaland health information can be met only by drawing onthe collections of the developed world. Even thoughNLM and WHO continue to provide some photocopiesof journal articles to developing countries, this arrange-ment can only partially meet the demand. Unless otherresources in developed countries can be found, the needfor interlibraryloans to developing countries will con-tinue to grow.

Table 11International MEDLARS Centers

Tapes

FranceGermanyJapanPAHO (BIREME)*Switzerland*

Tapes/Software

Australia*ChinaSweden

Online NLM

PAHO*CanadaColombiaEgyptFrance*ItalyKuwaitMexicoSouth AfricaSwitzerland*TaiwanUnited Kingdom

'Combined online/tapes

Special Foreign Currency Program

Authorized under Public Law 83-480, as amended,the Library's Special Foreign Currency Program utilizesU.S.-owned local foreign currencies to prepare and pub-lish biomedical scientific publications for the health-science community. This program, active since 1962, isthe oldest of NLM's extramural support activities. Al-though over the years NLM has sponsored collaborativePL-480 projects in seven countries,support in local cur-rency for the Library's program is presently availableonly in India.

During FY 1990, 26 projects totaling $345,512(equivalent in foreign currency) were active in India.About 15 percent supported the translationand publica-tion of biomedical monographs and bibliographies bynoted foreign scientists. Approximately 85 percentfunded the translationand publicationof major historicalmonographs. These classics in the history of medicineare selected in collaboration with the American Associa-tion for the History of Medicine.

Among the funded studies received in FY 1990was a translation from the German of Jacob Wolff's

The Science of Cancerous Disease from Earliest Times to thePresent, with a new introduction by the eminent Ameri-can medical historian, Dr. Saul Jarcho. No other English-language monograph in the history of the developmentof concepts of neoplasia in Western medicine has beenavailable, and Wolff's work constitutes a unique refer-ence source for investigators and medical historians inthe search for understanding the etiology of cancer.

Also released in FY 1990 was an English translationof the Developmental Genetics of Vertebrates by B.V.Konyukhov, Institute of General Genetics, Academy ofSciences of the USSR (Springfield, VA: National Techni-cal Information Service, 1990). Edited by Professor BruceM. Carlson, M.D., Ph.D., of the University of MichiganDepartment of Anatomy, this monograph is a compre-hensive study of the actions and interactions of genesduring development. It covers a wide variety of humangeneric defects, stressing the biological problems broughtout by these conditions. (A list of supported publicationsreceived in FY 1990 is included in Appendix 2.)

International Meetings and Visitors

The Library is a member of the International Councilfor Scientific and Technical Information (ICSTI). This or-ganization serves as a meeting ground for informationand abstracting agencies, commercial and governmental,from a number of countries. Common interests includeeconomics of primary and secondary publications, trans-border flow of information, electronic publication, stan-dardization, and the information needs of developingcountries. At the 1990 general meeting of ICSTI, held inGatlinburg, Tennessee, NLM was represented by theNLM Deputy Director and the NLM Director for Inter-national Programs. Both hold office in ICSTI.

The Library continues to attract many foreign visi-tors each year, including medical librarians, health pro-fessionals, and government officials. Many of thesevisitors have responsibility for medical, scientific, ortechnical information in their own countries. Their inter-est in NLM is more than cursory, and they are officiallyreceived and briefed on relevant aspects of NLM opera-tions and research. In 1990 visitors came from the follow-ing countries:

Argentina, Australia, Bangladesh, Belgium,Bra-zil, Burundi, China (PRO, Colombia, Cyprus,Czechoslovakia, East Germany, Egypt, France,Granada, Great Britain, Haiti, Hungary, Iceland,India, Indonesia, Iraq, Japan, Korea, Malaysia,Mauritania, Morocco, The Netherlands, Norway,Pakistan, Papua-New Guinea, Peru, Poland,South Africa, Spain, Surinam, Syria, Taiwan,Thailand, Togo, the USSR, West Germany,Yemen, and Yugoslavia.

56

ADMINISTRATION

Kenneth G. CarneyExecutive Officer

Financial Resources

In FY 1990, the Library had a total appropriation of$81,861,000. Table 12 displays the FY 1990 budget au-thority plus reimbursements from other agencies, andthe allocation of these resources by program activity.

Table 12Financial Resourcesand Allocations FY 1990(in thousands of dollars)

Budget authority:Appropriation, NLM.

Plus: Reimbursements ....Total

Budget allocation:Extramural ProgramsIntramural Programs

Library OperationsLister Hill National Center for

Biomedical CommunicationsNational Center for Biotechnology

InformationToxicology Information

Research Management and Support

Total,

$81,86116,43298,293

23,61867,806

(44,592)

(11,199)

(5,073)(6,942)

6,869

$98,293

Personnel

As the National Center for Biotechnology Informa-tion continued its rapid growth, it became necessary toestablish three branches within the Center:

• The Information Resources Branch, which sup-ports intramural and extramural information re-sources to serve the molecular biologycommunity;

• The Information Engineering Branch, which isconcerned with the development of automatedsystems for data analysis and retrieval; and

• The Basic Research Branch, which conducts basicresearch in computational molecular biology.

There were significant NLM administrative staffingchanges in 1990. These included the appointment ofa new Deputy Executive Officer, Sally S. Burke; NLMPersonnel Officer, Patricia Southcomb; NLM Budget

Kenneth G. Carney, Executive Officer; SallyBurke,Deputy Executive Officer

Officer, Susan Levine; and NLM EEO Officer, DavidNash.

The effort to recruit and hire the most effective per-sonnel to staff NLM programs continued to be a top pri-ority in 1990. A development that should facilitate thiseffort was the delegation of authority by the Office ofPersonnel Management to the NLM to run the LibrarianRegister for all of NIH. This delegation will expedite hir-ing significantly.

Although a hiring freeze was imposed in late Au-gust by the Department of Health and Human Serviceson all agency components, the NLM closed the fiscalyear at its full operating ceiling of 548 full-time equiva-lents (FTE's). The freeze was imposed pending resolu-tion of a deficit-reduction program by Congress.Congressional action is required to avoid effects of theGramm-Rudman-Hollings budget reduction law whichwould require major reductions in the FY 1991 budgetbeginning October 1,1990.

Awards

NLM Director, Donald A.B. Lindberg, M.D wasawarded an honorary doctor of laws degree from theUniversity of Missouri-Columbia where he served on thefaculty prior to accepting his current position at NLM."Perhaps more than anyone else in the world, you haveengineered the merger of the worlds of medicine andcomputers," said MU Chancellor Haskell Monroe, read-ing from the degree citation.

Administration 57

Rose Marie Woodsmall, Planning Office, and JohnAnderson, Director, OCCS were awarded the FrankBradway Rogers Information Advancement Award. Theaward was given for their pioneering effort in the devel-opment of Grateful Med. The Rogers Award is spon-sored by the Institute for Scientific Information and isgiven in recognition of an outstanding contribution inapplied technology for the delivery of health sciences in-formation.

NIH Merit Awards were presented in 1990 to:William J. Hagerty, OCCS, "for superior perfor-

mance in providing online availability of MEDLARS andother databases in NLM's computer facility."

Eve-Marie Lacroix, LO, "for exceptional leadership,foresight, and achievement in managing the programsand services of the Public Services Division."

Alice Ladson, LO, "for her exceptional contributionsin maintaining effective service to patrons in the ReadingRoom throughout a period of change, and for sustainedoutstanding performance."

Carol Unger, LO, "for her exceptional contributionto developing and managing the Library's preservationmicrofilming program and for sustained outstandingperformance."

Nancy Wright, LO, "for her excellent coordination ofcontract staffing needs under an extremely short dead-line so as to implement the building of the GENINFOBackbone database."

The NLM Director's Awards for 1990 were pre-sented to:

B. Earl Henderson, LHNCBC, "for your outstandingmanagement of the scientific and engineering programsof the Lister Hill Center, and for planning and initiatingan undergraduate research study program to supportthe professional engineering training of students fromhistorically black institutions of higher learning as part ofNLM's increased outreach to underserved communi-ties."

Sheldon Kot/.in, LO, "for your outstanding ability tomanage the creation of the MEDLINE database andaccess to the MEDLARS system."

The Board of Regents Award was presented toDavid Kenton,Office of Information Systems, in recogni-tion of over a decade of primary responsibility forNLM's biomedical informat ion retrieval system,ELHILL.

The NIH Harvey Bullock Award was presented toCynthia Gaines, SIS, to recogni/e her efforts in EqualEmployment Opportunity (EEO). Ms. Gaines has madesignificant contributionsin the past five years to thecause of EEO at NLM through service, communication,and coordination.

The Frank B. Rogers Award was established in 1989to recogni/e an employee who has made a significantcontribution to the Library's fundamental operational

programs and services. The first Rogers award was pre-sented to Margaret Byrnes, LO for her outstanding lead-ership in the preservation of the biomedical literature.

Equal Employment Opportunity

"Get To Know EEO; It's For Everyone." This is theprimary initiative being launched at the National Libraryof Medicine with the arrival of Mr. David Nash, NLM'snew EEO officer. His extensive knowledge and insightinto EEO derive from his previous experience at theEqual Employment Opportunity Commission and theDepartment of the Navy EEO office.

