The Official USU Newsletter

Learning to Care for Those in Harm’s Way

Volume 11, Issue 2 n February 29, 2016 

www.usuhs.edu
2 the pulse February 29, 2016

On the cover

Sharon Holland

Deputy Vice President for External Affairs and Managing Editor

Eric Ritter

Writer and Editor

MC3 Laura Bailey

Writer and Photographer

Tom Balfour

Photographer

 

Production

Editorial content is edited, prepared and 

provided by the USU Office of External 

Affairs unless otherwise indicated. The 

Pulse staff may include or exclude articles based upon news value, impact on 

the university and space availability.

Submissions

The Pulse is published biweekly on 

Mondays. The deadline for submissions 

is at 4 p.m. Tuesday prior to the publication date. Submissions can be sent to 

eric.ritter2@usuhs.edu or by calling 301-

295-3791.

By Sharon Holland

A novel gene alteration tied to aggressive 

prostate cancer in African American men

It is well established that 

prostate cancer is more prevalent 

in African American men when 

compared to men of other ethnicities. There has been a premise that 

a combination of genetics, lifestyle, 

nutritional and medical access reasons led to the significant statistical 

difference. 

However, in their study 

titled, “A Novel Genomic Alteration of LSAMP associates with 

Aggressive Prostate Cancer in African American Men,” published 

in EBioMedicine (http://www.sciencedirect.com/ science/article/

pii/S2352396415301870), researchers from the Uniformed Services 

University of the Health Sciences 

(USU), Walter Reed National Military Medical Center, DoD’s Joint Pathology Center (JPC), Dana-Farber 

Cancer Research Institute (DFCI), 

Genomatix GmbH and CytoTest, 

Inc., found some distinct genomic variations that also could be to 

blame. 

The genes studied were 

those associated with early stages 

of prostate cancer development and 

progression. In African American 

men with rapid disease progression, 

researchers, co-led by Drs. Shiv Srivastava (USU), Albert Dobi (USU) 

and Matthew Freedman (DFCI), 

noted that a tumor suppressor gene, 

LSAMP, was missing from a key 

chromosome. The authors contend 

that this might, in part, explain 

some of the more aggressive cancers 

seen in African American men. In 

contrast, Caucasian men with similar types of prostate cancers showed 

much lower frequency of LSAMP 

alterations but higher frequency of 

two widely studied prostate cancer 

driver genes, ERG and PTEN. 

The USU, Walter Reed 

Bethesda and JPC collaborative 

team, through comprehensive evaluations of matched cohorts of African American and Caucasian 

American prostate cancers, previously established a higher frequency of ERG alterations in Caucasians 

(50-70%) and its significantly lower frequency in African Americans 

(20-25%). These intriguing observations actually provided the rational 

for the current study focusing on 

whole genome evaluations of prostate cancers from these two patient 

populations. 

These findings reveal differentially distributed somatic mutations in prostate cancer across ancestral groups, and affirms the need 

for future evaluations of cancer genomes in global context with important implications for precision 

medicine strategies. 

“This highly collaborative 

study was made possible due to 

complementary expertise of investigators from different institutions. 

Equally significant were long-term 

biospecimen banks and multi-center database of the Center for Prostate Disease Research (CPDR) at 

USU and Walter Reed-Bethesda that 

comprises a high proportion (25%) 

of African American men treated 

for prostate cancer in the equal access Military Healthcare System. 

The new emerging knowledge on 

ethnicity-associated differences of 

the prostate cancer genome and 

perhaps other cancers needs more 

research and has promising potential to enhance the repertoire of new 

biomarkers and therapeutic targets 

that may benefit all patients,” said 

Srivastava. “Given the recent availability of next-generation sequencing opportunities at USU, we will 

be able to accelerate our research in 

this direction.” 

Students in their post-clerkship at the F. Edward Hebert School of Medicine (SOM) at 

the Uniformed Services University of the 

Health Sciences (USU) perform Advanced 

Cardiac Life Support (ACLS) skills during 

high fidelity ACLS simulation training and 

re-certification at the Val G. Hemming Simulation Center at USU, Feb. 19. A student 

volunteer instructor (far left) observes and 

grades the student team lead as they work 

through a simulation scenario. See story on 

page 5. (photo by MC3 Laura Bailey)
3 the pulse February 29, 2016

Army Lt. Col. (Dr.) Robert 

Mabry, a graduate of USU’s F. Edward Hébert School of Medicine 

class of 1999, has joined the staff of 

the House Committee on Energy 

and Commerce.

