NLM News 1994 July-August; Vol. 49, No. 4

	The NLM News is published 6 times a year by the National 
Library of Medicine (National Institutes of Health, Department of 
Health and Human Services).  Beginning with Vol. 49, No. 1, the NLM 
News is avaiable via the Internet.  To access, ftp to 
nlmpubs.nlm.nih.gov and login as anonymous.  Use your e-mail address 
as the password.  

	In addition to electronic access, the printed NLM News is 
mailed without charge to institutions and individuals interested in 
health sciences communications.  For further information, contact 
NLM's Office of Public Information (8600 Rockville Pike, Bethesda, 
MD 20894); e-mail address: publicinfo@occshost.nlm.nih.gov.  
NLM Director, Donald A.B. Lindberg, M.D.
Chief, Office of Public Information, Robert B. Mehnert,
Editor, Roger L. Gilkeson; e-mail address: 
Roger_Gilkeson@occshost.nlm.nih.gov 

********************************************************************

Contents:

Fixed-Fee and the Internet: A Formula that Works
Publications
New Database of Information on Macromolecular Structure Planned
"Improving Health through Advanced Computing & Communications"
Photo caption: "Outstanding Volunteer Service Award"
Exhibit of Arabic and Persian Manuscripts Opens
NLM Establishes Minority applicant Locator File
Grateful Med Developer Honored
Dr. Schoolman Named Acting Director of LHNCBC
NLM in Print
Monograph & Serial G aps

********************************************************************

Fixed-Fee and the Internet: A Formula that Works

by Karen A. Ginter, Manager, MEDLARS Promotion

	In May 1993, NLM announced the availabilty of its Fixed-Fee 
Access Plans via the Internet.  This initiative and the similar 
Flat-Rate programs implemented with medical associations, remove one 
of the final barriers to accessing the most-up-to-date biomedical 
information online--uncertain search costs.  Users are no longer 
concerned about whether they can explore resources thoroughly until 
they are certain they have found exactly what they need.  As a 
consequence, usage at NLM has grown by 286% in these programs and 
continues to grow rapidly.  

	There are currently over twenty Fixed-Fee and Flat-Rate 
programs in place in the United States, and numerous others are 
under consideration.  They range in size and scope from an Indian 
Health Service office in Arizona to all of the National Institutes 
of Health.  They include hospitals, universities, and governmental 
and commercial organizations.  The largest university program, the 
University of Illinois, incorporates five sites with a potential of 
75,000 users.  One state library group is looking into a Fixed-fee 
agreement for the entire state which would include K-12 and public 
libraries.

	Since every agreement has been unique in its requirements, the 
costs of these programs are determined individually.  The factors 
that are taken into consideration for pricing are 1) demographics, 
i.e., number of sites, total potential users, and types of users; 
and 2) historical MEDLINE usage from all sources.  The number of 
codes/passwords are determined by these factors.

Highlights from the Users Group Meeting

	A variety of experiences with the Fixed-Fee Program were 
discussed at the first annual users group meeting at the Medical 
Library Association meeting in San Antonio.

	Although Ann Weller of the University of Illinois expressed 
her astonishment at "belonging to yet another users group," the 
University's unique way of disseminating codes and passwords through 
a system developed jointly with NLM was of great interest to the 
group.  The codes are never given to users but are made available 
for the session only when the users select NLM on their Academic 
Data Network.

	Rosalie Stroman from the NIH Library reported that the 
Loansome Doc feature of Grateful Med is rated very highly by NIH 
scientists because they can request photocopies of journal articles 
directly from their computer workstations.  Yet another barrier to 
information access has been removed with Loansome Doc--the 
requirement that users must either go to or call the library to get 
the full text of an article.  In addition, the NIH Library is 
teaching command level searching to those users who do frequent 
searches and want the extra speed and sophistication of command 
level searching.  However, Jenny Harriman, electronic resources 
coordinator for the NIH Library, noted that Grateful Med  continues 
to be the system of choice for most of the NIH users.

	The University of Kentucky presented its effective Fixed-Fee 
marketing plan.  Users have been notified about the new program with 
very colorful announcement fliers and receive an equally colorful 
confirmation packet giving them all the information they need to 
effectively utilize Grateful Med on their LAN and the Internet.  
Jane Bryant, a former NLM staffer now at the University of Kentucky, 
made copies of these available to those at the meeting and welcomes 
inquiries from others about them.

