The Official USU Newsletter

Learning to Care for Those in Harm’s Way

Volume 11, Issue 7 n May 16, 2016

www.usuhs.edu
2 the pulse May 16, 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.

USU President Dr. Charles Rice addresses attendees at the inaugural 

Military Women's Health Research 

Conference, organized by USU, held 

at the Women in Military Service for 

America Memorial at Arlington National Cemetery, April 26. See story, 

page 3. (Photo by Eric Ritter) 

USU Receives Cyber Security ATO

The Uniformed Services 

University of the Health Sciences 

(USU) is a unique entity within the 

Department of Defense, and that 

uniqueness has carried over to the 

computer network it uses.

In order to perform the mission properly, USU needed to move 

primarily to a civilian “.edu” platform away from the regular DOD 

“.mil” system. In order to do that, 

USU needed to earn a letter from 

U.S. Cyber Command for the Authority to Operate (ATO) status—

which meant it could operate its 

unique mission while still maintaining the DOD’s level of cyber security 

and operations.

According to USU Chief Information Officer Timothy Rapp, 

having the .edu system will allow 

the USU student and faculty operate 

more affectively.

“Part of USU’s unique DOD 

mission involved communicating 

with countries such as China, for example, to set up collaborative efforts 

for medical programs that are in the 

interest of academics,” he said. “We 

wouldn’t be able to do that under 

the normal .mil DOD cyber system, 

because Internet communication 

with China on that system would be 

blocked.”

The USU Director of Operations and Communications, Joel 

Robertson, said a lot of work had 

to go in to establishing the required 

criteria toward earning that ATO.

“There was an entire baseline 

of controls we have to adhere to that 

addresses the DOD security model 

that talks about access controls and 

network architecture as well as user 

training and compliance,” Robertson said.

Achieving an ATO isn’t a 

green light for the network operators to relax their efforts either.

“Just because we got the ATO 

doesn’t mean we are to not keep up 

with our cyber security either,” Robertson explained. “It’s a continuous 

effort, because we always need to be 

proactive and patch systems, maintain the network architecture and 

constantly educate users on potential cyber security threats.”

Rapp explained that earning 

the ATO isn’t just good for USU users, but it also offers credibility toward working with other agencies.

“The ATO letter is also important, since we work with other 

government agencies on network 

projects,” Rapp said. “Before that 

begins, one of the first things they 

ask to see is an ATO. That ATO is 

like a passing report card. No one 

will want to connect with us if our 

report card is full of failures. It just 

really gives us credibility for them to 

want to work with us.”

Rapp said he applauds the 

work his IT staff accomplished in order to get this achievement through.

“Our guys put in a lot of 

work for this. A lot of the evaluators 

who came out to analyze our network said our networked more secure than some .mil sites that they 

visit. I think that’s an incredible 

compliment to the work our guys 

have done.” 

By Eric Ritter
3 the pulse May 16, 2016

See Conference, page 6

USU Hosts Inaugural Military Women's Health Research Conference

By Eric Ritter

Dr. Yvonne Maddox, Vice President for Research at USU (standing, left) directs audience questions to the panel of experts from throughout the Federal health sector during the inaugural Military Women's Health Research Conference 

held at the Women in Military Service for America Memorial at the Arlington National Cemetery, April 26. (Photo 

by Eric Ritter)

The Uniformed Services 

University of the Health Sciences 

(USU) hosted the inaugural Military Women’s Health Research Conference at the Women in Military 

Service for America Memorial at 

Arlington National Cemetery’, April 

26.

The educational forum focused on many topics such as reproduction, optimal readiness and 

cancer to just name a few. Those are 

just some of the topics that are increasingly important to the military 

and other Department of Defense 

(DOD) agencies and partners as the 

percentage of females joining the 

military ranks and opportunities for 

females continue to increase.

Dr. Arthur Kellermann, 

dean of the F. Edward Hébert School 

of Medicine at USU, said the conference was groundbreaking in terms 

of addressing how the future of the 

new focus on women’s health will 

benefit the DOD.

“I think this is one of the 

most important conferences we’re 

holding this year on one of the most 

important topics facing military 

health today,” he said. “Many of the 

issues brought up are more military-specific like deployments and 

how being away from children and 

dealing with relationships while in 

austere and sometimes hostile environments can affect women’s health. 

This is not something you would 

find regularly in the civilian environment, so there is clearly a need 

to focus on military women.”