The EEO Officer has visited most NLM offices andhas gotten to know many employees. He has spoken atvarious EEO-related meetings at the NLM and on theNIH campus. The Library's EEO program is addressingfundamental questions: What is EEO? How does itwork? How will EEO be utili/ed at the Library?

Among the program's new goals and objectives: theWorkforce 2000 challenge—how will the Library makebest use of this diversified work force? Reinvigoratingupward mobility for lower level employees—enhancingtheir skills so they can perform at their highest potentialand advance in accordance with their abilities and theavailability of opportunities. All these efforts will rely oncareer counseling and planning, training and education,job analysis, systematically identifying target jobs tomeet staffing needs, and establishing ways to measureemployee potential.

Working closely with the Library's EEO AdvisoryCommittee, the new EEO Officer is emphasizing the sys-tematic evaluation of EEO progress at NLM, identifyingproblem areas such as the need for more representationat NLM of Hispanic Americans, assessing the effective-ness of the overall EEO program, and reporting the re-sults of the continuing evaluations.

To deal with the sensitive issue of discriminationcomplaints, the EEO Office is putting more effort into ex-plaining to employees both the formal and informalcomplaints process. Guidance is being provided to man-agers and supervisors in how to avoid complaints by as-suring that all employees are treated within theguidelines of the law. It is important to avoid even theappearance of unfair discrimination in working condi-tions, training opportunities, assignments, position de-scriptions, vacancy announcements, and the style andtone of oral and written communications. Managers andsupervisors are being reminded that executive ability in-cludes constant concern with staff development and fairtreatment. In fact, the most crucial executive skill is to beable to motivate others.

In the areas of community outreach, the EEO Officertook part in the National Institutes of Health job fair andhas attended workshops and conferences that addressed

Programs and Services, FY1990

concerns of minorities, women, and the disabled. Amongthe actions taken for specific minorities:

• The NLM EEOOffice has been working closelywith the National Association for Equal Opportu-nity in Higher Education and, related to this, withthe NLM project with the Historically BlackColleges and Universities group.

• Also being targeted are groups such as the Na-tional Hispanic University, where NLM isattempting to get access to a large pool of quali-fied Hispanic American employee candidates.

• There are efforts to improve training and careeropportunities for Native Americans and AlaskanNatives

Table 13Staff, FY 1990 Full-Time Equivalents (FTEs)

• The NLM EEOOfficer has been consulting NLMstaff with disabilities about their special needs,with NLM management about the attitudinal andarchitectural barriers in employing people withdisabilities, and with such organizations as theNIH committee on persons with disabilities andthe Kaiser Foundation.

Late in FY 1990, at the NLM Annual EEO OpenMeeting, David Satcher, MD, president of MeharryMedical College in Nashville, Tennessee (and presidentof the Association of Minority Health Professionsschools), addressed the NLM staff on the history andcurrent state of minority health science education in theU.S. At this meeting, also, the new EEO Officer pre-sented his overall EEO plans for the Library.

Program

Office of the DirectorOffice of Public InformationOffice of AdministrationOf fice of Computer and Communications SystemsExtramural ProgramsLister Hill CenterNational Center for Biotechnology InformationSpecialized Information ServicesLibrary Operations

Full-TimePermanent

195

446216661135

224

Other

12432

11113

31

Total.

Total FTE Usage.

482

550

68

59

APPENDIX 1: ACRONYMS, ABBREVIATIONS, ANDINITIALISMS

AAOS (American Academy of Orthopaedic Surgeons)AAT (Art and Architecture Thesaurus)AHCPR (Agency for Health Care Policy and Research)AI/COAG (Artificial intelligence hemostasis

consultant system)AI/RHEUM (Artificial intelligencerheumatology

consultant system)AIDSDRUGS (AIDS drugs)AIDSLINE (AIDS information onLINE)AIDSTRIALS (AIDS ClinicalTRIALS)AKAT (Audio Knowledge Acquisition Tool)ANN (Artificial neural network)ANSWER (ATSDR/NLM's Workstation for Emergency

Response)APDB (AudiovisualProgram Development Branch)ARC (Annual Review of Carcinogens)ARL (Association of Research Libraries)ASB (Applications Services Branch)ASN (Abstract Syntax Notation)ATSDR (Agency for Toxic Substances and

Disease Registry)AVLINE (AudioVisuals onLINE)

BDIP Program (Biomedical Digital Image Processing)BICC (Biomedical Information Communications Center)BIOETHICSLINE (BIOETHICS onLINE)BIREME (Biblioteca Regional de Medicina - NLM's

MEDLARS Center in Brazil)BITNET (Because It's Time Network)BITNIS (BITNET NLM Intercommunication System)BLAST (Basic Local Alignment Search Tool)BOSC (Board of Scientific Counselors)CAFE (Cataloging Front-End)CANCERLIT (CANCERLITerature)CAS (Chemical Abstracts Service)CATLINE (CATalog onLINE)CCDS (Computer-based Curriculum Delivery Systems)CCEHRP (Committee to Coordinate Environmental

Health and Related Programs)CCRIS (Chemical Carcinogenesis Research

Information System)CD-ROM (Compact Disk-Read Only Memory)CHEMID (Chemical Identification File)CHEMLEARN (Microcomputer-based training

forCHEMLINE)CHEMLINE (CHEMical Dictionary OnLINE)

CLINPROT (CLINical cancer PROTocols)COACH (Expert searcher prototype system for Grateful

Med users)CODATA (Committee on Data for Science and

Technology)CRISP (Computer Retrieval of Informationon Scientific

Projects)CROSSFILE (Permits TOXNET users to search for data

from multiple files simultaneously)CSB (Computer Science Branch)CTX (Criteria Table Expert Systems)

DART (Developmental and Reproductive Toxicology)DBIR (Directory of Biotechnology Information

Resources)DENTALPROJ (Dental Projects database)DHHS (Department of Health and Human Services)DIRLINE (Directory of Information Resources Online)DOCLINE (DOCuments onLINE)DOCUSER (DOCument delivery USER)DRAW (Direct Read After Write—Disc)DSM-IIIR (American Psychiatric Association's

Diagnostic and Statistical Manual of MentalDisorders)

DSRT (Document Storage, Retrieval, and Transmission)DXP (Digital X-ray Prototype)

E.T. Net (Educational Technology Network)EDDS (Electronic Document Delivery SystemEDSR (Electronic Document Storage and Retrieval)EEO (Equal Employement Opportunity)EINECS (European Inventoryof Commercial

Chemical Substances)ELHILL (MEDLARS software named after

Senator Lister Hill)EMICBACK (Environmental Mutagen Information

Center Backfile)EPA (Environmental Protection Agency)ETICBACK (Environmental Teratology Information

Center Backfile)

FASEB (Federation of American Societies forExperimental Biology)

FEDRIP (Federal Research-In-Progress)FIRST (First Independent Research Support

and Transition)

60 Programs and Services, FY 1990

FTE (Full-time equivalents)

GenBank (National, NIH-supported DNA sequencedatabase)

Genlnfo (Databank of biological information aboutsequences, including the sequence itself, reflectingthe journal literature)

GM (Grateful Med)

HBCU's (Historically Black Colleges and Universities)HCTA (Health Care Technology Assessment)HEALTH (HEALTH planning & administration)HISTLINE (HISTory of medicine onLINE)HSDB (Hazardous Substances Data Bank)

1AIMS (Integrated Academic InformationManagement System)

ICST1 (International Council for Scientific andTechnical Information)

IEEE (Institute for Electrical and Electronics Engineers)ILAR (Institute of Laboratory Animal Research)ILL (Interlibrary Loan)INFORM (Used to obtain online NEWS and

systems information)INTROMED (A training/practice database)INTROTOX (A practice subset of HSDB for

TOXNET users)INVESTIGATOR (A research program for knowledge

acquisition planning)IRIS (Integrated Risk Information System)IRW (Image Retrieval Workstation)IRx (Information Retrieval Experiment)ISW (Image Server Workstation)ITB (Information Technology Branch)

JHU (Johns Hopkins University)

KB (Knowledge Base)

LAN (Local Area Network)LC (Library of Congress)LEXTOOL (An interactive lexicon building tool

for SPECIALIST)LHNCBC (Lister Hill National Center for Biomedical

Communications)LO (Library Operations)LSTRC (Literature Selection Technical Review

Committee)

MARC (Machine-Readable Catalog)MedlndEx (Medical Indexing Expert)MEDLARS (MEDical Literature Analysis and

Retrieval System)MEDLINE (MEDlars onLINE)MEDSTATS (Medical Statistics Expert System)

MEDTUTOR (Microcomputer-based tutorialfor MEDLINE)

MeSH (Medical Subject Headings)Micro-CSIN (Chemical Substances Information

Network)M1IS (Modified Interpretative Information System)MIM (Mendelian Inheritance in Man)MRAB (Machine-Readable Archives in Biomedicine)MRI (Magnetic resonance imaging)MUMPS (Massachusetts Utility Multi-Programming

System)

NAC (National Audiovisual Center)NCBI (NationalCenter for Biotechnology Information)NCHS (National Center for Health Statistics)NHANES (National Health and Nutrition Examination

Surveys)NIAMS (National Institute of Arthritis, Musculoskeletal

and Skin Diseases)NIEHS (National Institute of Environmental Health

Sciences)NIH (National Institutes of Health)NIOSH (National Institute for Occupational Safety

and Health)NLQ (Natural Language Query)NLS (Natural Language Systems)NTIS (National Technical Information Service)

