Uniformed Services University Board of Regents

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Uniformed Services University of the Health Sciences

“Learning to Care for Those in Harm’s Way”

Board of Regents Quarterly Meeting

November 5, 2019 BOARD OF REGENTS UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES 208th MEETING

November 5, 2019 | 8:00 a.m. Alvarez Board of Regents Room (D-3001) | Bethesda, MD

MEETING AGENDA

OPEN MEETING

8:00 a.m.: Meeting Call to Order Designated Federal Officer Ms. Sarah Marshall

8:00 - 8:05 a.m.: Opening Comments Chair, USU Board of Regent Dr. Jonathan Woodson

8:05 - 8:10 a.m.: Matters of General Consent Declaration of Board Actions Dr. Woodson

8:10 - 8:20 a.m.: Board Actions Degree Conferrals, Hébert School of Medicine (SOM) Dean, SOM Dr. Arthur Kellermann Degree Conferrals, Inouye Graduate School of Nursing (GSN) Dean, GSN Dr. Carol Romano Degree Conferrals, College of Allied Health Sciences (CAHS) Dean, CAHS Dr. Mitchell Seal

Faculty Appointments and Promotions, SOM Dean, SOM Dr. Kellermann Faculty Appointments and Promotions, PDC Executive Dean, PDC Dr. Schneid

Faculty Awards, SOM Dean, SOM Dr. Kellermann

8:20 - 8:45 a.m.: Office of the President, Uniformed Services University of the Health Sciences (USU) Report President, USU Dr. Richard Thomas

8:45 - 9:25 a.m.: Member Reports Academics Summary Board Member Dr. Michael Johns

Dr. Johns will provide the Board with a summary of reports from the University Registrar; the Office of Accreditation and Organizational Assessment; and the Faculty Senate. Finance and Administration Summary Board Member Dr. Leo Rouse

Dr. Rouse will provide the Board with a summary of reports from the Office of the Vice President for Finance and Administration; the Office of the Vice President for Information and Education Technology; the Office of General Counsel; and the Henry M. Jackson Foundation for the Advancement of Military Medicine.

9:25 - 9:40 a.m.: Break

9:40 - 10:00 a.m.: SOM Report Dean, SOM Dr. Kellermann

10:00 - 10:20 a.m.: GSN Report Dean, GSN Dr. Romano

10:20 - 10:40 a.m.: PDC Report Executive Dean, PDS Dr. Schneid

10:40 - 11:00 a.m.: CAHS Report Dean, CAHS Dr. Seal

11:00 - 11:05 a.m.: Open Meeting Closing Comments Board Chair Dr. Woodson

11:05 a.m.: Meeting Call to Adjourn Designated Federal Officer Ms. Marshall

11:05 – 11:15 a.m.: Break

CLOSED MEETING

11:15 a.m. - 12:00 p.m.:

Active Investigations. A report on active investigations at the University will be provided to the Board. The report will contain sensitive personnel information, may involve accusing a person of a crime or censuring an individual, and may disclose investigatory records.

Personnel Actions. A report on significant personnel actions will be provided to the Board and will contain sensitive personnel information and material that relates solely to the internal personnel rules and practices of the University. BOARD OF REGENTS UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES 208th MEETING

November 5, 2019 | Bethesda, Maryland

TABLE OF CONTENTS

Governing Documents • TAB 1 … Charter • TAB 2 … Membership Balance Plan • TAB 3 … Bylaws • TAB 4 … Current Membership

Administrative Documents • TAB 5 … Board Meeting Calendar • TAB 6 … Closed Session Determination • TAB 7 … Federal Register Notice

Matters of General Consent • TAB 8 … Chair’s Opening Comments • TAB 9 … Previous Meeting Minutes • TAB 10 … Declaration of Board Actions

Board Actions • TAB 11 … Degree Conferrals, F. Edward Hébert School of Medicine • TAB 12 … Degree Conferrals, Daniel K. Inouye Graduate School of Nursing • TAB 13 … Degree Conferrals, College of Allied Health Sciences • TAB 14 … Faculty Appointments and Promotions, F. Edward Hébert School of Medicine • TAB 15 … Faculty Appointments and Promotions, Postgraduate Dental College • TAB 16 … Faculty Awards, F. Edward Hébert School of Medicine Reports to the Board of Regents • TAB 17 … University President • Academics Summary Reports: • TAB 18 … University Registrar • TAB 19 … Office of Accreditation and Organizational Assessment • TAB 20 … Faculty Senate • Finance and Administration Summary Reports: • TAB 21 … Office of Finance and Administration • TAB 22 … Office of Information and Education Technology • TAB 23 … Office of General Counsel • TAB 24 … Henry M. Jackson Foundation for the Advancement of Military Medicine • TAB 25 … F. Edward Hébert School of Medicine • TAB 26 … Daniel K. Inouye Graduate School of Nursing • TAB 27 … Postgraduate Dental College • TAB 28 … College of Allied Health Sciences • TAB 29 ... Supplement (GSN) • TAB 30 ... Supplement (CAHS) TAB 1 Charter Charter Board of Regents, Uniformed Services University of the Health Sciences

1. Committee’s Official Designation: The Committee will be known as the Board of Regents, Uniformed Services University of the Health Sciences (“the Board”).

2. Authority: The Secretary of Defense, pursuant to 10 U.S.C. § 2113a and in accordance with the Federal Advisory Committee Act (FACA) (5 U.S.C., Appendix) and 41 C.F.R. § 102-3.50(a), established this non-discretionary Board.

3. Objectives and Scope of Activities: The Board shall assist the Secretary of Defense in an advisory capacity in carrying out the Secretary’s responsibility to conduct the business of the Uniformed Services University of the Health Sciences (“the University”).

4. Description of Duties: The Board shall provide advice and recommendations on academic and administrative matters critical to the full accreditation and successful operation of the University.

5. Agency or Official to Whom the Committee Reports: The Board reports to the Secretary of Defense and the Deputy Secretary of Defense, through the Under Secretary of Defense for Personnel and Readiness (USD(P&R)), who may act upon the Board’s advice and recommendations.

6. Support: The Department of Defense (DoD), through the Office of the USD(P&R), provides the necessary support for the Board and ensures compliance with the requirements of the FACA, the Government in the Sunshine Act of 1976 (5 U.S.C. § 552b) (“the Sunshine Act”), governing Federal statutes and regulations, and established DoD policies and procedures.

7. Estimated Annual Operating Costs and Staff Years: The estimated annual operating cost, to include travel, meetings, and contract support, is approximately $252,279.00. The estimated annual personnel cost to the DoD is 1.3 full-time equivalents.

8. Designated Federal Officer: The Board's Designated Federal Officer (DFO), pursuant to DoD policy, shall be a full-time or permanent part-time DoD officer or employee designated in accordance with DoD policies and procedures.

The Board's DFO is required to be in attendance at all Board and subcommittee meetings for the entire duration of each and every meeting. However, in the absence of the Board’s DFO, a properly approved Alternate DFO, duly designated to the Board in accordance with DoD policies and procedures, shall attend the entire duration of all Board or subcommittee meetings.

The DFO, or the Alternate DFO, calls all Board meetings; prepares and approves all meeting agendas; and adjourns any meeting when the DFO, or the Alternate DFO, determines adjournment to be in the public interest or required by governing regulations or DoD policies and procedures.

9. Estimated Number and Frequency of Meetings: The Board meets at the call of the Board’s DFO, in consultation with the Board’s Chair. The Board shall meet at least once a quarter.

10. Duration: The need for this advisory function is on a continuing basis; however, this charter is subject to renewal every two years.

1 Charter Board of Regents, Uniformed Services University of the Health Sciences

11. Termination: The Board terminates upon rescission of 10 U.S.C. § 2113a.

12. Membership and Designation: Pursuant to 10 U.S.C. § 2113a(b), the Board shall be composed of 15 members, appointed or designated as follows:

a. nine persons outstanding in the fields of health care, higher education administration, or public policy, who shall be appointed from civilian life by the DoD Appointing Authorities;

b. the Secretary of Defense, or his or her designee, who shall be an ex-officio member;

c. the Surgeons General of the Uniformed Services, who shall be ex-officio members; and

d. the President of the University, who shall be a non-voting, ex-officio member.

As directed by 10 U.S.C. § 2113a(c), the term of office of each member of the Board (other than ex- officio members) shall be six years except that:

a. any member appointed to fill a vacancy occurring before the expiration of the term for which his or her predecessor was appointed shall be appointed for the remainder of such term; and,

b. any member whose term of office has expired shall continue to serve until his or her successor is appointed.

In accordance with 10 U.S.C. § 2113a(d), one of the members of the Board (other than an ex- officio member) shall be designated as Chair by the DoD Appointing Authorities and shall be the presiding officer of the Board.

Board members who are not ex-officio members shall be appointed by the DoD Appointing Authorities, and their appointments will be renewed on an annual basis according to DoD policies and procedures. No member, unless approved by the DoD Appointing Authorities, may serve more than two consecutive terms of service on the Board, to include its subcommittees, or serve on more than two DoD federal advisory committees at one time.

Members of the Board who are not full-time or permanent part-time Federal officers or employees will be appointed as experts or consultants, pursuant to 5 U.S.C. § 3109, to serve as special government employee (SGE) members. Board members who are full-time or permanent part-time Federal officers or employees will be appointed, pursuant to 41 C.F.R. § 102-3.130(a), to serve as regular government employee (RGE) members.

All members of the Board are appointed to provide advice on the basis of their best judgment without representing any particular point of view and in a manner that is free from conflict of interest.

Pursuant to 10 U.S.C. § 2113a(e), Board members (other than ex-officio members), while attending conferences or meetings or while otherwise performing their duties as members, shall be entitled to receive compensation at a rate to be fixed by the Secretary of Defense. Each member is reimbursed

2 Charter Board of Regents, Uniformed Services University of the Health Sciences

for travel and per diem as it pertains to official business of the Board.

13. Subcommittees: The DoD, when necessary and consistent with the Board’s mission and DoD policies and procedures, may establish subcommittees, task forces, or working groups to support the Board. Establishment of subcommittees will be based upon a written determination, to include terms of reference, by the DoD Appointing Authorities or the USD(P&R) as the Board’s Sponsor. All subcommittees operate under the provisions of the FACA, the Sunshine Act, governing Federal statutes and regulations, and DoD policies and procedures.

Such subcommittees shall not work independently of the Board and shall report all their recommendations and advice solely to the Board for its thorough discussion and deliberation at a properly noticed and open meeting, subject to the Government in the Sunshine Act. Subcommittees, task forces, or working groups have no authority to make decisions and recommendations, verbally or in writing, on behalf of the Board. Neither the subcommittee nor any of its members may provide updates or reports directly to the DoD or any Federal officer or employee. If a majority of Board members are appointed to a particular subcommittee, then that subcommittee may be required to operate pursuant to the same notice and openness requirements of the FACA which govern the Board’s operations.

The appointment of individuals to serve on Board subcommittees shall be approved by the DoD Appointing Authorities for a term of service of one-to-four years, with annual renewals, in accordance with DoD policy and procedures. No member shall serve more than two consecutive terms of service on the subcommittee without prior approval from the DoD Appointing Authorities. Subcommittee members, if not full-time or permanent part-time Federal officers or employees, shall be appointed as an expert or consultant pursuant to 5 U.S.C. § 3109 to serve as an SGE member. Subcommittee members who are full-time or permanent part-time Federal officers or employees shall be appointed pursuant to 41 C.F.R. § 102-3.130(a) to serve as an RGE member.

Each subcommittee member is appointment to provide advice on the basis of his or her best judgment without representing any particular point of view and in a manner that is free from conflict of interest.

All subcommittees operate under the provisions of FACA, the Sunshine Act, governing Federal statutes and regulations, and established DoD policies and procedures.

Individuals who are appointed as subcommittee leaders in accordance with DoD policy shall serve a one-to-two year term of service, with annual renewal, provided the leadership term of service does not exceed the member’s approved subcommittee appointment.

14. Recordkeeping: The records of the Board and its subcommittees shall be managed in according with General Record Schedule 6.2, Federal Advisory Committee Records, or other approved agency records disposition schedule, and the appropriate DoD policies and procedures. These records will be available for public inspection and copying, subject to the Freedom of Information Act of 1966 (5 U.S.C. § 552, as amended).

15. Filing Date: May 2, 2019

3 TAB 2 Membership Balance Plan Membership Balance Plan Board of Regents, Uniformed Services University of the Health Sciences

Agency: Department of Defense (DoD)

1. Authority: The Secretary of Defense, pursuant to 10 U.S.C. § 2113a and in accordance with the Federal Advisory Committee Act (FACA) (5 U.S.C., Appendix) and 41 C.F.R. § 102-3.50(a), established the non-discretionary Board of Regents, Uniformed Services University of the Health Sciences (“the Board”).

2. Mission/Function: The Board shall assist the Secretary of Defense in an advisory capacity in carrying out the Secretary’s responsibility to conduct the business of the Uniformed Services University of the Health Sciences (“the University”). The Board shall provide advice and recommendations on academic and administrative matters critical to the full accreditation and successful operation of the University.

3. Points of View: Pursuant to 10 U.S.C. § 2113a(b), the Board shall be composed of 15 members, appointed or designated as follows:

a. nine persons outstanding in the fields of health care, higher education administration, or public policy, who shall be appointed from civilian life by the DoD Appointing Authorities;

b. the Secretary of Defense, or his or her designee, who shall be an ex-officio member;

c. the Surgeons General of the Uniformed Services, who shall be ex-officio members; and

d. the President of the University, who shall be a non-voting, ex-officio member.

Board members who are not ex-officio members shall be appointed by the DoD Appointing Authorities and their appointments will be renewed on an annual basis according to DoD policies and procedures. No member, unless approved by the DoD Appointing Authorities, may serve more than two consecutive terms of serve on the Board, to include its subcommittees, or serve on more than two DoD federal advisory committees at one time.

All members of the Board are appointed to provide advice on the basis of their best judgment without representing any particular point of view and in a manner that is free from conflict of interest.

The DoD has found that viewing the complex issues facing the Department through a multidisciplinary advisory committee provides the Department and, more importantly, the American public with a broader understanding of the issues on which to base subsequent policy decisions.

4. Other Balance Factors: NA

1 Membership Balance Plan Board of Regents, Uniformed Services University of the Health Sciences

5. Candidate Identification Process: The DoD, in selecting potential candidates for the Board, reviews the educational and professional credentials of individuals with extensive professional experience in the areas of health care, higher education administration, or public policy.

The Designated Federal Officer (DFO), in consultation with the Office of the Assistant Secretary of Defense for Health Affairs (ASD(HA)), and their professional staffs, as well as through recommendations by current members of the Board. The DFO, consulting with the ASD(HA), reviews the credentials of each individual and narrows the list of potential candidates. During the review, he or she strives to achieve a balance between the educational and professional credentials of the individuals and the subject matter likely to be reviewed by the Board. The ASD(HA), based on the approval of the Secretary of Defense, is the Secretary of Defense representative to the Board.

After the list of candidates has been narrowed, it is forwarded to the USD(P&R) for further scrutiny and formal nomination to the Secretary of Defense, the Deputy Secretary of Defense, and/or the Committee Management Officer for the Department of Defense (CMO) (“DoD Appointing Authorities”). Once the USD(P&R) has narrowed the list of candidates and before formal nomination to the Appointing Authorities, the list will undergo a review by the DoD Office of the General Counsel and the Advisory Committee Management Officer (ACMO) to ensure compliance with the Board’s statute, charter, and membership balance plan. Following this review, the ACMO forwards the list of potential nominees for approval by the DoD Appointing Authorities.

The DoD Appointing Authorities shall approve the appointment of members to the Board (other than ex-officio members) for a six-year term of service, except those Board members appointed to fill a vacancy occurring before the expiration of the term for which the predecessor was appointed shall be appointed for the remainder of such term. Any Board member whose term of office has expired shall continue to serve until the successor is appointed. No member may serve more than two consecutive terms of service without approval from the DoD Appointing Authorities.

Following approval by the DoD Appointment Authorities, the candidates are required to complete the necessary appointment paperwork, to include meeting ethics requirements stipulated by the Office of Government Ethics for advisory committee members. All appointment paperwork must be submitted to the appropriate DoD offices and processed at the earliest opportunity in accordance with DoD policy and procedures. If the required paperwork is not processed in accordance with DoD policy and procedures, the member will not be able to participate in any Board-related work or deliberation until all of his or her appointment processing actions are completed.

Membership vacancies for the Board and any subcommittees will be filled in the same manner as described in this section.

6. Subcommittee Balance: The DoD, when necessary and consistent with the Board’s mission and DoD policies and procedures, may establish subcommittees, task forces, or working groups to support the Board.

Individuals considered for appointment to any subcommittee of the Board may come from the Board itself or from new nominees, as recommended by the USD(P&R) and based upon the subject matters

2 Membership Balance Plan Board of Regents, Uniformed Services University of the Health Sciences

under consideration. Pursuant to DoD policy and procedures, the USD(P&R) shall follow the same procedures used for selecting and nominating individuals for appointment consideration by the DoD Appointing Authorities.

Subcommittee members will be appointed for a term of service of one-to-four years, subject to annual renewals; however, no member will serve more than two consecutive terms of service on the subcommittee unless previously authorized by the DoD Appointing Authorities. Subcommittee members, if not full-time or permanent part-time Federal officers or employees, shall be appointed as experts or consultants pursuant to 5 U.S.C. § 3109 to serve as SGE members. Subcommittee members, if not full-time or permanent part-time Federal officers or employees shall serve as RGE members pursuant to 41 C.F.R. § 102-3.130(a).

7. Other: As nominees are considered for appointment to the Board, the DoD adheres to the Office of Management and Budget’s Revised Guidance on Appointment of Lobbyists to Federal Committees, Boards, and Commissions (79 FR 47482; August 13, 2014) and the rules and regulations issued by the Office of Government Ethics.

8. Date Prepared/Updated: May 2, 2019

3 TAB 3 Bylaws

TAB 4 Current Membership BOARD OF REGENTS UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES

CURRENT MEMBERSHIP

NAME TITLE TERM EXP Ronald R. Blanck, D.O. Member, Board of Regents June 20, 2019c Honorable Sheila P. Burke, R.N., M.P.A. Member, Board of Regents July 19, 2023c GEN Richard Cody, USA, Ret Member, Board of Regents November 4, 2025 Michael M.E. Johns, M.D. Member, Board of Regents June 20, 2019c Kenneth P. Moritsugu, M.D., M.P.H. Member, Board of Regents June 20, 2019c Honorable Charles S. Robb, J.D. Member, Board of Regents November 4, 2021b Leo E. Rouse, D.D.S. Member, Board of Regents May 13, 2021b Honorable Gail R. Wilensky, Ph.D. Member, Board of Regents June 20, 2019a Honorable Jonathan Woodson, M.D. Chair, Board of Regents June 20, 2025b Thomas P. McCaffery, M.P.P. Secretary of Defense Designee and Ex Officio Assistant Secretary of Defense for Health Affairs* Richard W. Thomas, M.D., D.D.S. President, USU** Ex Officio LTG Raymond S. Dingle, MS, USA Surgeon General, United States Army Ex Officio VADM C. Forrest Faison, MC, USN Surgeon General, United States Navy Ex Officio Lt Gen Dorothy A. Hogg, USAF, NC Surgeon General, United States Air Force Ex Officio VADM Jerome M. Adams, USPHS Surgeon General of the United States Ex Officio

Gen Thomas R. Morgan, USMC (Ret) Military Advisor to the Board Advisor LTG Ronald J. Place, MC, USA Director, Defense Health Agency Advisor Brig Gen Paul Friedrichs, USAF, MC Joint Staff Surgeon Advisor RDML James L. Hancock, MC, USN Medical Officer of the Marine Corps Advisor Brig Gen Anita L. Fligge, USAF, NC Director, National Capital Region Advisor Medical Directorate COL Andrew Barr, MC, USA Director, Walter Reed National Military Advisor Medical Center Thomas W. Travis, M.D., M.P.H. Senior Vice President, Southern Region Advisor William M. Roberts, M.D., M.B.A. Senior Vice President, Western Region Advisor Arthur L. Kellermann, M.D., M.P.H. Dean, F. Edward Hébert School of Advisor Carol A. Romano, Ph.D., R.N. Medicine Dean, Daniel K. Inouye Graduate Advisor School of Nursing Thomas R. Schneid, D.M.D., M.S. Executive Dean, Postgraduate Dental College Advisor Mitchell J. Seal, Ed.D., R.N. Dean, College of Allied Health Sciences Advisor CAPT John R. Gilstad, MC, USN Director, Armed Forces Radiobiology Advisor Research Institute Mark E. Peterson, J.D. Legal Advisor to the Board of Advisor Jeffrey L. Longacre, M.D. Regents Executive Secretary Sarah Marshall Designated Federal Officer

a – currently serving predecessor’s term; b – currently serving first term; c – currently serving second term *The Secretary of Defense or designee is by statute an ex officio member. **The President, USU is a non-voting ex officio member as defined by statute. TAB 5 Board Meeting Calendar Board of Regents, Uniformed Services University of the Health Sciences

Board Meeting Calendar (2019-2020)

*Note: all meetings will occur at USU Bethesda Campus unless stated otherwise

Preparatory Session Meeting of Record Monday, February 3, 2020 Tuesday, February 4, 2020 Thursday, May 14, 2020 Friday, May 15, 2020 Monday, August 3, 2020 Tuesday, August 4, 2020 Monday, November 2, 2020 Tuesday, November 3, 2020

• Saturday, May 16, 2020 – Class of 2020 Commencement

Faculty Packet Due Dates (2019-2020)

*Note: packets not received by due date will not be presented at Board meeting

Meeting of Record Faculty Packets Due to CHR February 4, 2020 December 23, 2019 May 15, 2020 April 3, 2020 August 4, 2020 June 23, 2020 November 3, 2020 September 22, 2020

November 2019 TAB 6 Closed Session Determination

TAB 7 Federal Register Notice

TAB 8 Chair’s Opening Comments Chair’s Opening Comments November 2019

• Welcome Regents, Advisors and Guests

• Board of Regents Member Change

o GEN (USA, Ret) Richard Cody

 Filling seat of GEN Ron Griffith

o Submissions for Regent Replacements (those timing out) pending early January

• Board Advisor Leadership Changes

o US Army Surgeon General

 LTG Raymond Scott Dingle, MS, USA

o US Navy Surgeon General

 TBD

o WRNMMC Director

 COL Andrew Barr, MC, USA

o NCRMD Director

 Brig Gen Anita Fligge, USAF, NC

o Joint Staff Surgeon

 Brig Gen Paul Friedrichs, USAF, MC

• Next Board Meeting – February 3-4, 2020

o Board Meeting Calendars at Tab 5

• Closed Session Meeting

o Board Self-Assessment TAB 9 Previous Meeting Minutes Minutes of the Board of Regents Uniformed Services University of the Health Sciences

Meeting No. 207 August 6, 2019

The Board of Regents (Board), Uniformed Services University of the Health Sciences (USU), met on August 6, 2019, at the Navy Lodge North Island Naval Air Station in San Diego, CA. The meeting date and agenda items were published in the Federal Register and each Regent was duly notified prior to the meeting. The Board Executive Secretary, Jeffrey L. Longacre, M.D., and the Designated Federal Officer (DFO), MAJ Joshua Barricklow, were both present during the entire meeting. The meeting was called to order by the DFO at 8:00 a.m. Members and advisors listed below were in attendance:

Board Members Ronald R. Blanck, D.O., Chair Michael M.E. Johns, M.D., Member (via telephone) Kenneth P. Moritsugu, M.D., M.P.H., Member Leo Rouse, D.D.S, Member (via telephone) Honorable Gail R. Wilensky, Ph.D., Member Honorable Thomas P. McCaffery, Assistant Secretary of Defense for Health Affairs, Secretary of Defense designee Richard W. Thomas, M.D., D.D.S., President, USU VADM C. Forrest Faison, MC, USN, Surgeon General of the U.S. Navy VADM Jerome Adams, USPHS, Surgeon General of the United States BG Michael Place, MC, USA, Representing the Surgeon General of the U.S. Army Maj Gen Sean Murphy, USAF, MC, Representing the Surgeon General of the U.S. Air Force

Advisors to the Board William M. Roberts, M.D., M.B.A., Senior Vice President, Western Region, USU Charles E. Potter, M.A., M.S.S., Representing the Senior Vice President, Southern Region, USU Yvonne Maddox, Ph.D., Vice President for Research (VPR), USU Arthur L. Kellermann, M.D., M.P.H., Dean, F. Edward Hébert School of Medicine (SOM), USU Diane Seibert, Ph.D., A.R.N.P., Representing the Dean, Daniel K. Inouye Graduate School of Nursing (GSN), USU Thomas R. Schneid, D.M.D., M.S., Executive Dean, Postgraduate Dental College (PDC), USU Dennis Kilian, M.S.P.H., Representing the Dean, College of Allied Health Sciences (CAHS), USU CAPT John Gilstad, MC, USN, Director, Armed Forces Radiobiology Research Institute (AFRRI), USU Mark Peterson, J.D., Legal Advisor to the Board, USU

OPENING COMMENTS Chair Blanck welcomed the Board, Advisors and representatives to the USU Board meeting. The following points were included in his remarks: • HON McCaffery confirmed as ASD(HA) • MG(P) Ronald Place selected as incoming Director, DHA (VADM Bono retiring 3 SEP 2019) • COL Andrew Barr selected as incoming Director, Walter Reed National Military Medical Center • GEN Richard Cody approved as incoming Regent filling vacancy created by death of Regent (GEN) Ronald Griffith • Dr. Woodson officially approved as incoming USU Board of Regents Chair, replacing Dr. Blanck (who will remain a Board member until next year) • Next Board meeting 4-5 NOV 2019 on Bethesda campus

• Follow-up Board Issues o CAHS proposal for Joint Special Operations Medical Training Center collaboration (accredited EMT/Paramedic) still under review (assure resourcing available) o Conditional approvals of programs not desired by Board. Board will review when all requirements have been completed.

MATTERS OF GENERAL CONSENT Chair Blanck presented two matters of general consent: • Minutes of the May 2019 meeting at Tab 9 • Declaration of Board Actions (items electronically approved between the May 2019 meeting and this meeting) at Tab 10

Upon motion duly made and seconded, the Board Vote by voice vote: Approved the matters of general consent as presented by Chair Blanck.

BOARD ACTIONS Degree Conferral – SOM Graduate Education Dean Kellermann presented for endorsement ten degree candidates (Tab 11), six for the degree of Master of Science and four for the degree of Doctor of Philosophy.

Upon motion duly made and seconded, the Board Vote by voice vote: Concurred with the recommendations as presented by Dean Kellermann and recommended that the USU President confer the degrees as stated upon the ten candidates.

Degree Conferral – PDC Dean Schneid presented for Board endorsement four candidates for the degree of Master of Science in Oral Biology who have completed the academic requirements (Tab 12).

Upon motion duly made and seconded, the Board Vote by voice vote: Concurred with the recommendation as presented by Dean Schneid and recommended that the USU President confer the degree as stated upon the four candidates.

Degree Conferral – CAHS Associate Dean Kilian presented for Board endorsement candidates for the degree of Associate of Science in the Health Sciences and Bachelor of Health Sciences as noted in Tab 13. Two names have been stricken from the list by the respective Service (one stricken and one recycled). CAHS requests the authority to confer these degrees be delegated from the University President to the CAHS dean pending successful completion of academic requirements.

Upon motion duly made and seconded, the Board Vote by voice vote: Concurred with the recommendation of degree conferral as presented by Associate Dean Kilian with the caveat that the conferral of these degrees be delegated upon successful completion to the CAHS dean by the USU President.

Faculty Appointments and Promotions – SOM Dean Kellermann presented the recommendations made by the SOM Committee on Appointments, Promotion and Tenure at a meeting in June 2019 (Tab 14). Of note, one of the faculty listed is RDML James Hancock, a 1995 USU graduate, who is the 40th alumnus to attain general officer/flag officer rank.

Board of Regents, USU, August 6, 2019 Page 2/10

Upon motion duly made and seconded, the Board Vote by voice voted: Concurred with the recommendations as presented by Dean Kellermann and recommended that the USU President implement the actions for the faculty recommendations.

Faculty Appointments and Promotions – SOM Associate Dean Seibert presented the recommendations made by the GSN Committee on Appointments, Promotion and Tenure at a meeting on July 8, 2019 (Tab 15).

Upon motion duly made and seconded, the Board Vote by voice voted: Concurred with the recommendations as presented by Associate Dean Seibert and recommended that the USU President implement the actions for the faculty recommendations.

Faculty Appointments and Promotions – PDC Dean Schneid presented the recommendations made by the PDC Committee on Appointments, Promotion and Tenure at a meeting on June 26, 2019 (Tab 16).

Upon motion duly made and seconded, the Board Vote by voice voted: Concurred with the recommendations as presented by Dean Schneid and recommended that the USU President implement the actions for the faculty recommendations.

Faculty Appointments and Promotions – CAHS Associate Dean Kilian presented the recommendations made by the CAHS Committee on Appointments, Promotion and Tenure at a meeting on June 17, 2019 (Tab 17).

Upon motion duly made and seconded, the Board Vote by voice voted: Concurred with the recommendations as presented by Associate Dean Kilian and recommended that the USU President implement the actions for the faculty recommendations.

PRESIDENT’S REPORT The following points/updates were presented during President Thomas’ report to the Board: • Academic Health System legislative proposal continues to receive considerable support, to include professional staff members on the Hill. This initiative facilitates a cost-neutral, seamless mechanism to synergize support staffing and supervision of personnel within the entire National Capital Area to optimize medical education, research and clinical care. • Endowments legislative proposal resubmitted since it will likely not be approved this cycle. This proposal facilitates the university having authority to have access to no-year money for long-term planning. • New legislative proposal submitted to make the DHA Director a member of the USU Board of Regents. • Joint Education and Training Feasibility study still underway (projected completion 1 OCT 2019). Dr. Roberts and Dr. Nordholm (USU) participating in the Reform Management Work Group. • Analysis from Senior Strategy Group on the Military Training Network recommendations memo just signed by DHA Director. • Research and Development Feasibility study still underway. Essentially only one course of action that meets legislative intent (COA 5 where funds fall under the purview of DHA). Dr. Terry Rauch, Acting Deputy Assistant Secretary of Defense for Health Readiness and Policy Oversight (DASD HRPO), is the member representing the university vote. • Defense Health Command Report to Congress pending.

Board of Regents, USU, August 6, 2019 Page 3/10

• Analysis of the cost and value of military medical accessions by the Institute for Defense Analyses is nearing completion • Military manpower decrement remains on hold pending further analysis and assessment. Mr. McCaffery noted that there is Congressional language likely to come, but specifics not known. VADM Adams noted that the PHS is planning to increase the size of the Commissioned Corps in the event that providers are interested in shifting uniformed services. • DHA IG assessment of the USU-HJF relationship ongoing, in response to a DoD Hotline submission; suspense 1 OCT 2019. • USU Strategic Offsite this summer produced an updated Strategic Framework. It emphasizes the university’s ability to adapt in order to optimally support readiness and the warfighter, as well as the health and welfare of the military community. It emphasizes three strategic domains; Education, Research and Scholarship, Leadership and Leader Development, focusing on a series of strategic objectives that are measurable, concise, and focused on readiness. There is an explicit intent to nest the University Framework within the Services’ and MHS plans. • Office of Academic Support recently established to provide all components of the university with the necessary support to conduct their academic mission. It will include the Office of the Registrar, Learning Resource Center, Education Technology Innovation, Distance/Distributive Learning, Accreditation and Organizational Assessment, Photo/Video support, Academic Support policies, and others to be determined. Director currently being recruited with an Acting Director presently (Ms. Lorraine Breen). • Proposed GEN Ronald Griffith Institute for Military Medical Professionalism being created, to include the Defense Medical Center of Ethics, mandated from Health Affairs. This will incorporate a central office for medical ethics and professionalism for the MHS to tap into for information and guidance. Currently recruiting a bioethics faculty member, who will also be involved in the medical ethics curriculum for the medical students. MG Place asked if the intent of the Center/Institute is to include training for ethicists across the MTFs. • A catalyst for Building F is to decrease current off-base leasing expenditures. The 65% design phase is to be completed in approximately 3 months and “shovel ready” by spring 2020 with goal of FY21 award (single phase project). Environmental assessment in final draft. Presently consolidating university Centers at a single off-base location pending completion of Building F. NSAB Building 61 has become available and the university is looking at utilizing some of that space. San Antonio “South Beach” renovation project continues; it is currently vacant and next door to the present USU Campus South. • University Centers review underway. The intent is to review and ensure Center missions are relevant and supporting the Services. Review lead Col Todd Rasmussen. • MSCHE mid-cycle peer review underway. Next MSCHE site visit is March 2023 with a several- year preparation prior to 2023. Reviewed will include an additional 7 revised standards since last visit. With significant changes in the USU organization since 2013, e.g. PDC, CAHS, DL, Branch Campus, etc., a task map preparation timeline will be launched in Nov 2019 (next BOR meeting). • Fundamentals of Military Medicine text recently published by the Borden Institute. It is intended to fill a void for HPSP students and Residents new to the military, yet also being requested by active duty providers. It is being entertained as a foundation for a one-month distance learning elective to learn about military medicine and leadership.

MEMBER REPORTS – ACADEMICS SUMMARY Regent Moritsugu presented several highlights from the preparatory session. • School of Medicine: o LCME notified USU is fully compliant, full accreditation, with no additional status reports until the next review cycle. USU is the only medical school in the entire US that currently has full accreditation and no requirement for additional status reports.

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o Health Policy journal August edition devoted to military health, with numerous submissions included from USU faculty. o USU and WRNMMC received an expanded IND from the FDA to implement a new biomanufactured vascular graft that was inserted into a patient. o The SOM remains deeply concerned about how the potential MHS manpower cuts could dramatically decrease the number of staff and patients, degrading the learning environment for students and residents. o Dean Kellermann noted the second order effects of being over budget on the purchased care bill. Mr. McCaffery affirmed that the MHS is about $700M over budget, much of that includes “level setting” since last year there was under- execution and Congress removed $500M from the budget base. A reprogramming request has been submitted, effectively taking that deficit from the facility/procurement carryover. • Graduate School of Nursing o Education: GSN has been granted the maximum 10-year accreditation for both its Masters and Doctor of Nursing Practice programs. 100% of the 2019 of graduates passed board certification on first attempt. A new clinic rotation in Okinawa has been established. The Family Nurse Practitioner curriculum crosswalk has been completed to identify operational readiness components. o Operational Readiness: 24 students (GSN and SOM) attended the 7th iteration of the Dive Medicine Readiness Course in Key West. GSN hosted the Military Mountain Medicine Course at JBLM. Two faculty and four students participated in the USNS Mercy operational exercise in San Diego. In coordination with MEDCOM, GSN faculty were able to deploy in Psychiatric Mental Health Nurse Practitioner billets. o Leadership: LTC JoEllen Schimmels will be inducted as a fellow into the prestigious American Academy of Nursing. LTC Matthew D’Angelo has deployed for three months with the Special Operations community. The GSN currently has six administrative positions vacant. • Postgraduate Dental College o Degrees/Matriculations: 74 Master of Science in Oral Biology degrees recently conferred. A total of 469 MS degrees have been conferred since 2010. 74 Air Force General Dentistry Program Certificates were distributed. 78 new MS students entered training. First time ever, all 3 Services One-year General Dentistry Certificate Programs are affiliated with the PDC (52 Army, 47 Navy, 65 Air Force matriculates). o Plans underway for the PDC (faculty and residents) to participate in the interprofessional USU Military Contingency Medicine Course and Field Practicum (101). o Research: Maj Timothy Carlson, 2019 PDC graduate, finished first in the LSU School of Dentistry research competition. • College of Allied Health Sciences o Metrics: Enrollment has exceeded over 800 (rolling admission, with actual number closer to 1300) in 8 programs, supported by more than 200 faculty in 4 locations. CAHS continues as a charter member of the DoD Credentialing Task Force. o New Programs: Three new programs are presented for endorsement; Cytology Technician (Army), Occupational Therapy Assistant (Army and Navy) and Radiology Technician (Army, Navy, and Air Force). Concerns were raised about the number and types of programs being subsumed by CAHS. The discussion focused on the importance of maintaining quality and academic rigor in granting academic credit for additional programs. President Thomas noted that a very involved process has been put in place for a comprehensive review of each new program from any school. Chair Blanck noted that these three programs have completed all steps in this newly developed university process. Associate Dean Kilian noted all programs are funded.

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Upon motion duly made and seconded, the Board Vote by voice vote: Concurred with the recommendation as presented by Regent Moritsugu that these three additional CAHS programs be endorsed.

• Chair Blanck noted that the Board materials reference additional programs (p. 148 para 3) being explored for inclusion within the CAHS. Some may come to the Board for approval, some may not following the comprehensive review of each. He also noted a memo (p. 167) from the METC Commander asking the DHA if the university would absorb additional programs. • MG Place recommended that a process be put in place to assess the retention of these individuals to best determine the return of investment on this population. President Thomas noted the value of the SOM Long-term Career Outcome Study (LTCOS) and how that might incorporate the CAHS data to address this issue.

