The National Institutes of Health (NIH) (/ɛnaɪˈeɪtʃ/; each letter separately) is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late 1870s and is now part of the United States Department of Health and Human Services. The majority of NIH facilities are located in Bethesda, Maryland. The NIH conducts its own scientific research through its Intramural Research Program (IRP) and provides major biomedical research funding to non-NIH research facilities through its Extramural Research Program.
As of 2013, the IRP had 1,200 principal investigators and more than 4,000 postdoctoral fellows in basic, translational, and clinical research, being the largest biomedical research institution in the world, while, as of 2003, the extramural arm provided 28% of biomedical research funding spent annually in the U.S., or about US$26.4 billion.
The NIH comprises 27 separate institutes and centers of different biomedical disciplines and is responsible for many scientific accomplishments, including the discovery of fluoride to prevent tooth decay, the use of lithium to manage bipolar disorder, and the creation of vaccines against hepatitis, Haemophilus influenzae (HIB), and human papillomavirus (HPV).
|National Institutes of Health (NIH)|
National Institutes of Health logo
Aerial photo of the NIH Mark O. Hatfield Clinical Research Center, Bethesda, Maryland
|Headquarters||Bethesda, Maryland, U.S.|
|Annual budget||US$37 billion (as of 2018)|
|Parent agency||Department of Health & Human Services|
NIH's roots extend back to the Marine Hospital Service in the late 1790s that provided medical relief to sick and disabled men in the U.S. Navy. By 1870, a network of marine hospitals had developed and was placed under the charge of a medical officer within the Bureau of the Treasury Department. In the late 1870s, Congress allocated funds to investigate the causes of epidemics like cholera and yellow fever, and it created the National Board of Health, making medical research an official government initiative.
In 1887, a laboratory for the study of bacteria, the Hygienic Laboratory, was established at the Marine Hospital in New York. In the early 1900s, Congress began appropriating funds for the Marine Hospital Service. By 1922, this organization changed its name to Public Health Services and established a Special Cancer Investigations laboratory at Harvard Medical School. This marked the beginning of a partnership with universities. In 1930, the Hygienic Laboratory was re-designated as the National Institute of Health by the Ransdell Act, and was given $750,000 to construct two NIH buildings. Over the next few decades, Congress would increase funding tremendously to the NIH, and various institutes and centers within the NIH were created for specific research programs. In 1944, the Public Health Service Act was approved, and the National Cancer Institute became a division of NIH. In 1948, the name changed from National Institute of Health to National Institutes of Health.
In the 1960s, virologist and cancer researcher Chester M. Southam injected HeLa cancer cells into patients at the Jewish Chronic Disease Hospital.:130 When three doctors resigned after refusing to inject patients without their consent, the experiment gained considerable media attention.:133 The NIH was a major source of funding for Southam's research and had required all research involving human subjects to obtain their consent prior to any experimentation.:135 Upon investigating all of their grantee institutions, the NIH discovered that the majority of them did not protect the rights of human subjects. From then on, the NIH has required all grantee institutions to approve any research proposals involving human experimentation with review boards.:135
In 1967, the Division of Regional Medical Programs was created to administer grants for research for heart disease, cancer, and strokes. That same year, the NIH director lobbied the White House for increased federal funding in order to increase research and the speed with which health benefits could be brought to the people. An advisory committee was formed to oversee further development of the NIH and its research programs. By 1971 cancer research was in full force and President Nixon signed the National Cancer Act, initiating a National Cancer Program, President's Cancer Panel, National Cancer Advisory Board, and 15 new research, training, and demonstration centers.
Funding for the NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research, and 85 percent of all funding for health studies in universities. While government funding for research in other disciplines has been increasing at a rate similar to inflation since the 1970s, research funding for the NIH nearly tripled through the 1990s and early 2000s, but has remained relatively stagnant since then.
NIH Office of the Director is the central office responsible for setting policy for NIH, and for planning, managing and coordinating the programs and activities of all NIH components. The NIH Director plays an active role in shaping the agency's activities and outlook. The Director is responsible for providing leadership to the Institutes and Centers by identifying needs and opportunities, especially in efforts involving multiple Institutes. Within this Office is the Division of Program Coordination, Planning and Strategic Initiatives with 12 divisions including:
The Bayview Campus in Baltimore, Maryland houses the research programs of the National Institute on Aging, National Institute on Drug Abuse, and National Human Genome Research Institute with nearly 1,000 scientists and support staff. The Frederick National Laboratory in Frederick, MD and the nearby Riverside Research Park, houses many components of the National Cancer Institute, including the Center for Cancer Research, Office of Scientific Operations, Management Operations Support Branch, the division of Cancer Epidemiology and Genetics and the division of Cancer Treatment and Diagnosis.