OCCS (Office of Computer and CommunicationsSystems)

OCR (Optical character recognition)OHSU (Oregon Health Sciences University)OMIM (Online version, Mendelian Inheritance in Man)ORAU (Oak Ridge Associated Universities)ORNL (Oak Ridge National Laboratory)ORW (Online Reference Works)

PAHO (Pan American Health Organization)PAM (Principals of Ambulatory Medicine)PDQ (Physician Data Query)PIR (Protein Identification Resource)POPLINE (POPulation information onLINE)

RDBMS (Relational Database Management System)REFLINE (Subset of MEDLINE for NLM patrons)RML (Regional Medical Library)RQ List (Hazardous Substances Reportable Quantities

List)RTECS (Registry of Toxic Effects of Chemical

Substances)

SAAS (Selection and Acquisition Subsystem)SAIL (System for Automated Interlibrary Loan)

Acronyms, Abbreviations, and Initialisms 61

SDILINE (Selective Dissemination of InformationonLINE)

SERHOLD (Serial Holdings)SIC (Subcommittee on Information Coordination)SIS (Speciali/ed Information Services)SPECIALIST (experimental system for parsing,

analyzing, and accessing medical text)SPIE (Society of Photo-optical Instrumentation

Engineers)STIC (Science and Technology Information Center)SUPERLIST (Chemicals having regulatory or health

importance found on one or more of 16 Federal andState government lists.)

TESS (Technical Services System)TIP (Toxicology Information Program)TLC (The Learning Center for Interactive Technology)TOXLEARN (Microcomputer-based training for

TOXLINE)TOXLINE (TOXicology Information OnLINE)TOXLIT (TOXicology LITerature from special sources)TRI (Toxic Chemical Release Inventory)TSCA (Toxic Substances Control Act)

UMLS (Unified Medical Language System)

WHO (World Health Organization)WORM (Write Once Read Many—Disc)

62

APPENDIX 2: STAFF BIBLIOGRAPHY

Ackerman MJ. Computer briefs: computer virusesrevisited. J Med Pract Manag 1990 (̂3): 185-6.

Ackerman MJ. Computer briefs: understanding thelanguage of technology. J Med Pract Manag.1990;5(4):262-3.

Altschul SF, Lipman DJ. Protein database searchesfor multiple alignments. Proc Natl Acad Sci 1990;87:5509-13.

Arenales DW, Sinn SK. How to amputate: rules forjournal title abbreviations. CBE [Council of BiologyEditors] Views 1989;12(6):106-8.

Backus JEB. NATASHA National Archive onSexuality, Health, and Adolescence. CD-ROM Librarian1990;5(4):41-5.

Benson D, Boguski MS, Lipman DJ, Ostell J. TheNational Center for Biotechnology Information.Genomics 1990;6:389-91.

Black DE. The impact of the goal-setting process onsmall and small disadvantaged businesses. ContractManagement 1990;30(5):40-1.

Bleasby AJ, Wootton JC. Construction of validated,non-redundant composite protein sequence databases.Protein Engineering 1990;3:153-9.

Boguski MS. Big biology needs theoreticians. [Letterto the Editor]. Johns Hopkins Magazine 1990;42(2):5.

Boguski MS, Sikorski RS, Hieter P, Goebl M.Expanding family. Nature 1990;346:114.

Boyd K. Rare books, rare birds: ornithology and itsillustrators, 1450-1900. In: Page J, Morton ES, eds. Lordsof the air: the Smithsonian book of birds. Washington,DC, Smithsonian, 1989;48-51.

Boyd K. Medicine and the naturalist tradition.Bethesda, MD: National Library of Medicine, 1989;36.

Brand JL. The United States Public Health Serviceand international health, 1945-1950. Bull Hist Med1989;63:579-98.

Bustin M, Lehn DA, Landsman D. Structuralfeatures of the HMG chromosomal proteins and theirgenes. Biochim Biophys Acta 1990;! 049:231 -43.

Cassedy JF. Bissett Hawkins and vital statistics inearly 19th century Britain. In: Hawkins FB. Elements ofmedical statistics. Canton, MA; Science HistoryPublications;vii-xiv.

Cassedy JF. Medical men and the ecology of the oldSouth. In: Numbers RL, Savitt TL, eds. Science andmedicine in the old South. Baton Rouge, LA: LSU, 1989;166-78.

Clack ME, Riddick JF, Rowe RR, Arenales DW,Intner SS. The future of serials librarianship:part 2.Serials Review 1990;16(3):61-7.

Colaianni LA. The biological and medical scienceslibraries section of IFLA: a brief history. Librarianshipand Bibliography Abroad 1990;125;10-9.

Cookson JC, Sneiderman C, Colaianni JV, Hood A:Image compression for dermatology. Proceedings of theSociety of Photo-Optical Instrumentation Engineers,medical imaging IV 1990;!232:365-79.

Cosmides GJ. Toxicological information. FundamAppl Toxicol 1990;14(3):43943.

Crisci M. Public health in New York City in the latenineteenth century. Bethosda, MD: National LibraryofMedicine, 1990;22.

Dutcher GA. D I R L I N E : a national healthinformation and referral database. In: Mayfield-Smith K,Wiles DL, eds. Proceedings, fourth annual nationalsymposium on information technology as a resource tohealth and disability professionals. Columbia, SC:University of South Carolina, 1989;35-48.

Dutcher GA. DOCLINE: a national automatedinterlibrary loan request routing and referral system.Information Technology and Libraries 1989;8:359-70.

Ghosh D. A relational database of transcriptionfactors. Nucleic Acids Res 1990;!8:1749-56.

Ghosh D, Kieff E. Cis-acting regulatory elementsnear the Epstein-Barr virus latent-infection membraneprotein transcriptional start site. J Virol 1990;64:1855-8.

Hale PM, Cease KB, Houghten RM, Ouyang C,Putney S, Javaherian K, Margalit H, Cornette JL, SpougeJL, DeLisi C, Berzofsky J. T cell multideterminant regionsin the human immunodeficiency virus envelope:towards overcoming the problem of majorhistocompatibility complex restriction. Int Immunol1989;1:409-15.

Hauser SE, Thoma GR, Gass SI: Factors affecting theconversion rate of bound volumes to electronic form.Proceedings of electronic imaging '89 east conference.Waltham, MA: BIS CAP International, 1989;1041-6.

Staff Bibliography 63

Humphrey SM. MedlndEx: the medical indexingexpert system. In: Aluri R, Riggs DE, eds. Expert systemsin libraries. Norwood, NJ: Ablex, 1990;192-221.

Humphrey SM, Chien D. The MedlndEx systems:research on interactive knowledge-based indexing andknowledge management. NLM technical report no.NLM-LHC-90-03. Bethesda, MD: National Library ofMedicine, 1990;251.

Hunter L, ed. Working notes of the AAAI springsymposium series: artificial intelligence and molecularbiology. Menlo Park, CA: American Association forArtificial Intelligence, 1990;! 53.

Hunter L. Introduction:artificial intelligence andmolecular biology in the 1990s. In: Hunter L, ed.Working notes of the AAAI spring symposium seriessymposium: artificial intelligence and molecular biology.Menlo Park, CA: American Association for ArtificialIntelligence, 1990;l-3.

Hunter L. Knowledge acquisition planning forinterference from large datasets. In: Shriver BD, ed.Proceedings of the twenty-third annual Hawaiiinternational conference on system sciences; vol 2:Software track. Los Alamitos,CA: IEEE, 1990;35-44.

Hunter L Planning to learn. In: Piatelli-Palmarini M,ed. Proceedings of the twelfth annual conference of theCognitive Science Society. Hillsdale, NJ: LawrenceErlbaum Associates, 1990;26-34.

Karlin S, Altschul SF. Methods for assessing thestatistical significance of molecular sequence features byusing general scoring schemes. Proc Natl Acad Sci1990;87:2264-8.

Kingsland LC HI, ed. Computer methods andprograms in biomedicine [Special issue: finalists' papersfrom the student paper competitions at SCAMC 1987,198811989;30(2/3);72-237.

Kingsland LC III. Introduction. In: Kingsland LCIII,ed. Computer methods and programs in biomedicine[Special issue: finalists' papers from the student papercompetitions at SCAMC 1987,198811989;30(2/3);734.

Landsman D, Bustin M. Mouse non-histonechromosomal protein HMG-14 cDNA sequence. NucleicAcids Res 1990;!8:5311.

Layne SP, Dembo M, Spouge JL The kinetics of HIVinfectivity. Los Alamos Science 1989;! 8:90-109.

Layne SP, Merges MJ, Dembo M, Spouge JL, NaraPL. HIV requires multiple gp!20 molecules for CD4-mediated infection. Nature 1990;346:277-9.

Layne SP, Spouge JL, Dembo M. Measuring HIVinfectivity. In: Castillo-Chave/. C, ed. Lecture notes inbiomathematics: mathematical and statistical approachesto AIDS epidemiology. Berlin: Springer-Verlag, 1989;90-109.

Layne SP, Spouge JL, Dembo M. Quantifying theinfectivity of human immunodeficiency virus. Proc NatlAcad Sci USA 1989;86:4644-48.