MEMBER REPORTS – FINANCE AND ADMINISTRATION SUMMARY Regent Blanck provided the following highlights from the preparatory session: • Research (Tab 23) o Research awards at USU have increased from $311.2M to $809.9M over the past 9 years, to include NIH grants. Dr. Maddox noted the associated need for increased staffing to meet the load of administering increased awards. o A comprehensive student research program (8 weeks over the summer) for high school and college students has been established, currently having 20 participants. o A new peer-review process has been developed that utilizes individuals who are not involved in the research itself with more rigorous guidelines o Laboratory Animal Medicine moving to AFRRI (Aug 2020) while renovation occurs at USU o Suicide initiative that USU co-chairs, DoD Suicide Research Strategy Initiative Working Group (VA lead). VADM Adams emphasized the importance of suicide prevention and the importance of addressing the issue by coordinating efforts within all federal agencies, rather than have uncoordinated efforts. He asked if there was specific training in the USU curriculum on this topic and Dean Kellermann assured him there was. Dr. Maddox noted the importance of approaching this with longitudinal studies (civilian, DoD, VA). DASD HRPO has initiated a Suicide Prevention Strategic Plan, of which USU is an active participant. • Finance and Administration o As of 30 June, 75% of O&M budget executed; on target for remainder of fiscal year o Ongoing IG Assessment reviewing the USU-HJF financial relationship; report scheduled to be completed in OCT 2019. o From 2004-2018, USU funding has increased $2.6B, nearly all of it from research (base funding has not increased). o For 2025 POM, Congress authorized pay raises, but DoD did not provide the funding, thus USU needed to find $20M to fund those raises. o HPSP program under-executed its budget allocation for the last several years and that delta was taken for the subsequent years. The reduced allocation was spread across all sources, to include USU, to the amount of $20M over the next 5 years. o USU has received numerous new missions, many of which have been mandated, many have been unfunded. USU is looking at reprogramming $60M over the next 5 years.

Board of Regents, USU, August 6, 2019 Page 6/10

Chair Blanck called for a 15-minute break.

Break 9:26am

Chair Blanck reconvened the meeting.

ASSISTANT SECRETARY OF DEFENSE REPORT (AD HOC) Mr. McCaffery volunteered to present some of the activities and developments in his sphere. NDAA 17, Sec 702, regarding oversight and management of MTFs, is moving the transition approach from a geographic/time-based implementation, to where DHA will have authority, direction, and control of all CONUS MTFs on OCT 1, where each of the Services provide direct support and DHA stands up a headquarters. Functional capabilities will transfer in a conditions-based manner. This is the best option to manage risk. MHS owes Department leadership a description of those conditions. Secretary Esper has asked for a focused discussion on this topic. NDAA 17, Sec 703, regarding an assessment of the direct care system addressing the needs of active duty medical readiness of Service members and the quality training of the active duty medical providers. Based on workload data and civilian sector capabilities, 73 MTFs were reviewed (‘use cases’) and recommendations are pending (the recommendation for each MTF will span the spectrum from no change, consolidation, to downsizing). The MHS is strategizing the proposed military manpower reduction implementation with the Services and DHA. About 4,000 of the 18,000 billets are authorized but vacant billets. Those would be the first billets to repurpose. There will be some areas where there is not a good mitigation strategy, e.g. a market that does not have the capability to absorb the patient load, providers cannot be hired, etc. The ASD (HA) appreciates that there is concern by prospective providers, to include those in GME. He notes there will be changes, but he projects the MHS will provide the full range of training, but the amount of various specialty slots may change. MHS leadership believes more than ever there will need to be cooperation and collaboration between USU, DHA, and the Services since it will need to remain an integrated system. MG Place noted the proposed transition over 2-3 years (in contrast to the original proposal of 4 years) could be more painful. The focus will be on attrition, to include the vacant billets. VADM Faison noted the challenge regarding attrition, the key being to keep those who the Services want to keep. Also, he noted that certain specialty skills cannot be drastically cut, e.g. radiation health, where loss of a significant number cripples the medical capability to the fleet. Maj Gen Murphy noted the Air Force currently has the capability with the resource cuts to cover the active duty medical mission. The Air Force issue of concern is whether DHA will have the resources to cover the dependent and retiree requirement. Dean Kellermann suggested a ‘summit’ of military healthcare leaders to come up with options to avoid sending patients to the civilian network, since that increases purchased care costs and deprives providers from patients to maintain currency, and deprives trainees of case exposure to learn. Mr. McCaffery noted it was something to consider. Mr. McCaffery agreed that an emphasis should be to channel acuity and volume into key platforms to foster medical readiness, which includes pursuing partnerships within the market, i.e., civilian entities, VA, etc. Mr. McCaffery noted that the enterprise still needs to be able to determine the “go to war” requirements. VADM Adams noted that an assessment of each individual market capability is necessary.

USU SOUTHERN REGION REPORT Mr. Potter, Chief of Staff, Southern Region presented the report (Tab 25): • METC Board of Directors, through the Services (General Officers compose that Board), propose to CAHS what programs they would like us to consider absorbing. Since CAHS can do it more efficiently, the Services/DHA save money (they no longer need to pay a civilian institution for the degree/certificate). They asked CAHS to look at 16 programs that currently

Board of Regents, USU, August 6, 2019 Page 7/10

have arrangements with other academic institutions (phase 1). Another list showed an additional 31 programs for review, of which they do not yet have arrangements with other academic organizations (phase 2). Finally, phase 3 would be for the university to assume the “Big 3,” the Combat Medic (Army), the Hospital Corpsmen Basic (Navy), and the Aeromedical Services Apprenticeship (Air Force), the bolus of 17,000 students that go through METC annually. USU (Dean CAHS and VFA) determined that the average cost to the Services/METC of $150/student (in contrast to several thousands with civilian institutions), and an additional $100,000 for additional 40,000 semester hours to bring on support staff, advisors, etc. AMEDD C&S and METC conveyed that this would save them considerable money. METC has thus far provided the university $122,000 and plans on providing an additional $470,000 for next year. USU has developed a POM for $3M annually to assume the remaining programs. • South Beach Pavilion will revert back the military base at no cost on Dec 2021. The current lease of the real estate that the university is in now will expire in 2023. If USU was to buy it, the cost is currently at $990,000 (we disagree with that number since we renovated and furnished it). Discussions continue.

USU WESTERN REGION REPORT Dr. Roberts provided a summary of highlights (Tab 26): • Indo-Pacific Research Alliance for Military Medicine (IPRAMM) membership agreed to expand membership, to include; Health Affairs, VA, and DHA. Dr. Roberts and Dr. Maddox agreed during the report that the PHS should be included in the membership. VADM Adams accepted. The next meeting is scheduled in October in San Diego, including a suicide prevention breakout. • Education and Training Feasibility Study group is reviewing current drafts of the report. Previous drafts reveal COAs that align USU under the DHA, with which the University does not agree. President Thomas noted that for him and the HASC and SASC PSMs, this approach is a non-starter, in large part due to accreditation concerns. Mr. McCaffery noted that he has not received any of the numerous reports due, so the MHS is not near the point of a decision on any of them.

ARMED FORCES RADIOBIOLOGY RESEARCH INSTITUTE REPORT CAPT John Gilstad provided a highlight summary (Tab 27): • With the potential of nuclear weapon detonation in future conflict, AFRRI is posed to be ready for such a possibility in its education, research, and operational response roles. • Research Plan o Medical readiness for the nuclear environment. In addition to the previous focus on countermeasures, there will be a focus on combined injury and sublethal, prolonged exposed. This focus emphasizes readiness. A research plan has now been developed so that researchers will focus on those areas. A period of transition will occur getting the appropriately trained and focused researchers. . Current project underway with Department of Surgery to look at hemorrhagic shock resuscitation in the presence of radiation injury. . Current project with CSTS and NHRC is to investigate the psychological effects when a dosimeter is in use to see the amount of radiation exposure. • Resources Outlook o AFRRI has initiated discussion with DASD HRPO to obtain additional funding. o A capability-based assessment is underway in the JCIDS process, in an attempt to justify this new research focus and direction • Reactor Status

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o The reactor is functioning but not licensed to operate. License amendment is due for the totally digital console (only 2nd in the US to do so). Working with Purdue, the other such digital console in the US, to accomplish licensure. o President Thomas noted that USFK leadership was appreciative of the recent contributions and capabilities to the COCOM at a recent site visit.

BRIGADE REPORT CAPT Sean Hussey provided highlights of his report (Tab 28): • Key Brigade initiatives align with the university’s vision. A Commander’s Planning Document is forthcoming. o Leadership Development. Formalized programs with monthly meetings on how to define and improve future MHS leadership. Organic and outside subject matter expert speakers, staff rides to National Museum of Health, Pentagon (potential Service Chiefs) to connect Service members with their culture and readiness focus. o Reorganization of the Brigade structure that resembles what is found in operational staffs of line commands. An Operations Section is being developed (operations officer and civilian deputy with 6 enlisted members), to assume the roles of primary tasking authority for internal and external support. Personnel already at the university, but not centralized in the Brigade will be shifted (S4 individual from MEM, S6 individual from CIO, S8 from VFA). Goal is to more effectively support the university with this structure, expected to be in place in a few months. o Staff and enlisted training previously focused on getting them trained up as teachers, but overlooking their individual career training. Ops Cell has assumed this role to get training to ensure that they are competitive for positions and promotions (sent 36 people to 14 service schools). Brigade has also assumed the role of summer operational experiences for medical students, focusing on an operational experience more so than medical. o Command Climate Survey results to be presented at the next Board meeting. o President Thomas asked the University Chief of Staff, Mr. Robert Thompson, to provide an update on the university manpower analysis. Started in 2014, with the assistance of USAMAA, manpower requirements have been developed that are validated. The next step is how to allocate and develop authorizations. A manpower office has been established at the university to develop a joint table of distribution to present to the Services. President Thomas thanked the Services for the outstanding personnel they have historically provided to fill the billets. Chair Blanck asked when the Board would receive a formal briefing on this. President Thomas noted it would be ready for the next Board meeting.

OFFICE OF EXTERNAL AFFAIRS REPORT Dr. Longacre provided highlights of his report (Tab 29): • External Affairs o Presidential Leadership Series huge success o Numerous visiting delegations interested in hearing about the university and potential collaboration • Alumni Affairs o COL Drew Morgan currently on the International Space Station. He has a USU bioprinter there in zero gravity for testing. USU is testing the 4D bioprinter (prints tissue) in several austere environments (space and desert currently). • Freedom of Information Act o No recent patterns of increase or trends

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• Gift Acceptance o No recent increases in numbers or change in patterns (majority is event catering) • Publication/Presentation Clearances o Increased again this past year from 1500 to 1900 to 2100 in the past three years o Discussion underway with VPR to develop a system to assess not only the quantity of clearance submissions, but the impact of those eventually published. • Internet/Intranet o University evolving with technology. Intranet being developed for the day-to-day working resources, separate from the external-facing Internet. This compartmentalization makes navigating the USU website more efficient so that external stakeholders (students, researchers, DoD, Congress) do not get bogged down on pages that will now be separated into an Intranet site. • Social Media o Many of our stakeholders are now using handheld devices for USU interaction. The University is making great progress interacting with stakeholders through Twitter, Facebook, Pulse blog, etc.

• VADM Adams commented on the importance on engaging the public on gun safety. There is a gap in educating the public on what the DoD and PHS are doing in educating on gun safety. • Sharon Holland, Deputy Vice President External Affairs, will be leaving end of year. External Affairs will need to undergo a reorganization with her departure.

CLOSING REMARKS • GEN Cody has been approved as the newest Board of Regents member.

ADJOURNMENT Chair Blanck then adjourned the open portion of the meeting at 11:00 am.

SUBMITTED: APPROVED:

______Jeffrey L. Longacre, M.D. Ronald R. Blanck, D.O. Chair, Executive Secretary, Board of Regents Board of Regents

Prepared by: Jeffrey Longacre, MD Executive Secretary

Board of Regents, USU, August 6, 2019 Page 10/10 TAB 10 Declaration of Board Actions

TAB 11 Degree Conferrals Hébert School of Medicine UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu October 2, 2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR: PRESIDENT, USUHS

THROUGH: CHAI~OARD OF REGENTSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

THROUGH:DE~J~E

SUBJECT: Conferral of Graduate Degrees

The following Graduate Education students are scheduled to complete their respective programs on November 5, 2019 and have met all the academic requirements for graduation. The Associate Dean requests that the President, USUHS, award the following students their respective Master of Science and Doctor of Philosophy degrees.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Master of Science candidates:

Larissa Leigh Tate, Department of Medical and Clinical Psychology Kevin M. Wilfong, Department of Medical and Clinical Psychology

Doctor of Philosophy candidates:

Peter J. Attilio, Neuroscience Graduate Program John R. Reed, Neuroscience Graduate Program Sade Soares, Department of Medical and Clinical Psychology Philip J. Spreadborough, Molecular and Cell Biology Graduate Program William G. Valiant, Emerging Infectious Diseases Graduate Program Caitlin L. Williams, Emerging Infectious Diseases Graduate Program

Saibal Dey, PhD Associate Dean for Graduate Education

Approved / Not Approved

Richard W. Thomas, MD, DDS, FACS President

Learning to Carefor Thosein Harms 1#zy UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2, 2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUMFORRICHARDW.THOMAS,MD,DDS,FACS,PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Master of Science degree effective upon your approval:

Larissa Leigh Tate

MASTER OF SCIENCE

Department of Medical and Clinical Psychology

Attached is the candidate's Thesis Approval Form. Also attached are the certification of authorized use of Copyrighted materials, Thesis Title Page, Thesis Abstract, and Curriculum Vitae.

Arthur L. Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Care forzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAThose in Harm'szyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAUizy

. ------UNIFORMED SERVICES UNIVERSITY, SCHOOL OF MEDICINE GRADUATEPROGRAMS Graduate Education Office (A 1045),4301 Jones Bridge Road, Bethesda, MD 20814

September 9,2019

APPROVAL SHEET

Title of Dissertation: The Effect of Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder on Cognitive Performance and Social Functioning among Treatment- Seeking Active Duty US Service Members

Name of Candidate: Larissa Leigh Tate, Master of Science in Clinical PsychologyzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

09/20/2019

THESIS AND ABSTRACT APPROVED:

DATE:

Dr. Davi Ri , PhD DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY ~~~~~ee Chairperson W~/ c· --~ 9S:;~o!C) Dr. David~hD DEPARTMENT OF MEDICAL AND CLINCIAL PSYCHOLOGY Thesis Advisor

~~ s, D1 5"1' ]-D\~ D~ ne Bennion, PhD DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY Committee Member ~/ ~f( D¢. Joshua Gray, PhD DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY Committee Member

Saibal Dey, Ph.D., Associate Dean II www.usuhs.mil/graded II [email protected] Toll Free: 800-772-1747 II Commercial: 301-295-3913 / 9474 II DSN: 295-9474 The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled:

"The Effect of Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder on Cognitive Performance and Social Functioning among Treatment-Seeking Active Duty US Service Members" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

I Larissa Leigh" ate I Department of Medical and Clinical Psychology Uniformed Services University 11105/2019 The Effect of Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder on

Cognitive Performance and Social Functioning among Treatment-Seeking

Active Duty US Service Members

Larissa Leigh Tate

Thesis submitted to the Faculty of the Medical and Clinical Psychology Graduate Program Uniformed Services University of the Health Sciences in partial fulfilment of requirements for the degree of Master of Science, 2019 ABSTRACT

The Effect of Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder on

Cognitive Performance and Social Functioning among Treatment-Seeking Active Duty

US Service Members:

Larissa Leigh Tate, Master of Science, 2019

Thesis directed by: David S. Riggs, PhD, Department of Medical and Clinical

Psychology

TBI and PTSD have been labeled "signature wounds" of the conflicts in Iraq and

Afghanistan and can result in considerable distress for a significant number of service members. Despite their frequent comorbidity and overlapping symptoms, there is a dearth of knowledge regarding the combined effects ofTBI and PTSD on cognitive performance as well as how they impact social functioning. The present study first examined potentially synergistic effects of comorbid TBI and PTSD symptoms on cognitive performance in a sample of treatment-seeking service members with PTSD symptoms and/or TBI. While service members in the TBl-only, PTSD symptoms-only, and comorbid groups performed significantly below average compared to norms in regards to cognitive performance, service members with TBI-only did not significantly differ from those with PTSD symptoms-only. However, individuals with both TBI and PTSD symptoms performed worse than those with either condition alone. The study further

v explored the contributions of cognitive performance, neurobehavioral symptoms, and emotional distress on social functioning in a subsample of these service members. Results indicated a significant predictive relationship among cognitive performance, neurobehavioral symptoms, and emotional distress on social functioning. Additionally, neurobehavioral symptoms were found to completely mediate the relationship between emotional distress and social functioning. Findings highlight the importance of the symptom relationships between TBI and PTSD.

-zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA------LARISSA LEIGH (YASHKO) TATEzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 4301 JONES BRIDGE ROAD· BETHESDA, MD 20814 239.961.2755 [email protected] EDUCATION Aug 2017 - Present DOCTOR OF PHILOSOPHY, MEDICAL AND CLINICAL PSYCHOLOGY, Expected August 2022zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Uniformed Services University of the Health Sciences· Bethesda, Maryland

Aug 2015 - Dec 2016 MASTER OF PROFESSIONAL STUDIES, CLINICAL PSYCHOLOGICAL SCIENCE University of Maryland· College Park, Maryland

Aug 2011- May 2015 BACHELOR OFARTS,PSYCHOLOGY Hillsdale College· Hillsdale, MI CLINICALEXPERIENCE June 2019 - Present PSYCHOLOGYEXTERN, Intensive Outpatient Program (lOP) Fort Belvoir Community Hospital· Fort Belvoir, VA • Provide twice weekly individual psychotherapy to active duty service members; Co- facilitate 6-week Cognitive Behavioral Therapy for Insomnia group sessions

May 2018 - May 2019 NEUROPSYCHOLOGYEXTERN, Traumatic Brain Injury Clinic, Fort Belvoir Community Hospital· Fort Be/voir, VA • Conducted weekly outpatient neuropsychological evaluations, intakes, and feedback sessions; Provided individual psychotherapy to two active duty service members RESEARCHEXPERIENCE Jun 2019 - Present CLINICIAN ADMINISTERED ASSESSMENT FOR PTSD (CAPS-5) ASSESSOR Fort Belvoir Community Hospital· Fort Belvoir, VA; National Center for PTSD.Boston, MA Randomized Controlled Trial of Massed CPT for PTSDversus Treatment as Usual

Sept 2018 - Present PROJECT LEAD AND CO-INVESTIGATOR Uniformed Services University of the Health Sciences' Bethesda, MD Rates of Psychiatric Diagnoses in Deployed Service Members; Traumatic Brain Injury Demographics and Incidence Rates amongst Soldiers, Sailors, Airmen, and Marines

April 2018 - Present PRINCIPAL INVESTIGATOR Uniformed Services University of the Health Sciences' Bethesda, MD The Effect of Comorbid Traumatic Brain Injury and Posttraumatic Stress Disorder on Neuropsychological Performance, Emotional Distress, and Social Functioning

Aug 2017 - Present GRADUATERESEARCHASSISTANT Military Stress Studies Laboratory Uniformed Services University of the Health Sciences· Bethesda, MD A Non-Random Comparison of the Effectiveness of Pharmacotherapy and Psychotherapy for PTSDin Active Duty Military Personnel; Examination of Stellate Ganglion Block for PTSDin the MHS TEACHINGEXPERIENCE Aug 2018 - Present TEACHING ASSISTANT Uniformed Services University of the Health Sciences' Bethesda, Maryland • Courses: Clinical Assessment for Adults; Civilian Cohort TA; Cognitive Behavior Therapy II L.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAL.TatezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

SELECTED RECENT PUBLICATIONS Mallonee,S., Tate, L., De Oliveira, F., & Ruiz,A. (in press). Development and trial implementation of a 30-day outpatient program for subthreshold PTSD.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAMilitary Medicine.

Riggs, D., Tate, L., Chrestman, K., & Foa, E.(in press). Prolonged exposure (PE)therapy InJA Cohen (Ed.), Effective Treatments for PTSD:Practice Guidelines from the International Society for Traumatic Stress Studies, ThirdEdition. New York, New York:Guilford Publications.

Paxton, M., Tate, L., & Riggs,D. (in press). Application of cognitive behavioral therapy in a military population In A. Wenzel (Ed.), Handbook of Cognitive Behavioral Therapy. Washington, DC:American Psychological Association.

Tate, l., Paxton, M., Koehlmoos, T., Banaag, A., & Riggs,D. (in preparation). Traumatic brain injury demographics and incidence rates amongst soldiers, sailors, airmen, and marines.

Tate, l., Paxton, M., French, L., Law, W., Sullivan, K., & Riggs,D. (in preparation). Effects ofTBI and PTSD symptoms on cognitive performance among United States active duty service members.

Tate, l., Paxton, M., French, L., Law, W., Sullivan, K., & Riggs,D. (in preparation). Cognitive performance, neurobehavioral symptoms, and emotional distress as predictors of social functioning in USservice members.

SELECTED RECENT PRESENTATIONS Tate, l., Mallonee,S., De Oliveira, F., & Ruiz, A. (2019, August). Development and implementation of a 30-day outpatient program for subthreshold PTSD. Poster session presented at the 2019 Military Health System Research Symposium, Kissimmee, FL.

Tate, l., Paxton, M., French, L., Law, W., Sullivan, K., & Riggs, D. (2019, August). Effects ofTBI and PTSDsymptoms on the mayo-portland adaptability inventory subscales among service members. Poster session presented at the 2019 Military Health System Research Symposium, Kissimmee, FL.

Tate, L., Paxton, M., French, L., Law, W., Sullivan, K., & Riggs,D. (2019, May). Predictors of outcome functionality in US service members with traumatic brain injury and posttraumatic stress disorder: An examination of cognitive performance, neurobehavioral symptoms, and emotional distress. Poster session presented at 2019 Research Days, Bethesda, MD.

Paxton, M., Tate, L., Spangler, P.,Asabre, E., & Riggs,D. (2019, May). The mediating role of anxiety and depression in the relationship of PTSDto quality of life in a treatment-resistant sample of active duty service members and veterans. Poster session presented at 2019 Research Days, Bethesda, MD.

Tate, l. Paxton, M., French, L., Law, W., Sullivan, K., & Riggs, D. (2019, April). The effects of comorbid TBIand PTSD symptoms among USactive duty service members on an objective cognitive performance measure. Poster session presented at the ia" Annual Amygdala, Stress, and PTSDConference, Bethesda, MD.

Paxton, M., Tate, l., Spangler, P., Asabre, E., & Riggs,D. (2019, April). The relationship of PTSDto anxiety and depression: An examination of the moderating effect of sleep quality and nightmares. Poster session presented at the 14thAnnua I Amygdala, Stress, and PTSDConference, Bethesda, MD. UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712 usuhs.edu

October 2, 2019

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Master of Science degree effective upon your approval:

Kevin M. Wilfong

MASTER OF SCIENCE

Department of Medical and Clinical Psychology

Attached is the candidate's Thesis Approval Form. Also attached are the certification of authorized use of Copyrighted materials, Thesis Title Page, Thesis Abstract, and Curriculum Vitae.

Arthur L. Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Carefor Thosein Harm's Way UNIFORMED SERVICES UNIVERSITY, SCHOOL OF MEDICINE GRADUATEPROGRAMS Graduate Education Office(A 1045), 4301 Jones Bridge Road, Bethesda, MD20814

September 18,2019

APPROV AL SHEET

Title of Thesis: "The Impact of Brief Interventions on Functioning Among those Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the Primary Care Behavioral Health (PCBH) Model"

Name of Candidate: Kevin Wilfong, Master of Science in Medical and Clinical Psychology

Date: 18SEPT20 19

THESIS AND ABSTRACT APPROVED:

DATE:

effrey Goodie, Ph.D. DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY Thesis AdvisorzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

IIJ\/\zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA11 ~rI~ And'rewM'aters, Ph.D. DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY

David Krantz, P . DEPARTMENT 0 MEDICAL AND CLINICAL PSYCHOLOGY Committee Member

11 COPYRIGHT STATEMENT

The author hereby certifies that the use of any copyrighted materials in the thesis

manuscript entitled:

"The Impact of Brief Interventions on Functioning Among those Demonstrating

Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The

Effectiveness of the Primary Care Behavioral Health (PCBH) Model" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the

Kevin M. Wilfong

September 18, 2019

iii The Impact of Brief Interventions on Functioning Among those Demonstrating Anxiety,

Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the

Primary Care Behavioral Health (PCB H) Model

Kevin M. Wilfong

Thesis submitted to the Faculty of the Medical and Clinical Psychology Program Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Masters of Science, 2019 ABSTRACT

Title of Thesis: The Impact of Brief Interventions on Functioning Among those

Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care:

The Effectiveness of the Primary Care Behavioral Health (PCBH) Model

Kevin M. Wilfong, Master of Science, 2019

Thesis directed by: JeffreyzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAL. Goodie, Ph.D., ABPP, Professor and Director of Clinical

Training, Department of Medical and Clinical PsychologyzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Objective: The high prevalence of anxiety, depression, and adjustment disorders are tied to deleterious individual, fiscal, and organizational consequences. A growing method of treatment is the integration of behavioral health providers into the primary care setting, where half of individuals already present to seek care. Primary Care Behavioral Health

(PCBH) is one model of treatment in which behavioral health consultants (BHC) work directly with primary care providers to enhance a holistic approach to health care in a primary care clinic. There is growing evidence in support of the benefits of interventions in

PCBH model; however, there is a lack of available data demonstrating that it is effective for the treatment of behavioral health conditions - including anxiety, depression, and adjustment disorders. The purpose of the study is to evaluate the effectiveness of the PCBH model to improve the global functioning among those diagnosed with anxiety, depression, or adjustment disorder.

IV Method: As part of a routine extraction by the Solution Delivery Division of the

Defense Health Agency, J-9 Directorate, beneficiaries of the military healthcare system seen by behavioral health consultants (BHC) for anxiety, depression, and adjustment disorder (N = 5402) were assessed for functioning outcomes using the Behavioral Health

Measure - 20 (BHM-20). Appointment characteristics (e.g., appointment duration, appointment interval, and appointment number) were also assessed using Common

Procedural Terminology and electronic medical records completed by the BHCs. BHC procedures were expected to be consistent with competencies and standards published by the services, including brief interventions outlined for anxiety and depression. The study sample was predominately Caucasian (32.64%), female (64.77%), dependents seen for 2 to

4 appointments (87.89%).

Results: A reliable change index was calculated to compare pre-post difference scores in the BHM-20 to a clinically meaningful cutoff score. Of the 5,402 individuals analyzed, 52.55% showed improvement, 17.16% showed reliable improvement, 24.21% showed deterioration, 2.44% showed reliable deterioration and, 3.63% of the sample

showed no change between their first and last recorded scoreszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA(pzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA< 0.05). A hierarchical

linear regression was calculated to determine the relation between the baseline and change

in BHM-20 score when controlling for age, gender, time, and appointment characteristics.

A significant negative relation was found such that an increase in baseline functioning was

predictive of less positive change in functioning at the final appointment.

Finally, a mixed model analysis was used to determine the predictive value of

appointment characteristics. All relations were significant (p < 0.001), except the between-

subjects effects of appointment duration. Appointment duration revealed a nonsignificant

v between-subjects relation and negative within-subjects relation, meaning; individuals reported worse functioning at the start of atypically long appointments. Appointment interval revealed a negative between-subjects relation and positive within-subjects relation; meaning, individuals with generally longer time between appointments reported worse functioning outcomes but better functioning at the appointment following an atypically long time since the last appointment. Appointment number revealed a negative between- subjects relation and positive within-subjects relation; meaning, individuals with generally more appointments reported worse functioning outcomes but better functioning at each subsequent appointment.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Discussion: In summary, the current study provides additional data to support the effectiveness of interventions in the PCBH model, to include a conservative measure of the rate of clinically meaningful change, the relation between baseline severity and predicted change in global functioning, and the effect of appointment characteristics on functioning outcomes. Approximately one in six individuals with anxiety, depression, or adjustment disorder showed reliable improvement, with the greatest rates of reliable improvement in individuals with severe functioning at baseline. Additionally, individuals with greater severity at baseline reported more positive change in functioning by the final appointment.

Individuals with more frequent appointments showed greater functioning outcomes, with improving functioning at each appointment. However, individuals with a greater total number of appointments reported worse functioning outcomes. This suggests the PCBH model is most effective in a time-limited fashion, with diminishing returns at later appointments. The current study provides additional data to support the effectiveness of interventions in the PCBH model.

vi August 2019

Kevin Wilfong

[email protected] (281) 615-6193

EDIICATION

Doctor of Philosophy, Clinical Psychology, Enrolled May 2016 - Present Uniformed Services University of the Health Sciences, Bethesda, MD Faculty Advisor: Jeffrey Goodie, Ph.D., ABPP

Bachelor of Science, Psychology, May 2016 Minor Neuroscience Texas A&M University, College Station, TX Senior Thesis Title: Coping Styles as a Predictor of Trait and Behavioral Impulsivity Faculty Mentors: Sherecce Fields, Ph.D., Steve Balsis, Ph.D.

CI,INICAL EXPERIENCE

Clinical Extern: Practicum, July 2019- PresentzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Pediatric Specialists of Virginia Endocrinology, Behavioral Health Consultation Services Supervisors: Robyn Mehlenbeck, Ph.D. • Conducted evidence-based brief Cognitive-Behavioral interventions for the management of Type 1 Diabetes Mellitus, needle phobias, and other behavioral health concerns in children, adolescents, and young adults • Collaboratively develop T1DM management plans with culturally diverse families, including consideration for cultural barriers to medical recommendations and the use of Spanish and Arabic interpreters • Provide a weekly case review to staff Psychologists, Endocrinologists, and Nurses • Completed intake/progress notes using Electronic Medical Records • Received regular supervision from clinical externship director

RESEARCH EXPERIENCE

Health Psychology Research Group, Bethesda, Maryland

Graduate Researcher, November 2017 - Present The Impact of BriefInterventions on Functioning Among those Demonstrating Anxiety, Depressive, and Adjustment Disorder Symptoms in Primary Care: The Effectiveness of the Primary Care Behavioral Health (PCBH) Model . Research Advisors: Jeffrey Goodie, Ph.D., Chris Hunter, Ph.D. • Directed all phases of research development including aims, design, methodology, approach, IRB documentation, and data sharing agreement application Wilfong 2

• Developed manuscript outlining the current literature, specific aims, and methodology • Completed the data preparation, statistical analyses, results, discussion, and figures

PIJBI,ICATIONS

Goodie,1. L., Wilfong, K. M.,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& Kroke, P. (In Press). The influence of health behaviors upon the association between stress and depression and cardiovascular disease. In P. Chantler & K. Larkin (Eds.),zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBACardiovascular implications of stress and depression. New York, NY: Elsevier.

Goodie,1. L. & Wilfong, K. M. (In Press). Screening and assessment in integrated primary care settings. In 1. A. Suhr & M. Sellborn (Eds.), Cambridge handbook of clinical assessment and diagnosis. Cambridge (England): Cambridge University Press.

Kroke, P., Wilfong, K. M., & Goodie, 1. (2019). Risky driving and vehicle-associated morality in veteran populations: Trends, causes, and the way forward. The Military Psychologist, 34( 1), 6-10.

Balsis, S., Busch, A. J., Wilfong, K. M., Newman, 1. W., & Edens, 1. F. (2017). A statistical consideration regarding the threshold of the psychopathy checklist-revised. Journal of Personality Assessment, 99(5), 494-502.

SERVICE

Professional

Ad-Hoc Peer Reviewer Journal of Clinical Psychology in Medical Settings, September 2018 - Present Family, Systems and Health, May 2018 - Present American Psychologist, December 2018 Military Medicine, September 2018 Family Medicine, June 2018 Annuals of Behavioral Medicine, August 2017 APA's Military Psychology, April 2017 Journal of Adolescence, March 2017

University

Family Medicine Communication Workshop, Uniformed Services University Family Medicine and Pediatrics Clerkship Orientation Week Preceptor, September 2018 - Present .. ., . • Coached medical students in patient-centered communication skills WIthan emphasis on Motivational Interviewing skill development • Provided an interdisciplinary context for demonstrating biopsychosocial model in patient care and treatment conceptualization ., . • Constructed immediate feedback for continued development of communication skills UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2,2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

Peter J. Attilio

DOCTOR OF PHILOSOPHY

Neuroscience Graduate Program

Attached is the candidate's certification of successful completion of the Final Examination. Also attached are the Dissertation Approval Form, certification of authorized use of Copyrighted materials, Dissertation Title Page, Dissertation Abstract, and Curriculum Vitae. C+(~L~ Arthur L. Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Care forzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBATbosein Harms 1*Iy UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOLOF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045),4301 JonesBridge Road, Bethesda, MD 20814

FINAL EXAM INATIONIPRIVATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE NEUROSCIENCE GRADUATE PROGRAM

Name of Student: Peter J. Attilio

Date of Examination: June 28, 2019 Time: 10:00 AM Place: Room C2015

DECISION OF EXAMINATION COMMITTEE MEMBERS:

PASS FAILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

of.Kim er ymes DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Committee ChairzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA -: .~'JI~' Dr. Irwin Lucki DEPARTMENT OF PHARMACOLOGY & MOLECULAR THERAPEUTICS Committee Member

Dr. Sharon Juliano DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS

Dr. rew Snow DE :A.RTMENTOF PHARMACOLOGY & MOLECULAR THERAPEUTICS Committee Member UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA SCHOOL OF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045),4301 JonesBridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE NEUROSCIENCE GRADUATE PROGRAM

Title of Dissertation: "Candesartan Administration after Traumatic Brain Injury Alters Novel Molecular Pathways"

Name of Candidate: Peter J. Attilio Doctor of Philosophy Degree June 28, 2019

DISSERTATION AND ABSTRACT APPROVED:

DATE:

yrnev/ T OF ANATOMY, PHYSIOLOGY & GENETICS Committee Chair

Dissertation AdvisorzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

~"/~' 701}Jc/! Dr. Irwin Lucki DEPARTMENT OF PHARMACOLOGY & MOLECULAR THERAPEUTICS Committee Member

Dr. Sharon Juliano DEPARTMENT 0 ANATOMY, PHYSIOLOGY & GENETICS Committee Member

D~ - $1~ D PARTMENT OF PHARMACOLOGY & MOLECULAR THERAPEUTICS Committee Member COPYRIGHT STATEMENT

The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled: "Candesartan Administration After Traumatic Brain Injury Alters Novel Molecular Pathways" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.

Neuroscience Program Uniformed Services UniversityzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 07115/2019 CANDESARTAN ADMINISTRATION AFTER TRAUMATIC BRAIN INJURY

ALTERS NOVEL MOLECULAR PATHWAYS

Peter J Attilio

LTC,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAUS/ANC

Dissertation submitted to the Faculty of the Neuroscience Graduate Program Uniformed Services University of the Health ScienceszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA In partial fulfillment of the requirements for the degree of Doctor of Philosophy 2019 ABSTRACT

Candesartan Administration After Traumatic Brain Injury Alters Novel Molecular

Pathways:

Peter 1. Attilio, PhD,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA2019

Thesis directed by: Aviva 1. Symes PhD

Traumatic Brain Injury (TBI) remains a major cause of morbidity within the military health system. Soldiers who have a TBI may experience changes in memory, mood, and cognitive function that can last for years after injury. However, despite numerous studies showing potential benefit of various treatments after TBI in animal models, at the present time there are limited treatment options available. Understanding the molecular mechanisms of these treatments in animal models may assist in determining pathways that are critical to drug efficacy and provide biomarkers of drug target engagement. The FDA approved angiotensin receptor blocker (ARB) candesartan, normally used to treat hypertension, has efficacy in improving molecular and functional recovery in mice after controlled cortical impact injury (CCI). A sub-hypotensive dose of candesartan can be administered 6 hours after injury and improve recovery one month after injury including improved learning and memory in mice models and reduction in lesion volumes. In addition to its antagonism at the angiotensin II type 1 receptor, candesartan is also a partial agonist ofPPARy. Thus, candesartan's efficacy in improving recovery from TBI could work through multiple pathways. This analysis is

Vlll intended to elucidate potential mechanisms in which candesartan is producing this beneficial action.

In order to identify candidate targets of candesartan 's mechanism of action in beneficial recovery after TBI, we performed transcriptome profiling by mRNA-seq on multiple brain regions at 3 and 29 days after CCI injury in mice. We performed a moderate CCI on adult male C57BLl6 mice over the parietal cortex and administered candesartan (0.1 mg/kg/day) or vehicle starting at 6 hours after injury by intraperitoneal injection. Candesartan administration continued by daily intraperitoneal injection for mice sacrificed at 3 days post-injury (DPI), or by implantation of an osmotic mini pump at I-DPI until sacrifice at 29-DPI. Sham mice received anesthesia and an incision in the skin over the skull but no craniotomy. At either 3 or 29DPI animals were sacrificed, brains were removed, and the hippocampus, thalamus and hypothalamus dissected. RNA was isolated and mRNA-seq performed on 4 mice per group for each brain region at the two time points. Individual groups were compared to sham mice and differentially expressed genes (DEGs) were identified with a false discovery rate of 0.05 and an absolute log2 fold-change> 0.32.

As anticipated, each brain region over time displayed significantly different patterns of gene expression independent of treatment. The effect ofTBI on differential gene expression was more significant in the hippocampus and decreased the further from the injury, with little effect in the hypothalamus. This same pattern of differentially expressed genes occurred with candesartan treatment only suggesting that the hippocampus is a specific target for angiotensin system blockade. As expected, at 29-

DPI the total number of DEGs were significantly reduced.

IX In the acute period after CCI, candesartan significantly increased genes related to

DNA replication and maintenance and increased angiogenic related genes while TBI decreased angiogenic and VEGF related genes. Treatment with candesartan at 3-DPI shifted the immune response showing increased myeloid cell activation where TBI significantly increased immune system function related to cytokine production. Effects on the immune system lasts to 29-DPI with reductions in inflammatory related genes being reduced with candesartan treatment. At 29-DPI the long non-coding RNA Malatl was significantly reduced and is a known modulator of inflammation.

Additionally, animals that received candesartan without a TBI showed a significant reduction in transcriptome signatures enriched in Wnt signaling pathway, oxidoreductase activity, cellular adhesion, and transcellular transport functions. Further investigation into candesartan's actions in the Wnt pathway identified that candesartan pretreatment reduces activation ofWnt signaling in both astrocytes and endothelial cells.

