Miao Wins the American Society for Laser Medicine and Surgery 2020 Best of Session: Genitourinary Health

Imaging-Assisted Vaginal Laser Device Guides Treatment in Real-Time Via Digital Histology and
Angiography

Yusi Miao, Neha T. Sudol, Afiba Arthur, Jason J. Chen, Yan Li, Saijun Qiu, Yona Tadir, Felicia L. Lane,
Zhongping Chen

Beckman Laser Institute and Medical Clinic, University of California, Irvine, CA; University of California –
Irvine, Irvine, CA

Background: Genitourinary Syndrome of Menopause (GSM) affects up to 50% of women with regard to
general health and sexual function. Energy-based treatment such as ablative laser has demonstrated
promising short-term outcomes in relieving GSM symptoms. However, the safety and effectiveness of
energy therapy remain controversial, and most treatment protocols are not backed up by scientific data.
Since invasive biopsy cannot be “ethically” justified, and single samples are not scientifically
representative, histological evidence is lacking in this area. In the present study, we developed a non-
invasive optical biopsy device, integrated within a commercial vaginal laser probe to perform optical
histology and angiography.

Study Design/Materials and Method: This abstract reports on the clinical translation of the image-
assisted laser device, and the on-going human study to evaluate histological and blood vessel changes
post vaginal laser ablation. Imaging data are collected from patients undergoing a fractional-pixel
CO 2  laser treatment. In-house high-speed optical coherence tomography (OCT) imaging system is
integrated into the handle part of the laser treatment device to acquire imaging parameters; epithelium
thickness and blood vessel density in the lamina propria. 3D imaging data from the proximal and distal
vagina are acquired from each patient in parallel to the treatment every 6 weeks.

Results: The proposed imaging-assisted vaginal laser device showed exceptional accuracy, imaging area,
acquisition speed to assess tissue histology and angiogram in real-time. The spatial resolution was 2–3
orders of magnitude higher than the clinical ultrasound imaging device enough to resolve micrometer
changes in tissue. The imaging area from a single acquisition was 12 × 12 mm. The data acquisition
speed was less than 20 seconds with GPU-accelerated advanced processing. Preliminary data
demonstrated that laser treatment effects highly depend on the initial epithelium thickness and vascular
density. Patients with severe atrophy were more sensitive to laser treatment and showed pronounced
tissue proliferation.

Conclusion: The present study demonstrated a non-invasive optical histology technique for assessing
the effects of vaginal rejuvenation device. We anticipate the integrated treatment, monitoring device
will allow both physicians and laser industries to design a safer and more effective laser procedure
based on the histological evidence.

Click here to view the ASLMS 2020 abstracts.

Natasha Mesinkovska receives ICTS pilot study award

UCI Beckman Laser Institute & Medical Clinic’s Dr. Natasha Mesinkovska received a UCI Institute for Clinical & Translational 2020 Science Pilot Studies award for her alopecia areata research.  The ICTS Pilot Studies are designed to support exceptionally innovative and/or unconventional research projects that have the potential to create or overturn fundamental paradigms.

Alopecia areata (AA) is a hair loss disorder caused by an autoimmune attack on the hair follicle. Hair loss can range from small patches of scalp hair loss to total scalp (alopecia totalis) or total body hair loss (alopecia universalis). Genetic factors are thought to play a part in the development of AA, however the exact mechanism behind the disease is not completely understood. One of the key components of AA is over-activity of immune cells. This process is mediated by an intracellular protein, Janus Kinase (JAK), which promotes continuation of the disease process. Given this discovery, JAKs have emerged as highly-effective therapeutic targets for the treatment of AA.

Consistent with literature, many AA patients show strong hair regrowth in response to JAK inhibitors. Through the observation of patients in the Clinic, it has shown that hair regrowth occurs in patches that enlarge over time. This pattern of hair regrowth has been documented in multiple published studies, however not yet explicitly analyzed in humans..

Dr. Mesinkovska proposes that adult human hairs are, in principle, capable of activation of a collective chain reaction-like hair growth pattern. While this ability is not normally apparent in the healthy scalp, it can be obvious during AA resolution, a distinct disease state containing many dormant hair follicles. The first objective of the pilot grant is to collect strong clinical proof for a “spreading wave” pattern of hair regrowth in AA patients. This will be accomplished by non-invasively imaging the hair follicles on the edges of re-growing hair patches. The focus will be on identifying the spatial arrangement of quiescent hair follicles to early growing hair follicles – a telltale sign of spreading hair regrowth waves. This will then be confirmed on histology with biopsies of hair patch edges. For the first time, the data will provide direct support for the ability of human scalp hair follicles to collectively enter the regrowth phase, providing fundamentally new knowledge for the field of human hair and AA research.

The second objective of the research study is to collect RNA sequencing data from the edges of regrowing hair patches to identify novel signaling changes within the hair follicles and surrounding cells. These changes will include proteins that influence hair follicles to initiate regrowth, and thus are potential therapeutic targets for hair growth stimulation. Dr. Mesinkovska anticipates that their findings will lead to the development of new strategies for the treatment of AA; with the potential for the discovery of break-through therapies for additional types of hair loss.

Read the full abstract.

UCI Beckman Laser Gets New Director

by Jessie Yount, Orange County Business Journal

The University of California-Irvine Beckman Laser Institute and Medical Clinic has tapped Thomas Milner, a three-time entrepreneur and serial
technology inventor with 55 issued patents, to oversee and expand its research activities.

Milner was recently named director for the photonics institute; he’s the third person to have the position. Milner starts July 1. His plans include prioritizing diversity in faculty and establishing external advisory committees with industry and academic-like entities so that BLIMC is ultimately “recognized by the industry as an excellent partner for both knowledge, intellectual property, scientific and engineering expertise, and as a
source of students who wish to pursue industrial careers,” he said.