According to Dr. Yvonne 

Maddox, Vice President for Research at USU, the purpose of hosting the topic at the conference was 

a way to begin a dialogue with the 

DOD and federal health agencies 

like the Defense Health Agency, Department of Veterans Affairs, Public 

Health Service, National Institute of 

Health and Walter Reed Bethesda.

“We wanted to initiate dialogue to get all of the stake holders 

motivated around the topic,” she 

said. “Since USU is an integral part 

of DOD, we wanted to establish a research agenda, and look at what we 

can do to galvanize attitudes around 
4 the pulse May 16, 2016

By MC3 Laura Bailey

Nobel Laureate Delivers David Packard Lecture 

A 1997 Nobel Laureate 

delivered the 28th annual David 

Packard Lecture at the Uniformed 

Services University of the Health 

Sciences (USU), April 4, 2016. 

Stanley B. Prusiner, M.D., 

the director of the Institute for Neurodegenerative Diseases (IND) and 

a professor in the department of 

neurology at the University of California San Francisco (UCSF), delivered the 2016 lecture, sponsored by 

the USU Faculty Senate. 

“This is the most prestigious 

lecture of the university. It is named 

in honor of the former Deputy Secretary of Defense, co-founder of the 

Hewlett-Packard Company, and the 

second president of USU” said Navy 

Cmdr. James Palma, M.D., MPH, 

the president of the USU Faculty 

Senate. “Doctor Prusiner’s research 

has many ties to USU’s ongoing exploration into traumatic brain injury (TBI) and other neurologic disorders.”

Prusiner received his B.A. in 

Chemistry in 1964 and his M.D. in 

1968 from the University of Pennsylvania. After completing his military service as a lieutenant commander in the U.S. Public Health 

Service at the National Institutes 

of Health (NIH) and his neurology residency training at UCSF, he 

joined the UCSF faculty in 1974 and 

set up a laboratory to study brain 

diseases. He discovered an unprecedented class of pathogens that he 

named prions. 

Prions are proteins that acquire an alternative shape and become self-propagating. As prions 

accumulate, they cause neurodegenerative diseases in animals and 

humans. Prusiner’s discovery led 

him to develop a novel disease paradigm: prions cause disorders such as 

Creutzfeldt-Jakob disease (CJD) in 

humans that manifest as sporadic, 

inherited, and infectious illnesses. 

Based on his seminal discovery that prions can assemble into 

amyloid fibrils, he proposed that the 

more common neurodegenerative 

diseases including Alzheimer’s and 

Parkinson’s diseases may be caused 

by prions. Remarkably, a wealth of 

evidence continues to accumulate 

arguing that prions cause not only 

these common degenerative diseases, but also ALS, the frontotemporal 

dementias (FTDs), chronic traumatic encephalopathy (CTE), and 

multiple system atrophy (MSA). 

Much of Prusiner’s current research 

focuses on developing therapeutics 

that reduce the levels of the specific 

prions responsible for Alzheimer’s, 

Parkinson’s, MSA, the FTDs, CTE 

and CJD.

“It’s a very special honor to 

give this lecture to tell you about 

some very exciting new results in the 

field of chronic traumatic encephalopathy (CTI),” said Prusiner. “The 

big issue: Do some types of head 

trauma result in the production of 

tau proteins that turn into prions 

and if that’s true, can we intervene 

with medicines? Can we develop 

prophylactic medicines? Can we develop medicines that can be used in 

the later stages to stop the horrors 

that patients experience? Currently 

there is not a single drug that stops 

or even slows one neurodegenerative disease. There are certain drugs 

that treat the symptoms of the disease, but the symptoms continue to 

progress. Is there a spectrum that 

goes all the way from PTSD to TBIs 

and CTI? Is it a neurodegenerative 

process that goes on and on and on? 

The answer is: I don’t know. These 

are wonderful problems that some 

of you young people need to think 

about.”

Prusiner’s contributions to 

scientific research have been internationally recognized. He is a member of the National Academy of 

Sciences, the Institute of Medicine, 

the American Academy of Arts and 

Sciences, the American Philosophical Society, and a foreign member 

of the Royal Society, London. He is 

the recipient of numerous prizes, 

including the Potamkin Prize for 

Alzheimer’s Disease Research from 

the American Academy of Neurology (1991); the Richard Lounsbery 

Award for Extraordinary Scientific 

Research in Biology and Medicine 

from the National Academy of Sciences (1993); the Gairdner Foundation International Award (1993); the 

Albert Lasker Award for Basic Medical Research (1994); the Wolf Prize 

in Medicine from the State of Israel (1996); the Nobel Prize in Physiology or Medicine (1997); and the 

United States Presidential National 

Medal of Science (2009).
5 the pulse May 16, 2016

Eberly Wins National Teaching Award

By Eric Ritter

With a mix of innovation, 

strong subject knowledge, and an 

unexpected talent for video production, Air Force Lt. Col. (Dr.) 