Together these studies highlight multiple novel molecular pathways that may underly the beneficial effects of candesartan after brain injury. This includes alterations in immune status at both acute and chronic timepoints, alteration of angiogenesis after

TBI, and Wnt pathway activation. The research from this project further shows the potential benefit of angiotensin system modulation after TBI through multiple different molecular mechanisms.

x CURRICULUM VITAE

NAME: Peter 1. Attilio

Rank Branch AOC

Lieutenant Colonel Army Nurse Corps 66F

CIVILIAN EDUCATION:

Degree Academic Institution and Location Year

PhD in Neuroscience Uniformed Services University of thezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA2015- Health Sciences 2019

Masters of Science in Northeastern University 2009 Nursing Anesthesia Boston, Massachusetts

Bachelors of Science University of Delaware, 2002 in Nursing Newark, Delaware

MILITARY EDUCATION:

Course Location Year

Command and General Fort Knox, KY 2015 Staff College

SERE - High Risk Fort Bragg, NC 2012

Joint Forces Combat Trauma Fort Sam Houston, TX 2010 Management Course

US Army Graduate Program AMEDD Center and School 2007- in Anesthesia Nursing Fort Sam Houston, TX 2009

Captains Career Course AMEDD Center and School 2007 Fort Sam Houston, TX

Combat Casualty Care Course Camp Bullis, Texas 2007

C.J. Reddy Leadership Course Alexandria, VA 2005

Critical Care Nursing Course Walter Reed Army Medical Center, 2004 Washington, DC

Officer Basic Leaders Course AMEDD Center and School 2002 Fort Sam Houston, Texas

Reserve Officer Training Corps University of Delaware 2002 (ROTC) Newark, Delaware

Airborne Course Fort Benning, Georgia 2000

1 PUBLICATIONS:

Title Media Source Date The Effects of Blast Exposure on Protein Oxidative Medicine and May 2017 Deimination in the Brain Cellular Longevity Authors: Attilio, P. J., Flora, M., Kamnaksh, A., Bradshaw, D. J., Agoston, D., Mueller, G. P.

The Effect of Ellagic Acid on Platelet The AANA Journal Dec 2010 Activation as Measured by the Quantification ofP-Selectin using Flow Cytometry Authors: Attilio, P., Merritt, c., Sims, J., Kane, N., O'Sullivan, 1.

PODIUM PRESENTATIONS:

Title Media Source Date Investigation of the Molecular Mechanisms Uniformed Services University May 2019 of Candesartan After Brain Injury Research Days - Graduate Student Colloquium

Local Anesthetics USUHS Neuroscience Module Jan 2019 F. Edward Herbert School of Medicine

Basics of Anesthetic Pharmacology and Naval Postgraduate Dental Jul2017 Analgesia Residency Program: Walter Jul2018 Reed National Military Jul2019 Medical Center

Basic Anesthesia Pharmacology and 3rd Special Forces Group, Jun 2014 Techniques for the 18D Fort Bragg, NC

Grants:

Title Grant Organization Date Investigation of the Molecular Mechanisms Tri-Service Nursing Research 2017 of Candesartan After Brain Injury Program (TSNRP) Graduate Student Grant NI7-C03: $65,143

2 UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2,2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

John R. Reed

DOCTOR OF PHILOSOPHY

Neuroscience Graduate Program

Attached is the candidate's certification of successful completion of the Final Examination. Also attached are the Dissertation Approval Form, certification of authorized use of Copyrighted materials, Dissertation Title Page, Dissertation Abstract, and Curriculum Vitae.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

/\((jY) /~-+'J~n l Arthur u Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Carefor 1hoseinzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAHarmszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA1#;,y UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOLOF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045),4301 JonesBridge Road,Bethesda, MD 20814

FINAL EXAM INATIONIPRIV ATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE NEUROSCIENCE GRADUATE PROGRAM

Name of Student: John R. Reed

Date of Examination: June 27, 2019 Time: 11:00 AM Place: Room C2095

DECISION OF EXAM INATION COMMITTEE MEMBERS:

PASS FAILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

~'bzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAlJ;

~es ,/ DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Dissertation Advisor

:.:::~~ J DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Committee Member ~ ~# ~~V~<--L- Dr. Kwang H. Choi DEPARTMENT OF PSYCHIATRY Committee Member

~~CCOLOGY & MO:LARTHERAPEUTICS Committee Member UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA SCHOOL OF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE NEUROSCIENCE GRADUATE PROGRAM

Title of Dissertation: "Effects of Intranasal Insulin on CCI in a Rat Model"

Name of Candidate: John R. Reed Doctor of Philosophy Degree July 22, 2019

DISSERTATION AND ABSTRACT APPROVED:

DATE:

. Jos h McCabe EPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Committee Chair

~s - ;f-Ia-a!l'i DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Dissertation Advisor

~~ '7 ("2"7 I \q_ Dr. Martin Doughty DEPARTMENT OF ANATOMY, PHYSIOLOGY & GENETICS Committee Member

DEPARTMENT~& OF PSYCHIATRY Committee Member

r. ndrew L. Snow PARTMENT OF PHARMACOLOGY & MOLECULAR THERAPEUTICS Committee Member COPYRIGHT STATEMENT

The author hereby certifies that the use of any copyrighted material in the dissertation manuscript entitled: Effects of Intranasal Insulin on Controlled Cortical

Impact Brain Injury in a Rat Model is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.

[Signature]

Jo~R. Reed

July 22, 2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

VI Effects of Intranasal Insulin on Controlled Cortical Impact Brain Injury in a Rat Model

John Richard Reed

Dissertation submitted to the Faculty of the Neuroscience Graduate Program Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Doctor of Philosophy 2019 ABSTRACT

Effects of Intranasal Insulin on CCI in a Rat Model:

John R. Reed, Doctor of Philosophy, 2019

Thesis directed by: Kimberly R. Byrnes, PhD

Department of Anatomy, Physiology and Genetics

Professor, Program Director, Neuroscience Program

Traumatic brain injury (TBI) is a serious health problem that affects approximately 2.5 million people in the United States each year and causes serious cognitive and physical deficits lasting long after the acute injury. Physical and cognitive limitations, as well as anxiety, have been identified as common and critical issues after

TBI. One of the subcortical structures that is often damaged and is classically linked to memory and anxiety is the hippocampus. TBI results in a marked reduction in glucose uptake in the brain, including in the hippocampus, which can last for years after injury.

Currently, there is no effective treatment devised for the deficits that develop after TBI.

An additional complication is gaining access of the treatment to the central nervous system (CNS) because of the protection from the blood-brain barrier (BBB). Research has demonstrated that some drugs, such as insulin, can reach the CNS by intranasal administration through the olfactory and trigeminal pathways. Intranasal insulin administration has been shown to increase cerebral glucose uptake and improve memory

viii function in normal subjects and patients with Alzheimer's disease, without affecting systemic blood glucose or insulin levels. Our previous work demonstrated that after a moderate TBI in rats, intranasal insulin administered within 4 hours after injury significantly increased glucose uptake in the hippocampus, improved cognitive function, and reduced inflammation. However, the mechanism by which insulin has these effects and the temporal course of these effects is currently unclear. The goal of this study was to determine if intranasal insulin administration would reduce inflammation and neuronal loss in the hippocampus and reduce measures of anxiety in rats exposed to moderate TBI.

We also wanted to evaluate the mechanism by which intranasal insulin administration affects the hippocampus. To accomplish these goals, adult male Sprague Dawley rats were exposed to a moderate controlled cortical impact (CCI) injury. Intranasal insulin treatments were administered 4 hours after injury and then daily for 14 days. Multiple

behavior tests, including open field, elevated zero maze and light-dark box, were used to

assess anxiety. Histological analysis with NeuN was used to assess total number of

neurons in the hippocampus. In order to assess inflammation, microglial/macrophage

number and activation in the hippocampus was measured as well as the production of

cytokines. We found that intranasal insulin did not have a significant effect on neuronal

(NeuN) or microglial/macrophage (lbal) density, but did decrease expression ofCD86,

iNOS, and TNFa within the hippocampus at specific time points post injury. Cellular

signaling demonstrated that intranasal insulin increased the phosphorylated MEK to total

MEK ratio in the cortex 4 days post injury. With this model, TBI did not increase

anxiety-like behavior when compared to sham, negating the ability to evaluate treatment.

This is possibly due to the neuroprotective properties of isoflurane provided to both

IX groups during surgery and treatment. These data indicate that there is an effect on proinflammatory factors and the MAPK pathway that may playa role in intranasal insulin's effect after TBI.

These data add to the body of knowledge as to the mechanism of the effect of intranasal insulin after TBI. And though it falls short on giving any therapeutic insight for the treatment of anxiety, it does bring up some ideas for how to change the research paradigm in order to better evaluate this potential therapy in future experiments.

Intranasal insulin clearly decreases pro-inflammatory molecules that have been shown to be causes of pathogenesis.

x CURRICULUM VITAE

NAME: John R. Reed

Rank Branch AOC

Major ANC 66F

CIVILIAN EDUCATION: Degree Academic Institution and Location Year

PhD Neuroscience Uniformed Services UniversitylHealth Sciences 2019

Master of Science in Nurse Northeastern University 2010 Anesthesia Boston, MA

Master of Science in University of Phoenix 2003 NursinglMasters of Business Phoenix, AZ Administration

Associate Degree in Nursing Albuquerque TV-I 2000 Albuquerque, NM

Bachelor of Science in University of New Mexico 1997 Biology Albuquerque, NM

MILITARY EDUCATION: Course Location Year

Intermediate Level Education Command and General Staff College 2014 Fort Leavenworth, KS

Captains Career Course AMEDD Center and School 2012 Fort Sam Houston, TX

US Army Graduate Program AMEDD Center and School 2008 In Anesthesia Nursing Fort Sam Houston, TX

Officer Basic Course AMEDD Center and School 2003 Fort Sam Houston, Texas

CIVILIAN AND MILITARY WORK EXPERIENCE:zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Job Title Location Dates Program Director US Army Fort Gordon, GA August 2019 - CRNA Training Phase II present

Army PhD Student Bethesda, MD Aug 2015- USUHS present

StaffCRNA Fort Meade, MD Aug2015- Kimbrough Ambulatory Care Center present

1 Staff CRNA Landstuhl, Germany Jan 2011- Landstuhl Army Regional Medical Center July 2015

US Army CRNA Training Fort Gordon, GA June 2009- Phase II Dec 2010

US Army CRNA Training Fort Sam Houston, TX June 2008- Phase I June 2009

Instructor Portland, OR Mar 2005- University of Portland May 2008 School of Nursing

StaffRN - ER Portland, OR Jun 2007- Veterans Administration May 2008 Medical Center

StaffRN - ICU Hillsboro, OR Ju12003- Tuality Hospital May 2007

Army Nurse Critical Care Albuquerque, NM Sept 2002- US Army Reserve Ft. Lewis, WA May 2008

RN Specialty Residency Albuquerque, NM Jan 2001- ER and ICU Focus May 2003

Licensed Practical Nurse Albuquerque, NM Apr 2000- Presbyterian Hospital Oct 2000

Nurse Technician Albuquerque, NM Oct 1998- Presbyterian Hospital Apr 2000

STATE LICENSURE: State Year Expiration

Oregon - RN 2003 Aug 2020

SKILLS CERTIFICATION: Type Organization Expiration

CCRN American Association of Critical Care Nurses Nov 2010

PALS The Military Training Network Nov 2014

ACLS The Military Training Network Aug 2020

Basic Life Support The Military Training Network Aug 2020

DECORATIONS AND AWARDS: Award Location Date

Meritorious Service Medal Landstul, Germany 2015

2 Army Overseas Service Ribbon Landstul, Germany 2015 Army Commendation Medal Kosovo 2014

Armed Forces Exp Medal Kosovo 2014

NATO Medal Kosovo Kosovo 2014

Army Achievement Medal DDEAMC Fort Gordon, GA 2010

National Defense Service Medal #2 Ft. Sam Houston, TX 2008

Global War on TerrorismzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAFt. Sam Houston, IX 2008

Army Service Ribbon Ft. Sam Houston, TX 2008

Reserve Component Achievement Medal 6250thUSAH 2006

Joint Meritorious Unit Award USS Roanoke, Long Beach, Ca 1991

Kuwait Liberation Medal (Kuwait) USS Roanoke, Long Beach, Ca 1991

National Defense Service Medal USS Roanoke, Long Beach, Ca 1991

Southwest Asia Service USS Roanoke, Long Beach, Ca 1991

Sea Service Ribbon with Bronze Star USS Roanoke, Long Beach, Ca 1991zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

AFFILIATIONS AND PROFESSIONAL ORGANIZATION MEMBERSHIPS: Organization Date

American Association of Nurse Anesthetists 2011

Georgia Association of Nurse Anesthetists 2011

American Association of Nurse Anesthetists Student affiliation 2008

American Association of Critical Care Nurses 2004

Sigma Theta Tau International Honor Society of Nursing 2003

PUBLICA TIONS: Title

Brabazon, F., Wilson, C. M., Jaiswal, S., Reed, J., Frey, W. H., & Byrnes, K. R. (2017). Intranasal insulin treatment of an experimental model of moderate traumatic brain injury.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAJournal of Cerebral Blood FlowzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& Metabolism,0271678XI668510.

Austere Anesthesia Chapter 4 - Operations Other Than War in production

3 UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2,2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

Sade Soares

DOCTOR OF PHILOSOPHY

Department of Medical and Clinical Psychology

Arthur 1.Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Care for 1bosein Harm'szyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAWay UNIFORMED SERVICES UNIVERSity OF THE HEALTHSCIENCES SCHOOL OFzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAMEDIONE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

FINAL EXAMINATiONIPRlV ATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY Name of Student: Sade Soares

Date of Examination: June 11,2019 Time: 1:00 PM Place: Room CI022

DECISION OF EXAMINATION COMMITTEE MEMBERS:

PASS FAIL -/ / L/,. - .)J -- ..::b. Dr. Patrick DeLeon . DEPARTMENT OF MEDICAL & CLINICAL PSYCHOLOGY & GRADUATE SCHOOL OF NURSING Committee ChairzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ~v DEPARTMENT OF MEDICAL & CLINICAL PSYCHOLOGY Dissertation Advisor

zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ~~~;(Dr. Marian~0fSki- .' .: DEPARTMENT OF MEDICAL & CLINICAL PSYCHOLOGY Committee Member ~Z· Dr. Teresa Combs USUHS GRADUATE SCHOOL OF NURSING Committee Member UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOL OF MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE DEPARTMENT OF MEDICAL AND CLINICAL PSYCHOLOGY

Title of Dissertation: "Historical Trauma, Discrimination. Self-efficacy, Cultural Affiliation. Socioeconomic Status and Obesity within a Native Hawai'ian Population"

Name of Candidate: Sade Soares Doctor of Philosophy Degree June 11,2019

DISSERTATION AND ABSTRACT APPROVED:

DATE:zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Dr. Patrick Deleon DEPARTMENT OF MEDICALzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& CLINICAL PSYCHOLOGY & GRADUATE SCHOOL OF NURSING Committee ChairzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ~ t!j/b/19 DEPARTMENT OF MEDICAL & CLINICAL PSYCHOLOGY Dissertation Advisor ~ qj;C/;1- DEPARTMENT OF MEDICAL & CLINICAL PSYCHOLOGY

c~ _

Dr. Teresa Combs USUHS GRADUATE SCHOOL OF NURSING Committee Member COPYRIGHT STATEMENT

The author hereby certifies that the use of any copyrighted material in the dissertation manuscript entitled: "Historical trauma, discrimination, self-efficacy, cultural affiliation, socioeconomic status, and obesity within a Native Hawai'ian population" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Sadi SOMed,

Sade Soares MedicalzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& Clinical Psychology Uniformed Services University June 21,2019

DISCLAIMER

The views presented here are those of the author and are not to be construed as official or reflecting the views of the Uniformed Services University of the Health

Sciences, the Department of Defense or the U.S. Government.

v HISTORICAL TRAUMA, DISCRIMINATION, SELF-EFFICACY, CULTURAL

AFFILIATION, SOCIOECONOMIC STATUS AND OBESITY WITHIN A NATIVE

HAWAI'IAN POPULATION

Sade E.C. Soares

Dissertation submitted to the Faculty of the Medical and Clinical Psychology Graduate Program Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Doctor of Philosophy 2019 ABSTRACT

Historical trauma, discrimination, self-efficacy, cultural affiliation, socioeconomic status, and obesity within a Native Hawai'ian population.

Sade Soares, Ph.D., 2019

Thesis directed by: Tracy Sbrocco, Ph.D., Thesis Advisor, Medical and Clinical Psychology

Background: Native Hawai'ians experience poverty and obesity at greater rates compared to other racial/ethnic groups in Hawai'i and the greater United States. The historical trauma experienced by Native Hawai'ians is a potential explanatory variable for economic barriers associated with poverty and for health outcomes and disparities. The associations of historical trauma, discrimination, self-efficacy, and cultural affiliation on the socioeconomic status and health of Native Hawai'ians were examined in the present study.

Objective: This dissertation surveyed Native Hawai'ian individuals to investigate the relationships between historical trauma, self-efficacy, discrimination, cultural affiliation, socioeconomic status, and obesity. The long-term goal of this work is the development of culturally tailored health promotion and disease prevention policies and programs for Native

Hawai'ians.

Methods: Utilizing an online survey, participants completed measures assessing historical trauma, self-efficacy, perceived discrimination, and Native Hawai'ian cultural affiliation, socioeconomic status, and body mass index. Multiple linear regressions were conducted to examine the relationship between historical trauma on the following variables: self-efficacy, cultural affiliation, socioeconomic status, and obesity. The role of self-efficacy as a mediating factor in the relationships between historical trauma and SES and obesity was examined. Cultural affiliation was examined as a moderating variable in the relationships between historical trauma and SES and obesity. Discrimination, age and gender were covariates in all models.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Results: Study participants (N=146) were mostly female (76.7%) and married (57.5%), with a mean age of 43 years (SD = 11.5). Counter to prediction, historical trauma was not associated with SES or BMI. However, greater endorsement of historical trauma was associated with increased cultural affiliation. Self-efficacy did not mediate relationships as expected. However, self-efficacy was positively associated with SES and negatively associated with BMI. Cultural affiliation did not moderate relationships as expected but was positively associated with SES.

Perceived discrimination was negatively associated with self-efficacy and SES, and positively associated with BMI.

Discussion: The present study did not find historical trauma to be associated with SES or BMI.

However, historical trauma was positively associated with cultural affiliation. Sociocultural factors related to present day functioning, including cultural affiliation and discrimination, were associated with SES and BMI. And, self-efficacy, appeared to be a pivotal construct in understanding the relationship among present-day sociocultural factors and health outcomes that may be used to guide behavior change. Although not examined directly in this study, the potential impact of the multi-ethnic composition of the Native Hawai'ian population is worth further study. Experiences, socioeconomic and health outcomes may differ by racial-ethnic subgroups of Native Hawai'ians. Furthering our understanding of these groups my assist in developing culturally tailored programs to improve the health and well-being of Native Hawai'ians. Importantly, this work should extend beyond cross sectional studies and examine the longitudinal relationships of sociocultural variables and health outcomes among racial-ethnic

subgroups. And, given many Hawai'ian organizations are motivated by the Hawai'ian cultural

revitalization movement, the timing is right to conduct this work. Sade Soares, Captain, USA

Cell: 208-871-9468 : [email protected] Education and TrainingzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Uniformed Services University of the Health Sciences Expected 2019 PhD, Clinical Psychology Bethesda, Maryland

United States Military Academy 2010 BS, Psychology West Point, New York Spencer D. Dodge Award for Excellence in Psychology

Professional Affiliations

American Psychological Association of Graduate Students, Member Current APA SOciety for Military Psychology, Member Current District of Columbia Psychological Association, Member Current Hawai'i Psychological Association, Member Current District of Columbia Psychological Association, Campus Representative May 2016- May 2018 District of Columbia Psychological Association, Student Committee Chair Jan 2017- May 2018

Relevant Professional Experience

Clinical Psychology Intern Oct 2018 to Present Tripier Army Medical Center -Honolulu, Hawai'i • Provide behavioral health treatment and assessment to ajoint active duty, veteran, and military family member population

Clinical Psychology Extern Jun 2017 to May 2018 Hope Health Systems - Baltimore, Maryland • Conducted adult, child, and family therapy with a diverse population in a community mental health setting

Clinical Psychology Extern Sep 2016 to Sep 2017 Kimbrough Behavioral Health Clinic - Fort Meade, Maryland • Conducted individual therapy and psychodiagnostic assessment with diverse joint military population • Provided triadic supervision to behavioral health technicians

Interpersonal Psychotherapy Group Co-Leader Sep 2016 to Dec 2016 Preventing Obesity in Military Communities-Adolescents Uniformed Services University - Bethesda, Maryland • Co-led intervention group for study examining interpersonal psychotherapy intervention for obesity

Pediatric Neuropsychology Extern Aug 2015 to Aug 2016 Mt Washington Pediatric Hospital - Baltimore, Maryland • Conducted pediatric neuropsychological testing for diverse pediatric population, including in-utero drug exposure, brain injury, intellectual disabilities, feeding difficulties, as well as behavioral and emotional difficulties • Conducted family therapy and co-led social skills group for children who presented with Autism, ADHD, and related emotional/behavioral difficulties

Teaching Assistantships

Psychology Seminar and Clinical Training Teams Feb 2018 to May 2018 Social Psychology Nov 2017 to Feb 2018 Clinical Assessment Sep 2016 to May 2017 Psychopathology Aug 2015 to Nov 2015 Public Policy May 2015 to Nov 2015

Military Experience

Assistant Operations Officer May 2012 to Jan 2014 US Army - Boise, Idaho • Assistant Operations Officer at the Boise Military Entrance Processing Station, a geographically isolated and joint-staffed organization • Managed the administrative processing for approximately 2,000 military applicants a year, which included overseeing final contracts for military service, performing oaths of enlistment, and ensuring transport to Basic training • Performed quality assurance checks on medical samples and processing records, maintaining a zero-error record for the unit • Liaised with recruiting commands, guidance counselors, and basic training reception centers to resolve applicant processing issues • Supervised and evaluated civilians and military members • Assisted with the hiring process of civilian employees, including interview question development, resume review, and interview board participation.

Executive Assistant to Commanding General Apr 2011 to May 2012 US Army - Camp Arifjan, Kuwait • Coordinated all executive travel throughout Kuwait, Iraq, Qatar, Bahrain, Afghanistan, and the continental US for a one-star general, while ensuring her continuous safety and well-being • Composed all speeches, personal notes, talking points, and newspaper articles for commanding general • Supervised the command driver and served as fitness trainer for all members of the executive staff • Worked collaboratively with senior staff members throughout various organizations to develop, synchronize, and manage the general's calendar • Responsible and accountable for equipment utilized by the general in excess of $60,000

Publications

• Deleon, P.H. & Soares, S. (2016). Psychology and law: The increasingly relevant intersection, PsycCritiques, 61(16), Article 8. • Mokua, N., Deleon, P.H., Kaholokula, J.K., Soares, S., Tsark, J.U., & Haia, C. (2016). Challenges and promise of health equity for Native Hawaiians, National Academy of Medicine Discussion Paper. Available at https://nam.edu/challenges-and-promise-of-health-equity-for-native-hawaiiansl

Presentations

• Soares III, A. & Soares, S. (June 2019). Moving beyond financial literacy: A two-pronged approach to financial wellness. Workshop presented at the Hawai'i State Veterans Summit, Honolulu, HI.

References furnished upon request UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712 usuhs.edu

October 2, 2019

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

Philip J. Spreadborough

DOCTOR OF PHILOSOPHY

Molecular and Cell Biology Graduate Program

Arthur 1.Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Carefor Thosein Harm's mzy UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOLOF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

FINAL EXAMINA TIONIPRIV ATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE MOLECULAR AND CELL BIOLOGY GRADUATE PROGRAM

Name of Student: Philip Spreadborough

Date of Examination: August 5, 2019 Time: 1:00 PM Place: Room A2074

DECISION OF EXAMINATION COMMITTEE MEMBERS:

PASS FAILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

17.:/ / Dr. Brian sth fer DEPARTME T OF MICROBIOLOGY & IMMUNOLOGY

r. Thomas Davis DEPARTMENT OF SURGERY Dissertation AdvisorzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

~ tr./A-{Lru-(-~'/;,-, - L- Dr. Kim Williamson DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee Member

»: IO:;n jllilliIl Levi BURN/WOUND & REGEN ERA TIVE MEDICINE LABORATORY, UNIVERSITY OF MICHIGAN Committee Member UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOLOF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE MOLECULAR AND CELL BIOLOGY GRADUATE PROGRAM

Title of Dissertation: "The effects of tourniquet associated ischemia reperfusion injury on the development of secondary injury in a blast related model of lower limb extremity trauma"

Name of Candidate: Philip Spreadborough Doctor of Philosophy Degree August 5, 2019

DISSERTATION AND ABSTRACT APPROVED:

DATE:

" Committee Chairperson ..

homas Davis DEPARTMENT OF SURGERY Dissertation Advisor

Dr. Kim Williamson DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee MemberzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

~' ~. 5f}sj)0/1 r:sen-aJl1iIlLevi BURN/WOUND & REGENERATIVE MEDICINE LABORATORY, UNIVERSITY OF MICHIGAN Committee Member COPYRIGHT STATEMENT

The author hereby certifies that the use of any copyrighted material in the dissertation manuscript entitled: "The Effects Of Toumiquet Associated Ischemia

Reperfusion Injury On The Development Of Secondary Injury In A Blast-Related Model

Of Lower Limb Extremity Trauma" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

...... -.•.-.-.-.-~~.;~ _ .....--. ~=

Philip Spreadborough

November 5,2019

DISCLAIMER

The views presented here are those of the author and are not to be construed as official or reflecting the views of the Uniformed Services University of the Health

Sciences, the Department of Defense or the U.S. Government.

v THE EFFECTS OF TOURNIQUET ASSOCIATED ISCHEMIA REPERFUSION INJURY ON THE DEVELOPMENT OF SECONDARY INJURY IN A BLAST- RELATED MODEL OF LOWER LIMB EXTREMITY TRAUMA

Philip James Spreadborough

Thesis submitted to the Faculty of the Molecular and Cell Biology Graduate Program Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Doctor of Philosophy 2019 ABSTRACT

"The Effects of Tourniquet Associated Ischemia Reperfusion Injury on The Development of Secondary Injury in A Blast-Related Model of Lower Limb Extremity Trauma"

Philip James Spreadborough, Molecular and Cell Biology PhD Program, 2019

Thesis directed by: Dr Thomas Davis, Professor, Department of Surgery

Blast accounted for 70% of all mechanisms of injury during recent conflicts in

Iraq and Afghanistan. Improved pre-hospital survival, partly due to tourniquet use in controlling haemorrhage, means that secondary injury as the result of a dysregulated immune response to poly trauma is now a significant challenge. Multiple organ dysfunction syndrome (MODS) increases mortality 6-fold and quadruples the requirement for assistance in daily living at 2 years. Heterotopic ossification (HO) occurred in 65% of blast-related traumatic amputees, many of whom had tourniquets applied during care at point of wounding. This research sought to establish how blast exposure may potentiate the onset and effects of tourniquet-induced ischemia reperfusion

injury (IRI) with the subsequent development of either local or systemic secondary

injury.

A pre-clinical study was performed in a rodent model to assess the effect of a

120kPa systemic blast overpressure on the development of IRI following either 90 or 150

minutes of hind-limb tourniquet application. A further study was performed to assess the

Vll effect of tourniquet application in an established blast-associated lower extremity

traumatic amputation model. Analysis of blood biomarkers and tissue gene expression

was performed to assess changes in inflammatory mediators and signaling pathways, with

microCT imaging to assess HO formation.

Our results demonstrate that blast exposure following 150 minutes of

tourniquet application increases markers of IRI and end organ injury through increased

proinflammatory signaling. Tourniquets also increase proinflammatory signaling,

oxidative stress and damage molecule signaling in a complex injured limb above that

associated with traumatic amputation alone. This increases early remote organ

dysfunction as well as increasing total bone formation at 12 weeks post injury.

Hemorrhage remains the leading cause of preventable death in combat.

Tourniquets play an important role in the control of catastrophic hemorrhage. This

research highlights that mechanism of injury can reduce the duration of safe tourniquet

application, after which it may amplify the systemic inflammatory response and

predispose to secondary injury.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAIt is recommended that the risk of secondary injury be

reduced by maintaining short clinical timelines, promoting regular review of ongoing

need for tourniquet and considering removal once risk of catastrophic hemorrhage has

ceased.

Vlll Surgeon Lieutenant Commander Philip James Spreadborough BM MRCS DMCC FHEA Royal NavyzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Department of Surgery - Uniformed Services University of the Health Sciences 4301 Jones Bridge Rd, MD, USA. Email: [email protected]

Education

2016-Present Molecular and Cell Biology PhD Program, PhD Candidate as of June 2017 Uniformed Services University of the Health Sciences, Maryland, USA

2016 Fellow of the Higher Education Academy (FHEA)

2013-2016 Postgraduate Certificate in Medical Education with Merit University of Warwick, UK

2014 Intermediate Command and Staff Course (Maritime) Defence Academy of the United Kingdom, Shrivenham, UK

2013 Diploma in the Medical Care of Catastrophes (DMCC) Dissertation on 'The fluid resuscitation of trauma in conflict and catastrophes - evolving practices and the challenges posed' Worshipful SOcietyof Apothecaries, London, UK

2010 Diploma of Membership of the Royal College of Surgeons The Royal College of Surgeons of England, London, UK

2001-2006 Bachelor of Medicine (BM) University of Southampton, UK

Employment

2006-Present Medical Officer, United Kingdom Royal Navy

Specialization in general and trauma surgery with academic interests in translational medicine opportunities to improving military trauma care through the use of biological markers to advance clinical decision making to prevent secondary immune mediated injury and enable optimization of regenerative care. Experience of joint operations with US forces in both Afghanistan and CONUS while serving with the UK Royal Marines. Knowledge of deployed care at all echelons from Role 1 point of wounding care through to Role 4.

Fellowships/Awards/Prizes/Honors

2016 One Year Research Fellowship Royal College of Surgeons of England, UK

2008 Medical Education Associate Trainee Bursary Southampton University Hospitals Trust, UK 2007 TheHarris-Adams Postgraduate Prize Southampton University Hospitals Trust, UK

2000 The Institute of Physics Annual Prize of Physics in Practice Institute of Physics, UK

Current PhD Research

"The effects of tourniquet associated ischemia reperfusion injury (IRI) on the development of secondary injury in a blast-related model of lower limb extremity trauma".

Defining and analyzing any synergistic effects of ischemia reperfusion and blast injury on the development of secondary injury in a polytrauma model. This research assesses the effects on remote organ failure and local heterotopic ossification formation, and how the contribution of immune, gene and blood biomarkers may be used to develop prognostic indicators applicable to the battlefield.

Publications/Presentations

Publications: 21 articles, 19 PubMed listed. 4 first author, 3 second author. 5 further articles from the CholeS trial (study management group) and 7 citations as centre lead from collaborative research projects.

Tafazal H*, Spreadborough P*, Zakai D, Shastri-Hurst N, Ayaani S, Hanif M. (2018) Laparoscopic Cholecystectomy - A prospective cohort study assessing the impact of grade of operating surgeon on operative time and 30-day morbidity.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAnnals of the Royal College of Surgeons England 100(3):178-184.

Spreadborough P, Lort S, Pasquali S, Popplewell M, Owen A, Kreis I, Tucker 0, Vohra RS. (2016) A systematic review and meta-analysis of perioperative oral decontamination in patients undergoing major elective surgery. Perioperative Medicine. Mar;22(5):6.

Spreadborough P, Doran C. (2015) The current thinking on colorectal cancer. Journal of the Royal Naval Medical Service. Vol 101 Issue 1; p 47-54.

Vohra RS, Spreadborough P, Johnstone M, Marriott P, Bhangu A, Alderson D, Morton DG, Griffiths EA. (2015) Protocol for a multicentre, prospective, population- based cohort study of variation in practice of cholecystectomy and surgical outcomes (The CholeS study). British Medical Journal Open. 2015;5(1): e006399.

De Rosa A, Spreadborough P, Midwinter M (2011) The Platinum 10 Minutes. NHS Evidence - surgery, anaesthesia, perioperative and critical care.

Published abstracts: 6 (3 first author).

International/National Conference Presentations: 10 presentations - 4 oral, 6 posters. UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2, 2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

William G. Valiant

DOCTOR OF PHILOSOPHY

Emerging Infectious Diseases Graduate Program

Attached is the candidate's certification of successful completion of the Final Examination. Also attached are the Dissertation Approval Form, certification of authorized use of Copyrighted materials, Dissertation Title Page, Dissertation Abstract, and Curriculum Vitae.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

c*'~~Arthur L. Kellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to CareforzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA'Ihose in Harm'szyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAJ#zy UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA SCHOOL OF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

FINAL EXAMINATIONIPRIVATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE EMERGING INFECTIOUS DISEASES GRADUATE PROGRAM

Name of Student: William Valiant

Date of Examination: August 13,2019 Time: 2:00 PM Place: Room B4004

DECISION OF EXAMINATION COMMITTEE MEMBERS:

PASS FAIL (\~6V': Dr) Timothy H. Burgess DEPARTMENT OF PREVENTIVE MEDICINE & BIOSTATISTICS Committee Chairperson

ttapallil OF MICROBIOLOGY & IMMUNOLOGY Dissertation Advisor ) Dr. Christopher C. Bro r DEPARTMENT CROBIOLOGY & IMMUNOLOGY Committee Member

DEPARTMENT OF MEDICINE Committee Member UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA SCHOOL OF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE EMERGING INFECTIOUS DISEASES GRADUATE PROGRAM

Title of Dissertation: "Characterizing Severe Outcomes ofZika Virus Infection"

Name of Candidate: William Valiant Doctor of Philosophy Degree August 13,2019

DISSERTATION AND ABSTRACT APPROVED:

DATE:

r~~ 11zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA{)1A6 VJI7 Dr. Ti~othy H. Burgess DEPARTMENT OF PREVENTIVE MEDICINE & BIOSTATISTICS Committee Chairperson

attapallil OF MICROBIOLOGY & IMMUNOLOGY Dissertation Advisor --;) /

.Committee Member

Dr. Kathleen P. Pratt DEPARTMENT OF MEDICINE Committee Member The author hereby certifies that the use of any copyrighted material in the thesis manuscript entitled:

Understanding the Severe Consequences of Zika Virus Infection is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.

William Valiant Emerging Infectious Diseases Uniformed Services UniversityzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 09/10/2019 1zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAUnderstanding the Severe Consequences of Zika ViruszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

2 Inkction 3 4 5 Emerging Infectious Diseases Dissertation 6 William Valiant 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 Dissertation submitted to the Faculty of the Emerging Infectious Diseases Graduate Program, 36 Uniformed Services University of the Health Sciences, in partial fulfillment of the requirements 37 for the degree of Doctor of Philosophy. 2019

1 93zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAbstract

94 Zika virus (ZIKV) is a Flavivirus that emerged into the Americas in 2015, leading to a

95 public health emergency. ZIKV infection has been associated with microcephaly and other birth

96 defects when mothers are infected during the first trimester of pregnancy. As an emerging virus,

97 the consequences of ZIKV infection are not fully understood. We sought to investigate the

98 potential interactions between ZIKV and Dengue virus (DENY) as well as to understand the

99 pathogenesis of ZIKV within a target cell of the retina.

100 We hypothesized that ZIKV-induced antibodies have the capability to enhance DENV

101 infection, due to the structural similarity of the viruses. We found that rhesus macaques that have

102 previously been infected with ZIKV experience enhanced DENV infections. Additionally, ZIKV

103 infection results in an IgGl antibody response that is highly cross-reactive with DENV, but is not

104 able to neutralize DENV. These cross-reactive antibodies are able to enhance DENY-infectionzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAin

105 vitro. The presence of DENY-neutralizing antibodies within ZIKV-convalescent serum results in

106 a shift of the enhancing titer of the serum, indicating that the presence of DENY-neutralizing

107 antibodies can protect from ZIKV-induced enhancement. These results from experimentalzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

108 infection of rhesus macaques were mirrored in humans naturally infected with ZIKV.

109 Muller cells, a glial cell of the eye, have been identified as the target of ZIKV infection

110 within the retina. Muller cells are responsible for maintenance of homeostasis and also playa

111 role in regeneration of retinal damage. We found that ZIKV infection of Muller cells results in

112 the production ofInterferon lambda (lFNA.)andthe production ofInterferon Stimulated Genes. If

113 the IFNA.producedduring infection is neutralized, then the level of ZIKV replication in the cells

114 is decreased but Muller cells treated with IFNA.priorto infection are resistant to ZIKV.

5 115 These results highlight the potential severe outcomes of ZIKV infection that were not

116 understood as ZIKV emerged. ZIKV infection may have consequences for later DENV infection

117 and further epidemiologic studies are required to determine if areas affected by the ZIKV

118 outbreak will be at risk for outbreaks of severe dengue. Accompanying the adaptive immune

119 response, there is a strong innate immune response to ZIKV infection, but that response may lead

120 to pathogenic outcomes by promoting ZIKV replication. Further understanding of how the

121 immune response reacts to ZIKV may lead to potential therapeutics to prevent congenital zika

122 syndrome.

123

6 William G.Valiant

- 971-506-6361 [email protected]

Education 2015-Present Uniformed Services University of the Health Sciences Bethesda, MD PhD in Emerging Infectious Disease. Preventative medicine/biometrics track. Defended 9/27/19. OfficialGraduation 11/5/19. GPA:3.80 2011-2015 Oregon State University: College of Science, University Honors College, Corvallis, OR Honors Bachelor of Science Major: Microbiology. Minors: Chemistry, Public Health. Graduated Cum Lade. GPA:3.65

Research Experience 2016-Present Uniformed Services University, Department of Microbiology and Immunology Graduate Student Advisor: Joseph Mattapallil, DVMPhD Studied the pathogenesis of Zika virus in a rhesus macaque model of infection. 2015-2016 Uniformed Services University, Department of Microbiology and Immunology Graduate Rotation Student Advisors: Anne [erse, PhD; Steven Davies, PhD, Kim Williamson, PhD Participated in eleven-week rotations in three laboratories. 2011-2015 Oregon State University, College of Veterinary Medicine Undergraduate Research Assistant Advisor: Daniel D.Rockey, PhD Used microbiological techniques to investigate the properties of the genuszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAChlamydia.