Milner has also been granted joint appointments in the departments of biomedical engineering and surgery, and said one major piece of his plan is
working with the UCI Beall Applied Innovation center to convert research into viable commercial ventures that provide value to the community.

He added, “The future is great here in Irvine, and the community will benefit for decades to come.”

Optical Inventions

Milner counts prior ties to UCI; he notes that both his children were born at the University of California-Irvine Medical Center, when he was a Whitaker Research Fellow and research assistant professor at BLIMC from 1992 to 1997.

He’s no stranger to commercial translation. During his time at BLIMC, Milner and J. Stuart Nelson, medical director of the clinic, co-invented a dynamic cooling device that has significantly improved laser dermatological treatments. It was licensed to Wayland, Mass.-based Candela Laser Corp. and has brought UCI more than $40 million in royalties to date.

In 1998, Milner left Irvine to serve as the Joe King Professor at Cockrell School of Engineering at the University of Texas at Austin, where he received the Inventor of the Year award for an optical coherence tomography (OCT) technology that helps physicians diagnose conditions such as glaucoma and heart disease.

His technology led to the birth of two companies: Dermalucent LLC and CardioSpectra Inc., a high-resolution imaging company that sold to San
Diego-based Volcano Corp. for about $25 million in 2007.

Research Pipeline

Milner’s current research focuses on the treatment of chronic total occlusion (CTO), or the complete obstruction of an artery, which today requires an invasive bypass procedure to treat.

Milner has created a guidance and laser system that could treat CTO in a minimally invasive manner. It is currently being tested in animal trials.

While his work took him to Texas, Milner notes that he kept in touch with his colleagues in Irvine. When the pandemic began spreading in the U.S., Milner created a ventilator prototype used by the Bridge Ventilator Consortium group established at UCI.

The team said it expects to receive FDA approval for its low-cost and easy-tomanufacture breathing-assistance device any day now.

COVID-19 research at BLIMC include several ventilator-related projects, as well as a UV sterilization effort led by Chris Barty.

Barty is pioneering a new type of X-ray technology through his Irvine-based company Lumitron Technologies Inc., which was profiled in the May 20 print edition of the Business Journal.

The UCI Office of Research recently transitioned to Phase II of its reopening plan, allowing normal research activities at its various institutes to resume with enhanced sterilization and social distancing in place.

At BLIMC, that means basic research and clinical research can resume once faculty submit risk assessments.

Legacy of Innovators

Milner succeeds Bruce Tromberg, who left BLIMC in 2018 to lead the National Institute of Biomedical Imaging and Bioengineering in Bethesda,
Md.—one indication of the institute’s prominence in the field.

Arnold Beckman, the visionary behind today’s Beckman Coulter Inc., and Michael Berns launched BLIMC in 1982 with the mission to use light (or
photons) to study the basic biology of cells, and apply that knowledge to medical applications.

“Arnold Beckman was an innovator himself, and his legacy is what Beckman Laser Institute is all about—providing innovation to benefit people through new products and devices,” Milner said.

In his new role, Milner said he hopes to push the field of photonics beyond studies in the eyes and skin to cardiology and neurology such as Alzheimer’s disease, in turn providing “a better understanding of our overall health and wellbeing.”

Read full Orange County Business Journal article.

Beckman Laser Institute receives advanced nonlinear optical microscopy funding

Drs. Eric Potma and Mihaela Balu were awarded a $1.6M grant to acquire an innovative multiphoton microscope, offering advanced tissue imaging capabilities at depths beyond what can be achieved with standard optical imaging techniques. Besides its state-of-the-art imaging capabilities, the system is equipped with a custom-engineered modality, making it possible to rapidly capture selective imaging of important tissue components, such as lipids, collagen, melanin and cell metabolites.

The system supports numerous cutting-edge studies for the early detection of melanomas, hypoxia in retinal tissues, skin aging, malaria drug development, muscular dystrophy and many more diseases and conditions.  This unique instrument offers the advanced tissue imaging capabilities needed to propel the science of our research community into the next decade.

The Great Ventilator Rush

by Mark Harris, IEEE Spectrum

Early on in the COVID-19 pandemic, engineers launched extraordinary crash programs that produced scores of ventilator designs. What will happen to them now?

The projections were horrifying. Experts were forecasting upwards of 100 million people in the United States infected with the novel coronavirus, with 2 percent needing intensive care, and half of those requiring the use of medical ventilators.

In early March, it seemed as if the United States might need a million ventilators to cope with COVID-19—six times as many as hospitals had at the time. The federal government launched a crash purchasing program for 200,000 of the complex devices, but they would take months to arrive and cost tens of thousands of dollars each.

Across the United States and around the world, engineers sat up and took notice. At NASA’s Jet Propulsion Laboratory (JPL), in Pasadena, Calif., a chance meeting between engineers at a coffee machine led to a prototype low-cost ventilator in five days. At Virgin Orbit, a rocket startup in nearby Long Beach, engineers assembled their own ultrasimple but functional ventilator in three days.

And in Cleveland, a team at the Dan T. Moore Company, a holding company with an impressive portfolio in industrial R&D, had its first prototype up and running in just 12 hours. “It was made out of plywood and very crude,” says senior engineering manager Ryan Sarkisian. “But it gave us a good understanding of what the next steps would be for a rapid response–style solution.”

From the largest universities to domestic garages, hundreds of teams and even individuals scrambled to build ventilators for the expected onslaught. An evaluation of open-source ventilator projects has tracked 116 efforts globally, and it is far from comprehensive.

Meanwhile, the U.S. Food and Drug Administration (FDA) rushed through rules at the end of March that would allow, if the worst-case scenarios came to pass, new ventilators and other medical devices intended to treat COVID-19 to be deployed without the usual years-long safety assessments. Around the same time, General Electric and Ford announced that they were joining forces to rapidly manufacture 50,000 ventilators based on one of GE’s existing designs.