	Librarians are finding that these programs are doing a lot to 
promote library services.  Marge Kars of the Bronson Methodist 
Hospital, Kalamazoo, MI, recently commented that "they are banging 
down the door to get their passwords!"

	Public access to information is being accomplished with 
workstations set up in the various universites and through unique 
programs like that of the New York Academy of Medicine.  The Academy 
provides workstations for on-site public access from its location in 
New York City.  Library Director Arthur Downing, has been pleased 
with the very low volume of requests for assistance from users.  
Grateful Med can stand alone as a very user-friendly interface.

	End users have also played an important role in bringing about 
these agreements.  Dr. Barry Cooper of the College of Veterinary 
Medicine, Cornell University, a long-time user of Grateful Med, 
contacted NLM to request a fixed-fee agreement for his department.  
Working closely with the veterinary library and NLM, he was 
instrumental in bringing about the first example of fixed-fee 
pricing for a college within a university.  Susanne Whitaker, 
director of the Flower/Sprecher Library, says "every library should 
have such enthusiastic support by its users."

	Since the user meeting, there have been many new price levels 
established, and some price levels have been reduced.  NLM 
encourages community hospitals with a direct Internet connection to 
explore this option.

	If you would like more general information about this program 
or would like specific pricing information for your institution, I 
can be reached at my Internet address, Ginter@nlm.nih.gov or by 
phone at 301/402-4277.

PUBLICATIONS

New CBM on Hip Replacement

	NLM's Reference Section has produced a new bibliography, Total 
Hip Replacement, in support of a recent NIH Consensus Development 
Conference.  The publication is part of NLM's 1994 series of Current 
Bibliographies in Medicine (CBM94).  

	CBM94 series subscriptions, to include approximately 10 
titles, are available for $60 ($75 foreign) or individually for $8 
($10 foreign).  A list of available titles appears in each monthly 
issue of Abridged Index Medicus and Index Medicus.  Mail orders to: 
New Orders, Superintendent of Documents, P.O. Box 371954, 
Pittsburgh, PA 15250-7954.  GPO Phone Orders: 202/783-3238.  Recent 
CBMs are also accessible through FTP (see "AIDS Bibliography" 
below).

o CBM 94-5: Total hip replacement.  January 1991 through April 1994. 
1095 citations. [S/N 817-010-00005-9]

AHA Publishes Vocabulary Search Guide

	The American Hospital Association's Resource Center has 
published a 23-page "Vocabulary Search Guide" to help users 
determine the appropriate subject headings to look under when 
searching AHA's Hospital Literature Index.  The Guide is designed to 
overcome obstacles in finding, for example, such aspects of health 
care reform as all-payer systems, benchmarking, community networks, 
continuum of care, etc.  The Guide lists current topics and NLM's 
Medical Subject Headings under which these topics might appear.  To 
receive single copies, contact the American Hospital Association 
Resource Center, 840 North Lake Shore Drive, Chicago, IL 60611.  
Telephone: 312/280-6263; Fax 312/280-3061.

Kennedy Institute Publishes Scope Note
on Religious Perspectives in Bioethics

	The National Reference Center for Bioethics Literature of the 
Kennedy Institute of Ethics has published a new title in its "Scope 
Note" series on religious perspectives in bioethics.  Scope Note 25 
provides bibliographic citations to literature about the diverse and 
divergent attitudes religion can bring to bioethical issues.  These 
views often guide patients and health professionals when seeking or 
providing health care.  Topics covered include the physician-patient 
relationship, treatment refusal, contraception, abortion, 
sterilization, reproductive technologies, genetics, human 
experimentation, organ donation and transplantation, death, 
euthanasia, suicide, and prolongation of life.   Religious 
Perspectives on Bioethics appeared in the June 1994 issue of the 
Kennedy Institute of Ethics Journal.  A separate, 23-page reprint is 
available from the National Reference Center for Bioethics 
Literature, Kennedy Institute of Ethics, Georgetown University, 
Washington, DC 20057-1065, for $5 each, prepaid ($8 overseas 
airmail).  For further information, contact Pat McCarrick, 1-800-
MED-ETHX.