Lindberg DAB. AMIA [American MedicalInformatics Association] comes of age. MD Comput1990;7:76-7.

Lindberg DAB. Information policy [Letter to theEditorl. Science 1989;22:1547-8.

Lindberg DAB. Information systems to supportmedical practice and scientific discovery. Methods InfMed 1989;28:202-6.

Lindberg DAB. NLM offering more access, services.US Med 1990;36:23 .̂

Lindberg DAB. The Unif ied Medical LanguageSystem (UMLS) of the National Library of Medicine. JAm Med Rec Assoc 1990;61(5):40-2.

Locatis C. Education and the National Library ofMedicine. Learning Resources Quarterly 1990 Spr/Sum:6-7.

Locatis C, Letourneau G, Banvard R. Hypermediaand instruction. Education Technology R&D1990;37(4):65-77.

McCray AT. Parsing, analyzing, and accessingbiomedical text. In: Kat/en J, Newby GB, eds.Proceedings of the 52nd annual meeting of the AmericanSociety for Information Science. Medford, NJ: LearnedInformation, 1989;!92-7.

McCray AT, Browne AC, Srinivasan S, Aronson AR,Waldspurger TA, Pufahl I. The SPECIALIST naturallanguage processing system. NLM technical report no.NLM-LHC-90-02. Bethesda, MD: National Library ofMedicine, 1990;31.

McCray AT, Srinivasan S. Automated access to alarge medical dictionary: online assistance for researchand application in natural language processing. ComputBiomed Res 1990;23(2): 179-98.

Mehnert RB. National Libraryof Medicine. BowkerAnnu 1990;35:153-6.

Mehnert RB.The National Library of Medicine. ALAYearbook 1990;!5:175.

Moens HJ, Kingsland LC III. Evaluation and furtherdevelopment of A I / R H E U M with data from 1570consecutive outpatients of a Dutch rheumatologicalclinic. In: Cooper G, Musen M, Patil R, Widman L, eds.Working notes of the AAAI spring symposium seriessymposium: AI in medicine. Menlo Park, CA: AmericanAssociation for Artificial Intelligence, 1990;141-4.

Parascandola J. The preposterous provision: theAmerican Society for Pharmacology and ExperimentalTherapeutics' ban on industrial pharmacologists, 1908-1941. In: Higby G, Stroud E, eds. Pill peddlers: essays onthe history of the pharmaceutical industry. Madison, WI:American Institute of the History of Pharmacy, 1990;29-47.

Peitsch M, Boguski MS. Is apolipoprotein D amammalian milin binding protein? The New Biologist1990;2:1-10.

64 s and Services, FY 1990

Popescu N, Landsman D, Bustin M. Mapping thehuman gene coding for chromosomal protein HMG-17.Hum Genet 1990;85:376-8.

Rapp BA, Siegel ER, Woodsmall RM, Lyon-Hartmann B. Evaluating MEDLINE on CD-ROM: anoverview of field tests in library and clinical settings.Online Rev 1990;14(3):172-86.

Richards DT. Collection assessment activities atNLM. Developments |MLA| 1990;2(2):4-8.

Richards DT. Collection assessment in sciencelibraries: an overview. In: Burkhart RW, Burkhart ], eds.IAMSL1C at a crossroads: proceedings of the 1989 annualmeeting. St. Petersburg, FL: Florida Marine ResearchInstitute, 1990;89-98.

Rudd KE, Miller W, Ostell J, Benson DA. Alignmentof Escherichia coli K12 DMA sequences to a genomicrestriction map. Nucleic Acids Res 1990;!8:313-21.

Schuyler PL, McCray AT, Schoolman HM. A testcollection for experimentation in bibliographic retrieval.In: Barber B, Cao D, Qin D, Wagner G, eds. MEDINFO89: proceedings of the sixth conference on medicalinformatics. Amsterdam: North-Holland, 1989;910-12.

Schuyler PL. Integrated access to medical andpharmacological information: the Unified MedicalLanguage System at the NLM. In: Collier H, ed.Proceedings of the international chemical informationconference. Calne, England: Infomortics, 199();195-203.

Segev I, Fleshman JW, Burke RE.Compartmentalmodels of complex neurons. In: Kovh V, Segev I.Methods of neuronal modeling: from synapses tonetworks. Cambridge, MA: MIT, 1989;63-96.

Siegel ER, Cummings MM, Woodsmall RM.Bibliographic retrieval systems. In: Shortliffe EH,Perreault LE, eds. Medical informatics: computerapplications in health care. New York: Addison-Wesley,1990;434-65.

Sikorski RS, Boguski MS, Goebl M, Hieter P. Arepeating amino acid motif in CDC23 defines a family ofproteins and a new relationship among genes requiredfor mitosis and RNA synthesis. Cell 1990;60:307-17.

Smith K. Profile: the U.S. National Library ofMedicine. ICSTI Forum [Quarterly Newsletter of theInternational Council for Scientific and TechnicalInformation] 1990;!:8-9.

Spann ML, Perkins ML. CHEMLEARN:microcomputer-based training for CHEMLINE, analternative to formal classroom training. J Chem InfComput Sci 1990;30:48-52.

Spouge JL. Speeding up dynamic programmingalgorithms for finding optimal lattice paths. SIAMJournal of Applied Mathematics 1990;9:1552-66.

Spouge JL, Layne SP, Dembo M. Analytic results forquantifying HIV infectivity. Bull Math Biol 1989;51:715-30.

Srikantha T, Landsman D, and Bustin M. A singlecopy gene for chicken chromosomalprotein HMG-14b

has evolutionary conserved features, has lost one of itsintrons and codes for a rapidly evolving protein. J MolBiol 1990;211:49-61.

Teigen P. Centers of medical publishing before 1641.Papers of the Bibliographical Society of America1989;83:207-13.

Thoma GR. Electronic imaging for documentpreservation. In. Roth JP, i-d. Proceedings of the opticalinformation systems '89 conference. Westport, CT:Meckler, 1989:7.1-7.7.

Thoma GR. Image classification research: newstrategies and techniques. Proc ASIS 1989;26:244-5.

Thoma GR, Gass SI, Kendrick C: Interlibrary loansvia facsimile: performance and cost analysis. Bethesda,MD: National Library of Medicine, 1990;102.

Thoma GR, Hauser SE, Walker FL. Managing anarchive of electronic document images. Proc ASIS1989;26:59-65.

Thoma GR, Walker FL, Hauser SE. Documentpreservation by electronic imaging. In: Roth JP, ed.Converting information for WORM optical storage: acase study approach. Westport, CT: Meckler, 1990;92-131.

Tilley CB. Help desk hotline—at your service:MEDLARS Q&A. Database 1990;l3(5):103-4.

Tilley CB. Medical databases and health informationsystems. In: Williams ME, ed. Annual review ofinformation science and technology 1990;25:313-82.

Trainor CD, Evans T, Felsenfeld G, Boguski MS.Structure and evolution of a human erythroidtranscription factor. Nature 1990;343:92-6.

Tunis E. Early Western manuscripts in the NationalLibrary of Medicine: a short-title list. Bethesda, MD:National Library of Medicine, 1989;6.

Waldspurger T. Programming in Prolog: a logicalchoice for NLP. NLP.* [Natural Language Processing!1990;1(2):34-8.

Wallingford KT, Humphreys BL, Sellinger NE,Siegel ER. Bibliographic retrieval: a survey of individualusers of MEDLINE. MD Comput 1990;7(3):166-71.

Wexler PI. Finding and using toxics information.Whole Earth Review 199();66:120-1.

Wexler PI. The framework of toxicologyinformation. Toxicology 1990;60:67-98.

Wexler PI. A survey of toxicological information.Fundam Appl Toxicol 1990;4:649-57.

Woolf SH, Benson DA. The medical informationneeds of internists and pediatricians at an academicmedical center. Bull Med Libr Assoc 1989;77:372-80.

Wright ND, Kotx.in S, Kalina CR. Errata,retractions,and comments: what they are and where to find them.CBE [Council of Biology Editorsl Views 199();13(2):45-6.

Yamamoto WS, Dixon WJ, Ledley RS, Waxman BD,Schoolman HM, Stead EA. Planting the seeds—a panel.In: Blum BI, Dunca K, eds. A history of medicalinformatics. New York: Addison-Wesley, 1990;48-73.

65

APPENDIX 3: FY1990 EXTRAMURAL PROGRAMS-SUPPORTED PUBLICATIONS

Abendroth TW, Greenes RA. A clinical algorithmprocessor: enabling flow charts to organize a variety ofphysician tasks. In: Kingsland,LC, ed. Proceedings of theThirteenth A n n u a l Symposium on ComputerApplications in MedicalCare; Nov. 5-8,1989; Wash., DC:IEEE Computer Society Press; 1989: 983-4. (T15 LM07037).

Abendroth TW, Greenes RA. Computer presentationof clinical algorithms. MD Comput; 1989; 6(5): 295-9. (T15LM 07037).

Atwater EC. Of grandes dames, surgeons andhospitals: Batavia, New York. J 1 list Med Allied Sci; May1990; 45(3): 414-51. (R01LM 04435).

Atwater EC. Women, surgeons, and a worthyenterprise: the general hospital comes to upper NewYork State. In: Long, DE, Golden, J, eds. Americanhospital: communities and social contexts. Ithaca, NY:Cornell University Press; 1990. (KOI LM 04435).