With hundreds of thousands of traditional ventilators on order and potentially even more DIY devices coming soon, President Trump boasted in a speech on 29 April, “We became the king of ventilators, thousands and thousands of ventilators.”

Now, though, before most of the DIY ventilators could make it to production, let alone treat a patient, the need for them has faded away. Aggressive social distancing and isolation policies have slowed transmission of the coronavirus, while hospitals and state governments readily shared surplus ventilators with locations that were suffering the worst outbreaks, like New York City.

Today, some hospitals are even quieter than they were before COVID-19. “This morning in Cincinnati, there were 12 COVID-19 patients on a ventilator,” said Richard Branson, a professor of surgery emeritus at the University of Cincinnati College of Medicine. In a phone interview with IEEE Spectrum in late April, Branson, who is also editor in chief of the journal Respiratory Care, added “We usually have more patients on ventilators than that on a regular day, but we canceled all the [elective] surgeries.”

No one is complaining about having too many ventilators, of course. The story line, starting with the earnest pleas and the ensuing media frenzy, and continuing with the massive engineering response, certainly has a heartwarming ring. Countless engineers dropped what they were doing and worked long hours to design, build, and test impressive machines in weeks, rather than months or years. But an unforeseen twist in that story line raises some vexing questions. What has become of all these rapid-response ventilator projects and the tens of thousands of home-brewed devices they planned to produce? Has it all been a well-intentioned waste of time and money, a squandering of resources that could have been better put toward producing protective equipment or other materials? And even if any of these devices do find their way into hospitals, for example, in developing countries with a real need for ventilators, will they be safe and effective enough to actually use?

“There was one particular day where I was scrolling through Facebook, and one, two, three friends had lost a friend or family member to COVID-19,” remembers Wallace Santos, cofounder of Maingear, a maker of high-performance gaming computers based in Kenilworth, N.J. “That’s when I thought, Holy crap, this is really happening.

So when Rahul Sood, the chairman of Maingear’s board and a longtime tech entrepreneur, suggested that Maingear build a ventilator itself, Santos was interested—if skeptical. “I didn’t know if we could do it, but we started to investigate,” he says. “And the truth is that if we can build really complex and beautiful liquid-cooling systems [for computers], we can build a ventilator as well. It’s not that hard actually.”

Like most medical gear, ventilators come in different types and sizes, and with different features, capabilities, and levels of complexity. They all perform the same basic function: getting oxygen into, and in some cases clearing carbon dioxide away from, the lungs of people who are having trouble breathing or who have ceased to be able to breathe at all. In relatively mild cases, physicians may use a noninvasive type, in which a tight-fitting mask, akin to a full-face scuba mask, provides pressurized air to the patient’s nose and mouth.

More severe cases are treated with an invasive system, meaning they make use of a tube through the mouth or through an opening in the neck into the patient’s windpipe (trachea). With this setup, the patient is usually sedated or kept unconscious for the days or weeks it can take for the patient’s body to fight off the infection and regain the ability to breathe independently.

Ventilators must carry out several functions with extreme reliability. They must, of course, supply oxygen at higher-than-ambient pressure and allow carbon dioxide to be exhaled and cleared away from the patient’s lungs. The air they provide to the patient must be warm and moist, and yet free of bacteria and other pathogens. Also, they must be equipped with sensors and software that detect if the breathing mask or tube has been dislodged, if the patient’s breathing has become erratic or weaker, or if the breathing rate has simply changed. Finally, the machines must be designed so that they can be thoroughly cleaned and also contain, as much as possible, any pathogens in the patient’s exhalations. The systems must also be compatible with existing hospital infrastructure and procedures.

Consider Maingear’s design, which was based on an emergency ventilator that had already been used in Italy and Switzerland. To repurpose it for COVID-19, engineers made the part that touches a patient disposable rather than cleanable, to reduce the risk of cross infection. Maingear also rewrote some of its software and designed a tough PC-style case so that it could either be housed in a standard medical equipment rack, or moved about on wheels. “This thing is seven grand out the door,” says Sood. “And we can manufacture them very quickly in New York or New Jersey once we get FDA approval.”

At Dan T. Moore, engineering manager Sarkisian had a similarly abrupt introduction to ventilators. Before working on its ventilator, dubbed SecondBreath, his team had been developing lightweight, high-strength metal matrix composites for automotive brake pads. “We’re fairly green when it comes to medical devices,” he admits. “But understanding that manual resuscitation bags are readily available and already have FDA approval, we wanted to utilize that concept as a way to transfer breath to a patient.”

Just as it sounds, a manual resuscitation bag allows a trained medic to provide ventilation by squeezing on a rubberized bag attached to a face mask. Originally designed in the 1950s, these bags are simple and flexible, but they do require a trained operator. To bring the tactic into the modern age, Dan T. Moore’s engineers focused on automating, controlling, and monitoring that squeezing process.

After building a bag-squeezing prototype in 12 hours, Sarkisian’s team of nine automotive engineers refined the design by talking to local doctors and experimenting with different components. “We were trying to make it as cheap as possible, and to really understand the features that it needs to have to keep people alive,” Sarkisian says.

At a minimum, that meant a system that could reliably squeeze a bag for hours, or even days, on end, be readily usable by doctors accustomed to working with more sophisticated ventilators, and have a suite of alarms should anything go wrong.

“We had about two weeks working through prototypes, adding more alarms and different sensors to optimize our system,” says Sarkisian. “Then a little over a week testing out the system, and another two to three days at a local hospital on lung-simulator machines.” It took just 21 days from the first SecondBreath prototype to submitting the device to the FDA, and the company hopes to sell its devices for around US $6,000.

“It just shows you that medical devices are pretty dang expensive,” says Andrew Dorman, an engineer who worked on the SecondBreath project. “When people learn that we can make these ventilators in three weeks and can sell them for a fraction of the price, they might take a look at [the traditional] medical system and say, something’s wrong here.”

