We’re “Going to Have to Science the **** Out of This!”

When faced with the other-worldly, complex challenges of surviving on Mars after being left behind by his shipmates, Matt Damon, who plays an astronaut in the movie, The Martian, knows that his only chance of survival will require him to call on all of his scientific knowledge and understanding of the scientific method in order to meet his basic needs, explore new terrain, and establish new routines for everyday living.

Along the way, he must adapt to constant changes in the environment, technological disruptions, and the challenges of remote collaboration. Sound a little too familiar?  

The process of remote work that has become the new normal for most of NIH and NLM staff is beginning to resemble the experience of an astronaut stranded on Mars. It has required all of us to figure out how to meet our basic needs – food, socialization, activity, and rest; explore new terrain – home as the workplace; and identify new routines. We’ve continued to face man-made and natural challenges, such as fires, hurricanes and floods, been relegated to virtual meetings, and have worked collaboratively without the benefit of being in the same physical space. Yet, at no other time has it ever been so important for NLM to keep innovating for the future.  


I’m calling your attention back to the experience of our abandoned astronaut for a very specific reason — his use of scientific knowledge, insight, and experience to analyze opportunities and identify innovative solutions. This serves as a great model to illustrate the work happening at NLM.

NLM has prioritized the health and safety of our workforce while responding to COVID-19 and keeping our public-facing services available to the scientists, clinicians, patients, and families around the world who use them millions of times every day.  

We continue to work at the top of our game, adding nearly one million new citations in PubMed, expanding access to coronavirus literature through PubMed Central (PMC), and launching the first phase of the NIH Preprint Pilot to test the viability of making preprints searchable in PMC and increase the discoverability of early NIH-funded research results.

We’ve opened up new lines of research: our intramural investigators are applying their talents in computational modeling to examine microbiome in wastewater to detect evidence of the novel coronavirus, and using integrated comparative genomics and machine learning techniques to identify key genomic features that could differentiate SARS-CoV-2 from other strains of coronavirus that cause less severe disease.


Yet, it’s not enough to do just enough. We must continue to prepare to advance and support the future of scientific communication and build on the public’s trust in NLM.

It’s long been a hallmark of NLM to scan the external scientific environment, verify observed needs, and create scientific communication and dissemination tools to support the scientific environment.

Think back to the 1980s. Something was happening within our country (genomics revolution on the horizon) and across NLM (building the foundation of the scientific communication tools needed to support genomics) that led to the emergence of the National Center for Biotechnology Information in 1988.

Many, many forces needed to be aligned to make this happen: the critical vision of how a library could accelerate a genomics revolution; the talents of one of the best scientific analytical and communications workforces; the political goodwill of a Congress invigorated by scientific opportunity; the specific language needed to create the authorization legislation; and, of course, a bit of vision, hubris, and innovation brought about by the NLM team of Drs. David Lipman, James Ostell, Dennis Benson and David Landsman..


So how do we “science the **** out of this” to create the future of 2030 from the foundations of 2020? Doing for science what the decade of 1980-1990 did for genomics.  

First, we begin with our strongest suit — collecting, organizing, and disseminating scientific literature. We’re doing this by aligning our investment in novel products, such as moving NLM’s  Sequence Read Archive (SRA) to commercial cloud platforms, while stimulating new investigations such as computational approaches to curation at scale to accelerate the automated indexing of large health data sets. We’ll build on our strong foundation that grows from and relies on systematic, public-informed decision making related to the acquisition, indexing and dissemination of biomedical and health information as stated in our authorizing legislation. We’ll rely on our 2017-2027 Strategic Plan guided by the NLM Board of Regents. We’ll also engage our researchers and staff, who interact with the public, to make sure that NLM’s offerings are available to the public, 24/7, without charge or restriction.


What other sciences can help with this? Organizational science can help us remain open to future growth opportunities that may look different from our past successes. Public health sciences can identify the end-users of NLM services and offerings ranging from patients to clinicians to researchers to policymakers, so that we can continue to ensure we are meeting their needs. The biological, physical, and clinical sciences signal the future ways that we might understand the health and wellbeing of all, with social sciences providing tools to reposition organizations towards the future they hope to shape.

