WEBVTT 00:00:13.541 --> 00:00:18.834 position:50% align:middle - [Maryann] Hello and welcome to NCSBN's Scientific Symposium. 00:00:18.834 --> 00:00:25.206 position:50% align:middle I'm Maryann Alexander, Chief Officer of Nursing Regulation at NCSBN. 00:00:25.206 --> 00:00:33.629 position:50% align:middle The studies being presented today were conducted both by NCSBN's internal research staff, 00:00:33.629 --> 00:00:41.996 position:50% align:middle and external scientists funded through NCSBN's Center for Regulatory Excellence grant program. 00:00:42.464 --> 00:00:52.279 position:50% align:middle The grant program awards over $1 million annually for studies that advance the science of nursing regulation. 00:00:52.279 --> 00:00:58.991 position:50% align:middle The data from these studies are used to make nursing regulatory and policy decisions, 00:00:58.991 --> 00:01:10.170 position:50% align:middle develop national guidelines for nursing practice and education, develop important changes to nurse practice 00:01:10.170 --> 00:01:12.420 position:50% align:middle acts and regulations. 00:01:12.420 --> 00:01:20.047 position:50% align:middle We want to thank all the researchers and grantees for their important contributions to nursing science 00:01:20.047 --> 00:01:26.215 position:50% align:middle and a special thank you for those presenting at this year's Scientific Symposium. 00:01:26.215 --> 00:01:31.506 position:50% align:middle One of NCSBN's researchers was Jennifer Hayden. 00:01:31.506 --> 00:01:37.343 position:50% align:middle She was a young talented scientist that was the principal investigator 00:01:37.343 --> 00:01:41.184 position:50% align:middle for NCSBN's National Simulation Study. 00:01:41.184 --> 00:01:48.661 position:50% align:middle This study changed the way simulation is incorporated into the pre-licensure nursing curriculum 00:01:48.661 --> 00:01:50.440 position:50% align:middle around the world. 00:01:50.440 --> 00:01:56.996 position:50% align:middle Unfortunately, almost upon completion of the study, Jennifer passed away from breast cancer. 00:01:56.996 --> 00:02:05.942 position:50% align:middle Because of her important contributions to NCSBN and to nursing science and policy, we have named our 00:02:05.942 --> 00:02:11.388 position:50% align:middle Scientific Symposium keynote address in her memory. 00:02:11.388 --> 00:02:17.948 position:50% align:middle And now it is my pleasure to introduce to you the Jennifer Hayden keynote speaker. 00:02:17.948 --> 00:02:23.578 position:50% align:middle This year, we are honored to have with us Dr. Patricia Flatley Brennan. 00:02:23.578 --> 00:02:30.141 position:50% align:middle Dr. Brennan is the Director of the National Library of Medicine at NIH. 00:02:30.141 --> 00:02:38.232 position:50% align:middle She is the first woman and the first nurse to be named to this prestigious position. 00:02:38.232 --> 00:02:49.000 position:50% align:middle Prior to this she was the Lillian L. Moehlman Bascom Professor at the School of Nursing 00:02:49.000 --> 00:02:51.567 position:50% align:middle and College of Engineering at the University of Wisconsin in Madison. 00:02:51.567 --> 00:02:58.750 position:50% align:middle Currently, Dr. Brennan is working on the delivery of health information in new ways that are centered 00:02:58.750 --> 00:03:00.924 position:50% align:middle around the patient experience. 00:03:00.924 --> 00:03:08.345 position:50% align:middle Her laboratory develops interactive virtual reality experiences to better characterize patients 00:03:08.345 --> 00:03:18.267 position:50% align:middle with complex chronic conditions such as diabetes and heart failure, and a context in which they live. 00:03:18.267 --> 00:03:25.097 position:50% align:middle These simulations have several purposes, including enabling patients to rehearse 00:03:25.097 --> 00:03:29.879 position:50% align:middle problem-solving behaviors, to help improve their health outcomes, 00:03:29.879 --> 00:03:36.504 position:50% align:middle and disease management skills, inspiring design of innovative home care technologies, 00:03:36.504 --> 00:03:46.093 position:50% align:middle and improving understanding of the sensory behavior and cognitive processes that shape self-care. 00:03:46.093 --> 00:03:51.030 position:50% align:middle Dr. Brennan was on the faculty at Case Western for 10 years 00:03:51.030 --> 00:03:55.728 position:50% align:middle and for 20 years at the University of Wisconsin in Madison. 00:03:55.728 --> 00:04:02.773 position:50% align:middle She also is proudly the mother of a 20-year-old son named Connor. 00:04:02.773 --> 00:04:10.142 position:50% align:middle Thank you, and please join me in welcoming her to NCSBN's Scientific Symposium. 00:04:23.084 --> 00:04:24.438 position:50% align:middle - [Dr. Brennan] Good morning. 00:04:24.438 --> 00:04:29.929 position:50% align:middle I'm delighted to be here and quite honored to be the Jennifer Hayden speaker today. 00:04:29.929 --> 00:04:36.042 position:50% align:middle I'm bringing you ideas about open science and the way nursing and the National Library of Medicine 00:04:36.042 --> 00:04:37.433 position:50% align:middle can work together. 00:04:37.433 --> 00:04:42.506 position:50% align:middle We will be, at this next 40 minutes, having presentations and... 00:04:42.506 --> 00:04:44.723 position:50% align:middle Excuse me, I'm not seeing my slides. 00:04:44.723 --> 00:04:48.182 position:50% align:middle We'll be having presentations and conversations. 00:04:48.182 --> 00:04:54.752 position:50% align:middle This is an audience participation activity and we'll be here together with you to discuss the different ways 00:04:54.752 --> 00:04:58.255 position:50% align:middle that the NLM can help your scholars shape the public discourse. 00:04:58.969 --> 00:05:01.912 position:50% align:middle There are three objectives for the session today. 00:05:01.912 --> 00:05:07.364 position:50% align:middle First, to recognize the role of the National Library of Medicine in supporting the scientific responses 00:05:07.364 --> 00:05:08.864 position:50% align:middle to health challenges. 00:05:08.864 --> 00:05:14.440 position:50% align:middle Second, to critically appraise the contribution of the NLM's offerings of bibliographic and full-text 00:05:14.440 --> 00:05:19.979 position:50% align:middle literature databases, biomedical databases, and repositories such as clinicaltrials.gov 00:05:19.979 --> 00:05:22.136 position:50% align:middle in support of nursing science. 00:05:22.136 --> 00:05:28.052 position:50% align:middle And, finally, to devise pathways for public discourse that enhance the impact of one's science. 00:05:28.052 --> 00:05:33.645 position:50% align:middle Now, I recognize this is quite a large audience and quite a mixed audience so you may have different goals 00:05:33.645 --> 00:05:35.960 position:50% align:middle for what you would like to get out of my session. 00:05:35.960 --> 00:05:40.322 position:50% align:middle We are going to be having audience engagement throughout the entire session and we'll begin now 00:05:40.322 --> 00:05:41.912 position:50% align:middle with the first poll. 00:05:41.912 --> 00:05:44.501 position:50% align:middle If you go to your screen, to the right-hand side, 00:05:44.501 --> 00:05:47.102 position:50% align:middle you should see a poll that lists these three objectives. 00:05:47.102 --> 00:05:50.287 position:50% align:middle Please select the one that is most important to you. 00:06:10.003 --> 00:06:13.673 position:50% align:middle So, actually, interestingly enough, we're sort of evenly divided. 00:06:13.673 --> 00:06:18.898 position:50% align:middle Lots of interest in what the National Library of Medicine does, about 35% of the responders. 00:06:18.898 --> 00:06:24.336 position:50% align:middle Not as much interest in recognizing the role the library has played in supporting science 00:06:24.336 --> 00:06:27.398 position:50% align:middle but a lot of interest in devising pathways 00:06:27.398 --> 00:06:31.295 position:50% align:middle for enhancing the public health contribution of one science. 00:06:34.453 --> 00:06:39.656 position:50% align:middle To begin understanding the role of the National Library of Medicine and what our contributions are 00:06:39.656 --> 00:06:45.072 position:50% align:middle to nurses cholars and how they can shape the public discourse, please watch this short video. 00:06:45.072 --> 00:06:47.072 position:50% align:middle ♪ [music] ♪ 00:08:00.979 --> 00:08:06.587 position:50% align:middle Over the next 40 minutes, you're going to learn a lot about the National Library of Medicine. 00:08:06.587 --> 00:08:11.563 position:50% align:middle And you're probably going to come away with the idea that it's not your mother's library anymore. 00:08:11.563 --> 00:08:17.643 position:50% align:middle We're very excited to be part of the National Institutes of Health, which we joined in 1966. 00:08:17.643 --> 00:08:20.969 position:50% align:middle However, our library is 180 years old. 00:08:20.969 --> 00:08:26.012 position:50% align:middle Right now, in the 21st century, we focus on critical areas, 00:08:26.012 --> 00:08:28.818 position:50% align:middle critical infrastructure for knowledge and policy. 00:08:28.818 --> 00:08:31.763 position:50% align:middle We facilitate open access to the literature. 00:08:31.763 --> 00:08:36.193 position:50% align:middle We have resources such as PubMed Central, our full-text literature repository, 00:08:36.193 --> 00:08:43.207 position:50% align:middle the CORD-19 recollection which has over 120,000 COVID-specific articles that had been made open 00:08:43.207 --> 00:08:49.563 position:50% align:middle to the public for machine learning as well as for general perusing during this terrible pandemic, 00:08:49.563 --> 00:08:53.070 position:50% align:middle and PubMed, the bibliographic citation database that we have. 00:08:53.070 --> 00:08:59.655 position:50% align:middle We also conduct and support research in computational biology and computational health sciences. 00:08:59.655 --> 00:09:02.794 position:50% align:middle And we implement and establish training programs. 00:09:02.794 --> 00:09:07.365 position:50% align:middle We have training programs around the country, 16 programs in pre and post-doctoral training 00:09:07.365 --> 00:09:09.115 position:50% align:middle in biomedical informatics. 