New Database of Information on 
Macromolecular Structure Planned

	On July 11th, the National Library of Medicine and several 
other Government agencies signed an interagency agreement to 
establish a new database containing structural information about 
proteins and other biological macromolecules at the atomic level.  
In addition to NLM, the signatories included the National Institute 
of General Medical Sciences (NIGMS), the Department of Energy (DOE), 
and the National Science Foundation (NSF).  

	A number of Federal agencies currently support both basic and 
applied research to discover, understand, and apply structural 
information about biological macromolecules at the atomic level.  
Early in the 1970s, crystallographers and other researchers saw a 
clear need for a central database of such information.  
Consequently, with primary support from NSF, the Protein Data Bank 
at Brookhaven National Laboratory was established.  Over the years, 
as the types and amounts of relevant structural data increased, 
other agencies--notably DOE, NIGMS, and NLM--came to play important 
roles in the funding of the Data Bank, largely on the basis of 
informal coordination by agency staff.

	Recent advances in X-ray scattering, nuclear magnetic 
resonance, and computational techniques have led to rapid growth in 
the amount of atomic level structural data.  At the same time, the 
size and sophistication of the community of basic and applied 
researchers who make use of such data have also increased 
dramatically.  

	For these reasons, representatives of the participating 
agencies decided to take a fresh look at all aspects of a database 
of this type--including its structure, the types and format of data 
to be stored, the methods by which data is entered and retrieved, 
and the physical location and management of the database.  The new 
interagency agreement provides a formal basis for cooperation in 
soliciting and reviewing applications to manage such a database, as 
well as in funding and oversight of the award resulting from the 
review.  

	According to NLM Director Donald A. B. Lindberg, M.D., it is 
anticipated that the Library will contribute approximately $150,000 
per year to the overall project costs, which are estimated at 
$2,000,000 annually.  Depending on the advice of reviewers, it is 
expected that the award will be provided through a five-year 
cooperative agreement between NSF and the awardee.  A variety of 
educational and research institutions are likely to submit 
proposals, including DOE national laboratories and other Federally 
funded research and development centers, other government agencies, 
and private sector enterprises. 

"Improving Health through Advanced Computing & Communications"

	A one-day conference on "Improving Health through Advanced 
Computing & Communications: Realities Beyond the Promise" will be 
held on September 26 at the Natural History Museum of the 
Smithsonian.  Moderated by Dr. Michael DeBakey of Baylor University, 
the focus of the Conference is on High Performance Computing & 
Communications (HPCC) applications in healthcare.

	Senator Ernest F. Hollings, NLM Director Donald A. B. 
Lindberg, M.D., Dr. Anita Jones of the Department of Defense, and 
other key administration and congressional leaders will be speaking.  
In addition, several NLM/HPCC grantees will describe state wide 
healthcare test bed networks, real-time telemedicine in rural areas, 
teledermatology, and virtual surgery.

	Active members of the Friends of the National Library of 
Medicine and Federal employees may attend for a $50 registration fee 
(includes lunch, breaks, reception, and conference materials).  The 
fee for nonmembers is $100.

	To receive a brochure, send an e-mail message to fnlm@aol.com 
or Fax a request to (202) 462-9043 or call (202) 462-9600.

[caption for Photo] 
NLM Director Donald A. B. Lindberg, M.D., holds an award presented 
on June 9th to the National Library of Medicine by District of 
Columbia Public Schools Superintendent Franklin L. Smith.  The 
"Outstanding Volunteer Service Award" recognized the Library's 
partnership with D.C.'s Coolidge High School under the "Adopt-a-
School Program."  Under the partnership, Coolidge students are being 
exposed to a variety of NLM programs, including the Library's online 
databases and library science, use of the Internet, biotechnology, 
computer science, and engineering.  With Dr. Lindberg are NLM EEO 
Officer David Nash and former EEO Chairperson Cynthia Gaines, both 
of whom were active in planning and coordinating the NLM/Coolidge 
partnership.  