Virgin Orbit also made a bag-squeezing ventilator after its CEO, Dan Hart, offered his factory and workers to California governor Gavin Newsom. Newsom connected Hart to the California Emergency Medical Services Authority (EMSA), which identified ventilators as its key need at the time. “A consortium of physicians, scientists, and engineers led by the University of California, Irvine, and the University of Texas at Austin directed us [to] go and make the simplest possible ventilator,” says Virgin Orbit vice president for special projects Will Pomerantz. “We essentially took all the people who were going to be building next year’s rockets and said, ‘Next year’s rockets can probably wait a little bit—you’re going to be building or testing ventilators.’ ”

As a manufacturer of air-launched rockets for small satellites, Virgin Orbit realized that one of the bigger challenges was going to be dealing with supply chains disrupted by COVID-19 itself. “We tried to build it without requiring anything complex or specialized, or if it was, from an industry that does not touch upon medical devices at all,” says Pomerantz.

For example, instead of building a motor from scratch, the Virgin Orbit team utilized something they could find in almost any small town: the windshield wiper motor from one of the country’s most ubiquitous cars, a 2010 Toyota Camry.

This concern for manufacturability also drove the scientists and engineers at NASA’s JPL. They wanted their ventilator, an open-source design, to be within the reach of almost any competent mechanic, anywhere in the world. “Our target was that if a person had all the parts sitting in front of them, they could put it together alone in about 45 minutes, with as few tools as possible,” says Michael R. Johnson, a spacecraft mechatronics expert who served as chief mechanical engineer for the JPL’s ventilator, called VITAL (Ventilator Intervention Technology Accessible Locally). “We couldn’t make them fast enough. Not that anybody was saying anything—it was just understood.”

In the end, the JPL actually designed two different low-cost, easy-to-assemble ventilators, neither of which relied on existing resuscitation bags. A pneumatic device uses stored energy in the hospital gas supply to power the ventilation, while a design that uses a separate compressor serves situations where pressurized gases are unavailable. Not only would the two designs serve different needs, they would also reduce the chance of component shortages halting production entirely. A single circuit board serves both designs, using a simple microcontroller assembly running Arduino code.

The pneumatic ventilator was ready first and was sent straight to the Icahn School of Medicine at Mount Sinai, in New York City, for testing on human simulator machines and by medical staff. “The whole time it was there, we had a Zoom meeting running, and we were watching them use it,” says Johnson. “We would watch things like how they were pushing the buttons. There was one they were pushing really hard, and I thought, okay, let’s add a couple more support screws to the circuit board. Or we’d hear someone say how it wasn’t adjusting quite the way they’d like, so we made a note to change the sensitivity.”

Beyond the engineering work, preparing the descriptive and safety paperwork required by the FDA involved a significant investment of time and resources. Most efforts used outside lawyers and experts, with the JPL’s comprehensive submission running to 505 pages. “A big thing for the FDA is the failure modes and effects analysis, which we do all the time for our spacecraft,” says Johnson. “We asked a couple of medical companies if they could send us examples, and it turns out they’re actually less rigorous than what we do for our space missions.”

Probably best prepared for the administrative burden of developing a new ventilator in a matter of weeks was the team at the University of Minnesota’s Earl E. Bakken Medical Devices Center. For their day jobs, the engineers here work with industrial partners to come up with ideas for, and develop prototypes of, medical devices.

“We have iterative design processes that I’ve both learned and taught here, so I knew that this was possible if you took the right approach,” says Aaron Tucker, lead engineer for the university’s Coventor ventilator project. “We boiled it down to the key concepts—what you need on a bare minimum to survive when you’re being ventilated.”

The Coventor is another design that compresses commercially available ventilation bags, paring the parts down to just $150 of readily available components housed in plain sheet metal. The Coventor team worked closely with Boston Scientific, a large manufacturer of medical devices, to label their device so as to mitigate the risks around its limited capabilities. “Our experience and our ability to collaborate was why we ended up being [one of the first] approved for use by the FDA,” says Tucker. The Coventor’s selling price will be less than $1,000 when Boston Scientific moves it into production shortly.

By mid-May, the FDA had approved six new ventilators for emergency use, including devices from Coventor, SecondBreath, Virgin Orbit, and the JPL. All are limited to use during the pandemic, and only when standard ventilators are unavailable.

SecondBreath has manufactured 36 devices so far, while Virgin Orbit has produced a couple of hundred. Coventor and Boston Scientific have an order for 3,000 of their ventilators from UnitedHealth Group, a health care company in Minnesota. As of early June, none had been deployed in the United States.

“I don’t think any of these devices will ever be used in the United States,” says Branson, the University of Cincinnati surgery professor. “I give these people a lot of credit. They’re trying to do something positive. They’re very smart, they’re motivated, they’re well meaning, but they don’t know what they don’t know.”

In 2014, Branson coauthored a prescient paper for the journal Chest called “Surge Capacity Logistics: Care of the Critically Ill and Injured During Pandemics and Disasters.” In it, he and 10 colleagues came up with evidence-based recommendations for coping with a pandemic respiratory disease like COVID-19, including stockpiling ventilators that met a list of minimum requirements.

“Several of the ventilators the government is purchasing don’t meet these requirements,” Branson says. “Some barely meet not even half of them.” The ventilators authorized by the FDA for emergency use seem to similarly fall short, often in multiple areas. Branson notes that the bag-squeezing designs, in particular, are problematic.

“If everybody had paralyzed respiratory muscles and normal lungs, as in polio, a bag squeezer would work,” he says. “But this is an acute respiratory distress syndrome with parts of the lung that are stiff right next to parts of the lung that aren’t. If you’re not careful with how you deliver the breath, areas that are stiff get very little gas, and areas that are not get too much gas, and that injures them.”

