bims-librar Biomed News
on Biomedical librarianship
Issue of 2022–10–23
seventeen papers selected by
Thomas Krichel, Open Library Society



  1. Res Synth Methods. 2022 Oct 19.
      Systematic reviews are vital instruments for researchers to understand broad trends in a field and synthesize evidence on the effectiveness of interventions in addressing specific issues. The quality of a systematic review depends critically on having comprehensively surveyed all relevant literature on the review topic. In addition to database searching, handsearching is an important supplementary technique that helps increase the likelihood of identifying all relevant studies in a literature search. Traditional handsearching requires reviewers to manually browse through a curated list of field-specific journals and conference proceedings to find articles relevant to the review topic. This manual process is not only time-consuming, laborious, costly, and error-prone due to human fatigue, but it also lacks replicability due to its cumbersome manual nature. To address these issues, this paper presents a free and open-source Python package and an accompanying web-app, Paperfetcher, to automate the retrieval of article metadata for handsearching. With Paperfetcher's assistance, researchers can retrieve article metadata from designated journals within a specified time frame in just a few clicks. In addition to handsearching, it also incorporates a beta version of citation searching in both forward and backward directions. Paperfetcher has an easy-to-use interface which allows researchers to download the metadata of retrieved studies as a list of DOIs or as an RIS file to facilitate seamless import into systematic review screening software. To the best of our knowledge, Paperfetcher is the first tool to automate handsearching with high usability and a multi-disciplinary focus. This article is protected by copyright. All rights reserved.
    Keywords:  Systematic reviews; citation searching; handsearching; information retrieval; literature search; supplementary techniques
    DOI:  https://doi.org/10.1002/jrsm.1604
  2. Rev Bras Epidemiol. 2022 ;pii: S1415-790X2022000100421. [Epub ahead of print]25 e220030
       OBJECTIVE: To describe the main functions of the "Systematic Review Support" web-based system for removing duplicate articles and aiding eligibility analysis during the process of conducting systematic review studies.
    METHODS: The system was developed based on the incremental build model using the Agile methodology. The software is proprietary source code and was published on a proprietary platform. The architecture of the production environment allows the infrastructure used to increase or decrease according to demand. The system functions are presented with insertion of screenshots of the interfaces of the version for personal computers during the simulation of a systematic review.
    RESULTS: After importing the files containing the abstracts retrieved from the Pubmed, Embase, and Web of Science databases, the system identifies and removes duplicates for later reading and analysis of title and abstract, a stage which can be performed by one or more reviewers independently. After unblinding of reviewers, the decisions on the eligibility of the studies are compared automatically to help the researchers reach a consensus on any disagreements. Results can be filtered and a PDF produced containing the eligible studies.
    CONCLUSION: Version 1.0 of the system is available on the web (sysrev.azurewebsites.net) to assist researchers in the initial stages of systematic reviews.
    DOI:  https://doi.org/10.1590/1980-549720220030
  3. Health Info Libr J. 2022 Oct 20.
      Quality assurance (QA) is an important process in ensuring that systematic reviews and other evidence syntheses are supported by a high-quality search. This paper describes how the National Institute for Health and Care Excellence (NICE) in the UK established a development pathway to ensure its information specialists had the skills, knowledge and confidence to undertake search QA. The key component of the pathway is that it blends technical knowledge with interpersonal skills. The pathway develops technical skills in the early steps before using peer support activities to build confidence while undertaking a range of searches. QA is effective when the search lead communicates the contextual information that has influenced search development. QA is treated as a collaboration to get the right search for the review. The key requirements for search QA, alongside technical knowledge, are communication, collaboration and negotiation skills.
