Is NLM Building a Library on Mars?

Safe, productive human space travel requires more than sophisticated spacecraft. From environmental conditions to the physiological and psychosocial impacts, NASA’s astronauts face unique challenges while living in space.

To help address those challenges, NIH and NASA established a research partnership in January 2016. The research opportunities arising from this partnership and through NASA’s Human Research Program are expected to improve health both for the population on Earth and for those who travel to Mars and beyond.

What’s the Library’s role?

Well, we’re not getting ready to build an NLM outreach-to-Mars program (yet!), but we are involved in issues related to informatics and health information technology.

We’re expanding our collections and the standard health care terminologies (MeSH, SNOMED, LOINC, RxNorm) to address new environments (i.e., space) and the health concerns faced there (e.g., long-term muscle wasting, bone loss, space radiation exposure). MeSH, for example, already includes terms related to space flight, such as hypogravity and weightlessness; PubMed offers a subset of content focused on space life sciences; PubMed Central houses peer-reviewed papers resulting from NASA-funded research; and our History of Medicine Division holds a unique collection of scientific studies, technical reports, books, and pamphlets received from NASA in 2015.

We’ll also work to fully identify the information and resources needed to support biomedical research and to deliver health services to humans who may be light years away. We can potentially build upon NLM’s current work with machine learning and image recognition to speed diagnosis, and enhance our telemedicine efforts to account for an interplanetary communications delay approaching 42 minutes between Earth and Mars. We’ll further refine our emerging data science methodologies to accelerate discoveries in real time during manned missions. And perhaps most important to me, we’ll imagine—and plan for—a future without the internet.

No internet?!

Astronaut and moon reflected in the window of the space stationCurrently the internet is essential for the delivery of NLM’s most-used services, but there is no internet in space. We need to anticipate an independent technological infrastructure that will allow us to support research and medical care without it.

Such foresight, planning, and commitment can yield great results. Indeed, because of NLM’s leadership of the High Performance Communication and Computing Program 24 years ago (1992), we had satellite communication services in place to support the long-distance conversation between NIH Director Francis Collins and Astronaut Kate Rubins last October (2016).

But thinking systematically about how to deliver scientific knowledge in space will yield benefits long before the Orion spacecraft sets course for Mars.

While we don’t expect the internet here on Earth to go away, we must be prepared to deliver 24/7 access to NLM resources in the event of an interruption in internet service, whether due to natural disasters, construction failures, cyberterrorism, or even solar flares.

So, the next time you hear that NLM is working on human space exploration, remember that, while we’re planning for an information-rich future, we’re also ensuring an information-available present.

The library on Mars will come later.

Read Vint Cerf’s reply to this post, There Is an Internet in Space.

Co-authored by Dianne Babski, Deputy Associate Director for Library Operations, who serves as the NLM representative to the NIH/NASA Biomedical Research Partnership.

Photo credit (Mars in space, top): Composite NASA Hubble Space Telescope Image (October 19, 2014) | cropped

Sharing Small Data Files for More Analysis Power

Guest post by Ashley Hintz, curator for NLM NCBI’s Sequence Read Archive.

Imagine the rows upon rows of books in the stacks of a research library. Then imagine how much information is stored in those books.

An organism’s entire genome is the equivalent of that large library with its multiple floors of loaded shelves. It is densely packed with information.

Just as reference librarians specialize in locating specific information within the library, bioinformaticians specialize in working through, analyzing, and understanding genomes.

And as librarians determine how best to search the online catalog to locate a specific item within the library, bioinformaticians write computer scripts to filter the massive amount of genomic data and identify the parts most relevant to particular research questions. Such filtering creates smaller data files that are easier to analyze, visualize, and share with colleagues.

Unfortunately, many researchers don’t start with the smaller, filtered genomic data sets.

These researchers are stuck believing they must always begin their analysis from the full genome, even though most of the genome’s elements have nothing to do with their research questions.

The idea that you must have the original raw sequence data to analyze the data correctly means that large amounts of data (sometimes terabytes) get moved on a regular basis, or, given the data’s large size, they never move, so access to them is limited.

It’s the equivalent of checking out the whole library when a couple books will answer your questions.

Genomes can be filtered by SNPs (or single nucleotide polymorphisms) from a vcf file, collections of genes, or read counts for gene expression data. All of these smaller data files have practical-use cases and deliver what researchers are commonly interested in.