The National Institute of Environmental Health Sciences is located in the Research Triangle region of North Carolina.
Other ICs have satellite locations in addition to operations at the main campus. The National Institute of Allergy and Infectious Diseases maintains its Rocky Mountain Labs in Hamilton, Montana, with an emphasis on BSL3 and BSL4 laboratory work. NIDKK operates the Phoenix Epidemiology and Clinical Research Branch in Phoenix, AZ.
NIH devotes 10% of its funding to research within its own facilities (intramural research). The institution gives 80% of its funding in research grants to extramural (outside) researchers. Of this extramural funding, a certain percentage (2.8% in 2014) must be granted to small businesses under the SBIR/STTR program. The extramural funding consists of about 50,000 grants to more than 325,000 researchers at more than 3000 institutions. In FY 2010, NIH spent US$10.7bn (not including temporary funding from the American Recovery and Reinvestment Act of 2009) on clinical research, US$7.4bn on genetics-related research, US$6.0bn on prevention research, US$5.8bn on cancer, and US$5.7bn on biotechnology.
In 2008 a Congressional mandate called for investigators funded by the NIH to submit an electronic version of their final manuscripts to the National Library of Medicine's research repository, PubMed Central (PMC), no later than 12 months after the official date of publication. The NIH Public Access Policy was the first public access mandate for a U.S. public funding agency.
On February 13, 2012, the National Institutes of Health (NIH) announced a new group of individuals assigned to research pain. This committee is composed of researchers from different organizations and will focus to "coordinate pain research activities across the federal government with the goals of stimulating pain research collaboration… and providing an important avenue for public involvement" ("Members of new," 2012). With a committee such as this research will not be conducted by each individual organization or person but instead a collaborating group which will increase the information available. With this hopefully more pain management will be available including techniques for arthritis sufferers.
In 2000, the Joint Economic Committee of Congress reported NIH research, which was funded at $16 billion a year in 2000, that some econometric studies had given a rate of return of 25 to 40 percent per year by reducing the economic cost of illness in the US. It found that of the 21 drugs with the highest therapeutic impact on society introduced between 1965 and 1992, public funding was "instrumental" for 15. As of 2011 NIH-supported research helped to discover 153 new FDA-approved drugs, vaccines, and new indications for drugs in the 40 years prior. One study found NIH funding aided either directly or indirectly in developing the drugs or drug targets for all of the 210 FDA-approved drugs from 2010 to 2016. In 2015, Pierre Azoulay et al. estimated $10 million invested in research generated two to three new patents.
Since its inception, the NIH intramural research program has been a source of many pivotal scientific and medical discoveries. Some of these include:
In September 2006, the NIH Blueprint for Neuroscience Research started a contract for the NIH Toolbox for the Assessment of Neurological and Behavioral Function to develop a set of state-of-the-art measurement tools to enhance collection of data in large cohort studies. Scientists from more than 100 institutions nationwide contributed. In September 2012, the NIH Toolbox was rolled out to the research community. NIH Toolbox assessments are based, where possible, on Item Response Theory and adapted for testing by computer.
To allocate funds, the NIH must first obtain its budget from Congress. This process begins with institute and center (IC) leaders collaborating with scientists to determine the most important and promising research areas within their fields. IC leaders discuss research areas with NIH management who then develops a budget request for continuing projects, new research proposals, and new initiatives from the Director. NIH submits its budget request to the Department of Health and Human Services (HHS), and the HHS considers this request as a portion of its budget. Many adjustments and appeals occur between NIH and HHS before the agency submits NIH's budget request to the Office of Management and Budget (OMB). OMB determines what amounts and research areas are approved for incorporation into the President's final budget. The President then sends NIH's budget request to Congress in February for the next fiscal year's allocations. The House and Senate Appropriations Subcommittees deliberate and by fall, Congress usually appropriates funding. This process takes approximately 18 months before the NIH can allocate any actual funds.