    Keywords:  continuing professional development (CPD); guideline development; informationist; mentoring; peer review; review and systematic search
    DOI:  https://doi.org/10.1111/hir.12460
  4. J Assoc Inf Sci Technol. 2022 Nov;73(11): 1594-1607
      This investigation explores the initial impact of the COVID-19 pandemic on live chat virtual reference services (VRS) in academic libraries and on user behaviors from March to December 2020 using Goffman's theoretical framework (1956, 1967, 1971). Data from 300 responses by academic librarians to two longitudinal online surveys and 28 semi-structured interviews were quantitatively and qualitatively analyzed. Results revealed that academic librarians were well-positioned to provide VRS as university information hubs during pandemic shutdowns. Qualitative analysis revealed that participants received gratitude for VRS help, but also experienced frustrations and angst with limited accessibility during COVID-19. Participants reported changes including VRS volume, level of complexity, and question topics. Results reveal the range and frequency of new services with librarians striving to make personal connections with users through VRS, video consultations, video chat, and other strategies. Participants found it difficult to maintain these connections, coping through grit and mutual support when remote work became necessary. They adapted to challenges, including isolation, technology learning curves, and disrupted work routines. Librarians' responses chronicle their innovative approaches, fierce determination, emotional labor, and dedication to helping users and colleagues through this unprecedented time. Results have vital implications for the future of VRS.
    DOI:  https://doi.org/10.1002/asi.24698
  5. JMIR Med Educ. 2022 Oct 21. 8(4): e37730
       BACKGROUND: Preclinical medical learners are embedded in technology-rich environments, allowing them rapid access to a large volume of information. The anatomy laboratory is an environment in which faculty can assess the development of professional skills such as information literacy in preclinical medical learners. In the anatomy laboratory, many students use Google Images searches in addition to or in place of other course materials as a resource to locate and identify anatomical structures. However, the most frequent sources as well as the educational quality of these images are unknown.
    OBJECTIVE: This study was designed to assess the sources and educational value of Google Images search results for commonly searched anatomical structures.
    METHODS: The top 10 Google Images search results were collected for 39 anatomical structures. Image source websites were recorded and categorized based on the purpose and target audience of the site publishing the image. Educational value was determined through assessment of relevance (is the searched structure depicted in the image?), accuracy (does the image contain errors?), and usefulness (will the image assist a learner in locating the structure on an anatomical donor?). A reliable scoring rubric was developed to assess an image's usefulness.
    RESULTS: A total of 390 images were analyzed. Most often, images were sourced from websites targeting health care professionals and health care professions students (38% of images), while Wikipedia was the most frequent single source of image results (62/390 results). Of the 390 total images, 363 (93.1%) depicted the searched structure and were therefore considered relevant. However, only 43.0% (156/363) of relevant images met the threshold to be deemed useful in identifying the searched structure in an anatomical donor. The usefulness of images did not significantly differ across source categories.
    CONCLUSIONS: Anatomy faculty may use these results to develop interventions for gaps in information literacy in preclinical medical learners in the context of image searches in the anatomy laboratory.
    Keywords:  Google; anatomical images; anatomy; anatomy laboratory; educational value; images; information literacy; internet search; literacy information; medical education; medical students; scoring rubric
    DOI:  https://doi.org/10.2196/37730
  6. Comput Intell Neurosci. 2022 ;2022 7892738
      Internet technology has a great impact on the application and development of libraries. In order to provide users with more convenient and efficient services, this paper puts forward the development strategy of unmanned intelligent digital libraries in the era of "Internet +." Design by IntelliSense module, network transmission module, data storage and analysis module, and intelligent service module of no wisdom digital library service mode, IntelliSense module using RFID technology, close range wireless communication technology, and other Internet technologies to collect the wisdom of unmanned services of all kinds of information in the digital library; use network transmission module of the wireless LAN network, Internet technology such as RFID network to transmit information collected to store in a data storage and analysis module; and at the same time using k-means clustering algorithm in data mining techniques such as analysis of collected data, based on the analysis results provide users with intelligence services such as search, wisdom is recommended. The experimental results show that the developed strategy meets the expected functional requirements, can accurately perceive the location of data, and effectively realize the intelligent service function.
    DOI:  https://doi.org/10.1155/2022/7892738
  7. CJC Open. 2022 Oct;4(10): 858-865
       Background: Patient educational resources on heart failure (HF) medications may improve patient understanding, which is critical for informed decision-making and patient self-efficacy. The purpose of our study was to evaluate the quality and readability of written medication educational resources available online.
    Methods: Two investigators searched Google, Yahoo, and Bing for written patient educational resources that addressed at least one HF medication. We assessed educational quality using the Ensuring Quality Information for Patients (EQIP) tool (range 0 [worst] to 100 [best]), and we evaluated readability using the Flesch-Kincaid Grade Level.