Leadership Experience 2017-2018 USUHSInstitutional Animal Care and Use Committee Scientific Member Served as a voting member of the IACUC.Served as a designated member reviewer, participated in full committee reviews, and laboratory inspections. 2017-2019 USUHSGlobal Health Interest Group Graduate Student Representative (2017-2018) President (2018-2019) Assisted in the organization of various interest group events such as guest lectures, and the organization of public health case competition teams.

Awards JHonors 2018 Uniformed Services University- Sanford Research Fellowship in Tropical Medicine 2018 American Society for Virology- Travel Grant 2016 National Academy of Medicine DCPH case competition- Practicality Prize 2015 American Society for Microbiology- Travel Grant 2011-2015 Oregon State University - Presidential Scholar 2011,2013,2014 Oregon State University- Honor Roll Publications Valiant. William G. "Understanding the severe consequences of Zika Virus infection." Thesis. Unoformed Services University of the Health Sciences, 2019. Print.

Hutchinson, E. B., Chatterjee, M., Reyes, L.,Djankpa, F. T., Valiant. W. G.,Dardzinski, B.,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA!II & Juliano, S. L. (2019). The effect of Zika virus infection in the ferret.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAJournal of Comparative Neurology. Valiant. W. GilHuang, Y.J. S.,Vanlandingham, D. L.,Higgs, S.,Lewis, M. G.,& Mattapallil, J. J. (2018). Zika convalescent macaques display delayed induction of anmanestic cross-neutralizing antibody responses after dengue infection. Emerging microbes & infections, 7(1), 130. Valiant. W. GilLalani, T., Yun, H. C.,Kunz, A., Burgess, T. H., & Mattapallil, J. J. (2018). Human Serum with High Neutralizing Antibody Titres Against Both Zika and Dengue Virus Shows Delayed In Vitro Antibody Dependent Enhancement of Dengue Virus Infection. OpenForum Infectious Diseases. Valiant. W. Gil& Mattapallil, J. J. (2018). A Simple Flow Cytometry Based Assay to Determine In Vitro Antibody Dependent Enhancement of Dengue Virus Using Zika Virus Convalescent Serum. Journal of visualized experiments: JoVE,(134). George, J.*, Valiant. W. G.*,Mattapallil, M.J.,Walker, M., Huang, Y.J. S.,Vanlandingham, D. L.,Higgs, S. & Mattapallil, J. J. (2017). Prior exposure to Zika virus significantly enhances peak Dengue-2 viremia in Rhesus macaques. Scientific Reports, 7(1), 10498. Valiant. William G. "The Broad Spectrum Antiviral Compound ST-669 Affects Vesicular Trafficking in Chlamydia- infected Cells."Thesis. Oregon State University, 2015. Print. Sandoz, K.M.,Valiant. W. GilEriksen, S. G.,Hruby, D. E.,Allen, R. D., & Rockey, D. D. (2014). The broad spectrum antiviral compound ST-669 restricts Chlamydial inclusion development and bacterial growth and localizes to host cell lipid droplets within treated cells. Antimicrobial agents and chemotherapy, AAC-02064.

Oral Presentations Valiant. W. G. (April, 2019) Previous Zika exposure enhances Dengue disease. Three minute thesis competition. Uniformed Services University, Bethesda MD. Valiant. W. G. (February, 2019) The severe outcomes of Zika virus infection. Emerging Infectious Diseases Senior Seminar. Uniformed Services University, Bethesda MD. Valiant. W. G. (May, 2015) The Broad Spectrum Antiviral Compound ST-669 Affects Vesicular Trafficking in Chlamydia-infected Cells. Thesis defense, Oregon State University, Corvallis, OR. Valiant. W. G. (May, 2014) Antichlamydial compound ST-669. Podium presentation at Pathogenesis Research in Progress Seminars, Oregon State University, Corvallis, OR. Valiant. W. G. (September, 2012) Performing a transformation of C. trachomatis. Podium presentation at Howard Hughes Medical Institute Summer Research Symposium, Oregon State University, Corvallis, OR.

Poster Presentations Valiant. W. GilHuang, Y.S.,Vanlandingham, D. L.,Higgs, S.,Yun, H. C.,Kunz, A., Lalani, T., Lewis, M. G.,Burgess T, H., Mattpallil, J, J. (August, 2018 Future) Zika virus infection in Humans and Macaques Enhance Dengue Virus Infection. Poster presentation at Military Health System Research Symposium. Kissimmee, FL. Valiant. W. GilMattapallil, J.J (July 2018,) Innate Interferons protect Mullerglia cellsfrom Zika virus infection. Poster presentation at American Society of Virology Annual Meeting, College Park, MD. Valiant. W. Gil Rockey, D. D. (June, 2015) The Broad Spectrum Antiviral Compound St-669 Affects Vesicular Trafficking In Chlamydia-infected Cells.Poster presentation at American Society of Microbiology general meeting, New Orleans, LA. Valiant. W. Gil Rockey, D. D. (June, 2014) The broad spectrum antiviral compound ST-669 restricts chlamydial inclusion development and bacterial growth. Poster presentation at Celebrating Undergraduate Excellence, Oregon State University, Corvallis, OR. Valiant. W. Gil Putman, T. E., Rockey, D. D. (June, 2013) Obtaining whole chlamydial genome sequences using a culture-independent method. Poster presentation at Celebrating Undergraduate Excellence, Oregon State University, Corvallis, OR. UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4712zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA usuhs.edu

October 2,2019zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

MEMORANDUM FOR RICHARD W. THOMAS, MD, DDS, FACS, PRESIDENT, USUHS

Through: Chair, Board of Regents

SUBJECT: Certification of Graduate Student

The graduate student listed below is presented for certification to receive the Doctor of Philosophy degree effective upon your approval:

Caitlin L. Williams

DOCTOR OF PHILOSOPHY

Emerging Infectious Diseases Graduate Program

Attached is the candidate's certification of successful completion of the Final Examination. Also attached are the Dissertation Approval Form, certification of authorized use of Copyrighted materials, Dissertation Title Page, Dissertation Abstract, and Curriculum Vitae.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA C~~n Arthur LKellermann, MD, MPH Dean, USUHS, School of Medicine

Attachments: As statedzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Learning to Care for Thosein Harm'szyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAWay UNIFORMEDSERVICESUNIVERSITYOFTHEHEALTHSCIENCES SCHOOL OF MEDICINE GRADUATE PROGRAMSzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

FINAL EXAMINAnON/PRIV ATE DEFENSE FOR THE DEGREE OF DOCTOR OF PHILOSOPHY IN THE EMERGING INFECTIOUS DISEASES GRADUATE PROGRAM

Name of Student: Caitlin Williams

Date of Examination: August 23,2019 Time: 1:00 PM Place: Room B4004

DECISION OF EXAMINAnON COMMITTEE MEMBERS:

PASS FAILzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ~Z~ ~ Dr. Ann E. Jerse,zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA_j DEPARTMENT?~ MICROBIOLOGY & IMMUNOLOGY Committee Chairperson J)~ dLuv I( x_ Dr. D. Scott Merrell DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY

D;SS~fdVisor ; _fi /~-~:L( 1ft1- / Dr. Edward Mitre DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee Member

~' [Ikui: V/ r:KriStiLFfank DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee Member

Committee Member UNIFORMEDSERVICESzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAUNIVERSin' OF THE HEALTH SCIENCES SCHOOL OF MEDICINE GRADUATE PROGRAMS Graduate Education Office (A 1045), 4301 Jones Bridge Road, Bethesda, MD 20814

APPROVAL OF THE DOCTORAL DISSERTATION IN THE EMERGING INFECTIOUS DISEASES GRADUATE PROGRAM

Title of Dissertation: "Copper Resistance in the Emerging PathogenzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAcinetobacter baumannii"

Name of Candidate: Caitlin Williams Doctor of Philosophy Degree August 23, 2019

DISSERTATION AND ABSTRACT APPROVED:

DATE: i

{lunzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA'Z~~ Dr. Ann E. Jerse ,/ DEPARTMENT O!YMICROBIOLOGY & IMMUNOLOGY Committee Chairperson

Dr. D. Scott Merrell DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Disserta~dvisor .../:_~V~.oj~t:1 /~ Dr. Edward Mitre DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee Member

DEPARTMENT OF MICROBIOLOGY & IMMUNOLOGY Committee Member

The author hereby certifies that the use of any copyrighted material in the dissertation manuscript entitled: "Copper Resistance in the Emerging PathogenzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

Acinetobacter baumannii" is appropriately acknowledged and, beyond brief excerpts, is with the permission of the copyright owner.zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA

ISignature]

Caitlin L. Williams

November 5, 2019

DISCLAIMER

The views presented here are those of the author and are not to be construed as official or reflecting the views of the Uniformed Services University of the Health

Sciences, the Department of Defense or the U.S. Government.

VI Copper Resistance in the Emerging PathogenzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAcinetobacter baumannii

Caitlin Lee Williams

Dissertation submitted to the Faculty of the Emerging Infectious Diseases Graduate Program Uniformed Services University of the Health Sciences In partial fulfillment of the requirements for the degree of Doctor of Philosophy 2019 ABSTRACT

Copper Resistance in the Emerging PathogenzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAcinetobacter baumannii

Caitlin L. Williams, Doctor of Philosophy, 2019

Thesis directed by: D. Scott Merrell, Ph.D.

Professor, Department of Microbiology and Immunology

While most Acinetobacter species are environmental soil bacteria, Acinetobacter baumannii has recently emerged as a prominent nosocomial pathogen. The ability to survive in harsh, dry environments likely aided in in the establishment of A. baumannii in the healthcare setting. In the past few decades, A. baumannii has rapidly acquired numerous mechanisms of antibiotic resistance, and extensive drug resistance is now common. Lack of efficacious treatments leads to increased patient morbidity and mortality. Indeed, both the CDC and WHO have classified multidrug-resistantzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAA. baumannii as a significant threat to human health. Clearly, novel therapeutic options are needed to treat patients infected with drug-resistant A. baumannii.

Copper resistance has been shown to contribute to virulence of some bacterial pathogens, likely by helping to combat host copper-mediated immune mechanisms.

However, very little is known about the copper resistance mechanisms of A. baumannii or whether copper resistance plays a role in virulence. A more complete understanding of the copper resistance mechanisms of A. baumannii and their contribution to virulence

Vll may lead to the identification of novel drug targets in multidrug-resistant organisms. The work presented in this dissertation identifies numerous genes that mediate copper resistance; these genes are present in multiplezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAA. baumannii clinical isolates.

Furthermore, a particular set of genes that is found in some clinical strains is implicated in the highest levels of copper resistance. Our findings suggest that copper re~istance is multifactorial inzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAA. baumannii and that the range in levels of copper resistance seen among strains is dependent on the presence of certain copper-related genes.

Furthermore, in a model clinical isolate, we utilize transposon mutant strains to assess the roles of individual proteins in in vitro copper resistance and in vivo virulence in two infection models. We determine that many genes, most from the group previously predicted to convey a high degree of copper resistance, contribute individually to copper resistance; strains bearing mutations in these genes demonstrate reduced growth in the presence of copper. Furthermore, many of the genes contribute to virulence; strains bearing certain mutations are attenuated in vivo. En masse, our data suggest that copper resistance contributes to virulence of A. baumannii and is mediated by a number of genes; we believe that these factors have potential as novel drug targets in multidrug- resistant A. baumannii.

Vlll Curriculum Vitae Caitlin L. Williams September 1, 2019 Cell: (757) 570-0492

Work Address University of North Carolina - Chapel Hill Department of Microbiology and Immunology Marsico Hall, 125 Mason Farm Road, Chapel Hill, NC 27599

Education/Training

2008 - 2012 B.S. Biochemistry and Molecular Biology, GPA 3.56 University of Richmond, Richmond, VA Edinburgh University, Edinburgh, UK (Study Abroad, Spring 2010) Biochemistry Honors Program Thesis: Characterization of Achromobactin Iron Acquisition inzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBASodalis glossinidius Advisor: Laura J. Runyen-Janecky, Ph.D. 2013 - 2019 Ph.D., Emerging Infectious Diseases, GPA 3.88 Uniformed Services University of the Health Sciences, Bethesda, MD Advisor: D. Scott Merrell, Ph.D. Dissertation: Copper Resistance in the Emerging Pathogen Acinetobacter baumannii 2019 - present Post-doctoral Fellow, SPIRE Program University of North Carolina, Chapel Hill, NC Advisor: Rita Tamayo, Ph.D.

Professional History

2012 - 2013 MiddlezyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA& High School Teacher, Prishtina High School, Prishtina, Kosovo 2009 - 2012 Student Researcher, Department of Biology, Advisor: Laura Runyen-Janecky, University of Richmond, Richmond, VA 2008 - 2009 Student Researcher, Department of Physics, Advisor: Ovidiu Lipan, University of Richmond, Richmond, VA

Awards

University of Richmond Dean's List, 2009 - 2011 Robert F. Smart Award in Biology, 2011 Biochemistry and Molecular Biology Junior Research Award, 2011 Biochemistry and Molecular Biology Senior Research Award, 2012 Emma L. Bockman Memorial Award, 2017 USUHS Research Days Best Poster Presentation, 2018 USUHS Research Days Best Platform Presentation, 2019

Funding

Robert F. Smart Award in Biology, University of Richmond, 201 i, $4,500 TOStudent Research Grant, Uniformed Services University, 2017, $2,500 Emma L. Bockman Memorial Award, 2017, $750 University Service

USUHS Graduate Student Activities: Inviting, coordinating, and hosting student-invited seminar speaker Dr. Michael Schmidt Open house support (point of contact, hosting prospective students) Teaching: Teaching Assistant, Medical Microbiology Lab, USUHS, 2016 - 2018 Mentoring: Savannah Stull, Lyon College, Summer Intern, 2018 Caleigh Crawford, Holton Arms School for Girls, Summer Intern, 2015 Patrick LaBreck, Rotation Student, 2014

Oral Presentations

1. Copper Resistance inzyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBAAcinetobacter baumannii. 2017. Invited Speaker, Department of Biology Seminar Series, University of Richmond. 2. Copper Resistance is Important for Virulence in Acinetobacter baumannii. 2018. Rapid Fire Talk. American Society for Microbiology Microbe Meeting. Atlanta, GA. 3. Copper Resistance is Important for Virulence in Acinetobacter baumannii. 2019. American Society for Microbiology DC Branch Meeting. Washington, DC. 4. Copper Resistance is Important for Virulence in Acinetobacter baumannii. 2019. Uniformed Services University Research Days Graduate Student Colloquium.

Peer Reviewed Research PublicationszyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA * denotes publications using maiden name 1. Cates, J, GC Graham, N Omattage, E Pavesich, J Shaw, CL Smith* and 0 Lipan. 2011. Sensing the heat stress by Mammalian cells. BMC Biophys 4:16 2. Smith, CL*, BL Weiss, S Aksoy and LJ Runyen-Janecky. 2013. Characterization of Achromobactin iron acquisition operon in Sodalis glossinidius. Appl Environ Microbiol 79: 2872-81 3. Williams, CL, HM Neu, 11Gilbreath, SL Michel, DV Zurawski and DS Merrell. 2016. Copper Resistance of the Emerging Pathogen Acinetobacter baumannii. Appl Environ Microbiol82: 6174-88. 4. Williams, CL, HM Neu, YA Alamneh, RM Reddinger, AC Jacobs, S Singh, R Abu-Taleb, SLJ Michel, DV Zurawski and DS Merrell. Characterization of Acinetobacter baumannii Copper Resistance Reveals a Role in Virulence. (Submitted, Infect Immun)

Book Chapters

1. Williams, CL and DS Merrell. "Testing Metal Sensitivity of A. baumannii Strains: Survival in Copper- Supplemented Liquid Media and on Copper-Containing Surfaces." Volume Name: "Acinetobacter baumannii: Methods and Protocols." Methods in Molecular Biology, vol. 1946:51-60. Indranil Biswas and Philip N. Rather (eds.), © Springer Science+Business Media, LLC, part of Springer Nature, 2019. 2. Williams, CL, HM Neu, SLJ Michel and DS Merrell. "Measuring Intracellular Metal Concentration via ICP-MS Following Copper Exposure." Volume Name: "Acinetobacter baumannii: Methods and Protocols." Methods in Molecular Biology, vol. 1946:195-200. Indranil Biswas and Philip N. Rather (eds.), © Springer Science+Business Media, LLC, part of Springer Nature, 2019. TAB 12 Degree Conferrals Inouye Graduate School of Nursing

TAB 13 Degree Conferrals College of Allied Health Sciences UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES COLLEGE OF ALLIED HEALTH SCIENCES 2787 WINFIELD SCOTT ROAD, BLDG 2398 JBSA FT. SAM HOUSTON, TEXAS 78234

30 September 2019

MEMORANDUM FOR PRESIDENT USU

THROUGH: BOARD OF REGENTS

SUBJECT: CAHS Graduates

The College of Allied Health Sciences’ students identified on page two and three of this document are projected to complete the indicated program, meeting all academic, clinical and scholarly requirements to graduate in December 2019, for the degree indicated. The Dean, CAHS, requests the President, USU, award the following students the Associate or Bachelors of Science in Health Sciences degree, as listed, pending completion of degree requirements.

______M. J. Seal, EdD, MEd-IT, BSN, AS, RN Richard W. Thomas, MD, DDS, FACS Chief Academic Officer and Dean, CAHS President

Approved / Not Approved ______Date

College of Allied Health Sciences Projected Graduates – December 2019

Last Name First Name Initial Branch Rank Degree Program/Major Adams-Ward Jennifer S. ARMY E-7 ASHS Ed & Training Admin & Ldrshp Arthur David L. ARMY E-6 ASHS Ed & Training Admin & Ldrshp Bindner Kaitlyn M. NAVY E-5 BSHS Public Health Blair Josie G. ARMY E-4 BSHS Medical Lab Technician Bonagofski Ari C. ARMY E-4 BSHS Medical Lab Technician Burge Kelsey L. NAVY E-3 BSHS Medical Lab Technician Camarillo Victor J. NAVY E-3 BSHS Public Health Carranza Steve D. NAVY E-1 ASHS Public Health Carroll Holly N. NAVY E-5 ASHS Public Health Cash Scott B. ARMY E-6 ASHS Ed & Training Admin & Ldrshp Coffey James D. ARMY E-4 ASHS Public Health Combs Benjamin D. ARMY E-3 ASHS Medical Lab Technician Dancel Angelica I. ARMY E-4 BSHS Medical Lab Technician Davis Josh J. ARMY E-6 ASHS Ed & Training Admin & Ldrshp Fernandez Juan C. ARMY E-4 BSHS Medical Lab Technician Franco Cassandra E. ARMY E-5 ASHS Ed & Training Admin & Ldrshp Fuller Sydney M. ARMY E-4 BSHS Medical Lab Technician Garcia Amber N. ARMY E-2 ASHS Medical Lab Technician Hufford Christopher ARMY E-4 BSHS Medical Lab Technician Lee Ryan C. ARMY E-6 ASHS Ed & Training Admin & Ldrshp Marantz Tom ARMY E-4 BSHS Medical Lab Technician Marks Christopher A. ARMY E-3 ASHS Medical Lab Technician McGill Darby M. ARMY E-3 ASHS Medical Lab Technician Melendez Elizabeth ARMY E-4 BSHS Medical Lab Technician Miller Colton ARMY E-3 ASHS Medical Lab Technician Ndenge Claudia L. ARMY E-4 BSHS Medical Lab Technician Norman Sidney A. ARMY E-6 ASHS Ed & Training Admin & Ldrshp Odle Katelyn N. ARMY E-3 BSHS Medical Lab Technician

Page 2

Last Name First Name Initial Branch Rank Degree Program/Major Oueda Noaga R. NAVY E-6 ASHS Ed & Training Admin & Ldrshp Pena Jessica NAVY E-3 BSHS Medical Lab Technician Rodriguez- Velasco Mauricio ARMY E-7 ASHS Ed & Training Admin & Ldrshp Rowatt Matthew C. ARMY E-3 BSHS Medical Lab Technician Shyrock Laura A. NAVY E-3 ASHS Public Health Stewart Forest R. NAVY E-6 ASHS Ed & Training Admin & Ldrshp Tran Eric R. ARMY E-3 ASHS Medical Lab Technician Urbanczyk Phillip J. ARMY E-4 BSHS Medical Lab Technician Varela Raul ARMY E-4 BSHS Medical Lab Technician Wagner Gerrit W. ARMY E-5 ASHS Public Health (Health Physics) Woldesenbet Fantahun G. NAVY E-4 ASHS Medical Lab Technician Zapata Velasquez Jazmine ARMY E-3 ASHS Medical Lab Technician

Page 3 TAB 14 Faculty Appointments and Promotions Hébert School of Medicine

PROPOSED FACULTY RECOMMENDATIONS November 5th, 2019 BOR LIST

DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT DUTY STATION

Primary Appointments (Billeted)

ANATOMY, PHYSIOLOGY AND GENETICS

POLSTON, Eva Associate Professor Appointment/ PhD Non-Tenure USUHS

ZHANG, Yumin Professor Promotion/ MD, PhD With Tenure USUHS

MEDICINE

PRATT, Kathleen Professor Promotion/ PhD With Tenure USUHS

MILITARY AND EMERGENCY MEDICINE

GOOLSBY, Craig Professor Promotion/ MD Non-Tenured USUHS

PSYCHIATRY

MEYER, Eric Associate Professor Promotion/ MAJ, USAF, MC Non-Tenured USUHS

Primary Appointments (Non-Billeted)

ANESTHESIOLOGY

DUNFORD, John Clinical Associate Professor Promotion/ MD Non-Tenured Mclean, VA

FAMILY MEDICINE

GADDEY, Heidi Associate Professor Promotion/ Lt Col, USAF, MC Non-Tenured Omaha, NE DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT DUTY STATION

KLEIN, David Associate Professor Promotion/ Lt Col, USAF, MC Non-Tenured Ft. Belvoir, VA

MEDICINE

BLYTH, Dana Associate Professor Promotion/ Maj, USAF, MC Non-Tenured Ft. Sam Houston, TX

CAP, Andrew Professor Promotion/ COL, MC, USA Non-Tenured Ft. Sam Houston, TX

KEITH, Michael Professor Promotion/ MD Non-Tenured Fairfax, VA

KELLER, Anthony Clinical Associate Professor Promotion/ CDR, MC, USN Non-Tenured San Diego, CA

WILLIAMS, Paul Adjunct Associate Professor Appointment/ MD Non-Tenured Philadelphia, PA

NEUROLOGY

HARTMAN, Adam Adjunct Associate Professor Appointment/ MD Non-Tenured Bethesda, MD

LEKHY, Tanya Adjunct Professor Promotion/ MD Non-Tenured Bethesda, MD

OBSTETRICS AND GYNECOLOGY

HAN, Jasmine Associate Professor Promotion/ LTC, MC, USA Non-Tenured Tacoma, WA

KEYSER, Erin Associate Professor Promotion/ MAJ, MC, USA Non-Tenured Ft. Sam Houston, TX

LEVY, Gary Associate Professor Promotion/ LTC, MC, USA Non-Tenured Honolulu, HI

SPITZER, Trimble Associate Professor Promotion/ Lt Col, USAF, MC Non-Tenured Portsmouth, VA

VACCARO, Christine Associate Professor Promotion/ LTC, USA, MC Non-Tenured Bethesda, MD DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT DUTY STATION

PEDIATRICS

DOBSON, Craig Associate Professor Promotion/ COL, MC, USA Non-Tenured Bethesda, MD

LIPTON, Andrew Clinical Associate Professor Promotion/ COL, MC, USA Non-Tenured Bethesda, MD

MATOS, Renee Associate Professor Promotion/ Lt Col, USAF, MC Non-Tenured Ft. Sam Houston, TX

PHYSICAL MEDICINE AND REHABILITION

HENDERSHOT, Brad Associate Professor Promotion/ PhD Non-Tenured Bethesda, MD PREVENTIVE MEDICINE AND BIOSTATISTICS

BERNIER, Jean-Robert Adjunct Professor Appointment/ MD, MPH Non-Tenured Manotick, ON

SURGERY

ANDREATTA, Pamela Professor Appointment/ PhD Non-Tenured Bethesda, MD

ARTHURS, Zachary Associate Professor Appointment/ LTC, MC, USA Non-Tenured Ft. Sam Houston, TX

FRANCHETTI, Cristina Clinical Associate Professor Promotion/ Lt Col, USAF, MC Non-Tenured APO, AE

GUARNACCIA, Steven Adjunct Professor Appointment/ MD Non-Tenured McLean, Va

Hu, Hai Adjunct Associate Professor Promotion/ PhD Non-Tenured Windber, PA

JANAKIRAM, Naveena Associate Professor Appointment/ PhD Non-Tenured Bethesda, MD

KIM, Timothy Adjunct Associate Professor Appointment/ MD Non-Tenured Arlington, VA

MCCLATCHEY, Scott Professor Promotion/ MD Non-Tenured San Diego, CA

NELSON, Kenneth Associate Professor Promotion/ LTC, MC, USA Non-Tenured Ft. Bragg, NC DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT DUTY STATION

SERRA, Renee Clinical Associate Professor Appointment/ LTC, MC, USA Non-Tenured Tacoma, WA

SHEPPS, Craig Clinical Associate Professor Promotion/ CAPT, MC, USN Non-Tenured Portsmouth, VA

TINTLE, Scott Associate Professor Promotion/ CDR, MC, USN Non-Tenured Bethesda, MD

VALERIO, Ian Adjunct Professor Promotion/ CAPT, MC, USN Non-Tenured Columbus, OH

Secondary Appointments (Billeted)

BIOCHEMISTRY

PAZGIER, Marzena Associate Professor Appointment/ PhD Non-Tenured USUHS

MILITARY AND EMERGENCY MEDICINE

MEYER, Eric Associate Professor Appointment/ MAJ, USAF, MC Non-Tenured USUHS

MOLECULAR AND CELL BIOLOGY

PAZGIER, Marzena Associate Professor Appointment/ PhD Non-Tenured USUHS

PRATT, Kathleen Professor Promotion/ PhD Non-Tenured USUHS

NEUROSCIENCE

FENG, Yuanyi Associate Professor Appointment/ MD, PhD Non-Tenured USUHS

SWANBERG, Margaret Associate Professor Appointment/ DO Non-Tenured USUHS

ZHANG, Yumin Professor Promotion/ MD, PhD Non-Tenured USUHS DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT

DUTY STATION

PSYCHIATRY

SWANBERG, Margaret Associate Professor Appointment/ DO Non-Tenured USUHS

Secondary Appointments (Non- Billeted)

MILITARY AND EMERGENCY MEDICINE

KNAPP, Christopher Clinical Associate Professor Appointment/ Brig Gen, USAF, MC Non-Tenured Granite City, IL

PAMPLIN, Jeremy Associate Professor Appointment/ COL, MC, USA Non-Tenured Ft. Detrick, MD

PSYCHIATRY

RUSSELL, Dale Adjunct Associate Professor Appointment/ PhD Non-Tenured Bethesda, MD

TAB 15 Faculty Appointments and Promotions Postgraduate Dental College UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES POSTGRADUATE DENTAL COLLEGE SOUTHERN REGION OFFICE 2787 WINFIELD SCOTT ROAD, SUITE 220 JBSA FORT SAM HOUSTON, TEXAS 78234-7510 https://www.usuhs.edu/pdc

23 September 2019

MEMORANDUM FOR BOARD OF REGENTS

SUBJECT: Faculty Appointments and Promotions, Postgraduate Dental College

Attached are the recommendations made by the Postgraduate Dental College’s Committee on Appointments and Promotions (PDC CAP) at a meeting on 23 September 2019. I request that you endorse these recommendations and forward them to the President of the University for further action.

Thomas R. Schneid, DMD, MS Executive Dean and Professor Postgraduate Dental College

Attachments

Learning to Care for Those in Harms’ Way POSTGRADUATE DENTAL COLLEGE FACULTY RECOMMENDATIONS

5 November 2019

BOARD OF REGENTS

SCHOOL/NAME PROPOSED RANK CURRENT DUTY STATION

Air Force Postgraduate Dental School (AFPDS)

Sturdivant, Rodney Adjunct Professor JBSA Lackland, TX PhD (Civ) Biostatistics (Appointment)

Sheridan, Ryan Associate Professor JBSA Lackland, TX Maj, USAF, DC Endodontics (Promotion)

Chen, Wen Adjunct Associate Professor JBSA Fort Sam Houston, TX Biochecmistry and Molecular Biology PhD (Civ) (Appointment)

Hwang, Yoon Adjunct Associate Professor JBSA Fort Sam Houston, TX PhD (Civ) Microbiology (Appointment) TAB 16 Faculty Awards Hebert School of Medicine

UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES DANIEL K. INOUYE GRADUATE SCHOOL OF NURSING 4301 JONES BRIDGE ROAD BETHESDA, MARYLAND 20814-4799 www.usuhs.edu

3 September 2019

MEMORANDUM FOR THE PRESIDENT, USU

THROUGH: USU BOARD OF REGENTS

SUBJECT: Distinguished Service Award for Dr. David Welling

The USU Names and Honors Committee fully supports the presentation of the Distinguished Service Award to Dr. Welling for his many years of distinguished service to the Military Health System and the Uniformed Services University as Chair and Professor in the Department of Surgery.

Thank you for your consideration.

Carol A. Romano PhD, RN, FAAN Dean and Professor Chair of Names and Honors Committee

Learning to Care for Those in Harm’s Way TAB 17 University President Report USU Board of Regents

President’s Report November 2019

Richard W. Thomas, MD, DDS President

as of 15 October 2019 Issue Updates

Institute for Defense Analyses (IDA) Report “Analysis of DoD Accession Alternativesfor Military Physicians: Readiness Value and Cost”

Building F update

University Budget • 10% cut

Defense-Wide Review • Alternatives of 10%/25%/50% reduction

NDAA 19 • Joint Education and Training Feasibility Study • Research and Development Feasibility Study • Defense Health Command

Legislative Proposals • FY21 cycle . Academic Health System . Endowments . DHA Director as USU Regent Significant Events

- Aug 5-14 USU Military Field Practicum 102 (Advanced Combat Medical Experience) - Aug 19-22 Military Health System Research Symposium - Aug 23 Antietam Road March - Sept 19 USU Val Hemming Simulation Center 20th Anniversary - Sept 20 USU Founders Day - Sept 23- Oct 4 Military Contingency Medicine - Sept 24 Polish Ministry of Defense - Oct 4 Robert Wood Johnson Health Policy Fellows - Oct 5-9 Bushmaster Field Exercise - Oct 14-18 Bushmaster Field Exercise - Oct 17 White House NSC, OSTP, and FBI Discussion on Health Data Security - Oct 23 NASA LiveLink International Space Station (Alumnus Drew Morgan) Questions & Discussion TAB 18 University Registrar Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Wendy Kutchner, Ed.D, M Ed. Date: October 11, 2019

Title & Department: AVP, Academic Records and University Registrar Phone: 301-295-1667

Information X Action Purpose:

Subject: Academic Records Update

Significant Issues:

1. Policies and Procedures – On 16 June 2019, Dr. Thomas signed the Charter for the Registrar Coordination Committee (RCC) to recommend specific policies, processes, and procedures related to Registrar functions. The Committee is chaired by the University Registrar and has a standing representative from CIO, AOA, SOM, GEO, GSN, PDC, and CAHS. The first meeting was held on 14 August 2019 with a focus on the ConOps Development of Academic Support Services as well as a SWOT analysis of the current Registrar operations. While there are several structural issues that need adjustment going forward to ensure MSCHE compliance and operational efficiency, the committee’s 26 September 2019 meeting focused was on a centralized university catalog. This topic was socialized using the new Presidential Policy on the University Catalog (PPM-011-2019) issued on 23 September 2019.

2. Statement of Work (SOW) for the University Catalog - Over the past twelve months the Office of the University Registrar (OUR) and CIO have been reviewing catalog vendor features that will best meet USUHS needs for MSCHE accreditation. As of October 2019, the specifications have been finalized and submitted to Contracts for procurement. While we await the purchase process, OUR is working closely with RCC leaders to collect data for entry into the new software which is anticipated to take until March 2020 to gather.

The new catalog product will also provide a curriculum module that houses a workflow communication tool for academic programs to track each curricular stage. In preparation for a centralized curricular management software, GSN was selected to pilot the structural design process using a Lean Six Sigma approach in September 2019. During the Lean Six Sigma workshop on GSN curriculum, Program Directors were able to immediately put solutions into place that would address their current needs to verify credit calculations, move to one syllabi template, identify syllabi updates needed for their SOP, increase Curriculum Committee feedback to All Faculty, assign Core Course ownership, and create a gate keeper to close the loop on curricular activities. Furthermore, GSN has validated the benefits that a centralized curricular management software tool will provide for their School as well as expressed the desire to further implement the syllabi module of the software. A follow up meeting will be held in November 2019 to track progress with curriculum management and system design within GSN.

3. Empower re-implementation – USUHS has submitted both Admissions and Registrar system changes to the Student Information System (SIS) vendor Empower and will be reviewing the re-implementation planning the week of Oct. 14th. The project will have a significant amount of structural rebuild to address the academic record problems. Removing the SOM Lottery process from Empower will facilitate many of the needed design changes in Empower but brings along another project of implementing the Lottery in a second software. CIO has meet with SOM and identified MedHub as a strong Lottery product along with many other features that support the undergraduate and graduate medical student needs.

Current and Future Concerns: DoD regulations may impact the delivery methods available for the technology. Funding/Budget Estimate/Fiscal Impact: Curriculum management and catalog software will go out to bid in the next 3 months while the Empower solutions will require new funding. Staffing Impact: Technology and OUR staffing will have increased responsibility. Board Action Requested: Support of academic plan and software funding. TAB 19 Office of Accreditation and Organizational Assessment Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Stephen J., Henske, MHA Date: 26 Sept 2019 Asst. VP, Accreditation & Org. Assessment

Department: Office of Accreditation Phone 301-295-3681

Purpose: Information X Action: None

Subject: Semi-Annual Report

Significant accreditation/inspection notifications to acknowledge since the Oct 2019 Report.

1. As reported by Dr. Tom Schneid at the May BOR meeting, the US Air Force Dental Service has officially notified him and Commission on Dental Accreditation (CODA) that they were consolidating the Endodontic Residency program currently at Keesler AFB with the program at Joint Base San Antonio, TX as of 0-1 July 2020. On August 19, 2019, the Commission on Dental Accreditation (CODA) approved the closure and the proposed Teach-out plan. Dr.Schneid also received a memorandum from the Dean of the Air Force Dental School on 02 August 2019 advising the Postgraduate Dental College that it was planning to sun-set the two-year General Dentistry residency program on 30 June 2020. This will eliminate any new students being admitted to the USU Masters of Science in Oral Biology at the Keesler AFB site. Notification has now been made to Middle States Commission on Higher Education that USU will be closing one of its additional locations in accordance with their Substantive Change Policy and 34 CFR 602.22. USU Office of Accreditation has been requested to submit a teach-out plan for Keesler and is working with the Postgraduate Dental College to obtain and forward that plan.

2. The University’s assessment of the Middle States Commission (MSCHE) Mid-Point Peer Review Data Report was submitted to Dr. Christy Faison, SVP for Accreditation Relations on Sept 23, 2019. This is step #1 of a nine step mid-accreditation cycle review process. Given the unique nature of this academic institution, special attention will be needed to ensure the Peer Evaluators understand the military, government financial management, budgeting, funding, student management and DoD organizational structure and processes.

3. The National Capital Region Simulation Consortium (AEI) accreditation site visit is scheduled for November 14-15, 2019.

4. Applied Science Accreditation Commission (ABET) accreditation site visit scheduled during 2022. A reaccreditation evaluation visit request to ABET will be required around January 31, 2021.

5. Council on Education for Public Health (CEPH) accreditation sit visit is scheduled for the December 2020 time frame. Sept 2019 6. Our Master’s degree program in Healthcare Administration and Policy are scheduled for its first reaccreditation site visit by the Commission on the Accreditation of Healthcare Management Education (CAMHE) in March 2020. The program is actively preparing for this visit.

7. Our Annual Middle States Commission (MSCHE) Conference is at Philadelphia from Dec 9-11, 2019.

8. Accreditation staff assistant visit to San Antonio is being planned and scheduled for the November 2019 time frame.

Sept 2019 TAB 20 Faculty Senate Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Penny Pierce, PhD, RN, FAAN Date: 15 July 2018

Title & Department: President, Faculty Assembly Phone 301-295-1240

Purpose: Information X Action

Subject: Faculty Senate Report

Significant Issues: 1. Salary Comparability Analysis. The Faculty Senate Committee on Comparability and Welfare, chaired by Viqar Syed, Ph.D., presented the recent salary data at the 20 June Faculty Assembly. Data for categories containing three or fewer individuals are redacted. Faculty salary data for the 2017-18 academic year was compared to national norms for the SOM and GSN (AAMC, AACN reports). A PDF of the full report is attached. a. For the SOM, data continue to reveal gaps in the comparability of salaries for physicians with median salaries for MDs in clinical science departments being 18-24% less for faculty and 49% less for chairs. This finding does represent a small improvement over last year, which was 21-25% less for faculty and 50% less for Chairs. b. For the SOM, Ph.D. faculty in Basic Science departments have comparable (+/- 5%) salaries at the Assistant and Associate level and earn 6% less at the Full Professor level. Chairs earn 16% less than the median. In Clinical Science departments, Associate Professors earn 7% less than the median while Assistant and Full Professors are comparable. c. In the SOM, there is gender disparity of 7% for Ph.D. faculty seen at the Professor level only. For M.D.s, there is gender disparity in pay of 19% at the Assistant rank and 6% at the Professor level. The senate will continue to monitor this factor in its yearly analysis. d. The Comparability Committee also monitored, for a second year, disparities in salaries of research prefixed faculty in comparison to tenure track faculty. Research prefixed faculty are paid 27% (Assistant), 18% (Associate) and 26% (Professor) less than their non-prefixed colleagues. This gap has grown since last year, where disparity ranged from 19-22%. These differences were highlighted to leadership by the Senate in 2018 and will be re-emphasized. e. For the GSN, USU faculty at the ranks of Assistant and Full Professor are paid 15-16% and 5-9% percent more, respectively, than their peers nationally and at public universities defined as faculty in “Institutions with an Academic Health Center.” These figures represent a decrease from last year’s (25-27% (Assistant) and 8-11% (Professor) above). Data for Associate Professors and Chairs are redacted due to small numbers. Note that GSN civilian faculty are a small pool of individuals, which skew the group data. Due to the small numbers, gender analysis could not be presented, but it should be noted that in two ranks, the most highly compensated female was paid 22% and 32% less than the most highly compensated male.

