“…Previous efforts to develop integrated biomedical knowledge systems have used various database types, architectural patterns, and automation frameworks. For persistence, knowledge systems have used relational databases [34], distributed graph databases [33, 57], multimodal NoSQL databases [35, 57], RDF triple-stores [41, 42, 58], document-oriented databases [32, 46, 54], and—with increasing frequency [36, 37, 39, 44, 54]—the open-source graph database Neo4j (github:neo4j/neo4j). Knowledge systems have also differed in terms of the ingestion method used in their construction; many systems [32, 35, 41, 42, 54] utilized an extract-transform-load (ETL) approach, whereas others [44, 46, 59] used API endpoints to query upstream knowledge sources; one [39] blended both ETL and API approaches for knowledge graph construction.…”