    Results: From 693 identified webpages, 39 HF medication educational resources met study eligibility. Among included resources, the median Ensuring Quality Information for Patients score was 61% (interquartile range 54%-68%), with 2 (5%) rated as high quality (score ≥ 75%). The median Flesch-Kincaid Grade Level was 8 (interquartile range 8-12), with 4 (10%) resources meeting the recommended 6th-grade reading level.
    Conclusions: Most HF medication educational resources available on the Internet are of acceptable educational quality, but could readily be improved. Most resources were beyond the recommended reading grade level for educational resources, limiting their utility for patients with a low literacy level.
    DOI:  https://doi.org/10.1016/j.cjco.2022.07.004
  8. Interact J Med Res. 2022 Oct 20. 11(2): e38759
       BACKGROUND: The Association of American Medical Colleges has recently issued recommendations for the upcoming 2022-2023 application cycle that residency programs should conduct all interviews for this upcoming application cycle over the web. In light of these recommendations, many students will have limited exposure to anesthesiology programs and will rely on information gleaned digitally. This change means that the aspects of program websites used to provide information, such as size, structure, location, requirements, and contact information, will be crucial in helping prospective residents decide where and how to apply in the future. An evaluation of website usability, which includes initial appearance along with factors that influence its ease of navigation and convenience of use, can thus be applied to anesthesiology residency websites. Areas of need can be targeted to increase web presence and provide effective pathways to exhibit the different attributes of their programs to future applicants.
    OBJECTIVE: This study aimed to compile a list of US anesthesiology residency programs and their websites while objectively analyzing the websites using a formally published usability scoring system, as well as to identify positive and negative trends to offer areas of improvement among anesthesiology residency websites.
    METHODS: We included only 114 US anesthesiology residency program websites in our sample set, since some websites we analyzed showed errors or inconclusive. Website usability was separated into 4 distinct categories for analysis based on methodology outlined in previous literature on both health care website usability and residency website usability. The 4 categories were Accessibility, Marketing, Content Quality, and Technology. Each website was then analyzed and scored based on key components highlighted within the 4 categories. The multiple factors were then graded using a percentage system to create a comprehensive score for each program.
    RESULTS: The highest scoring category was Content Quality (mean 4.7, SD 2.48, SE 0.23). The lowest scoring category was Technology (mean 0.9, SD 0.38, SE 0.04).
    CONCLUSIONS: Through the application of a health care website usability framework, multiple anesthesiology residency programs were analyzed and scored in the areas of Accessibility, Marketing, Content Quality, and Technology, which allowed us to determine the effectiveness of the usability of these websites to convey information to their end user. Websites must communicate vital information, with usability at the forefront, to continue to grow, especially as the United States faces challenges due to the COVID-19 pandemic. Our recommendation is that anesthesiology programs should strive to improve website usability to increase the ease by which applicants can collect vital information about anesthesiology programs. A few proposed solutions include making changes such as decreasing error pages on websites, migrating away from using in-line cascading style sheets, and improving web page loading speeds to improve the Technology category.
    Keywords:  communication; education in anesthesia; medical student education; quality improvement; technology in education
    DOI:  https://doi.org/10.2196/38759
  9. J Surg Res. 2022 Oct 15. pii: S0022-4804(22)00585-6. [Epub ahead of print]282 65-70
       INTRODUCTION: Patients often discuss information obtained from Internet sources during clinic visits, which can be of variable quality and depth. We sought to review and assess information on the Internet regarding common operations within endocrine surgery.
    METHODS: Using Google's search engine, the top 100 websites from the search phrase "parathyroid surgery," and the top 100 websites from the phrase "thyroid surgery" were identified. Each website was evaluated for accessibility, accuracy, and completeness of information about gland hormone function, associated disease processes, and surgery itself. Results were stratified based on the website type, and bivariate analysis was performed to determine accuracy by category. Presence of author credentials, last webpage update, and presence of advertisements were also assessed. Inter-rater reliability was calculated for each variable.
    RESULTS: For parathyroid surgery, at least two-thirds of all websites included information about surgery, hormone function, and disease processes. For thyroid surgery, 71% of websites included procedure information, but only 52% included information about hormone function and 56% about disease processes. Less than 30% of all websites included advertisements and less than 25% listed author credentials or provided references. Academic or research-affiliated sources were most likely to have zero inaccuracies, but 44% of all websites had at least one potential inaccuracy. Inter-rater reliability achieved at least moderate agreement (>0.41) for 56% of variables.