Lecture, Reception on September 12
Exhibit of Arabic and Persian Manuscripts Opens

	"Islamic Culture and the Medical Arts"--an exhibit of Arabic 
and Persian Manuscripts from the collection of the National Library 
of Medicine--will be shown in the Library's main lobby from 
September 12 through December 1994.

	The occasion for the exhibit is the 900th anniversary of the 
oldest item in NLM's collection, a manuscript copy of a treatise on 
gastrointestinal diseases by al-Razi, dated November 30, 1094.  
	The medical manuscripts displayed date from the 11th to the 
19th century, and were produced in countries ranging from North 
Africa to India.  This diverse collection includes translations from 
Galen to Hippocrates, classic Arabic treatises by al-Razi (Rhazes) 
and Ibn Sina (Avicenna), and works on a variety of subjects, 
including ophthalmology, anatomy, drugs, medicinal plants, and 
alchemy.  The continuing vitality of the calligraphic tradition is 
seen in the inclusion in the exhibit of a Koran copied by a 
contemporary Arab American physician, Dr. Ahmad Younis.

	Beautifully colored and gilded illuminations grace several 
manuscripts, and others contain interesting illustrations, most 
medical, some fanciful.  Of special note among the latter are the 
charming animals and plants in Qazwini's Wonders of Creation.

	To mark the opening of the exhibit on September 12, the 
library will present a program on Islamic culture and medicine in 
the Lister Hill Center Auditorium, beginning at 1:00 p.m.  Emilie 
Savage Smith (University of Oxford), Esin Atil (Freer Gallery of 
Art), and Mark D. Jordan (University of Notre Dame) will speak about 
Islamic medicine, Islamic illustration, and the transmission of 
Islamic science to the West.  The program will include a calligraphy 
demonstration by a Washington area calligrapher, Mohamed Zakariya.

	The League of Arab States, U.S. Arab Chamber of Commerce, and 
the Arab American Medical Association, D.C. Chapter, are providing 
generous support for the exhibit and lecture program.

	Following the lecture, the Friends of the National Library of 
Medicine will sponsor a reception in the main Rotunda of Building 
38.  To attend, R.S.V.P.. to the Friends of the NLM--fax: 202/462-
9043; telephone: 202/462-9600.  

	For further information about the exhibit and lecture, please 
contact Anne Whitaker of the Library's History of Medicine Division: 
301/496-5405.

[Photo] Anatomical drawing from a Persian manuscript of Mansur's 
Anatomy, 1488.

[Photo]
Imaginary animals and human figures from a Persian manuscript of 
Qazwini's Wonders of Creation, 18th century.

NLM Establishes Minority Applicant Locator File

	As part of its continuing efforts to diversify NLM's work 
force, the Library has established the "Minority Applicant Locator 
File (MinApp)."  The database targets six Federal position series:  
Librarian, Post-Doctoral Fellow, Technical Information Specialist, 
Computer Specialist, Library Technician, and Clerk/Office 
Automation.  Persons interested in applying for positions at NLM in 
any of the targeted series should complete a Minority Applicant File 
Job Interest Form (available from NLM's EEO Office; see below).  As 
vacancies in these series are announced, the Equal Employment 
Opportunity Office will notify potential applicants by sending 
detailed vacancy announcements.  Those who apply are subject to the 
same review process as other candidates.

	To achieve the goal of creating a larger minority applicant 
pool, the Library intends to inform minority communities about the 
Library and its employment and training opportunities.  To this end, 
the Library maintains a database of colleges and universities, 
academic programs, and minority, library, and science-oriented 
organizations.  Information about MinApp and notices of training 
opportunities are being directed to groups in this database as well 
as to appropriate electronic mailing lists.

	The Library has also compiled information on training 
opportunities sponsored by NLM's various organizational units.  
Training opportunities in the Division of Library Operations, the 
Division of Extramural Programs, the National Center for 
Biotechnology Information (NCBI), and the Lister Hill National 
Center for Biomedical Communications are included.  The NLM Training 
Opportunities Information Sheet and the Minority Applicant File Job 
Interest Form are available from the EEO Office.  Suggestions for 
additional organizations or programs to be included in the database 
of contacts may also be directed to the EEO Office, National Library 
of Medicine, 8600 Rockville Pike, Bethesda, Maryland, 20894, (301) 
496-1046, or David_Nash@occshost.nlm.nih.gov (e-mail address).