Current technology also makes sharing these filtered data files incredibly easy. Given their small size (mere gigabytes), it’s more on the scale of sharing pictures of your children or pets.

Sounds good, but what can one accomplish with these filtered genome datasets?

One example: perinatal screening for genes and/or SNPs that can potentially cause disease. Once the entire genome or exome is sequenced, the doctor can examine a vcf file of SNPs, filter that file further using data about the family’s medical history or the infant’s clinical symptoms, and then transfer the data files easily to a specialist for a second opinion. In these cases, the smaller data file becomes a powerful diagnostic tool.

A second example: gene expression data used in research. Instead of each scientist recalculating read counts (such as FPKMs), one researcher can share smaller analysis files with others. The smaller files can then be used to identify and visualize meaningful differences in expression between genes or samples. This sharing is not only more efficient; it also facilitates the collaboration necessary to tackle such significant and complex medical issues as obesity, Alzheimer’s, and autoimmune diseases, all of which show differences in the expression levels of certain genes.

These examples just scratch the surface of the power behind filtering genome data for data analysis, visualization, and sharing.

With genome sequencing growing more affordable, the amount of sequence data is expected to grow more rapidly, so we need to change the mindset that we must start with the whole library to see results. Think “focused” instead of “complete,” or, as the librarians like to say, “precision over recall.”

It’s one more example of where less, most definitely, can be more.

Channeling My Inner Betsy

A few of the lessons she imparted to me

In just a few days Betsy Humphreys, MLS, will officially retire from the National Library of Medicine after 44 years of outstanding service.

Over the past two weeks we have been celebrating her and acknowledging her incredible contributions to the nation’s health through her many roles at NLM. Currently NLM’s deputy director, Betsy served as the first woman and first librarian to lead the Library (2015-2016 Acting Director) after many, many years in various leadership positions here, including as associate director of Library Operations. Over the years, Betsy received many accolades for her work, including the Medical Library Association’s Carla J. Funk Award, the Morris F. Collen Award from AMIA, and even an honorary LOINC code, 86466-0: Maestro of scalable info infrastructure. And though I could go on at length about Betsy’s accomplishments and all that she has done to advance access to medical information—for the good of NLM and the country—I’ve been pondering instead how I’m going to keep Betsy with us after she retires by channeling my “inner Betsy” as I lead NLM toward its third century.

Humphreys holds a plaque while standing next to Vreeman
Betsy Humphreys accepts a plaque from Dr. Daniel Vreeman of the Regenstrief Institute acknowledging her enduring contributions to health data standards.

First, I will draw on the amazing storehouse of knowledge Betsy developed over decades about how best to deliver the scientific literature to researchers, clinicians, and the public. That knowledge significantly exceeds what she managed to transfer to me over the 10 months we worked together, but fortunately, it exists in the work processes and practices of the 1,700 women and men at NLM and in the national bodies shaped by Betsy’s influence. Whether it’s an efficient and effective way to apply the MeSH terminology to citations or the importance of making SNOMED CT freely available, Betsy not only knew what to do but made sure it was done in a sustainable manner.

Next, I will conduct myself with generosity, grace, and good will. Betsy can discern the best talents within everyone, and she consistently noted those talents when she introduced someone or described his/her work to a new colleague. More than once I heard Betsy say, “You know, we have just the best person for handling…” whatever task needed to be handled. Obviously, she knew the players, but it was her ability to hold her colleagues in unquestioning positive regard that enabled the most effective partnerships to flourish and got the best people to address complex tasks.

I will channel a commitment to accountability—to science, to society, to patients, to partners, and to the authors who entrusted their works to NLM for archiving and distribution. Betsy didn’t wait for someone to ask for follow-up; she provided it as part of the workplace discourse. Maintaining accountability to our diverse stakeholders sometimes meant describing to one set of stakeholders why a decision apparently in support of a different set of priorities needed to be made and was most likely the best course. Betsy took that on and did it with tact and skill.

I will try to channel Betsy’s loyalty to her colleagues, to NLM, and to NIH. Betsy’s sense of accountability arose from this loyalty—her commitment to make possible a scientist’s research, a work team’s new process, a colleague’s investment in one of NLM’s services. Betsy didn’t often speak of loyalty; she simply demonstrated it.