The Committee is the oldest 

standing legislative committee in 

the U.S. House of Representatives 

and is responsible for the country's 

telecommunications, consumer 

protection, food and drug safety, 

public health research, environmental quality, energy policy, and interstate and foreign commerce. Mabry, 

who is currently serving as a Robert 

Woods Johnson Fellow, will work 

side by side with Committee staffers 

and legislators to help shape healthcare policy.

“It’s the staff behind the 

scenes that are the lifeblood of congressional committees, and this is 

certainly true of the Energy and 

Commerce Committee,” said House 

Energy and Commerce Committee 

Chairman Fred Upton (R-MI). “We 

are also delighted to welcome Dr. 

Robert Mabry, whose record of service as a Green Beret in the military 

is beyond remarkable – from Mogadishu during ‘Black Hawk Down’ 

to several tours in Afghanistan, we 

are lucky to have a true hero on the 

team. We’ve got a great staff that has 

us well positioned to build upon 

our bipartisan record of success in 

2016.”

"The Robert Wood Johnson Health Policy Fellowship is the 

premiere health policy leadership 

program in the Nation,” said Mabry. “The Military Health System will 

face increasingly complex challenges going forward. I felt this would 

be an incredible opportunity for me 

to further develop myself as a MHS 

leader and see how complex healthcare policy challenges are tackled at 

the national level."

Mabry to join House Energy and Commerce Committee

By Sharon Holland

Army Lt. Col. (Dr.) Robert Mabry. 

(Photo courtesy of the Robert Wood 

Johnson Foundation)

Children with Autism at Increased Risk for 

Ear Infection Complications 

by Sharon Holland

Children with Austism Spectrum Disorders (ASD) are twice as 

likely to experience complications 

from ear infections, according to a 

new study published online in the 

Journal of Autism Developmental 

Disorders, “Otitis Media and Related Complications Among Children 

with Autism Spectrum Disorders,” 

Jan. 6, 2016.

The study, conducted by 

a team of scientists with the Uniformed Services University of the 

Health Sciences (USU) and Walter Reed National Military Medical 

Center pediatric clinical research 

group in Bethesda, Md., along with 

collaborators from Madigan Army 

Medical Center, Tacoma, Wash., 

and the Naval Medical Center in 

Portsmouth, Va., sought to evaluate the association between ASD 

and otitis media. Acute otitis media 

(AOM) symptoms can be masked by 

communication deficits, common 

to children with autism spectrum 

disorders (ASD). Using ICD-9-CM 

diagnostic codes, the researchers, 

who included Maj. (Dr.) Cade Nylund, Ms. Apryl Susi, Capt. (Dr.) 

Gregory Gorman, Dr. Elizabeth 

Hisle-Gorman, Col. (Dr.) Christine 

Erdie-Lalena, Lt. Cmdr. (Dr.) Marilisa Elrod, and Maj. (Dr.) Daniel 

Adams, performed a retrospective 

case-cohort study comparing AOM, 

and otitis-related diagnoses among 

children with and without ASD. 

Children with ASD had a 

significantly increased rate of AOM, 

otitis media with effusion, otorrhea, 

and PE tube placement. Children 

with ASD were more than twice as 

likely to develop mastoiditis, and to 

undergo mastoidectomy and tympanoplasty. The team concluded 

found that children with ASD are 

more likely to have middle ear infections and otitis-related complications, highlighting the importance 

of routine middle ear examinations 

and close attention to hearing impairment in this population.

“A key take-away is that children with autism are a unique and 

susceptible population. I suspect 

the increase rate of ear infections 

may be linked to a lower vaccination 

rate for pneumococcus and influenza in children before or after they 

are diagnosed with autism and may 

be an indicator of the adverse effect 

of the popular myth that vaccination leads to or may worsen autism,” 

said Nylund, an assistant professor 

of Pediatrics at the USU. “The increased rate of mastoiditis is a clear 

indicator of delayed or missed ear 

infections, which highlights the difficulty in caring for children with 

autism who so often have difficulties 

communicating pain or cooperating 

with exams. An astute patient provider can overcome such obstacles 

for these children.”
4 the pulse February 29, 2016

by Sharon Holland

Kostas-Polston helps lead charge 

against HPV-related cancer

By MC3 Laura Bailey

Elizabeth Kostas-Polston, assistant 

professor at the Daniel K. Inouye 

Graduate School of Nursing (GSN) at 

USU. (Photo by Tom Balfour)

Elizabeth Kostas-Polston, an 

assistant professor at the Daniel K. 