However, the marooned astronaut in the movie did not completely rely on science alone. You might remember his (dis)pleasure at discovering the disco music left by his commander. (He didn’t really like her choice of music.) This minor plot point tells us that to effectively “science the **** out of this” requires that we continue to look to the arts and humanities to translate science into the human experience to help us understand what goes on inside of us, and show us what it means to be a human being. The arts and humanities are an important part of the way we bring our own inspirations and ways to design the future.

How will we make this happen? We’ll need to identify, align, and share new models for innovation. We’ll have to learn to relax the structure of video conference technologies to mimic the hallway and in-person conversations and reduce the sense of ‘presentation’ on the screen to become presence in the moment.

But most importantly, we’ll need your ideas and guidance. How do we keep innovation alive under the constraints of our everyday life in COVID-19? Can you help inspire us to innovate?

All for One…Health for All: The Role of Open Access, Evidence-Based Information to Improve Health for All Species

Guest post by Kristine M. Alpi, MLS, MPH, PhD, AHIP, OHSU Library, Oregon Health & Science University; Tova Johnson, MPH, MA, MLIS, OHSU Library, Oregon Health & Science University; and Heather K. Moberly, MSLS, AHIP, FHEA, PgCert (Vet Ed), University Libraries, Texas A&M University

Physical isolation arising from the COVID-19 pandemic has led many people to increasingly engage with the outdoor environment or bring companion animals into their lives as supports for their physical and mental wellbeing.

This connection among the health of humans, animals, and the environment exemplifies the One Health approach. 

One Health is not new, but it has gained new life amid rising concerns over COVID-19 and the environment in recent years. This model encourages collaboration across disciplines, with experts in human, animal, and environmental health, along with other specialties, to achieve better public health outcomes. While leaders often come from veterinary medicine or public health, anyone committed to keeping the world healthy is a potential partner in One Health. 


Providing high-quality, timely information to the people and professionals who need it most is critical to protecting the health of people, animals, and the environment. The FDA uses the term animal health literacy to provide the public with information about drug and food safety concerns that can have an impact on animals and humans. The joint NLM/FDA resource, DailyMed, includes drug listings approved for either humans or animals.

NLM’s MedlinePlus online health information resource provides robust information on animal-human interactions, but typically with a focus on those that threaten human health such as animal bites or zoonoses (diseases that can be passed between humans and animals). To get information from animal health experts, we can look to information providers such as veterinary educators to provide insights offering the interconnected One Health perspective.

Just as MedlinePlus relies, in part, on health professional societies to provide information on specialized care, veterinary medicine trains specialists in topics ranging from behavior to surgery, and provides information to support decision-making about large and small companion animal healthcare. Animal health information in multiple languages is not centrally coordinated, but the American College of Veterinary Surgeons is one example that offers information in Spanish as well as English.


Beyond personal experiences caring for animals at home or at work, One Health is a critical framework for providing timely, open, high-quality information during times of wildfires and natural disasters that can affect all species. Responding to natural disasters brings together teams who work primarily with humans and teams who typically work with animals. Many veterinary schools provide emergency preparedness education in addition to deploying veterinary emergency teams to respond to emergency situations that may be all species-focused or primarily a human health oriented mission. Central knowledge resources like the American Red Cross also provide apps and information to support people and pets during times of crisis.

Libraries who participate in the NLM-supported Network of the National Library of Medicine are essential resources for people seeking information online from trusted sources. Health sciences librarians, particularly the members of the Medical Library Association’s Animal and Veterinary Information Specialist Caucus, support the health of all species by addressing questions raised by people who live, work, and share the broader environment with companion animals and wildlife. These questions may come to public, community college, and university libraries who rely on free and direct access to high-quality resources written for a variety of audiences.

We recently presented Health Questions for All Species as a free webinar for the Oregon Reference Summit to highlight how to use NLM and other open access, evidence-based resources to address One Health questions. We acknowledged the value of regionally and culturally specific resources for populations who are particularly challenged by certain conditions or environmental exposures, and discussed similarities and differences in human and animal information sources, terminology and readability.