00:09:09.115 --> 00:09:14.050 position:50% align:middle We host hundreds of training programs throughout the year for clinicians, patients, 00:09:14.050 --> 00:09:19.108 position:50% align:middle and librarians to better understand data science and the resources of the National Library of Medicine. 00:09:19.108 --> 00:09:21.665 position:50% align:middle And we focus on informing policy. 00:09:21.665 --> 00:09:26.615 position:50% align:middle Now, as a federal body, we can't make policy but we do provide the educational 00:09:26.615 --> 00:09:33.207 position:50% align:middle and informational resources to shape policy around open data, research integrity, information access, 00:09:33.207 --> 00:09:35.295 position:50% align:middle and research accountability. 00:09:35.295 --> 00:09:39.234 position:50% align:middle Our focus today is on open science and public accountability. 00:09:39.234 --> 00:09:44.642 position:50% align:middle And the phrase that comes up quite often within open science concepts is the idea of open access. 00:09:44.642 --> 00:09:50.464 position:50% align:middle Now nurses, particularly nurses in practice who graduated from their programs that have been richly 00:09:50.464 --> 00:09:55.031 position:50% align:middle supported by libraries suddenly find that they can't always get access to the journals 00:09:55.031 --> 00:09:56.841 position:50% align:middle they're used to getting access to. 00:09:56.841 --> 00:10:02.382 position:50% align:middle The concept of open access means bringing the literature in the open to all who may need it. 00:10:02.382 --> 00:10:07.933 position:50% align:middle We're going to have a brief poll now to talk a little bit more about specifically what does it mean 00:10:07.933 --> 00:10:11.461 position:50% align:middle for the library to open access to literature and data? 00:10:11.461 --> 00:10:14.496 position:50% align:middle There's a new poll that's upped just now. 00:10:18.869 --> 00:10:20.308 position:50% align:middle Please respond. 00:10:28.559 --> 00:10:32.100 position:50% align:middle I'll try to give it a little more time this time so that everyone gets a chance to respond. 00:10:32.100 --> 00:10:33.783 position:50% align:middle What is open access? 00:10:37.464 --> 00:10:39.124 position:50% align:middle Not everyone will know the answer to this. 00:10:39.124 --> 00:10:40.781 position:50% align:middle Don't be concerned. 00:10:40.781 --> 00:10:43.553 position:50% align:middle We want to make sure we start off at the same point, though. 00:10:49.800 --> 00:10:52.821 position:50% align:middle There's a new poll that's upped just now. 00:10:56.623 --> 00:10:58.394 position:50% align:middle Please respond. 00:11:35.198 --> 00:11:36.471 position:50% align:middle So please respond. 00:11:38.310 --> 00:11:41.735 position:50% align:middle Open access, 42% of you got this correct. 00:11:41.735 --> 00:11:46.718 position:50% align:middle It's a set of principles and a range of practices through which research outputs 00:11:46.718 --> 00:11:50.402 position:50% align:middle including journal articles, but not only journal articles, 00:11:50.402 --> 00:11:54.894 position:50% align:middle are distributed online, free of cost, or other access barriers. 00:11:54.894 --> 00:12:01.294 position:50% align:middle Now often, open access is thought of as the publishers making a decision to remove the paywalls. 00:12:01.294 --> 00:12:05.598 position:50% align:middle And in fact, very often, that is a critical piece of open access, 00:12:05.598 --> 00:12:11.278 position:50% align:middle that is publisher's charge through subscription or through other mechanisms to get access to journals. 00:12:11.278 --> 00:12:22.418 position:50% align:middle But generally, from the perspective of the library, the open access is a partnership that allows for access 00:12:22.418 --> 00:12:28.798 position:50% align:middle to information generated by researchers supported by research activities and communicated 00:12:28.798 --> 00:12:34.007 position:50% align:middle through many mechanisms, including publications, journal repositories, and journal resources. 00:12:34.007 --> 00:12:39.339 position:50% align:middle The National Library of Medicine is building the 21st Century Collection. 00:12:39.339 --> 00:12:43.830 position:50% align:middle The 21st Century Collection has three key responsibilities. 00:12:43.830 --> 00:12:46.095 position:50% align:middle First and foremost, we preserve. 00:12:46.095 --> 00:12:50.152 position:50% align:middle We preserve materials that are available for the centuries to use. 00:12:50.152 --> 00:12:55.565 position:50% align:middle You might be surprised to know that in our library, we house 10th-century manuscripts from China 00:12:55.565 --> 00:13:01.168 position:50% align:middle that have helped us understand some of the basics of neuropathic and plant-based interventions. 00:13:01.168 --> 00:13:04.874 position:50% align:middle But increasingly, libraries are becoming electronic. 00:13:04.874 --> 00:13:07.374 position:50% align:middle And so we connect to other resources. 00:13:07.374 --> 00:13:14.423 position:50% align:middle We connect to the publishers, we connect to different sources of information, data repositories. 00:13:14.423 --> 00:13:19.394 position:50% align:middle In the future, discovery in the moment will become important. 00:13:19.394 --> 00:13:22.570 position:50% align:middle What is the answer to the question that you haven't yet thought of? 00:13:22.570 --> 00:13:27.295 position:50% align:middle Many of our resources are now connected because we create elaborate interconnections 00:13:27.295 --> 00:13:32.034 position:50% align:middle through search strategies, but in the future, we have a need to think about and anticipate 00:13:32.034 --> 00:13:34.590 position:50% align:middle the information needs as they unfold. 00:13:34.590 --> 00:13:39.298 position:50% align:middle Now, if you look across the bottom of the screen, our primary substrate for libraries has 00:13:39.298 --> 00:13:40.858 position:50% align:middle always been literature. 00:13:40.858 --> 00:13:47.798 position:50% align:middle But also I want you to think about that globe in the center, an interconnected set of literature, data, 00:13:47.798 --> 00:13:52.600 position:50% align:middle other products of research, code, pipelines that may be of value to document 00:13:52.600 --> 00:13:55.002 position:50% align:middle and show the rigor and reproducibility of our work. 00:13:55.002 --> 00:13:58.043 position:50% align:middle And of course, increasingly, data are important. 00:13:58.043 --> 00:14:03.634 position:50% align:middle Now, the National Library of Medicine has two key resources that are most familiar to the general public 00:14:03.634 --> 00:14:04.764 position:50% align:middle and to nurses. 00:14:04.764 --> 00:14:11.314 position:50% align:middle First is PubMed, a search engine that accesses the MEDLINE databases of reference, citations to articles 00:14:11.314 --> 00:14:14.146 position:50% align:middle in PubMed Central and some other related materials. 00:14:14.146 --> 00:14:17.864 position:50% align:middle We have over 30 million citations in PubMed. 00:14:17.864 --> 00:14:24.604 position:50% align:middle PubMed Central is a free digital repository that archives publicly accessible full scholarly articles 00:14:24.604 --> 00:14:28.424 position:50% align:middle and serves as the public archive for the NIH Public Policy. 00:14:28.424 --> 00:14:33.841 position:50% align:middle and for many other federal institutions, including, for example, the Department of Agriculture. 00:14:33.841 --> 00:14:39.977 position:50% align:middle We have these resources available 24 hours a day, 7 days a week. 00:14:39.977 --> 00:14:45.208 position:50% align:middle But during this period of time, with the tremendous public health emergency we have going on, 00:14:45.208 --> 00:14:52.427 position:50% align:middle we established the COVID-19 resource and began making available from first with a partnership 00:14:52.427 --> 00:15:01.090 position:50% align:middle of 50 publishers, over 95,000 articles that were made accessible and machine-accessible. 00:15:01.090 --> 00:15:07.173 position:50% align:middle This allowed for increasing the discovery process, identifying relationships between various medic drugs 00:15:07.173 --> 00:15:12.028 position:50% align:middle that are existing in use, and new possible targets for the COVID pandemic. 00:15:12.028 --> 00:15:18.171 position:50% align:middle This partnership required that we work closely with the publishers and the Office of Science, Technology, 00:15:18.171 --> 00:15:24.569 position:50% align:middle and Policy to remove the legal and financial barriers to accessing this information. 00:15:24.569 --> 00:15:28.220 position:50% align:middle I'll be glad to talk about that more in the question and answer session if you have some interest here. 00:15:28.220 --> 00:15:35.994 position:50% align:middle In addition to PubMed Central, we're partnering with the Allen Institute to build the CORD-19 data set. 00:15:35.994 --> 00:15:42.508 position:50% align:middle This has provided a challenge base for other investigators, for individuals with clever ideas, 00:15:42.508 --> 00:15:45.669 position:50% align:middle to be able to mine and extract this information. 00:15:45.669 --> 00:15:52.651 position:50% align:middle The concept of preprints, that is publishing a manuscript prior to a journal review, 00:15:52.651 --> 00:15:56.935 position:50% align:middle is getting greater hold in many disciplines, including the Health Sciences. 00:15:56.935 --> 00:16:04.383 position:50% align:middle The NIH began accepting preprints as a credible evidence of progress towards research goals 00:16:04.383 --> 00:16:05.813 position:50% align:middle about two years ago. 00:16:05.813 --> 00:16:10.943 position:50% align:middle Starting in the spring of this year, in June, the NLM launched the preprint pilot, 00:16:10.943 --> 00:16:16.298 position:50% align:middle where we now are making preprints discoverable through PubMed Central and through PubMed. 00:16:16.298 --> 00:16:21.303 position:50% align:middle We're focusing at this point only on the COVID-19 articles, related articles. 00:16:21.303 --> 00:16:26.185 position:50% align:middle But what this is allowing is the literature now, before it has gone through peer review, can be 00:16:26.185 --> 00:16:28.442 position:50% align:middle quickly accessible to researchers. 