Grateful Med Developer Honored

Davis B. McCarn, a former NLM employee, recently received the 
American Library Association's 1994 Library and Information 
Technology Association (LITA)/Gaylord Award for Achievement in 
Library and Information Technology.  Mr. McCarn was cited for his 
leadership from the early days of MEDLARS through the development of 
Grateful Med, the Library's highly successful, user friendly 
software for searching MEDLINE and other databases that appeared in 
1986.  Since Mr. McCarn's retirement from NLM in 1978, in addition 
to Grateful Med, he has developed a number of systems for 
computerized publishing and online services.  He also organized 
PUBLIUS, a Maryland state political action committee for the 
promotion of libraries in Maryland.  

Dr. Schoolman Named 
Acting Director of LHNCBC

NLM Director Donald A. B. Lindberg, M.D., has named Harold M. 
Schoolman, M.D., acting director of the Library's research and 
development component, the Lister Hill National Center for 
Biomedical Communications.  Dr. Schoolman is NLM deputy director for 
research and education.  The announcement followed the retirement of 
Daniel R. Masys, M.D., from the Public Health Service Commissioned 
Corps to become director of biomedical informatics at the School of 
Medicine, University of California-San Diego (News, May-June 1994).  

NLM in Print

	The following references cite works that discuss the products 
and services of the National Library of Medicine.  If you know of 
other appropriate citations for this column, please send reprints or 
references to the editor, NLM News, National Library of Medicine, 
Bethesda, MD 20894. (Note: Some of the articles below may be from 
journals that are out of scope for the NLM collection and are 
therefore not available from the Library on interlibrary loan.)
	Adebonojo LG, Earl MF. POPLINE: a valuable supplement for 
health information. Database 1994 Jun:112-5.
	Bowden VM, Kromer ME, Tobia RC. Assessment of physicians' 
information needs in five Texas counties. Bull Med Libr Assoc 1994 
Apr;82(2):189-96.
	Broering NC, editor. High-performance medical libraries: 
advances in information management for the virtual era. Westport, 
Conn: Meckler; 1993. 229 p. [See Jacobson below.]
	Chiang D. Reaching NLM through the Internet. Med Ref Serv Q 
1994 Spring;13(1):83-92.
	Glowniak JV, Bushway MK. Computer networks as a medical 
resource. JAMA 1994 Jun 22;271(24):1934-9.
	Gorman PN, Ash J, Wykoff L. Can primary care physicians' 
questions be answered using the medical journal literature? Bull Med 
Libr Assoc 1994 Apr;82(2):140-6.
	Green CJ. GRATEFUL MED [letter]. Bull Med Libr Assoc 1994 Jan; 
82(1):77-8.
	Harruff, RC et al. Remediation of pathology students using the 
National Library of Medicine Videodisc Series in pathology. Bull 
Pathol Ed 1992;17:37-45.
	Husten L. ACC members enjoy NLM database services. Cardiology 
1994 Jun:19,31.
	Huth EJ. The online journal for current clinical trials makes 
it onto the MEDLINE map [editorial]. Online J Curr Clin Trials 1994 
Feb 11;Doc No 116:[897 words; 6 paragraphs].
	Jacobson S. High-performance medical libraries: advances in 
information management for the virtual era [book review]. Inf 
Technol & Libr 1994 Jun;13(2):154-5. [See Broering above.]
	Klein MS, Ross FV, Adams DL, Gilbert CM. Effect of online 
literature searching on length of stay and patient care costs. Acad 
Med 1994 Jun;69(6):489-95.
	Lindberg DAB. NLM is exit on information superhighway 
[letter]. Nation's Health 1994 Jul:2-3.
	Levine M, Walter S, Lee H, Haines T, Holbrook A, Moyer V. 
Users' guides to the medical literature. IV. How to use an article 
about harm. Evidence-Based Medicine Working Group. JAMA 1994 May 
25;271(20):1615-9.
	Lowe HJ, Barnett GO. Understanding and using the medical 
subject headings (MeSH) vocabulary to perform literature searches. 
JAMA 1994 Apr 13;271(14):1103-8.
	McCann B. Anatomical information will soon be available to 
physicians over the Internet computer network. Anesthesiology News 
1994 May:23, 41.
	McKibbon KA, Walker-Dilks CJ. Beyond ACP Journal Club: how to 
harness MEDLINE to solve clinical problems [editorial]. ACP J Club 
1994 Mar-Apr;120 Suppl 2:A10-2.
	Mehnert RB. National Library of Medicine. In: The Bowker 
annual. 39th ed. New York: R R Bowker; 1994. p.168-72.
	Miller JA. Anatomy via the internet. Bioscience 1994 Jun:397.
	Smith K. The U.S. National Information Infrastructure and High 
Performance Computing and Communications. Science Internat 1994 
Jun;56:23-5.
	Sneiderman CA, Hood AF, Patterson JW. Evaluation of an 
interactive computer video tutorial on malignant melanoma. J 
biocommun 1994;21:2-5.
	Solomon MJ, Laxamana A, Devore L, McLeod RS. Randomized 
controlled trials in surgery. Surgery 1994 Jun;115(6):707-12.
	Sparks SM. The Educational Technology Network (E.T.NET). Nurs 
Health Care 1994 Mar;15(3):134-41.
	Vasta BM, Lantz RE. TOXNET's windows of opportunity open 
through M Technology. HMT/M Technol Special 1994 Jun:M-4--M-6.
	Watson MM, Perrin R. A comparison of CINAHL and MEDLINE CD-ROM 
in four allied health areas. Bull Med Libr Assoc 1994 Apr;82(2): 
214-6.
	o Database [HSTAR] joins Nat'l Library of Medicine. Link-up 
1994 May/Jun;11(3):12.
	o Free AIDS database [news]. Lancet 1994 Feb 5;343(8893):351.
	o MisHIN project grant approved. J Miss State Med Assn 1994 
May:132-3.