We hope this information expanded your awareness about how NLM and other information resources can promote One Health through an integrated approach to searching and addressing issues that impact humans, animals and our environment.

The One Health Commission is a great place for educational resources for teachers and learners who want to take another step towards Health for All.

Did you learn something new today? What can you do to contribute to One Health?

Kristine M. Alpi, MLS, MPH, PhD, AHIP, OHSU Library, Oregon Health & Science University and Adjunct Assistant Professor, Department of Population Health & Pathobiology, North Carolina State University.

Tova Johnson, MPH, MA, MLIS, OHSU Library, Oregon Health & Science University.

Heather K. Moberly, MSLS, AHIP, FHEA, PgCert (Vet Ed), Medical Sciences Library and department of Veterinary Integrative Biosciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University. Heather is a 2020 recipient of the Friends of the National Library of Medicine’s Michael E. DeBakey Library Services Outreach Award

Biomedical Informatics and Health Equity: Using One to Improve the Other

Guest post by Kevin B. Johnson, MD, MS, Cornelius Vanderbilt Professor and Chair of Biomedical Informatics, and Professor of Pediatrics at Vanderbilt University Medical Center.

I started Informatics in the Round for a lay audience seeking to understand the world of biomedical informatics. There are other podcasts out there about the latest and the greatest in research, but I really wanted to create a space where people could learn more about the field and hear from leaders who continue to inspire me.

Earlier this month, #ShutDownSTEM gave me the opportunity to bring together academicians and biomedical informatics leaders to outline what our role as informaticians should be in the fight against racism in all its forms. One of the leaders who joined me in that discussion and encouraged me to share this with all of you was NLM Director Patricia Flatley Brennan, RN, PhD.

I often refer to Dr. Brennan as the newly minted matriarch of our field. Her contributions to this recent discussion were, not surprisingly, incredibly insightful. The entire conversation can be found here.

As chair of the Department of Biomedical Informatics at Vanderbilt and an informatics evangelist, I want — no, I need — to share some highlights from this conversation in the hope of broadening the discussion. There is much we haven’t done that is clearly within both our skill set and reach.

Click on the image above to listen to the full episode.

How Bioinformatics Can Support an Equitable Future

I started the conversation by setting the stage for a discussion of how biomedical informatics can play a role in the fight against racism. As a medical specialty, the field is about aggregating and transforming health data to create knowledge, improve lives, and build a world with better health outcomes.

We’ve been an equal opportunity field that thinks of technology as the great equalizer when it comes to health care. But we’ve missed a key opportunity to embrace equity along with equality. In an equitable world, the benefits of informatics would not simply be made available to all equally; rather, we would recognize, embrace, and adapt solutions to the unique needs of the many in our society who cannot type, who don’t speak English, who fear giving out private information to the government because of historical missteps, or who have jobs that challenge our traditional care models.

To respond to the realities of our built environment, our field needs to understand where the people are and what they need. From a technology standpoint, this requires designing models that reflect more than just the average care needs. We need to build technologies based on an understanding of how diverse people are, as opposed to how similar we are. We need to think about the presumptions that we make, often unconsciously, and how our presumptions get built into technologies.

A challenge that we often face in the field of informatics is that we spend a lot of time on the technology side and don’t pay enough attention to the people side. Some call this the “softer side,” and it’s often pushed to the side with the intention to address it later. Unconscious bias can show up in very subtle ways, such as sending out a confirmation email and presuming that there will be a response or assuming that a patient even has a personal email address. And we often picture the nuclear family when we think about relationships.

We need to immerse ourselves in diverse stories and relationships so that we can see how technology fits into people’s lives and how to create tools to meet their needs. For example, how do we help young-adult graduates of the foster care system collect and summarize their past medical histories from what could be a dozen different parents? 

As we think about how health care systems are built and experienced, let’s take into consideration factors that impact who is represented at all levels of those systems. Our actions are rarely nefarious and are quickly corrected when called out as biased, in most cases. But, unfortunately, groups that lack diversity don’t have stakeholders who easily notice when actions leave underrepresented groups behind. Where is our diversity in science?