00:16:28.442 --> 00:16:31.953 position:50% align:middle Of course, this requires that we be sure that people understand our brand, 00:16:31.953 --> 00:16:37.364 position:50% align:middle and make sure that they don't confuse a preprint with an actual archive article that's been reviewed. 00:16:37.364 --> 00:16:43.720 position:50% align:middle So we use a lot of banner headings and electronic indicators to identify and differentiate 00:16:43.720 --> 00:16:47.170 position:50% align:middle what is a preprint from what is an actual article. 00:16:47.170 --> 00:16:52.642 position:50% align:middle We are only doing this for NIH-funded research because we know we have a trusted brand there. 00:16:52.642 --> 00:16:59.224 position:50% align:middle Improving access to the research literature is a critical, critical requirement of the library. 00:16:59.224 --> 00:17:03.416 position:50% align:middle As I indicated earlier, we have over 30 million citations. 00:17:03.416 --> 00:17:09.270 position:50% align:middle Two and a half million users come every day to use these resources, and conduct millions and millions 00:17:09.270 --> 00:17:11.150 position:50% align:middle of searches throughout the month. 00:17:11.150 --> 00:17:17.039 position:50% align:middle Now, what this means if we have 30 million resources, 30 million searches, we have too much literature 00:17:17.039 --> 00:17:18.562 position:50% align:middle for you to read all at once. 00:17:18.562 --> 00:17:25.124 position:50% align:middle And we know also that an individual who conducts a PubMed search often gets pages and pages of citations. 00:17:25.124 --> 00:17:30.079 position:50% align:middle We've been working, over the last couple of years, to integrate artificial intelligence solutions 00:17:30.079 --> 00:17:34.850 position:50% align:middle to make sure it's possible to get access to the most relevant literature. 00:17:34.850 --> 00:17:38.518 position:50% align:middle We've developed something that we call the best match process 00:17:38.518 --> 00:17:41.855 position:50% align:middle using a learning-to-rank artificial intelligence scheme. 00:17:41.855 --> 00:17:47.955 position:50% align:middle So when your query comes in at point number one, we translate it by mapping it to known vocabularies 00:17:47.955 --> 00:17:54.552 position:50% align:middle and terminology, and extract from our 30 million citations what might be the most likely 00:17:54.552 --> 00:17:56.255 position:50% align:middle top hits for you. 00:17:56.255 --> 00:18:00.878 position:50% align:middle But this still may be too many pages for you, to many papers for you to review efficiently. 00:18:00.878 --> 00:18:04.915 position:50% align:middle So then we apply this artificial intelligence learning-to-rank algorithm, 00:18:04.915 --> 00:18:06.915 position:50% align:middle which uses thousands of features. 00:18:07.034 --> 00:18:08.994 position:50% align:middle How often has this article been cited? 00:18:08.994 --> 00:18:11.404 position:50% align:middle What else has been cited along with this article? 00:18:11.404 --> 00:18:13.094 position:50% align:middle How recent is this article? 00:18:18.452 --> 00:18:18.634 position:50% align:middle And then we return to the individual, return to the searcher what we call the best match. 00:18:18.634 --> 00:18:24.434 position:50% align:middle This differentiates from our previous approach where we used to provide our resources in a reverse 00:18:24.434 --> 00:18:28.625 position:50% align:middle chronological order, that is most recent first, and you can still get that. 00:18:28.625 --> 00:18:33.834 position:50% align:middle But what we're finding is by using our AI mechanisms, we're able to get information 00:18:33.834 --> 00:18:35.775 position:50% align:middle into people's hands faster. 00:18:35.775 --> 00:18:39.386 position:50% align:middle What it looks like on the screen is you see in front of you. 00:18:39.386 --> 00:18:44.064 position:50% align:middle In the right-hand side, in the green box, you know, you can select either Best match or Most recent. 00:18:44.064 --> 00:18:49.145 position:50% align:middle And when you select the Best Match, a pop-up box appears that gives you... 00:18:49.145 --> 00:18:53.624 position:50% align:middle and identifies for you the best citations you could possibly get. 00:18:53.624 --> 00:18:57.554 position:50% align:middle We're continuing to improve this both by understanding how much click-through, 00:18:57.554 --> 00:19:00.438 position:50% align:middle how much do people actually read the citations we provide, 00:19:00.438 --> 00:19:04.766 position:50% align:middle and also by getting responses and feedback from our stakeholders around the world. 00:19:04.766 --> 00:19:10.235 position:50% align:middle This best match algorithm, according to our users, does produce better PubMed searches. 00:19:10.235 --> 00:19:15.290 position:50% align:middle But importantly, what it means for our researcher is that your work now is not going to be buried 00:19:15.290 --> 00:19:16.375 position:50% align:middle on page 30. 00:19:16.375 --> 00:19:18.920 position:50% align:middle It may be on page 1 of the citations. 00:19:18.920 --> 00:19:25.566 position:50% align:middle And since over 80% of the people who use the PubMed resource only go to the first page 00:19:25.566 --> 00:19:29.431 position:50% align:middle and they don't go beyond that, it's great to get things pushed up front quicker. 00:19:29.431 --> 00:19:37.654 position:50% align:middle We envision a world where the PubMed Clinical Queries provide quick, customized access 00:19:37.654 --> 00:19:40.328 position:50% align:middle to facilitate discovery of the PubMed resources, 00:19:40.328 --> 00:19:43.854 position:50% align:middle getting them available as quickly as possible to individuals. 00:19:43.854 --> 00:19:49.644 position:50% align:middle We run these filters by topic, research topic categories but we're also able to help 00:19:49.644 --> 00:19:54.474 position:50% align:middle people create individual clinical queries for their own clinical populations. 00:19:54.474 --> 00:19:59.366 position:50% align:middle This does help us to accelerate discovery and opens up the literature more quickly. 00:19:59.366 --> 00:20:04.322 position:50% align:middle Opening up the literature is not only making the literature available but making it accessible in ways 00:20:04.322 --> 00:20:06.055 position:50% align:middle that people can consume it. 00:20:06.055 --> 00:20:11.574 position:50% align:middle A good deal of our work though focuses on research data sets and making research data sets 00:20:11.574 --> 00:20:14.960 position:50% align:middle reusable and discoverable around the world. 00:20:14.960 --> 00:20:19.373 position:50% align:middle On the screen in front of you, you see a number of different important research data sets 00:20:19.373 --> 00:20:25.401 position:50% align:middle such as the Kids First study from Pennsylvania or the All of Us, the million participants of the… 00:20:25.401 --> 00:20:30.324 position:50% align:middle participants to understand health and everyday living, Cancer Moonshot, the Framingham Study, 00:20:30.324 --> 00:20:32.107 position:50% align:middle and the NCBI. 00:20:32.107 --> 00:20:35.021 position:50% align:middle That's our National Center for Biotechnology Information. 00:20:35.021 --> 00:20:42.117 position:50% align:middle Finding ways to connect these data sets and make them available by a query not only accelerates research, 00:20:42.117 --> 00:20:45.484 position:50% align:middle but it also provides a wonderful platform for training for our students. 00:20:45.484 --> 00:20:51.062 position:50% align:middle And for those of you who are looking to shape public policy, being able to access data directly 00:20:51.062 --> 00:20:54.959 position:50% align:middle provides a strengthening to the base of the policies you're trying to shape. 00:20:54.959 --> 00:21:01.210 position:50% align:middle Most recently, we've been looking at how to better support the use of model organisms in research. 00:21:01.210 --> 00:21:06.644 position:50% align:middle Model organisms are important because they provide a way to better understand a particular physiologic 00:21:06.644 --> 00:21:12.634 position:50% align:middle oriented process that's relevant to humans, but can be studied in another species. 00:21:12.634 --> 00:21:18.819 position:50% align:middle In our case, most of our model organisms provide part replicas of humans like zebrafish, 00:21:18.819 --> 00:21:21.069 position:50% align:middle or rats or mice. 00:21:21.069 --> 00:21:23.810 position:50% align:middle Some of you may have even studied some of these in school. 00:21:23.810 --> 00:21:29.501 position:50% align:middle But to build the knowledge base that connects them together requires that we construct the ecosystem 00:21:29.501 --> 00:21:31.400 position:50% align:middle that you see on the left-hand side here. 00:21:31.400 --> 00:21:36.749 position:50% align:middle So on the upper part of that left-hand blue document, you see various organisms, 00:21:36.749 --> 00:21:42.670 position:50% align:middle the sequences, and the anatomy, and images about those organisms. 00:21:42.670 --> 00:21:49.832 position:50% align:middle In the two circles, you see the data related to those organisms, transcriptomes, genes, orthologs, 00:21:49.832 --> 00:21:52.733 position:50% align:middle as well as the tools to interrogate the data. 00:21:52.733 --> 00:21:57.205 position:50% align:middle The BLAST search was just a broad analysis search or genome annotation. 00:21:57.205 --> 00:22:02.516 position:50% align:middle The role of the National Library of Medicine is to bring those two circles together with the communities 00:22:02.516 --> 00:22:03.995 position:50% align:middle that want to study them. 00:22:03.995 --> 00:22:09.646 position:50% align:middle And we also work very closely with those communities to annotate and to provide the critical description 00:22:09.646 --> 00:22:14.984 position:50% align:middle of what gene structure appears in multiple organisms, for example, or doesn't have the same function 00:22:14.984 --> 00:22:16.396 position:50% align:middle in multiple organisms. 