Ball S, Wright L, Mil ler PL. SENEX, an object-oriented biomedical knowledge base. In: Kingsland, LC,ed. Proceedings of the Thirteenth AnnualSymposium onComputer Applications in Medical Care; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press; 1989: 85-9. (T15 LM 07056).

Balla JI , Elstein AS, Christensen C. Obstacles toacceptance of clinical decision analysis. British MedicalJournal; Mar 4,1989; 298: 579-82. (R01LM 04583).

Bankowit/, RA, McNeil MA, Miller RA. Effect of acomputer-assisted general medicine diagnosticconsultation service on housestaff diagnostic strategy.Meth Inform Med; 1989; 28: 352-6. (R01 LM 04622).

Banks G. Artificial intelligence in medical diagnosis:the INTERNIST/CADUCEUS approach. CRC CriticalReviews in Medical Informatics; 1(1): 23-54. (R01 LM04431).

Beck JR. Evaluating serum tests for iron deficiency.Am J Clin Pathol; 1990; 93: 296-7. (K04 LM 00086).

Beck JR, Shult/. EK, Edwards BR. Medicalinformatics for the other ninety percent: the Dartmouthexperience. Acad Med; May 1990; 65(5): 298-301. (K04LM 00086).

Beck JR. On changing institutions. Medical DecisionMaking; 1990; 10:1. (K04 LM 00086).

Beck JR, Colice GL. Relative operating characteristicanalysis applied to tests of pulmonary function. SeminRespir Med; Jul 1989; 10(3): 211-7. (K04 LM 00086).

Beck JR. Touching all the bases in diagnostic testassessment. Am J Med; Mar 1990; 88: 203-4. (K04 LM(XX)86).

Bergeron BP, Greenes RA. Clinical skill-buildingsimulations in cardiology: HeartLab and EkgLab.Comput Methods Programs Biomed; 1989; 30: 111-26.(T15LM07037).

Bergeron BP. Microcomputer-based digital signalprocessing. Collegiate Microcomputer; Nov 1989; 7(4):339-64. (R01 LM04715).

Bergeron BP. Program instrumentation: a techniquefor evaluatingeducationalsoftware. CollegiateMicrocomputer; Feb 1990; 8(1): 34-46. (R01 LM 04715).

Brophy R, Brophy M. Medical sports fitness: anancient parody of Greek medicine. Literature andMedicine; 1989; 8:156-65. (R01 LM 03699).

Chandrasekaran B, Smith JW, Sticklen J. 'Deep'models and their relation to diagnosis. Artif Intell Med;1989; 1:29-40. (K04LM 00083).

Clyman JI, Black HR, Miller PL. Assessing practiceconformance for hypertension management using anexpert system. In: Kingsland,LC, ed. Proceedings of theThirteenth Annual Symposium on ComputerApplications in Medical Care; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press; 1989:124-8.(R01LM04336).

Cohn AI, Fisher PR, Mutalik P, Miller PL, Swett HA.AXON: a computer-based approach to intelligentretrieval of radiographic studies using "axes" of clinicalrelevance. In: Proceedings of MED1NFO-89; Dec 1989;Singapore: 432-6. (R01 LM 04336).

Cohn Al, Rosenbaum S, Factor M, Sittig DF,Gelemter D, Miller PL. Sequential clinical "scenes": aparadigm for computer-based intelligent hemodynamicmonitoring. In: Kingsland,LC, ed. Proceedings of theThirteenth AnnualSymposium on ComputerApplications in MedicalCare; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press; 1989: 5-KKROILM 04336).

Colice GL, Malenka DJ, Beck JR. Decision making atthe bedside. Sem Respir Med; Jul 1989; 10(3): 264-70.(K04 LM 00086).

Dejongh M, Smith JW. Integratingmultiple modelsof expertise. Proceedings of the AAAI SpringSymposium on AI in Medicine; Mar 27-29,1990;StanfordUniversity: 45-8. (K04LM 00083).

66 Services, FY 1990

DePuey EG, Garcia EV, E/querra NF. Three-dimensional techniques and artificial intelligence inthallium-201 cardiac imaging. AJR Am J Roentgenol; Jun1989; 152:1161-8. (R01 LM 04692).

Duffy, J. The Sanitarians:a history of Americanpublic health. Urbana, IL: Univ. of Illinois Press; 1990.(R01 LM 03549).

Elkin PL, McLatchey J, Packer M, Hoffer E, CiminoC, Studney D, Barnett GO. Automated batch searching ofMEDLINE for DXplain. In: Kingland, LC, ed.Proceedings of the Thirteenth Annual Symposium onComputer Applications in Medical Care; Nov. 5-8,1989;Wash., DC: IEEE Computer Society Press; 1989:436-40.(T15 LM 07037).

Elstein AS. Decision analysis in surgical education.World J Surg; 1989; 13: 287-91. (R01 LM 04583).

Elstein AS, Shulman LS, Sprafka SA. Medicalproblem solving: a ten-year retrospective. Evaluation &the Health Professions; Mar 1990; 13(1): 5-36. (R01 LM04583).

Estes JW, Kuhnke L. French observations of diseaseand drug use in late eighteenth century Cairo. J Hist MedAllied Sci; Apr 1984; 39:121-50. (R01 LM 03172).

E/querra NF, Garcia EV. Artificial intelligence innuclear medicine imaging. Am J Cardiac Imaging;Jun1989; 3(2): 130-41. (R01 LM 4692).

Factor M, Sittig DF, Cohn AI, Gelemter DH, MillerPL, Rosenbaum S. A parallel software architecture forbuilding intelligent medical monitors. In: Kingsland, LC,ed. Proceedings of the Thirteenth Annual Symposium onComputer Applications in Medical Care; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press; 1989:11-6.(T15LM07056).

Factor M, Gelemter DH. The process trellis: asoftware architecture for intelligent monitors. In:Proceedings:"Tools for Artificial Intelligence:TAI 89":IEEE Computer Society Press; 1989:174-81. (T15 LM07056).

Fertig S, Gelemter DH. FGP: a virtual machinefordatabase-driven expert systems. In: Proceedings of theIEEE International Workshop on Tools for ArtificialIntelligence: IEEE Computer Society Press; 1989: 388-92.(T15 LM 07056).

Fertig S, Gelemter D. Musing in an expert database.In: Proceedings of the Second International Conferenceon Expert Database Systems; April 1988; George MasonUniv., Fairfax, VA: 319-32. (T15 LM 07056).

Fraser J, Strohm P, Smith JW et al. Errors inabductive reasoning. In: 1989 IEEE InternationalConference on Systems, Man, and Cybernetics;conference proceedings; Nov 17-17,1989; Cambridge,MA: 1136-41. (K04 LM 00083).

Friedman CP, Twarog RG, File DD, Youngblood PL,deBliek R. Computer databases as an educational tool inthe basic sciences. Acad Med; 1990; 65(1): 15-6. (R01LM04843).

Gelbart NR. The French Revolution as medicalevent: the journalistic ga/e. History of European Ideas;1989; 10(4): 417-27. (R01 LM 04384).

Gordeeva ND, DevishviliVM, ZinchenkoVP.Microstructural analysis of the execution of complexmotor actions, methods and results. Zinchenko VP, ed.;Introduction by Cole M «ind Minick N. New Delhi, India:Amerind Publishing Co.; 1989. Distributed throughNational Technical Information Service. (01-517-N.48).

Graves J, Corcoran S. Design of nursing informationsystems: conceptual and practice elements. J Prof Nurs;May-Jun 1988; 4(3): 168-77. (T15 LM 07041).

Graves JR, Corcoran S. The study of nursinginformatics. IMAGE: J Nurs Scholarship; Winter 1989;21(4): 227-31. (T15 LM 07041).

Greenes RA. "Desktop knowledge": a new focus formedical education and decision support. In: Salamon R,Protti D, Moehr J, eds. Proceedings of the InternationalSymposium of Medical Informatics and Education;May1989; University of Victoria, BC, Canada: 89-96. (T15 LM07037).

Greenes RA, Tarabar D, Slosser E. Explorer-2: amulti-modal knowledge management framework formedical education and decision support. In: Kingsland,LC, ed. Proceedings of the Thirteenth AnnualSymposium on Computer Applications in Medical Care;Nov. 5-8,1989; Wash., DC: IEEE Computer Society Press;1989:1024-5. (T15 LM 07037).

Greenes RA, Tarabar DB,Krauss M, Anderson G,Wolnik WJ, et al. Knowledge management as a decisionsupport method: a diagnostic workup strategyapplication. Comput Biomed Res; 1989; 22:113-35. (T15LM 07037).

Greenes RA, Shortliffe EH. Medical informatics; anemerging academic discipline and institutional priority.JAMA; Feb 23,1990; 263(8): 1114-20. (T15 LM 07037).

Haug PJ, Ranum DL, Frederick PR. Computeri/edextraction of coded findings from free-text radiologicreports. Radiology; Feb 1990; 174(2): 543-8. (R01LM04932).

Hawkins FB. Elementsof medical statistics.Introduction by Cassedy JH. New Delhi, India: AmerindPublishing Company. Distributed through ScienceHistory Publications; 1989. (01-517-N.41).

