Interventional pulmonologists at UC Davis Health are expanding treatment options for patients with severe emphysema. They are conducting a clinical trial that provides access to a novel implantable investigational device designed to reduce lung hyperinflation and help patients breathe more comfortably.

“Many people with emphysema struggle with severe shortness of breath and feel limited in what they can do each day,” said Chinh Phan, director of the UC Davis Interventional Pulmonology Program and principal investigator of the trial. “This investigational device offers a new approach intended to treat the affected lung while potentially reducing some of the complications associated with current procedures. When medications aren’t enough, we hope this new minimally invasive treatment can help patients with severe emphysema breathe easier and live better.”

BREATHE-3 clinical trial

The BREATHE-3 clinical trial is a pivotal, multicenter, randomized controlled trial evaluating the safety and efficacy of the Apreo BREATHE Airway Scaffold. The device represents a new potential therapy for individuals with severe emphysema who continue to experience significant shortness of breath despite optimal medical management.

How the therapy works

The Apreo BREATHE Airway Scaffold is a small, self-expanding implant that is placed into selected airways using a bronchoscope. Once placed, the scaffold is designed to:

• Reduce lung hyperinflation by supporting weakened or narrowed airways
• Potentially improve breathing efficiency, stamina, and overall quality of life by facilitating the release of trapped air

Unlike other lung volume reduction procedures, this device aims to treat multiple regions of the lung (up to six scaffolds) without removing tissue or blocking airflow. 

UC Davis Medical Center is the only site in California providing this investigational therapy and the team successfully treated its first patient in January.

BREATHE‑3 will include up to 250 patients at 25 sites in the United States and Europe. Participants will be followed for three years. The study will look at changes in lung function, quality of life and a person’s exercise capacity.

“Through this research, we hope to bring forward a treatment that helps people with severe emphysema breathe better and improve their daily lives,” Phan added.

A faculty member at the Betty Irene Moore School of Nursing at UC Davis is working to address that gap — and his effort has earned him top recognition from the University of California.

Assistant Professor Alex Fauer received the Early Career Faculty Research Excellence Award from the UC Office of the President.

The award includes a one-time $50,000 allocation in the 2026-27 academic year to support his research project: “Survival Outcomes and Cost-Effectiveness of a Geriatric Assessment-Guided Model of Supportive Care for Older Adults with Cancer.”

The competitive award honors promising early career faculty whose research shows strong potential to improve lives and shape the future of their fields.

Improving outcomes for older adults with cancer

Fauer‘s research focuses on improving care for aging patients with cancer, one of the fastest-growing patient populations in the United States. His work examines how geriatric assessment-guided supportive care — including coordinated symptom management, care planning and family support — can improve survival, reduce emergency visits and hospitalizations, lower treatment complications and better align care with patients’ goals and quality of life.

The clinic, set to open on May 12 on the UC Davis Health campus, provides care for patients with conditions that were diagnosed in infancy and may still require the expertise of pediatric specialists. These include anorectal malformations, Hirschsprung disease, cloacal anomalies and other congenital colorectal and pelvic conditions.

Many of these patients continue to experience long-term issues such as fecal incontinence, chronic constipation, pelvic floor dysfunction, urinary concerns, and sexual and reproductive health challenges.

“These patients often fall into the gap between pediatric and adult care systems,” said Payam Saadai, interim co-chief of the Division of Pediatric General, Thoracic and Fetal Surgery in the UC Davis Department of Surgery and director of the Pediatric Colorectal Center at UC Davis Children’s Hospital. “Some patients have continued to follow with pediatric providers, even beyond the typical age cutoff, due to a lack of access to adult providers with appropriate expertise. Others have transitioned to adult colorectal surgeons or gastrointestinal physicians, who may be less familiar with congenital conditions.”

According to several studies, many patients experience gaps in care or suboptimal long-term management, which this clinic is specifically designed to address, Saadai said.

Fewer than five adult congenital colorectal programs exist nationwide, making the UC Davis Health clinic a uniquely valuable resource both regionally and nationally.

The multidisciplinary clinic brings together pediatric and adult specialists in congenital colorectal care under one roof. Pediatric specialists bring knowledge and experience in treating the original congenital anatomy, prior surgeries and lifelong disease trajectory. Adult providers contribute expertise in managing adult physiology, comorbidities and long-term complications. A collaborative model ensures continuity, addresses inherent fragmentation in the health care system, and allows for both comprehensive and more individualized patient care.

