Publications by authors named "Joshua Stein"

Single-cell and spatial transcriptomics provide unprecedented insight into the inner workings of disease. Pharmacotranscriptomic approaches are powerful tools that leverage gene expression data for drug repurposing and treatment discovery in many diseases. Multiple databases attempt to connect human cellular transcriptional responses to small molecules for use in transcriptome-based drug discovery efforts.

View Article and Find Full Text PDF

Objective: To identify clinical factors associated with conversion to exfoliation glaucoma (XFG) in exfoliation syndrome (XFS) patients who are most at risk of progression to XFG within 3 years for increased surveillance and early preventive interventions.

Design: A retrospective patient cohort study design was employed.

Subjects: A source population of XFS patients ≥ 50 years was identified from electronic medical records in the Utah Population Database.

View Article and Find Full Text PDF

The digitization of health records through electronic health records (EHRs) has transformed the landscape of ophthalmic research, particularly in the study of glaucoma. EHRs offer a wealth of structured and unstructured data, allowing for comprehensive analyses of patient characteristics, treatment histories, and outcomes. This review comprehensively discusses different EHR data sources, their strengths, limitations, and applicability towards glaucoma research.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates how sex, race, and ethnicity impact the development of AI models for predicting glaucoma progression requiring surgery, emphasizing fairness and multicenter perspectives.
  • Researchers analyzed data from over 39,000 glaucoma patients across 7 academic eye centers, using different modeling approaches that either included or excluded sensitive demographic attributes.
  • Results showed that excluding sensitive attributes improved classification performance internally, but when assessed externally, including these attributes enhanced performance, highlighting the complexity between accuracy and fairness in AI predictions.
View Article and Find Full Text PDF

Importance: Besides race, little is known about how other social determinants of health (SDOH) affect quality of diabetic eye care.

Objective: To evaluate the association between multiple SDOH and monitoring for diabetic retinopathy (DR) in accordance with clinical practice guidelines (CPGs).

Design, Setting, And Participants: This cohort study was conducted in 11 US medical centers and included adult patients (18-75 years old) with diabetes.

View Article and Find Full Text PDF

Purpose: Electronic health records (EHRs) contain a vast amount of clinical data. Improved automated classification approaches have the potential to accurately and efficiently identify patient cohorts for research. We evaluated if a rule-based natural language processing (NLP) algorithm using clinical notes performed better for classifying proliferative diabetic retinopathy (PDR) and nonproliferative diabetic retinopathy (NPDR) severity compared with International Classification of Diseases, ninth edition (ICD-9) or 10th edition (ICD-10) codes.

View Article and Find Full Text PDF

Purpose: Diabetic macular edema (DME), a leading cause of visual impairment, can occur regardless of diabetic retinopathy (DR) stage. Poor metabolic control is hypothesized to contribute to DME development, although large-scale studies have yet to identify such an association. This study aims to determine whether measurable markers of dysmetabolism are associated with DME development in persons with diabetes.

View Article and Find Full Text PDF

Objective/purpose: Standardization of eye care data is important for clinical interoperability and research. We aimed to address gaps in the representations of glaucoma examination concepts within Systemized Nomenclature of Medicine - Clinical Terms (SNOMED-CT), the preferred terminology of the American Academy of Ophthalmology.

Design: Study of data elements.

View Article and Find Full Text PDF

Purpose: There is a longstanding belief that prostaglandin analogs (PGAs) may predispose patients with glaucoma to develop acute cystoid macular edema (CME). However, there is little solid evidence supporting this notion. The purpose of this study is to compare CME incidence rates among patients initiating treatment with different glaucoma medication classes.

View Article and Find Full Text PDF
Article Synopsis
  • - The research on plant-microbe interactions has evolved from studying single microbes to examining entire plant microbiomes, emphasizing their critical role in plant health and sustainable agriculture.
  • - Recent advancements in 'omics technologies and AI hold promise for enhancing our understanding and application of plant microbiomes, which can help tackle global food security challenges.
  • - A collaborative and transdisciplinary approach is essential for effectively translating research into practical agricultural solutions, while managing expectations about the real-world impacts of these discoveries.
View Article and Find Full Text PDF

Background: Prior works have studied the impact of social determinants on various cancers but there is limited analysis on eye-orbit cancers. Current literature tends to focus on socioeconomic status and race, with sparse analysis of interdisciplinary contributions. We examined social determinants as measured by the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), quantifying eye and orbit melanoma disparities across the United States.

