bims-librar Biomed News
on Biomedical librarianship
Issue of 2021–10–17
forty-two papers selected by
Thomas Krichel, Open Library Society



  1. J Med Libr Assoc. 2021 Jul 01. 109(3): 382-387
       Objective: To compare the accuracy, time to answer, user confidence, and user satisfaction between UpToDate and DynaMed (formerly DynaMed Plus), which are two popular point-of-care information tools.
    Methods: A crossover study was conducted with medical residents in obstetrics and gynecology and family medicine at the University of Toronto in order to compare the speed and accuracy with which they retrieved answers to clinical questions using UpToDate and DynaMed. Experiments took place between February 2017 and December 2019. Following a short tutorial on how to use each tool and completion of a background survey, participants attempted to find answers to two clinical questions in each tool. Time to answer each question, the chosen answer, confidence score, and satisfaction score were recorded for each clinical question.
    Results: A total of 57 residents took part in the experiment, including 32 from family medicine and 25 from obstetrics and gynecology. Accuracy in clinical answers was equal between UpToDate (average 1.35 out of 2) and DynaMed (average 1.36 out of 2). However, time to answer was 2.5 minutes faster in UpToDate compared to DynaMed. Participants were also more confident and satisfied with their answers in UpToDate compared to DynaMed.
    Conclusions: Despite a preference for UpToDate and a higher confidence in responses, the accuracy of clinical answers in UpToDate was equal to those in DynaMed. Previous exposure to UpToDate likely played a major role in participants' preferences. More research in this area is recommended.
    Keywords:  DynaMed; UpToDate; point of care tools
    DOI:  https://doi.org/10.5195/jmla.2021.1176
  2. J Med Libr Assoc. 2021 Jul 01. 109(3): 376-381
      Technology advances in eHealth and mHealth are changing the way that health care consumers and providers communicate, receive and deliver care, and access health information. As electronic health records and smartphones have become ubiquitous in the United States, opportunities and applications for the integration of eHealth and mHealth have increased. In addition to technology advances, the changing health care model is simultaneously adapting to and driving initiatives in digital health care. With these digital initiatives have come challenges, including data overload, security and privacy concerns, deficits in technological and health literacy skills, and sorting through the vast number of choices of digital applications. Navigating this changing landscape can be overwhelming and time consuming for both health care providers and consumers. Librarians are uniquely positioned to assist providers and consumers to break down barriers within the digital health care landscape through data management initiatives, technology and health literacy instruction, and finding and evaluating health information and digital health technologies.
    Keywords:  digital health technology; eHealth; librarian roles; mHealth
    DOI:  https://doi.org/10.5195/jmla.2021.1180
  3. J Med Libr Assoc. 2021 Jul 01. 109(3): 497-502
       Background: Prior to 2020, library orientation for first-year medical students at Weill Cornell Medicine took the form of an on-site treasure hunt competition. Due to the COVID-19 pandemic, the orientation for the MD class of 2024 was shifted to an all-virtual format. This shift mandated a full redesign of the library orientation.
    Case Presentation: The Samuel J. Wood Library sought to preserve the excitement and fun of the treasure hunt in the new virtual format. The competition was redesigned as a Zoom meeting using breakout rooms, with library faculty and staff serving as team facilitators. Tasks were rewritten, shifting the focus from the library's physical spaces to its virtual services and online resources. The redesigned orientation was evaluated using two data sources: a postsession survey of student participants and a debriefing of the library employees who participated. Student evaluations were positive, while the faculty and staff provided numerous suggestions for improving future virtual orientations.
    Conclusions: A successful virtual library orientation requires careful preparation, including testing the competition tasks, full rehearsal with library facilitators, and a thoughtful approach to technology and logistics. We have chosen to share the materials we developed for other academic health sciences libraries that may wish to take a similar approach to their own virtual orientations.
    Keywords:  library orientation; remote learning; undergraduate medical education
    DOI:  https://doi.org/10.5195/jmla.2021.1190
  4. J Med Libr Assoc. 2021 Jul 01. 109(3): 483-489
       Background: Over a decade ago, the Hill report argued that a shift in vision was required to change the perception of National Health Service (NHS) Library and Knowledge Services (LKS) in England from "book repositories" to essential services that underpin clinical decision-making by patients, carers, and health care professionals. Health Education England's Knowledge for Healthcare: A Development Framework for Library and Knowledge Services in England 2015-2020 advocates embedding librarians within clinical and management teams in order to provide access to high-quality evidence at the point of need.
    Case Presentation: In April 2019, Royal Papworth Hospital relocated twelve miles from its historic village location in Papworth Everard to its new state-of-the-art hospital on the Cambridge Biomedical Campus. The design for this new hospital did not accommodate a traditional library space and therefore necessitated a transformation of the LKS. The organization opted to embed the LKS staff into the clinical setting and relegate 80% of the print collection to off-site storage. This project and its associated steps are presented as an example of health care library transformation.
    Conclusion: Embedding the LKS team in the clinical setting, engaging in proactive outreach activity, and improving our marketing led to a 44% increase in literature searches requested compared to the same eleven-month period in the previous year. A 40% decrease in our print book loans indicates additional barriers to using a click-and-collect service and the need for greater investment in our e-book provision. However, early outcomes for our best-fit service transformation are positive. Having an open, dual mindset has enabled the service to embrace change and maximize emerging opportunities to collaborate with clinical staff on new projects.
    Keywords:  embedded librarianship; innovation; project management; transformation
    DOI:  https://doi.org/10.5195/jmla.2021.1167
  5. F1000Res. 2020 ;9 1386
      Background: Up-to-date guidance on comprehensive study identification for systematic reviews is crucial. According to current recommendations, systematic searching should combine electronic database searching with supplementary search methods. One such supplementary search method is citation tracking. It aims at collecting directly and/or indirectly cited and citing references from "seed references". Tailored and evidence-guided recommendations concerning the use of citation tracking are strongly needed. Objective: We intend to develop recommendations for the use of citation tracking in health-related systematic literature searching. Our study will be guided by the following research questions: What are the benefits of citation tracking for health-related systematic literature searching? Which perspectives and experiences do experts in the field of literature retrieval methods have with regard to citation tracking in health-related systematic literature searching? Methods: Our study will have two parts: a scoping review and an expert survey. The scoping review aims at identifying methodological studies on benefits or problems of citation tracking in health-related systematic literature searching with no restrictions on study design, language, and publication date. We will perform database searching in MEDLINE, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science Core Collection, two information science databases, and free web searching. Two reviewers will independently assess full texts of selected abstracts. We will conduct direct backward and forward citation tracking on included articles. The results of the scoping review will inform our expert survey through which we aim to learn about experts΄ perspectives and experiences. We will narratively synthesize the results and derive recommendations for performing health-related systematic reviews.
