Giving Thanks Where Thanks is Due

One of the great joys of being the Director of the National Library of Medicine is the many opportunities for me to express gratitude. In the past, I have given thanks to NLM staff who are veterans (2021), for progress during my tenure (2020), and to our amazing NLM staff members (2019). This year, I am pausing to give thanks for the outstanding products and services developed and stewarded by our NLM staff, made available every day of the year to anyone with an internet connection—and even to some without!

First, I am thankful for our information collections in their many forms. The NLM Board of Regents oversees our Collection and Preservation Policy, which guides NLM as it meets its mission to acquire, organize, preserve, and disseminate biomedical knowledge from around the world. Our collection spans ten centuries from the 11th to the 21st, and ranges from the third oldest Arabic medical manuscript in existence to the “Rosetta Stone” of modern science, Marshall Nirenberg’s genetic chart, from genomic sequences essential for current and future research to information for mothers taking care of sick children.

Organizing the collections and making them findable and accessible builds on the knowledge of library and information science. This foundational knowledge means we can tag objects—real or virtual—with codes and terms that help with organization and retrieval. It also means we use our knowledge of library and information science to guide efforts to annotate and curate molecular data, literature citations, and images so they are accessible to the public. So I am grateful not only for the 66 miles of shelving that hold our precious objects, books, and journals here in Bethesda, but for the ever-powerful computer clouds that preserve our high-value research databases and 34 million bibliographic citations in PubMed. Libraries do more than house books; they use sophisticated knowledge to organize materials and make them readily available.

I am thankful for the ways that staff at NLM’s National Center for Biotechnology Information (NCBI) manages the submission, curation, and dissemination of our enormous genomic and molecular databases. From ClinVar (our collection of genomic sequences linked to clinical annotation) to the Sequence Read Archive (the world’s largest scientific data repository), our staff makes sure that depositors can effectively deposit data, scientific curators can conduct quality checks, and web and interface designers allow access to the data. A few years ago, the NCBI team led a cloud migration process to make available data from the entire 15-petabyte SRA resource on two commercial cloud providers. This bold step democratized sequence-based scientific inquiry and harnessed the computational power of cloud platforms, which contributed to industrial innovations and shortened the pathway for scientific discovery from days and months to minutes and hours. I am thankful for the role NLM plays in accelerating scientific advances and leveraging research resources for public health benefit.

NLM offers more than 1,000 easy-to-read health topic articles through our online consumer health information resource known as MedlinePlus. MedlinePlus is available in both English and Spanish, thereby assuring information access to speakers of two of the world’s most common languages. Through MedlinePlus Connect, our technical team also provides direct, tailored access to MedlinePlus resources automatically through electronic health records, patient portals, and other health information technology systems to deliver information from MedlinePlus to patients and providers at the point of care. I am thankful for the efforts of the MedlinePlus teams that bring timely and trusted information to the lives of everyone, everywhere.

I hinted earlier that there are two main pathways to access NLM products and services. Electronic access, supporting both human- and machine-readable forms, is by far the most common pathway to NLM. We also support the Network of the National Library of Medicine (NNLM) and its more than 8,000 members around the country in public, hospital, and academic medical center libraries to bring the power of NLM and its resources to the public. I am grateful for everyone who works as part of NNLM for their ability to bring NLM’s products and services to communities everywhere as well as how the needs and practices of those communities bring awareness of NLM.

As you pause this year in thanksgiving for the many public services that support you in everyday life, please remember to give thanks for NLM’s products and services. We think they are world class, and we are grateful for our ability to serve you.

What’s New in NLM’s Extramural Programs?

Guest post by Andrew Wiley, Video Producer, NLM Office of Communications and Public Liaison (OCPL).

NLM recently released videos on two exciting projects funded through the Extramural Programs Division.

Using Machine Intelligence to Prevent Medication Dispensing Errors

With help from an NLM grant, Drs. Corey Lester, Raed Al Kontar, and Xi Jessie Yang of the University of Michigan College of Pharmacy in Ann Arbor, Michigan, are using machine intelligence (MI) to assist in the pill verification process and help avoid dangerous and costly pharmacy dispensing errors.

Pharmacists play a critical role in helping safeguard people and communities, and we acknowledge their assistance this October as we celebrate American Pharmacists Month. Dr. Lester and his colleagues are making sure that MI reports accurate information to encourage providers to make sound, trustworthy decisions. In doing so, pharmacists can ensure that patients get the correct pills in the correct bottle and create safer systems that can save lives. Dr. Lester’s proposal was to develop and design artificial intelligence, specifically a computer vision model, that could look at a picture of pills inside a medication bottle and accurately identify the contents of that bottle.

Watch the video about this research and find the transcript here.

After Foster Care: Empowering Youths with Personal Health Records

At Cincinnati Children’s Hospital Medical Center, Dr. Dexheimer is using NLM grant funding to help young adults who are aging out of the foster care system access their personal health records. According to Dr. Dexheimer, there are 427,000 children in the foster care system, and approximately 5,000 youths emancipate, or age out, every year.