Matthew Eberly, assistant professor 

of Pediatrics at the Uniformed Services University of the Health Sciences (USU), was recently awarded the Council of Medical Student 

Education in Pediatrics (COMSEP) 

2016 Teaching/Education Award.

The national award is presented annually to an individual 

who shows positive contributions 

towards education and leadership in 

the field of pediatric medical education.

Eberly developed a 

high-quality online faculty development course known as the “New 

Preceptor Start-up Package" which 

included six videos: The Rhythm of 

RIME, Direct Observation, Teaching Tools, One-Minute Preceptor, 

and Giving Feedback. The pursuit 

of producing the videos all began 

because of a small student overlap 

between two classes.

“When we began the clerkships under the new USU curriculum in 2013, we had to open up ten 

additional pediatric training sites 

at military community hospitals 

around the country, because we had 

seven months where the Class of 

2014 overlapped on their clerkships 

with the Class of 2015,” he said. “We 

just didn’t have enough room for all 

of the students at our original sites.”

Eberly said he and his staff 

then pursued the idea of using videos to help prepare the pediatricians 

to teach and mentor the med students.

The video collection allowed 

for a convenient way to train faculty 

at distant sites the essentials of precepting students, such as teaching 

on-the-fly, giving feedback, and performing direct observation of medical interviews. 

“Most of the pediatricians at 

these sites had never worked with 

clerkship students before, so we 

wanted to give them an instructional video package that provided the 

tools they needed to be successful 

teachers of novice learners,” he explained.

He continued saying the 

added benefit was that offering the 

package via video freed them from 

traveling to so many sites in the limited amount of time they had.

“It was a good way to quickly disseminate the information to 

the preceptors without us having to 

travel to these places individually. 

So, they are able to watch the videos 

on their own time, which worked 

out for everyone.”

He said he also sought to improve the educational experience of 

the rotating medical students by creating several videos specifically for 

the students. His Oral Case Presentation Guide is a 22-minute movie 

with narration, animation, and skits 

involving over 20 student and faculty actors. It explains how to give an 

effective oral presentation while on 

Rounds or in clinic and highlights 

common mistakes that medical students make. Another video he developed, Pediatric Physical Exam 

Pearls, is presented to the students 

on the first day of the clerkship to 

help familiarize them with tips and 

techniques for the examination of 

infants and toddlers.

Eberly said the good thing 

that came out of this was that members of COMSEP heard about these 

videos and requested using the videos for their own institutions. They 

found it useful, because medical 

schools across the country are increasingly relying on community 

preceptors at satellite clinics to teach 

their medical students. Videos such 

as the One-Minute Preceptor are especially popular for this purpose. 

“Winning an award from an 

organization that represents pediatric clerkship directors from around 

the country felt like a big honor and 

was certainly humbling for me,” 

he said. “I didn’t expect when we 

were creating these videos that they 

would go this far. I’m very glad, because it seems to have allowed other people to use the videos for their 

own training purposes.”

Making the videos wasn’t 

easy right away for him either. Eberly said he had to teach himself how 

to shoot and edit the videos.

He said he had some prior 

basic knowledge of video production using a camcorder. But after 

several weeks of research online, he 

decided he needed more items to 

produce the videos. He learned by 

watching lots of videography tutorials online and through many hours 

of practice.

COMPEP has even asked 

him to host a workshop at their annual conference on using video to 

enhance medical student education. 

He added that it was an 

overall enjoyable experience putting 

the video package together.

“The videos required lots of 

actors, so it was fun getting some 

of the USU students involved to be 

actors in them. They really enjoyed 

seeing themselves in the videos.”

Eberly said he plans on creating more videos as new topics become available.
6 the pulse May 16, 2016

USU Students Travel to India for First look into Country's Medical Practice 

By MC3 Laura Bailey

Three fourth-year students 

at the F. Edward Hébert School of 

Medicine (SOM) at the Uniformed 

Services University of the Health 

Sciences (USU) are the first students 

to participate in the Armed Forces 

Medical College (AFMC), Pune, India, Partnership. India is a strategic 

partner of the U.S. in the war against 

terror and an emerging global economic power. As such, it provides a 

unique backdrop and ideal means to 

expose final-year medical students 

to India’s medical practices and culture. 