Another problem is that most of the DIY ventilators do not allow for patients to breathe on their own, requiring them to be heavily sedated. “But in New York City [at the height of the outbreak], they ran out of drugs to sedate people,” Branson notes. “And paralyzing people has its own negative consequences,” he adds. “In general, the less sophisticated the device is, the more sophisticated the caregiver has to be.”

But in the kind of crises where emergency ventilators will be needed, medical staff will already be stretched dangerously thin. Branson believes that asking them to suddenly start using unfamiliar new devices that lack traditional protective features and alarms is a recipe for disaster. “You can’t change the standards of care to meet the requirements of the ventilator,” he says.

With the need for ventilators down sharply in North America, and with many medical professionals there reluctant to use home-brewed ventilators, what will become of all this work? Some DIY ventilator teams are already looking overseas. Indeed, Coventor, SecondBreath, and the JPL all designed their devices with an eye on developing countries. “We know that the ‘Cadillac’ ventilators we’re used to in the U.S. are not available in many countries, for cost and other reasons,” says Coventor’s Tucker. “We’re thinking about whether and how we can start to move the Coventor overseas. Nothing prevents it from being used globally. We even picked a global power supply.”

Virgin Orbit has already found a manufacturer in South Africa to produce at least 1,000 of its resuscitators for use by the African Union.

Whether the U.S. startups can sail past foreign regulators as swiftly as they did the FDA remains to be seen. And there are already plenty of engineers innovating overseas, of course. In India, for example, AgVa Healthcare has been marketing a compact ventilator for less than $3,000 and claims to be building 10,000 units a month.

None of the organizations Spectrum spoke with would put a dollar amount on their DIY ventilator efforts, but the combined total is very likely well into the millions. Branson suggests that some of those funds might have been better deployed in proven technologies. “The answer would be to have money and resources given to people who already make FDA-approved devices, to make more of them,” he says. Other tech companies also focused on much simpler items that are still in short supply, such as protective masks and gloves.

For now, as the adrenaline rush from having produced their first ventilators ebbs, some of the ventilator teams are experiencing a welcome lull. “It did a lot for employee morale to feel like we were all putting our shoulders to it and pushing together,” says Virgin Orbit’s Pomerantz. “If the world needs our ventilators, we’ll keep building them. And if it doesn’t, thank goodness. We’re happy to get back to our day jobs.”

Not everyone is convinced that the worst is over. Sood is keen to keep Maingear’s development effort on track. “Based on everything that we’ve seen and all the data we looked at, this is just wave one of a multiwave process,” he says. “We think that wave two, sometime in the fall, might even be worse, and they’re going to start asking for ventilators again. We want to get our machines prepared and ready ahead of time.”

Sood’s pessimism has plenty of company. When the JPL recently invited firms to ask for (free) licenses to manufacture NASA’s open-source ventilators, it received more than 200 applications from organizations all over the world. The best-case scenario, from all perspectives, is that such efforts continue to be a magnificent waste of time and money.

Read the full article on IEEE Spectrum.

Beckman Laser Institute receives Air Force funding for wounded warriors project

Photo by Laurel Hungerford

Renewed grant of $6.8 million to aid in development of optics-based trauma treatments

Irvine, Calif., June 11, 2020 — The Air Force Office of Scientific Research has granted $6.8 million in renewed funding to the Beckman Laser Institute & Medical Clinic at the University of California, Irvine for an ongoing project to develop advanced medical technologies to aid warriors on the battlefield.

“This program is one of the longest continually funded initiatives in UCI history, having received its first grant in 1986 and totaling almost $30 million during its lifetime,” said Michael Berns, UCI’s Arnold and Mabel Beckman chair in laser biomedicine and distinguished professor of surgery, biomedical engineering, and developmental & cell biology. “The research ultimately can benefit all branches of the military, and there are significant portions that already have applications in civilian medicine.”

Titled “Advanced Optical Technologies for Defense Trauma and Critical Care,” the program integrates eight projects to develop potentially life-saving innovations for critical care evaluation and patient treatment. Another will specifically address traumatic brain injury.

Continuing until March 2023, the projects will fill device capability gaps in the Joint Forces Health Protection initiative under the U.S. Department of Defense.

The subprojects include:

  • Development of a non-invasive wearable sensor to provide continuous physiologic information;
  • Creation of wearable hemodynamic and metabolic sensors for critical-care assessment and the monitoring of lactate and other hemodynamic markers;
  • Modification of flow-enhanced pulse oximetry for improved patient monitoring in field conditions and during transport;
  • Development of a durable, compact blood-coagulation analyzer for real-time assessment;
  • Enhancement of a commercially available surgical camera invented by this program to quantitatively and non-invasively assess burns and wounds;
  • Invention of a functional optical coherence tomography tool to add airway compliance and ciliary function capabilities to the characterization of inhalation airway injury;
  • Validation of a hand-held, point-of-care wound infection and biofilm imaging device;
  • Innovation of an in-vitro assay system for structural and functional mechanisms of traumatic brain and spinal cord injury.

The Beckman Laser Institute will collaborate with the U.S. Army Institute of Surgical Research and the Air Force Research Laboratory on an ongoing basis to complete these goals. In addition, the Air Force funding will support laboratory facilities and an administrative core to service the project and provide for the filing of intellectual property rights for patent protection and commercialization plans.

The program has already led to the launch of start-up companies which market technologies for non- or minimally invasive imaging for different diseases and human conditions. These include Modulim (formerly Modulated Imaging), OCT Medical Imaging Inc. and Laser Associated Sciences, all of which are based in Irvine.

“UCI is ideally suited for this program with the unique translational design of the Beckman Laser Institute & Medical Clinic, including its photonic incubator, along with resources and support of the UCI Beall Applied Innovation for commercialization of devices,” Berns said.

Read full UCI News press release.