00:22:16.396 --> 00:22:23.666 position:50% align:middle So, our library is designed not only for human readers but also for machine processing of large and vast 00:22:23.666 --> 00:22:25.043 position:50% align:middle amounts of data. 00:22:25.043 --> 00:22:30.306 position:50% align:middle Our goals are to provide a central portal, the ability to work in the cloud, 00:22:30.306 --> 00:22:34.687 position:50% align:middle the ability to have large-scale compute properties that don't require a single institution 00:22:34.687 --> 00:22:41.398 position:50% align:middle to hold a number of resources, to include shared tools and scalable analysis that provides the infrastructure 00:22:41.398 --> 00:22:42.698 position:50% align:middle for data science. 00:22:42.698 --> 00:22:45.618 position:50% align:middle Now, nursing is just beginning to really exploit these resources. 00:22:45.618 --> 00:22:49.527 position:50% align:middle And I'm looking forward to making them even more useful to the nursing community. 00:22:49.527 --> 00:22:54.554 position:50% align:middle The National Library of Medicine, in addition to providing a wide range of resources 00:22:54.554 --> 00:23:00.199 position:50% align:middle to communicate about and support the conduct of research, also conducts research itself. 00:23:00.199 --> 00:23:05.838 position:50% align:middle Let me pause here and take you to another poll and ask you to… 00:23:05.838 --> 00:23:12.011 position:50% align:middle Did you know know that the National Library of Medicine has a… 00:23:12.011 --> 00:23:17.962 position:50% align:middle funds both internal research in our campus at Bethesda, as well as extramural research? 00:24:15.900 --> 00:24:19.764 position:50% align:middle Most of you did not know that the National Library of Medicine funded research. 00:24:19.764 --> 00:24:25.825 position:50% align:middle But now I'm delighted to tell you that we spend over $60 million around the country every year 00:24:25.825 --> 00:24:30.555 position:50% align:middle creating the kind of research infrastructure necessary to support patient care, 00:24:30.555 --> 00:24:34.995 position:50% align:middle as well as necessary to support effective information management use. 00:24:34.995 --> 00:24:39.991 position:50% align:middle On the screen in front of you, you see our broad-based research portfolio. 00:24:39.991 --> 00:24:45.615 position:50% align:middle Our research portfolio focuses on understanding the machine learning tools that can be used 00:24:45.615 --> 00:24:50.918 position:50% align:middle in a variety of resources but particularly applied to learning from electronic health records. 00:24:50.918 --> 00:24:53.740 position:50% align:middle We support information standards and discovery. 00:24:53.740 --> 00:25:00.059 position:50% align:middle We do a lot of our work on image processing and creating a way to use machine learning 00:25:00.059 --> 00:25:01.633 position:50% align:middle to interpret images. 00:25:01.633 --> 00:25:07.463 position:50% align:middle Our focus here is not so much to cure cancer but to build better tools and make the tools 00:25:07.463 --> 00:25:11.476 position:50% align:middle better available for the analysts who are working to cure cancer. 00:25:11.476 --> 00:25:16.746 position:50% align:middle We focus on natural language processing a lot, extracting meaning from text but also on statistical 00:25:16.746 --> 00:25:23.737 position:50% align:middle analysis and our biologically-driven research makes use of our genomic databases to be sure that we can better 00:25:23.737 --> 00:25:27.785 position:50% align:middle understand and have access to the secrets that are hidden within genes. 00:25:27.785 --> 00:25:32.934 position:50% align:middle A lot of our work does focus on the electronic health record as a source of information 00:25:32.934 --> 00:25:35.267 position:50% align:middle and engagement for understanding. 00:25:35.267 --> 00:25:40.688 position:50% align:middle What we're trying to envision is a future of understanding how an individual from the level 00:25:40.688 --> 00:25:47.449 position:50% align:middle of their genetic structure to their functional everyday being, to their image, sorry, 00:25:47.449 --> 00:25:53.586 position:50% align:middle their anatomy and physiology to bring this together in a way for us to better understand and therefore, 00:25:53.586 --> 00:25:57.668 position:50% align:middle as a society, better improve the health for all. 00:25:57.668 --> 00:26:03.056 position:50% align:middle Some of the work that we do focus very specifically on tools that could be of use to nurses. 00:26:03.056 --> 00:26:06.570 position:50% align:middle A project in particular is a project called the THYME Project. 00:26:06.570 --> 00:26:10.486 position:50% align:middle This is conducted in Boston by Guergana Savova's group. 00:26:10.486 --> 00:26:16.192 position:50% align:middle And basically what she's learning to do is to take a broad range of clinical information 00:26:16.192 --> 00:26:20.416 position:50% align:middle from the clinical text and begin to provide sequence narratives. 00:26:20.416 --> 00:26:25.992 position:50% align:middle Now, she's using natural language processing to create patient timelines and then annotate these 00:26:25.992 --> 00:26:31.715 position:50% align:middle within a document so that a clinician who's looking across the broad range of a patient's care challenges 00:26:31.715 --> 00:26:33.834 position:50% align:middle can see what has happened in what sequence. 00:26:33.834 --> 00:26:39.057 position:50% align:middle Now, what the National Library of Medicine does uniquely that other institutes in NIH don't do is we 00:26:39.057 --> 00:26:41.330 position:50% align:middle try to develop reusable tools. 00:26:41.330 --> 00:26:46.554 position:50% align:middle So as Dr. Savova's group is developing an understanding of what constitutes a disorder 00:26:46.554 --> 00:26:49.107 position:50% align:middle and how do we understand the clinical narrative over time, 00:26:49.107 --> 00:26:54.245 position:50% align:middle she's also making those tools available for other investigators and for other health care systems 00:26:54.245 --> 00:26:57.527 position:50% align:middle to be able to make use and reuse her information. 00:26:59.362 --> 00:27:02.624 position:50% align:middle We are quite interested in better support for clinical trials. 00:27:02.624 --> 00:27:08.729 position:50% align:middle As you know, the COVID-19 pandemic recognized and relied on clinical studies 00:27:08.729 --> 00:27:10.869 position:50% align:middle engaging patients very quickly. 00:27:10.869 --> 00:27:17.250 position:50% align:middle And yet in order to conduct clinical trials, we need to have strong and good record systems so that the trial, 00:27:17.250 --> 00:27:21.041 position:50% align:middle that particular protocol, the inclusion criteria are all available. 00:27:21.041 --> 00:27:28.230 position:50% align:middle We have a fantastic resource called ClinicalTrials.gov, which is a place where all research, clinical trial 00:27:28.230 --> 00:27:33.130 position:50% align:middle research that is designed either to be conducted in support of an FDA application 00:27:34.383 --> 00:27:37.513 position:50% align:middle or is supported by the NIH must be registered. 00:27:37.513 --> 00:27:40.583 position:50% align:middle Excuse me, the results can also be reported there. 00:27:40.583 --> 00:27:48.542 position:50% align:middle This ClinicalTrials.gov repository actually allows for clinical trials as well as patients to better find 00:27:48.542 --> 00:27:50.183 position:50% align:middle out what studies might be available. 00:27:50.183 --> 00:27:54.895 position:50% align:middle What's going on in their area that they might find relevant to someone that they care about 00:27:54.895 --> 00:27:57.468 position:50% align:middle or help them in their own management of a disease. 00:27:57.468 --> 00:28:07.273 position:50% align:middle Since 2019, we also report, within one year of completion, the final outcomes of every clinical trial. 00:28:07.273 --> 00:28:11.819 position:50% align:middle This is a really important public accountability responsibility that the NLM takes on. 00:28:11.819 --> 00:28:18.277 position:50% align:middle We've learned that fully one-third of all clinical trials funded by NIH never make it into 00:28:18.277 --> 00:28:23.345 position:50% align:middle a clinical record, never make it into an archival publication, never even get to a preprint. 00:28:23.345 --> 00:28:29.254 position:50% align:middle So by having a structured way to report the outcomes of clinical trials, NLM is supporting rigor 00:28:29.254 --> 00:28:33.453 position:50% align:middle and reproducibility in clinical trials research. 00:28:33.453 --> 00:28:37.062 position:50% align:middle We're also trying to find ways to match patients to trials better. 00:28:37.062 --> 00:28:42.182 position:50% align:middle Where, in this case, we take the eligibility criteria that is in the narrative description 00:28:42.182 --> 00:28:48.163 position:50% align:middle in the ClinicalTrials.gov application and build tools that allow an investigator to scan through 00:28:48.163 --> 00:28:54.368 position:50% align:middle clinical records safely and protecting patient privacy to identify people that might be good candidates 00:28:54.368 --> 00:28:56.817 position:50% align:middle to participate in a research program. 00:28:56.817 --> 00:29:04.102 position:50% align:middle The National Library of Medicine then supports its own research, focusing on reusable methods 00:29:04.102 --> 00:29:10.521 position:50% align:middle and better use of data including clinical data and supports the research of others by providing registries 00:29:10.521 --> 00:29:13.712 position:50% align:middle and repositories such as ClinicalTrials.gov. 00:29:14.615 --> 00:29:19.700 position:50% align:middle I now want to talk a little bit about what we do for training before we start going into public policy. 00:29:22.065 --> 00:29:28.263 position:50% align:middle On your polls now, please turn to our question about training. 00:29:28.263 --> 00:29:31.566 position:50% align:middle The NLM recognizes that data science is new to most people 00:29:31.566 --> 00:29:33.676 position:50% align:middle and everyone's going to need some kind of training. 00:29:33.676 --> 00:29:38.909 position:50% align:middle So what type of training do you think is your preferred means of learning? 