Still from the video of a smiling Betsy Humphreys
Click to watch the tribute video to Betsy Humphreys.

Finally I will channel Betsy’s commitment to personal health and work-life balance. While many of us are sipping that second cup of coffee as we peruse the Sunday paper, Betsy and her husband/hiking partner, Glenn, are out traversing some trail, whether somewhere in the mid-Atlantic region or across the globe in the Italian Dolomites. Many a Monday was enriched by Betsy’s enthusiastic, bright-eyed description of how she and Glenn enjoyed a vista or found new flowers on a familiar path.

Betsy imparted these and many other lessons I’m sure I can put to good use, and I hope to channel my inner Betsy throughout my entire tenure at the National Library of Medicine.

How you will channel your inner Betsy? Chime in below.

The Hōkūleʽa Worldwide Voyage Comes Full Circle: The NLM Connection

Guest post by Dr. Fred Wood, Outreach and Evaluation Scientist in the Office of Health Information Programs Development.

On June 17, the ocean-going, double-hulled canoe Hōkūleʽa (named for Arcturus, the Star of Gladness) successfully completed its historic Worldwide Voyage.  The Hōkūleʽa departed Honolulu, Hawaiʽi, on May 18, 2014 and over the last three years traveled more than 60,000 nautical miles, stopping at 150 ports in 27 nations, while completing its circumnavigation of the globe.

Launched in 1975, the Hōkūleʽa recreates the type of ocean-going canoes used by Polynesians for thousands of years to traverse the Pacific Ocean and to discover other Pacific islands, including Hawaiʽi.  Hōkūleʽa’s original mission was to prove that traditional double-hulled canoes “powered” only by native knowledge of the wind and swells, as well as the sun, moon, stars, and ocean wildlife, could voyage across the 2,500 miles each way between Hawaiʽi and Tahiti. Once accomplished, this initial mission expanded to include voyages to other islands throughout the Pacific, west to Asia, and east to the US mainland.

Building on this voyaging success, the Hōkūleʽa transformed into a symbol for a broader revitalization of Native Hawaiian culture, pride, ecological sustainability, and health, messages that remain at the heart of its global voyage.

When that voyage reached Washington, DC in May 2016, NLM hosted Nainoa Thompson, one of only a handful of Native Hawaiians trained in the traditional navigation methods referred to as wayfinding. Thompson spoke passionately about the history and role of the Hōkūleʽa in promoting Hawaiian culture and health, and in advocating for environmental protection, sustainability of the oceans, and world peace.

Even before the Worldwide Voyage and Thompson’s lecture, NLM had closely followed the Hōkūleʽa and honored its importance in NLM exhibitions and associated websites and apps.

model of a double-hulled sailing canoe
A scale model of the Hōkūleʻa graced the entrance to the Library from 2011-2015.

For the NLM exhibition Native Voices: Native Peoples Concepts of Health and Illness, the Library commissioned a one-sixth scale model of the Hōkūleʽa built by Hawaiian artisans to the exact specifications of the full-sized canoe. The model was on display for several years in the NLM rotunda. In addition, Native Voices included interviews with Thompson, and with several of Hōkūleʽa medical officers, including Drs. Ben Young, Ben Tamura, and Marjorie Mau, who served on various legs of the Hōkūleʽa’s 40+ years of ocean voyaging.

The Hōkūleʽa and the ancient arts of navigation and voyaging were also at the center of the NLM exhibition A Voyage to Health, which looked at how the resurgence of Native Hawaiian culture helped heal the soul of the community. When the canoe and her crew returned to Honolulu last week, A Voyage to Health was there as part of the welcoming celebration.

Both traveling exhibitions have visited dozens of venues across Hawaiʽi and the rest of the US. And NLM’s scale-model Hōkūleʽa is now on display at the Disney Aulani Resort, in West Oahu, under auspices of the Friends of the Hōkūleʽa and Hawaiʽiloa.

NLM celebrates the accomplishments of the Hōkūleʻa and the entire Hawaiian voyaging community that participated in the Mālama Honua (“Care for the Earth”) Worldwide Voyage.  As that voyage comes to a close, NLM acknowledges once again its significance as an icon of Hawaiian culture, values, and health.