    Keywords:  Citation Tracking; Literature Search; Methods; Research Methodology; Scoping Review; Supplementary Search; Survey; Systematic Review
    DOI:  https://doi.org/10.12688/f1000research.27337.1
  6. J Med Libr Assoc. 2021 Jul 01. 109(3): 432-440
       Objective: An innovative funding scheme for health care librarians to attend an intensive short course in teaching evidence-based practice was established in the West of England in 2016. This evaluation aims to understand the value of the scheme and the impact of the training opportunity for the librarians, establish an evidence base for continuing with the funding scheme, and inform the development of plans to build additional capacity among health care librarians to provide critical appraisal training.
    Methods: Seven librarians working in health care system settings were funded by the scheme between 2016 and 2018. Post-course feedback forms gathered initial views on course content and delivery, which informed the development of questions for the qualitative phase of the evaluation. All seven librarians participated in group discussions and individual interviews.
    Results: The course boosted confidence, provided valuable new skills, and positively impacted careers of the librarians through access to new opportunities. It inspired the development of new approaches to critical appraisal training. An important need was identified among the librarians for more education in teaching. Librarians funded by the scheme have successfully cascaded the training to their colleagues.
    Conclusion: This evaluation supports the continuation of the funding scheme to further build capacity among health care librarians to teach evidence-based practice. It suggests additional investment in this type of specialist training, as well as in education in teaching skills, would be beneficial for health care librarians. Evidence from this evaluation is informing new plans to support these professionals with the vital service they provide, which contributes to the evidence-based culture of their organizations and to patient outcomes.
    Keywords:  capacity building; critical appraisal; evaluation; evidence-based practice; librarians
    DOI:  https://doi.org/10.5195/jmla.2021.1126
  7. Health Info Libr J. 2021 Oct 11.
       BACKGROUND: The importance of high-quality health information for patient safety has been established in the literature, yet the impact of the professionals who are the custodians of health information is absent.
    OBJECTIVES: This article presents the results of a systematic literature review examining the impact of the Health Information Management (HIM) profession on patient safety.
    METHODS: A PRISMA approach was adopted for the review of selected databases and specific journals. Titles identified as relating to HIM and patient quality were screened using Covidence ® by title and abstract, followed by full text. The quality of selected articles was assessed and thematically analysed.
    RESULTS: Analysis of the 8 included articles found that the key themes from the non-empirical research were data quality, information governance, corporate governance, skills and knowledge required for HIM professionals.
    DISCUSSION: Most publications focussed on HIM professional involvement in maintaining standards for data quality and health records, but not the professional qualifications themselves.
    CONCLUSIONS: There are links between patient safety and health records, and between health records and HIM professional work. More empirical research is needed to demonstrate how qualified HIM professionals contribute to patient safety.
    Keywords:  governance; health records; information management; information skills; patient information; review; systematic
    DOI:  https://doi.org/10.1111/hir.12400
  8. J Med Libr Assoc. 2021 Jul 01. 109(3): 450-458
       Objective: This study investigates research data management (RDM) services using a crosstab framework with the National Institutes of Health (NIH) Library as a case study to provide practical considerations for libraries seeking to improve their RDM services.
    Methods: We conducted semistructured interviews with four librarians who provide data services at the NIH Library regarding library user characteristics, RDM services provided, RDM infrastructure, and collaboration experiences. Through the analysis of interview transcripts, we identified and analyzed the NIH Library's RDM services according to Online Computer Library Center (OCLC)'s three categories of RDM services and the six stages of the data lifecycle.
    Results: The findings show that the two models' crosstab framework can provide an overview of an institution's current RDM services and identify service gaps. The NIH Library tends to take more responsibility in providing education and expertise services while relying more on information technology departments for curation services. The library provides significant support for data creation, analysis, and sharing stages to meet biomedical researchers' needs, suggesting areas for potential expansion of RDM services in the less supported stages of data description, storage, and preservation. Based on these findings, we recommend three key considerations for libraries: identify gaps in current services, identify services that can be supported via partnerships, and get regular feedback from users.
    Conclusion: These findings provide a deeper understanding of RDM support on the basis of RDM service categories and the data lifecycle and promote discussion of issues to be considered for future improvements in RDM services.
    Keywords:  case study; library services; research data management
    DOI:  https://doi.org/10.5195/jmla.2021.995
  9. J Med Libr Assoc. 2021 Jul 01. 109(3): 365-375
       Objective: The purpose of this scoping review is to evaluate the extent of library or librarian involvement in informatics education in the health domain.
    Methods: We searched eight databases from their inception to 2019 for reports of informatics educational activities for health professionals or health professions students that involved library staff or resources. Two reviewers independently screened all titles/abstracts (n=2,196) and resolved inclusion decisions by consensus. From the full text of the 36 papers that met the inclusion criteria, we extracted data on 41 educational activities.
    Results: The most frequent coded purposes of activities were "teaching clinical tools" (n=19, 46.3%) and "technology" (n=17; 41.5%). Medical students were the most frequent primary audience (34.1%), though 41.5% of activities had multiple audiences. Evaluation was reported for 24 activities (58.5%), only a few of which assessed short or post-activity impact on attitudes, knowledge, or skills. The most common long-term outcome was applying skills in other courses or clinical experiences. Thematic analysis yielded three areas of outcomes and issues for the library and organizational partners: expanded opportunities, technology and resource issues, and value demonstration.
    Conclusions: Limited published examples of health informatics educational activities provide models for library roles in informatics education. More librarians should report on their informatics educational activities and provide sufficient details on the interventions and their evaluation. This would strengthen the evidence base about the potential impact of libraries within informatics education.
    Keywords:  educational services; health sciences libraries; informatics education; librarian-educators
    DOI:  https://doi.org/10.5195/jmla.2021.1081
  10. J Med Libr Assoc. 2021 Jul 01. 109(3): 490-496
       Background: Over four years of hosting library data workshops, we conducted post-workshop evaluation of attendees' satisfaction with the workshops but not longer-term follow-up. To best allocate library resources and most effectively serve the needs of our users, we sought to determine whether our data workshops were impactful and useful to our community. This paper describes a pilot project to evaluate the impact of data workshops at our academic health sciences library.