    CONCLUSIONS: There is a wide array of information available to patients online, and accuracy varies based on multiple factors including the type of website. Endocrine surgeons and related practitioners must be cognizant of this fact when discussing treatment plans with patients.
    Keywords:  Endocrine; Internet; Misinformation; Parathyroid; Thyroid
    DOI:  https://doi.org/10.1016/j.jss.2022.09.004
  10. AEM Educ Train. 2022 Oct;6(5): e10812
       Background: Free open-access medical education (FOAM) resources have become highly utilized resources in emergency medicine education. However, FOAM content often lacks the traditional peer review process, leaving quality assessment to the readers. In this systematic online academic resource (SOAR) review, we apply a systematic methodology to assess the quality of FOAM resources on sickle cell disease (SCD).
    Methods: We searched keywords for SCD using FOAM Search and the top 50 FOAM websites listed on the Social Media Index. Resources found were screened using inclusion/exclusion criteria, and a total of 53 resources underwent full-text quality assessment using the revised Medical Education Translational Resources Impact and Quality (rMETRIQ) tool.
    Results: The search yielded 520 resources, of which 53 met the criteria for quality assessment. A total of eight posts (15.1% of posts) were identified as high quality (rMETRIQ ≥ 16). The most commonly addressed topics within SCD topics included acute chest syndrome, acute pain crisis and general review of SCD. A total of 11 posts (21% of posts) were found to have an rMETRIQ score of less than 7, which may indicate poor quality. The most commonly identified type of resource was personalized reading (64%) and a number of posts were deemed to not have an appropriate use due to poor quality (15%).
    Conclusions: We were able to systematically search a wide range of resources to identify, appraise, and organize FOAM resources on the topic of SCD. A final list of eight high-quality resources can guide trainees, educator recommendations, and FOAM authors.
    DOI:  https://doi.org/10.1002/aet2.10812
  11. J Med Internet Res. 2022 Oct 17. 24(10): e39555
       BACKGROUND: Peripheral artery disease (PAD) affects millions of people worldwide, and a core component of management of the condition is self-management. The internet is an important source of health information for many people. However, the content of websites regarding treatment recommendations for PAD has not been fully evaluated.
    OBJECTIVE: This study aimed to assess the credibility, accuracy, and comprehensiveness of websites found via a common search engine, by comparing the content to current guidelines for treatment and management of PAD and intermittent claudication (IC).
    METHODS: A review of websites from hospitals, universities, governments, consumer organizations, and professional associations in the United States and the United Kingdom was conducted. Website recommendations for the treatment of PAD and IC were coded in accordance with the guidelines of the National Institute for Health and Care Excellence (NICE) and the American Heart Association (AHA). Primary outcomes were website credibility (4-item Journal of the American Medical Association benchmark), website accuracy (in terms of the percentage of accurate recommendations), and comprehensiveness of website recommendations (in terms of the percentage of guideline recommendations that were appropriately covered). Secondary outcomes were readability (Flesch-Kincaid grade level) and website quality (Health On the Net Foundation's code of conduct).
    RESULTS: After screening, 62 websites were included in this analysis. Only 45% (28/62) of websites met the credibility requirement by stating they were updated after the NICE guidelines were published. Declaration of authorship and funding and the presence of reference lists were less commonly reported. Regarding accuracy, 81% (556/685) of website recommendations were deemed accurate on following NICE's and the AHA's recommendations. Comprehensiveness was low, with an average of 40% (25/62) of guideline treatment recommendations being appropriately covered by websites. In most cases, readability scores revealed that the websites were too complex for web-based consumer health information.
    CONCLUSIONS: Web-based information from reputable sources about the treatment and management of PAD and IC are generally accurate but have low comprehensiveness, credibility, and readability.
    Keywords:  digital health; eHealth; education; health information; intermittent claudication; internet; peripheral artery disease
    DOI:  https://doi.org/10.2196/39555
  12. Acta Orthop Traumatol Turc. 2022 Oct 17.
       OBJECTIVE: Videos uploaded to YouTube do not go through a review process, and therefore, videos related to patellofemoral instability may have little educational value. The purpose of this study was to assess the educational quality of YouTube videos regarding patellofemoral instability.