Army 2nd Lt. Daniel Hart, 

2nd Lt. Anant Shukla and Lt. Nicholas Singh-Miller pioneered to Pune, 

India as the first USU student diplomats to participate in the AFMC 

partnership. Their selection was 

based on their highly competitive 

academic records, essays, personal 

interviews and the strength of their 

capstone projects. The collaboration 

between the two premier institutions 

was several years in the making and 

the direct culmination of hard work 

by leadership of the Indian Military 

Medical Services (IMMS), USU, 

Capstone Director, AFMC, Pacific 

Command (PACOM) and the U.S. 

Embassy in New Delhi. 

“Prior to this trip from USU 

to AFMC, I was often reminded to 

keep an open mind while in India,” 

said Hart. “From my initial ride in 

an auto-rickshaw in the crowded 

streets of New Delhi to my tour of 

the Indian Military Paraplegic Rehabilitation Center to assisting in 

the neurosurgery operating theater, 

I found my experience to be enriching, challenging, absorbing and 

mind-opening.”

A high patient intake, the 

sheer variety of illnesses and workload proved challenging. 

“Each resident sees 15 to 20 

patients in four hours of clinic,” said 

Hart. “This pace drives a very quick 

decision-making process which is 

clearly evident in the residents’ efficiency. Then, being a teaching institution, the command hospital attached to AFMC opens its doors to 

civilian cases and thereby cares for 

a wide breadth and severity of cases 

from the states surrounding Pune.”

“My education at USU has 

been rigorous, but I am blown away 

daily by residents’ detailed knowledge of diseases and disease processes as well as their effective use of 

the physical exam,” said Singh-Miller, who returned from India Jan. 29, 

2016. “This, no doubt, is due to the 

incredible patient load and variety 

that they see while training here. For 

instance, in just one day, I saw a case 

of ricketts, malnutrition secondary 

to a VSD, pulmonary tuberculosis 

in a child with newly-diagnosed 

HIV, and a child with dengue fever, 

alongside many URIs, well-baby 

checks and other chief complaints. 

The day to day ebb and flow of work 

is very different to what I’m used to; 

records are kept on paper, orders 

are written on paper, residents set 

most of the IVs and do most of the 

blood draws. They start at 7:30 a.m., 

round at least twice daily, attend lectures and, except for those working 

the nights, end at 9 p.m.. There are 

no work hour restrictions and I am 

not sure if the first-year residents 

actually ever sleep. The team really 

only takes a half-day break on Sunday. Despite the heavy workload, 

the residents and staff display camaraderie.”

Additionally, student diplomats had to work around the language barriers that are commonplace in a place such as India where 

36 states boast more than 122 major languages and more than 1,000 

mother tongues. 

“Being an amalgamation of 

hundreds of disparate cultures, even 

my Indian colleagues admitted that 

when they travel merely 100 miles 

from their hometowns, they often 

find themselves in areas where nobody speaks their local tongue,” said 

Hart. “Hiring an interpreter who 

spoke English, Hindi and Marathi, 

the most prominent local language 

around Pune, was invaluable in allowing me to interact one on one 

with the civilian population in both 

outpatient clinics and wards.”

Despite the many challenges, all of the student diplomats were 

successful in tackling their day to 

day tasks and completing their capstone projects. Hart’s project focused 

on neuropsychiatric assessments in 

patients with traumatic brain injury 

while Singh-Miller’s project aimed 

to understand the unique challenges faced by Indian families with autistic children. Anant conducted a 

unique study that enrolled patients 

with benign prostatic hyperplasia 

for comparing the international 

prostate symptom scores between 

U.S. and Indian patients – something that had not previously been 

measured in the military system, according to Lt. Col. Amit Agrawal, of 

the Command Hospital in Pune. 

“We are so very grateful to 

the Departments of Surgery, PMB 

and Global Health, the capstone 

project director, Dr. Ottolini, the 

International Relations Committee led by doctors Welling, Rich, 

Elster and Longacre,” said Rahul 

M. Jindal, M.D., PhD, a professor 

in the Department of Surgery and 

Division of Global Health at USU 

and Walter Reed National Military 

Medical Center. “All this would not 

have been possible without the extensive logistics support of AFMC, 

Brig. Kanitkar and LG Chopra, the 

US Embassy in New Delhi and PACOM.”
7 the pulse May 16, 2016

Conference from Page 3

this agenda, and specifically, once 

we understand what the agenda is 

and how it should be addressed, it’s 

up to USU to lead and steer this 

agenda. This conference was a way 

to see how the stakeholders can contribute to this collectively.”