    Case Presentation: We surveyed individuals who signed up for data workshops between 2016 and 2019. Surveys included open-ended and multiple-choice questions, with the goal of having participants describe their motivations for taking the workshop(s) and how they ultimately used what they learned. An analysis of responses using the Applied Thematic Analysis model indicated that the workshops had an impact on the respondents, although the strength of our conclusions is limited by a relatively low response rate.
    Conclusions: Survey results indicated that our workshops impacted how researchers at our medical center collect and analyze data, supporting the conclusion that we should concentrate our educational efforts on providing skills-based workshops. The low response rate and time-consuming nature of the analysis point toward several improvements for future evaluation efforts, including better tracking of workshop attendees, a shorter survey with fewer open-ended questions, and survey implementation within one year of the workshop date.
    Keywords:  data education; data science; library evaluation; library workshops
    DOI:  https://doi.org/10.5195/jmla.2021.1047
  11. J Med Libr Assoc. 2021 Jul 01. 109(3): 406-413
       Objectives: Current literature recommends online research guides as an easy and effective tool to promote LGBTQ+ health information to both health care providers and the public. This cross-sectional study was designed to determine how extensive LGBTQ+ health guides are among hospital and academic libraries and which features are most prevalent.
    Methods: In order to locate LGBTQ+ health guides for content analysis, we searched for guides on the websites of libraries belonging to the Association of Academic Health Sciences Libraries (AAHSL) and the Canadian Association of Research Libraries (CARL). Additionally, we searched the Springshare interface for LibGuides with the word "health" and either "LGBT" or "transgender." Content analysis was performed to identify major characteristics of the located guides, including target audience and the information type provided.
    Results: LGBTQ+ research guides were identified for 74 libraries. Of these, 5 were hospital libraries, and the rest were academic libraries. Of 158 AAHSL member libraries, 48 (30.4%) had LGBTQ+ guides on their websites. Nearly all guides (95.9%) provided general LGBTQ+ health information, and a large majority (87.8%) also had information resources for transgender health. Smaller percentages of guides contained information on HIV/AIDS (48.6%) and women's health (16.2%).
    Conclusions: Even though literature recommends creating LGBTQ+ health guides, most health sciences libraries are missing an opportunity by not developing and maintaining these guides. Further research may be needed to determine the usage and usefulness of existing guides and to better identify barriers preventing libraries from creating guides.
    Keywords:  HIV/AIDS; LGBTQ+; health disparities; health information; health sciences libraries; research guides; transgender; women's health
    DOI:  https://doi.org/10.5195/jmla.2021.1189
  12. J Med Libr Assoc. 2021 Jul 01. 109(3): 441-449
       Objective: This study compares two maps of biomedical sciences using Medical Subject Headings (MeSH) term co-assignments versus MeSH terms of citing/cited articles and reveals similarities and differences between the two approaches.
    Methods: MeSH terms assigned to 397,475 journal articles published in 2015, as well as their 4,632,992 cited references, were retrieved from Web of Science and MEDLINE databases, respectively, which formed over 7 million MeSH co-assignments and nearly 18 million direct citation pairs. We generated six network visualizations of biomedical science at three levels using Gephi software based on these MeSH co-assignments and citation pairs.
    Results: The MeSH co-assignment map contained more nodes and edges, as MeSH co-assignments cover all medical topics discussed in articles. By contrast, the MeSH citation map contained fewer but larger nodes and wider edges, as citation links indicate connections to two similar medical topics.
    Conclusion: These two types of maps emphasize different aspects of biomedical sciences, with MeSH co-assignment maps focusing on the relationship between topics in different categories and MeSH direct citation maps providing insights into relationships between topics in the same or similar category.
    Keywords:  Gephi; MeSH; citation; co-assignment; map of life sciences
    DOI:  https://doi.org/10.5195/jmla.2021.1173
  13. Genomics Inform. 2021 Sep;19(3): e26
      Previous approaches to create a controlled vocabulary for Japanese have resorted to existing bilingual dictionary and transformation rules to allow such mappings. However, given the possible new terms introduced due to coronavirus disease 2019 (COVID-19) and the emphasis on respiratory and infection-related terms, coverage might not be guaranteed. We propose creating a Japanese bilingual controlled vocabulary based on MeSH terms assigned to COVID-19 related publications in this work. For such, we resorted to manual curation of several bilingual dictionaries and a computational approach based on machine translation of sentences containing such terms and the ranking of possible translations for the individual terms by mutual information. Our results show that we achieved nearly 99% occurrence coverage in LitCovid, while our computational approach presented average accuracy of 63.33% for all terms, and 84.51% for drugs and chemicals.
    Keywords:  COVID-19; Japanese; controlled vocabulary; multilingualism; natural language processing; translation
    DOI:  https://doi.org/10.5808/gi.21014
  14. Genomics Inform. 2021 Sep;19(3): e25
      The coronavirus disease 2019 (COVID-19) pandemic has led to a flood of research papers and the information has been updated with considerable frequency. For society to derive benefits from this research, it is necessary to promote sharing up-to-date knowledge from these papers. However, because most research papers are written in English, it is difficult for people who are not familiar with English medical terms to obtain knowledge from them. To facilitate sharing knowledge from COVID-19 papers written in English for Japanese speakers, we tried to construct a dictionary with an open license by assigning Japanese terms to MeSH unique identifiers (UIDs) annotated to words in the texts of COVID-19 papers. Using this dictionary, 98.99% of all occurrences of MeSH terms in COVID-19 papers were covered. We also created a curated version of the dictionary and uploaded it to PubDictionary for wider use in the PubAnnotation system.
    Keywords:  COVID-19; Japanese; MeSH; medical vocabulary
    DOI:  https://doi.org/10.5808/gi.21012
  15. J Med Libr Assoc. 2021 Jul 01. 109(3): 359-361
      In 2020, the Journal of the Medical Library Association (JMLA) launched an initiative aimed at providing more equitable opportunities for authors, reviewers, and editorial team members. This editorial provides an update on the steps we have taken thus far to empower authors, increase the diversity of our editorial team, and make equity-minded recommendations to the Medical Library Association.
    DOI:  https://doi.org/10.5195/jmla.2021.1279
  16. J Med Libr Assoc. 2021 Jul 01. 109(3): 362-364
      To help ensure that authors of articles published in the Journal of the Medical Library Association (JMLA) receive appropriate recognition for their contributions and to make individual author roles more transparent to readers, JMLA articles will begin including Author Contribution statements using the Contributor Role Taxonomy.