Over the last century, the responsibility to allocate funding has shifted from the OD and Advisory Committee to the individual ICs and Congress increasingly set apart funding for particular causes. In the 1970s, Congress began to earmark funds specifically for cancer research, and in the 1980s there was a significant amount allocated for AIDS/HIV research.
Funding for the NIH has often been a source of contention in Congress, serving as a proxy for the political currents of the time. During the 1980s, President Reagan repeatedly tried to cut funding for research, only to see Congress partly restore funding. The political contention over NIH funding slowed the nation's response to the AIDS epidemic; while AIDS was reported in newspaper articles from 1981, no funding was provided for research on the disease. In 1984 National Cancer Institute scientists found implications that "variants of a human cancer virus called HTLV-III are the primary cause of acquired immunodeficiency syndrome (AIDS)," a new epidemic that gripped the nation.
In 1992, the NIH encompassed nearly 1 percent of the federal government's operating budget and controlled more than 50 percent of all funding for health research and 85 percent of all funding for health studies in universities. From 1993 to 2001 the NIH budget doubled. Since then, funding essentially remained flat, and during the decade following the financial crisis, the NIH budget struggled to keep up with inflation.
In 1999 Congress increased the NIH's budget by $2.3 billion to $17.2 billion in 2000. In 2009 Congress again increased the NIH budget to $31 billion in 2010. In 2017 and 2018, despite President Trump's proposals to cut the NIH budget, Congress passed laws with bipartisan support that substantially increasing appropriations for NIH, which was 37.3 billion dollars annually in FY2018.
Researchers at universities or other institutions outside of NIH can apply for research project grants (RPGs) from the NIH. There are numerous funding mechanisms for different project types (e.g., basic research, clinical research etc.) and career stages (e.g., early career, postdoc fellowships etc.). The NIH regularly issues "requests for applications" (RFAs), e.g., on specific programmatic priorities or timely medical problems (such as Zika virus research in early 2016). In addition, researchers can apply for "investigator-initiated grants" whose subject is determined by the scientist.
The total number of applicants has increased substantially, from about 60,000 investigators who had applied during the period from 1999 to 2003 to slightly less than 90,000 in who had applied during the period from 2011 to 2015. Due to this, the "cumulative investigator rate," that is, the likelihood that unique investigators are funded over a 5-year window, has declined from 43% to 31%.
R01 grants are the most common funding mechanism and include investigator-initiated projects. The roughly 27,000 to 29,000 R01 applications had a funding success of 17-19% during 2012 though 2014. Similarly, the 13,000 to 14,000 R21 applications had a funding success of 13-14% during the same period. In FY 2016, the total number of grant applications received by the NIH was 54,220, with approximately 19% being awarded funding. Institutes have varying funding rates. The National Cancer Institute awarded funding to 12% of applicants, while the National Institute for General Medical Science awarded funding to 30% of applicants.
NIH employs five broad decision criteria in its funding policy. First, ensure the highest quality of scientific research by employing an arduous peer review process. Second, seize opportunities that have the greatest potential to yield new knowledge and that will lead to better prevention and treatment of disease. Third, maintain a diverse research portfolio in order to capitalize on major discoveries in a variety of fields such as cell biology, genetics, physics, engineering, and computer science. Fourth, address public health needs according to the disease burden (e.g., prevalence and mortality). And fifth, construct and support the scientific infrastructure (e.g., well-equipped laboratories and safe research facilities) necessary to conduct research.
Advisory committee members advise the Institute on policy and procedures affecting the external research programs and provide a second level of review for all grant and cooperative agreement applications considered by the Institute for funding.
In 2014, it was announced that the NIH is directing scientists to perform their experiments with both female and male animals, or cells derived from females as well as males if they are studying cell cultures, and that the NIH would take the balance of each study design into consideration when awarding grants. The announcement also stated that this rule would probably not apply when studying sex-specific diseases (for example, ovarian or testicular cancer).
When a government shutdown occurs, the NIH continues to treat people who are already enrolled in clinical trials, but does not start any new clinical trials and does not admit new patients who are not already enrolled in a clinical trial, except for the most critically ill, as determined by the NIH Director.
One of the goals of the NIH is to "expand the base in medical and associated sciences in order to ensure a continued high return on the public investment in research." Taxpayer dollars funding NIH are from the taxpayers, making them the primary beneficiaries of advances in research. Thus, the general public is a key stakeholder in the decisions resulting from the NIH funding policy. However, some in the general public do not feel their interests are being represented, and individuals have formed patient advocacy groups to represent their own interests.