00:30:32.570 --> 00:30:38.871 position:50% align:middle Well, I see a strong interest in webinars, short, informative focused, and flexible. 00:30:38.871 --> 00:30:43.556 position:50% align:middle Some preference for Zoom and no one wants injestible biochips. 00:30:43.556 --> 00:30:45.236 position:50% align:middle That's a pretty bizarre idea. 00:30:45.236 --> 00:30:50.004 position:50% align:middle But actually, I had a colleague about 20 years ago advocating that we should somehow find a way to 00:30:50.004 --> 00:30:54.638 position:50% align:middle encapsulate knowledge into capsules and then swallow it. 00:30:54.638 --> 00:30:59.930 position:50% align:middle Never saw that one as becoming a great use for us, particularly for professional development. 00:31:00.044 --> 00:31:04.513 position:50% align:middle But the National Library of Medicine is deeply involved in training across the career lifespan. 00:31:05.012 --> 00:31:09.461 position:50% align:middle So let's talk about some of the things that we do for expanding and enhancing research training 00:31:09.461 --> 00:31:11.752 position:50% align:middle for biomedical informatics and data science. 00:31:11.752 --> 00:31:16.943 position:50% align:middle I see a strong interest in webinars, short, informative, focused, and flexible. 00:31:16.943 --> 00:31:20.739 position:50% align:middle Some preference for Zoom, sorry about that. 00:31:22.216 --> 00:31:28.292 position:50% align:middle The training that we do at the National Library of Medicine focuses on skills training for biomedical 00:31:28.292 --> 00:31:29.963 position:50% align:middle informatics and data science. 00:31:29.963 --> 00:31:36.518 position:50% align:middle We provide training to undergraduates, to doctoral students, and to postdoctoral students. 00:31:36.518 --> 00:31:42.004 position:50% align:middle Nurses are eligible to participate in our training programs, and many of our training programs exist 00:31:42.004 --> 00:31:47.165 position:50% align:middle in schools and universities that have strong partnerships with schools of nursing. 00:31:47.165 --> 00:31:52.263 position:50% align:middle These training programs provide support and a stipend for an individual to study for several years. 00:31:52.263 --> 00:31:57.063 position:50% align:middle The important goal in the beginning of our training program is to begin...to come with an idea, 00:31:57.063 --> 00:32:01.203 position:50% align:middle come with a thought, come with a question that can be answered by developing 00:32:01.203 --> 00:32:04.690 position:50% align:middle better methods and better use of data and information. 00:32:04.690 --> 00:32:07.871 position:50% align:middle We also provide training across society. 00:32:07.871 --> 00:32:12.993 position:50% align:middle We recognize that laboratory scientists, patients, and clinicians all are being faced with 00:32:12.993 --> 00:32:14.837 position:50% align:middle this data science revolution. 00:32:14.893 --> 00:32:20.109 position:50% align:middle And it's really quite a step away from what we've learned in the developing evidence-based practice 00:32:20.109 --> 00:32:23.065 position:50% align:middle or some of what we learned in our research programs in school. 00:32:23.065 --> 00:32:29.274 position:50% align:middle So we are focusing a lot on the use of webinars, particularly webinars that make the library's resources 00:32:29.274 --> 00:32:32.026 position:50% align:middle more useful to people around the world. 00:32:32.026 --> 00:32:34.473 position:50% align:middle But we don't stop with professionals. 00:32:34.473 --> 00:32:39.946 position:50% align:middle We also are trying to reach into the next generation of lay people, of consumers, 00:32:39.946 --> 00:32:45.812 position:50% align:middle and librarians to make sure that the data revolution that's coming is available to everyone. 00:32:45.812 --> 00:32:49.641 position:50% align:middle In the screen in front of you, you see the map of the United States 00:32:49.641 --> 00:32:54.783 position:50% align:middle and those star points indicate the regions of the network of theNational Library of Medicine. 00:32:54.783 --> 00:33:01.252 position:50% align:middle The National Library of Medicine network is 8,000 points of presence around the country that are driven 00:33:01.252 --> 00:33:07.705 position:50% align:middle to best understanding to best development of the library's resources in the community. 00:33:07.705 --> 00:33:12.450 position:50% align:middle So we have close connections with communities, we have individuals that can help train 00:33:12.450 --> 00:33:15.595 position:50% align:middle or help make accessible our own resources. 00:33:15.595 --> 00:33:19.895 position:50% align:middle We use this now, we've used this several times in the All of Us program. 00:33:19.895 --> 00:33:24.715 position:50% align:middle We provide the community engagement structure to make sure that there was somebody present in every community 00:33:24.715 --> 00:33:28.226 position:50% align:middle to help answer questions in the...under the seal, 00:33:28.226 --> 00:33:33.913 position:50% align:middle sorry, the Heal Initiative that's helped to end addictions long term. 00:33:33.913 --> 00:33:38.700 position:50% align:middle Our network of the National Libraries of Medicine provided a place for disseminating information, 00:33:38.700 --> 00:33:44.293 position:50% align:middle and also for getting information to the local clinicians and researchers about new initiatives 00:33:44.293 --> 00:33:45.810 position:50% align:middle and new strategies. 00:33:45.810 --> 00:33:50.002 position:50% align:middle Under the COVID-19 pandemic, our network once again has come into play. 00:33:50.002 --> 00:33:55.813 position:50% align:middle Our network includes everything from hospital libraries to academic health science centers, 00:33:55.813 --> 00:33:57.870 position:50% align:middle to public libraries in the community. 00:33:57.870 --> 00:34:01.450 position:50% align:middle And each of those serves slightly different people, but make sure the resources, 00:34:01.450 --> 00:34:05.030 position:50% align:middle the National Library of Medicine, come forward and can be present. 00:34:05.030 --> 00:34:10.716 position:50% align:middle Now, we're starting to assist with information about vaccines and helping to improve vaccine acceptance 00:34:10.716 --> 00:34:12.239 position:50% align:middle across the country. 00:34:12.239 --> 00:34:17.320 position:50% align:middle Our training programs, sometimes are degree-granting, sometimes are certificate-producing, 00:34:17.320 --> 00:34:23.506 position:50% align:middle and sometimes are information-generating for individuals, all are open and freely available 00:34:23.506 --> 00:34:29.033 position:50% align:middle around the country, and are freely available almost online everywhere in the world. 00:34:30.585 --> 00:34:37.263 position:50% align:middle I now want to turn or my last set of comments in our last 25 minutes or so to talk about the key concepts 00:34:37.263 --> 00:34:41.990 position:50% align:middle for this meeting, which is how do we take all these resources and really begin to inform policy? 00:34:41.990 --> 00:34:45.116 position:50% align:middle I have two polling questions for you right now 00:34:45.116 --> 00:34:50.753 position:50% align:middle because I want to better understand the policies that are most important to you. 00:34:50.900 --> 00:34:53.397 position:50% align:middle The first question I want you to answer is, 00:34:53.397 --> 00:34:59.930 position:50% align:middle what is the most critical public policy that your expertise could help inform and shape? 00:36:32.998 --> 00:36:35.057 position:50% align:middle Thanks and thanks to whoever's managing the poll. 00:36:35.057 --> 00:36:36.206 position:50% align:middle I appreciate that. 00:36:36.206 --> 00:36:43.450 position:50% align:middle So, the major public policy concern that was identified by this group as critical is promoting 00:36:43.450 --> 00:36:44.879 position:50% align:middle patient safety in hospitals. 00:36:44.879 --> 00:36:49.167 position:50% align:middle Almost 60% of you identified that as your key public policy. 00:36:49.167 --> 00:36:51.644 position:50% align:middle There are others on here. 00:36:51.644 --> 00:36:55.555 position:50% align:middle Some are going to write into the chat with the public policy issues that they had... 00:36:55.555 --> 00:36:56.798 position:50% align:middle that they're interested in. 00:36:56.798 --> 00:37:00.365 position:50% align:middle There's about 18% of the people that were going to write something themselves. 00:37:00.365 --> 00:37:07.565 position:50% align:middle There is the other policy issues that generated interest though were reducing maternal mortality. 00:37:07.565 --> 00:37:11.881 position:50% align:middle About 10% of you are interested in that. Ensuring food security for all. 00:37:11.881 --> 00:37:18.904 position:50% align:middle About 5% are interested in that. And preventing elder abuse, about 8% are interested in that. 00:37:23.596 --> 00:37:29.416 position:50% align:middle Now, I'm going to take you to this next poll which is a question about nursing-related policies. 00:37:29.416 --> 00:37:34.473 position:50% align:middle And I hope you understand the distinction between public policy and nursing-related policies. 00:37:34.473 --> 00:37:40.111 position:50% align:middle Nurses must participate in shaping the policies of health for all, but we also must participate 00:37:40.111 --> 00:37:43.184 position:50% align:middle in the policies that are relevant to our discipline. 00:37:43.184 --> 00:37:48.727 position:50% align:middle So, on the screen in front of you, and in the poll rather, you have a set of four options 00:37:48.727 --> 00:37:51.529 position:50% align:middle or opportunity to write your own into the chat. 00:38:39.389 --> 00:38:45.441 position:50% align:middle Well, now, I see a rousing 38% think we need to focus on workforce development. 00:38:45.441 --> 00:38:49.327 position:50% align:middle But 35% of you are interested in practicing at the top of our licenses. 00:38:49.327 --> 00:38:53.919 position:50% align:middle Only 5, excuse me, 3% are interested in pay equity 00:38:53.919 --> 00:38:58.858 position:50% align:middle and about 5% of you will write something into the chat, which we'll take a look at in a few minutes. 