Inouye Graduate School of Nursing 

(GSN) and the principle investigator 

of a Department of Defense funded 

research project at the Uniformed 

Services University of the Health 

Sciences (USU), is tackling Human 

Papilloma Virus (HPV) related oral 

cancer head on. 

The project, funded in 2015, 

focuses on assuring the effective 

translation of knowledge for new 

approaches to health promotion, 

disease prevention and the diagnosis, treatment and management of 

HPV-related cancers. 

Along with colleagues from 

Walter Reed National Military 

Medical Center as well as the John 

P. Murtha Cancer Center, KostasPolston is working to find answers. 

“Our understanding of 

HPV-caused oropharyngeal cancer is limited,” said Kostas-Polston. 

“We do not understand the biology 

well nor do we have clinical screening guidelines. Further, and unbeknownst to most, HPV-caused oropharyngeal cancer is most prevalent 

in men.”

The virus is most often regarded as a women’s health issue, 

when in fact, it is not, she said. Nearly all sexually active individuals, including men and boys, will become 

infected with one or more strains of 

the HPV virus at some point in their 

lives. 

“Education and prevention 

are critical,” said Kostas-Polston. 

“Educating men is paramount to 

accessing health care. For the most 

part, it is a cultural norm for women, from a very early age, to regularly see a health care provider. It’s just 

what we do—we get into the habit 

early on. Men, on the other hand, do 

not typically see a health care provider anywhere near as often. This 

is evidenced in that women are the 

primary consumers of health care. It 

is critical that we reach out to men 

and encourage them to, together 

with their health care provider, be 

proactive about their health.We’re 

looking at what is the best approach 

to getting the word out to men,” said 

Kostas-Polston. 

In addition to establishing 

better education practices, the project seeks to identify better methods 

for screening that match those of 

today’s cervical cancer screenings, 

she said. In fact, health care providers have done such a great job 

with cervical cancer screening that 

it is estimated that HPV-caused oropharyngeal cancer will become the 

most commonly occurring HPV 

cancer in the next few years. In clinical settings, they are already seeing 

evidence of a growing number of 

cases. The increase in cases is due in 

part to the way the virus works. 

“Symptoms associated with 

HPV-caused oropharyngeal cancer are usually non-specific,” said 

Kostas-Polston. “Those with persistent infection may go undiagnosed for years or even decades. 

Unfortunately, by the time an individual presents to the clinic, the 

cancer has progressed; often to an 

advanced stage. Although the majority will ‘clear’ the virus, a subgroup of all those infected will not. 

The risk for developing an HPV-related cancer in men and women increases when the virus persists.”

HPV is a very complex virus, she said. Right now, there is no 

way to know who will develop cancer caused by HPV infection, but 

perhaps with time and ongoing research efforts, she and others on the 

project can find the answers to one 

of the most common sexually transmitted diseases. 

“We have the expertise and 

the technology to accomplish these 

lofty goals; I believe what we are 

looking for will be found in existing 

technologies,” said Kostas-Polston. 

“We simply need to identify what 

works best for good health outcomes.”
5 the pulse February 29, 2016

USU students volunteer time for ACLS

By MC3 Laura Bailey

Students at the F. Edward 

Hébert School of Medicine (SOM) 

at the Uniformed Services University of the Health Sciences (USU)

volunteered their expertise during 

the Advanced Cardiac Life Support 

course at the Val G. Hemming Simulation Center (SIMCEN), Feb. 19. 

“We sent out an email to our 

students a few weeks ago requesting 

volunteers to teach ACLS,” said Air 

Force Col. (Dr.) Rita DuBoyce, the 

senior director of clinical education 

at the SIMCEN and an assistant 

professor of medicine. “We know 

a lot of our students have prior experience in emergency and medical 

fields and their willingness to volunteer really helps out our faculty who 

are already very busy teaching other 

classes. Their experience is perfect 

for helping their less experienced 

peers who, having just returned 

from their clerkships, need to brush 

up on ACLS as well as recertify.” 

After a year of clinical rotations and possibly having seen real-life cardiac events in the hospitals 

where the students completed their 

clerkships, the students are going 

through the ACLS course again, but 

with more experience under their 

belts, said Army Lt. Jason Ausman, 

a third-year medical student at USU 

and one of the ACLS student volunteer instructors. 

“As ACLS instructors, we’re 

grading the team lead during simulated scenarios,” said Ausman. 