2. Clearance Process for Surveys and Questionnaires. a. After several years of effort by the faculty, a policy was established in June 2018 for the initial review of research information collection requests at the University level. This new policy facilitated the performance of research by both students and faculty on military-relevant emergent health care topics (suicide, sexual assault, human performance). Previously, approval had required a minimum 6-12 month process under the OMB “Paperwork Reduction Act” (PRA) and/or DoDI 1100.13. That delay had negatively impacted both the education and the research mission, endangered accreditation, and hindered faculty recruitment, productivity and retention. b. The faculty was informed in April 2019, that this policy was not in compliance with regulations and that the new procedure requires all requests for human use research, exempt or non-exempt, to be reviewed by the DoD “Information Management Control Officer” (IMCO). This reinstitutes the previous time delay for research that is not subject to formal clearance. In addition, a narrowed definition of what constitutes human-use research would result in more projects requiring this formal clearance, 6-12 month process. c. The faculty’s opinion is that “Processes can be implemented within USU to serve the greater purpose of the PRA, which is to serve the public by ensuring that research is scientifically meaningful and does not overburden participants. Most of these determinations are already in place as part of the HRPPO (Human Research Protection Program Office) duties as recognized for internal information collection. Similar determinants could and should be used for public information data collection proposed for USU research studies through an OMB waiver. Clearly, the public good is better served by enabling health related research to serve and better our nation’s health.” (Senate Policy Paper, Feb. 2018, Strategies to Facilitate Research at USU). The Research Policy Committee is continuing to work with the Office of Research on this crucial issue.

3. USU Education Day. Led by CAPT Greg Gorman, the Senate Education Committee hosted the 12th annual USU Education Day on June 10th entitled Reach out & Teach Someone: Long-Distance Learning. a. The objectives of Education Day are to:  Promote continuing education of faculty, staff, and students at USU and its affiliated teaching institutions.  Provide interdisciplinary discussion of innovative and effective strategies used in health science education.  Facilitate transfer of strategies between and among research and clinical disciplines. b. The agenda included: i. Keynote presentations: 1. CAHS Dean Mitchell Seal, Ed.D. Evidence-based Education in the Digital Age 2. Ronald Cervero, Ph.D. Professor of Medicine and Associate Director, Remote Campus Education Engaging our learners: The key to high quality (Distance) learning ii. Five semi-finalist presentations and selection of the Innovation in Education Award winners: 1. Maj Cade Salmon, D.D.S. Microsoft Access-enhanced Application of EPAs in Postgraduate Dental Education 2. Anita Samuel, Ph.D. Using instructor created videos to enhance student engagement in online learning iii. Presentation by the winner of the Teaching and Technology Award Kelly Cozza, M.D. Department of Psychiatry Clerkship Tele-Simulation

4. Senate elections were held in June and announced at the 20 June Faculty Assembly. Newly elected officers and members of the Senate are:

President-Elect: Bernard Dardzinski, Ph.D. (SOM)

Secretary-Treasurer: MSG Jerry Crouch, Ed.D. (CAHS)

SOM Clinical Science Senators: Beth Aronson. M.D.; Maria Mendonca-Torres, M.D.; Marzena Pazgier, Ph.D.

SOM Basic Science Senators: LCDR James Dunford, Ph.D.; Luke Michaelson, Ph.D.; LTC Cuong Nguyen, D.O.

SOM Non-Billeted Senator: LCDR J. Kent Werner, M.D.

GSN Senator: Jill Schramm, D.N.P.

PDC Senators: LCDR James Hawkins, D.D.S.; LTC Nathan Krivitzky, D.D.S.; COL Lisa Yarbrough, D.M.D.

CAHS Senators: LCPO Branden Clayton, B.S.; 1LT Hamidah Brown, M.P.H.

Funding/Budget Estimate/Fiscal Impact: N/A

Staffing Impact: The Faculty Senate relies on the service of its membership but does not have administrative support to coordinate and execute its many functions throughout the year.

Board Action Requested: None

Current & Future Concerns: The Faculty Senate continues to serve as the voice of the faculty in all matters influencing our academic and scientific mission while attending to the morale and welfare of our community. TAB 21 Finance and Administration Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Walter W. Tinling Date: 07 October 2019

Title & Department: Vice President, Finance & Administration Phone: 295-3083

Purpose: Information √ Action

Subject: Resource Management Report

Significant Issues:

USU completed a successful financial and acquisition closeout in FY2019. Expiring appropriations (FY2019 O&M; FY18/19 RDT&E; FY2017 Procurement; and FY2017 Royalty) were fully obligated (99.9%). Several, large FY2019/2020 RDT&E (obligation rate 68%) cooperative agreement awards required additional justifications and reviews and were deferred to October, but these are expected to be obligated by the end of the month.

Challenges faced at fiscal year-end included sluggish systems (GFEBS and PD2) with limited access; delays from trading partners (e.g., NAVFAC); and the need to operate in both DAI and GFEBS. In FY2020, only a few contract actions with existing option periods will be processed in DAI, so the majority of our transactions will be in GFEBS. This should simplify FY2020 fiscal year-end processing.

Current and Future Concerns:

Budget: We have received our O&M funding for the 52-day CR (through 21 November 2019). The CR funding is adequate to meet sustained operations. DHA expects to distribute our RDT&E funding in a couple weeks. At this time we are anticipating a reduction to our BAG 6 (Education & Training) funding based upon a draft congressional mark for “excess growth” in equipment. USU will work closely with DHA to ensure any reduction to our program is equitable and in concert with Congressional direction.

Audit: The Kearney & Co. audit continues with USU receiving and responding to sample requests and working to ensure our documentation supports the transactions. A large sample request was received in September for three fiscal quarters (about 80%) of civilian personnel gains and losses. Additional response time was requested and granted, and CHR successfully completed the request. IG Assessment: An out brief of the IG assessment of USU-HJF interactions is anticipated in October.

Programming: For the POM21-25 cycle, USU submitted a Change Proposal for a cost-neutral funding realignment to rebalance civilian FTEs to ceiling controls. A POM issue was also submitted to resource 12 additional CAHS METC programs. We expect these program changes to be successfully incorporated in our program.

At this time USU has not received any additional information about the proposed DoD Chief Management Officer CMO Table Drop reductions. Our program was however reduced in the budget cycle based on Fiscal Guidance shortfalls, $3.4M in FY2021 and $3.0M in FY2022.

Staffing Impact:

Staffing continues to be challenging in the finance and acquisition departments. Additional administrative requirements have been imposed (e.g., a requirement for every cross organizational transfer of funds to be accompanied by a 7600A and B Agreement; additional reporting requirements; etc.). We continue to make slow, but steady progress in filling its critical hiring actions for new faculty and staff positions.

Board Action Requested: No Board action requested at this time. FY2019 ACTUALS FY2020 PLAN

FY19 O&M Funded Obligations PLAN DAI $ 10,640,000 $ 10,601,531 GFEBS $ 227,554,000 $ 227,073,552

Total $ 238,194,000 $ 237,675,082 $ 222,353,000

FY18/19 R&D CORE - DAI $ 30,127,000 OTHER - DAI $ 813,000 $ 30,940,000 $ 30,882,758

CORE - GFEBS $ 29,067,000 OTHER - GFEBS $ 37,725,000 $ 66,792,000 $ 66,722,684

Total $ 97,732,000 $ 97,605,442

FY18/19 R&D GDF DAI $ 8,847,000 $ 8,825,535 GFEBS $ 75,383,000 $ 75,341,426

Total $ 84,230,000 $ 84,166,961

FY19/20 R&D CORE $ 64,718,000 $ 125,456,000 OTHER $ 23,306,000 TBD

Total $ 88,024,000 $ 59,649,026

FY19/20 R&D GDF GFEBS $ 82,899,000 $ 47,274,935 TBD

Total $ 82,899,000 $ 47,274,935

FY17/19 PROC $ 3,362,000 $ 3,355,563 FY18/20 PROC $ 6,603,000 $ 6,005,696 FY19/21 PROC $ - $ - TBD FY20/22 PROC $ 435,000

TOTALS$ 601,044,000 $ 535,732,706 $ 348,244,000 TAB 22 Office of Information and Education Technology Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Timothy J. Rapp Date: 08 Oct 2019

Title & Department: VP, Information & Education Phone 301.295.4231 Technology/CIO

Purpose: Information X Action

Subject: Vice President’s Report: Information & Education Technology/CIO

1. DoD IT Reform Efforts - a. BLUF - USU remains eager to take advantage of any DoD IT reform efforts that do NOT deprecate existing capabilities, increase costs, or negatively impact the accreditation requirements of degree granting academic organizations.

b. BACKGROUND: USU is included as part of broad DoD IT Reform efforts which are focused on gaining efficiencies in order to provide additional resources to the warfighters. Example IT Reform initiatives include: consolidation of IT & Business Systems, Cyber responsibility consolidation, centralized IT commodity purchasing, standardize on one NIPR/SIPR network, rationalize business (HR, FM, Contract) systems to include Learning Management Systems (LMS) and related Training & Education support contracts, reduce to a single Authorizing Official (AO), move to a single 4th Estate (4E) Enterprise Collaboration and Productivity Suite, and centralize wireless device management and patch management at the 4E and/or DoD CIO level.

c. POTENTIAL IMPACT: This could represent a significant risk to USU’s ability to meet our 10 USC 104 and 34 CFR 602.16-20 obligations, maintain external accreditations from bodies representing each of our thirty-three (33) educational programs, and maintain access to academic pricing.

d. UPDATES SINCE LAST BOARD MEETING (DOD CIO Reform Efforts): i. A meeting with DoD IT Reform Principle, Ms. Essye Miller, was held in May 2019 to discuss USU reform concerns and accreditation impacts. DoD CIO’s two substantive comments were: (1) that the academic vs. CETA prices being discussed is an apples to oranges comparison and did not reflect the true top 10 CETA efforts underway in the DoD CIO’s office and (2) that academic accreditation is not a concern and will not be negatively impacted by IT reform. 1. USU has confirmed with DoD CIO and J6 that the products that have both academic and CETA pricing in place are cheaper with academic pricing, with DoD CIO and J6 acknowledging that “CETA commercial pricing cannot even come close to the .edu discount offered by vendors”, i.e. it is an apples to apples comparison. 2. USU reached out to MSCHE with the specific IT Reform negative impact example used during the May 19 meeting (e.g. deprecation of an ePortfolio capability that is common to almost all universities as a result of CMO business system reform policy/processes) for their determination on accreditation impacts. We are still waiting for their response. ii. The DoD Academic Information Technology Consortium (DAITC) charter was finalized and the initial DAITC meeting held in July with all DoD academic organizations. DoD CIO IT Reform efforts will now work thru this consortium which has been placed inside the existing reform governance structure.

iii. Responses to an extensive data call were completed in August 2019. DoD CIO will use this data call to scope and phase academic consolidation efforts which from a network services perspective have been pushed to later phases (e.g. 2022/23).

e. UPDATES SINCE LAST BOARD MEETING (DOD CMO Reform Efforts): i. CMO held an IT Reform kick-off meeting in August focused on Defense Business System (DBS) consolidation across four primary thrust areas: (1) Business systems consolidation, (2) Business system PEO rationalization, (3) Business system development workforce, and (4) consolidation of 4th Estate Authorizing Officials (AOs). ii. Any AO consolidation which misaligns strategic risk management decisions from the mission and business functions, consistent with USU organizational goals, is a significant risk, i.e. same arguments previously made with DoD CIO now need to be addressed with CMO. iii. The DBS definition being used is not what’s in 10 USC 2222 or aligned to prior DoD definitions, but instead considers a DBS to include systems in any dollar amount with only systems directly supporting operational warfighter missions excluded. This means all academic systems would now be considered a DBS. USU will continue to make the BLUF case listed above with CMO representatives as this moves forward.

2. Two Bullet Updates a. Migration of .edu to Mid-Atlantic Crossroads (MAX) • WHAT - Conversion of USU’s primary network circuit to a regional high- bandwidth, high-performance Gigabit point of presence Research & Education Network, which provides greater advanced network services at lower operating costs. This is a project which predates DoD IT Reform, but has been embraced by DoD CIO as a best practice for all Defense .EDUs. • STATUS - USU has established dual 100Gbps uplinks to regional points of presence through MAX, allowing researchers to transfer data to academic, research, and industrial partners 100x faster than previously. Next steps will involve conversion of USU’s day to day networking to the same platform, further driving down operational expenses while increasing resiliency of operations.

b. Academic Systems Rationalization • WHAT - Rationalization of numerous academic support functions IAW Federal/DoD guidance and industry best practices. • STATUS - Representatives from all USU schools and CIO personnel did a day- and-a-half deep dive into the capabilities of MedHub. The team assessed the use of MedHub for lottery, evaluations, MSPE, curriculum mapping, data analytics and student performance. MedHub is already used by GME. Schools agreed to pursue acquisition of MedHub as the USU-wide solution for these functions. Additional work must be done on data integration and security approvals. There is a meeting in October to discuss the approach with Acquisitions. 3. Board Action Requested: None. TAB 23 Office of General Counsel Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Mark E. Peterson, JD, LLM Date: 26 Sep 2019

Title & Department: General Counsel Phone: 301-295-3028

Purpose: Information X Action

Subject: Office of General Counsel

Significant Issues (discussion, background): • The Office of General Counsel (OGC) is responsible for legal advice and services for the USU Board of Regents, USU President, and USU faculty, staff, and students in the following areas: ethics and standards of conduct; civilian personnel law; contract and fiscal law; intellectual property; military justice & legal assistance (Brigade JAG); claims; litigation; administrative law; and legislative affairs. As part of the Defense Legal Services Agency, OGC reports to the DoD General Counsel through the Deputy General Counsel (Personnel and Health Policy), Mr. Paul Koffsky. • OGC has unique responsibility for the USU Technology Transfer Program, which is managed jointly by OGC and the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF), as well as the related Research and Education endowment accounts at HJF. • As General Counsel and Designated Agency Ethics Official, I am supported by a Deputy General Counsel (Mr. Sam Smith); two full time Associate General Counsels (Mr. Steven Weiss and Ms. Sarah Stanton); two part time Associate General Counsels (Mr. Bradley Beall and Mr. Joseph Procaccino); the Brigade Judge Advocate (Lt. Col. William Dazell, USAF, JA); and two Army Reservists (COL Tom Carter, JA, USAR and MAJ Michael Grogan, JA, USAR). Our Paralegal position is currently occupied by Mrs. Allison Ryan.

Current & Future Concerns: • Fiscal Law: The addition this past year of Ms. Sarah Stanton, a contract and fiscal law specialist, and Mr. Sam Smith, an experienced military and government counsel, increased OGC’s capability and capacity to address long standing fiscal law issues that were of concern within OGC. Working closely with Mr. Walt Tinling’s staffs in finance and acquisitions, OGC continues to ensure fiscal law compliance, solve problems, and identify areas of improvement for current business practices. • Our biggest success this year in this arena has been to obtain authority from DoD for USU to use $45 million in royalties and investment income that was locked in dispute. • To assist USU, OGC has produced a manual that provides legal guidance in the exercise of USU’s authorities granted by 10 USC § 2113(g). This manual has been reviewed and approved by the Fiscal Division of DoD OGC, and will be a useful aid.

November 2019

• Technology Transfer: OGC has special responsibility for the USU Technology Transfer Program (T2). This provides unique challenges to OGC as well as the University as T2 works closely with the Office of Research and the USU research community, yet the T2 office is not aligned under the Office of Research. More importantly, the current arrangement was developed under a former statutory provision that only authorized USU to use special transactional authorities with HJF. Since the statute was amended in 2012, USU has developed working collaborations with a number of non- profit entities other than HJF, which also require intellectual property development and support. • OGC proposes that a new technology transfer office be stood up under Office of Research composed of Federal and contractor personnel once the new Vice President of Research is in place. Plans should be developed in the interim. • This plan will include the hiring of an attorney technology transfer specialist, possibly a patent attorney, to increase OGC’s legal capability in support to the University in the area of T2. A current position within OGC remains unfilled; OGC would use that position to hire for a technology transfer specialist.

• Personnel Staffing & Appearances: USU has grown and developed with tremendous support from HJF, which currently provides critical personnel support across the University. As the relationship has evolved, HJF has also become a major research business partner to USU, involving millions of dollars annually. USU Centers are overwhelmingly staffed and run by HJF personnel, and many are located at HJF. While many of these HJF personnel are working on specific research projects with USU, some of these employees only work on administrative matters to support USU Centers or USU Departments and Offices, such as the Office of Research. More importantly, some of these positions require duties that actually or could be perceived to impact current or future funding of research activities between USU and HJF. Given newer statutory authority allowing for collaborations with “any other non-profit entity”, it is time for USU to reassess those positions in which HJF personnel are providing non-research activity support to avoid the appearance of conflicts of interest in USU decision making. To accomplish this, USU should consider contracting for a number of positions currently staffed by HJF.

• Remote Support: OGC is continuingly looking for ways to improve our responsiveness to our USU client. Of particular challenge is OGC services and support to USU-South and USU-West offices. One of our main focus areas in the upcoming year will be to continue to find ways to better support off-campus locations, to include many of the USU Centers, USU-South, and USU-West.

Funding/Budget Estimate/Fiscal Impact (source & time frame for funding): None

Staffing Impact: No new positions foreseen, but must fill vacant position.

Board Action Requested: Continue to support

November 2019

TAB 24 Henry M. Jackson Foundation Report Uniformed Services University of the Health Sciences Board of Regents

BOARD BRIEF Submitted by: Joseph Caravalho, Jr., M.D. Date: November 4-5, 2019 Title & Department: HJF President and CEO Phone: 240-694-2017 Purpose: Board of Regents (Fall 2019 Meeting) Subject: Henry M. Jackson Foundation for the Advancement of Military Medicine Report

Report Summary USU Research Spending Supported by HJF • Research spending is projected to increase to (in millions) approximately $250 million in FY 2019 300 • HJF welcomes USU Walter Reed Surgery 251.2 Centers to Rockledge Dr., Bethesda, Maryland 250 24.7 • The USU-HJF Personnel Services 216.8 215.0 197.0 22.1 Memorandum of Agreement celebrates its 200 23.9 20.4 204.4 one-year anniversary 20.2 17.1 17.6 • HJF fully dispersed endowment funds back to 17.7 175.7 177.0 USU in accordance with USU requests. 150 159.1

Research Support 100 HJF currently manages 455 awards on behalf of USU investigators. Total spending in FY 2019 is 50 projected to be over $250 million, an increase of $36 million, or 16 percent over 2018. Sponsors include Uniformed Services University, the 0 FY 2016 FY 2017 FY 2018 FY 2019 Department of Defense, Army, Navy, Air Force, Actual Actual Actual Preliminary the National Institutes of Health, and other non-federal organizations. Direct Spending Overhead HJF G&A

Research Spending by Award Type

Award Type Award Count FY19 Direct FY19 Indirect Total Spend Cooperative Agreements 251 $148.5 million $29.6 million $178.1 million Grants 135 43.3 13.7 57.0 Endowments 28 7.0 2.9 9.9 Contracts 16 5.0 0.5 5.5 CRADA 16 0.5 0.14 0.63 Total 455 $204.4 million $46.8 million $251.2 million

The majority of research awards are made through cooperative agreements and grants.

1 USU FY19 Projected HJF Employees Supporting USU Direct Spending by Sponsor (1,275 Total) ($204.4 million) 516/40% USU Main Campus

98/8% Teleworkers USU $171.2M 22/2% NIH

Army $8.2M 77/6% Other Non-DoD Navy $0.1M All HJF NIH $13.1M USU Direct Employees 126/9% Other DoD Other $11.8M Spending by Site 102/8% WRNMMC

334/26% USU Leased Space

Consolidating Military Medical Research to Propel Advances location on Rockledge Drive. The Center for Prostate Disease Research (CPDR) moved personnel and laboratory facilities in December 2018, the Surgical Critical Care Initiative (SC2i) moved in May 2019, and the Murtha Cancer Center Research Program (MCCRP) moved in July 2019. The centers and their HJF staff members are all co-located in newly renovated space that will serve to propel the development of cutting-edge research and drive the discovery of solutions to advance critical and surgical care in public and private healthcare systems. Two additional USU Walter Reed Surgery research programs, HJF has recently welcomed three USU Walter Reed the Battlefield Shock and Organ Support program and National Military Medical Center Department of the Osseointegration program, will be joining these three Surgery research centers to the HJF Home Office centers during the second quarter of 2020.

Council of Center Directors The Council of Center Directors (CCD) is a USU- to establish and operate USU Centers as critical led, HJF-supported entity that brings together the research units that provide an important mechanism to University’s diverse areas of research with the goal continually improve medical care and support for our of facilitating collaborative efforts and creating service members and their families. administrative and research efficiencies. More than Working with HJF, CCD Director Dr. Todd Rasmussen 14 Centers exist at the University, and their research has worked tirelessly to coalesce the Centers into a efforts are aligned to meet the needs of the Military collaborative research consortium. The CCD has published Health System. two annual reports highlighting individual Center Through a Presidential Policy Memo signed in achievements and has hosted a Center’s Forum at the July 2019, USU President Thomas has endorsed a most recent Military Health System Research Symposium. CCD-developed framework to design a pathway

2 HJF Employees Trend 1400 1,275 Personnel Support Memorandum 1,191 1,178 1200 154 of Agreement 1,105 96 90 81 658 The Personnel Support Memorandum of Agreement 1000 974 614 617 79 567 (PESMOA) allows HJF to provide a wide array of critical skill sets to enhance the USU mission. 800 482 The agreement, established in September 2018, 600 supersedes a previous agreement (known as the Crossbill) and currently makes available over 150 HJF 400 457 481 471 463 employees to multiple areas within the University to End of Year Headcount Year of End 413 include education, technology, research support, the 200 Val Hemming Simulation Center, and other technical or administrative activities. 0 FY15 FY16FY17 FY18 FY19

USU On USU Off Crossbill PESMOA

Endowments and Education Funds HJF currently manages 32 endowment awards on behalf of USU. HJF also manages 134 USU education funds used for various education and training needs, including conference attendance, exam fees and textbooks.

As of Growth of $100 in the Endowment Portfolio ENDOWMENTS AT-A-GLANCE August 31, 2019 Total Portfolio $168 Policy Benchmark $163 Number of Endowment Awards in 32 $200 Support of USU Portfolio Value $38.1 million $150 Portfolio Performance (since 2010, 6.0% $100 inception with Commonfund)

Portfolio Benchmark (since 2010, 5.7% $50 inception with Commonfund) FY 2019 USU Endowment Spending $9.4 million $0 2012 2014 2016 2018

EDUCATION FUNDS AT-A-GLANCE As of August 31, 2019 Number of Active Education Projects in Support of USU 134 Total Value $2.6 million FY 2019 USU Education Fund Spending $0.8 million

Signiﬁcant FY 2019 Endowment Activity • During the year ending Sept. 30, 2018, USU notified HJF of the need to return certain unspent contributions previously provided by USU resulting from royalty payments USU received, as well as subsequent unspent earnings on those contributions. This amount stood at $48,034,918 at the end of FY 2018. During FY 2019 through the present, HJF has fully disbursed these funds adjusted for earnings during the period back to USU in accordance with USU requests. This has resulted in the closure of seven endowment awards. • The Center for Prostate Disease Research Endowment incurred expenses of $6.9 million on the CPDR endowment primarily to renovate an off-site space for its critical ongoing activities.

3 TAB 25 Hébert School of Medicine Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Arthur L. Kellermann, M.D., M.P.H. Date: November 2019

Title & Department: Dean, School of Medicine Phone 301-295-3016

Purpose: Information X Action

Subject: Dean’s Report: School of Medicine (SoM)

Notable Achievements:

Health Affairs, a leading journal on health policy, published its first theme issue on Military Health. USU’s Defense Health Horizons program served as a key facilitator for this project using support provided by the Defense Health Program. Several USU faculty members published papers in the issue. Three faculty members, COL (Ret) Craig Shriver, COL Peter Learn and COL Jeremy Pamplin, presented their work at the journal’s highly successful public briefing, which was held at the Reserve Officer’s Association building on 12 SEP. BOR members Dr. Jonathan Woodson and Dr. Sheila Burke also spoke at the briefing.

USU SoM’s Graduate Education Programs reviewed by a Blue Ribbon Committee. Graduate education at USU is an essential component of military medical education and research and is vital for the ongoing accreditation of the School of Medicine. In May, we hosted a 2-day site visit from an elite 3-person team led by Dr. Alan Leshner, former CEO of the American Association for the Advancement of Science (AAAS). He was accompanied by Dr. Michael Gottesman, Deputy Director of intramural research at the NIH and Dr. Emily Miller, Senior VP for Policy at the Association of American Universities (AAU). We received their final report in July, and are currently developing a strategic plan for graduate education at USU to capitalize on our unique assets and institutional partners. We have an opportunity to create a model program that could influence the future of graduate STEM education in the United States

The School of Medicine’s National Faculty Development Program supports military GME and active duty medical officers throughout the MHS. Military GME and clinical education of USU and HPSP medical students is critical to generate the future medical force on which the MHS relies. Under the leadership of Dr. Jessica Survey, the SoM’s Faculty Development program substantially expanded its programs and offerings over the last FY. In addition to making frequent trips to MTFs to deliver short courses on faculty development, academic leadership and mentoring for academic promotion, we continued to build our FOCUS (Faculty Development Outreach & Certification for the Uniformed Services) faculty to help MTFs meet the increasing ACGME requirements expected of military residency programs. Strengthening USU’s national faculty does not only benefits our medical students; it benefits HPSP, MHS GME and is factor in retaining high-impact military medical officers. (Appendix A)

In FY 2019, our Faculty Development Program: • Delivered 441 workshops in 21 different locations. This is 32% more than FY18 and double what was done in FY17. One workshop was held in a deployed location. • Reached 7,511 registered attendees (>2,500 more than in FY18). • Taught 1,770 unique individuals (i.e., learners who attended one or more workshops. This is 700-plus more we taught in FY18). About 25% of our learners are non-docs. • Granted >10,000 credit hours and 103 teaching certificates. Attendees value our certificates and want more. In response, we rolled out a new Advanced Teaching certificate on 1 OCT. It includes more content, peer observation and feedback, and self-reflection.

USU’s Center for Deployment Psychology (CDP) delivers behavioral health training throughout the MHS. In addition to training civilian practitioners who provide services through purchased care, CDP provides behavioral health continuing education workshops at MTFs and online. These workshops focus on increasing awareness and use of effective treatments for behavioral health issues that are important to the DoD including PTSD, sleep problems, depression and suicide. Over the past year alone, more than 1,500 DoD behavioral health professionals attended CDP workshops, earning nearly 18,000 continuing education credit hours.

The School of Medicine is building bridges to the VA. The Director of USU’s Center for the study of traumatic stress, Dr. Robert Ursano was tapped by the White House to serve as Risk Identification Section Lead on the Research Line of Effort (LOE) for Executive Order (EO) 13861 "National Roadmap to Empower Veterans and End Suicide." He attended the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS) Kickoff Meeting and is an active member of this interagency team. At the request of the VA senior leadership, Dr. Kellermann has joined the VA’s Special Medical Advisory Group, its oldest Advisory Committee (est. 1945). VA and HHS senior leaders are interested in partnering to expand medical student enrollment at USU with the understanding that the additional PHS officers we would educate would work for the VA and develop into health system leaders.

USU working to Readiness for Deployment. A key element of the Clinical Readiness Program (KSA) is objective assessment and remediation of critical expeditionary skills. To that end, USU-Walter Reed Surgery held the third beta test of the ASSET+ course was held at USU last month. Twelve attending surgeons participated alongside the same number of faculty. The cadaver based ASSET+ focuses on the individualized assessment of critical KSA skills including trauma and vascular exposures and over a two day course has both formative and summative elements. Senior Navy leadership (RADM Gillingham, RDML Darrin Via and RDML Jim Hancock) participated in ASSET+ during a site visit, as they have been strong proponents of the KSA effort. Future plans for ASSET+ include expansion to other sites and replacement of the current Emergency War Surgery Course. The current and future renovations of the ATL space will serve as the ‘epicenter’ for innovation in surgical readiness with the evolution of ASSET+ and allow the lessons learned to permeate both UME and GME. (Class photo at end of report) Emory Global Health Case Competition. An interdisciplinary team of six graduate and medical students represented USU in this global challenge which challenges competitors to develop a multidisciplinary approach to solving 21st century global health problems. USU took second place out of 30 participating teams from schools around the world, including Yale, Brown, Vanderbilt, Emory, the University of Toronto in Canada, and the winning team, University of Melbourne, Australia. This years’ task was to formulate nation-specific recommendations for “Implementing Innovative Hurricane Disaster Preparedness Strategies in a Changing Global Climate.” USU’s team included Sarah Walsh, an MD/PhD student in USU’s Molecular and Cellular Biology program, CPT Sybil Mallonee, a Clinical Psychology doctoral student, June Early, a Preventive Medicine and Biostatistics student pursuing her PhD in public health, and first-year medical students 2LT Elizabeth Rich and 2LT Sarah Fitzpatrick, and 2d Lt Hailey Reneau.

Col (Ret) Dr. Paul Hemmer elected a Master of the American College of Physicians. A Professor in our Department of Medicine (MED) and Chair of the School of Medicine Curriculum Committee, Dr. Hemmer is an outstanding internist and educator. This is a huge honor for the School, the University and for him. He joins Dr. Lisa Moores and Dr. Lou Pangaro as a MACP.

Concerns: The Faculty, medical students and NCC house staff continue to track discussions about the future strength and nature of the military medical workforce with great concern. The impact on their morale and future career planning is substantial but at present unquantified.

Action Items: None

Dean’s Office Updates:

Academic Affairs: • The Women in Medicine Summit Award Committee recognized Dr. Jesssica Servey as a 2019 Honorable Mention for the #IStandWithHer Award! She will receive it at the Women in Medicine Summit in Chicago, 20-21 September.

Diversity and Inclusion: • Associate Dean for Diversity and Inclusion – CDR Patcho Santiago, checked-in to the command in late August and soon thereafter, participated on behalf of the SoM in the STEM Equity Achievement (SEA) Change Institutional Workshop at the American Association for the Advancement of Science (AAAS). • Community Pipeline update: Led by our Diversity Recruiter, Mrs. Shawntell Williams, the SoM’s Science, Service, Medicine and Mentoring (S2M2) and inaugural S2M2 Junior programs concluded this summer with poster presentations by local high school and (for the first time) middle school students who participated in hands-on workshops led by students, faculty, and staff. • Campus Groups hold Inclusivity Seminars: The Department of Microbiology and Immunology hosted a forum co-sponsored by Lean In and the Task Force for Inclusivity on “Men in the #MeToo Era.” The USU chapter of the Group on Women in Medicine and Science (GWIMS) invited Dr. Andrea Austin to lead a discussion on “Gender Bias and Developing Male Allies.” Spectrum, the LGBTQ Student Interest Group, in conjunction with the Psychiatry Interest Group, hosted a brown bag seminar exploring the psychosocial facets of sex and gender.

Graduate Education Office (GEO): • Admissions: This Fall GEO welcomed one of our largest classes ever, with 35 students admitted across all USU Ph.D. programs, including four in the MD/PhD Physician Scientist program. Before starting their coursework, incoming students completed a revamped, two- week GEO orientation designed to streamline onboarding procedures and foster camaraderie across programs. Of the 35 new graduate students enrolled, 11 are active duty personnel, several with prior military service. • Student Achievements: o Meghan Byrne, a 4th year Clinical Psychology student working with Dr. Marian Tanofsky-Kraff, received a prestigious Ruth L. Kirschstein Predoctoral Individual National Research Service Award (F-31) from the National Institute of Mental Health. This highly competitive, mentored training grant supports promising doctoral candidates on their path to becoming productive, independent scientists in health-related research. o Erin Sheffels, a 5th year Molecular & Cell Biology student working with Dr. Robert Kortum, was the recipient of the 2019 Henry M. Jackson Fellowship Award. This HJF Fellowship provides one year of salary and travel support for an outstanding senior USU SoM graduate student who is nearing completion of their Ph.D. dissertation work. Reflecting the highly competitive field of applicants considered, the selection committee also highlighted two Honorable Mentions: Britney Hardy and Patrick LaBreck, both 5th year students from the Emerging Infectious Diseases program and mentored by Dr. Douglas (Scotty) Merrell. HJF graciously provided these students with travel support to attend an upcoming scientific conference.

National Capital Consortium (NCC)/Graduate Medical Education: • NCC Endocrine fellows and staff contributed 4 chapters in Endocrine Secrets book, 7th Edition Chapter 37 - Congenital Adrenal Hyperplasia (Harris M. Baloch, Nicole O. Vietor, and Robert A. Vigersky) Chapter 39 - Hyperthyroidism (Thanh D. Hoang and Henry B. Burch) Chapter 50 - Male hypogonadism (Katherine N. Vu, Vinh Q. Mai, and Robert A. Vigersky) Chapter 51 - Erectile Dysfunction (Mark M. Cruz, Thanh D. Hoang, and Robert A. Vigersky) • LT Brett Sadowski, an NCC GI fellow, was competitively selected for the American College of gastroenterology Young Physician Leadership Scholars Program. • NCC Radiology residents achieved a 100% pass rate on the American Board of Radiology core exam.

Office of Medical Education: • 2019 AAMC Graduation Questionnaire (GQ) provides stellar results. USU Medicine class of 2019 graduates rated their education as “excellent” or "good" at higher rates than other medical schools in almost all areas, including “Strength of Basic Science Preparation for Clerkships,” “Curricular Integration,” “Preparedness for Residency,” and “Quality of Clinical Clerkships.” On the all-important question “Overall, I am Satisfied with the Quality of My Medical Education,” 93.2% of USU graduates agreed or strongly agreed with the statement - four percentage points higher than grads of other allopathic medical schools. Even more remarkably, N% of USU’s grads “strongly agreed,” compared to only N% of US medical school grads overall. (Appendix B)

Medical Student Recruitment and Admissions: • Med Student Recruiting: On 10 September, we conducted our first 2-hour virtual training session for 35 of our newest “Military Medicine Ambassadors” (MMAs). To date, we have nearly 200 registered MMAs, many but not all of them USU alumni. The mission of the MMA program is to make known the opportunities available to practice medicine as a uniformed physician through USU, the Armed Forces’ Health Professions Scholarship Program (HPSP), and other accession options. Our goal is to ensure that every individual with a propensity for service as a uniformed medical officer is aware of USU, HPSP, and the other pathways available to become a uniformed medical officer. We recently created an MMA Handbook which defines the mission and vision for the program. It provides a wealth of information about USU and the service HPSP programs. With the support of our new MMAs, our recruiting team recently participated in several events, including the 2019 National Conference for Historically Black Colleges and Universities, campus visits to Georgetown, Johns Hopkins, the University of Dayton, Cedarville University, the U. of Mississippi, Drexel, the University of Maryland, College Park, Virginia Tech, UVA, Grand Canyon University, Rhodes College, Christian Brothers University, and the University of Memphis. • Admissions update: Our 2020 Admissions Cycle is in full swing as we continue to review and interview applicants for the class of 2024 on a weekly basis. At the close of September, we have 2,878 applications, which is similar to prior years. • Selecting the best: On 03 Sept, our Admission Committee hosted Dr. Quinn Capers, Vice Dean for Faculty Affairs at The Ohio State University School of Medicine. Dr. Capers visited us to lead a workshop on how to mitigate Implicit Bias for medical school admissions. He provided us with an arsenal of tools to mitigate unconscious bias so we consistently select the best all-around applicants. When Dr. Capers arrived on campus, he was greeted by a number of our MS1 and MS2, students, who welcomed Dr. Capers with a push up challenge. You can see it here: https://youtu.be/Zdm1BOtrBuk

Office of Medical Student Affairs: • Two students in the Class 2021 were selected for notable positions in the American Medical Association's (AMA) Medical Student Section. 2nd Lt Laura Barrera was appointed Chair of the Women in Medicine Committee. 2LT Kristan Baird was appointed as Vice Chair of the Committee on Long Range Planning. • Class 2021 student ENS Quinn Bott (USPHS) was competitively selected to participate in the Center for Disease Control (CDC) Epidemiology Elective Program. • USU’s “Dermatones,” still flush with their successful performance in Manhattan for the Arnold Gold Foundation, have been invited to perform at the AAMC Learn Serve Lead Conference in Phoenix AZ on Veteran's Day! • Class of 2020 We are nearing the finish line with GME Applications by our MS4 students (Class 2020). They have been very engaged, thoughtful, and responsive. We anticipate a high rate of matches. This year, at the direction of the services, 80 members of the class are simultaneously applying through the civilian match. This has substantially increased student and institutional work flow. This group of students did phenomenally well on the USMLE Step 2CK examination. We are currently stand at a 98% pass rate, with only four scores pending. The average Step 2CK score is a 240, and 48 students scoring 250 or higher! The class is now heading into the field for Bushmaster. • Class of 2021 has completed two of the three main clerkship blocks. They have performed well thus far. • Class of 2022 is finishing up their 6th preclinical module. As they head into the final module, we will be meeting with them to ease their transition to clinical clerkships and begin to sort through the process of specialty selection. • Class of 2023: just elected their student leadership for the pre-clerkship period. They will soon finish their first module and will then head to FIG for MFP 101. This is a highlight for every new class as they interact with their classmates in a team-based environment.