Haynes RB, McKibbon KA, Walker CJ, Ryan N,Fit/gerald D, Ramsden MF.Online access to MEDLINEin clinical settings. Ann Intern Med; 1990; 112:78-84. (R01LM 04696).

Haynes RB. Organi/ing and accessing the literature.Bull N Y Acad Med; Jul-Aug 1989; 65(6): 673-86. (R01 LM4096).

Healy JC, Spackman KA, Beck JR. Small expertsystems in clinical pathology. Arch Pathol Lab Med; Sep1989; 113:981-3. (K04LM 00086).

Extramural Programs-Support Publications 67

Healy JC, Rainer RO, Beck JR. Wright-Giemsa:automated generation of peripheral blood smears forhematology education. In: Kingsland, LC, ed.Proceedings of the Thirteenth Annual Symposium onComputer Applications in MedicalCare; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press: 907-10.(K04 LM 00084).

Hendrickson G, Doddato TM. Setting prioritiesduring the shortage. Nurs Outlook; Nov/Dec 1989; 37(6):280-4. (G08 LM 04419).

Hendricks RL. Liberal default, labor support, andconservative neutrality: the Kaiser Permanente MedicalCare Program after World War II . J Policy Hist; 1989;1(2):156-80.(R01 LM 04902).

Hippocrates Vol. VI. Potter, P, trans. Cambridge,MA: Loeb Classical Library, Harvard University Press;1988. (R01LM02813).

Jarcho S, trans. Clinical consultations and letters byIppolito Francesco Albertini, Francesco Torti and otherphysicians. Boston, MA: The Francis A. CountwayLibrary of Medicine; 1989. (R01 LM 04047).

Johnson K, SticklenJ, Smith J W. IDABLE—application of an intelligent data base to medicalsystems. In: Proceedings of the 1988 Spring SymposiumSeries on Artificial Intelligence in Medicine; Mar 22-24,1988; Stanford, CA: 43-4. (K04 LM 00083).

Johnson KA, Smith J W, Smith P. Design of a bloodbank tutor. In: Proceedings of the AAAI SpringSymposium on Al in Medicine; Mar 27-29,1990; StanfordUniversity: 1024. (K04 LM 00083).

Johnson TR, Smith JW. A flexible technique forabduction. In: Proceedings of the AAAI SpringSymposium Series on AI in Medicine; Mar 27-29,1990;Stanford University: 105-7. (K04 LM 00083).

Johnson TR, Smith J W, Bylander T. HYPER—hypothesis matching using compiled knowledge. In:Proceedings of the 1988 Spring Symposium Series onArtificial Intelligence in Medicine;Mar 22-24,1988;Stanford University: 45-6. (K04 LM 00083).

Kairys SW, Olmstead EM, O'Connor GT. Steroidtreatment of laryngotracheitis: a meta-analysis of theevidence from randomi/ed trials. Pediatrics; May 1989;83(5): 683-93. (R01 LM 04667).

Kalet IJ, Palus/ynski WS. Optimi/ation of radiationtherapy treatment plans using structured evaluation. In:AAAI Spring Symposium Series. Symposium: Al inMedicine; Mar 27-9,1990; Stanford Univ: 110-2. (R01 LM04174).

Kassirer JP, Kopelman RI. What is a differentialdiagnosis? Hosp Pract; Aug 15,1990:19-28. (R01 LM04493).

Kleinmunt/ B.Clinical and actuarial judgment.Science; Jan 12,1990; 247:146. (R01LM 04583).

Kleinmunt/ B. Why we still use our heads instead offormulas: toward an integrative approach. Psychol Bull;1990; 107(3):296-310. (R01LM 04583).

Konyukhov VC. Developmental genetics ofvertebrates. Carlson BM,ed. New Delhi, India: AmerindPublishing Co. Distributed through theNationalTechnical Information Service; 1990. (01-513-N.28).

Kuhnke L. Lives at risk: public health in Nineteenth-Century Egypt. Berkeley,CA: Universityof CaliforniaPress; 1990. (R01 LM03127).

Lindsley D, Zimm, G. Drosophila informationservice 68: the genome of drosophila melanogaster, Part4: genes L-Z, balancers, transposable elements. La Jolla,CA: Universityof Calif., San Diego; 1990. (R01 LM03689).

Lyon HC, Henderson JV, Beck JR et al. Amultipurpose interactive videodisc with ethical, legal,medical, educational and research implications: theinformed patient decision-making procedure. In:Kingsland LC, ed. Proceedings of the Thirteenth AnnualSymposium on Computer Applications in Medical Care;Nov 5-8,1989; Washington, DC: IEEE Computer SocietyPress: 1043-5. (K04LM (XX)86).

Malenka DJ, Colice GL, Jacobs C, BeckJR.Mediastinal staging in non-small-cell lung cancer.Medical Decision Making; Oct-Dec 1989; 9(4): 231-42.(K04 LM 00086).

McKinin EJ, Sievert ME. A comparison of full-textand abstracts for information retrieval in clinicalmedicine. In: Proceedings of the Tenth National OnlineMeeting; May 9-11,1989; New York:295-301. (R01LM04605).

McKinin EJ,Sievert ME, Johnson ED. Usingrepetition to increase precision in files with large blocksof text. Online Review; 1989; 13(5): 369-82. (R01LM04605).

Mi MP. Book review; Handbook of record linkage;methods for health and statistical studies,administration, and business, H.B. Newcombe, Oxford,England: Oxford University Press, 1988,210 pp, $40.00.Genet Epidemiol; 1989; 6: 553-5. (R01 LM 04617).

Miller PL. Exploringthe critiquingapproach: clinicalpractice-based feedback by computer. Biomed MeasInforContr; 1987-8; 2(2): 108-2. (R01 LM 04336).

Miller PL, Ball S, Kidd KK. The human genemapping library database: representational challengesposed by new bioscience technologies and by evolvingbiomedical knowledge. In: Kingsland,LC, ed.Proceedings of the Thirteenth Annual Symposium onComputer Applications in Medical Care; Nov 5-8,1989;Washington, DC: IEEE Computer Society Press; 1989: 81-4.(T15LM07056).

Miller RA, Masarie FE. Use of the Quick MedicalReference (QMR)Program as a tool for medicalinformation. Meth Inform Med; 1989; 28: 340-5. (R01 LM04622).

O'Connor GT, Olmstead EM, Zug K, Baughman RD,Beck JR, Dunn JL, Seal P, LewandowskiJF. Detection ofhepatotoxicity associated with methotrexate therapy for

68 Programs niui Services, FY 1990

psoriasis. Arch Dermatol;Sep 1989; 125:1209-17. (R01LM 04667).

O'Connor GT, Buring JE, Yusuf S, Goldhabor SZ,Olmstead EM, Paffenbarger RS,Hennekens CH. Anoverview of randomi/ed trials of rehabilitation withexercise after myocardial infarction. Circulation; Aug1989; 80(2): 234-44. (R01 LM 04667).

Owen RL, Staib LH, Anandan P, Duncan JS.Measurement of left ventricularwall motion fromcontour shape deformation. In: Proceedings of the 1989International Conference on Information Processing inMedical Imaging; June 1989; Berkeley, CA: 1-16. (T15 LM07056).

Packard R. White plague, black labor: tuberculosisand the political economy of health and disease in SouthAfrica. Berkeley, CA: University of California Press;1989. (R01 LM 04532).

Packer MS, Hoffer EP, Barnett GO, Famiglietti KT,Kim RJ, McLatchey JP, Elkin PL, Cimino C, Studney DR.Evolution of DXplain: a decision support system. In:Kingsland, LC, ed. Proceedings of the Thirteenth AnnualSymposium on Computer Applications in Medical Care;Nov. 5-8,1989; Wash., DC: IEEE Computer Society Press;1989: 949-51. (T15 LM 07037).

Palusxynski W, Kalet I. Cancer radiotherapy:treatment plan construction and optimi/ation. In:Proceedings 1988 Spring Symposium Series ArtificialIntelligence in Medicine; Mar 22-4,1988; Stanford Univ:67-8. (R01 LM04174).

Palus/ynski W, Kalet I. Design optimi/ation usingdynamic evaluation. In: Proceedings of the EleventhInternational Joint Conference on Artificial Intelligence,Vol. 2; Aug 20-5,1989; Detroit, MI: 1408-12. (R01LM04174).

Pao ML. A bibliometric analysis of research fundingin schistosomiasis: a progress report. Proceedings ofASIS; 1989; 26:156-61. (R01 LM 04680).

Pao ML. Compiling a database for libraryinformation science research. Journal of Education forLibrary and Information Science; Winter 1989; 29(3): 221-3. (R01 LM 04680).

Pao ML. Importance of quality data for bibliometricresearch. In: National Online Meeting Proceedings; 1989.NJ: Learned Information; 1989:321-7. (R01 LM 04680).

Parker RC, Miller RA. Creation of realistic appearingsimulated patient cases using the INTERNIST-1 /QMRknowledge base and interrelationship properties ofmanifestations. Meth Inform Med; 1989; 28: 346-51.(R01LM 04622).

Payne TH, Goodson JD, Morgan MM, Barnett GO.Antihypertensive medication selection in essentialhypertension: retrospective studies using COSTAR. In:Kingsland, LC, ed. Proceedings of the Thirteenth AnnualSymposium on Computer Applications in Medical Care;

Nov 5-8,1989; Wash., DC': IEEE Computer Society Press;1989: 718-22. (T15 LM 07037).