Important stakeholders of the NIH funding policy include researchers and scientists. Extramural researchers differ from intramural researchers in that they are not employed by the NIH but may apply for funding. Throughout the history of the NIH, the amount of funding received has increased, but the proportion to each IC remains relatively constant. The individual ICs then decide who will receive the grant money and how much will be allotted.
Policy changes on who receives funding significantly affects researchers. For example, the NIH has recently attempted to approve more first-time NIH R01 applicants, or the research grant applications of young scientists. To encourage the participation of young scientists, the application process has been shortened and made easier. In addition, first-time applicants are being offered more funding for their research grants than those who have received grants in the past.
In 2011 and 2012, the Department of Health and Human Services Office of Inspector General published a series of audit reports revealing that throughout the fiscal years 2000–2010, institutes under the aegis of the NIH did not comply with the time and amount requirements specified in appropriations statutes, in awarding federal contracts to commercial partners, committing the federal government to tens of millions of dollars of expenditure ahead of appropriation of funds from Congress.
The NIH is composed of 27 separate institutes and centers (ICs) that conduct and coordinate research across different disciplines of biomedical science. These are:
In addition, the National Center for Research Resources operated from April 13, 1962 to December 23, 2011.
ClinicalTrials.gov is a registry of clinical trials. It is run by the United States National Library of Medicine (NLM) at the National Institutes of Health, and is the largest clinical trials database, currently holding registrations from over 230,000 trials from 195 countries in the world.Entrez
The Entrez (pronounced ɒnˈtreɪ) Global Query Cross-Database Search System is a federated search engine, or web portal that allows users to search many discrete health sciences databases at the National Center for Biotechnology Information (NCBI) website. The NCBI is a part of the National Library of Medicine (NLM), which is itself a department of the National Institutes of Health (NIH), which in turn is a part of the United States Department of Health and Human Services. The name "Entrez" (a greeting meaning "Come in!" in French) was chosen to reflect the spirit of welcoming the public to search the content available from the NLM.
Entrez Global Query is an integrated search and retrieval system that provides access to all databases simultaneously with a single query string and user interface. Entrez can efficiently retrieve related sequences, structures, and references. The Entrez system can provide views of gene and protein sequences and chromosome maps. Some textbooks are also available online through the Entrez system.Eunice Kennedy Shriver National Institute of Child Health and Human Development
The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is one of the National Institutes of Health (NIH) in the United States Department of Health and Human Services. It supports and conducts research aimed at improving the health of children, adults, families, and communities, including:
Reducing infant deaths
Promoting healthy pregnancy and childbirth
Investigating growth and human development
Examining problems of birth defects and intellectual and developmental disabilities
Understanding reproductive health
Enhancing function across the lifespan through rehabilitation researchFrancis Collins
Francis Sellers Collins (born April 14, 1950) is an American physician-geneticist who discovered the genes associated with a number of diseases and led the Human Genome Project. He is director of the National Institutes of Health (NIH) in Bethesda, Maryland, United States.
Before being appointed director of the NIH, Collins led the Human Genome Project and other genomics research initiatives as director of the National Human Genome Research Institute (NHGRI), one of the 27 institutes and centers at NIH. Before joining NHGRI, he earned a reputation as a gene hunter at the University of Michigan. He has been elected to the Institute of Medicine and the National Academy of Sciences, and has received the Presidential Medal of Freedom and the National Medal of Science.
Collins also has written a number of books on science, medicine, and religion, including the New York Times bestseller, The Language of God: A Scientist Presents Evidence for Belief. After leaving the directorship of NHGRI and before becoming director of the NIH, he founded and served as president of The BioLogos Foundation, which promotes discourse on the relationship between science and religion and advocates the perspective that belief in Christianity can be reconciled with acceptance of evolution and science, especially through the advancement of evolutionary creation. In 2009, Pope Benedict XVI appointed Collins to the Pontifical Academy of Sciences.James A. Shannon
James Augustine Shannon (9 August 1904 – 20 May 1994) was an American nephrologist who served as director of National Institutes of Health (NIH) from 1955-1968. In 1962 he was awarded the Public Welfare Medal from the National Academy of Sciences.