The clinic is anchored by advanced nurse practitioner Kendall Ouzts, a nationally-recognized expert in congenital colorectal diseases. Ouzts is an educator in congenital colorectal diseases and serves as the clinical lead for the program. She works alongside adult colorectal surgeon Sean Flynn, pediatric GI physician Maheen Hassan, and Saadai.

“In addition to clinical care, this program creates opportunities for care standardization, patient education and smoother transition from pediatric to adult services, which can be modeled for other clinical service lines at UC Davis Health,” Saadai said. “Over time, we will also support research and outcomes tracking to further improve care for this population.”

The clinic team sees patients the second Tuesday of every month. It is located in the new Pediatric Surgery and Subspecialty Clinic, 2221 Stockton Blvd., Suite E, Sacramento. For more information, call 916-734-4148.

Jawdat Al-Bassam, an associate professor of molecular and cellular biology at UC Davis, often hears from these families.

“I’ve gotten emails from folks all over the world,” he said.

By the time they contact him, they’ve undergone a bewildering medical journey lasting months or years — and received devastating news: Their child has a rare genetic disorder called a chaperone tubulinopathy. 

“The parents are asking if there’s a way to do gene therapy,” Al-Bassam said. These life-shortening diseases, with names like infantile encephalopathy, corpus callosum hypoplasia and Kenny-Caffey syndrome, currently have no treatments. But Al-Bassam and his team have made a major discovery that could change that.

In two scientific papers — one published May 8, and the other in December 2025 — they have mapped the structure and mechanics of a critical cellular machine that malfunctions in people with these diseases.

In addition to enabling new treatments, this discovery could help scientists identify dozens of other genetic diseases in which children experience various neurological problems with no clear explanation.

Cellular skeletons guide neural connections

Al-Bassam studies structures called microtubules, which form protein skeletons inside cells. As a cell grows and changes shape, its cytoskeleton drives the process — lengthening its scaffold of microtubules.

“They are the cell’s force generators,” Al-Bassam said. These telescoping structures are crucial in the developing nervous system.

They help nerve cells grow the long tendrils, called axons, that connect with other nerve cells. These axons allow neurons to communicate across long distances, especially in the optic nerves that connect the eyes to the brain, in the corpus callosum that connects the left and right hemispheres of the brain, and in the long nerves that reach down to the arms, legs, lungs and other organs.

For a baby to develop normal vision, cognition, coordination and breathing, the neurons have to connect properly. The microtubules must form perfectly inside the growing neurons. 

The cell builds microtubules from two proteins, called α-tubulin and β-tubulin. Before they can be used, they have to be snapped together into thousands of αβ-tubulin “dimers” — forming the building blocks that can then assemble into microtubules. 

Cells control the formation of microtubules, in part, by controlling the supply of the αβ-tubulin dimers. Special “chaperone” proteins — called “tubulin cofactors” — perform this delicate process. As soon as a cell produces a β-tubulin protein, these cofactors assemble into a cage that holds onto the β-tubulin until it can find an α-tubulin and snap them together into an αβ heterodimer, which it then releases.

But this process can easily go awry, with terrible consequences.

If the tubulin cofactors malfunction, it reduces the cell’s supply of αβ-tubulin, disrupting the microtubules that guide neuronal growth. “Even a small percent decrease in αβ-tubulin supply is toxic to the cell,” Al-Bassam said.

Devastating disorders of unknown origins

Scientists have discovered that some children with severe, unexplained neurologic disorders actually have mutations in their tubulin cofactor genes. This may reduce the supply of αβ-tubulin — leading to underdeveloped corpus callosum, optic nerves and other brain structures. 

“Some of these mutants were identified almost 35 years ago in yeast,” Al-Bassam said. They were discovered 15 years later in humans. But the delicate proteins were difficult to study, he said, “so this whole field of research was essentially shelved for a long time.”

The UC Davis team has now broken that impasse. Using cryo-electron microscopy (Cryo-EM), they found how these proteins assemble into a complex machine. Their initial results, published in December 2025 in Nature Communications,show the elegant spring-and-latch mechanism that it uses to capture β-tubulin, snap it onto α-tubulin, and release the αβ dimer. “This was a surprise,” Al-Bassam said. “It was really beautiful.”