During our conversation, we heard difficult messages from two younger Black faculty. One expressed fear that the issues that might propel them into a career in data science and informatics were not issues that would be rewarded through extramural funding and promotion. Another was convinced that the perception of academia as slow to embrace change, skeptical of new ideas, and mired in red tape was off-putting to people of color who historically have seen those behaviors lead to discriminatory actions. 

Those are tough pills to swallow, but things we need to confront directly.

Throughout the conversation, we examined our privilege and how we can break down barriers and eliminate anti-Black racism with the goal of equity in mind. There is no single answer, but the best thing we can give to young people and to our colleagues is the capacity to be brave. We also discussed how people who experience privilege must be willing to use that privilege to build bridges and close the gap. We need to continue to be voices that say these issues matter.

As we strive for justice and meaningful change, we need to better inform ourselves about the perceptions of underrepresented groups that negatively affect their career choices. We need to narrow the research funding gap and examine the peer-driven study process, including biases in the review process and in publishing.

The National Library of Medicine uses grant mechanisms (G08, R01) to develop informatics to reduce health disparities and supports research that examines how information can be presented in culturally relevant ways. NLM’s data science work, including COVID-19 research, encourages researchers to develop techniques that illustrate the causes of and solutions to the health disparities that exist in the world today.

I encourage you to listen to the full discussion to hear more from our thoughtful panelists.  

And I leave you with this challenge: What will you do today, or this year, to build bridges and close the gap on your team, in your workplace, and in your community?

Dr. Johnson received his MD from The Johns Hopkins Hospital in Baltimore and his MS in Medical Informatics from Stanford University. He is an internationally known scholar and educator in clinical informatics, having served as a board-certified pediatrician and consistently funded researcher as well as chief information officer during his tenure at Vanderbilt.  

In addition to leadership roles in the American Academy of Pediatrics, the American Board of Pediatrics, the American Medical Informatics Association, and the National Academy of Medicine, Dr. Johnson serves as chair of the 
NLM Board of Scientific Counselors and sits on the NIH Council of Councils.

NIH One Step Closer to Speeding Delivery of COVID-19 Testing Technologies to Those Who Need It Most Through RADx-UP

This piece was authored in collaboration with the leadership across NIH and represents a unified effort to meet the challenges presented by the COVID-19 pandemic with excellence and innovation.

Before the nation can safely return to business as usual, it will be essential to develop and deliver effective and reliable COVID-19 testing and then implement it widely so that it is available to everyone. The NIH is rising to this challenge through the NIH’s Rapid Acceleration of Diagnostics (RADx) initiative — a national call for scientists and organizations to advance their innovative ideas for new COVID-19 testing approaches and strategies.

To speed innovation in the development, commercialization, and implementation of technologies for COVID-19 testing, NIH will use a variety of mechanisms, including extramural grants, contracts, and cooperative agreements, to move more advanced diagnostic technologies swiftly through the development pipeline toward commercialization and widespread availability — with the goal of making millions of tests available to Americans each week, especially those most vulnerable to and disproportionately affected by COVID-19.

To achieve this goal, NIH is partnering with other government organizations including the Biomedical Advanced Research and Development Authority (BARDA), the Centers for Disease Control and Prevention (CDC), the Defense Advanced Research Projects Agency (DARPA), the Health Resources and Services Administration (HRSA), and the U.S. Food and Drug Administration (FDA). 

RADx Underserved Populations (RADx-UP)

One of the four RADx components, RADx Underserved Populations (RADx-UP) will establish a network of community-engaged projects to improve access to and acceptance of COVID-19 testing for underserved and vulnerable populations who are disproportionately affected by COVID-19. This includes populations most affected by health disparities, particularly African Americans, Hispanics or Latinos, and American Indians/Alaska Natives; those in nursing homes, jails, rural areas, or underserved urban areas; pregnant women; and the homeless.

The overarching goal of RADx-UP is to understand the factors associated with disparities in COVID-19 morbidity and mortality and, ultimately, to mitigate them through enhanced access to or acceptance of testing. RADx-UP will utilize implementation science projects to learn how to increase uptake of viral testing and engagement with care in these populations, who are disproportionately affected by, have the highest infection rates of, or are most at risk for complications or poor outcomes from the COVID-19 pandemic.