Using the Health Hero online platform, Dr. Dexheimer is providing emancipated young adults with access to and control over their own personal health records and improving their health care knowledge as a result. Health care outcomes for these young adults are poor partially due to lack of access to their medical history. The video also includes two young women who recently emancipated from foster care, who were willing to share their stories and experiences using Health Hero.

Watch the video about this effort and find the transcript here.

Get More Video Content and Learn More About NLM

Visit Welcome to NLM to take a virtual tour and to learn more about NLM’s programs, tools, and resources. Be sure to subscribe to the NLM YouTube channel for access to more great video content.

Mr. Wiley is a video producer and writer for NLM OCPL. Before joining NLM in 2008, Mr. Wiley produced local television in Frederick, Maryland and worked as a video journalist for The Frederick News-Post.

Engaging with Purpose: Libraries as Healing Spaces

Over the past month, students across the country started their first day of school—it’s a day of excitement, promise, and the hope of new growth. For some students, including those who were at Robb Elementary School in Uvalde, Texas, it’s a challenging time—how to reach for the future without the pain of the past. Importantly, libraries help!

Libraries know the importance of engaging with their communities, and they know how to do this. Over the summer, El Progreso Memorial Library in Uvalde, Texas, became a center of healing for the community—a place to bring people together in times of sorrow, as well as times of joy. I urge you to watch this news segment about how the El Progreso Memorial Library helped support its community in need and to think about the special role that libraries play in strengthening communities.

Through our Network of the National Library of Medicine (NNLM), NLM supports member libraries’ responses within communities around the country to address their health information needs. Our primary goal for engagement through the NNLM is to open a pathway between the community and NLM to make sure our resources are available, accessible, usable, and relevant to them, and to learn from them how they can best access our resources.

We can’t lift up communities without engaging with them, and we can’t be everything to communities. But by our engagement, we co-define the rules of engagement and show how what we do supports what they need.

The story of the El Progreso Memorial Library’s response to the needs of the Uvalde community inspired me in a way that I had not expected. Many times, the “rules of engagement” begin with a clear delineation of who we are and what our business is, essentially letting us step into a community with what we already know how to do. Suppose we started off at a different place—the place that engages with the community by beginning with the question, “What do you need?”

Now, starting with this question does not require us to be all things to all people—this would be foolhardy and frankly not something that would help us be true to our stewardship of the public’s federal investment. But… by starting with the question—“What do you need?”—perhaps we would organize our resources in ways we have yet to envision that make them even more accessible and responsive for those communities. This effort aligns with the second goal of the NLM Strategic Plan to engage with new people in new ways.

And maybe we would learn new things or more effective ways to reach communities. Libraries have a special space in the panoply of communities—we bring a wide range of resources to a wide range of people. Engaging with openness brings us closer to those who need us to bring those resources to them!

Please look around at the communities you are part of and that you serve. Think of how you reach into those communities and of new ways to ask, “What do you need?” to better understand how to serve them!

When You Stand on the Shoulders of a Giant, What Do You See?

This blog contains my remarks from the 2022 Lindberg-King Lecture and Scientific Symposium: Science, Society, and the Legacy of Donald A.B. Lindberg, M.D., which took place on September 1, 2022. Watch a recording of the event here.

I had the great fortune of becoming the director of the National Library of Medicine immediately following the 30-plus-year tenure of Donald A.B. Lindberg, MD. I am sure that each of you here today treasures your own recollection of Don, maybe from a conversation or a laugh you may have had with this great leader, teacher, visionary, and colleague (and husband to Mary, father, grandfather, and friend). I am both proud and humbled to stand on the shoulders of this giant as I lead this incredible organization.

I know more viscerally than most about Don’s legacy as NLM director. I sit in the office he occupied, I walk the halls he walked, I work with the people he hired, and I see and experience the fruits of his judgement, investments, and vision.

I now sit where Don once sat, representing NLM at the leadership table of NIH with the other Institute and Center directors. With Don paving the way, I have a platform to extend NLM’s thought leadership and technical knowledge to guide NIH’s continued efforts to advance data-driven discovery. The good will and collaborative spirit engendered by Don across NIH opened doors for me and helped me continue his legacy to deliver on the promise of science accelerated by broad access to literature and data.

Don and I share a deep commitment to ensuring that the public benefits from NLM’s efforts to assemble, organize, preserve, and disseminate biomedical knowledge for society. It was his early vision that made MedlinePlus a trusted resource for consumer health information and ensured that the PubMed citation database and the PubMed Central full-text literature repository were open and accessible to everyone, everywhere, with an Internet connection, at any time and place.  

Don’s commitment to the public was also evident in his efforts to educate the next generation of biomedical informatics scholars. Frankly, I believe that of all of the aspects of his job, engagement with trainees was his favorite!