These experiments were led by Aryan Taheri, a former UC Davis undergraduate who was working in Al-Bassam’s lab at the time; Taheri has since graduated and is now pursuing a Ph.D. at UC Berkeley. “He’s extremely talented,” Al-Bassam said. “We look forward to seeing more amazing work from him in the future.”

In the second paper, published May 8 in Science Advances, Al-Bassam and Taheri unveil additional cryo-EM structures, showing the machine frozen in at least nine different configurations. These snapshots reveal how it functions in a complex cycle, snapping together αβ-dimers when they are needed, and pulling them apart when they aren’t.

These discoveries won’t immediately lead to treatments, but they could offer hope to affected families, Al-Bassam said: “For the first time, we have a precise picture of exactly what’s going wrong, and what a future therapy would need to fix.”

They could also allow disorders to be diagnosed more quickly. Today, families often endure a diagnostic odyssey in which the genomes of parent and child are sequenced in search of a mutation that might explain the problem — often yielding inconclusive results. A clearer understanding of which mutations disrupt the function of tubulin cofactors could lead to quicker diagnosis.

This new knowledge might even spur the discovery of other genetic disorders still flying under the radar. 

“Many children are born with minor, unexplained neurologic disorders,” Al-Bassam said. “Some of them may turn out to have small changes in these genes. Finding that out would be a huge step forward.”

Al-Bassam’s research is funded by the National Institutes of Health. His team’s research on αβ-tubulin biogenesis utilized advanced scientific facilities at UC Davis, including the Biological Electron Microscopy Campus Core and the High Performance Computing Core.

A new study led by UC Davis Professor Courtney Lyles stresses the importance of keeping a human in the loop to review how AI makes decisions, to help reduce bias and improve safety. The study was published in Social Science and Medicine.

Lyles is the director of the UC Davis Center for Healthcare Policy and Research. She is also a co-founder and co-director of UC S.O.L.V.E Health Tech, an initiative involving researchers from UC Davis, UC Berkeley and UC San Francisco and private digital health companies.

In this Q&A, Lyles answers questions on AI use in health care and ways to detect and prevent bias. She also shares two examples of how UC Davis Health is building fairer and more reliable AI systems to serve patients and physicians.

What is this study about?

The study is a collaboration with Google and researchers at University of California and Northeastern University. We used a human-centered approach to critically assess explainable AI model to identify areas of bias. We formed a panel of experts in different fields to find potential factors driving bias in the AI interpretation.

Why can bias be a problem in AI health care systems?

Interpretation of AI models requires an understanding of the social and structural forces that shape health data.

Without this lens, AI systems may produce outputs that sound convincing but are incomplete, biased or unsafe. As AI becomes woven into everyday clinical care, we can’t rely on algorithms alone. Human expertise in combination with explainable AI tools become essential.

What is explainable AI and why is it important in evaluating AI models?

Explainable AI (XAI) is about understanding why the model made decisions the way it did. It provides insights by peeling back what AI is doing so we can understand how the model arrived at its determinations and predictions.

How would human reviewers assess bias in XAI models?

Our study has shown that a panel of experts from several disciplines can look closely at XAI model output and provide additional contextual interpretation of whether the results make sense in the real world. In the study, this panel included experts from medicine, epidemiology, behavioral science, engineering and data science.

The study also recommends including community members and patient advocates. Their lived experience offers insight that traditional experts may miss and can help ensure AI tools reflect the needs of the communities they serve.

This interdisciplinary framework shows how bringing diverse voices into the process makes AI not only more accurate, but more equitable, more trustworthy and more reliable.

How does an interdisciplinary panel assess XAI results?

When an XAI tool highlights why a model makes certain predictions, it often reveals patterns.

When reviewing XAI findings, interdisciplinary experts could then ask:

• Could this pattern be caused by differences in the dataset?
• Is this result linked to how patients interact with medical devices?
• Does this reflect a social or structural issue rather than a medical one?

This process helps uncover where AI may be relying on “shortcut features” — patterns that look meaningful but actually reflect bias in the data.

How can you turn this XAI study into real-world practice?

Our work included a case study of how this interdisciplinary panel of experts reviewed real-world XAI results from medical imaging and suggested clear next steps for research and practice.

By combining technical tools with human judgment, this approach can also be used in other cases, improving accuracy and grounding results in context. In practice, you can establish teams ahead of time to gather the right types of expertise at the AI decision-making table. This improves implementation and trust between data scientists, clinicians, patients and communities.