    DOI:  https://doi.org/10.5195/jmla.2021.1294
  17. J Med Libr Assoc. 2021 Jul 01. 109(3): 505-506
      Invisible labor is a term used by labor economists to describe work that contributes, and is often even necessary, to the economy but largely goes unrecognized and unpaid. Despite the fact that systematic review searching is a significant task for many librarians and knowledge professionals, the search process can be considered a form of invisible labor because it often goes without recognition. This occurs sometimes through not granting authorship to the librarian who performed the intellectual contribution of search development and sometimes through a devaluing of the search process by the choice of language used to describe the search. By using the term search as a passive verb or noun, authors devalue the real intellectual labor involved in searching, which includes decisions related to search terms and combinations, database selection, and other search parameters. This commentary explores the context of how searching is described through the concept of invisible labor.
    Keywords:  authorship; feminism; information storage and retrieval; librarians; systematic reviews as topic; work
    DOI:  https://doi.org/10.5195/jmla.2021.1226
  18. J Med Libr Assoc. 2021 Jul 01. 109(3): 478-482
       Background: Game-based learning is a successful strategy for teaching various concepts to students, from general orientations to more in-depth material. Pharmacy students in a first-year lab course were introduced to library and drug information resources through a lecture-style class in their first week of school, which was ineffective in terms of engagement. To combat this issue, the pharmacy liaison librarian advocated for moving this class session later in the semester and proposed a game-based activity to replace the lecture.
    Case Presentation: "The Amazing Race: Drug Information Edition" was inspired by a well-known TV competition that involves completing several stages (called "legs") of challenges to finish the race. The librarian developed questions designed to make students use various parts of the library website as well as two drug information databases. Students competed in teams, and the first three teams to complete the race were awarded small prizes. The race was first implemented in 2018, and modifications were made to the 2019 iteration based on student feedback.
    Conclusions: Despite several challenges, the race was well received by both the students and the course instructors and increased engagement with introductory library and drug information material. The activity has enhanced the librarian's relationship and collaboration with the course faculty and made a positive impression on the students.
    Keywords:  drug information resources; game-based learning; library instruction
    DOI:  https://doi.org/10.5195/jmla.2021.1178
  19. J Med Libr Assoc. 2021 Jul 01. 109(3): 510-513
      This article briefly discusses the value and impact of biography collections in medical education by illustrating the case of the Campus Bio-Medico University of Rome (UCBM) Library. The UCBM Library collects, curates, and provides access to a special biography collection with the purpose of documenting the history of men and women who contributed in the field of medicine and related sciences. This article highlights the importance of academic medical libraries collecting biographical works in order to transmit knowledge and values in medical school curriculum.
    Keywords:  academic medical libraries; biographies collections; medical biographies; medical education; medical humanities
    DOI:  https://doi.org/10.5195/jmla.2021.1312
  20. Database (Oxford). 2021 Oct 13. pii: baab065. [Epub ahead of print]2021
      Body fluid proteome has been intensively studied as a primary source for disease biomarker discovery. Using advanced proteomics technologies, early research success has resulted in increasingly accumulated proteins detected in different body fluids, among which many are promising biomarkers. However, despite a handful of small-scale and specific data resources, current research is clearly lacking effort compiling published body fluid proteins into a centralized and sustainable repository that can provide users with systematic analytic tools. In this study, we developed a new database of human body fluid proteome (HBFP) that focuses on experimentally validated proteome in 17 types of human body fluids. The current database archives 11 827 unique proteins reported by 164 scientific publications, with a maximal false discovery rate of 0.01 on both the peptide and protein levels since 2001, and enables users to query, analyze and download protein entries with respect to each body fluid. Three unique features of this new system include the following: (i) the protein annotation page includes detailed abundance information based on relative qualitative measures of peptides reported in the original references, (ii) a new score is calculated on each reported protein to indicate the discovery confidence and (iii) HBFP catalogs 7354 proteins with at least two non-nested uniquely mapping peptides of nine amino acids according to the Human Proteome Project Data Interpretation Guidelines, while the remaining 4473 proteins have more than two unique peptides without given sequence information. As an important resource for human protein secretome, we anticipate that this new HBFP database can be a powerful tool that facilitates research in clinical proteomics and biomarker discovery. Database URL: https://bmbl.bmi.osumc.edu/HBFP/.
    DOI:  https://doi.org/10.1093/database/baab065
  21. J Med Libr Assoc. 2021 Jul 01. 109(3): 388-394
       Objective: A growing volume of studies address methods for performing systematic reviews of qualitative studies. One such methodological aspect is the conceptual framework used to structure the review question and plan the search strategy for locating relevant studies. The purpose of this case study was to evaluate the retrieval potential of each element of conceptual frameworks in qualitative systematic reviews in the health sciences.
    Methods: The presence of elements from conceptual frameworks in publication titles, abstracts, and controlled vocabulary in CINAHL and PubMed was analyzed using a set of qualitative reviews and their included studies as a gold standard. Using a sample of 101 publications, we determined whether particular publications could be retrieved if a specific element from the conceptual framework was used in the search strategy.
    Results: We found that the relative recall of conceptual framework elements varied considerably, with higher recall for patient/population (99%) and research type (97%) and lower recall for intervention/phenomenon of interest (74%), outcome (79%), and context (61%).
    Conclusion: The use of patient/population and research type elements had high relative recall for qualitative studies. However, other elements should be used with great care due to lower relative recall.
    Keywords:  CINAHL; PubMed; conceptualization models; qualitative reviews; systematic searching
    DOI:  https://doi.org/10.5195/jmla.2021.1150
  22. Artif Intell Med. 2021 Oct;pii: S0933-3657(21)00160-3. [Epub ahead of print]120 102167
      Biomedical natural language processing (NLP) has an important role in extracting consequential information in medical discharge notes. Detecting meaningful features from unstructured notes is a challenging task in medical document classification. The domain specific phrases and different synonyms within the medical documents make it hard to analyze them. Analyzing clinical notes becomes more challenging for short documents like abstract texts. All of these can result in poor classification performance, especially when there is a shortage of the clinical data in real life. Two new approaches (an ontology-guided approach and a combined ontology-based with dictionary-based approach) are suggested for augmenting medical data to enrich training data. Three different deep learning approaches are used to evaluate the classification performance of the proposed methods. The obtained results show that the proposed methods improved the classification accuracy in clinical notes classification.