Perlin MW. Call-graph caching: transformingprograms into networks. In: Proceedings of the EleventhInternational Joint Conference on Artificial Intelligence;August 1989; Detroit, MI; 1989.: 122-8. (R01 LM 04707).

Perlin MW. In: Constraint-based specificationofproduction rules; October 1989; Fairfax, Va.: IEEEComputer Society Press; 1989: 332-8. (R01 LM 04704).

Perlin MW. A cooperative interface architecture fornetworks and users. In: 28th Annual TechnicalSymposium, National Instituteof Standards andTechnology; August 1989; Washington, DC: Associationfor Computing Machinery; 1989: 5-12. (R01 LM 04707).

Perlin MW, Debaud J-M.Match box: fine-grainedparallelism of the match level. In: IEEE InternationalWorkshop on Tools for Artificial Intelligence; October1989; Fairfax, Va.: IEEE Computer Society Press; 1989:428-34. (R01 LM 04707).

Perlin MW. Scoping, inheritance,and frames.Pittsburgh, Pa.: Sch. of Comp. Sci., Carnegie Mellon U.;Feb. 27,1990; CMU-CS-90-114; 13p. (R01 LM 04707).

Pincetl SP, Eccles RL, Barnett GO, Foster EA,Famiglietti KT, PigginsJL VLS-RENAL;an integratedbasic science reference tool. In: Kingsland, LC, ed.Proceedings of the Thirteenth AnnualSymposium onComputer Applications in Medical Care; Nov. 5-8,1989;Wash., DC: IEEE Computer Society Press; 1989:1033-4.(T15LM07037).

Politser PE. Cognitive guidelines for simplifyingmedical information: data framing and perception. JBehavioral Decision Making;1989; 2:149-65. (R01LM04132).

Politser PE. How to make laboratory informationmore informative: psychological and statisticalconsiderations. In: Keller H, Trendelenburg Ch, eds.Data presentation interpretation. New York: de Gruyter;1989:11-31.(R01 LM04132).

Politser PE. Medical education for a changing future:new concepts for revising texts. Med Educ; 1987; 21: 320-33. (R01 LM 04132).

Rabinowit/, M. Prerequisite knowledge for learningand problem solving. In: Hedley, C, Hout/, Baratta, A,eds. Cognition, curriculum, and literacy. Norwood, NJ:Ablex Publishing Corp.; 1990: 47-58. (R01 LM 04583).

Rathe R, Cope L, Greenes RA. System architecturefor a clinical workstation providing "point of use"knowledge access. In: Kingsland LC, ed. Proceedings ofthe Thirteenth Annual Symposium on ComputerApplications in Medical Care; Nov. 5-8,1989; Wash., DC:IEEE Computer Society Press; 1989: 669-72. (T15 LM07037).

Regan-Smith MG, O'Connor GT, Kwoh CK, BrownLA, Olmstead EM, BurnettJB. Lack of correlation

Extnwiural 69

between the Stembrocker staging of hand radiographsand the functional health status of individuals withrheumatoid arthritis Arthritis Rheum, Feb 1989,12(2)128-33 (R01 LM 04667)

Senyk O The integration of compiled and explicitcausal knowledge for diagnostic, reasoning In GreenesRA, ed Proceedings of the Twelfth Annual Symposiumon Computer Applications in Medical Care, Nov 6-9,1988, Washington, DC IEEE Computer Society Press,1988 106-9 R29 LM 04659)

Senyk O, Patil RS,Sonnenberg FA Systematicknowledge base design for medical diagnosis AppliedArtificial Intelligence, 1989,3 249-74 (R29 LM 04659)

Sievert ME, McKinin EJ, Slough M A comparison ofindexing and full-text for the retrieval of clinical medicalliterature In Borgman CL, Pai EYH,eds Proceedings ofthe 51st ASIS Annual Meeting, Got 23-7,1988, Atlanta,GA Medford, NJ Learned Information, 1988,25 143-6(R01 LM 04605)

Sievert ME, McKinin EJ Why full-text misses somerelevant documents an analysis of documents notretrieved by CCML or MEDIS In Kat/er,J, Newby GB,ed Proceedings of the 52nd ASIS Annual Meeting, Oct30-Nov2,1989, Wash, DC Medford, NJ LearnedInformation, Inc, 1989,26 34-8 (R01 LM 04605)

Sittig DF, Factor M Physiologic trend detection andartifact rejection a parallel implementation of a multi-state Kalman filtering algorithm In Kingsland, LC, edProceedings of the Thirteenth Annual Symposium onComputer Applications in Medical Care, Nov 5-8,1989,Washington, DC IEEE Computer Society Press, 1989569-74 (R01 LM 04336)

Smith J, Fischer O Towards taxonomies ofabductive systems at the knowledge and symbol levelIn Proceedings of the AAAI Spring Symposium Serieson AI in Medicine, Mar 27-29,1990, Stanford University171-5 (K04 LM 00083)

Smith JW, Svirbely JR Laboratory informationsystems In Shortliffe EH, Perreault LE, eds Medicalinformatics, computer applications in health careReading, MA Addison-Wesley, 1990 273-97 (K04 LM00083)

Staib LH, Duncan JS Left ventricular analysis fromcardiac images using deformable models InProceedings of Computers in Cardiology IEEEComputer Society Press, 1988 427-30 (T15 LM 07056)

Staib LH, Duncan JS Parametncally deformablecontour models In Proceedings of the IEEE ComputerSociety Conference on Computer Vision and PatternRecognition, June 4-8,1989, San Diego, CA Washington,DC IEEE Computer Society Press, 1989 98-103 (T15LM07056)

Stair TO, Corn M, Broenng NC First year'sexperience of the M AChnical computer workstations

project AcadMedJ.in 1990,65(1) 20-22 (G08 LM04392)

Svirbely JR, Smith JW, Speicher CE Computers andlaboratory information systems In SnyderJR,Senhauser DA, eds Administmtion and supervision inlaboratory medicine Second ed "hiladelphiaLippmcott, 1989 299-314 (K04 Livl 00083)

Swett HA, Fisher PR, Cohn A I, Miller PL, MutalikPG Expert system-controlled image display Radiology,1989,172 487-93 (T15 LM 07056 and R01 LM 04336)

Swett HA, Fisher P, Mutalik P, Miller PL Wright LThe I MAGE/ICON system voice activated intelligentimage display for radiologic diagnosis In Kingsland,LC, ed Proceedings of the Thirteenth AnnualSymposium on Computer Applications in Medical Care,Nov 5-8,1989, Washington, DC IEEE Computer SocietyPress, 1989 977-8 (R01 LM 04336)

Swett HA, Rothschild M, Weltm GG, Fisher PR,Miller PL Optimi/mg radiologic workup an artificialintelligence approach Journal of Digital Imaging, Feb1989,2(1) 15-20 (R01 LM 04336 and Tl5 LM 07056)

Tarabar DB,Greenes RA, Slosser ET An object-oriented software architecture for the Explorer-2knowledge management environment In KingslandLC, ed Proceedings of The Thirteenth AnnualSymposium on Computer Applications in Medical Care,Nov 5-8,1989, Wash , DC IEEE Computer Society Press,1989 93-97 (T15 LM 07037)

VirchowR Letters to his parents, 1839-1864 Rabl M,ed Translation revised and edited with an introductionand two appendices by Rather LJ Canton, MA ScienceI Iistory Publications, 1989 (01-517-N 01)

Walker CJ, McKibbon KA, Ryan NC, Ramsden MF,Fit/gerald D, Haynes RB Methods for assessing thecompetence of physicians' use of MEDLINE withGRATEFUL MED In Kingsland, LC, ed Proceedings ofthe Thirteenth Annual Symposium of ComputerApplications in Medical Care, Nov 5-8,1989,Washington, DC IEEE Computer Society Press 441-4(R01 LM 04696)

Wemstem MC, Graham JD, Siegel JE, Fmeberg HVCost-effectiveness analysis of AIDS preventionprograms concepts, complications, and illustrations InTurner CF, Miller HG, Moses LE,eds AIDS sexualbehavior and intravenous drug use Washington, DCNational Academy Press, 1989 471-99 (T15 LM 07037)

Wolff J The science of cancerous disease fromearliest times to the present, with a new introduction byJarcho S Canton, MA Science History Publications,1989 (01-513-N32and R01 LM 04293)

Wolford G, Taylor HA The conjunction fallacy'Memory & Cognition, 1990,18(1) 47-53 (K04 LM 00086)

70

APPENDIX 4: BOARD OF REGENTS

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

Appointed Members:

DETMER, Don E., M.D.(Chairman)Vice President for Health SciencesUniversity of VirginiaCharlottesville, VA

ANDERSON, Rachael K.Director, Health Sciences LibraryColumbia UniversityNew York, NY

BEERING, Steven C, M.D.President, Purdue UniversityWest Lafayette, IN

CAPE, Ronald E., Ph.D.Chairman, Cetus CorporationEmeryville, CA

COHN, Lawrence H.,M.D.Chief of Cardiac SurgeryBrigham and Women's HospitalBoston, MA