More Information
Native Voices Exhibition: NLM Hōkūleʽa microsite
Video: Nainoa Thompson’s Special Lecture on the Hōkūle’a and Native Hawaiian Health (May 23, 2016)
NIH Record: “For Native Hawaiians, Canoe Instills Pride, Healing”

Remembering Judith Caruthers

Joining a new community with ties to my past

The threads of my life are coming together in unexpected ways.

As you read in last week’s post, I delivered the Leiter Lecture at the Medical Library Association’s annual meeting. I opened the lecture with a brief introduction to me—nurse, industrial engineer, consumer health information advocate, technologist. Sensing those in attendance needed to better understand my bona fides for serving as the NLM Director, I also spontaneously reflected aloud on my own graduate school experience and the librarians I knew then.

It was a fortuitous and meaningful tangent.

During my graduate studies at the University of Wisconsin-Madison, I hung out with librarians. And not just any librarians. These were some heavy hitters: Charley Seavey, Bob Martin, Wayne Wiegand, and the indomitable Judith Caruthers.  Judith, Charley, and I (and a few others) met in Frank Baker’s class on statistics in educational psychology. We bonded together to interpret regression coefficients, calculate variance explained, and absorb the mysteries and utilities of the general linear model. Beyond beers and homework sessions, we shared the philosophies and mysteries of our chosen disciplines: me from industrial engineering, Judith and Charley from library science, and Diana Pounder from educational administration.

Little did I know those Friday afternoons on the terrace were helping to form the basis upon which I would build a career leading the National Library of Medicine.

Judith came to graduate school as a grown up. She was already the research librarian for the Louisiana State University Medical Center in New Orleans and had taken a leave of absence to work on her doctorate.

To those of us waiting to start our careers, Judith was a sophisticate, and she taught me many things. Her dissertation exploring metadata in what was then known as ProCite introduced me to the systematic study of curation. She helped me to reason through how information engendered perspective and to see that the job of an information professional, whether librarian or engineer, was to preserve meaning and afford access. She also taught me to think of my career and my job as intertwined but never identical.

Judith and I became great friends, establishing a deep connection forged from mutual affection and compatible intellects. Judith taught me to eat crawfish, and I introduced her to Wisconsin brats. And every year, as the Mardi Gras krewes gathered in New Orleans, Judith oversaw the northern version of the king cake celebration, making sure her southern traditions warmed our Wisconsin winters.

Judith died in 2001 after a valiant battle with cancer. She left me before I was ready to let her go, and I think of her often—her gorgeous smile, her southern drawl, and her engulfing hugs.

So what a great surprise and gift it was to me that my spontaneous reminiscences at the start of the Leiter Lecture were greeted with tweets and hugs from members of the MLA community who also knew Judith—one of her LSU colleagues, a librarian whom Judith had guided to graduate school, another friend and colleague who worked with her.

I came away from the MLA meeting realizing not only have I encountered a new and vibrant professional community but also an amazing and welcome connection to my past. I can’t help but look forward to the tapestry created from the weaving of these long-connected threads.

Postscript: Judith’s good friend and LSU colleague Wilba Swearingen wrote more about her in a lovely tribute following her death.

Big Shoes to Fill

Joe Leiter and the lecture that bears his name

Last week I attended the Medical Library Association Annual Meeting in Seattle, where I gave the Joseph Leiter Lecture, one of the most prestigious named lectures in the medical library community.

Joe Leiter served as the National Library of Medicine’s first Associate Director for Library Operations from 1965 through 1983.  Joe, as he preferred to be called, was—like me—not a librarian. A biochemist by training, he came to the NLM from the National Cancer Institute, where he was chief of NCI’s Cancer Chemotherapy Service Center, investigated environmental carcinogens and developed drug therapies for cancer.

Automation, the promise of information systems, and the chance to expand private-public partnerships lured Joe to the NLM under Director Marty Cummings.  Joe was credited with developing MEDLINE (teaming up with the late Davis McCarn) and DOCLINE, expanding the Regional Medical Libraries, rejuvenating the NLM Associate Program, introducing contracts to boost library services, and increasing the efficiency and effectiveness of the training offered on NLM’s specialized databases. Through it all Joe never lost sight of the library’s end users, appraising every investment, every new initiative, and every advance in terms of how it would meet the needs of health science librarians and the people they served.