    Keywords:  Data augmentation; Machine learning; Medical document classification; Natural language processing; Unified Medical Language System
    DOI:  https://doi.org/10.1016/j.artmed.2021.102167
  23. J Med Libr Assoc. 2021 Jul 01. 109(3): 464-471
       Objective: This study aims to identify the core journals cited in the health care management literature and to determine their coverage in the foremost bibliographic databases used by the discipline.
    Methods: Using the methodology outlined by the Medical Library Association's Nursing and Allied Health Resource Section (NAHRS) protocol for "Mapping the Literature of Nursing and Allied Health Professions," this study updates an earlier study published in 2007. Cited references from articles published in a three-year range (2016-2018) were collected from five health care management journals. Using Bradford's Law of Scattering, cited journal titles were tabulated and ranked according to the number of times cited. Eleven databases were used to determine coverage of the most highly cited journal titles for all source journals, as well as for a subset of practitioner-oriented journals.
    Results: The most highly cited sources were journals, followed by government documents, Internet resources, books, and miscellaneous resources. The databases with the most complete coverage of Zone 1 and 2 were Scopus, Web of Science Core Collection, and PubMed, while the worst performing databases were Health Business Elite, ABI/Inform, and Business Source Complete.
    Conclusions: The literature of health care management has expanded rapidly in the last decade, with cumulative citations increasing by 76.6% and the number of cited journal titles increasing by nearly 70% since the original study. Coverage of the core journals in popular databases remains high, although specialized health care management and business databases did not perform as well as general or biomedical databases.
    DOI:  https://doi.org/10.5195/jmla.2021.1121
  24. Genomics Inform. 2021 Sep;19(3): e24
      Tracking the most recent advances in Coronavirus disease 2019 (COVID-19)-related research is essential, given the disease's novelty and its impact on society. However, with the publication pace speeding up, researchers and clinicians require automatic approaches to keep up with the incoming information regarding this disease. A solution to this problem requires the development of text mining pipelines; the efficiency of which strongly depends on the availability of curated corpora. However, there is a lack of COVID-19-related corpora, even more, if considering other languages besides English. This project's main contribution was the annotation of a multilingual parallel corpus and the generation of a recommendation dataset (EN-PT and EN-ES) regarding relevant entities, their relations, and recommendation, providing this resource to the community to improve the text mining research on COVID-19-related literature. This work was developed during the 7th Biomedical Linked Annotation Hackathon (BLAH7).
    Keywords:  COVID-19; entity extraction; recommendation; relation extraction; text mining
    DOI:  https://doi.org/10.5808/gi.21008
  25. Sensors (Basel). 2021 Sep 26. pii: 6430. [Epub ahead of print]21(19):
      The literature on coronaviruses counts more than 300,000 publications. Finding relevant papers concerning arbitrary queries is essential to discovery helpful knowledge. Current best information retrieval (IR) use deep learning approaches and need supervised training sets with labeled data, namely to know a priori the queries and their corresponding relevant papers. Creating such labeled datasets is time-expensive and requires prominent experts' efforts, resources insufficiently available under a pandemic time pressure. We present a new self-supervised solution, called SUBLIMER, that does not require labels to learn to search on corpora of scientific papers for most relevant against arbitrary queries. SUBLIMER is a novel efficient IR engine trained on the unsupervised COVID-19 Open Research Dataset (CORD19), using deep metric learning. The core point of our self-supervised approach is that it uses no labels, but exploits the bibliography citations from papers to create a latent space where their spatial proximity is a metric of semantic similarity; for this reason, it can also be applied to other domains of papers corpora. SUBLIMER, despite is self-supervised, outperforms the Precision@5 (P@5) and Bpref of the state-of-the-art competitors on CORD19, which, differently from our approach, require both labeled datasets and a number of trainable parameters that is an order of magnitude higher than our.
    Keywords:  COVID-19; NLP; healthcare; information retrieval; language model; metric learning; self-supervised learning
    DOI:  https://doi.org/10.3390/s21196430
  26. J Med Libr Assoc. 2021 Jul 01. 109(3): 422-431
       Objective: The COVID-19 pandemic highlights the public's need for quality health information that is understandable. This study aimed to identify (1) the extent to which COVID-19 messaging by state public health departments is understandable, actionable, and clear; (2) whether materials produced by public health departments are easily readable; (3) relationships between material type and understandability, actionability, clarity, and reading grade level; and (4) potential strategies to improve public health messaging around COVID-19.
    Methods: Based on US Centers for Disease Control and Prevention statistics from June 30, 2020, we identified the ten states with the most COVID-19 cases and selected forty-two materials (i.e., webpages, infographics, and videos) related to COVID-19 prevention according to predefined eligibility criteria. We applied three validated health literacy tools (i.e., Patient Education Materials Assessment Tool, CDC Clear Communication Index, and Flesch-Kincaid Grade Level) to assess material understandability, actionability, clarity, and readability. We also analyzed correlations between scores on the three health literacy tools and material types.
    Results: Overall, COVID-19 materials had high understandability and actionability but could be improved in terms of clarity and readability. Material type was significantly correlated with understandability, actionability, and clarity. Infographics and videos received higher scores on all tools.
    Conclusions: Based on our findings, we recommend public health entities apply a combination of these tools when developing health information materials to improve their understandability, actionability, and clarity. We also recommend using infographics and videos when possible, taking a human-centered approach to information design, and providing multiple modes and platforms for information delivery.
    Keywords:  COVID-19; communication; consumers; health communication; health education; health information; health literacy; infodemic; information design; public health; state health department
    DOI:  https://doi.org/10.5195/jmla.2021.1165
  27. Genomics Inform. 2021 Sep;19(3): e22
      Automatic document classification for highly interrelated classes is a demanding task that becomes more challenging when there is little labeled data for training. Such is the case of the coronavirus disease 2019 (COVID-19) Clinical repository-a repository of classified and translated academic articles related to COVID-19 and relevant to the clinical practice-where a 3-way classification scheme is being applied to COVID-19 literature. During the 7th Biomedical Linked Annotation Hackathon (BLAH7) hackathon, we performed experiments to explore the use of named-entity-recognition (NER) to improve the classification. We processed the literature with OntoGene's Biomedical Entity Recogniser (OGER) and used the resulting identified Named Entities (NE) and their links to major biological databases as extra input features for the classifier. We compared the results with a baseline model without the OGER extracted features. In these proof-of-concept experiments, we observed a clear gain on COVID-19 literature classification. In particular, NE's origin was useful to classify document types and NE's type for clinical specialties. Due to the limitations of the small dataset, we can only conclude that our results suggests that NER would benefit this classification task. In order to accurately estimate this benefit, further experiments with a larger dataset would be needed.