UCI Surgeon, Diehard Ducks Fan Making a Difference During Pandemic

by Kyle Shohara, AnaheimDucks.com

Though he tried as best he could, Dr. J. Stuart Nelson couldn’t fully disconnect from the world outside.

It was early March and when he and his wife were in the Maldives for their 35th wedding anniversary – a trip that, under any other circumstances, would’ve been a chance to unwind and enjoy the sights and sounds of the popular tourist destination nearly 10,000 miles from his Orange County home. Instead, the Laguna Niguel resident found himself checking the news every morning on TV and on his phone. He’d constantly get texts from his four kids keeping him updated on the latest developments from back home.

March would normally be a time Dr. Nelson’s at Honda Center cheering for his beloved Ducks. As an inaugural Orange Alliance member, he’s been attending Ducks games since 1993. He was in the house when Anaheim made its first Stanley Cup Final appearance in 2003 and again in 2007 when the Ducks became the first California team to win hockey’s ultimate prize.

It was during his time in the Maldives when the World Health Organization (WHO) made the assessment that COVID-19 could be characterized as a pandemic. The situation was rapidly evolving. Dr. Nelson knew the way things were before he and his wife left weren’t going to be the way they were when they returned.

They managed to return home on March 19, the day California Governor Gavin Newsom issued a stay-at-home order to “protect the health and well-being of all Californians and to establish consistency across the state in order to slow the spread of COVID-19,” as stated on the State of California’s website.

“It was a weird thing to leave in the first week of March when everything was fine, and then come home to find out everything was closed,” says Dr. Nelson, Medical Director of UCI Beckman Laser Institute and Medical Clinic and professor of surgery and biomedical engineering. “That was a shock.”

Dr. Nelson is engaged in full-time clinical practice at UCI Beckman Laser Institute and Medical Clinic on the campus on UC Irvine, serving patients with pediatric port wine stain birthmarks, hemangiomas and other vascular malformations and skin disorders. But like many businesses in the state, his clinic was temporarily closed. “Since we’re an outpatient surgical clinic, we were closed for about six weeks,” he says. “We’ve since reopened on May 11. The clinic is up and functioning, but it’s a very different world now. We’re all wearing masks, face shields and personal protective equipment that we didn’t really need previously.”

While the clinic was closed, Dr. Nelson stayed busy. “I was doing two things,” he says. “I was continuing my research work, and as medical director, I was preparing to open the clinic again with all the new requirements the university had put in place so we could see patients safely.”

The biggest difference now than how it was in the past, Dr. Nelson says, is change. “Rather than me coming to greet my patient, it’s sort of an awkward introduction. I can’t see your face and you can’t see my face. We can’t shake hands. It’s a very strange thing to now go see a doctor.

“Before, that was one of the most personal things you can do. Now it’s become very distant. It just doesn’t have the same interaction. I miss shaking peoples’ hands and being able to see their faces, their facial features and their reactions. Now we can’t because everyone is covered by masks.”

There have been nearly two million COVID-19 cases reported in the United States as of June 8, according to the Centers for Disease Control and Prevention (CDC), and more than 7,500 confirmed cases in Orange County, per the Los Angeles Times.

“We’re talking about a highly infectious virus,” says Dr. Nelson. “A virus that is really unknown to researchers. We’re talking about a virus that, as we sit here in early-June 2020, has no treatment or vaccination. I have tremendous respect for my emergency medicine and intensive care colleagues. They’re putting themselves in harm’s way every day. Many of my colleagues are putting themselves at great personal risk.”

Though the patients he sees are pre-screened and required to fill out a questionnaire prior to arrival, the work Dr. Nelson performs requires him to be within inches of them. “When I’m doing procedures on infants, young children and adults, I’m sitting six inches from them,” he said. “We’re all doing this. It’s one thing to say, ‘Maintain your social distance.’ But how do you do a surgical procedure from six feet away? I can’t do that. I have to touch the person and be right next to them.”

Patients having an anesthesia procedure or one requiring sedation are required to get a COVID-19 test within 72 hours of their procedure, he says. “It’s been a lot to assimilate and get organized, but we’re doing it, and we will continue to do it and do it well. We’ll provide the service that we need to provide for families.”

Born and raised in Vancouver, British Columbia, Dr. Nelson considers himself a hockey lifer. He was part of a sold-out crowd of 15,062 at Pacific Coliseum to witness the first game in Canucks history back on Oct. 9, 1970 against the LA Kings.

After moving to Southern California, Dr. Nelson admits he followed the Kings as a “peripheral fan.” That loose allegiance ended once the Mighty Ducks of Anaheim franchise was awarded by the NHL in December 1992. “The next day I called and signed up for season tickets,” he says. “I’ve been a season ticket holder since Day 1.”

He was elated when he heard the Ducks and UCI Health agreed to a multi-year partnership two years ago. As the “official hospital partner of the franchise,” UCI Health continues to serve as the club’s season presenting sponsor through the 2020-21 season. “I was glad when UCI partnered with the Ducks,” he says. “I was very happy. We’re the regional medical center and flagship hospital in the area. We should be the team taking care of the Ducks. It was the UCI team that took care of [St. Louis Blues defenseman] Jay Bouwmeester. It was a UCI cardiologist who implanted the [Implantable Cardioverter-Defibrillator (ICD)].”

Like other Ducks fans, Dr. Nelson has his eye on the upcoming NHL Draft Lottery on June 26. The Ducks have never held the first pick in any draft in the club’s 26-year history. “They’ve got a franchise goaltender in John Gibson,” Dr. Nelson says. “They have good, young defensemen. I’m hoping Trevor Zegras develops. We have two first-round picks in this draft. We need a kid who can come in and play the NHL game.”

Read full article on the Anaheim Ducks website.