View Article and Find Full Text PDF

The removal of dying cells, or efferocytosis, is an indispensable part of resolving inflammation. However, the inflammatory microenvironment of the atherosclerotic plaque frequently affects the biology of both apoptotic cells and resident phagocytes, rendering efferocytosis dysfunctional. To overcome this problem, a chimeric antigen receptor (CAR) macrophage that can target and engulf phagocytosis-resistant apoptotic cells expressing CD47 is developed.

View Article and Find Full Text PDF

Purpose: Advances in artificial intelligence have enabled the development of predictive models for glaucoma. However, most work is single-center and uncertainty exists regarding the generalizability of such models. The purpose of this study was to build and evaluate machine learning (ML) approaches to predict glaucoma progression requiring surgery using data from a large multicenter consortium of electronic health records (EHR).

View Article and Find Full Text PDF

Purpose: Nearly all published ophthalmology-related Big Data studies rely exclusively on International Classification of Diseases (ICD) billing codes to identify patients with particular ocular conditions. However, inaccurate or nonspecific codes may be used. We assessed whether natural language processing (NLP), as an alternative approach, could more accurately identify lens pathology.

View Article and Find Full Text PDF

Prcis: Drive-through intraocular pressure (IOP) measurement using iCare tonometry is a promising method of low-contact, high-throughput IOP monitoring. However, owing to its vulnerability to variable measurement technique and local air currents, the iCare may overestimate IOPs.

Purpose: During the COVID-19 pandemic, a drive-through IOP measurement protocol using the iCare tonometer was established to facilitate low-contact monitoring of select glaucoma patients.

View Article and Find Full Text PDF

Pelvic floor hernias represent a rare type of hernia and a rare etiology of pelvic symptoms. The rarest type of pelvic floor hernias are sciatic hernias, which present with a variety of symptoms depending on the hernia contents and location. Many different treatment approaches are described in the literature.

View Article and Find Full Text PDF

Nanotechnology has emerged as a promising approach for the targeted delivery of therapeutic agents while improving their efficacy and safety. As a result, nanomaterial development for the selective targeting of cancers, with the possibility of treating off-target, detrimental sequelae caused by chemotherapy, is an important area of research. Breast and ovarian cancer are among the most common cancer types in women, and chemotherapy is an essential treatment modality for these diseases.

View Article and Find Full Text PDF

Purpose: To develop a class of new metrics for evaluating the performance of intraocular lens power calculation formulas robust to issues that can arise with AI-based methods.

Methods: The dataset consists of surgical information and biometry measurements of 6893 eyes of 5016 cataract patients who received Alcon SN60WF lenses at University of Michigan's Kellogg Eye Center. We designed two types of new metrics: the MAEPI (Mean Absolute Error in Prediction of Intraocular Lens [IOL]) and the CIR (Correct IOL Rate) and compared the new metrics with traditional metrics including the mean absolute error (MAE), median absolute error, and standard deviation.

View Article and Find Full Text PDF

Purpose: To rigorously develop a prototype clinical decision support (CDS) system to help clinicians determine the appropriate timing for follow-up visual field testing for patients with glaucoma and to identify themes regarding the context of use for glaucoma CDS systems, design requirements, and design solutions to meet these requirements.

Design: Semistructured qualitative interviews and iterative design cycles.

Participants: Clinicians who care for patients with glaucoma, purposefully sampled to ensure a representation of a range of clinical specialties (glaucoma specialist, general ophthalmologist, optometrist) and years in clinical practice.

View Article and Find Full Text PDF

Perovskite solar cells (PSCs) promise high efficiencies and low manufacturing costs. Most formulations, however, contain lead, which raises health and environmental concerns. In this review, we use a risk assessment approach to identify and evaluate the technology risks to the environment and human health.

View Article and Find Full Text PDF