When you stand on the shoulders of a giant, you have a great advantage. The foundation Don built and the relationships he established provided me, the 4th appointed director of NLM, with a playbook right out of the gate. It is not enough to solely rely on his vision to guide our future as Don also inspired innovation; in one of our last conversations, he said to me, “This is your game—make sure you play it well!” In order to do that, I cannot simply stand on the shoulders of a giant; I must also keep my head up and my eyes forward to the future to envision new pathways and find new opportunities to bring forward the riches of NLM to the future benefit of science and society.

I close by inviting all of you to stand on the shoulders of this giant and meld your sights with his, for it is not by holding tight to that which he could see, but by using his vision as a stepping-off point for our own that will serve his legacy.

NLM is Celebrating 40 Years of Biomedical Training

Guest post by Richard C. Palmer, DrPH, JD, Acting Director, Division of Extramural Programs, National Library of Medicine (NLM), National Institutes of Health (NIH).

This summer, NLM is marking its 40th year of supporting Biomedical Informatics and Data Research Training (T15). This is an amazing accomplishment, and I extend my congratulations to all the past and present institutional training grant directors, trainees, and NLM staff that have helped mature the field, grow the scientific workforce, and prepare this country for a biomedical revolution. This revolution harnesses the power of data to improve scientific exploration, clinical care, public health practice, and personal health.

Although almost 40 years have passed, NLM is more committed than ever to support career training, which is a central component of the NLM Strategic Plan. Recently, NLM released a new R25 program focused on supporting innovative educational programs and research experiences aimed at preparing talented and diverse students for future careers in biomedical informatics and data science. NLM also recently awarded 18 T15 grant awards, the largest number of awards made to date, to help ensure an available data-driven biomedical informatics and data science workforce. About 170 graduate and postdoctoral students will be trained annually by the T15 program to meet this growing workforce demand. NLM recognizes that we need to invest in training to ensure that a well-trained informatics and data science workforce exists to address the health needs of this nation.

Personally, I am amazed with just how fast the biomedical informatics and data science field has grown in the past 10 years. I entered this field with a study that aimed to build a clinical decision support tool to help manage fall risk for older adults—I vividly remember the headache associated with the interoperability (a computer or software inability to exchange and utilize data or other information) of data sources. Since then, I have witnessed rapid change occurring—due in part to the continued advances in computing, data storage, and standardization—that has allowed biomedical informatics to quickly advance. This change is occurring rapidly. To harness this acceleration in the acquisition, storage, retrieval, and use of information in health research and for the biomedical enterprise, we need a highly skilled workforce, and the demand for scientists trained in these areas and who can apply these skills to health and biomedicine is higher than the current supply. NLM’s commitment to training is helping ensure that a workforce capable of leading innovation exists.

Since joining NLM, I have had the opportunity to learn more about NLM’s T15 training program and the impact it’s had. Forty years is a long time, so I pieced together data to identify a common trend: The majority of the T15 trainees move on to research-oriented roles in academic institutions, not-for-profit research organizations, governmental and public health agencies, pharmaceutical and software companies, and health care organizations. Those in training over the past 10 years published 2,350 articles, with nearly 23% of these publications being highly cited, and were associated with 23 patents. In addition, T15 trainees are taking on leadership roles in academia, health centers, and research organizations. Even NIH’s own Dr. Josh Denny, who leads the All of Us program, and Dr. Michael Chiang, Director of the National Eye Institute, are former T15 trainees.

Just recently, I was able to participate in my first T15 trainee conference hosted by the University at Buffalo, SUNY and saw what research T15 trainees were involved with. What impressed me was the passion these trainees had for the science and their commitment to tackling pressing biomedical issues. Trainees are conducting research in areas including basic biomedical research, health care delivery, clinical and translational research, public health surveillance, and consumer health. Given their level of engagement, there is little doubt that many current T15 trainees will build successful scientific careers that will benefit society tremendously. At NLM, we are committed to training and fostering the development of the next generation of biomedical informatics and data scientists and look forward to the scientific advances they make. They say time flies when you’re having fun, and the last four decades sure have flown by. Here’s to another 40 years of NLM-supported training!

Dr. Palmer oversees NLM’s grant programs for research, resources, workforce development, and small business related to biomedical informatics and data science. Prior to joining NLM, Dr. Palmer was a Health Scientist Administrator at the National Institute on Minority Health and Health Disparities. He has over 25 years of extramural research experience and has been an investigator on NIH and CDC funded research grants. Dr. Palmer has conducted research in health care and community-based settings aimed at addressing health disparities, understanding health care decision-making, and improving health outcomes and disease management among older adults.

Want to learn more about NLM’s support for training?

View a panel discussion on Lindberg and the Advancement of Science through Research Training held during the 2022 Lindberg-King Lecture and Scientific Symposium: Science, Society, and the Legacy of Donald A.B. Lindberg, MD on September 1. The panel addressed the leadership of Dr. Donald A.B. Lindberg, former NLM director, in the advancement of science through research training with emphasis on the field of informatics.

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