00:38:58.858 --> 00:39:04.336 position:50% align:middle There's many, many, many public policies that nurses need to participate in, 00:39:04.336 --> 00:39:10.296 position:50% align:middle and many ways that we will be creating for the future the kind of policies that are useful 00:39:10.296 --> 00:39:13.668 position:50% align:middle to bring the health goals that we want to have for our society. 00:39:13.668 --> 00:39:17.038 position:50% align:middle Today's focus is largely on data science and open science. 00:39:17.038 --> 00:39:24.288 position:50% align:middle That is making sure that the large amount of data that we have available is useful and used for the purposes 00:39:24.288 --> 00:39:26.048 position:50% align:middle of health and health science. 00:39:26.048 --> 00:39:31.912 position:50% align:middle When we move towards a model of open science, we need to recognize that there are several policy issues 00:39:31.912 --> 00:39:34.416 position:50% align:middle that have to come into play and interconnect. 00:39:34.416 --> 00:39:38.677 position:50% align:middle And perhaps none is more important than the idea of patient privacy. 00:39:38.677 --> 00:39:44.000 position:50% align:middle How do we make sure we can leverage our understanding of data, whether it's knowing where you've been walking 00:39:44.000 --> 00:39:49.090 position:50% align:middle with your cell phone or knowing your genetic code, in a way that advances society 00:39:49.090 --> 00:39:51.240 position:50% align:middle without exploiting individuals. 00:39:51.240 --> 00:39:54.595 position:50% align:middle Nurses must participate in these discussions. 00:39:54.595 --> 00:39:58.900 position:50% align:middle These discussions are happening at all levels, from the local to the state, to the county levels, 00:39:58.900 --> 00:40:04.666 position:50% align:middle and they are providing a way for individuals to really explore the challenge, 00:40:04.666 --> 00:40:07.957 position:50% align:middle essentially the trade-off between privacy and science. 00:40:07.957 --> 00:40:15.334 position:50% align:middle Now, we can make the future that we need to have happen if nurses are engaged in understanding public policy 00:40:15.334 --> 00:40:16.464 position:50% align:middle and shaping it. 00:40:16.464 --> 00:40:22.444 position:50% align:middle So I want to focus my comments now on what are nurse scholars' special roles in using data-driven science 00:40:22.444 --> 00:40:23.998 position:50% align:middle to shape policy. 00:40:23.998 --> 00:40:28.382 position:50% align:middle We can do things that no other health profession can do. 00:40:28.382 --> 00:40:36.175 position:50% align:middle So I'd like to consider your…to think about our policy activities as being grounded in our base discipline. 00:40:36.175 --> 00:40:40.275 position:50% align:middle And first and foremost, recognize the dignity of the source. 00:40:40.275 --> 00:40:44.405 position:50% align:middle That is respecting the dignity of the individual, the person, the family, 00:40:44.405 --> 00:40:48.845 position:50% align:middle the community that's providing us with information should also be benefiting from the provision 00:40:48.845 --> 00:40:55.019 position:50% align:middle of that information, including being able to be assured of privacy and confidentiality. 00:40:55.019 --> 00:41:00.295 position:50% align:middle Next, it's critically important to have principled approaches to discovery. 00:41:00.295 --> 00:41:05.825 position:50% align:middle Our nursing science traditions are strong and theory-driven, and grounded in the ability to better 00:41:05.825 --> 00:41:09.145 position:50% align:middle understand phenomenon because we use theory. 00:41:09.145 --> 00:41:15.915 position:50% align:middle This brings us to a way of understanding patients and the patient experience in novel ways. 00:41:15.915 --> 00:41:21.808 position:50% align:middle So principled approaches discovery and use of theory to guide interpretation are critical 00:41:21.808 --> 00:41:27.396 position:50% align:middle but they allow us to take special attention to the phenomenon of concern to nursing: 00:41:27.396 --> 00:41:30.142 position:50% align:middle the diagnosis and treatment of human responses. 00:41:30.142 --> 00:41:35.323 position:50% align:middle No other discipline focuses on the diagnosis and treatment of human responses. 00:41:35.323 --> 00:41:41.351 position:50% align:middle So when that knowledge is needed to shape policy, we must be the ones that bring it forward 00:41:41.351 --> 00:41:43.465 position:50% align:middle and make sure it's incorporated. 00:41:43.465 --> 00:41:49.486 position:50% align:middle We must remember that we should ask and answer questions that are germane to the discipline 00:41:49.486 --> 00:41:51.629 position:50% align:middle and to the people that we serve. 00:41:52.913 --> 00:41:57.779 position:50% align:middle We begin by thinking about how do we enhance the impact of our science. 00:41:57.779 --> 00:42:02.465 position:50% align:middle Being a great researcher writing terrific papers is only part of the story. 00:42:02.465 --> 00:42:07.278 position:50% align:middle Creating pathways for public discourse, that's what I want to focus on for the last couple 00:42:07.278 --> 00:42:08.797 position:50% align:middle of minutes of my talk. 00:42:08.797 --> 00:42:13.688 position:50% align:middle But you must begin always with this level of rigor and reproducibility. 00:42:13.688 --> 00:42:22.393 position:50% align:middle Good science is the foundation of good policies, and it's our [inaduble]. 00:42:22.393 --> 00:42:31.048 position:50% align:middle Secondly, a step must begin before we begin anything and that is to build your network. 00:42:31.048 --> 00:42:35.806 position:50% align:middle Build your networking conversation, not just in conversation with other researchers, 00:42:35.806 --> 00:42:42.343 position:50% align:middle but with the people who your research is designed to help and also with the people who helped to shape 00:42:42.343 --> 00:42:47.720 position:50% align:middle and manage the policies that are relevant to the care approaches that you want to have happened. 00:42:47.720 --> 00:42:51.136 position:50% align:middle Building a network is a career lifetime commitment. 00:42:51.136 --> 00:42:53.506 position:50% align:middle It doesn't happen project by project. 00:42:53.506 --> 00:42:59.651 position:50% align:middle And being known, sharing your willingness to work on policy, sharing your concerns about policies 00:42:59.651 --> 00:43:03.278 position:50% align:middle with other policymakers is a way of framing this network. 00:43:03.278 --> 00:43:08.965 position:50% align:middle The next step is to know what you know and to know what you don't know. 00:43:08.965 --> 00:43:15.410 position:50% align:middle But often, as we shape public policy, we have a focus on a thematic concern. 00:43:15.410 --> 00:43:21.020 position:50% align:middle But we need to be sure we also bring together those who understand the analytics that are used 00:43:21.020 --> 00:43:26.777 position:50% align:middle to highlight that thematic concern, the statistics, or the data science that underlies an activity. 00:43:26.777 --> 00:43:32.728 position:50% align:middle It is not solely the responsibility of nurses to know everything, but to know that everything that's critical 00:43:32.728 --> 00:43:38.299 position:50% align:middle to their policy concept is in fact made present, made available to the group. 00:43:41.371 --> 00:43:46.908 position:50% align:middle Amplifying your story comes in part by preserving trust and provenance in a highly 00:43:46.908 --> 00:43:49.098 position:50% align:middle distributed information environment. 00:43:49.098 --> 00:43:54.501 position:50% align:middle We well recognize that we're deeply suffering from an information-disinformation tension 00:43:54.501 --> 00:43:56.658 position:50% align:middle in our society right now. 00:43:56.658 --> 00:44:02.696 position:50% align:middle But for nursing, to get their materials explained and available to the public and thoughtfully 00:44:02.696 --> 00:44:09.919 position:50% align:middle entered into the public policy debate really requires that we use strategies that amplify trust. 00:44:09.919 --> 00:44:15.038 position:50% align:middle and provenances the consistency of a message and the source of the message in a highly 00:44:15.038 --> 00:44:17.028 position:50% align:middle distributed information environment. 00:44:17.028 --> 00:44:23.338 position:50% align:middle When we make use of Twitter or other kinds of public social media, we have to remember that our job 00:44:23.338 --> 00:44:29.518 position:50% align:middle is to leverage these in a way that is trustable and amplifying a message, not adding to the confusion 00:44:29.518 --> 00:44:31.253 position:50% align:middle of the conversation. 00:44:33.544 --> 00:44:38.859 position:50% align:middle We need to think about how to leverage and how to make good use of these emerging technologies. 00:44:38.859 --> 00:44:45.907 position:50% align:middle How could artificial intelligence or augmented reality help to bring forward an illustration of the policy 00:44:45.907 --> 00:44:49.457 position:50% align:middle you're trying to shape or the consequences of that policy? 00:44:49.457 --> 00:44:54.654 position:50% align:middle Considering how different ways of communicating, providing multiple channels of interaction, 00:44:54.654 --> 00:44:58.911 position:50% align:middle will allow your research to be presented to a number of different audiences. 00:44:58.911 --> 00:45:05.006 position:50% align:middle The opportunities to engage with the public have never been greater,. The chance for nurses to shape, 00:45:05.006 --> 00:45:10.098 position:50% align:middle to build their networks, to amplify their stories will come from effective use 00:45:10.098 --> 00:45:12.527 position:50% align:middle of emerging technologies. 00:45:12.527 --> 00:45:18.368 position:50% align:middle And please don't forget that storytelling is critical in policy development. 00:45:18.368 --> 00:45:21.143 position:50% align:middle The plural of anecdotes isn't data. 00:45:21.143 --> 00:45:27.129 position:50% align:middle So just having lots and lots of stories doesn't replace the need for data-driven sciences to shape policies 00:45:27.129 --> 00:45:30.726 position:50% align:middle but the stories are what sell the science. 