SoM Commandant: • COL Kimball-Eayrs was selected as the Consultant to the Army Surgeon General for General Pediatrics, effective 1 July. • In the month of July, SOM had 1 student become an Airborne graduate and 6 students become Air Assault graduates.

Good News:

Anatomy, Physiology & Genetics (APG): • Dr. Denes Agoston was invited speaker at the annual MHSRS (Military Health Science Research Symposium). He gave a presentation on the molecular changes following exposures to training associated subconcussive blast. • APG faculty and others from USU and Cold Spring Harbor Laboratory collaborated with the NINDS (A. Griffin, L. Latour) to assess the extent of vascular damage in human TBI. • Dr. Jeremy Smyth's lab published a paper in the journal Scientific Reports titled "A novel, dynein-independent mechanism associates the endoplasmic reticulum with astral microtubules in dividing Drosophila spermatocytes". These findings have significant implications for wound healing, stem cell physiology, and cancer biology, all of which are highly relevant to military health.

Family Medicine (FAM): • On 11 July, twenty leaders from the Veterans Administration (VA) National Telehealth Primary Care Call Group were briefed (by invitation) concerning USU’s B3 telehealth course and subsequent publication. Since then, the VA’s telehealth training checklist has been revised to incorporate USU’s telehealth checklist. Our research has impact.

Medicine (MED): • Dr. Louis Pangaro (MED) and Dr. Catherine Witkop (MEE) have received a $30,000 award from the American Medical Association, Accelerating Change in Medical Education Innovation Grants Program for their project "Accelerating Progress toward Independence in Health Systems Science - Assessment in Clinical Rotations." • Dr. Steven Durning will serve as an A1 for a one million Euro, European Commission Erasmus Knowledge Alliance grant, to inform clinical reasoning, "Developing, implementing and disseminating an adaptive clinical reasoning curriculum to health care students and educators.” • LTC Jacob Collen, is terminal author on a recent publication in "Sleep and Breathing," entitled, "A randomized, placebo-controlled trail using a novel PAP delivery platform to treat patients with OSA and co-morbid PTSD." • Dr. Lara Varpio was competitively selected for the Karolinska Institute KIPRIME Fellows Program! This program is for individuals who are believed to have great potential to win the Karolinska Prize in Medical Education (our version of the Nobel Prize) in the future. Dr. Varpio was one of 12 individuals selected globally for this honor. It is a tremendous accomplishment!! • Maj David Lindholm, USU/MED, Clerkship Director, Joint Base San Antonio, was selected to teach the Military Tropical Medicine course at USU to 84 tri-service, foreign medical officers, giving 2 hours of lecture on respiratory infections.

Military and Emergency Medicine (MEM): • Two MEM faculty attended the MS-13 space launch on 20 July, the 50th anniversary of mankind's first walk on the moon. COL Andrew "Drew" Morgan (SOM Class of 2002 and a USU Clinical Associate Professor) lifted off in a Soyuz from the Baikonur Cosmodrome to dock with the International Space Station. COL Richard Scheuring (a USU SoM Associate Professor) served as his Flight Surgeon throughout training and the launch. • The Advanced Combat Medical Experience (ACME) Teaching Assistant (TA) Course concluded in July and the main ACME Course for the other MS2s occurred in August. • Medical students transitioning from their first to second years have completed their Summer Operational Experiences and the Advanced Combat Medical Experience (ACME - MFP 102), which pulls together Health Services Support concepts and Combat Medical Skills (CMS) acquired across the first year to execute Tactical Combat Casualty Care (TCCC) in a field setting. • 23 September – 4 October, MEM conducted a reengineered Military Contingency Medicine (MCM) course which is the preparatory for Operation Bushmaster for 4th-year medical students, GSN nurse practitioners, and students from five international partners. The content focused on joint HSS capabilities outlined in JP 4-02, covered a wider range of military mission types, and integrated more ethics and reflective activities. MAJ Laura Tilley an Assistant Professor in MEM, is the new course director. • 5 October – 18 October, MFP 101 and MFP 202 "Operation Bushmaster" will occur at Fort Indiantown Gap, Pennsylvania. Lt Col Leslie Vojta is the new Course Director for Bushmaster as well as the Department’s Emergency Medicine clerkships.

Microbiology (MIC): • Dr. Joseph Mattapallil, Associate Professor, was a recipient of the USU Dean's Annual Teaching Award for the 2018-2019 academic year. Dr. Mattapallil is an educator and mentor in both the medical and graduate curriculums: as instructor, course director, capstone rotation mentor and Co-director of the Bench to Bedside and Beyond Module.

Medical and Clinical Psychology (MPS): • 4th year Clinical student Meghan Byrne received an NIH F31 award for her project Neural Underpinnings of Anxiety in Relation to Eating Behaviors in Adolescence. • 3rd year Clinical student Maegan Paxton was awarded a CSTS fellowship to support her ongoing graduate education.

Pathology (PAT): • Professor Dan Perl was named to receive the 2019 James J. Leonard Award for Excellence in Clinical Research. This recognition was awarded for his manuscript in Lancet Neurology that described unique morphologic changes in the brains of blast-exposed service members with severe persistent neurologic/behavioral symptomatology, suggesting a novel disease mechanism. On 30 SEP to 1 OCT, Dr. Perl addressed the Navy SEAL Foundation's IMPACT forum and participating in a panel on suicide among active duty Special Operations Forces.

Pediatrics (PED): • PED faculty (billeted and national) trained Uganda People's Defence Force medical personnel as part of a CGHE sponsored program to stand-up a field hospital capable of supporting UN peacekeeping missions. This is the first iteration of the International Military Medical Humanitarian Assistance Training (IMMHAT) and represents an expansion of Military Pediatric support combatant command missions. • PED faculty presented 9 posters and 3 presentations at MHSRS on topics including: humanitarian assistance operations, force health protection & traveler health, pharmacogenomics, telehealth, respiratory infectious disease surveillance, thyroid cancer screening, vaccine uptake, machine learning to predict institutional risk of nosocomial infections, and the effect of deployments on child health.

Pharmacology (PHA): • Best poster at the 2019 USU Comprehensive Student Research. Training Program (USU- CSRTP) symposium went to trainee Sumayyah Mahdi working with Dr. Mumeko Tsuda from the Rat Behavior Core. Dr. Irwin Lucki (PHA) and Dr. Tao-Yiao Wu (OBG) also contributed to the poster. Their poster was titled: “Sprague Dawley rats from different vendors: Differences in anxiety behavior and stress responses.” Congratulations!

Physical Medicine and Rehabilitation (PMR): • Dr. Matthew Miller recently supported a mission to Ukraine for a week to continue an effort led by LTC George Smolinski to build a rehabilitation curriculum. Our focus was on Traumatic Peripheral Nerve injuries, which generally require a multidisciplinary approach because they often result in chronic pain and disability. • On 6-8 September, the U.S. Public Health Service Commissioned Corps operated a medical clinic in Pimlico Elementary School, Baltimore, MD. The officers provided $275,880 worth of medical, dental, and vision care to 603 patients. LCDR Danny Benbassat supported the mental health team and provided substance abuse and mental health education to patients as well as help triage clients. Preventive Medicine and Biostatistics (PMB): • Dr. Sherrie Wilcox, Assistant Professor, PMB’s Division of Social and Behavioral Sciences will receive the inaugural Ayman El-Mohandes Young Professional Public Health Innovation Award. Dr. Wilcox is being honored for her development of innovative interventions to support wounded military personnel and their family caregivers. • LTC Eric Garges was selected as the 2019 recipient of the William Gorgas Preventive Medicine Award. The award is being given for his distinguished work in preventive medicine in the area of clinical application, education, and research in sexually transmitted infections and tropical medicine. It will be presented at the Annual Awards Banquet during the upcoming AMSUS Annual Continuing Education Meeting, 2-6 December. • Second Year MSPH student CPT Lynnea Jensen obtained a $25,000 grant from the Deployed War-Fighter Protection Research Program to investigate exposures to personnel applying permethrin during field treatment of uniforms.

Psychiatry (PSY): • Dr. Patricia Spangler moderated the panel on Biomarkers in Psychotherapy Research at the 50th Annual International Meeting of the Society for Psychotherapy Research in Buenos Aires, Argentina. • Dr. David Benedek was interviewed by Dr. Carol Bernstein, past President of the American Psychiatric Association, on Sirius XM Doctor Radio regarding the recent publication “Association of Firearm Ownership, Use, Accessibility and Storage Practices with Suicide Risk among U.S. Army Soldiers.” He also participated as a panelist at the Sea Service Leadership Association’s Joint Women’s Leadership Symposium in Washington, DC on “Understanding PTSD in Women.” The audience was approximately 350 female military officers and enlisted personnel in leadership positions from all branches of the Uniformed Services. • Dr. Gary Wynn coordinated and hosted an international NATO Meeting held at USC in Los Angeles, CA. The meeting title was “Leveraging Technology in Military Mental Health: Virtual Reality, Neuromodulation, and Telehealth.” The audience included participants from the U.S., Canada, the Netherlands, and Australia. • Presentation: Morganstein, J.C. (2019, Jul). Science of Stress and Trauma: Impact and Interventions. Reintegration from High-Threat Posts and Military Deployments seminar, Drug Enforcement Administration, Department of Justice, Quantico, VA. • Committee on the Well-Being of Military Families of the National Academy of Sciences, Engineering and Medicine (NASEM) released their report. Dr. Stephen Cozza, Professor of PSY, was a member of the Committee. It is entitled, “Strengthening the Military Family Readiness System for a Changing American Society.” • Russell, D. W., Kazman, J., & Russell, C. A. (2019). Body Composition and Physical Fitness Tests Among US Army Soldiers: A Comparison of the Active and Reserve Components. Public Health Reports. Available online ahead of print. • Dr. James West presented "Psychiatric Dimensions of Disaster and the Impact of Climate Change" to the Southern Psychiatric Association in Louisville, KY. • Article published: Agtarap, S., Campbell-Sills, L., Thomas, M. L., Kessler, R. C., Ursano, R. J., & Stein, M. B. (2019). Postconcussive, posttraumatic stress and depressive symptoms in recently deployed U.S. Army soldiers with traumatic brain injury. Psychol Assess Center for Health Professions Education (HPE) • In September, President Thomas authorized the charter establishing HPE as USU’s newest center. All USU’s centers are interdisciplinary, interschool, and work on topics that are vital to military health. Because force generation is critical requirement to sustaining the MHS and therefore the health of the force, the HPE Center will play a vital role. • The Center’s Masters in Health Professions Education (MHPE) program has converted over 15 courses to blended/distance learning format so that a Master/HPE and a PhD in HPE is available and can be completed from anywhere across the globe! • HPE will host twelve International Medical Education Exchange (IMEX) visitors to USU on 24-25 Oct 2019. IMEX is group of international scholars that visit partnering institutions to share an international orientation on medical education. http://www.imexchange.eu/imex.php

Center for Neuroscience and Regenerative Medicine (CNRM): • Dr. David Brody presented a plenary talk titled "Blast-related concussive traumatic brain injuries from the wars in Iraq and Afghanistan" to a packed house in London. It was attended by several high level UK officials including His Royal Highness, the Duke of Sussex.

Infectious Disease Clinical Research Program (IDCRP): • The TIDOS project, led by Prof. David Tribble, has been recognized by DoD's Blast Injury Research Program Coordinating Office for several knowledge product contributions that are improving management of blast injury complications. One was recently highlighted: https://blastinjuryresearch.amedd.army.mil/index.cfm/news_and_highlights/research_highlig hts/FY19/infection_factors

Murtha Cancer Center Research Program (MCCRP): • At the 2019 MHSRS, MCCRP scientists delivered 22 oncology-related posters and presentations. The acceptance of this research recognized that advancements in cancer care not only increase Return To Duty rates after cancer treatment, but also reduce medical discharges, decrease the number of hospital stays and outpatient visits, and lessen the overall caregiver workload and DoD healthcare costs. • On 11 September, Dr. Craig Shriver spoke at the Annual Halsted Society Meeting. The Halsted Society is a prestigious organization named after William Halsted, an American surgeon who emphasized strict aseptic technique during surgical procedures, was a champion of newly discovered anesthetics, and introduced radical mastectomy for breast cancer. He was one of the founding professors at Johns Hopkins. • On 17 September, the Directors of the USU MCCRP Breast, Prostate, and Gynecological Cancer Centers of Excellence provided the annual Review and Analysis of their research programs to senior members of the DHA led by Dr. Terry Rauch. Dr. Shriver presented an update of the Tri–Federal Precision Oncology Program that includes scientific collaborations with DoD, USU, NCI, VA, WRB, PNNL, AFHSB, and JPC, and he also presented the USU Breast Center of Excellence annual update. • On 23 September at the Pentagon, Dr. Shriver briefed the Joint Requirements Oversight Council Health Readiness Working Group on the status of the DASD(HRP&O) Cancer Care Initial Capabilities Document and research gaps that were addressed this past year. \ • MCCRP held the Applied Proteogenomics Organizational Learning and Outcomes (APOLLO) semi-annual retreat on 27 September. DoD, VA, and NCI scientists reported on the advances made in the six tri-federal APOLLO cancer research initiatives. A special guest speaker from NASA Goddard gave a luncheon talk on the original APOLLO moon landing program. Also present in the audience were members of the National Security Council (NSC), and the Office of Management and Budget (OMB). They were excited by the MCCRP APOLLO program’s accomplishments and future goals.

National Center for Disaster Medicine and Public Health (NCDMPH): • In collaboration with the Naval War College and the Johns Hopkins APL, the NCDMPH conducted a 2-day humanitarian 'war game' with DOD, CDC, OFDA, USAID, UN agencies and multiple NGOs.

Val Hemming Simulation Center (SIM): • On 19 September, the Val G. Hemming Simcenter celebrated 20 years of service to the University under the leadership of Dr. Joseph Lopreiato and Ms. Anita Springs. Former Dean Hemming was the guest of honor. The day included tours, demonstrations and active operations with the first year SOM students. • On 19 August, Drs. Mark Bowyer, Joseph Lopreiato and Ms. Rachael Dampman presented their work on teaching novices the procedure of cricothyroidotomy at the annual MHS research Symposium in Orlando, FL. • On 18 September, Ms. Betsy Weissbrod, medical illustrator, was award a CRADA to commercialize her invention of wearable tattoos to simulate combat wounds and traumatic injuries on humans and mannequins. • Between July and September, Dr. Mark Bowyer, surgical director of the Simulation Center published 3 manuscripts on error recognition in trauma, fasciotomy and trauma surgery in the surgical literature. • On 15 August, Dr. Alan Liu, Director of Virtual Environments, presented his work on medical virtual environments at the National University of Singapore. •

Graduates and Faculty of the Most Recent ASSET+ Course BOR Report FY 19 Faculty Development Program

The Faculty Development Program has continued to expand its programs over the last FY. In addition to our travels to MTFs to deliver faculty development, academic leadership training and mentorship about academic promotion, the program has continued to build its FOCUS faculty and strategic planning for the increasing accreditation requirements for faculty development.

Core annual metrics for the Faculty Development Program

1. Workshops locally at USU and across the MHS. 21 different MTFs had USU sponsored Faculty Development, including a deployed location.

Workshops 450 FY19 had 441 350 workshops delivered. This is 32% more than 250 FY18 and doubled FY17. 150

50 FY14 FY15 FY16 FY17 FY18 FY19

Attendees FY19 had 7511 attendees. This is >2500 more than FY18. This number 8000 calculated as each individual 7000 multiplied by the number of 6000 workshops. Total individuals 5000 who attended at least one 4000 workshop in FY is 1770 (more than 700 over FY18). 3000 2000 1000 FY19 had 32.7% non- 0 physicians attend the Faculty FY14 FY15 FY16 FY17 FY 18 FY19 Development workshops. Certificates This number reflects the accumulation of workshops 120 individual faculty members have attained. The goal with the 100 certificate program was to encourage continuous learning 80 over years. In FY19 we granted >10,000 credit hours and 103 60 certificates. This is sought after and recognized by faculty. In 40 response to the desire for more, a 20 new Advanced Teaching certificate will start 1 October that 0 not only include more content, but FY11 FY12 FY13 FY14 FY15 FY16 FY17 FY18 FY19 also peer observation and feedback, and self-reflection.

2. Impact and Outcomes a. Immediate workshop evaluations demonstrate nearly 100% of faculty will use the information presented in their everyday job b. Evaluations from faculty taking workshops in the past – 98% state they will use the information in their jobs. 75% state at least monthly. c. Repeated comments in all aspects regarding benefits of sharing across the MTFs programs, evaluations, and problem solving. d. Additional feedback from residency program directors state a preference to maintain our interdisciplinary program (aids in community of educators, sharing ideas, and decreasing isolation of problems) over specialty only sessions. e. 8 Tri-service multi-site multi-specialty presented 7 workshops in September at the Toronto International Summit on Leadership Education for Physicians and the International Conference on Resident Education.

3. Academic Leadership Week – created to meet the needs of program directors, designated institutional officials, clerkship directors to lead and manage programs a. This week continues to be a high-yield 5 days where leadership principles are applied to educational problems. Largest positive comments continue around connecting across services, MTFs and specialties and discovering people have similar issues.

4. Educational Resources a. Small pocket-sized cards are being created for faculty to have as a resource after attending many workshops. The number will be increasing over FY20.

5. Site Director’s Meeting a. In order to meet LCME requirements for consistency across our clerkship sites, the Faculty Development program orchestrated the 5th annual meeting of all site director’s in the MHS. This was the initial year having the administrative staff here as well which increased perspectives as student cases were discussed and problems solved. 6. FOCUS faculty (Faculty Development Outreach and Certification for the Uniformed Services) a. With the increasing demand from faculty, and the increasingly specific requirements and monitoring from the ACGME, we started a rigorous standardization program to deliver foundational principles at the core GME MTFs. This would meet local needs for scheduling flexibility, annual requirements, and repeated sessions to reach as many as possible. b. These faculty received 56 hours of content training, as well as solidifying facilitation skills and working technology with little assistance in new locations. Additional hours were spent traveling to understand different MTFs and the global needs of the MHS. They received peer observation and feedback from other peers in the program as well as USU faculty. c. The goal is to create a group that can work together for years refining and improving content, that is multi-disciplinary to serve the MHS. Looking globally allows for the continuation of the members even when moving. Over the past 6 months, 3 members of the FOCUS faculty have moved from one GME location to another. As long as the FOCUS faculty remains in GME they would remain current in needs from the accreditation agencies. Members of the group aid each other with pertinent examples not in their own specialty, to use as they teach diverse groups of educators. It would be helpful for sustainability to allocate these faculty to remain in academic medicine, for an entire military career, as leaders for sustainability and growth. It takes 12-15 months to have each faculty be fully functional with the FOCUS requirements. d. Evaluations over the past 15 months have demonstrated equal ratings delivering these foundational workshops as USU faculty. The tiered system allows USU faculty to deliver more controversial or complex sessions when traveling to a MTF. e. The program started in December 2017, and only 3 of the 27 have dropped out of the program. This year we will be adding 2 more sessions. f. In The program started in December 2017, and only 3 of the 27 have dropped out of the program. This year we will be adding 2 more sessions. In addition, many FOCUS faculty are clustered at the large MTFs, smaller MTFs can reach out and ask FOCUS faculty to travel increasing faculty development, and keeping the standardization across the MHS regardless of MTF size or number of GME programs. g. As of 1 July 2019, the ACGME requires monitoring that every core faculty member has faculty development in four specific areas. FOCUS faculty can deliver content in 1 area currently and will be 3 by March 2020. USU Faculty Development has created reports, piloted in May 2019, that can be given to each residency or fellowship program to report to the ACGME. This graph demonstrates the 100 impact of the FOCUS faculty as the program has evolved. 80 In FY14 the majority of credit obtained by faculty was 60 through participating in outside conferences. Now we 40 offer standardized material to our faculty across the MHS 20 with clear vocabulary. In FY19 38.5% of all workshops 0 were taught by FOCUS FY14 FY15 FY16 FY17 FY18 FY19 faculty. The impact of the USU FOCUS Non-USU added flexibility of these local faculty is in the early stages.

Below is a list of those faculty and the workshops that can be delivered:

Name Specialty Service Current location Trained workshops Natalie Burman Pediatrics Navy NMC San Diego All 13 workshops Melissa Buryk Peds Endocrinology Navy NMC Portsmouth Dana Blyth Infectious Disease Air Force San Antonio Feedback, Kristen Bunch Gyn Oncology Army Tripler Precepting, Vincent Casiano Family Medicine Army Ft Benning Small Group Teaching, Carlton Covey Family Medicine Air Force Travis AFB Large Group Teaching, Alan Dupre Emergency Air Force Wright Patterson AFB Learning Climate, Medicine Bedside Teaching Gabriel Harris Family Medicine Air Force Offutt AFB Andrew McDermott Family Medicine Navy Rota Spain Gabriel Peterson Radiology Air Force WRNMMC Erin Seefeldt Ophthalmology Army Madigan Sabrina Silver Family Medicine Air Force Eglin AFB Dawn Sloan Family Medicine Army Ft Benning Peter Guevara Dentist Army San Antonio Narrative Assessments, Gayle Haischer- Neonatology Air Force San Antonio Create a Poster, Rollo Active Learning, Diane Hale Gen Surgery Army San Antonio Role Modeling, J. Dave Honeycutt Family Medicine Civ Nellis AFB EPAs and Milestones, James Knowles Dentist Air Force San Antonio Direct observation, Justin Lafreniere Internal Medicine Navy NMC Portsmouth Supervision George Mount Rheumatology Army Madigan Christopher Neal Neurosurgery Army WRNNMC Michael Orestes Otolaryngology Army WRNMMC Jason Sapp Internal Medicine Army Tripler Joshua Will Family Medicine Army Ft Benning

Appendix B: AAMC Graduation Questionnaire (GQ) 2019 Report on F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences

USU Class of 2019 graduates are satisfied with the quality of their medical education

• Response to statement: “Overall, I am Satisfied with the Quality of My Medical Education”

Strongly Disagree Neutral Agree Strongly Agree or Disagree

All Schools 4.6% 6.2% 49.4% 39.8% USU - 2019 2.5% 4.3% 26.7% 66.5%

They felt that our integrated basic and clinical science curriculum prepared them for clerkships

• Grads rated strength of Basic Science Preparation for Clerkships as “excellent” or “good” at rates higher than graduates from other schools • Curricular Integration (Clinical Experience and Basic Sciences) also noted to be “excellent” or “good” by over 91.5% of graduates, over 10% points higher than other medical schools They indicated that our clerkships provided them with high quality experiences

• In all major clinical experiences, more graduates reported faculty were effective teachers than graduates from other medical schools • Over 90% of students in Emergency Medicine, Family Medicine, Internal Medicine, Pediatrics, and Surgery reported that the quality of their clinical clerkships was good or excellent—in each case, this was greater than seen in other medical schools • Over 95% of students in all the major clerkships reported they received mid-term feedback and clinical observation Across the board, USU graduates reported they have the skills to begin residency

• 100% of grads reported their training in communication skills and application of evidence-based medicine were sufficient preparation for residency • Over 99% of graduates agreed or strongly agreed that they understand the ethical and professional values that are expected of the profession • Over 95% of graduates reported their understanding of common conditions and clinical management as well as social sciences of medicine prepared them for residency Choice of specialty by USU grads is highly influenced by role model influence, fellowship options

• 95% of USU grads said level of educational debt had “no influence” on their decision (as compared to over half of grads from all other schools) Areas to strengthen (based on statistical summaries and free text comments) are already being addressed as priorities by the SoM

• Fewer USU grads than those from other medical schools participated in a research project with a faculty member and/or authored a peer-reviewed paper, oral, or poster presentation • USU graduates reported being less satisfied with tutoring services than grads from other schools • 69% of USU grads “agreed” or “strongly agreed” that diversity within their class enhanced their training and skills to work with individuals; this is a similar level to other schools • USU graduates reported that they were less likely to participate in electives or volunteer in activities that provided experiences related to health disparities, cultural awareness, or providing health education TAB 26 Inouye Graduate School of Nursing Report Board of Regents Brief

Submitted by: Carol A. Romano, PhD, RN, FAAN Date: October 7, 2019

Title & School: Dean, Graduate School of Nursing Phone: 301-295-9004

Purpose: Information Action ______

Subject: Dean’s Report – Graduate School of Nursing

Education

• The 4th annual GSN High-Level Disinfection and Sterility Assurance conference conducted in collaboration with industry partners was attended by 90 students and staff from USU, 30 MTFs in 17 states (CONUS and OCONUS), NIH & VA.

• The Psychiatric Mental Health Nurse Practitioner program hosted the Combat and Operational Stress Course in collaboration with U.S. Army Medical Center of Excellence, and SOM Psychology and Psychiatry Departments. Inter-professional attendees included students, psychiatric residents, nurse practitioners, chaplains, registered nurses, and technicians. Seven specialties and four uniformed services were represented.

• PhD Program completed transition from quarters to a semester hour curriculum plan.

• DNP Student admission applications (112 applicants) are under review for the incoming Class of 2023. First time admission cycle is being coordinated with Air Force selection process schedule.

• Initiated conversation with US Public Health Service Chief Nurse and Deputy Surgeon General to expand PHS officer access to nurse practitioner program for nurses in health service component of Immigration Service.

• 5 DNP Students participated in a operational readiness exercise on the USNS Mercy focused on interoperatibility with the Fleet. Invitation to continue USNS Mercy

November 2019 collaboration with GSN for future training exercises was extended by the Senior Nurse Executive and participation in a December exercise with students is planned.

• Leadership of the operational elective courses, Mountain, Wilderness Medicine and Dive, transitioned to CDR Kennett Radford as co-project director with Mr. Chris Mottler; Dr. Matthew Welder resigned in October. USU has requested additional funds from the Army to maintain the Wilderness and Mountain courses. Wilderness Medicine and Dive Medicine courses conducted at JBLM, WA and Key West, FL respectively in October.

• All nurse practitioner students completed the two week Military Contingency Medicine preparatory course for ‘Bushmaster” and the mass casualty field exercise.

• The annual clinical faculty curriculum review conducted November 4-6 and included all clinical faculty from 11 remote clinical sites to evaluate the current APRN Phase II curriculum and address planned changes.

• Dean Romano attended the annual meeting of the American Association of Colleges of Nursing and was an invited member to the University of Pennsylvania School of Nursing International PhD Summit to re-envision and advance research doctoral education.

• The LTC Isabelle Bagin memorial lecture, co-sponsored by the Army Nurse Corps Association held November 4th in collaboration with WRNMMC; Dr. Tenor Venemma, from Johns Hopkins keynoted on disaster response.

Research and Scholarship • GSN Faculty, Dr. Elizabeth Kostas Polsten, received FDA approval for a multi-site clinical trial on point of care medical device for military women’s urogenital health and readiness in austere environments. Label comprehension and usability testing are in progress.

• GSN presence at the Military Health System Research Symposium included 12 posters and several presentations by faculty, students and alum.

• Associate Dean for Academic Affairs was an invited speaker at the Taipei International Military Medicine Forum in Taiwan themed “Seamless Care- Battlefield to Bedside”.

Publications • Martin, M.J., Holcomb, J., Polk, T., Hannon, M., Eastridge, B., Malik, S.Z., Blackman, V., Galante, J.M., Grabo, D., Schreiber, M., Gurney, J., Butler, F.K., Shackelford, S. 2019. The "top 10" Research and Development Priorities for Battlefield Surgical Care: Results

November 2019 from the Committee on Surgical Combat Casualty Care Research gap Analysis. J Trauma Acute Care Surg. 2019 Jan 10. doi: 10.1097/TA.0000000000002200. • Cuevas, D., Rucker, M., Johnson, D., Crerar, C., Wofford, K. & Bonds, R. (2019). Implementation of a Standardized Preoperative Diabetes Medication Guideline and its Effect on Day of Procedure Blood Glucose Levels. Journal of PeriAnesthesia Nursing, 34(2), 303- 309. • D’Angelo, M.R., Seibert, D., Wanzer, L., Johnson, H., Alguire, K., Dillon, D., Welder, M.D. and Romano, C. (2019) Operational Readiness: Redesigning Advanced Practice Registered Nurse (APRN) Curriculum for an Evolving Battlefield Military Medicine, 184:(3-4), e156–e162, https://doi.org/10.1093/milmed/usy269. • McCants, K., Reid, K, Williams, I., Miller, E., Dutton, S., Rubin, R. (2019). The impact of case management on reducing readmissions for patients diagnosed with heart failure and diabetes. Professional Case Management; (4)24: 177-193. • O’Driscoll, L., Moore, C., & Bonds, R. (2019). Identification and Management of Ischemic Stroke in the Postanesthesia Care Unit. Journal of PeriAnesthesia Nursing, 34(5), 881–888. https://doi.org/10.1016/j.jopan.2019.01.011 • Schimmels, J. (2019). Chapter 12: Behavioral/Psychological. In Dennison, R. D. (Ed.), Pass Critical Care Registered Nurse (CCRN)! (5th ed., pp. 741-761). St. Louis, MO: Elsevier. • Schimmels, J. & Waits, W. (2019). A tale of two compulsions-Two case studies using Accelerated Resolution Therapy (ART) for obsessive compulsive disorder (OCD). Military Medicine, (printed ahead of publication) • Seibert, D. (2019) Gene editing: the power and risks of creation, Journal of the American Association of Nurse Practitioners, 31(2):85-88. doi: 10.1097/JXX.0000000000000196. • Reed, E.K., Steinmark, L., Seibert, D.C. Edelman, E. (2019). Somatic testing: Implications for targeted treatment. Seminars in Oncology Nursing, 35(1), 22-33. • Seibert, D. (2019) Subject matter expert for "Genomic Health Care Today and Tomorrow: Expert Perspectives. In Seminars in Oncology Nursing, Vol, 35, No. 1, 2019: p 131-143." • Schramm, J.F., Seibert D.C., Thompson, J.M., Binder, M.M. King Young, S. and Deleon, P.H. (2019) Primary Care in American Samoa: How Nurse Practitioners Created a Bridge Across an Ocean, Military Medicine, 184:(3-4), 72–77, https://doi.org/10.1093/milmed/usy219. • Wanzer, L.J., Dunn, D., and Skupski, F. (2019). Body Art in the Perioperative Setting. In C. Kasper, V. Blackman, J. Schimmels, P. DeLeon (Eds.), Annual Review of Nursing Research: Informing and Evaluating Policy with Nursing Science (pp.75-105). New York: Spring Publishing. • Wasserman,J., Palmer, R.C., Gomez, M., Berzon, R. Ibrahim, S., Ayanian, J., Ibrahim,S., Ayanian, J. “Advancing Health Services Research to Eliminate Health Care Disparities”, American Journal of Public Health 109, no. S1 (January 1, 2019): pp. S64-S69.

November 2019 • Talbot,L., Wilson, C., Nayback-Beebe, A., Metter, E., Hatzfeld, J. (2019). Nursing’s Role in Preventing and Managing Back Pain in Military Members: Proceedings of the First Back Pain Summit. Nursing Outlook. (Invited Manuscript). • Hopkins D, Wilson C. (2019). Polycystic Ovary Syndrome in Active Duty Service Women: A Retrospective Analysis. Military Medicine, usz023, https://doi.org/10.1093/milmed/usz023. • Krause-Parello, C.A.; Friedmann, E.; Wilson, C.; Hatzfeld, J.J.' Kolassa J.; Hackney, A.; & Morales, K.A. (2019). Relation of post-traumatic stress disorder symptom severity to the efficacy of an animal-assisted intervention for stress reduction after military aeromedical evacuation. Stress and Health, 1-11. https://doi.org/10.1002/smi.2881. • Morales, K.A.; Krause-Parello, C.A.; Hatzfeld, J.J.; Simpson, M.; Kolassa, J. & Wilson C. (2019). Strategic aeromedical evaluation (AE): Examining biological and psychological stress in AE patients. Military Behavioral Health, 1, 31-39. https://doi.org/10.1080/21635781.2018.1543062 • Heboyan, V., Krengel, M.H., Sullivan, K., Iobst, S., Klimas, N., Wilson, C., & Coughlin, S.S. (2019). Sex differences in Gulf War Illness: A reanalysis of data from the CDC Air Force Study using CDC and Modified Kanses Case Definitions. Journal of Occupational and Environmental Medicine, 61, 610-616. DOI: 10.1097/JOM.0000000000001620. • Coughlin, S.S., Heboyan, V., Sullivan, K., Krengel, M., Wilson, C., Iobst, S., Klimas, N. (2019). Cardiovascular disease among female veterans of the 1991 Gulf War era. Journal of Environmental Health Sciences, 5, 24-25. doi:10.15436/2378-6841.19.2455.

• Johnson, H.L. (in press). The promise of autism genetics: Still waiting. Journal of the American Association of Nurse Practitioners. • Hays, S.M., Johnson, H.L., & Taylor, L.A. (in press). A toddler with sudden onset tremors and change in temperament. The Journal for Nurse Practitioners. • Johnson, H.L. (in press). Abnormal Cervical Screen. In A.H. & R.H. (Eds.). Clinical Guidelines in Primary Care: A Reference and Review Book (3rd ed.). Advanced Practice Education Associates: Scott, LA. [Peer reviewed](Invited) • Johnson, H.L. (in press). Autism Spectrum Disorder. In A.H. & R.H. (Eds.). Clinical Guidelines in Primary Care: A Reference and Review Book (3rd ed.). Advanced Practice Education Associates: Scott, LA. [Peer reviewed](Invited) • Johnson, H.L. (in press). Human Papillomavirus. In A.H. & R.H. (Eds.). Clinical Guidelines in Primary Care: A Reference and Review Book (3rd ed.). Advanced Practice Education Associates: Scott, LA. [Peer reviewed](Invited) • Johnson, H.L. (in press). Intellectual Disability. In A.H. & R.H. (Eds.). Clinical Guidelines in Primary Care: A Reference and Review Book (3rd ed.). Advanced Practice Education Associates: Scott, LA. [Peer reviewed](Invited) • Korkosz, J.A., Fuller, A.J., Sheehy, S., Taylor, L., Seibert, D.C., & Johnson, H.L. (in press). Taking the leap from clinical practice to academic faculty: a beginner's guide. Journal of the American Association of Nurse Practitioners.

November 2019 • Kostas-Polston, E. A., Braun, L. A., & Miedema, J. (In-Review, 2019). Promoting military women’s self-maintenance of urogenital health and operational readiness: A qualitative study using the inductive thematic analysis method. Submitted to the Journal of Midwifery & Women’s Health (*Data-based). • Dan, D., Moore, C. (2020). Surviving a Broken Heart: A Case of Interoperative Cardiac Arrest and Takotsubo Cardiomyopathy, AANA Journal, in press. • Shah, A., Moore, C., & Brigger, M. (2019). Auricular acupuncture for adult tonsillectomy. Laryngoscope, in press • Phillips, A. K. & Kostas-Polston, E. A. (In-Review, 2019). Menstrual suppression in US military women: Literature review and gap analysis. Submitted to the Journal of Nursing Scholarship. • Radford, K., Spencer, H., Zhang, M., Berman, R., Girasek, Q., & Choi, K. (2019). Association between intravenous ketamine-induced stress hormone levels and long-term fear memory renewal in Sprague-Dawley rats. Behavioral Brain Research (In Press). • Hughes, V., Busch, D., Trautmann, J., & Sloane, E. (accepted for publication). Key Components for Successful Nurse Practitioner Student Learning in an International Clinical Setting. COJ Nursing & Healthcare. • Stanley, A., Durham, C., Sterrett, J., & Wallace, J. (in press). Safety of over-the-counter medications in pregnancy. MCN The American Journal of Maternal Child Nursing. • Stanley, A., Wallace, J., Spell, J., Scott, E., & Hernandez, A. (in press). Management of common endocrine disorders in pregnancy. Palmetto Pharmacist. • Wanzer, L., Oliver, J., Rodriguez, J., Bradley, D. & Taylor, L.A. (In Press). Impact of the CNS on the Transformation of Military Healthcare from Bedside to Battlefield" Journal of Clinical Nurse Specialist.

Leadership and Service

● GSN Family Nurse Practitioner Alum, BG Jack Davis, sworn in as 26th Army Nurse Corps Chief; is the second GSN alum to earn flag rank.

● GSN piloted the USU Lean 6-Sigma initiative to document and standardize the academic curriculum review and approval process that will integrate and contribute to an on line comprehensive USU course catalog.

● Two 2019 graduates deployed to the USS Bataan to provide disaster relief to the Bahamas due to Hurricane Dorian, providing general anesthesia, emergent airway management, and operational resource management while ensuring a walking blood bank. This demonstrates the importance of operational readiness components of the GSN curriculum.

November 2019 ● CDR Wallace- Received the 2019 Practice Article of the Year Award from the American Journal of Maternal Child Nursing.

● CDR Virginia Blackman led the TSNRP Evidence Based Practice Workshop and the IMPACT-ICU training workshop at Tripler Army Medical Center

Faculty & Staff

• New faculty orientation to include12 hours of required health professional on-line education developed in collaboration with Dr. Steve Durning and Health Professional Education faculty.

• 4 new faculty reported for orientation. Administrative vacancies are being filled, temporarily, with contractors. GS hiring actions are pending. Current administrative staff assuming responsibilities for workload needs.

• Dean’s secretary (Patricia Handel) retired after 28 years of Federal service, 17years at USU.