    Keywords:  COVID-19; NLP; Named Entity Recognition; classification
    DOI:  https://doi.org/10.5808/gi.21018
  28. J Med Libr Assoc. 2021 Jul 01. 109(3): 472-477
       Background: Health science education needs images that represent both the diversity of patients served and the diversity of its students and clinicians. To begin to address this need, a nurse educator and librarian collaborated to launch the Oregon Health & Science University (OHSU) Educational Use Photo Diversity Repository. This online resource provides educators of health professional students with access to photos of pathophysiological conditions in skin of various colors so their students can increase their awareness of issues related to health and diversity and prepare themselves for more effective clinical work with their future patients.
    Case Presentation: The OHSU Educational Use Photo Diversity Repository became a university-wide project, leveraging the thoughts of an image advisory board, clinicians, faculty members, administrators, and students. Key considerations were given to the workflows used to submit photos as well as the controlled vocabulary for submitting images. The repository was started with photos already in existence, with future plans to have images taken specifically for the repository.
    Conclusions: This repository is playing an important role as OHSU and the health sciences in general reflect on the role of systemic racism in health care and clinical education. Negotiating issues of consent, patient health information, and privacy around using different technologies to take photos is a complex and ongoing process. The repository provides opportunities for closely examining these processes and creating improvements that result in more equitable education.
    Keywords:  cultural humility; diversity; health science education; inclusion
    DOI:  https://doi.org/10.5195/jmla.2021.1171
  29. J Med Libr Assoc. 2021 Jul 01. 109(3): 395-405
       Objective: We analyzed the COVID-19 Open Research Dataset (CORD-19) to understand leading research institutions, collaborations among institutions, major publication venues, key research concepts, and topics covered by pandemic-related research.
    Methods: We conducted a descriptive analysis of authors' institutions and relationships, automatic content extraction of key words and phrases from titles and abstracts, and topic modeling and evolution. Data visualization techniques were applied to present the results of the analysis.
    Results: We found that leading research institutions on COVID-19 included the Chinese Academy of Sciences, the US National Institutes of Health, and the University of California. Research studies mostly involved collaboration among different institutions at national and international levels. In addition to bioRxiv, major publication venues included journals such as The BMJ, PLOS One, Journal of Virology, and The Lancet. Key research concepts included the coronavirus, acute respiratory impairments, health care, and social distancing. The ten most popular topics were identified through topic modeling and included human metapneumovirus and livestock, clinical outcomes of severe patients, and risk factors for higher mortality rate.
    Conclusion: Data analytics is a powerful approach for quickly processing and understanding large-scale datasets like CORD-19. This approach could help medical librarians, researchers, and the public understand important characteristics of COVID-19 research and could be applied to the analysis of other large datasets.
    Keywords:  CORD-19 dataset; COVID-19 pandemic; data analytics; global research roadmap; topic modeling
    DOI:  https://doi.org/10.5195/jmla.2021.1141
  30. Int J Environ Res Public Health. 2021 Sep 25. pii: 10077. [Epub ahead of print]18(19):
      Disordered social media use, often referred to as "social media addiction", has not been officially recognized by medical bodies such as the American Psychiatric Association or the World Health Organization. However, websites still present information to laypeople on how to treat and manage social media addiction, which can pose the risk of spreading low quality or incorrect information. As such, we aimed to assess how the most popular social media addiction websites present information across multiple metrics. We conducted an in-depth online search to identify the top social media addiction websites in November 2019 (N = 23). Websites were separated into four distinct classifications: (1) treatment/therapy/medical; (2) informational; (3) news article; and (4) blog/essay. Based on previous website analysis research, three trained coders evaluated these websites on six metrics: (1) design; (2) credibility; (3) accessibility; (4) literacy; (5) engagement; and (6) social media addiction content. Design features were the top-rated metric across all websites, followed by credibility. Websites scored the lowest for the engagement and social media addiction content metrics. Across website classifications, scores for social media addiction content varied greatly, with blog/essay websites ranking the lowest and informational websites ranking the highest. Our findings provide necessary information for both patients and healthcare providers, apprising these individuals and the field about the current online health information landscape for disordered social media use.
    Keywords:  content analysis; health information; health literacy; problematic social media use; social media addiction; websites
    DOI:  https://doi.org/10.3390/ijerph181910077
  31. Int J Med Inform. 2021 Sep 29. pii: S1386-5056(21)00227-6. [Epub ahead of print]156 104601
       OBJECTIVES: To evaluate the linguistic changes of transgender-related resources prior to 1999 to create a comprehensive dataset of resources using an ontology-derived search system, laying a framework for ontology-based reviews to be used in informatics.
    METHODS: We analyzed 77 bibliographies and 11 databases for transgender resources published prior to 31 December 1999. We used 858 variants of the term "transgender" to identify resources. Individual sources were tagged by subject matter and major conceptual terminology usage. We evaluated the accuracy of a Gender, Sex, and Sexual Orientation (GSSO) ontology-based mechanism on tagging relevant literature searches.
    RESULTS: We identified 3,058 sources in 19 languages. Primary subjects covered included surgery, psychology, psychiatry, endocrinology, and sexology. The GSSO-based tagging mechanism correctly tagged 97.7% of MEDLINE resources as transgender-related.
    DISCUSSION: The GSSO-based tagging mechanism was more effective than keyword-specific elucidations of terminologically complex literature and was just as effective at manual identification of subjects discussed within resources. Diverse language relating to transgender persons can be identified using the GSSO, which can also be used for structured literature review based on subject matter thus improving research in the area.
    Keywords:  Bibliography; Biological Ontologies; Natural Language Processing; Transgender Persons; Transsexualism
    DOI:  https://doi.org/10.1016/j.ijmedinf.2021.104601
  32. Neurol Neurochir Pol. 2021 Oct 15.
       INTRODUCTION: The internet allows patients to access a vast amount of health information. We aimed to evaluate the credibility of YouTube videos that members of the public are accessing on brain aneurysms, and to evaluate what characteristics drive audience engagement.