Some of the other topics discussed were the Zika virus, sexual 

abuse, family violence and fertility 

and infertility issues.

“Another prime example of 

why military women-specific studies are important, is that there is a 

high level of premature births and 

post-partum depression within the 

military, and we don’t understand 

that. So, that’s other of the many areas discussed," Maddox said.

She also said the health of 

women wasn’t the only topic addressed, but women taking a leadership role in health research leadership was also stressed.

“It wasn’t just about health 

research,” she said. “The panel discussed how women physicians, professors, clinicians and other health 

professionals could impact research 

because of women’s unique needs 

along ethnic, racial and cultural differences. Those woman leaders will 

be a very important part of the research agenda and how it will influence the military.”

Dr. Maddox noted that she 

was impressed and encouraged by 

the level of participation and support for the conference.

“The energy behind this 

meeting was well beyond my expectations,” Maddox said. "I knew people would want to come given that it 

was one of the first such meetings, 

but I wasn’t expecting such an energetic group.”

Maddox continued by saying the results of the conference 

were immediate following the event, 

as many of the DOD leadership 

came forward to discuss next steps. 

“Our leadership at health 

affairs, who attended the meeting, 

spoke of how powerful the conference was and that we should ensure 

that a session on women’s health is 

held at the Military Health System 

Research Conference--which is a 

well-attended annual national conference to highlight research for all 

of the DOD. The session is already 

being planned. 

Maddox said that when the 

Office of Research began planning 

this conference, there had been no 

discussion around making it an annual event, but the reaction from 

the co-sponsors and others who 

attended was so positive that they 

are now planning regular follow-up 

seminars and other collaborative 

projects on the importance of women’s health research.

“I’m hopeful that in the next 

few months, we will get enough support that we will get more funding 

opportunities to explore some more 

research for us to study the issues in 

a structured and more formalized 

way.”

Kellermann said he was very 

impressed with the quality of the 

presentations and panels throughout the event.

“What’s impressed me so far 

has been the caliber of the work by 

the military medical officers who 

are also women and taking a leadership role on these topics, and the 

expertise of the panels and how they 

addressed the questions that have 

come forth from the audience,” he 

said. “The composition of the panels themselves was comprised of 

military women, and clearly they 

are driving this leadership role [and 

many of the topics of] this conference, but more importantly driving 

our knowledge of care for women’s 

health issues.”

Kellermann added the location of the conference was also well 

planned.

“To have the conference at 

the Women’s Memorial [at the Arlington National Cemetery] was 

very symbolic and really added 

meaning to the event.”

Maddox said USU taking 

the leadership role in this topic is 

also greatly symbolic for everyone 

involved.

“There is an enamored view 

of universities,” she explained. “It’s 

USU being an intellectual spark that 

DOD and others see. As a hub for 

learning and the acquiring of knowledge, we took and accepted the lead 

on this on behalf of the Department. 

What pleases me is that the other 

organizations allowed us to take the 

lead, followed and the product surely was beneficial to everyone. ” 

Focusing on the issue of 

women’s health in the military isn’t 

a totally new concept. Maddox did 

explain that it took a new course of 

action when the first lady, Michelle 

Obama, began looking into military 

families and their needs.

“Over the months in planning for the conference, her office 

was very supportive, and this support helped drive the focus of family 

and its tie to women’s health.”

Maddox said she is extremely proud to be working on this topic 

and looks forward to working more 

closely with the other organizations 

and other projects.

“This has been my dream 

and a goal since arriving at USU,” 

she said. “To have this kind of visibility for women’s health and on 

such a scale as this, is an absolute 

dream.”
8 the pulse May 16, 2016

Final Frame

Senior Associate Dean, professor of Family Medicine, Dr. Brian Reamy (left) presents this year’s Henry Wu award to 

Dr. Brian C. Schaefer, an associate professor in the Department of Microbiology and Immunology at the F. Edward 

Hébert School of Medicine (SOM) at USU. Schaefer won the award for his paper entitled, “Selective Autophagy of the 

Adaptor Protein Bcl10 Modulates T Cell Receptor Activation of NF-κB,” published in Immunity, June 29, 2012.