“We’re looking for that team leader 

to really delegate tasks, make sure 

that everybody is working together 

and knows what they’re supposed to 

be doing.”

“During an emergency situation, you’ll have one person on the 

defibrillator, another person is doing compressions and airway, someone else is focused on medications 

– but the team lead is like the conductor of the whole orchestra,” said 

Navy Ensign Erin Mack a third-year 

medical student at USU and a student volunteer instructor.

“They’re the one person 

whose only task is to take a step back 

and see the overall picture. They’re 

calling the shots and communicating back and forth with each team 

member from start to finish. So, 

they have to know how to manage 

a lot all at once while keeping a cool 

head. It’s not as easy as it might look 

on TV and it takes a lot of practice.”

“We trained for these kinds 

of scenarios regularly,” said Ausman 

as he recalled his more than eight 

years as a civilian paramedic in Ft. 

Myers, Fla. “We used our training 

to save real people. I was also an instructor at a paramedic school and 

used to teach students how to run 

through these exact same situations 

and how to take care of people in the 

field.”

He and his fellow instructors hope that their peers will benefit from the graded refresher course 

and come away from it feeling more 

confident. 

Repetition through training 

is the key to becoming confident in 

any skill including ACLS, said Ausman. With experience and practice 

comes the ability to perform a task 

as if it were second nature and then 

the ability to teach it to others. 

“I was an emergency medical technician for five years with 

the Air Force prior to enrolling at 

USU,” said Air Force 2nd Lt. Jeremy Brenneman, a third-year medical student at USU and ACLS student volunteer instructor. “Before I 

joined the Air Force I was a civilian 

firefighter for another five years in 

Wilmington, N.C. With 10 years of 

experience working in emergency 

situations, I’m very familiar with 

ACLS and feel very confident that I 

can help my peers really get it down. 

I was excited to volunteer as a student instructor because I’m looking 

to go into emergency medicine. This 

[ACLS] is right up my alley.” 

“Watching the student volunteer instructors help their peers 

is really amazing,” said DuBoyce. 

“They really do know their stuff and 

it’s really amazing to see them step 

into this role of instructing. It will 

be interesting to see them once they 

are in their residencies and I have 

high hopes that they will continue 

to grow as leaders and mentors.” 

The student teams performed several drills designed to measure their skills during the ACLS. 

Student teachers were on hand from USU to monitor the drills. (Photo by MC3 Laura Bailey) 
6 the pulse February 29, 2016

USU staffer shares benefit of 

non-profit pet sitters 

It was love at first sight.

Navy Mass Communication Specialist Third Class (MC3), 

Laura Bailey, finished breakfast at 

the Southside Diner in Baltimore 

when she saw him – an energetic, 

lovable pit-bull mix up for adoption 

through a mobile adoption facility.

“The rest is history. He is a 

love,” Bailey said. “I walked over to 

him and he pretty much just leaned 

into me. He’s just the sweetest dog; 

and he was so sweet when I first met 

him. He’s even sweeter now that 

we’ve gotten to know each other and 

build that trust, but he just stole my 

heart.”

But Sam, as he is now affectionately called, was not planned. 

Bailey was set to leave for three 

weeks of training in October in a 

mere two months. Bailey would 

support a two-week training exercise called Operation Bush Master, 

a combat zone readiness training 

military medical students at The 

Uniformed Services University of 

the Health Sciences participate in 

once a year.

With no close family members nearby, Bailey decided to deploy Sam — to Germantown, Md.

While trying to figure out 

what to do with Sam for three 

weeks, Bailey remembered a commercial featured on the Armed 

Forces Network for Dogs on Deployment – a nonprofit that helps 

single servicemembers place their 

dogs or cats with boarders at no cost 

for the duration of their training or 

deployment.

Bailey made an account with 

the website and determined what 

she was looking for in a possible 

boarder for her furry family member – a person who would make him 

feel safe, loved and a part of the family.

“I really didn’t know much 

about it, but I didn’t really have anything to lose at that point, Bailey 

said. “I looked into it and it sounded 

almost too good to be true. It didn’t 

cost any money. Honestly, I didn’t 

know what to expect really. I registered hoping for the best and got a 

message from Karen.”

Karen White, Germantown, 

is the Rockville coordinator for 

Dogs on Deployment and a registered boarder. She had been a part 

of the organization for a few years 

but never boarded a dog until Sam.

“I felt like it was something 

I needed to do,” White said. “When 

you register to be a boarder you 

don’t ever have to take an animal, 

but you see the animals in need in 

your area that you can do a search 

criteria for. She was close, needed it 

and it felt like I needed to just do it.”