DAVIS, Ruth M., Ph.D.President, The Pymatuning Group, Inc.Arlington, VA

DeNARDIS, Lawrence]., Ph.D.President, Connecticut Public Expenditure CouncilHartford, CT

KAHN, Robert E., Ph.D.President, Corporation for National Research InitiativesReston, VA

SMITH, Alvy Ray, Ph.D.Executive Vice President, PixarRichmond, CA

SPURLOCK, Jeanne, M.D.Deputy Medical Director, andDirector, Department of Minority National AffairsAmerican Psychiatric AssociationWashington, DC

Ex Officio Members:

Librarian of Congress

Surgeon GeneralPublic Health Service

Surgeon GeneralDepartment of the Air Force

Surgeon GeneralDepartment of the Navy

Surgeon GeneralDepartment of the Army

Chief Medical DirectorDepartment of Veterans Affairs

Assistant Director for Biological SciencesNational Science Foundation

DirectorNational Agricultural Library

DeanUniformed Services University of the Health Sciences

77

APPENDIX 5: BOARD OF SCIENTIFIC COUNSELORS/LISTER HILL CENTER

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

Members:

YU, Victor L, M D (Chairman)Professor of MedicineUniversity of PittsburghPittsburgh, PA

BRUTLAG, Douglas L , Ph DAssociate Professor of BiochemistryStanford University School of MedicineStanford, CA

ERNST, Ruann F, Ph DDirector of MarketingInformation SystemsHewlett-Packard CompanyCupertino, CA

FOSTER, John, PhDProfessor and ChairDepartment of Electrical EngineeringNorth Carolina A & T State UniversityGreensboro, NC

FRISSE, Mark E , M DAssistant Professor of MedicineWashington UniversitySchool of MedicineSt Louis, MO

FRYBACK, Dennis G , Ph DProfessor, Department of Industrial EngineeringUniversity of Wisconsin-MadisonMadison, WI

HAMM, Gregory HDirector, Molecular Biology Computing LaboratoryWaksman InstituteRutgers UniversityPiscataway, NJ

LEHNERT, Wendy G , Ph DProfessor of Computer and Information ScienceDepartment of Computer and Information ScienceUniversity of MassachusettsAmherst, MA

72

APPENDIX 6: BOARD OF SCIENTIFIC COUNSELORS/NATIONAL CENTER FORBIOTECHNOLOGY INFORMATION

The NationalCenter for Biotechnology Information Board of Scientific Counselors meets periodically to reviewand make recommendations on the Library's biotechnology-related programs.

Members:

SAUER, Robert T., Ph.D. (Chairman) CANTOR, Charles R., I'll D.Professor, Department of Biology Professor, Departmentof Molecular BiologyMassachusetts Instituteof Technology University of CaliforniaCambridge, MA Berkeley, CA

ALONSO, Rafael, Ph.D. DHVEREUX, John R., Ph.D.Assistant Professor President,Genetics Computer Group, Inc.Department of Computer Science Madison, WlPrinceton UniversityPrinceton, NJ KELLY, Thomas J., M.D., Ph.D.

Professor and DirectorBERMAN, Helen M., Ph.D. Department of Molecular Biology and GeneticsProfessor, Department of Chemistry TheJohns \ lopkins University School of MedicineRutgers University Baltimore, MDPiscataway, NJ

APPENDIX 7: BIOMEDICAL LIBRARY REVIEW COMMITTEE

The Biomedical Library Review Committee meets three times n year to review applications for grants under theMedical Library Assistance Act.

Members:

STEAD, William W., M.D. (Chairman)Associate Professor of MedicineDirector, Medical Center Information SystemsDuke University Medical CenterDurham, NC

ABARBANEL, R.M., M.D., Ph.D.Manager, Engineering Computing and AnalysisBoeing Computer ServicesSeattle, WA

ABOLA, Enrique E., Ph.D.Associate ChemistDepartment of ChemistryBrcx)khaven NationalLaboratoryUpton, NY

BECKJ. Robert, M.D.Director, Biomedical Information

Communication CenterThe Oregon Health Sciences UniversityPortland, OR

BUCHANAN, Bruce C,., Ph.D.Professor of Computer Science, Philosophy

and MedicineUniversity of PittsburghPittsburgh, PA

CHANDRASEKARAN, B., Ph.D.Professor, Department of Computer and

Information ScienceOhio State UniversityColumbus, OH

FAZZONE, Nancy B.Director of Library ServicesSalem HospitalSalem, MA

FENICHEL, Carol H., Ph.D.Director of the Library and Professor of

Information ScienceI lahnemannUniversityPhiladelphia, PA

FRIEDMAN, Charles P., Ph.D.Director, Laboratory for Computing and CognitionUniversity of North Carolina School of MedicineChapel Hill, NC

FULLER, Sherrilynne, Ph.D.Director, Health Sciences Library and

Information CenterUniversity of WashingtonSeattle, W A 98195

GARDNER, Reed M., Ph.D.Professor, Department of Medical InformaticsUniversity of UtahSalt Lake City, UT

HAMBERG, Cheryl J.Director of the LibraryMeharry Medical College LibraryNashville, TN

IIAYNES, R. Brian, M.D.Chief, Health Information Research UnitMcMaster UniversityI lamilton, Ontario

JAFFE,ConradeC, M.D.Professor of Diagnostic Radiology and Internal MedicineYale UniversityNew Haven, CT

MESSERLE, JudithLibrarianThe Francis A. Countway Library of MedicineI larvard Medical SchoolBoston, MA

74 s and Services, FY 79.90

MYERS, Eugene W., I'h.D.Associate ProfessorDepartment of Computer ScienceUniversity of ArizonaTucson, AZ

I'EARSON, William R., Ph.D.Associate ProfessorUniversity of Virginia Schcx>l of MedicineCharlottesville, VA

SIEVERT, MaryEllen C., Ph.D.Associate ProfessorSchool of Library and Information ScienceUniversity of Missouri-ColumbiaColumbia, MO

STORMO, Gary D., Ph.D.Assistant ProfessorDepartment of Molecular, Cellular and

Developmental BiologyUniversity of ColoradoBoulder, CO

TRAVIS, Larry E., Ph.D.Professor of Computer SciencesUniversity of Wisconsin-MadisonMadison, WI

WILLIAMS, Arthur L, I'h.D.Associate Professor of BiologyDepartment of BiologyClark-Atlanta UniversityAtlanta, CA

75

APPENDIX 8: LITERATURE SELECTION TECHNICALREVIEW COMMITTEE

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

Members:

GUNN, Albert E., M.D.(Chairman)Associate Dean for AdmissionsThe University of Texas Medical School at HoustonHouston, TX

ANDERSON, Philip C, M.D.Professor and ChairmanDepartment of DermatologyUniversity of Missouri Sch(x>l of MedicineColumbia, MO

BERG, Alfred O., M.D., M.P.H.Associate Professor/Director of ResearchDepartment of Family MedicineUniversity of WashingtonSeattle, WA

BONAPARTE, Beverly H., Ph.D.President, The Gladstone Group, Inc.New York, NY

BRACHMAN, Philip S., M.D.Professor, School of Public HealthEmory UniversityAtlanta, GA

CASHEL,C. Michael, M.D., Ph.D.Chief, Section on Molecular RegulationsNational Institute of Child Health and Human

DevelopmentBethesda, MD

DeBAKEY, Lois E., Ph.D.Professor of Scientific CommunicationBaylor College of MedicineHouston, TX

EAKIN, DottieDirector, Medical Sciences LibraryTexas A & M UniversityCollege Station,TX

PARKER, Curtis L, Ph.D.Professor and Chairman of AnatomyMorehouse School of MedicineAtlanta, GA

RABSON, Alan S., M.D.,Director, Division of Cancer Biology and DiagnosisNational Cancer InstituteBethesda, MD

UTIGER, Robert D., M.D.Deputy EditorNew England Journal of MedicineBoston, MA

WEAVER, William Lynn, M.D.,F.A.C.S.Director of SurgeryInterfaith Medical CenterBnx)klyn, NY

Board of Regents (June 1990): Second row, from the left: Dr. Donald A. B.Lindberg; Dr. Alvy Ray Smith; Dr. Lawrence H. Cohn; Col. Howard E. Fauver,Jr.; Col. Charles K. Maffet; Mr. Duane Staub. Front row, from the left: Dr.Jeanne Spurlock; Dr. Kathleen A. McCormick; Dr. Ronald E. Cape; Ms. NinaW. Matheson; Dr. Edward A. Feigenbaum; Dr. Steven C. Beering; Ms.Karen Renninger; Dr. Mary E. Clutter; Dr. Don E. Detmer (Chairman).

The National Library of Medicine (building on right) contains the collection,Reading Rooms, offices, and work areas associated with the collection. The10-story Lister Hill Center (left) houses the Library's computer and audiovisualfacilities, auditorium, cafeteria, offices, and communication laboratories.

DISCRIMINATION PROHIBITED: Under provisions of applicable public laws enacted byCongress since 1964, no person in the United States shall, on the ground of race, color, nationalorigin, sex, or handicap, be excluded from participation in, be denied the benefits of, or be subjectedto discrimination under any program or activity receiving Federal financial assistance. In addition,Executive Order 11141 prohibits discrimination on the basis of age by contractors andsubcontractors in the performance of Federal contracts. Therefore, the National Library of Medicinemust be operated in compliance with these laws and executive order.

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