November 2019 TAB 27 Postgraduate Dental College Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Thomas R. Schneid, DMD, MS Date: October 8, 2019

Title & Department: Executive Dean, Postgraduate Dental Phone: 210-299-8506 College (PDC)

Purpose: Information X Action

Subject: PDC Executive Dean’s Report

Significant Issues:

1. Accreditation: Commission on Dental Accreditation (CODA) - Final reports were received from the Commission on Dental Accreditation (CODA) for Site Visits held in 2018. The Master of Science (MS) degree program, Endodontics Residency, at the Air Force Postgraduate Dental School (AFPDS) at Keesler Air Force Base and the Air Force 1-year certificate program at Barksdale Air Force Base were granted the highest accreditation status of “approval without reporting requirements” with their next site visit scheduled for 2025. The Endodontics Residency at Keesler Air Force Base also is designated as “Teach Out” due to the pending closure of that program in the summer of 2020 and all CODA requirements for that action have been met. Middle States Commission on Higher Education (MSCHE) – The PDC submitted outcomes data for the 2019 MSCHE Mid-cycle Review of the University (See Attachment 1). The data illustrate CODA accreditation results, graduation rate history, and written board pass rates for the PDC MS degree program. Of note: 1) Since 2013, all 20 Graduate Dental Education programs within the USU PDC MS degree program successfully achieved CODA’s highest accreditation rating. 2) The PDC has a cumulative 93% graduation rate since 2010. Of the 469 graduates, only 3 students required additional time to complete program requirements, resulting in a 99.4% on-time graduation rate. 3) Since 2015, PDC graduates demonstrated a cumulative first-time written board exam pass-rate of 94%. 4) A Teach-out plan is being drafted for submission to MSCHE that will address the closing of Keesler AFB as an “Additional Location” for the MS in Oral Biology degree. All actions are being coordinated through the Assistant Vice President for Accreditation and Organizational Assessment.

2. Postgraduate Dental College faculty and residents supported a number of Deployments, Humanitarian Assistance and Community Service events during the previous fiscal year. (See Attachment 2) In addition, significant faculty and resident participation in Leadership (See Attachment 3) and Interprofessional Education activities (See Attachment 4) are listed in the designated attachments. 3. Military Field Practicum (MFP 101)/Military Contingency Medicine (MCM) Course: Naval Postgraduate Dental School (NPDS) faculty provided lectures on Forward Management of Maxillofacial/Dental Injuries and Forward Management of Non-traumatic Oral and Dental Injuries to School of Medicine and Graduate School of Nursing students during the MCM course. The objective was to familiarize future non-dental health professionals with common dental emergencies that may be encountered in the deployed setting, along with basic diagnosis and management. As of the date of this report, planning continues for faculty and residents from the Navy and Air Force Certificate programs to jointly participate in MFP 101 with 1st year medical students. The dental residents will be assigned to platoons with medical students where field medical and expeditionary skills will be taught in a joint environment. This is the 6th consecutive year that the PDC has participated in USU field exercises.

4. Research Activities of Note:

- The following items of significance are reported for fiscal year 2019: Manuscripts/Abstracts Published or Submitted/Accepted for Publication (74), Presentations (261), and Awards (37). (See Attachment 5)

- The Executive Dean, the Associate Dean for Dental Research (ADDR), fifteen PDC faculty members, current and former students attended the 2019 Military Health System Research Symposium (MHSRS). Thirteen dental posters were displayed and an evening Tri-Service Dental Research Session was held, which included 7 oral presentations. The tri-service participation, coordinated by the PDC ADDR, represented the first comprehensive dental involvement in recent memory. Plans are underway for an expanded dental program in 2020.

- The ADDR taught a 4-day Research Design Course at Fort Bragg to the first-year Comprehensive Dentistry and Endodontics residency students who are enrolled in the USU MS Degree in Oral Biology program.

- The ADDR met with the Director of Craniofacial Health and Restorative Medicine, Naval Medicine Research Unit, San Antonio (NAMRU-SA) to plan Tri-Service research collaboration for the PDC residency class entering July 2020. Based on the recently signed MOU, NAMRU-SA is prepared to serve as primary research mentors for PDC students.

- The ADDR joined President Thomas and other senior USU leaders to a visit to Army Futures Command in Austin, TX and addressed a potential collaborative strategic approach for developing a comprehensive dental research program.

- The Executive Dean, ADDR, Associate Dean for Faculty Affairs (ADFA), and the Director of the Tri-Service Center for Oral Health Studies (TSCOHS) met with the DHA Data Innovation Branch, Enterprise Intelligence and Data Solutions Program Management Office staff to explore potential support for resident research and the PDC Long Term Career Outcome Study. The areas of data access and statistical support are currently being explored.

- The ADDR and the Director, TSCOHS are collaborating with Dr. Kostas-Polston from the Graduate School of Nursing, along with her colleagues from the National Cancer Institute and the University of Texas MD Anderson Cancer Center, on research concerning Human Papilloma Virus associated oropharyngeal squamous cell carcinoma.

- The Executive Dean and the ADDR held a conference call with the Associate Dean for Research, the Ohio State University, College of Public Health Division of Environmental Health Sciences to explore research collaboration in the area of Oral Cancer. Mutual areas of research interest were identified and a MOU is currently being drafted. Discussions to explore potential research collaborations also have been initiated with the University of Kentucky

5. Faculty Affairs Update:

- The fourth iteration of the faculty development course, Dental Faculty Development (DFD) I, Introduction to Graduate Teaching, is being offered on the USU Sakai Learning Management System for PDC faculty who are new to graduate teaching. 20 Army, Navy, and Air Force dental faculty are enrolled from multiple locations within the PDC. The course provides faculty with an introduction to the teaching and developmental resources available to them as USU faculty and includes coursework in adult learning theory, curriculum design, assessment/feedback and dental graduate program “best practices”. Based on input from prior learners and faculty, the course was expanded to include additional content and a hands-on portion to teach the development of an eLearning module. Sixteen hours of credit toward the USU School Of Medicine Faculty Development Certificate in Teaching will be earned.

- The Associate Dean for Faculty Affairs (ADFA) and the Tri-Service Center for Oral Health Studies, continued a collaboration in the USU Long Term Career Outcome Study (LTCOS), for interdisciplinary research involving military dental and medical officers and students.

- A one-day hands-on Sakai eLearning Development course was conducted at the AF Postgraduate Dental School for 12 faculty learners, who earned 1credit hour toward the USU Faculty Development Certificate in Teaching.

- The PDC in collaboration with USU Information and Education Technology, implemented a faculty appointment and promotion online workflow platform. This platform provides a centralized location for all documents required by faculty to apply for a USU PDC faculty appointment at the Instructor or Assistant Professor levels.

- The ADFA has been identified as an on-call dentistry subject matter expert to the Defense Medical Ethics Center at USU.

- The ADFA completed the admission requirements and was accepted into the Midwest Angle Orthodontic Society in Feb 2019.

6. Tri-Service Center for Oral Health Studies (TSCOHS) update:

- The TSCOHS staff have been primary writers and contributors for their respective services to the upcoming 2020 Surgeon General’s Report (SGR) on Oral Health. The contributions address the current status of dentistry and oral health in the Services, progress since the last SGR in 2000, continuing challenges faced while improving readiness, and describing the opportunities and initiatives that will lead to improvements in military dentistry and oral healthcare. - The Director of the TSCOHS has been identified as an on-call dentistry subject matter expert to the Defense Medical Ethics Center at USU.

- The TSCOHS participated in the Military Health System Research Symposium (MHSRS) held in August. The Assistant Director represented TSCOHS at the USU Centers’ Forum. The Director delivered an Oral Presentation at the Tri-Service Dental Research Session on Dental Disease Non-Battle Injury Encounters in Three Air Force Deployed Locations.

7. The Executive Dean received a briefing from Dr. Rochelle Rollins, Senior Policy Advisor to the US Surgeon General and CAPT Renee Joskow, Chief Dental Officer for HRSA on the Surgeon General’s 2020 Report on Oral Health, presently in draft.

8. Planning is underway for the 2019 Federal Services Dental Educator Workshop. It will be held at the USU from April 14-16. The Air Force is the host Service. The focus of the meeting will be developing and implementing plans for shared curricula. Additional emphasis will be placed on faculty development training, as well as collaboration and considerations for integration/resource sharing among the expected 80-100 Army, Navy, Air Force, VA, and Public Health Service dental educator attendees that are predominantly USU faculty.

9. The Executive Dean and the three Service Postgraduate Dental School Deans will be attending the American Dental Education Association’s Annual Deans’ Conference from November 9 - 12 and participating in the Council of Deans’ meeting. The theme of the meeting is It’s About the People. We will be honored to have Dr. Thomas join us for a portion of the meeting.

Current & Future Concerns:

Funding/Budget Estimate/Fiscal Impact:

Staffing Impact:

Board Action Requested: Attachment 1

Postgraduate Dental College (PDC) Outcomes

1. Accreditation

Since 2013, all 20 Graduate Dental Education (GDE) residencies within the USU PDC MS in Oral Biology degree program underwent successful site visits from their programmatic accrediting agency, the Commission on Dental Accreditation (CODA). All programs (100%) earned the accreditation rating of “Approval, without reporting requirements” for a full 7 year term. Note 1: Two GDE programs, Comprehensive Dentistry and Endodontics within the Air Force Postgraduate Dental School at Keesler AFB, recently notified CODA of impending changes at the completion of Academic Year 2020 (30 June 2020). The Endodontics GDE program will close and is now listed as “Approval, without reporting requirements (teach-out)”. The Endodontics program is complying with CODA’s teach-out standards. The Comprehensive Dentistry program will convert from a 24 month, Masters Degree required program to a 12-month program that will not include the Masters Degree component. The end result is that following graduation of the final resident classes for these two programs on 30 June 2020, Keesler AFB will no longer be a component of the PDC, nor will it be an additional location of USU. A Teach-Out plan is presently being drafted for submission to Middle States Commission on Higher Education.

2. Graduation Rate (2012-2019) – Masters of Science in Oral Biology Degrees earned Graduation Year # Admitted # Withdrawals # Graduates Graduation % 2012 30 2 28 93 2013 48 5 43 90 2014 58 5 53 91 2015 64 7 57 89 2016 69 3 66 96 2017 73 3 70 96 2018 83 5 78 94 2019 80 6 74 93 2020 81 1 80 - 2021 80 1 79 - 2022 23 0 - - Cumulative 505 36 469 93

Note 1: Of the 469 graduates of the PDC, only 3 required additional time for program completion for a 99.4% on-time graduation rate. All 3 delayed graduates completed program requirements and earned their degree within 6 months of the scheduled program completion date (1 – 30 day delay, 1 – 4 month delay, 1 – 5 month delay). Note 2: Numbers in red may change and are not included in cumulative totals.

3. Written Board Certification Pass-Rate 2015-2019

Program 2015 2016 2017 2018 2019 Cumulative

Comp Dentistry 23 of 28 13 of 14 24 of 26 24 of 28 25 of 28 109 of 124

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Endodontics 8 of 8 13 of 13 11 of 11 17 of 17 16 of 16 65 of 65 Orthodontics 6 of 6 5 of 5 5 of 5 7 of 7 5 of 5 28 of 28 Orofacial Pain 3 of 3 1 of 1 1 of 2 NR 1 of 1 6 of 7 Oral Pathology NR 1 of 1 NA NA 1 of 1 2 of 2 Periodontics 3 of 3 4 of 4 7 of 7 3 of 3 4 of 4 21 of 21 Prosthodontics 4 of 4 4 of 4 4 of 4 6 of 6 9 of 9 27 of 27

Annual Total 47 of 52 41 of 42 52 of 55 57 of 61 61 of 64 258 of 274 Percentage 90% 98% 95% 93% 95% 94%

Note 1: NR means results were not reported by the program.

Note 2: NA means there were no students scheduled to graduate from the program for that year.

Note 3: Results are reported for written portion of board examinations taken while students are enrolled in their respective program. Not all program locations require their students to take this examination as an outcome measure. Specifically, it remains voluntary for Army students.

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Deployments/Humanitarian Assistance/Community Service

Air Force Postgraduate Dental School Offutt AFB - Col Michael Webb (Associate Professor of Comprehensive Dentistry) deployed to ADAB, UAE.

Air Force Postgraduate Dental School US Air Force Academy - Maj Evan Roberts (Assistant Professor of Comprehensive Dentistry) deployed to ADAB, UAE.

The Staff and Residents from the Naval Postgraduate Dental School Oral and Maxillofacial Pathology Residency completed 51 missions to Port Mortuary, Dover AFB in support of Forensic Operations, resulting in 97 postmortem dental examinations and identifications.

Air Force Postgraduate Dental School Andrews/Bolling – Eight Residents participated in an Innovative Readiness Training (IRT) exercise where residents treated patients in rural Missouri under field conditions.

Air Force Postgraduate Dental School Eglin AFB – Two residents participated in an IRT providing dental care for underserved populations in Georgia.

Air Force Postgraduate Dental School Scott AFB - Maj Paula Morse (Program Director and Assistant Professor of Comprehensive Dentistry), Maj Amber Miller (Endodontist and Assistant Professor of Endodontics), 6 residents and 7 technicians participated in an IRT mission to the underserved population of Sikeston, MO.

Air Force Postgraduate Dental School Wright Patterson AFB - Maj Peter Ingoldsby (Assistant Professor of Oral and Maxillofacial Surgery) and one dental technician participated in the Appalachian Care IRT in Wise, VA in support of the Air National Guard, Air Force Reserve, Active Duty Air Force, Active Duty Army, Army Reserve, and Navy Reserve.

Endodontics Residents (Army Postgraduate Dental School Fort Bragg) provided 3 root canal procedures on military working dogs and attempted to teach Veterinary colleagues to be able to perform the procedure if needed.

Air Force Postgraduate Dental School Keesler AFB – Keesler teaching staff members, Lt Col Roger Miller (AFPDS Keesler Assistant Professor of Prosthodontics), Lt Col Steve Black (AFPDS Keesler Assistant Professor of Endodontics), and Lt Col Jared Cardon (AFPDS Keesler Associate Professor of Endodontics), participated in Hurricane Michael relief efforts in Panama City, FL.

Air Force Postgraduate Dental School Keesler AFB – Comprehensive Dentistry residency class participated in a civilian-sponsored mission trip to Kingstown, Jamaica. They were accompanied by their faculty mentor, Lt Col Roger Miller (AFPDS Keesler Assistant Professor of Prosthodontics).

Air Force Postgraduate Dental School Wright Patterson AFB – Eight residents participated in National Dental Children’s Health Month visiting 4 local child development centers and youth centers. Comprehensive Dentistry Residents (Army Postgraduate Dental School Fort Bragg) participated in North Carolina Dental Society Foundation Missions of Mercy w/ MG (ret) Temple providing extractions, restorations, and interim RPDs for underserved populations.

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Leadership

Leadership - Military

Surgeon General Consultants/Specialty Leaders

Col Richard Batzer (AFPDS Lackland) – Prosthodontics Lt Col Sara Cushen-Corker (AFPDS Lackland) – Maxillofacial Prosthetics Dr. Kraig Vandewalle (AFPDS Lackland) – Dental Research Col Michael Webb (AFPDS Offutt) – AEGD-1 Residencies Col James Knowles (AFPDS Lackland) – General Dentistry CAPT Michael Rudmann (NPDS) – Comprehensive Dentistry and ACP General Dentistry CAPT Andrew Avillo (NPDS) – PGY-1 Programs CDR Calvin Suffridge (NPDS) – Endodontics CDR Laleh Abdolazadeh (NPDS) – Maxillofacial Prosthetics and Dental Implants CAPT Scott Koistra (NPDS) – Operative Dentistry CAPT Richard Adcook (NPDS) – Operative Dentistry CAPT Steve Hargitai (NPDS) – Orofacial Pain LTC Alex Smith (US Army) – Orofacial Pain CAPT John Bissell (NPDS) – Laser Dentistry

Presidential Dental Support Team

CAPT Michael Rudmann (NPDS Assistant Professor of Comprehensive Dentistry) served on the Presidential Dental Support Team where he provides dental care to White House leadership and personnel stationed at the Naval Support Facility Thurmont.

CAPT Andrew Avillo (NPDS) is assigned to the Presidential Dental Support Team where he serves as the dentist for the POTUS and First Family.

CDR Daniel Honl (NPDS, Assistant Professor of Oral and Maxillofacial Surgery) serves as the Oral Surgeon for the POTUS and First Family.

Other Accomplishments

LTC(P) Tom Johnson (APDS Associate Professor of Periodontics) - awarded the Army Surgeon General’s “A” designator. Lt Col Cade Salmon (AFPDS Lackland Associate Professor of Prosthodontics) Named as Chair, Air Force Dental Service CAD/CAM Working Group.

Maj Joseph McCombs (AFPDS Lackland Associate Professor of Periodontics) won Squadron Field Grade Officer of the Year and Group Field Grade Officer of the Year 2018.

Lt Col Christopher Nuttall (AFPDS Travis Associate Professor of Comprehensive Dentistry) serves as one of two Air Force delegates to the American Dental Association.

Dr. Kraig Vandewalle (AFPDS Lackland Professor of Comprehensive Dentistry)

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Chairman, 59 Dental Training Squadron Dental Research Function

Deputy Chairman, 59th Medical Wing (MDW) Institutional Review Board

Senior Director, Science and Technology Office, WHASC

Chairman, AF Dental Research Working Group

Member, 59 MDW Science Advisory Committee & 59 MDW Human Research Protection Program.

LCDR James Hawkins (NPDS, Assistant Professor of Orofacial Pain)

Quality Assurance & Patient Safety Dental Advisor, NPDS & WRNMMC

CDR Calvin Suffridge (NPDS Associate Professor of Endodontics) is the President of the US Navy Association of Endodontists.

CDR John Neal (NPDS Assistant Professor of Endodontics) is the Secretary of the NPDS Faculty Forum and the Vice President of the US Navy Association of Endodontists.

CDR Andrea Lisell (NPDS, Assistant Professor of Endodontics) serves as the Secretary, US Navy Association of Endodontists.

CDR Keith Merchant (NPDS Associate Professor of Periodontics) was elected President of the NPDS Faculty Forum.

CDR Ling Ye (NPDS, Associate Professor of Research) serves as the NMPDC Research Integrity Leader and is a voting member of the WRNMMC IRB.

LCDR Nicolas Hamlin serves as the NMPDC Human Research Protection Program, Alternate Contact.

USU Committee Service

Col Michael Wajdowicz (AFPDS Professor of Comprehensive Dentistry): Chair, AFPDS Committee on Appointments and Promotion

Col Michael Wajdowicz (AFPDS Professor of Comprehensive Dentistry): Chair, PDC Committee on Appointments and Promotion

Col Richard Batzer (AFPDS Associate Professor of Prosthodontics): Chair, AFPDS Curriculum

COL Ryan Snyder (APDS Associate Professor of Orthodontics, with duties at AFPDS): Chair, AFPDS Academic Admissions Committee

CDR John Neal (NPDS Assistant Professor of Endodontics): Member, Human Anatomical Review Committee

CDR Jared Geller (NPDS Associate Professor of Comprehensive Dentistry): Senator, USU Faculty Assembly

Attachment 3

LTC Alexander Smith (USA Assistant Professor of Orofacial Pain, with duties at NPDS): Member, Learning Resources Center Advisory Committee

CAPT Scott Koistra: (NPDS Professor of Operative Dentistry): Chair, PDC Committee on Appointments and Promotion

CAPT Steve Hargitai (NPDS Professor of Orofacial Pain): Member, PDC Committee on Appointments and Promotion

LCDR James Hawkins (NPDS Assistant Professor of Orofacial Pain): Senator, USU Faculty Assembly

LTC Joseph Dutner (APDS Assistant Professor of Endodontics): Senator, USU Faculty Assembly

Leadership – Education COL Cynthia Aita-Holmes (APDS Assistant Professor of Prosthodontics) served as the American College of Prosthodontists Region 6 Representative for the Army.

Lt Col Steven Black (AFPDS Keesler Assistant Professor of Endodontics) served as a Research Competition judge at the 2019 American Association of Endodontists Annual Meeting.

Lt Col Cade Salmon (AFPDS Lackland Associate Professor of Prosthodontics)

Served as guest examiner for Stony Brook (NY) Advanced Education Program in Prosthodontics mock board examinations.

Elected Secretary of the Texas Section of American College of Prosthodontists

Appointed to the American College of Prosthodontists Committee to the American Board of Prosthodontists

Lt Col Jarom Ray (AFPDS Lackland Associate Professor of Endodontics)

Named as the 2020 Surgical Track Organizer at the American Association of Endodontists Annual Session, Nashville TN

Invited editorial author American Association of Endodontists Communique

Col Richard Townsend (AFPDS Lackland Associate Professor of Orofacial Pain) was appointed to the American Board of Orofacial Pain Board of Directors.

Col Richard Batzer (AFPDS Lackland Assistant Professor of Prosthodontics) was elected as the Air Force Representative to the American College of Prosthodontists Region 6 (Federal Services).

Maj Ryan Sheridan (AFPDS Lackland Assistant Professor of Prosthodontics)

Elected as Director, American College of Prosthodontists for Region 6 (Federal Services)

Appointed to the American College of Prosthodontists Digital Dentistry Symposium Task Force

Appointed to the American College of Prosthodontists Research Committee

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Appointed to the American College of Prosthodontists National Prosthodontic Resident Examination Subcommittee

Col Michael Webb (AFPDS Offutt Associate Professor of Comprehensive Dentistry)

Councilor, Section on Postdoctoral General Dentistry, American Dental Education Association

Commission on Dental Accreditation Review Committee for Advanced Education in General Dentistry, GPR, Dental Anesthesia, Oral Medicine, Orofacial Pain

CDR Jared Geller (NPDS Associate Professor of Comprehensive Dentistry) served as the President, NPDS Faculty Forum.

Lt Col Nicholas DuVall (AFPDS Eglin Associate Professor of Comprehensive Dentistry) serves as an Examiner for the American Board of General Dentistry Standardized Oral Treatment Plan.

LCDR James Hawkins (NPDS, Assistant Professor of Orofacial Pain)

American Board of Orofacial Pain oral board examiner

Co-Chair, American Academy of Orofacial Pain “Resident & Academic Training” committee

Founding Member, American Academy of Orofacial Pain “Mentorship” committee CDR Calvin Suffridge (NPDS Associate Professor of Endodontics) is the President of the Edward C. Pennick Endodontic Study Club.

CDR John Neal (NPDS Assistant Professor of Endodontics) is the President and Program Chair of the Edward C. Pennick Endodontic Study Club.

CAPT Scott Koistra (NPDS, Professor of Operative Dentistry) serves on the Executive Council, American Board of Operative Dentistry.

CAPT Steve Hargitai (NPDS, Professor of Orofacial Pain) is a Director for the American Board of Orofacial Pain.

LTC Alex Smith (NPDS Assistant Professor of Orofacial Pain) serves as an Academy of General Dentistry Fellowship Review Exam Instructor.

CAPT Anton Petrich (NPDS Assistant Professor of Prosthodontics)

Serves as a member of the American Academy of Fixed Prosthodontics Credentialing Review Committee

Serves as a member of the American College of Prosthodontic Review Committee for the mock written board exam

MAJ Jeanette Obryhim (APDS Fort Gordon, Assistant Professor of Periodontics) participated in the 2019 American Academy of Periodontology Leadership, Engagement, Action, and Development (LEAD) Program.

Attachment 3

Journal Review

Lt Col Jarom Ray (AFPDS Lackland Associate Professor of Endodontics) serves on the Journal of Endodontics Scientific Advisory Board.

Maj Ryan Sheridan (AFPDS Lackland Assistant Professor of Prosthodontics) appointed as a Reviewer, Journal of Prosthodontics.

Lt Col Aaron Harding (AFPDS Lackland Assistant Professor of Prosthodontics) was appointed to the Editorial Review Board, Journal of Prosthodontics.

Maj Angela Synatzske (AFPDS Lackland Assistant Professor of Periodontics) was named a peer reviewer for the Military Medicine Journal.

Lt Col Dimitri Villareal (AFPDS Lackland Assistant Professor of Periodontics) was named a peer reviewer for the Military Medicine Journal.

Lt Col Nicholas DuVall (AFPDS Eglin Associate Professor of Comprehensive Dentistry) serves as a Reviewer, Operative Dentistry and the Journal of Esthetic and Restorative Dentistry.

LCDR James Hawkins (NPDS, Assistant Professor of Orofacial Pain) serves as a Reviewer for the journal, Pain Medicine.

CAPT Scott Koistra (NPDS, Professor of Operative Dentistry) serves on the Editorial Review Board for the Operative Dentistry Journal.

Commission on Dental Accreditation Site Visitors

CAPT Arthur George (NPDS) – PGY-1 Programs CDR Jared Geller (NPDS) – PGY-1 Programs Lt Col Christopher Nuttall (AFPDS) – PGY-1 Programs

Resident Research Projects Mentored Dr. John Schmidt (NPDS, Associate Professor of Orofacial Pain) supervised 11 residents in the following programs: Comprehensive Dentistry (8), Oral Pathology (1), Orofacial Pain (2)

CAPT Arthur George (NPDS, Assistant Professor of Comprehensive Dentistry) served as Associate Investigator for 7 Comprehensive Dentistry residents

CDR Calvin Suffridge (NPDS, Associate Professor of Endodontics) supervised 1 resident and served as an Associate Investigator for 4 residents

CDR John Neal (NPDS, Assistant Professor of Endodontics) supervised 2 residents and served as an Associate Investigator for 2 residents

CDR Andrea Lisell (NPDS, Assistant Professor of Endodontics) served as an Associate Investigator for 2 residents

CAPT Nancy Osborne (NPDS, Adjunct Assistant Professor of Endodontics) served as an Associate Investigator for 2 residents

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CAPT Steve Hargitai (NPDS, Professor of Orofacial Pain) served as an Associate Investigator for 1 resident

LTC Alex Smith (NPDS, Assistant Professor of Orofacial Pain served as an Associate Investigator for 2 residents

LTC James Hawkins (NPDS, Assistant Professor of Orofacial Pain served as an Associate Investigator for 2 residents

Faculty Development

Col James Knowles (AFPDS Associate Professor of Comprehensive Dentistry) served on the Faculty Development Outreach and Certification for Uniformed Services (FOCUS) Team, providing training as part of a USU Multi-health professions team.

COL Peter Guevara (APDS Professor of Comprehensive Dentistry) served on the Faculty Development Outreach and Certification for Uniformed Services (FOCUS) Team, providing training as part of a USU Multi-health professions team.

COL Lisa Yarbrough (APDS, Associate Professor of Comprehensive Dentistry) served as a Developer and Administrator for the Distributed Learning Dental Faculty Development Course.

USU School of Medicine Faculty Development Teaching Certificate Recipients

Lt Col James Renda (AFPDS, Assistant Professor of Comprehensive Dentistry) Col Gerry Whisler (AFPDS, Associate Professor of Comprehensive Dentistry) Lt Col Emily Ibarra (AFPDS, Assistant Professor of Comprehensive Dentistry) LCDR James Hawkins (NPDS, Assistant Professor of Orofacial Pain) Col James Knowles (AFPDS, Associate Professor of Comprehensive Dentistry) Col Scott Greening (AFPDS, Assistant Professor of Orthodontics) CAPT Andrew Avillo (NPDS, Associate Professor of Comprehensive Dentistry) Lt Col Nathan Krivitzky (AFPDS, Associate Professor of Comprehensive Dentistry) LTC Michael Ryhn (APDS, Associate Professor of Oral and Maxillofacial Surgery)

USU Academic Leadership Course Graduates and Certificate Recipients COL Lisa Yarbrough (APDS) LTC Brandon Gage (APDS) LTC Walter Dimalanta (APDS) LTC Joseph Dutner (APDS) Lt Col Nicholas DuVall (AFPDS) Maj Paula Morse (AFPDS) Lt Col James Renda (AFPDS) Maj Casey Slack (AFPDS) Lt Col Erin Speier (AFPDS)

Attachment 5

PDC Publications FY 19 PUBLISHED MANUSCRIPTS (34)

Minimally Invasive- Endoscopic- Oral and Maxillofacial Surgery Hakim M, McCain J, Ahn D, Troulis M Oral & Maxillofacial Surgery Clinics of North America. Nov 2019.

Effect of High-Speed Sintering on the Properties of Zirconia-Oxide Materials Soult MD, Lien W, Gallardo FF, Vandewalle KS Gen Dent 2019, Sept-Oct; 67(5).

Shear Bond Comparison between 4 Bioceramic Materials and Dual-cure Composite Resin Hursh KA, Kirkpatrick TC, Cardon JW, Brewster JA, Black SW, Himel VT, Sabey KA. J Endod. 2019 Sep 3. Pii: S0099-2399(19)30542-4. Doi: 10.1016/j.joen.2019.07.008. [Epub ahead of print]

Strength Characteristics of Newer Resin-Modified Glass Ionomers in Stress Bearing Areas Fuhrmann DJ, Whipple SJ, Murchison DF, Vandewalle KS Oper Dent 2019, Sept [Epub ahead of print].

Adjunctive Nd: YAG Laser Irradiation for Ridge Preservation and Immediate Implant Procedures: A Consecutive Case Series Choi AY, Reddy CM, McGary RT, Hill RB, Swenson DT, Seibel P, Hoag JM, Berridge JP, Johnson TM. Clin Adv Periodontics. 2019 Sep; 9(3):125-134. Doi: 10.1002/cap.10059. Epub 2019 Apr 10.

Assessing the accuracy of casting and additive manufacturing techniques for fabrication of a complete palatal coverage metal framework Forrester K, Sheridan R, Phoenix RD Journal of Prosthodontics 2019 August (epub, ahead of print).

Flexural strength of denture base acrylic resins processed by conventional and CAD-CAM methods Aguirre BC, Chen JH, Kontogiorgos ED, Murchison DF, Nagy WW. J Prosthet Dent. 2019 Jul 26. pii: S0022-3913(19)30224-0. doi: 10.1016/j.prosdent.2019.03.010. [Epub ahead of print]

The tissue-supported sling suture: technique and clinical applications McGary RT, Johnson TM, Berridge JP, Baron D Clinical Advances in Periodontics [online ahead of print, accepted for publication14 July 2019]

Human Gingival Epithelial Growth In Vitro on a Polymer-Infiltrated Ceramic Network Restorative Material Smallidge MJ, Sabol JV, Aita-Holmes C, Chuang H, Dickinson DP.

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J Prosthodont. 2019 Jun;28(5):541-546. doi: 10.1111/jopr.13017. Epub 2019 Feb 3

Clinical evaluation of a chairside amalgam separator to meet Environmental Protection Agency dental wastewater regulatory compliance Olivera DS, Morgan MT, Tewolde SN, Botts EC, Horvath FP, Hamlin NJ. Journal of Operative Dentistry. Published online: 07 Jun 2019.

Rational prophylactic antibiotic selection for sinus elevation surgery Akers JA, Johnson TM, Hill RB, Kawaguchi S. Clin Adv Periodontics. [online ahead of print, accepted for publication 3 June 2019].

Buccal bone thickness adjacent to virtual dental implants following guided bone regeneration Phillips DJ, Swenson DT, Johnson TM. J Periodontol 2019; Jun,90:595-607.

Frequency of adequate mesiodistal space and faciolingual alveolar width for implant placement at human anterior tooth positions Wilson JP, Johnson TM. JADA. [online ahead of print, accepted for publication 3 May 2019].

Construction of a genetically modified T7Select phage system to express the antimicrobial peptide 1018. Lemon D, Kay M, Titus J, Ford A, Chen W, Hamlin N, Hwang Y. Journal of Microbiology 2019 Vol. 57. Published online: 03 May 2019

Longitudinal Analysis of CAD/CAM Restoration Incorporation Rates into Navy Dentistry Dickens N, Haider H, Lien W, Simecek J, Stahl J. Mil Med. 2019 May 1;184(5-6):e365-e372. doi: 10.1093/milmed/usy260.

Antibacterial effects and cytotoxicity of two dermaseptin derivatives. Lemon D, Titus J, Kay M, Johnson M, Hamlin N, Hwang Y. Defense Technical Information Center. Report date: 01 Apr 2019. Published online: 02 Apr 2019.

Characterization of the clinical performance of a chairside amalgam separator in a military dental treatment facility Morgan M, Tewolde S, Botts E, Horvath F, Titus J, Dinh T, Shartzer J, Hamlin N, Olivera D. Defense Technical Information Center. Report date: 12 Dec 2018. Published online: 01 Apr 2019.

Focus on epithelialized palatal grafts. Part 2: Implant site development Berridge JP, Johnson TM, Erley KJ, Hill RB, Lane JD, Schlam KK, Dunham DD, Miller PD. Clin Adv Periodontics. [online ahead of print, accepted for publication 31 March 2019].

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The Development of Lingualized Occlusion Engelmeier RL, Phoenix RD. J Prosthodont. 2019 Jan;28(1):e118-e131. doi: 10.1111/jopr.12624. Epub 2017 Apr 19. Review

Comparative Biocompatibility and Osteogenic Potential of Two Bioceramic Sealers Giacomino C, Wealleans J, Kuhn N, Diogenes A J Endod 2019 45:51-56.

Effectiveness of various decontamination methods on CAD/CAM camera mirror sleeves Kruze JP, Henrichs LE, Mack K, Vandewalle KS Int J Comput Dent. 2019; 22(2):177-185.

Rhinosinusitis and Endodontic Disease Fleming A, Suffridge C. Clinical Update NPDS. Aug 2019, Vol. 41, No.4

Seromucinous Hamartoma of the Nasal Cavity Tong KN, Serra RM, Shih RY, Foss RD. Head Neck Pathol. 2019 Jun;13(2):239-242. doi: 10.1007/s12105-018-0914-6. Epub 2018 Mar 28

Case Definitions and Diagnostic Criteria of Peri-Implant Diseases and Conditions Tibbet B, Wilson J. Clinical Update NPDS. Jun 2019, Vol. 41, No.3

The New Classification System for Periodontal Diseases and Conditions; A Review of the 2017 AAP World Workshop on the Classification of Periodontal Disease Kaye R, Merchant K. Clinical Update NPDS. Jun 2019, Vol. 41, No.2

Review of the 2017 AAP World Workshop on the Classification of Periodontal Disease; Part I: The New Classification System for Gingival Diseases & Conditions Polak E, Merchant K. Clinical Update NPDS. Jun 2019, Vol. 41, No.1

Lipoma of the Parotid Gland Tong KN, Seltzer S, Castle JT. Head Neck Pathol. 2019 Mar 19. doi: 10.1007/s12105-019-01023-3. [Epub ahead of print]

Regenerative treatment following mandibular third molar extraction leads to increased clinical attachment level at adjacent second molars Pesut C and Hamlin N.

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Critically Appraised Topic (CAT), University of Texas Health Science Center San Antonio online CATs library. Published online: 11 Nov 2018.

Polish retention of ceramic-polymer CAD/CAM materials Partin-Agarwal K, Terwilliger RJ, Lien W, Jessup JP, Motyka NC, Vandewalle KS Gen Dent. 2018 Nov-Dec; 66(6):65-70.

Evaluation of antimicrobial peptides against Pseudomonas aeruginosa in various media Lemon D, Titus J, Kay M, Johnson M, Hamlin N, Hwang Y. Defense Technical Information Center. Report date: 10 Aug 2018. Published online: 23 Oct 2018.

Focus on epithelialized palatal grafts. Part 3: Methods to enhance patient comfort at palatal donor sites Berridge JP, Johnson TM, Cheng AW, Swenson DT, Miller PD. Clin Adv Periodontics. [online ahead of print, accepted for publication 8 October 2018].

Painful Oral Lesions Hargitai, I A Den Clin N Am, Oct; 62(4):597-609 (2018).

Psychosocial considerations in TMD Bartley EJ, Schmidt JE, Carlson CR, Fillingim, RB. In Klasser, GD and Gremillion, HA (Eds.), Temporomandibular Disorders. Cham, Switzerland: Springer Publishing, 2018, p. 193-217. ISBN 978-3-319-57245-1.

Orofacial Pain Schmidt, JE & Hawkins, JM. In Arnold, C. (Ed.), Handbook of Psychosocial Interventions for Chronic Pain: An Evidence-Based Guide: Routledge Publishing, 2018, p. 399-425. ISBN 978-0-8153-7082-6.

PUBLISHED ABSTRACTS (22)

Development of a Magnetic Nanorod Reinforced Bulk Fill Composite A. Ochoa, Z. Skeete, A. Jaffar, T. Yuan, N. Hamlin, W. Lien. J Dent Res 2019, abstract #0656.

Mineralization of Ridge Preservation Products May Negatively Impact Cellular Activity K. Jones Morris, A. DiGeorge Foushee, A. Jaffar, T. Yuan, N. Hamlin. J Dent Res 2019, abstract #1928.

Military Field Storage Conditions Affect Biofilm Formation on Dental Materials S. Moffett, D. Lemon, A. A. Ford, J. Hoyle, N. Hamlin, T. Truong, W. Lien, Y. Hwang.

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J Dent Res 2019, abstract #1333.

Micro-CT Evaluation of EndoSequence BC Sealer HiFlow Performance by Technique Carlson T, Cardon J, Brewster J, Black S, Sabey K J Endod – OR 21; Vol 45, May 2019

Targeted Endodontic Microsurgery and EMS: A Surgical Simulation Comparison Hawkins T, Wealleans J, Ray J J Endod OR 25; Vol 45, May 2019

Cyclic Fatigue Comparison of 6 Different Brands of Nickel-Titanium Rotary Files Kim P, Cardon J, Black S, Kirkpatrick T, Sabey K J Endod OR 03; Vol 45, May 2019

Clinician-Centered Assessment of 3D-printed Stents for Targeted Endodontic Microsurgery Anderson J, Wealleans J, Ray J J Endo OR 23; Vol 45, May 2019

CAD Marginal Fit Comparison of Lithium Silicate and Lithium Disilicate Fluke, C J Dent Res 2019, abstract #0651.

Long-term Volumetric Analysis of Resin Composites Stored in PBS Grenier, J J Dent Res 2019, abstract #0337.

Dentin Bonding Agent Volatility in Relation to Shear Bond Strength Hoch, C J Dent Res 2019, abstract #1891.

Endodontic Access Effect-Lithium Disilicate & Lithium Silicate Fracture Resistance Spilsbury, G J Dent Res 2019, abstract #0647.

Composite Resin Core Buildup Material Porosity Brewster JA, Roberts, HW J Dent Res 2019, abstract #1870.