Specific activities of RADx-UP may include establishing multiple clinical research sites across the country to conduct real-time evaluations of a variety of testing methods in specific populations, areas, and settings, as well as encouraging collaboration between the program sites and the community — such as tribal health centers, places of worship, homeless shelters, and prison systems — to identify and address their unique needs.

This initiative will also develop testing strategies to apply the technological advances emerging from the various RADx efforts in real-world settings.

The RADx-UP program includes four associated funding opportunity announcements.

The first funding opportunity is a limited solicitation targeting networks and consortia with established research infrastructures and community partnerships with underserved and vulnerable communities. The goal of this funding opportunity is to better understand COVID-19 testing patterns and implement strategies or interventions with the potential to rapidly increase reach, access, acceptance, uptake, and sustainment of FDA-authorized and approved diagnostics among vulnerable populations in underserved geographic locations. Proposals are due August 7, 2020. 

The second funding opportunity has a similar focus, but shifts the pool of grants eligible for supplements to individual research awards that include community-collaborations or partnerships to support COVID-19 testing, or that have the capacity to ramp up quickly, to reach underserved or vulnerable populations. Proposals are due August 7, 2020 and September 8, 2020.

The third funding opportunity addresses the urgent need to understand the social, ethical, and behavioral implications  of COVID-19 testing among underserved and/or vulnerable populations across the United States. The overarching goal is to understand factors that have led to disproportionate burden of the pandemic on these underserved populations so that interventions can be implemented to decrease these disparities. Proposals are due August 7, 2020 and September 8, 2020.

The final funding opportunity will fund a single organization to create a Coordination and Data Collection Center that will serve as a national resource, working with NIH scientific staff, and consortium members to coordinate and facilitate research activities across the programs supported by the funding opportunities identified above. Proposals are due August 7, 2020.

The other elements of RADx are:

  • RADx Tech (RADx-tech) to speed the development, validation, and commercialization of innovative point-of-care and home-based tests, as well as improve clinical laboratory tests that can directly detect SARS CoV-2, the virus that causes COVID-19. Led by the National Institute of Biomedical Imaging and Bioengineering, this fast track program leverages the Point of Care Technologies Research Network (POCTRN) to stimulate the development and commercialization of innovative technologies to significantly increase the nation’s testing capacity for SARS CoV-2.. 
  • RADx Radical (RADx-rad) to support new, non-traditional approaches, including the development of rapid detection devices and home-based testing technologies, that address gaps in current COVID-19 testing mechanisms. The program will also support new or non-traditional applications of existing approaches to make them more usable, accessible, or accurate. These may lead to new ways to identify the  SARS-CoV-2 virus as well as potential future viruses. Watch for new funding announcements from this program later this summer.
  • RADx Advanced Technology Platforms (RADx-ATP) to increase testing capacity and output by identifying existing and late-stage testing platforms for COVID-19 that are advanced enough to achieve rapid scale-up or expanded geographical placement in a short amount of time. These efforts will focus on scaling up technologies, including improving existing high-throughput platforms, to increase overall performance.

Want to Learn More?

If you are interested in learning more, NIH will hold two pre-application webinars. Registration is required

  • The first webinar will be held on Friday, June 26, 2020, from 2:00pm – 4:00pm EDT. This webinar will provide an overview of the RADx-UP initiative, followed by presentations on each funding opportunity (NOT-OD-20-119, NOT-OD-20-120, NOT-OD-20-121, and RFA-OD-20-013).
  • The second webinar will be held on Wednesday, July 1, 2020, from 3:00pm – 5:00pm EDT. This webinar will focus on questions for applications for the Coordinating and Data Collection Center in response to RFA-OD-20-013. Questions related to the other three FOAs will also be addressed.

During this period of heightened awareness about the ways social injustices contribute to ongoing health disparities, it is essential that agencies use their mission-focused efforts to understand and, where possible, ameliorate health disparities.

Please let us know how you believe we can better serve science and society.