A man of amazing energies and intellectual generosity, Joe single-handedly inspired, cajoled, and in some cases badgered NLM staff to operate at the top of their game. Ever the passionate advocate, he also worked to advance women and minorities in the profession. As former Associate Director for Library Operations Sheldon Kotzin noted, Joe “never wavered in his commitment to the principles of equal opportunity.”

As Joe approached retirement he endowed a lectureship to be given annually: every odd year at the MLA meeting; on the even years, at or near NLM.

Many notable people have delivered the Leiter Lecture, among them Nobel Prize winner Joshua Lederberg; renowned heart surgeon Michael DeBakey; Tony Fauci, director of the National Institute of Allergy and Infectious Diseases; and Francis Collins, NIH Director and a pioneering geneticist who led the effort to map the human genome.

I had big shoes to fill.

I listened to some of the earlier lectures and thought of the innovations portended by those visions. The future—or futures—my predecessors envisioned is the present we are living now. Their stories became our stories, and I hope the story I contributed will blossom into a shared vision of how the National Library of Medicine can and will serve society—as the NIH hub for data science, and as a platform for discovery and a pathway to engagement in the development and expansion of data-powered health.

It’s a vision that ultimately holds the individual at the center and imagines a future I like to think Joe Leiter would support.

Go as Far as You Can See. Then See How Far You Can Go.

Be ready for the next part of the journey.

It’s that time of year when the esteemed and well-known are asked to give graduation addresses. You remember those addresses—simultaneously inspirational, compelling, and entertaining and all in ten minutes or less!

This year, somehow, I have become one of those people, or by virtue of my position as the director of the National Library of Medicine, I am a good stand-in for one. I was invited to speak to the graduates of the School of Nursing at the University of Pennsylvania and the Frances Payne Bolton School of Nursing at Case Western Reserve University.

It’s an extreme honor to be invited, of course, but what was I going to say?

A recent book, The Sixteenth Rail: The Evidence, the Scientist, and the Lindbergh Kidnapping by Adam Schrager, provided my jumping-off point. The book itself—a look at how Arthur Koehler, a wood forensics expert, helped capture the kidnapper of the Lindbergh baby—is fascinating, but that expert’s personal story is what inspired me. His adherence to the scientific process and his willingness to serve made me think that in another incarnation he could have been a nurse or a librarian!

Koehler himself was inspired by the adage, “Go as far as you can see, and then see how far you can go.” When I read that, I knew I had the beginnings of my commencement address.

And so, to the new graduates, particularly those in the helping professions, I offer these comments.


Our work is action focused. No one gets to be a good nurse or a good librarian simply by watching.  And yet we must often take the initiative to make clear to others where and how we can be of service. The moments where a nurse or a librarian may be of assistance might not even be recognized by the person in need, who may be baffled by a problem, worried about some health concern, or just overwhelmed into inactivity.

As a dictum, “go” also places control of your career solely in your hands—a reminder that as skilled and educated professionals we have the freedom to direct our efforts and shape our futures.

As far as you can see.

At graduation, each graduate has his or her eyes on a unique horizon. For some it may be the start of graduate school in a few months. For others, it’s a new job in a new city. Still others may see family, volunteer service, or travel.

Pay attention to what you see and to what you see along the way. And for those in the helping professions, pay attention as well to how you see those who need your service. What do you notice about them—appearance, action, behavior? Cultivate your curiosity but always maintain your respect. See others the way you’d like them to see you—your strengths, your good will, your desires.

Use that input and that knowledge to guide your movements, to go forth purposefully, and to be fully engaged in whatever pursuits you deem important. But remember, even as you enter this phase of life, “as far as you can see” is nowhere as far as you can actually—and are likely—to go.

Once you get to that place— that as-far-as-you-can-see place—you will be a new you, with new confidence, new ideas, new desires, new lenses, new frameworks, and new goals. You will then have a new platform to launch into whatever is about to happen next.

See how far you can go.

As you stand in that new place, pause, look around, and don’t forget to glance backwards—even briefly. Your future isn’t defined by your past, but your past is what prepared you for it.

Take stock of what you need with you in that future—friends, finances, humility, humor, knowledge. And what you don’t have, build, acquire, borrow, or buy, so you’ll be ready for the next part of the journey.

Because the beauty of the journey is that there is always a new horizon to see, to move toward, and then to move on from.

How far will you go?