    METHODS: A standard search was performed on the YouTube database using the following terms: "unstable kneecap," "patellar instability," "patellofemoral instability," "kneecap dislocation," and "patellar dislocation," and the top 50 videos based on the "relevance" assignment of the YouTube algorithm were included for analysis. The properties, content, and source of each video were recorded. The educational quality of videos was analyzed according to scores obtained using DISCERN, the criteria of Journal of the American Medical Association, Global Quality Score, and Patellofemoral Instability Specific Score, and the quality of the videos was evaluated according to the groupings of these scoring systems.
    RESULTS: A total of 250 videos were identified, of which 89 were included in the study for analysis. The mean video duration was 11.72 ± 22.03 minutes. The median number of views was 4516.5 (range, 3-6 044 971). The content of the videos was disease-specific in 60%, 20% were related to surgical technique or approach, and 14.1% were exercise videos. Most of the videos were uploaded by physicians (33.7%). The Global Quality Score and DISCERN scores were significantly correlated with video duration. The Patellofemoral Instability Specific Score was significantly correlated with video duration, number of views, view rate, likes, and Video Power Index. According to the DISCERN classification, 69.9% of the videos were very insufficient or insufficient. According to the Patellofemoral Instability Specific Score, 65.2% of videos were evaluated as very low or low. According to the Global Quality Score, 60.7% of videos were rated as poor quality.
    CONCLUSION: The quality of YouTube videos about Patellofemoral instability is insufficient. It was found that viewers tend to watch short and low-quality videos.
    DOI:  https://doi.org/10.5152/j.aott.2022.22005
  13. Patient Educ Couns. 2022 Oct 10. pii: S0738-3991(22)00445-1. [Epub ahead of print]
       OBJECTIVES: African American women below screening age disproportionately face greater mortality from breast cancer relative to peers of other races and African American women of screening age. The current study examines breast cancer knowledge and health information seeking of African American women below screening age.
    METHODS: We collected survey data from 99 African American women below screening age on their breast cancer knowledge and health information seeking behaviors. As secondary analysis, we harmonized data from a previous study to compare breast cancer knowledge between African American women below and of (N = 209) screening age.
    RESULTS: The average woman below screening age correctly answered 2.84 (SD=1.08) of six breast cancer knowledge items, 2.67 (SD=1.01) of five mammogram items, 1.44 (SD=0.86) of three treatment items, and had lower knowledge (p < .001) in each area relative to screening age women. Women below screening age sought information primarily from medical providers and the internet.
    CONCLUSIONS: A strategy for eliminating early-onset breast cancer disparities impacting African American women is addressing the limited breast cancer knowledge in this age group. Practice Implications In addition to age-appropriate information for this group, guidance for medical providers would be beneficial, as providers are this group's most common source of health information.
    Keywords:  African American; Breast cancer; Cancer disparities; Health information
    DOI:  https://doi.org/10.1016/j.pec.2022.10.002
  14. J Med Internet Res. 2021 Jun 19. 23(6): e25868
       BACKGROUND: Health care professionals (HCPs) routinely have questions concerning the medications they are recommending. There are numerous resources available; however, each has its own advantages and disadvantages.
    OBJECTIVE: The purpose of this survey was to gain knowledge of the preferred methods and sources HCPs use to obtain information concerning medications.
    METHODS: A total of 511 HCPs (202 physicians, 105 pharmacists, 100 advance practice nurses, 53 registered nurses, and 51 physician assistants) were surveyed through a third-party market research firm. All participants were practicing in the United States. Individuals working for a pharmaceutical company were excluded. The survey collected demographics, frequency of searching medical information, types of questions searched, sources of medical information, and rationale for preferred and nonpreferred sources of medical information. Use of medical information resources were rated on a 5-point ordinal scale. Data were analyzed with descriptive statistics.