A collection of his papers is held at the National Library of Medicine in Bethesda, Maryland.MedlinePlus
MedlinePlus is an online information service produced by the United States National Library of Medicine. The service provides curated consumer health information in English and Spanish.
The site brings together information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), other U.S. government agencies, and health-related organizations. There is also a site optimized for display on mobile devices, in both English and Spanish. In 2015, about 400 million people from around the world used MedlinePlus. The service is funded by the NLM and is free to users.
MedlinePlus provides encyclopedic information on health and drug issues, and provides a directory of medical services. MedlinePlus Connect links patients or providers in electronic health record (EHR) systems to related MedlinePlus information on conditions or medications.
PubMed Health is another NLM site that offers consumer health information, in addition to information for health professionals.NIH Public Access Policy
The NIH Public Access Policy is an open access mandate, drafted in 2004 and mandated in 2008, requiring that research papers describing research funded by the National Institutes of Health must be available to the public free through PubMed Central within 12 months of publication. PubMed Central is the self-archiving repository in which authors or their publishers deposit their publications. Copyright is retained by the usual holders, but authors may submit papers with one of the Creative Commons licenses.National Cancer Institute
The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH), which is one of eleven agencies that are part of the U.S. Department of Health and Human Services. The NCI coordinates the United States National Cancer Program and conducts and supports research, training, health information dissemination, and other activities related to the causes, prevention, diagnosis, and treatment of cancer; the supportive care of cancer patients and their families; and cancer survivorship.
On June 10, 2017, President Donald Trump announced his appointment of Dr. Norman Edward “Ned” Sharpless, M.D., as director of the National Cancer Institute. On October 17 of that year, Dr. Sharpless was sworn in as the NCI's 15th director.NCI is the oldest and has the largest budget and research program of the 27 institutes and centers of the NIH. It fulfills the majority of its mission via an extramural program that provides grants for cancer research. Additionally, the National Cancer Institute has intramural research programs in Bethesda, Maryland and at the Frederick National Laboratory for Cancer Research at Fort Detrick, in Frederick, Maryland. The NCI receives more than US$5 billion in funding each year.The NCI supports a nationwide network of 69 NCI-designated Cancer Centers with a dedicated focus on cancer research and treatment and maintains the National Clinical Trials Network.National Center for Biotechnology Information
The National Centre for Biotechnology Information (NCBI) is part of the United States National Library of Medicine (NLM), a branch of the National Institutes of Health (NIH). The NCBI is located in Bethesda, Maryland and was founded in 1988 through legislation sponsored by Senator Claude Pepper.
The NCBI houses a series of databases relevant to biotechnology and biomedicine and is an important resource for bioinformatics tools and services. Major databases include GenBank for DNA sequences and PubMed, a bibliographic database for the biomedical literature. Other databases include the NCBI Epigenomics database. All these databases are available online through the Entrez search engine.
NCBI was directed by David Lipman, one of the original authors of the BLAST sequence alignment program and a widely respected figure in bioinformatics. He also led an intramural research program, including groups led by Stephen Altschul (another BLAST co-author), David Landsman, Eugene Koonin, John Wilbur, Teresa Przytycka, and Zhiyong Lu. David Lipman stood down from his post in May 2017.National Heart, Lung, and Blood Institute
The National Heart, Lung, and Blood Institute (NHLBI) is the third largest Institute of the National Institutes of Health, located in Bethesda, Maryland, United States. It is tasked with allocating about $3.0 billion in tax revenue per year (fiscal year 2015 estimate) to advancing the understanding of the following issues: development and progression of disease, diagnosis of disease, treatment of disease, disease prevention, reduction of health care disparities within the American population, and advancing the effectiveness of the US medical system. NHLBI's Director is Gary H. Gibbons (2012-present).National Institute of Environmental Health Sciences
The National Institute of Environmental Health Sciences (NIEHS) conducts research into the effects of the environment on human disease, as one of the 27 institutes and centers of the National Institutes of Health (NIH).National Institute on Aging
The National Institute on Aging (NIA) is a division of the U.S. National Institutes of Health (NIH), located in Bethesda, Maryland. The NIA itself is headquartered in Baltimore, Maryland.
The NIA leads a broad scientific effort to understand the nature of aging and to extend the healthy, active years of life. In 1974, Congress granted authority to form NIA to provide leadership in aging research, training, health information dissemination, and other programs relevant to aging and older people. Subsequent amendments to this legislation designated the NIA as the primary Federal agency on Alzheimer's disease research.