Robert G. W. Brown Presented with the Albert Nelson Marquis Lifetime Achievement Award by Marquis Who’s Who

Dr. Brown has been endorsed by Marquis Who’s Who as a leader in the fields of physics and engineering

IRVINE, CA, June 03, 2020/24-7PressRelease/ — Marquis Who’s Who, the world’s premier publisher of biographical profiles, is proud to present Dr. Robert G.W. Brown with the Albert Nelson Marquis Lifetime Achievement Award. An accomplished listee, Dr. Brown celebrates many years experience in his professional network, and has been noted for achievements, leadership qualities, and the credentials and successes he has accrued in his field. As in all Marquis Who’s Who biographical volumes, individuals profiled are selected on the basis of current reference value. Factors such as position, noteworthy accomplishments, visibility, and prominence in a field are all taken into account during the selection process.

Having accrued over 45 years of expertise in his field, Dr. Brown has most recently distinguished himself as a professor at the University of California Irvine in the Beckman Laser Institute and Medical Center and a visiting professor in the department of computer science on campus since 2009. Throughout his career, he has taught at various additional institutions such as Queen’s University Belfast and the University of Nottingham, was a consultant for numerous companies and government research centers in the U.K. and the U.S., and held various other roles, including as principal scientist for Rockwell Collins Inc. between 2011 and 2015, where he led nano-plasmonic research activities. A multinational corporation company headquartered in Cedar Rapids, Iowa, Rockwell provides avionics and information technology systems and services to government agencies and aircraft manufacturers.

Dr. Brown likewise found success as the chief technology officer at Ostendo Technologies Inc. from 2006 to 2009, a specialist displays company. Most recently, he served as the chief executive officer for the American Institute of Physics (AIP) between 2015 and 2017, in College Park, MD. A federation of physical science societies, the AIP advances, promotes and serves the physical sciences for the benefit of humanity.

Dr. Brown attended the University of London where he acquired a Bachelor of Science in physics in 1973. Pursuing additional studies, he later received a Doctor of Philosophy in engineering at the University of Surrey near London in 1983. An elected fellow of the American Physical Society, the U.K. Institute of Physics and the Institute of Electronic Engineers, Dr. Brown is also a member of the European Academy of the Sciences and Arts. Aligned with several boards and committees throughout his career, Dr. Brown was notably the vice chairman of the Tesla Foundation Board, was a board member of the AIP, and former microgravity experimental advisory board for the National Aeronautics and Space Administration. Additionally, he was active on the U.K. Home Office Science and Technology reference committee.

Specializing in lasers, photonics, nano-technology and photonic-medicine, Dr. Brown was responsible for inventing new nano-detector, electronic correlator, APD photo-detector, laser-diode, liquid-crystal display and optical-fiber technologies that have since been developed into successful products for experiments involving jet-engines, macromolecules, U.S. submarines and the space shuttle. He notably holds 55 patents. As a result of his years of research and accomplishments in his field, Dr. Brown has likewise authored or co-authored over 120 peer reviewed articles and research papers in scholarly journals. He is also currently the editor-in-chief of the Handbook of Optoelectronics through CRC Press and is the former four-time co-chairman of the OSA’s International Photon Correlation Conference and former co-editor-in-chief of several related special-issues of Applied Optics.

In recognition of his achievements, Dr. Brown received an MoD (Defense) Prize for Outstanding Technology Transfer in the U.K. and a Sharp Corporation Prize for Novel Laser-Diode Invention in Japan. His U.K. Institute of Physics team also received the prestigious Queen’s Award for Enterprise in 2000 at Buckingham Palace in London. A celebrated Marquis listee, Dr. Brown has been included in the 70th edition of Who’s Who in America, the 12th edition of Who’s Who in Science and Engineering and the 33rd edition of Who’s Who in the World.

Read full press release.

Thomas Milner to Lead Beckman Laser Institute

by Lori Brandt, UCI Samueli School of Engineering

The UC Irvine Beckman Laser Institute and Medical Clinic has named Thomas Milner its third director. Milner, a pioneering developer of optical-based medical instrumentation, also will join the faculty in the departments of biomedical engineering and surgery, effective July 1, 2020.

Milner comes to UCI from the University of Texas at Austin, where he was the Joe King Professor at the Cockrell School of Engineering. Milner’s research involves development of novel optical tomographic imaging modalities and laser surgical procedures for diagnosis and treatment of disease. His inventions have helped physicians better detect and diagnose illnesses such as glaucoma and heart disease, and they have helped treat many dermatological conditions. He has published 187 journal articles, holds 55 issued U.S. patents and has started two technology companies. Milner is a fellow of the National Academy of Inventors, the American Institute for Medical and Biological Engineering and the American Society for Lasers in Medicine and Surgery.

“I am very excited that Professor Milner has been selected to lead the Beckman Laser Institute,” said Zoran Nenadic, professor and chair of the Department of Biomedical Engineering. “He brings a wealth of experience in the development of novel optical imaging techniques and laser surgical procedures for diagnosis and treatment of diseases. In addition to his academic record, he is a prolific inventor and entrepreneur. Besides his leadership role, Tom will make significant academic contributions to our department, and I look forward to working with him.”

“BLIMC is one of the world’s foremost centers in biophotonics and photomedicine,” said Milner, who spent five years at the Beckman Laser Institute in the early 1990s, first as a Whitaker Research Fellow (1992-94) then as a research assistant professor (1994-97), before moving to University of Texas in 1998. “It is an honor to be able to lead BLIMC into the next generation of transformative science and engineering to advance human health.”

Milner looks forward to leading BLIMC and participating in “a culture where innovation and translation is supported, encouraged and celebrated,” he said. “We want BLIMC to be recognized by industry as an excellent partner for both knowledge, intellectual property, scientific and engineering expertise, and as a source of students who wish to pursue industrial careers.”

Milner’s goals for the BLIMC include developing a strategic plan with input from various stakeholders including faculty, the medical school, industry, science, engineering and university administration. He also plans to establish an external advisory committee for the institute.