Following Dogs on Deployment protocol, the two women talked and scheduled a meet-and-greet 

to determine how Sam got along 

with Karen, her husband, Bob, and 

their dogs.

Bailey said she was put at 

ease and felt that Karen and Bob 

were the right people to care for 

Sam.

“When I walked into their 

house, it was really welcoming, but 

they also really seemed to know 

Courtesy of Hannah Troyer 

Editor, Andrews Gazette, JBA

Dog on Deployment Rockville Coordinator, Karen White, laughs with Dogs 

on Deployment member, MC3 Laura Bailey and her dog, Sam. Bailey used 

the pet foster program when she participated in last year's Bushmaster (Photo 

courtesy of Hanna Troyer, Andrews Gazette, JBA)

Winter from Page 4
7 the pulse February 29, 2016

Pets, from Page 5

what they were doing with dogs,” 

Bailey said. I wanted someone who 

had dog experiences because it’s one 

thing to call a friend and have them 

watch your dog. It’s another to leave 

them. Since they had dogs, I knew 

they would know exactly what to do 

with him.”

A contract was signed between the two parties that outlined 

what to do in certain circumstances so no questions were left unanswered during the three weeks.

Sam felt at ease, too.

“He was a part of our family 

for three weeks. He slept in the bed 

with my husband and I and the other dogs and snored away with everyone else and couldn’t have been 

happier,” White said.

Sam is one of more than 850 

dogs nationwide that have been successfully deployed through Dogs 

on Deployment since its creation in 

2011 by a dual military couple.

Monica Ruiz, Falls Church, 

Va., has boarded five of the 850 dogs 

and has been a boarder since Nov. 

2012 when her own dog had to be 

put down. Ruiz’s deployments range 

from one to nine months and is currently boarding a German Shepard 

for a service member. The deployment is scheduled to last a year.

Ruiz shares the same sentiment as White when it comes to 

bonding with the boarded pets – 

and their family members.

“Being a volunteer boarder has been one of the best things 

of I’ve done in my life,” Ruiz said. 

“It’s really hard to say goodbye to a 

dog who has become such a huge 

and important part of my life. But, 

seeing the joy on the owners’ faces 

and the excitement of the dogs to be 

with their people again makes it all 

worthwhile. The joy of that reunion 

– and knowing that I’ve played a part 

in making it possible – is why I do 

what I do.” While the three’s deployment processes went seamlessly, too 

often, service members are unaware 

of the service the organization provides.

“You see all the time someone serving turning in a pet into a 

shelter, and it just breaks your heart 

because once they relinquish ownership of their animal there’s not much 

we can do about it,” White said. “But 

if they had known about us beforehand, we could have helped them.”

As a coordinator, White 

spends lots of time attending local events to get the word out and 

raise donations for the organization. 

White, Bailey, and Ruiz realize the 

organization is “definitely filling a 

need” and “takes a huge weight off 

service members shoulders,” according to Ruiz.

“Pets are family. And especially for us single folks, our friends 

go off on deployments and they 

leave their (spouses) and children 

behind and that’s tough,” Bailey 

said. “But they get to come home to 

them. Us single folks come home to 

sometimes a dog or a cat. And he is 

my family.”

Since Sam’s deployment, 

White and Bailey haven’t been able 

to hang out in person, but are now 

Facebook friends and keep tabs on 

each other’s everyday lives.

If she were to deploy or go 

through weeks of training again, 

Bailey said she would chose Karen 

again “in a heartbeat.”

“I don’t think any of the 

boarders sign up to do it to be anything but supportive of the troops,” 

White said. “You’re doing it for the 

pure love of country, man and dog. 

It’s corny, but it’s true.”

“It’s a huge service for the 

country- putting their lives on the 

line — and I just think the least you 

can do is watch their dog or cat. 

They should be able to come home 

to everyone they love.”

MC3 Laura Bailey snuggles with her dog, Sam, in her home as often as she 

can when she doesn't leave for training. (Photo courtesy of MC3 Laura Bailey
8 the pulse February 29, 2016

Final Frame

Students at the F. Edward Hebert School of Medicine (SOM) at the Uniformed Services University of the Health Sciences (USU) learn how to salsa dance at a Dancing Docs instructional class at USU. Dancing Docs is a social group at 

USU run by SOM students and encourages social enrichment through dance. (Photo by MC3 Laura Bailey)

Dancing Docs