NIA is led by Director, Richard J. Hodes, M.D, and Deputy Director: Marie Bernard, M.D.National Institutes of Health Director's Pioneer Award
National Institutes of Health Director's Pioneer Award is a research initiative first announced in 2004 designed to support individual scientists' biomedical research. The focus is specifically on "pioneering" research that is highly innovative and has a potential to produce paradigm shifting results.
The awards, made annually from the National Institutes of Health common fund, are each worth $500,000 per year, or $2,500,000 for five years.National Institutes of Health Police
National Institutes of Health Police are responsible for security and law-enforcement functions at NIH facilities, including the National Institutes of Health main campus in Bethesda, Maryland and at the NIH Rocky Mountain Laboratory in Montana. According to Fox News, the General Accounting Office reported, in January 2012, that officers in the National Institutes of Health Police had lower salaries than comparable Police Departments. A new officer in the United States Capitol Police earned $61,000 a year, while a new officer in the National Institutes of Health Police started at just $39,000.National Institutes of Health campus
The National Institutes of Health (NIH) campus is located in Bethesda, Maryland. Most of the institutes house their Divisions of Intramural Research on this campus spread out among various buildings.PubChem
PubChem is a database of chemical molecules and their activities against biological assays. The system is maintained by the National Center for Biotechnology Information (NCBI), a component of the National Library of Medicine, which is part of the United States National Institutes of Health (NIH). PubChem can be accessed for free through a web user interface. Millions of compound structures and descriptive datasets can be freely downloaded via FTP. PubChem contains substance descriptions and small molecules with fewer than 1000 atoms and 1000 bonds. More than 80 database vendors contribute to the growing PubChem database.PubMed
PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintains the database as part of the Entrez system of information retrieval.From 1971 to 1997, MEDLINE online access to the MEDLARS Online computerized database primarily had been through institutional facilities, such as university libraries. PubMed, first released in January 1996, ushered in the era of private, free, home- and office-based MEDLINE searching. The PubMed system was offered free to the public starting in June 1997.PubMed Central
PubMed Central (PMC) is a free digital repository that archives publicly accessible full-text scholarly articles that have been published within the biomedical and life sciences journal literature. As one of the major research databases within the suite of resources that have been developed by the National Center for Biotechnology Information (NCBI), PubMed Central is much more than just a document repository. Submissions into PMC undergo an indexing and formatting procedure which results in enhanced metadata, medical ontology, and unique identifiers which all enrich the XML structured data for each article on deposit. Content within PMC can easily be interlinked to many other NCBI databases and accessed via Entrez search and retrieval systems, further enhancing the public's ability to freely discover, read and build upon this portfolio of biomedical knowledge.PubMed Central is very distinct from PubMed. PubMed Central is a free digital archive of full articles, accessible to anyone from anywhere via a web browser (with varying provisions for reuse). Conversely, although PubMed is a searchable database of biomedical citations and abstracts, the full-text article physically resides elsewhere (in print or online, free or behind a subscriber paywall).
As of December 2018, the PMC archive contained over 5.2 million articles, with contributions coming directly from publishers or authors depositing their own manuscripts into the repository per the NIH Public Access Policy. Older data shows that from Jan 2013 to Jan 2014 author-initiated deposits exceeded 103,000 papers during this 12-month period. PMC also identifies about 4,000 journals which now participate in some capacity to automatically deposit their published content into the PMC repository. Some participating publishers will delay the release of their articles on PubMed Central for a set time after publication, this is often referred to as an "embargo period", and can range from a few months to a few years depending on the journal. (Embargoes of six to twelve months are the most common.) However, PubMed Central is a key example of "systematic external distribution by a third party" which is still prohibited by the contributor agreements of many publishers.United States National Library of Medicine
The United States National Library of Medicine (NLM), operated by the United States federal government, is the world's largest medical library.Located in Bethesda, Maryland, the NLM is an institute within the National Institutes of Health. Its collections include more than seven million books, journals, technical reports, manuscripts, microfilms, photographs, and images on medicine and related sciences, including some of the world's oldest and rarest works.
The current director of the NLM is Patricia Flatley Brennan.
National Institutes of Health
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Hospitals in Maryland
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