00:45:30.726 --> 00:45:35.606 position:50% align:middle Stories and storytelling of the impact, the consequences, the opportunity, 00:45:35.606 --> 00:45:43.349 position:50% align:middle the ability, the unique perspective that your research brings to a particular problem takes it a long way 00:45:43.349 --> 00:45:47.618 position:50% align:middle to helping others who have the ability to shape and decide on the policies, 00:45:47.618 --> 00:45:52.543 position:50% align:middle which policies should be attended to and how they should be enacted. 00:45:52.543 --> 00:45:57.738 position:50% align:middle And, finally, please think carefully about transporting. 00:45:57.738 --> 00:46:00.473 position:50% align:middle How do you transform science into action? 00:46:00.473 --> 00:46:04.773 position:50% align:middle Sometimes, it's through clinical care. Sometimes, it's through the ability to engage 00:46:04.773 --> 00:46:09.440 position:50% align:middle with individuals and develop a story that they can then take forward. 00:46:09.440 --> 00:46:16.053 position:50% align:middle Sometimes, it's the changing of a product or developing of a whole new model of a community engagement. 00:46:16.053 --> 00:46:22.943 position:50% align:middle There's lots of ways that we transport our science into action and nursing creativity can help us go a long way 00:46:22.943 --> 00:46:29.047 position:50% align:middle in addressing the critical policies concerns that can be answered and addressed by the knowledge 00:46:29.047 --> 00:46:32.513 position:50% align:middle that we build uniquely as nursing around society. 00:46:32.513 --> 00:46:39.685 position:50% align:middle I want to close my remarks by reminding you that the National Library of Medicine has, for almost 200 years, 00:46:39.685 --> 00:46:43.075 position:50% align:middle served as a trusted source of health information. 00:46:43.075 --> 00:46:50.035 position:50% align:middle That trusted source of health information benefits from nursing and nursing knowledge and should support and 00:46:50.035 --> 00:46:53.535 position:50% align:middle develop nursing and nursing knowledge as we go forward. 00:46:53.535 --> 00:46:57.435 position:50% align:middle I look forward to continuing to work with you in any way that I can. 00:46:57.435 --> 00:47:01.026 position:50% align:middle You can reach me on email or on Twitter 00:47:01.026 --> 00:47:05.443 position:50% align:middle or every Wednesday morning, the blog Musings from the Mezzanine comes out. 00:47:05.443 --> 00:47:08.789 position:50% align:middle I try to showcase nursing stories periodically through the year. 00:47:08.789 --> 00:47:13.053 position:50% align:middle If one of you has an idea that you'd like to include in a Musings blog post, 00:47:13.053 --> 00:47:14.393 position:50% align:middle please reach out and get in touch with me. 00:47:14.393 --> 00:47:16.598 position:50% align:middle I often have guest bloggers. 00:47:16.598 --> 00:47:18.118 position:50% align:middle Thanks very much for your time. 00:47:18.118 --> 00:47:20.582 position:50% align:middle Thank you for your patience with the technologies. 00:47:20.582 --> 00:47:23.892 position:50% align:middle Thanks to the tech people who've been very supportive through this session 00:47:23.892 --> 00:47:28.852 position:50% align:middle and I believe I've left us about 10 minutes for some questions and conversation. 00:47:54.886 --> 00:47:59.242 position:50% align:middle - Dr. Brennan, thank you very much. That was an excellent presentation and 00:47:59.242 --> 00:48:02.316 position:50% align:middle extremely informative and enlightening. 00:48:02.316 --> 00:48:07.769 position:50% align:middle I'd like to open it up now for questions for Dr. Brennan. 00:48:07.769 --> 00:48:11.814 position:50% align:middle Please put them in the Q&A section on your website. 00:48:11.814 --> 00:48:17.016 position:50% align:middle Dr. Brennan, the first question I have is from Carrie Downing. 00:48:17.016 --> 00:48:23.090 position:50% align:middle She asks, "How many clinical trials do not make it to publication?" 00:48:23.090 --> 00:48:27.611 position:50% align:middle She says she knows you mentioned it but she missed the number. 00:48:27.611 --> 00:48:32.662 position:50% align:middle - Carrie, this is a number I'm not very proud to be restating again. 00:48:32.662 --> 00:48:39.381 position:50% align:middle But from the work of Deborah Zarin, Z-A-R-I-N, over the last five years, we think that it's about 00:48:39.381 --> 00:48:45.602 position:50% align:middle one-third of all clinical trials that were funded by the NIH never appear on publication. 00:48:45.602 --> 00:48:50.601 position:50% align:middle Now, there are other clinical trials that are not funded by the NIH that don't appear, 00:48:50.601 --> 00:48:52.339 position:50% align:middle don't ever make it to publication. 00:48:52.339 --> 00:48:58.406 position:50% align:middle And frankly, we also have challenges with clinical trials that are conducted internationally. 00:48:58.406 --> 00:49:05.094 position:50% align:middle Sometimes, the challenge is because there are… there's a difference in the way studies are conducted, 00:49:05.094 --> 00:49:08.884 position:50% align:middle there's culture around sampling plans and an analytic plan. 00:49:08.884 --> 00:49:15.276 position:50% align:middle Sometimes, there's no results and journals are actually much more likely to publish positive results 00:49:15.276 --> 00:49:20.204 position:50% align:middle or results that at least are definitive, rather than a study that comes to the end and says, 00:49:20.204 --> 00:49:22.408 position:50% align:middle "Well, we don't really know that this made a difference ." 00:49:22.408 --> 00:49:29.487 position:50% align:middle One of the critical pieces about communication about studies is knowing what failed is as important 00:49:29.487 --> 00:49:31.234 position:50% align:middle as knowing what worked. 00:49:31.234 --> 00:49:36.153 position:50% align:middle And that kind of information can be found by looking at the ClinicalTrials.gov repository 00:49:36.153 --> 00:49:37.869 position:50% align:middle to look at our results. 00:49:40.206 --> 00:49:41.223 position:50% align:middle - Thank you. 00:49:41.223 --> 00:49:44.469 position:50% align:middle I have another question for you from Kathy Scott. 00:49:44.469 --> 00:49:53.146 position:50% align:middle She asks, "Could you say more about open science publications and the responsibility of the author 00:49:53.146 --> 00:49:55.299 position:50% align:middle versus the publisher?" 00:49:55.299 --> 00:50:00.704 position:50% align:middle - I can say to…from the perspective of the director of the National Library of Medicine 00:50:00.704 --> 00:50:04.485 position:50% align:middle but I'm not a publisher so I can't speak specifically for them. 00:50:04.743 --> 00:50:10.307 position:50% align:middle When you say open science publications, I believe you might be referring to open access publication. 00:50:10.400 --> 00:50:18.123 position:50% align:middle In the PubMed Central repository we have something referred to as the open access subset. 00:50:18.123 --> 00:50:22.381 position:50% align:middle These are journals where the journals themselves are completely open. 00:50:22.381 --> 00:50:28.013 position:50% align:middle Now, in most open access journals, that is, the journal makes all of its publications, 00:50:28.013 --> 00:50:32.685 position:50% align:middle all of its articles available without a paywall and available electronically, 00:50:32.685 --> 00:50:39.910 position:50% align:middle in most open access publications, there is a process called author use fees or author publication fees. 00:50:39.910 --> 00:50:47.077 position:50% align:middle And this is a fee that the author pays, as the publication is being developed, to support the cost 00:50:47.077 --> 00:50:48.585 position:50% align:middle of managing the journal. 00:50:48.585 --> 00:50:56.290 position:50% align:middle So in many cases, author fees or other publication fees are required to support an open-access journal. 00:50:56.290 --> 00:51:04.527 position:50% align:middle The National Institutes of Health does allow investigators to include in their grant budget 00:51:04.527 --> 00:51:07.864 position:50% align:middle fees that would need to be paid for open access journal. 00:51:07.864 --> 00:51:14.056 position:50% align:middle So the fee can be charged to a grant budget and that does help support the ability to publish 00:51:14.056 --> 00:51:15.574 position:50% align:middle in a lot of different outlets. 00:51:15.574 --> 00:51:20.414 position:50% align:middle We encourage authors to use open access journals where possible. 00:51:20.414 --> 00:51:25.703 position:50% align:middle The National Institutes of Health has a wonderful set of recommendations of how to pick a good journal 00:51:25.703 --> 00:51:26.833 position:50% align:middle to publish in. 00:51:26.833 --> 00:51:31.787 position:50% align:middle And this is a way to help ensure that your materials reach the most people. 00:51:31.787 --> 00:51:37.600 position:50% align:middle Now, publishing in a what we would consider a traditional journal isn't necessarily a bad thing. 00:51:37.600 --> 00:51:41.849 position:50% align:middle And the journals are beginning to become more flexible in their approaches. 00:51:41.849 --> 00:51:46.441 position:50% align:middle So even the journal of my field, the Journal of the American Medical Informatics Association 00:51:46.441 --> 00:51:49.704 position:50% align:middle has an ability to unlock journal articles. 00:51:49.704 --> 00:51:54.268 position:50% align:middle That is we can open journal articles, remove the paywall for everyone. 00:51:54.268 --> 00:51:58.712 position:50% align:middle This then allows information to be distributed much more quickly. 00:51:58.712 --> 00:52:03.840 position:50% align:middle And just as a reminder, the NIH does have a policy, that within one year, 00:52:03.840 --> 00:52:11.583 position:50% align:middle any articles describing research supported by an NIH funding must be completely open access. 00:52:11.583 --> 00:52:14.365 position:50% align:middle That is the journal can hold an embargo for one year. 00:52:14.365 --> 00:52:18.653 position:50% align:middle But after one year the article has to be freely available to the public. 