    MATERIAL AND METHODS: The first 50 videos for each of the following search terms were taken for analysis: 'brain aneurysm', 'cerebral aneurysm' and 'intracranial aneurysm'. The quality of each video was evaluated by two neurosurgeons and two medical students independently using the Journal of the American Medical Association (JAMA) and the DISCERN instruments. Qualitative and quantitative video data was analysed for quality and audience engagement. Inter-rater agreement was ascertained.
    RESULTS: Out of a total of 150 videos, 70 met the inclusion criteria. The mean total DISCERN score was 36.5 ± 8.4 (out of 75 points), indicating that the videos were of poor quality. The mean JAMA score was 2.7 ± 0.7 (out of 4 points). Inter-rater agreement between the four raters was excellent (intraclass correlation coefficient 0.90 for DISCERN and 0.93 for JAMA). Most videos were uploaded by hospitals (50%) or educational health channels (30%). Videos had a higher number of average daily views when they included animation (P = 0.0093) and diagrams (P = 0.0422).
    CONCLUSIONS: YouTube is a poor source of patient information on brain aneurysms. Our quality and audience engagement analysis may help content creators (i.e. hospital staff and physicians) to create more holistic, educational and engaging medical videos concerning brain aneurysms. Physicians could usefully refer their patients to the highest quality videos that we have found.
    Keywords:  YouTube; aneurysm; brain aneurysm; cerebral aneurysm; internet; intracranial aneurysm; quality
    DOI:  https://doi.org/10.5603/PJNNS.a2021.0073
  33. Female Pelvic Med Reconstr Surg. 2021 Oct 07.
       OBJECTIVE: The aim of the study was to evaluate the quality of patient-focused websites addressing postpartum pelvic floor health.
    METHODS: The Google search engine was used to perform a search of the following 3 terms: (1) "postpartum pelvic floor (PPF)," (2) "postpartum leaking urine (PLU)," and (3) "postpartum leaking stool (PLS)." The top 20 results from each search term were evaluated using the DISCERN quality appraisal tool and Journal of the American Medical Association (JAMA) benchmark criteria by 2 independent researchers. Websites were also categorized by type. Cohen κ was performed to determine interrater reliability between reviewers. The Kruskal-Wallis test was used to evaluate the differences in DISCERN and JAMA criteria scores.
    RESULTS: The weighted mean κ between the investigators for each search term was κ = 0.47 (range = 0.163 [PPF] to 0.759 [PLU]), suggesting moderate agreement between reviewers. There was a significant difference in mean DISCERN scores between the terms, with "postpartum leaking urine" yielding the highest mean score. When comparing DISCERN scores by category, society- and government-sponsored websites (mean = 55 ± 13) scored significantly higher than other categories. Using JAMA criteria, mean scores ranged between 1.83 and 2.83/4, but there were no significant differences between websites.
    CONCLUSIONS: The overall quality of health information available on the internet regarding postpartum pelvic health is low. Higher-quality search results are found within society- and government-sponsored websites as well as under the search term "postpartum leaking urine." It is important for health care providers to guide their patients to websites with reliable information about postpartum pelvic floor recovery.
    DOI:  https://doi.org/10.1097/SPV.0000000000001101
  34. Int J Spine Surg. 2021 Oct 14. pii: 8133. [Epub ahead of print]
       BACKGROUND: As spine surgery in the ambulatory setting becomes more frequent, patients should comprehend the difference from traditional hospital-based, outpatient settings. Limited research exists on the readability of online articles surrounding spine surgery in the ambulatory surgery center (ASC). In this study, we intend to evaluate the readability of online articles pertaining to spine surgery in the outpatient and ambulatory surgical settings.
    METHODS: Three search engines were queried, and the first 100 articles pertaining to each outpatient spine surgery search term were collected. Advertisements, videos, and peer-reviewed scientific articles were excluded. Articles were categorized by publishing source as follows: hospital or institution, general medical Websites, private practice, or surgery center. Flesch-Kincaid (FK) grade level, Flesch Reading Ease (FRE) score, word count, sentences per paragraph, words per sentence, and characters per word were evaluated for each article. Student's t tests compared readability metrics between groups based on setting and procedure region.
    RESULTS: A total of 342 articles was analyzed; 279 articles were outpatient hospital related, and 63 ASC related. Flesch-Kincaid grade levels or FRE scores were not significantly different between outpatient hospital and ambulatory center. Comparison of ASC to outpatient articles from a hospital or institution source significantly differed in FRE score (40.7 versus 32.4) and FK grade level (12.3 versus 13.9; all P < .05). Articles addressing procedure type were significantly different in FRE score (36.2 versus 30.0) and FK grade level (13.0 ± 2.1 versus 14.3 ± 1.8).
    CONCLUSIONS: Hospital, private practice, and medical journalists should be aware of significant differences in readability of patient-accessible ASC articles. These articles may be more difficult to read than outpatient hospital articles, and production of more reading-level-appropriate online literature is required.
    LEVEL OF EVIDENCE: 3 CLINICAL RELEVANCE: There is a significant difference in the readability of patient-accessible ASC articles.
    Keywords:  ambulatory surgical center; outpatient spine surgery; patient education; readability
    DOI:  https://doi.org/10.14444/8133
  35. Ophthalmol Glaucoma. 2021 Oct 09. pii: S2589-4196(21)00237-4. [Epub ahead of print]
       OBJECTIVE OR PURPOSE: To evaluate the quality, reliability, and popularity of videos relating to glaucoma on YouTube DESIGN: A retrospective, cross-sectional study on YouTube videos about glaucoma was conducted SUBJECTS, PARTICIPANTS, AND/OR CONTROLS: 100 YouTube videos were analyzed for this study.
    METHODS, INTERVENTION, OR TESTING: An online YouTube search for glaucoma videos was conducted simulating a user search using the keywords glaucoma, high eye pressure, and high intraocular pressure. The first 100 videos were analyzed, and each video was evaluated by two independent reviewers using the mDISCERN (1-5), JAMA (0-4), and Global Quality (GQ) (1-5) criteria to assess quality and reliability. Videos were further categorized into three groups depending on the source of their upload. Group 1 was videos uploaded by academic or government institutions, Group 2 included videos uploaded by private medical practices, and Group 3 included videos uploaded by independent users.
    MAIN OUTCOME MEASURES: mDISCERN, JAMA, and GQ scores for quality and reliability of information. Video power index (VPI) for video popularity.