Monograph & Serial G aps]

	NLM regularly seeks the help of the medical library community 
in filling gaps in its monograph and serial collections.  If you can 
provide any of these items we would be most grateful.  

Monographs

	If you are able to provide a copy of any of the monographs 
listed below, please send to:

		National Library of Medicine
		TSD-MONOGRAPHS Attn: L. Turnage
		Bethesda, MD 20894

	Gallagher, Hugh Gregory.  FDR's splendid deception.  New York: 
Dodd, Mead; 1985.
	Lee, Robert D.  Nutritional assessment.  Madison, Wis.: Brown 
& Benchmark; 1993.
	Miller, Dare.  Secret of canine communication: an in-depth 
manual for breeders, owners, veterinarians.  Los Angeles: Canine  
Behavior Institute; 1969.
	Mitchell, S. Weir.  Doctor and patient.  New York: Arno Press; 
1972.  (Medicine & society in America).

Serials Gaps

Please address serial issues to:

		National Library of Medicine
		TSD-GAPS Attn: C. Fields
		Bethesda, MD 20894

Biomedical and Environmental Sciences 4:1-2,4, 1991
Clinics in Communication Disorders 1:4, 1991; 2:2, 1992
EXS 69:1993
Gynecologic Oncology 45:1, 1992
International Dental Journal 42:4-6, 1992; 43:1-2, 1993
International Journal of Psycho-Analysis 66: pt. 4, 1985
Journal of the American Osteopathic Association 90:11, 1990
Journal of the American Veterinary Medical Association 201:8, 1992
Journal of Developmental and Behavioral Pediatrics 14:1-2, 1993
Journal of Experimental Child Psychology 51:3, 1991
Journal of Investigative Surgery 1:1, 1988
Journal of Pediatric Gastroenterology and Nutrition 17:1, 1993
Journal of Pediatrics 122:6, 1993
Ma Tsui Hsueh Tsa Chi Anaesthesiologica Sinica 31:2-3, 1993
Minnesota Medicine 76:1-6, 1993
Modern Pathology 6:2, 1993
New Jersey Medicine 83:8-9, 1986; 89:5, 1992
Nurse Practitioner 16:12, 1991
Oncogene 3:1, 1988
Optometry and Vision Science 70:9-10, 1993
Seminars in Respiratory Infections 2:1,4, 1987
Therapia Hungarica 40:3, 1992