“I mostly look forward to working with a number of people of excellent character and vision who are working very hard to make our world a better place for all people,” he said.

Read the full UCI Samueli School of Engineering article.

Researchers Outside Medicine Have a New Focus: Covid-19

by Jason Douglas and Max Colchester, The Wall Street Journal

Engineers, physicists, volcanologists and others who never dreamed they would work on a deadly pandemic are now part of the global effort to understand and contain the coronavirus

Rajat Mittal spent a decade exploring how our larynxes generate sound and the physics behind blood flow. Now the fluid dynamics expert is wholly absorbed in a new scientific quest: to understand how droplets of moisture spread the new coronavirus from person to person.

“It seems to intersect with everything I’ve trained for all my professional life,” he said.

Researchers who never dreamed they would be working on responses to a deadly pandemic are redirecting their expertise to the global effort to understand and contain Covid-19. While virologists and epidemiologists pore over the new coronavirus and the disease itself, other experts are focused on critical questions about managing society as governments world-wide ease restrictions on daily life to revive comatose economies.

Engineers are helping public-health officials figure out how transmission of the virus can be suppressed in mass-transit systems, office blocks and theme parks. Academics who have learned how to make snap judgments on life-or-death decisions are drawing up advice for policy makers.

An algorithm tuned to air pollution is being repurposed to track social distancing. A team at the University of California, Irvine, is researching whether components from Blu-ray video players can be used as ultraviolet lasers to disinfect surfaces.

“There’s a buzz about, what can thinking minds do about it?” said Mr. Mittal, a professor of mechanical engineering at Johns Hopkins University in Baltimore, whose focus now is on designing more effective face masks. “How can I take what I know and turn it around and use it to attack this disease?”

The mobilization comes as restrictions on daily life ease around the globe, prodding policy makers to seek out a wider set of experts to shape the post-Covid world than the epidemiologists who have dominated so far.

“It would be nice to have a little bit more of a balanced perspective,” said Mark Birkin, co-director of the Leeds Institute for Data Analytics in the U.K., who is building a computer model that aims to show how loosening lockdown measures affects social interactions.

The new coronavirus has infected more than five million people world-wide and killed more than 340,000, according to the World Health Organization. The stringent measures restricting work and travel imposed by governments to stop its spread have cratered the global economy. The International Monetary Fund expects the world economy to contract by 3% this year, led by record-breaking falls in output in the U.S. and Europe.

With the disease better contained, although not eliminated, governments are easing lockdowns to get people back to work. But absent a vaccine or widespread immunity to infection, that revival poses a multitude of challenges around how people can safely interact at schools, offices and factories without inadvertently giving the virus a chance to proliferate again.

Such questions are prompting experts from diverse fields to drop what they were doing and refocus on Covid-19.

Until recently, James Walsh was fine-tuning a complex computer model to map air pollution in London. Now the researcher at the London-based Alan Turing Institute is working on models to determine whether people are respecting social-distancing rules aimed at limiting transmission of the virus.

“It’s never really been my expertise to work in anything relating to biological viruses or anything of that form,” said Mr. Walsh.

Michael Batty, a professor of planning at University College London, has been building computer models of cities since the 1970s, figuring out such things as how to keep people moving if a subway line breaks down. Now he wonders whether our cities and buildings will need to be redesigned altogether.

“Nobody has ever looked at a situation where everything breaks,” he said. Mr. Batty is coordinating research sponsored by the U.K.’s Royal Society looking into how people arrive at, move within, and exit small spaces such as railway stations and supermarkets, with the goal of figuring out ways to keep people safe.

A preliminary concern: One-way systems to steer shoppers around grocery aisles may not be the right answer, since some evidence suggests it keeps people inside stores longer, raising the likelihood of close contact with others, he said.

Jessica Fanzo, professor of global food and agricultural policy and ethics at Johns Hopkins, is racing to figure out how the pandemic is affecting food supplies in low-income countries. “It is a moment to pause and figure out how we can readjust and make for a more resilient world,” she said.

The eruption of Covid-19 in China last year has triggered a flood of research that continues to pour online and fill the pages of scientific journals world-wide. Doctors and disease experts are still trying to pin down exactly how lethal the virus is, figure out how many people have had it, and come up with a vaccine. For every robust finding adding to our understanding of the bug, there are dozens of questionable claims spreading on social media. Policy makers are under pressure to act quickly despite the uncertainty.

Willy Aspinall, emeritus professor of volcanology at the University of Bristol, learned how to synthesize expert judgments using advanced statistical techniques during two decades advising ministers on the Caribbean island of Montserrat about the risks of a volcanic eruption. He believes such techniques could help policy makers feel their way through the next, uncertain stages of the pandemic with better advice, and is piloting a study looking at reopening schools.

“People are looking over their shoulder and asking, ‘What the hell can volcanologists tell us?’ Actually, we’ve got quite extensive experience managing scientific uncertainty in decision support,” he said.

Such unexpected links between public health and other fields are popping up again and again.

Michael Kinzel, assistant professor of mechanical and aerospace engineering at the University of Central Florida, is working on a cough drop that alters saliva to prevent the formation of the fine aerosolized droplets that transfer the virus from an infected person deep into the lungs of a new victim. A postdoctoral colleague in the project has been sniffing pepper in isolation to induce sneezes as part of the research.

The idea came to him after his wife, a virologist, in a Facebook argument with neighbors, explained this method of transmission. In a lifetime spent poring over aircraft design, he knew a lot about making liquid fuels into fine particles to better ignite in a jet engine. “What we’re doing is the exact opposite,” he said.

Mr. Kinzel sees in the pandemic the promise of one of those rare moments when cross-pollination between academic fields leads to big leaps in knowledge. “It helps force people to look outside the box,” he said.

Read the full Wall Street Journal article.