    RESULTS: Of the 511 respondents, 88.5% (452/511) searched for medical information either daily or several times per week. The most common questions involved dosing and administration, drug-drug interactions, adverse events and safety, clinical practice guidelines, and disease state information. The main rationale for using specific medical websites or apps and general online search engines frequently or very frequently was ease of use (medical websites or apps: 269/356, 75.6%; general online search engines: 248/284, 87.3%). Accuracy was the main rationale for frequent or very frequent use of medical literature search databases (163/245, 66.5%), prescribing labels or information (122/213, 57.3%), and professional literature (120/195, 61.5%). The main reason for rarely or never using specific medical websites or apps and medical literature search databases was unfamiliarity (medical websites or apps: 16/48, 33%; medical literature search databases: 35/78, 45%); for general online search engines, inaccuracy (34/54, 63%); and for prescribing labels or information and professional literature, excessive time (prescribing labels or information : 54/102, 52.9%; professional literature: 66/106, 62.3%). The pharmaceutical company was sometimes used as a resource for medical information. When the medical information department was used, the call center and the website were considered thorough and complete (call center: 14/25, 56%; website: 33/55, 60%). However, the rationale for not using the call center was the time required (199/346, 57.5%) and the website being unfamiliar (129/267, 48.3%).
    CONCLUSIONS: The driving forces in the selection of resources are accuracy and ease of use. There is an opportunity to increase awareness of all the appropriate resources for HCPs which may aid in their daily clinical decisions. Specifically, pharmaceutical company medical information departments can help fulfill this need by addressing two major challenges with use of the pharmaceutical company: lack of awareness of medical information services and the speed at which responses are disseminated. Overall, there is lack of understanding or appreciation of the range of pathways to obtain published information and knowledge from pharmaceutical company medical information services. Among the many challenges resource champions will face are the ability to effectively make resources and their platforms accessible, known, and useful to the scientific community.
    Keywords:  access to information; databases; information-seeking behavior; internet; medical information; medical literature; nurses; pharmacists; physicians; search tools
    DOI:  https://doi.org/10.2196/25868
  15. J Health Commun. 2022 Oct 17. 1-10
      The Health Information National Trends Survey (HINTS) is a well-established U.S.-based research program administered by the National Cancer Institute to track the public access to and use of health information. This paper introduces a German research initiative, part of the International Studies to Investigate Global Health Information Trends (INSIGHTS) research consortium. This adaptation of the HINTS is important for initiating analyses of global health communication practices and comparing health information seeking behaviors (HISB) across nations to pinpoint potentials and challenges of health information provision and contribute to a deeper understanding of socio-contextual determinants of HISB. First cross-country comparisons revealed that the share of residents seeking for health information is high in the U.S. (80%) and Germany (74%), but different primary sources are used. Whereas a clear majority of U.S. residents chose the Internet to gather health information (74.9%), Germans most often turn to health professionals (48.0%). Socio-structural and health(care)-related predictors were found to contribute to the explanation of HISB in both countries, whereas information-related predictors were only relevant in Germany. The results indicate the need to engage in patient-provider communication to initiate HISB and to improve the access to information for residents with lower socio-economic backgrounds.
    DOI:  https://doi.org/10.1080/10810730.2022.2134522
  16. HSS J. 2022 Nov;18(4): 485-489
       Background: Stem cell therapies have emerged as a potential treatment for osteoarthritis (OA), but their role remains controversial. Their growing popularity may lead patients to search for information online, but search queries and sources are unknown.
    Purpose: We sought to (1) identify the most frequently asked questions on Google related to knee OA and stem cell therapy, (2) assess the types of websites accessed through these searches, and (3) evaluate the transparency of these websites.
    Methods: The search terms "knee," "osteoarthritis," and "stem cell" were entered into Google. Frequently asked questions suggested by Google, and their corresponding websites were extracted. Questions and websites were classified by type. Journal of the American Medical Association (JAMA) benchmark criteria were used as a measure of website transparency (range: 0-4). Analysis of variance tests were performed to compare JAMA benchmark criteria between website types.
    Results: Of the 145 questions and website extracted, the most common question subtype pertained to non-stem cell treatments (41.4%) for knee OA; the most common website types were medical publishers (24.8%) and nonacademic medical practices (22.8%). JAMA scores were highest for medical publishers (mean: 3.81) and lowest for nonacademic medical practices (mean: 1.55). Nonacademic medical practices had significantly worse JAMA scores compared with commercial, academic, and medical publishers.
    Conclusion: The most frequent questions pertained to non-stem cell treatments, although questions related to stem cell efficacy were most common among the 10 most frequent questions. Google searches on knee OA and stem cell therapies often directed the user to websites lacking transparency and verifiable information. Further research is warranted.
    Keywords:  Google; arthritis; body sites; knee; osteoarthritis; stem cell therapy
    DOI:  https://doi.org/10.1177/15563316221089930