Top Row (left to right):
Diana W. Bianchi, M.D., Director, Eunice Kennedy Shriver National Institute of Child Health and Human Development 
Patricia Flatley Brennan, R.N., Ph.D., Director, National Library of Medicine
Gary H. Gibbons, M.D., Director, National Heart, Lung, and Blood Institute
Joshua Gordon, M.D., Ph.D., Director, National Institute of Mental Health
 
Middle Row (left to right):
Richard J. Hodes, M.D., Director, National Institute on Aging
Jon R. Lorsch, Ph.D., Director, National Institute of General Medical Sciences
George A. Mensah, M.D., Division Director, National Heart, Lung, and Blood Institute
Eliseo J. Pérez-Stable, M.D., Director, National Institute on Minority Health and Health Disparities
 
Bottom Row (left to right):
William Riley, Ph.D., Director, NIH Office of Behavioral and Social Sciences Research
Tara A. Schwetz, Ph.D., Associate Deputy Director, National Institutes of Health and Acting Director, National Institute of Nursing Research
Nora D. Volkow, M.D., Director, National Institute on Drug

Graduation 2020: Tradition in the Midst of Change

Each year around this time, I’m invited to address a new group of graduates, to provide greetings and remarks at this important juncture in their lives. Over the years, I’ve sat in different parts of the commencement audience as a graduate, faculty member, parent, and speaker. It’s inspiring to listen to these speeches and a great honor to be invited to give one.

I’ve written before about the challenges of delivering one of these talks — to be inspirational, witty, and wise, all within nine minutes! Today, I want to talk about how graduation in 2020 is both different and not so different after all.

This year, so many things surrounding graduation — a ceremony marking the transition from learner to practitioner; a signal that the courses and tests and papers have all been completed, passed, and submitted; a celebration with the friends and family who accompanied the graduate on this journey — aren’t the same.

Social distancing and the larger response to COVID-19 meant an abrupt end to in-person classes and meetings with advisors for the last half of the spring semester. Coursework was completed in “distance mode,” through online discussions and video presentations. Tests evolved into computer-delivered multiple-choice questionnaires, with the ubiquitous empty box to be filled with the wisdom the student had acquired. Papers were submitted via email or uploaded to a course management website. And Zoom parties and video chats have replaced the hugs and handshakes that once marked the graduate’s accomplishment.

But how traditional are these “traditions” that 2020’s graduates are missing? Less so than we might think, I’ll bet. Over the last 50 years, graduation classes have become more diverse. The solemn pomp-and-circumstance procession has been replaced with joyful shouts of extended families and the sight of graduates’ small children wandering down the aisles.

And graduation ceremonies and celebrations have been cut short before for many reasons — both historical and personal — such as times of conflict, the necessity to enter the workforce immediately, or other family obligations, just to note a few. So just as graduation this year looks different, so too did graduation in 2001, in 1980, in 1970, and in 1950.

Graduation season this year is characterized by many trans-societal disturbances — a global health crisis, protests against systemic injustices, and vast economic uncertainty. The graduates of today will be called on to shape and serve a world that is deeply in need of their energy and expertise.

It’s not right to send them forth simply with an apology that the world isn’t like it used to be — there have always been uncertainties, challenges, and complexities. Instead, it is critical to remind graduates that the world awaits their skills and welcomes them to craft a path to a future of service and opportunity.

So my message to the 2020 Columbia University Department of Biomedical Informatics graduates, delivered via a 90-second live video instead of a 9-minute podium speech, applauded their accomplishments and expressed my deepest confidence that the world will be a better, healthier place because of their talent and training in biomedical informatics. As graduates of one of the 16 NLM-supported predoctoral and postdoctoral training programs in biomedical informatics and data science, these men and women represent a unique group of professionals equipped with the biomedical informatics and data science skills necessary to extract knowledge from data and return it to practice. 

I promised them, as I promise all of you, that the National Library of Medicine would travel beside the nurses, physicians, researchers, patients, and leaders of the future, serving as a consistent source of trustable knowledge about health, health challenges, and the technologies and information needed to advance health for all. 

What did you promise your graduate this year?