00:52:18.653 --> 00:52:25.089 position:50% align:middle In the last year or so, we've been seeing new initiatives come through the Congress 00:52:25.089 --> 00:52:30.963 position:50% align:middle that have required that if we're going to receive special funds for a certain kind of research 00:52:30.963 --> 00:52:36.985 position:50% align:middle at NIH, we must make the journal…all the articles funded under those special initiatives 00:52:36.985 --> 00:52:40.399 position:50% align:middle really accessible immediately at the point of publication. 00:52:40.399 --> 00:52:45.032 position:50% align:middle And that includes the 21st Century Cures, which is funding a lot of cancer research right now, 00:52:45.032 --> 00:52:49.359 position:50% align:middle and the Heal Initiative, helping to end addictions long term. 00:52:49.359 --> 00:52:56.064 position:50% align:middle In both of these cases, the Congress has recognized the urgency of getting information 00:52:56.064 --> 00:53:01.308 position:50% align:middle out to the public really requires that the information be available as quickly as possible. 00:53:03.659 --> 00:53:04.817 position:50% align:middle - Great. Thank you. 00:53:04.817 --> 00:53:13.140 position:50% align:middle And I have another question from Supa Tula who asks, "Do you see the term 'evidence-based research' 00:53:13.140 --> 00:53:18.629 position:50% align:middle being replaced in light of the expanding field of data science?" 00:53:18.629 --> 00:53:23.312 position:50% align:middle - This is a really good question, and I'm really glad you brought it up because we 00:53:23.312 --> 00:53:28.983 position:50% align:middle worked really hard in nursing to talk about evidence-based practice and now we're kind of changing 00:53:28.983 --> 00:53:30.153 position:50% align:middle the game a little bit. 00:53:30.153 --> 00:53:32.314 position:50% align:middle And people want to know, well, what's really different? 00:53:32.314 --> 00:53:33.585 position:50% align:middle What's new here? 00:53:33.585 --> 00:53:39.702 position:50% align:middle Many of the data-driven studies, the data science studies that we are involved with 00:53:39.702 --> 00:53:45.165 position:50% align:middle do not provide the same kind of evidence that traditional clinical trials provide. 00:53:45.165 --> 00:53:50.223 position:50% align:middle So there will always be a place for the evidence generated through clinical trials. 00:53:50.223 --> 00:53:56.804 position:50% align:middle However, more importantly, is for individuals to consider what constitutes evidence. 00:53:56.804 --> 00:54:01.045 position:50% align:middle And we see with data science a broadening of what constitutes evidence. 00:54:01.045 --> 00:54:07.314 position:50% align:middle Many data science studies are hypothesis-generating as opposed to hypothesis-resolving. 00:54:07.314 --> 00:54:13.635 position:50% align:middle So a data science study might identify patterns that had not previously been identified, 00:54:13.635 --> 00:54:18.148 position:50% align:middle inspect those patterns, and provide ways to then subsequently do testing 00:54:18.148 --> 00:54:20.193 position:50% align:middle different kinds of evaluation. 00:54:20.193 --> 00:54:27.594 position:50% align:middle I also see a trend towards expanding from clinical trials to observational studies, 00:54:27.594 --> 00:54:31.209 position:50% align:middle and practical clinical trials as another kind of evidence. 00:54:31.209 --> 00:54:39.413 position:50% align:middle Essentially, the concept of clinical trials is a highly controlled process where only under certain conditions 00:54:39.413 --> 00:54:45.953 position:50% align:middle is a very specified intervention evaluated against other interventions or against a usual care treatment. 00:54:45.953 --> 00:54:51.983 position:50% align:middle Yet sometimes, the constraints of a clinical trial are too constraining and they don't depict the reality 00:54:51.983 --> 00:54:53.283 position:50% align:middle of everyday living. 00:54:53.283 --> 00:54:58.088 position:50% align:middle In my own work, what I've noticed is that the way people organize health information in their house 00:54:58.088 --> 00:55:02.989 position:50% align:middle actually varies and affects their ability to remember to take their medications. 00:55:02.989 --> 00:55:09.174 position:50% align:middle So, when I work with people who are developing homecare clinical trials, I try to encourage them to take a map 00:55:09.174 --> 00:55:11.604 position:50% align:middle of the house, take a look at what else is going on there. 00:55:11.604 --> 00:55:16.120 position:50% align:middle Now, in your future, what I hope we'll see is not evidence-based 00:55:16.120 --> 00:55:20.662 position:50% align:middle versus data science, but an appreciation of what data science approaches 00:55:20.662 --> 00:55:23.822 position:50% align:middle can provide to the evidence-based for nursing practice. 00:55:26.327 --> 00:55:28.027 position:50% align:middle - Thank you very much. 00:55:28.027 --> 00:55:31.339 position:50% align:middle I have a question from Katherine Stansfield. 00:55:31.339 --> 00:55:39.189 position:50% align:middle And she asks, "Is open access available for all nurses internationally?" 00:55:41.335 --> 00:55:44.829 position:50% align:middle - Katherine, that's a very good question. 00:55:44.829 --> 00:55:52.392 position:50% align:middle Oopen access, any journal, any article that is identified in PubMed Central, 00:55:52.392 --> 00:55:58.767 position:50% align:middle or any journal that's identified as an open-access journal in PubMed Central are available internationally 00:55:58.767 --> 00:56:01.202 position:50% align:middle with one constraint. 00:56:01.202 --> 00:56:07.948 position:50% align:middle And that is, in countries where there is a constraint on internet use or internet access, 00:56:07.948 --> 00:56:12.293 position:50% align:middle those individuals are sometimes not able to get to our resources. 00:56:15.756 --> 00:56:16.472 position:50% align:middle - Thank you. 00:56:16.472 --> 00:56:20.768 position:50% align:middle I have one last question for you from Michelle Buck. 00:56:20.768 --> 00:56:25.708 position:50% align:middle She says, "Thank you for an excellent and informative presentation. 00:56:25.708 --> 00:56:34.716 position:50% align:middle Is the AI process you've described to identify the best resources for data search used by any other data 00:56:34.716 --> 00:56:38.588 position:50% align:middle repositories or is it unique to PubMed?" 00:56:38.588 --> 00:56:41.274 position:50% align:middle - That's another good question. 00:56:41.274 --> 00:56:46.468 position:50% align:middle We work very closely with our colleagues at Google, who have a very sophisticated search process, 00:56:46.468 --> 00:56:52.549 position:50% align:middle and with colleagues around the world who maintain literature and data resources. 00:56:52.549 --> 00:56:59.039 position:50% align:middle So the algorithm that we use and the way it is implemented is unique to the NIH. 00:56:59.039 --> 00:57:04.233 position:50% align:middle It is documented in an article in Nature from 2018. 00:57:04.233 --> 00:57:07.461 position:50% align:middle The first author is Lu, L-U. 00:57:07.461 --> 00:57:13.705 position:50% align:middle And the algorithm is designed to be optimized for an individual search. 00:57:13.705 --> 00:57:18.464 position:50% align:middle So it's not defining what is the best article about wound care? 00:57:18.464 --> 00:57:21.267 position:50% align:middle Or what is the best article about anxiety management? 00:57:21.267 --> 00:57:26.759 position:50% align:middle It says, "Given what you're searching for, what is the best match to your questions?" 00:57:26.759 --> 00:57:32.453 position:50% align:middle This actually relates a little bit to our question earlier about,to what extent does data science compete 00:57:32.453 --> 00:57:34.327 position:50% align:middle with evidence-based practice? 00:57:34.327 --> 00:57:38.373 position:50% align:middle When we use AI, we're using it for a specific purpose. 00:57:38.373 --> 00:57:41.772 position:50% align:middle And we're very cautious not to go beyond that. 00:57:41.772 --> 00:57:48.769 position:50% align:middle And that's part of why we do not provide authors, for example, information about how often their 00:57:48.769 --> 00:57:51.753 position:50% align:middle particular article turned up in an individual search. 00:57:51.753 --> 00:57:54.249 position:50% align:middle We provided information about the citations. 00:57:54.249 --> 00:57:59.500 position:50% align:middle That is once an individual has published a paper and cited an article, we can provide quick access 00:57:59.500 --> 00:58:01.656 position:50% align:middle to the number of times an article was cited. 00:58:01.656 --> 00:58:06.526 position:50% align:middle But we don't want to see this as a competition, or some kind of a gold star that your article got 00:58:06.526 --> 00:58:07.856 position:50% align:middle to pulled more than others. 00:58:07.856 --> 00:58:14.196 position:50% align:middle Our approaches to searching and search itself is a wonderful point of research right now, 00:58:14.196 --> 00:58:18.681 position:50% align:middle very exciting area of research, where lots of work is being done to try to determine 00:58:18.681 --> 00:58:20.866 position:50% align:middle the best most efficient way to search. 00:58:20.866 --> 00:58:26.296 position:50% align:middle My hope in the future is that our search algorithms will become more in the moment being able to answer 00:58:26.296 --> 00:58:28.392 position:50% align:middle questions on the fly as they arise. 00:58:30.178 --> 00:58:37.179 position:50% align:middle - Dr. Brennan, thank you so very much for your excellent presentation and the answers to all these 00:58:37.179 --> 00:58:39.120 position:50% align:middle really important questions. 00:58:39.120 --> 00:58:40.504 position:50% align:middle Thank you again. 00:58:40.504 --> 00:58:43.066 position:50% align:middle - Thank you and good luck with your program today. 00:58:43.066 --> 00:58:44.554 position:50% align:middle I appreciate being invited. 00:58:44.554 --> 00:58:45.602 position:50% align:middle Thank you. - Thank you.