    RESULTS: There was no substantial difference in scoring observed between the two independent reviewers. The overall mean mDISCERN score (±SE) was 3.81 ± 0.06, mean JAMA score (±SE) was 2.93 ± 0.07, and mean GQ score (±SE) was 3.98 ± 0.06. The overall VPI score (±SE) was 9.9 ± 2.9. There were significant positive correlations between video popularity and quality of information for all three criteria (p<0.05). The videos in Group 1 and 2 scored higher in mDISCERN than Group 3 but did not score higher with either the JAMA or GQ criteria. Videos in Group 3 were the most popular when compared to videos in Group 1 or 2 (p<0.01).
    CONCLUSIONS: Overall, many of the videos had adequate quality and reliability scores. There was no difference between Groups 1-3 in two of the three criteria used suggesting a similar quality of information provided between academic, private, and independent sources.
    Keywords:  YouTube; glaucoma; popularity; quality; videos
    DOI:  https://doi.org/10.1016/j.ogla.2021.10.002
  36. Int J Spine Surg. 2021 Oct 14. pii: 8132. [Epub ahead of print]
       BACKGROUND: Recent publications have demonstrated that information has been transmitted inappropriately to the lay person in different pathologies. This limitation is also observed in Spanish language. We evaluate the availability and readability of online patient education material (PEM) on spinal cord injury (SCI) information for the Spanish-speaking population from academic neurosurgery residency programs in the United States.
    METHODS: This is a descriptive analysis of online SCI PEM from neurosurgical residency programs websites. We assess the availability of information in Spanish using a modification of a previously published classification. To assess accessibility, we calculated the time spent and the number of clicks to find the information in Spanish. We calculated the readability of the material using the "Indice Flesch-Szigriszt" (INFLESZ), which determines the difficulty of readability of health-related material in Spanish.
    RESULTS: A total of 116 accredited neurosurgery residency programs comprised our cohort. Ten (9%) programs had available "mirrored" information in Spanish from its original version in English, 9 (8.1%) used a translation software, 79 (71.2%) provide interpreter services, and 3 (2%) did not have written information or information about translation services. A mean of 72.9 seconds (SD +/- 71.2) were required to have access to the Spanish information or contact information for translation services. Twelve (57.1%) websites with written Spanish information had an INFLESZ score above 55.00, which translates as an appropriate readability level for the general population.
    CONCLUSIONS: More than half of the academic neurosurgery programs or affiliated hospital websites do not provide written informative material about SCI in Spanish. When available, the information is not always transmitted with a level of readability appropriate for the layperson. Most of the websites provide translation or interpreter services that are not directly related to SCI.
    Keywords:  Spanish; availability; readability; residency; spinal cord injury
    DOI:  https://doi.org/10.14444/8132
  37. Int J Environ Res Public Health. 2021 Sep 29. pii: 10241. [Epub ahead of print]18(19):
      In addition to preserving their health, young people can also play a role in providing information to wider society. Nutrition habits that have developed over the years at college have an impact on the foundation of a lifelong lifestyle. Our aim was to identify university students' online and offline information-seeking attitudes related to healthy nutrition and create a new theoretical concept. Participants were university students (n = 612), and the self-administered, paper-based questionnaires were sent out to nine Hungarian universities. Both descriptive and multivariate statistical procedures were used in the analysis. Online and offline information sources were categorized. In relation to university students' information-seeking competence, the component of electronic health literacy was determined. In analyzing attitudes, the components of acceptance of, incentive for, and rejection of or ambivalence towards healthy nutrition were identified. The information-seeking categories related to the stages of university students' conscious transition to healthy nutrition were also identified. University students' competences related to electronic health literacy are essentially favorable. This target group accepts healthy nutrition and tries to recommend it to others, too. However, a rejecting or ambivalent attitude could also be identified. Online and offline sources of information accompany university students' transition of the relevant stages of changes. The theoretical concept that we developed can contribute to bridging gaps in the interrelatedness of diverse information sources and healthy nutrition.
    Keywords:  Hungary; attitude; eating habits; health; nutrition; online and offline information sources; university students
    DOI:  https://doi.org/10.3390/ijerph181910241
  38. Int J Environ Res Public Health. 2021 Sep 30. pii: 10329. [Epub ahead of print]18(19):
      Effective multilingual communication of authoritative health information plays an important role in helping to reduce health disparities and inequalities in developed and developing countries. Health information communication from the World Health Organization is governed by key principles including health information relevance, credibility, understandability, actionability, accessibility. Multilingual health information developed under these principles provide valuable benchmarks to assess the quality of health resources developed by local health authorities. In this paper, we developed machine learning classifiers for health professionals with or without Chinese proficiency to assess public-oriented health information in Chinese based on the definition of effective health communication by the WHO. We compared our optimized classifier (SVM_F5) with the state-of-art Chinese readability classifier (Chinese Readability Index Explorer CRIE 3.0), and classifiers adapted from established English readability formula, Gunning Fog Index, Automated Readability Index. Our optimized classifier achieved statistically significant higher area under the receiver operator curve (AUC of ROC), accuracy, sensitivity, and specificity than those of SVM using CRIE 3.0 features and SVM using linguistic features of Gunning Fog Index and Automated Readability Index (ARI). The statistically improved performance of our optimized classifier compared to that of SVM classifiers adapted from popular readability formula suggests that evaluation of health communication effectiveness as defined by the principles of the WHO is more complex than information readability assessment. Our SVM classifier validated on health information covering diverse topics (environmental health, infectious diseases, pregnancy, maternity care, non-communicable diseases, tobacco control) can aid effectively in the automatic assessment of original, translated Chinese public health information of whether they satisfy or not the current international standard of effective health communication as set by the WHO.
    Keywords:  Chinese health resources; accessibility; health translation; readability
    DOI:  https://doi.org/10.3390/ijerph181910329
  39. J Med Libr Assoc. 2021 Jul 01. 109(3): 523-525
      Colandr.https://colandrcommunity.com;colandrteam@gmail.com; pricing: free.
    DOI:  https://doi.org/10.5195/jmla.2021.1263
  40. J Med Libr Assoc. 2021 Jul 01. 109(3): 520-522
      EndNote 20 desktop version. Released October 2020. Clarivate, 1500 Spring Garden Street, Fourth Floor, Philadelphia, PA 19130; https://endnote.com/; 1-888-418-1937; onetime purchase full license, $249.95, discounts available, contact for institutional pricing. For a list of technical requirements, visit https://endnote.com/product-details/compatibility.
    DOI:  https://doi.org/10.5195/jmla.2021.1260