Efficacy of Auricular Acupuncture in Reducing Pain after Third-Molar Extractions Jensen C, Brooks H, Townsend R, McMahon S, Krutoy B, Stanley B, Labella C, Powell-Davis V, Vandewalle K. J Dent Res 2019, abstract #1250.

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Efficacy of Screening for GERD in the Dental Setting Ellis A, Miller CB, Kosaraju A, Francis, JM, Solivan-Ortiz AM, Parke A, Jessup J, Vandewalle KS J Dent Res 2019, abstract #0395.

A Survey of Air Force General Dentists Regarding CAD/CAM Usage Walker SA, Kosaraju A, Lien W, Vandewalle KS J Dent Res 2019, abstract #1786.

Flexural Strength Degradation of New Cubic-Containing Zirconia Materials Holman C, Lien W, Gallardo FF, Vandewalle KS J Dent Res 2019, abstract #1263.

Effect of Various Surface Treatments on the Pull-Off Bond Strength Between Lithium Disilicate and a Titanium Implant Abutment Base Kemarly K, Parke A, Arnason S, Lien W, Vandewalle K J Dent Res 2019, abstract #1313.

Efficacy of Pulpal Anesthesia Using a Needle-less Syringe Christensen C, Arnason S, Oates R, Crabtree M, Kersey J, Vandewalle K J Dent Res 2019, abstract #1243.

Effect of High-Intensity Light Curing on Depth-of-Cure and Intrapulpal-Temperature Increase Slack WE, Yancey EM, Lien W, Sheridan RR, Phoenix RD, Vandewalle KS J Dent Res 2019, abstract #1872.

Statistical Nanoindentation Analysis of Modern Dental Composites Jones SD, Vandewalle KS, Lien W J Dent Res 2019, abstract #0664.

Assessing Physical Activity in Orofacial Pain Patients Corbett, JT, Hargitai, IA, Ling, Y, Brooks, DI, Schmidt, JE. Ann Behav Med 2019, 53 (Suppl 1), B320.

Predictors of Self-Reported Cognitive Functioning in Neuro-Oncology Ferguson, R, Dean, AM, Schmidt, JE, Mabold, JL, Pritchard, AK, Drappatz, J, Lieberman, FS, Bovbjerg, DH. Ann Behav Med 2019, 53 (Suppl 1), A106.

SUBMITTED/ACCEPTED FOR PUBLICATION (18)

Hypermobility and Hypomobility Disorders of the Temporomandibular Joint D. Ahn, M. Hakim, M. August, L. Kaban, M. Troulis Peterson’s Oral & Maxillofacial Surgery 4ed. (submitted)

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TMJ Arthrocentesis and Arthroscopy J. Montero, D. Ahn, M. Hakim, J. McCain. Peterson’s Oral & Maxillofacial Surgery 4ed. (submitted)

The Effect of Screw Channel Angulation on Reverse Torque Values of Dental Implant Abutment Screws Hu E, Petrich A, Hamlin C. J Prosthdont. 2019 (submitted)

Targeted Endodontic Microsurgery: A Clinically Oriented Assessment of Three 3D Printers Anderson JA, Wealleans JA, Ray JJ. Journal of Endodontics, 2019 (submitted)

Efficacy of Screening for GERD in the Dental Setting Ellis A, Miller CB, Kosaraju A, Francis, JM, Solivan-Ortiz AM, Parke A, Jessup J, Vandewalle KS JADA, 2019 (submitted)

Targeted Endodontic Microsurgery and EMS: A Surgical Simulation Comparison Hawkins T, Wealleans J, Ray J Journal of Endodontics, 2019 (submitted)

Digital Workflow Options for Targeted EMS Sheridan RR, Giacomino CM, Wealleans JA, Ray JJ. International Endodontic Journal, 2019 (submitted)

Temporal Tendonitis Preston S. Duffin, DDS, MS; Alexander Smith, DDS, MS; James M. Hawkins, DDS, MS Journal of the Academy of General Dentistry, 2019 (submitted)

Managing antral wall discontinuities in sinus elevation surgery Joseph F. Capetillo, Thomas M. Johnson, Dane T. Swenson, Robert W. Herold Clinical Advances in Periodontics, 2019 (submitted)

Fracture necrosis: an ominous risk indicator for tooth loss CPT James P. Wilson, LTC Joseph M. Dutner, COL Robert W. Herold, LTC Jason S. Bullock, COL Daniel D. Dunham, and LTC Thomas M. Johnson Clinical Advances in Periodontics, 2019 (submitted)

Pediatric Obstructive Sleep Apnea: A Multi-Disciplinary Approach Stark, Thomas R California Dental Journal, 2019 (submitted)

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Orthodontic treatment of periodontally compromised teeth following laser periodontal therapy Ronald W. Bice, Thomas M. Johnson Clinical Advances in Periodontics, 2019 (submitted)

Evaluation of the Importance of Soft Tissue Biopsy in Dentistry Tong KN, Schmidt JE, Martinez A, Jones BE. Oral Oncology, 2019 (submitted)

Assessing the Accuracy of Two Posterior Tooth-size Discrepancy Prediction Methods Fallis, DW Angle Orthodontist, 2019 (submitted)

Effect of Deep Margin Elevation on CAD-CAM-Fabricated Ceramic Inlays Vertolli TJ, Martinsen BD, Hanson CM, Howard RS, Kooistra S, Ye L. Operative Dentistry, 2018 (submitted)

Eagle’s Syndrome: Varied Clinical Presentations John E. Dinan, DMD; Alexander Smith, DDS, MS; Istvan A. Hargitai, DDS, MS; John E. Schmidt, PhD, MS; James M. Hawkins, DDS, MSJADA, 2018 (submitted)

The Effect of Dental Unit Waterline Antimicrobials on the Shear Bond Strength of Orthodontic Brackets Carey JF, Hernandez-Feldpausch MA, Howard RS, Molinaro JD, Huber JH, Ye L. The Angle Orthodontist, 2018 (submitted)

Fracture Strength of Titanium-based Implant Crowns Vandewalle KS IADR Abstract, 2020 (submitted)

Presentations

National/International (104)

International Association of Dental Research (16)

Capt C. Austin Fluke (AFPDS Keesler, Comprehensive Dentistry), CAD Marginal Fit Comparison of Lithium Silicate and Lithium Disilicate (Poster Presentation) Capt Joshua Grenier (AFPDS Keesler, Comprehensive Dentistry), Long-term Volumetric Analysis of Resin Composites Stored in PBS (Oral Presentation) Capt Cory Hoch (AFPDS Keesler, Comprehensive Dentistry), Dentin Bonding Agent Volatility in Relation to Shear Bond Strength (Poster Presentation)

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Capt Greg Spilsbury (AFPDS Keesler, Comprehensive Dentistry), Endodontic Access Effect-Lithium Disilicate & Lithium Silicate Fracture Resistance (Poster Presentation) Brewster JA, Roberts, HW (AFPDS Keesler) Composite Resin Core Buildup Material Porosity; (Poster Presentation) Jensen C, (AFPDS Lackland, Comprehensive Dentistry), Efficacy of Auricular Acupuncture in Reducing Pain After Third-Molar Extractions Ellis A, (AFPDS Lackland, Comprehensive Dentistry), Efficacy of Screening for GERD in the Dental Setting Walker SA, (AFPDS Lackland, Comprehensive Dentistry), A Survey of Air Force General Dentists Regarding CAD/CAM Usage. Holman C, (AFPDS Lackland, Comprehensive Dentistry), Flexural Strength Degradation of New Cubic- Containing Zirconia Materials. Kemarly K, (AFPDS Lackland, Comprehensive Dentistry), Effect of Various Surface Treatments on the Pull- Off Bond Strength Between Lithium Disilicate and a Titanium Implant Abutment Base. Christensen C, (AFPDS Lackland, Comprehensive Dentistry), Efficacy of Pulpal Anesthesia Using a Needle- less Syringe. Slack WE, (AFPDS Lackland, Prosthodontics), Effect of High-Intensity Light Curing on Depth-of-Cure and Intrapulpal-Temperature Increase. Jones SD, (APDS Fort Hood, Comprehensive Dentistry), Statistical Nanoindentation Analysis of Modern Dental Composites. Schmidt A, (NPDS, Orofacial Pain, USU Masters in Oral Biology Class of 2018), Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices for Patients with Moderated and Severe Obstructive Sleep Apnea LT Travis Vertolli (NPDS, Comprehensive Dentistry, USU Masters in Oral Biology Class of 2018), Effect of Deep Margin Elevation on CAD-CAM Fabricated Ceramic Inlays CPT Carolina Wentworth (APDS, Fort Hood Comprehensive Dentistry, USU Masters in Oral Biology Class of 2019), Effects of Filler Distribution on Fracture Resistance of Modern Dental Composites

American Association of Endodontists (21)

Carlson T. (AFPDS Keesler) Micro-CT Evaluation of EndoSequence BC Sealer HiFlow Performance by Technique. Kim P. (AFPDS Keesler) Cyclic Fatigue Comparison of 6 Different Brands of Nickel-Titanium Rotary Files. Ray J. and Wealleans J. (AFPDS Lackland) Targeted Endodontic Microsurgery: This Changes Everything Ray J. and Wealleans J. (AFPDS Lackland) Targeted Endodontic Microsurgery (AAE Surgical Film) Anderson J. (AFPDS Lackland) Clinician-centered comparison of 3D-printed stents for Targeted Endodontic Microsurgery Hawkins T. (AFPDS Lackland) Targeted Endodontic Microsurgery and EMS: A Surgical Simulation Comparison Giacomino M. and Anderson J. (AFPDS Lackland) Principles of Endodontic 3D Printing and Surgical Guide Design: Tools to Get Started Anderson J. (AFPDS Lackland) Targeted Endodontic Microsurgery: A Clinically- Oriented Assessment of Three 3D Printers (Resident Oral Research Presentation)

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Ligon, K. (NPDS) Depth Limitations of Obturation Armamentarium with Continuous Wave Technique Kopacz, M. (NPDS) A Clinical Evaluation of Cone Beam Computed Tomography Layton, G. (NPDS) Needle Deformation During Local Anesthesia: Are We Changing Our Needles Frequently Enough? Layton, G. (NPDS) Needle Deformation During Local Anesthesia: Are We Changing Our Needles Frequently Enough? Donaldson, B. (NPDS) Maxillary Sinusitis vs Odontogenic Sinusitis: An Overview Lewis, M. (NPDS) Depth Limitations of Obturation Armamentarium with Continuous Wave Technique Fleming, A. (NPDS) Maxillary Sinusitis vs Odontogenic Sinusitis: An Overview Hershey, R. (NPDS) Digital Radiography: Improved measurement accuracy when using reference point for calibration Neal, R. (NPDS) Oral Sedation: Case Selection and Patient Management in Endodontics Harris, K. (NPDS) Needle Deformation During Local Anesthesia: Are We Changing Our Needles Frequently Enough? MAJ Mauro Correa Jr. (APDS Fort Gordon Endodontics): Heat Generation Changes With Electrically- Heated Pluggers after Multiple Autoclave Cycles at Different Operating Temperatures CPT Roland Miguel (APDS Fort Gordon Endodontics): Apical Pressures Generated by the XP-3D Finisher and Irrigation Adjuncts CPT Scott Otterson (APDS Fort Gordon Endodontics): Surface Integrity of Root Ends Following Apical Resection with Targeted Trephine Burs

American Academy of Fixed Prosthodontics Annual Meeting (3)

LT Diewitt Duong (NPDS Prosthodontics) Dynamic 3D Navigation for Accurate and Precise Placement of Dental Implants LCDR Gabrielle Jung (NPDS Prosthodontics) Management of an Endodontically Accessed Lithium Disilicate Molar Restoration LCDR Robert Holmes (NPDS Prosthodontics) Spacer Device for Assistance During Conversion of an Immediate Implant Prosthesis

American College of Prosthodontists Annual Meeting (6)

Capt Harrison Gordner (AFPDS Prosthodontics) Effect of tooth brushing on longevity of custom characterization of acrylic denture teeth (Poster Presentation) Capt Theresa Kim (AFPDS Prosthodontics) An investigation of the effect of cleaning solutions on plaque removal, surface roughness and hardness of oral appliances (Poster Presentation) MAJ Farzan Pouranfar (AFPDS Prosthodontics) Effect of tooth brushing on longevity of custom characterization of hybrid ceramics (Poster Presentation) LT Frank Gentz (NPDS Prosthodontics) Application of Aqueous Coloring Liquids to Presintered Monolithic Zirconia Restorations CPT Eric Hu (NPDS Prosthodontics) Maintaining Screw Retrievability Of An Implant Restoration With A Lingual Locking Screw

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MAJ Jacob England (NPDS Prosthodontics) Force Required to Remove Prefabricated Posts from Teeth Treated with an Er:YAG and Nd:YAG Laser

American Academy of Periodontology Annual Meeting (6)

LT Ryan Kaye (NPDS Periodontics) The use of a novel implant osteotomy technique (Oral Presentation) LT Claus Ullstad (NPDS Periodontics) The efficacy of ND-YAG Laser decontamination in an in-vitro peri- implantitis model (Oral Presentation) CPT Dane Swenson (APDS Periodontics Fort Gordon) Overlay analysis of cone-beam computed tomography images acquired before and after guided bone regeneration CPT (P) Dan Phillips (APDS Periodontics Fort Gordon) Buccal bone thickness adjacent to virtual dental implants following guided bone regeneration CPT (P) Ryan McGary (APDS Periodontics Fort Gordon) Investigation into possible somatic cell de- differentiation CPT Rick Hill (APDS Periodontics Fort Gordon) Investigation into possible somatic cell de-differentiation

American Association of Orthodontists (AFPDS – Tri Service Orthodontic Residency Program – Table Clinics) (5)

Maj Chartrand (USAF): Change in Mandibular Incisor Facial Bone Following Class II Correction with a Compressed Coil Spring Functional Appliance CPT Cox (USA): Cone Beam Computed Tomography Interpretation in Orthodontic Practices Maj Nguyen (USAF): Comparison of Orthodontic Adhesives for Bonding of Ceramic Brackets to CAD/CAM Provisional Crowns LCDR Reed (USN): A Survey of the Utilization of Ligation Bracket Systems by Orthodontists in the United States MAJ Stateson (USA): The Use of CBCTs to Determine Relative Anchorage Values by Measuring Maxillary Root Surface Areas within Bone

American Academy of Oral and Maxillofacial Pathology (1)

Tong, K, Schmidt, J, Martinez, A, Jones, B. Evaluation of the Importance of Soft Tissue Biopsy in Dentistry Abstract submitted to the annual meeting of the American Academy of Oral and Maxillofacial Pathology, June 2019, Miami, FL.

American Academy of Pediatric Dentistry (1)

Stark, TR. (APDS Assistant Professor of Pediatric Dentistry) Pediatric Dentistry for the Military- Connected Child

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American Academy of Maxillofacial Prosthetics (1)

CDR Laleh Abdolazadeh (NPDS, Associate Professor of Maxillofacial Prosthetics) Soft tissue Radiation Bolus (Oral Presentation)

Hinman Dental Meeting – AFPDS (8)

Capt Benjamin Bacon (AFPDS Eglin AFB): Peri-Implantitis: An Overview of Treatment Modalities Capt Emillie Brandt (AFPDS Eglin AFB): Decoronation: A Treatment Option for the Management of Ankylosed Teeth in Pediatric Patients Capt Joseph Crosariol (AFPDS Eglin AFB): CAD/CAM for Complete Dentures Capt Andrew Hamilton (AFPDS Eglin AFB): An Overview of Battlefield Acupuncture Capt Michael Love (AFPDS Eglin AFB): Hall Technique in Pediatric Dentistry Capt Colt Sicher (AFPDS Eglin AFB): An Overview of the Endocrown Technique Capt Shelby Willoughby (AFPDS Eglin AFB): Icon Infiltration Capt Yangdi Zhou (AFPDS Eglin AFB): Biologic Reshaping

Academy of General Dentistry (7)

Klingman, D (AFPDS, Associate Professor of Oral Pathology) presented a lecture on Oral Pathology, Oral Medicine, Pharmacology and Medical Emergencies, at the Fellowship Review Course x 3. Klingman, D (AFPDS, Associate Professor of Oral Pathology) presented a webinar on Radiographic Pathology; Interpretation of Images in 2 and 3 Dimensions, for the Academy of General Dentistry. Einhorn, M (AFPDS, Assistant Professor of General Dentistry) presented lectures to the Fellowship Review Course LCDR Sara Chilcutt (NPDS, Comprehensive Dentistry) Lip Hemangioma Ablation using Diode Laser LT Wei Liu (NPDS, Comprehensive Dentistry) Short Implants for Tall Orders CDR Andrew Silvestri (NPDS, Comprehensive Dentistry) Utilizing CAD for Immediate Orthodontic Retainers: A Digital Workflow LCDR Jennifer Steigerwald (NPDS, Comprehensive Dentistry) Multiple Invasive Cervical Resorption Defects in a Young Adult

Society of Behavioral Medicine (2)

Corbett, JT, Hargitai, IA, Ling, Y, Brooks, DI, Schmidt, JE. (NPDS Orofacial Pain) Assessing Physical Activity in Orofacial Pain Patients (Poster) Ferguson, R, Dean, AM, Schmidt, JE, Mabold, JL, Pritchard, AK, Drappatz, J, Lieberman, FS, Bovbjerg, DH. Predictors of Self-Reported Cognitive Functioning in Neuro-Oncology (Oral Abstract)

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International Academy of Gnathology – AFPDS Prosthodontics (5)

Maj Ryan Sheridan (Assistant Professor of Prosthodontics) Crown/Abutment Workflows: Capture, Design, and Manufacture (Oral Presentation) Lt Col Joshua Vess: The Patient As a Substitute for the Articulator: A Case Report (Table Clinic) Major Jessamy Thornton: The Total Joint Replacement Prosthesis: Planning, Surgery, and Restorative Implications (Table Clinic) Major Melissa Thomas: Digital Articulation: What’s Available? (Table Clinic) Major Joshua Decker: Clinical Implications of Optical Scanning Accuracy and Resolution (Table Clinic)

Military Health System Research Symposium 2019 (19)

POSTER PRESENTATIONS (12)

Hofferber C, Ye L (NPDS) Volumetric Changes in Edentulous Alveolar Ridge Sites Utilizing Guided Bone Regeneration and a Custom Titanium Ridge Augmentation Matrix Lam D, O’Connor A, Avillo A, Ye L, Schmidt J (NPDS) The Effects of Therapy Dog Intervention on Anxiety in Adult Patients Undergoing Dental Procedures: A Pilot Study Giacomino M, Wealleans J, Kuhn N, Diogenes A (AFPDS) Comparative Biocompatibility and Osteogenic Potential of Two Bioceramic Sealers Christensen C, Arnason S, Oates R, Crabtree M, Kersey J, Vandewalle KS (AFPDS) Efficacy of Pulpal Anesthesia Using a Needle-less Syringe Stukel J, Macaitis J, Chen W, Botts E, Grunlan M, Lien W, Burdette A (AFPDS) Evaluation of Mesenchymal Stromal Cell Differentiation for Healing of Large Tissue Defects Lin J, Zhu K, Solivan-Ortiz A, Larsen S, Irwin S, Schneid T, Shriver C, Lee S (AFPDS) Dual Tobacco Use and Related Factors among Active Duty Service Members in the US Military Lemon D, Chen W, Horvath F, Hoyle J, Hamlin N, Truong T, Olivera O, Hwang Y (NPDS) Simulating Field Storage Conditions for Evaluating Medical and Dental Materials CAPT Joshua Berridge, Ft Bragg (APDS) Methods to Enhance Patient Comfort at Epithelialized Palatal Graft Donor Sites MAJ Joseph F. Capetillo, Ft Hood (APDS) Combination Bone Replacement Graft with Dense Polytetrafluoroethylene Barrier Membrane for Treatment of an Infrabony Periodontal Defect MAJ Joshua A. Akers, Ft Gordon (APDS) Rational Prophylactic Antibiotic Selection for Sinus Elevation Surgery CPT Ryan T. McGary, Ft Jackson (APDS) Tunnel Access for Guided Bone Regeneration CPT Daniel J. Phillips, Ft Benning (APDS) Buccal Bone Thickness Adjacent to Virtual Dental Implants Following Guided Bone Regeneration

ORAL PRESENTATIONS (7)

Dr. Thomas Schneid (PDC): Introduction and Overview to Military Dental Research Dr. John Simecek (NPDS): The Incidence and Impact of Disease and Non-Battle Injury (DNBI)

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Lt Col (Dr.) Scott Irwin (AFPDS): Dental DNBI Encounters in three Air Force Deployed Locations Dr. Kraig Vandewalle (AFPDS): Efficacy of Screening for GERD Base on Dental Erosion Maj (Dr.) Michelle Giacomino (AFPDS): Guided Endodontic Microsurgery MAJ (Dr.) Ryan McGary (APDS): Guided Bone Regeneration Dr. Rod Phoenix (PDC): CAD/CAM Technologies in Military Dental Research

Tri-Service Dental Symposium – Tokyo, Japan (1) - LTC Joseph Dutner presented 3 lectures

DS World – LTC(P) Michael Mansell (APDS Associate Professor of Comprehensive Dentistry) Digital Dentistry in the US Army

American Academy of Orofacial Pain (1) – LCDR James Hawkins (NPDS, Assistant Professor of Orofacial Pain) Headache in the Orofacial Pain Practice

Laryngoscope and Otolaryngology Spring Meeting (1) - Baumann K, Jones B, Brooks D, Garibyan L, Farinelli B, Orestes M. - Distribution of Human Tongue Fat and Obstructive Sleep Apnea

Regional/Local (157)

USU 2019 Research Day (4)

Maj Michelle Giacomino (AFPDS) - Comparative Biocompatibility and Osteogenic Potential of Two Bioceramic Sealers LCDR Abigail Schmidt (NPDS) – Tracking Pulse Oximeter Findings Before, During and After Titration of Mandibular Advancement Devices for Patients with Moderated and Severe Obstructive Sleep Apnea MAJ Albert Cheng (APDS) – Cellular Events of Wound Healing/Regeneration in a Canine Supra-Alveolar Peri-implant Defect Model Dr. Rodney D. Phoenix (PDC, Professor of Prosthodontics) - The Significance of Research in Graduate Dental Education

Napa-Solano Dental Society – AFPDS Travis AFB AEGD-1 (8)

Capt Alexandra Cleveland: Efficacy of laser treatment for dentin hypersensitivity Capt Jeremiah Gossett: Sleep apnea treatment modalities Capt Jeanne Kiernan: Understanding Lingual Nerve Injury Capt Leanne McCarron: Laser Assisted Regeneration: What’s the Evidence? Capt Shane Pascoe: Temporary Anchorage Devices for Orthodontic Intrusion Capt John Smith: The Endocrown Capt Zachary Snider: Digital Flow of Single Unit Implant Restorations with Cerec Omnicam Capt Victor Sun: Resin Infiltration of White Spot Lesions

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Dayton Dental Society – AFPDS Wright Patterson AEGD-1 (9)

Col David Klingman (AFPDS Lackland – Associate Professor of Oral Pathology) Radiographic Pathology; Interpretation of Images in 2 and 3 Dimensions (Oral Presentation) Capt Eric Cheng: The Use of Toluidine for Oral Cancer Screening Capt Haylea Craigmiles: Natural Tooth Restorative Alternatives to Implants Capt Keane Fink: Immediate Loading Anterior Implant with Temporary with Digital Workflow Capt Eric Lines: Digital Workflow for the Placement of a Guided Single Implant Capt Mega Margapuram: Fill, but No Drill: Progressing Towards a Future with Natural Tooth Repair Capt Elisabeth Mauro: Digital Workflow for Orthodontic Aligners Using Blue Sky Bio Software Capt Renee Smith: Understanding Root Resorption Capt Jonathan Taylor: Restoration of a Single Implant Using a Digital Work Flow

Okaloosa Co Dental Society - AFPDS Eglin AFB AEGD-1 (8)

Capt Benjamin Bacon (Eglin AFB): Peri-Implantitis: An Overview of Treatment Modalities Capt Emillie Brandt (Eglin AFB): Decoronation: A Treatment Option for the Management of Ankylosed Teeth in Pediatric Patients Capt Joseph Crosariol (Eglin AFB): CAD/CAM for Complete Dentures Capt Andrew Hamilton (Eglin AFB): An Overview of Battlefield Acupuncture Capt Michael Love (Eglin AFB): Hall Technique in Pediatric Dentistry Capt Colt Sicher (Eglin AFB): An Overview of the Endocrown Technique Capt Shelby Willoughby (Eglin AFB): Icon Infiltration Capt Yangdi Zhou (Eglin AFB): Biologic Reshaping

Federal Services Dental Symposium – NCR Tri-Service (27)

Capt Matthew Bean (AFPDS Andrews-Bolling): Acupuncture and Its Role in Diminishing ‘Gag-Reflex’ and as an Alternative to Analgesics Capt Ashleigh Denny (AFPDS Andrews-Bolling): CBD: A New Wonder Drug? Capt Mario Endiakov (AFPDS Andrews-Bolling): Silver Diamine Fluoride: Clinical Application Guide and Unique Case Applications Capt Aaron Gause (AFPDS Andrews-Bolling): Guided Endodontic Surgery Capt Lindsey Miller (AFPDS Andrews-Bolling): Amnion Chorion Membranes Capt Michael Millet (AFPDS Andrews-Bolling): The Use of Buffered Anesthetic in Dentistry Capt Nshomba Stan (AFPDS Andrews-Bolling): Accelerated Osteogenic Orthodontics Capt Jamica Taylor (AFPDS Andrews-Bolling): Optimized CAD/CAM Workflow Capt Adam Yu (AFPDS Andrews-Bolling): Botox in Dentistry LCDR Erik Anderson (NPDS Comprehensive Dentistry): Bicuspidization of a Mandibular Molar Utilizing CAD/CAM Technology LCDR Erin Bailey (NPDS Comprehensive Dentistry): In-House Clear Aligner Therapy: Digital Workflow Utilizing BlueSky Bio

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LCDR Richard Bartol (NPDS Comprehensive Dentistry): Treatment of an Impacted Maxillary Canine with Closed Eruption CDR Mitchell Checchi (NPDS Comprehensive Dentistry): Resin-Infiltrated Ceramics for CAD/CAM Restorations LCDR Alan Chen (NPDS Comprehensive Dentistry): Ergonomics: Effect of Hand Instrument Design of Dental Providers CDR Patrick Fox (NPDS Comprehensive Dentistry): The Effects of Therapy Dog Intervention on Distress in Adult Patients Undergoing Dental Procedures LCDR Hoan Nghiem (NPDS Comprehensive Dentistry): The Application of Corticotomy-Accelerated Orthodontics (CAO) and CAD/CAM in Implant Restoration – A Case Report LCDR James Shaul (NPDS Comprehensive Dentistry): Immediate Long Term Provisional Fixed Dental Prosthesis with CAD/CAM Ligon, K. (NPDS Endodontics): Depth Limitations of Obturation Armamentarium with Continuous Wave Technique Layton, G. (NPDS Endodontics): Needle Deformation During Local Anesthesia: Are We Changing Our Needles Frequently Enough? Donaldson, B. (NPDS Endodontics): Maxillary Sinusitis vs Odontogenic Sinusitis: An Overview Lewis, M. (NPDS Endodontics): Depth Limitations of Obturation Armamentarium with Continuous Wave Technique Fleming, A. (NPDS Endodontics): Maxillary Sinusitis vs Odontogenic Sinusitis: An Overview Hershey, R. (NPDS Endodontics): Digital Radiography: Improved measurement accuracy when using reference point for calibration Neal, R. (NPDS Endodontics): Oral Sedation: Case Selection and Patient Management in Endodontics Harris, K. (NPDS Endodontics): Needle Deformation During Local Anesthesia: Are We Changing Our Needles Frequently Enough? Dinan, J. (NPDS Orofacial Pain): Cranial Neuralgias

Hampton Roads Federal Services Dental Symposium – Naval Medical Center, Portsmouth Coastal Virginia Dental Education Symposium – Joint Base Langley-Eustis, Langley VA (AFPDS AEGD-1 Langley) (9)

Col Richard Buck: A Gnathological Approach to TMD Capt Ethan Brockett: Surgical Guides for Endodontic Microsurgery Capt JT Corcoran: A Minimally Invasive Treatment for Gingival Recession Capt Dennilyn Morell: Role of Dental Stem Cells in Regenerative Dentistry Capt Patrick Orme: Bulk Fill Composites: Are they the Future? Maj Benjamin Pass: Gentlewave: A Paradigm for Postmodern Endodontics? Capt Kenneth Stuart: CAD/CAM Material Selection Capt Jared Ure: Esthetic Crown Lengthening Capt Patrick VanCura: The Use of Silver Diamine Fluoride in Adult Patients

16 Attachment 5

American College of Prosthodontists – Texas Section – AFPDS Prosthodontics Residents Clinical Case Presentations (8)

Lt Col Joshua Vess MAJ Farzan Pouranfar Maj Melissa Thomas Maj Jessamy Thornton Capt Harrison Gordner Capt Theresa Kim Capt Troy Decker Capt Joshua Nardone

Air Force Junior Dental Leadership Course Poster Session (11)

Capt B. Matthew Sherwood (Barksdale): The Role of Resin Infiltration in Managing Caries Capt Hattie Willard (Barksdale): Botulinum Toxin: A Treatment Modality for Chronic Cephalgia Capt Dennilyn Morell (Langley): Role of Dental Stem Cells in Regenerative Dentistry Capt Christine Esposito (Nellis): Lip Repositioning Capt Adam Biwer (Nellis): Third Molar Autotransplantation Capt Anthony Ewell-Kollmann (Offutt): Glycine Powder Air-Polishing Capt Jessica Smith (Offutt): Advances in Digital Dentistry Capt Alexandra Cleveland (Travis): Efficacy of laser treatment for dentin hypersensitivity Capt Leanne McCarron (Travis): Laser Assisted Regeneration: What’s the Evidence? Capt Mega Margapuram (Wright Patterson): Fill, but No Drill: Progressing Towards a Future with Natural Tooth Repair Capt Elisabeth Mauro (Wright Patterson): Digital Workflow for Orthodontic Aligners Using Blue Sky Bio Software

Front Range Dental CE Day – AFPDS USAFA AEGD-1 (5)

Capt Kristina Reck: Predicting Final Lip Positions Prior To Bimaxillary Orthognathic Surgery On A Class III Patient Capt Glen Myers: Dental Applications of Battlefield Acupuncture Capt Logan Cash: A Modern Perspective on the Diagnosis, Treatment, and Prevention of Caries Capt Li Mueckay: C-shaped Root Canals Diagnosis and Treatment 2d Lt Dan Lee: Short Implants (≤8mm)

Omaha District Dental Society Meeting – AFPDS Offutt AEGD-1 (9)

Col Marco Galvez: Transplantation Capt Anthony Ewell-Kollmann: Glycine Powder Air-Polishing Capt Melody Ianetta: Digital Dentures: Case Study

17 Attachment 5

Capt Christopher Jones: Platelet Rich Fibrin Capt Robert Koski: Tooth Autotransplantation Capt Abigail Peters: E-cigarettes and Marijuana Capt Nicole Searcey: Mandibular Advancement Devices Capt Jessica Smith: Advances in Digital Dentures Capt Ross Thompson: Use of Botox in Dentistry

Scott AFB Gateway Dental CE Day – AFPDS Scott AEGD-1 (12)

Capt Phoebe Blakeley (Poster): The Opioid Epidemic: The Dentist's Role in the Crisis that has Swept the Country Capt Don Ho (Poster): Non-traditional Whitening Techniques Capt Emily Kopec (Poster): Acupuncture as an Aid to Analgesia Capt L. Patrick McCarthy (Poster): Conventional versus Digital Impressions Capt William Senn (Poster): Diagnostic Aids for Oral Cancer Screening Capt Kristina Shute (Poster): The Link Between Sleep Bruxism and Obstructive Sleep Apnea Maj Michael Silverman (Oral): Interdisciplinary Orthodontics Maj Amber Miller (Oral): CBCT in Endodontics Maj Tom Heidenreich (Oral): Virtual Orthognathic Surgery Planning Maj Todd Schultz (Oral): Dentoalveolar Trauma Capt Keaton Forrester (Oral): Current Concepts in Prosthodontics Lt Col Ketu Lincoln (Oral): Overview of Maxillofacial Prosthodontics

Coastal Virginia Dental Education Symposium – AFPDS Langley AEGD-1 (8)

Capt Ethan Brockett: Targeted Endodontic Microsurgery Capt JT Corcoran: A Minimally Invasive Treatment Alternative for Gingival Recession Capt Dennilyn Morell: Role of Dental Stem Cells in Regenerative Dentistry Capt Patrick Orme: Treatment Modalities for Anterior White Spot Lesions Maj Benjamin Pass: A Vision for Minimally Invasive Endodontics Capt Kenneth Stuart: CAD/CAM Material Selection Capt Jared Ure: Esthetic Crown Lengthening Capt Patrick VanCura: Silver Diamine Fluoride: New Elements for Application

San Antonio Military Health System & Universities Research Forum – AFPDS Lackland (9)

Jensen C: Efficacy of Auricular Acupuncture in Reducing Pain after Third-Molar Extractions. Ellis A: Efficacy of Screening for GERD in the Dental Setting. Walker SA: A Survey of Air Force General Dentists Regarding CAD/CAM Usage. Holman C: Flexural Strength Degradation of New Cubic-Containing Zirconia Materials. Kemarly K: Effect of Various Surface Treatments on the Pull-Off Bond Strength Between Lithium Disilicate and a Titanium Implant Abutment Base.

Attachment 5

Christensen C: Efficacy of Pulpal Anesthesia Using a Needle-less Syringe. Slack WE: Effect of High-Intensity Light Curing on Depth-of-Cure and Intrapulpal-Temperature Increase. Jones SD: Statistical Nanoindentation Analysis of Modern Dental Composites. Stoner R: Shear Bond Strength of Indirect Bonding Variables; Tray Thickness and Material.

Northeast Implant Symposium – Boston MA – NPDS (2)

LT Patrick McCurdy: Digitally Designed and Milled Implant Overdenture Abutments for Removable Partial Denture Prosthesis in a Compromised Situation MAJ Jacob England: Stackable Implant Surgical Template Digitally Designed and Fabricated for Full-Arch Implant Rehabilitation

Lt Col Jarom Ray (AFPDS Lackland, Endodontics; Associate Professor of Endodontics) presentations on 3D Printing and Targeted Endodontic Microsurgery (6)

Navy Postgraduate Dental School Endodontics Residency Quad School Meeting (Lecture/Lab) Edward C. Penick Endodontic Meeting, Washington D.C. (Lecture) University of Toronto Endodontic Residency, Toronto, Canada (Lecture) Virginia Commonwealth University, Richmond, Virginia (Lecture) University of Texas Health Science Center Houston (Lecture) The Dental Collage of Georgia at Augusta University, March 2019 (Lecture/Lab)

Penick Endodontic Study Club, American Association of Endodontists (1)

Kopacz M. (NPDS Endodontics, USU Masters in Oral Biology Class of 2019) A Clinical Evaluation of Cone Beam Computed Tomography

University of Texas Health Science Center Endodontics CE Day (1)

Capt Julie Anderson (AFPDS Eglin): Endodontic Applications of 3D Printing

Army Institute for Surgical Research Army Burn and Multiple Trauma Symposium (1)

Maj Hannah Colburn (AFPDS Assistant Professor of Prosthodontics) - Maxillofacial Prosthetics: Medical and Surgical Support Services

Glenn Maze Symposium (Fort Gordon Periodontics, Medical University of South Carolina, Augusta University (4)

CPT(P) Dan Phillips (APDS Fort Gordon) Extraction socket management in the esthetic zone utilizing immediate implants CPT(P) Ryan McGary (APDS Fort Gordon) Contemporary ridge augmentation

19 Attachment 5

CPT Dane Swenson (APDS Fort Gordon) Epithelialized palatal grafts CPT Rick Hill (APDS Fort Gordon) Nd:YAG laser applications in periodontics

Southern Nevada Dental Society Meeting – AFPDS Nellis AEGD-1 (2)

Capt William Lee: Exparel Capt Lindsay Ortman: What’s New with Silver Diamine Fluoride?

Greater New York Dental Meeting (1)

Major Ryan Sheridan (AFPDS Lackland, Assistant Professor of Prosthodontics) Obstructive Sleep Apnea: Management by the Dental Team (Oral Presentation)

San Antonio Society of Pathologists (1) – Col David Klingman (AFPDS, Associate Professor of Oral Pathology)

Sinonasal Masses (Oral Presentation)

Alaska Federal Services Meeting, Anchorage, Alaska (1) - LTC Matthew Phillips presented 4 lectures

Awards (37)

Maj C. Michelle Giacomino (AFPDS Endodontics, JBSA-Lackland, USU MS Oral Biology Class of 2018) was awarded the USU Board of Regent’s Patrick D. Sculley, DDS, Award for the Postgraduate Dental College.

Maj Timothy Carlson (AFPDS Endodontics, Keesler AFB, USU MS Oral Biology Class of 2019) - Awarded the Dr. Robert B. Brannon Research Award, Louisiana State University Postgraduate Dental Research Oral Presentation, June 2019, LA

Maj Daniel Chartrand (AFPDS TORP, JBSA-Lackland, USU MS Oral Biology Class of 2019) - Won the Joseph E. Johnson Clinical Award for his research at the 2019 American Association of Orthodontists Annual Session in Los Angeles, California.

Maj Coleman Christensen (AFPDS Lackland Comprehensive Dentistry, USU MS Oral Biology Class of 2019) was awarded the Young Investigator Prize for Innovation by the Dental Anesthesia Research Group (DAR) at International Association of Dental Research (IADR)

LCDR Elizabeth A. Polak (NPDS Periodontics, USU MS Oral Biology Class of 2019) placed 1st overall in the 2019 NPDS Research Competition

LCDR Alyse Fleming and LT Blake Donaldson (NPDS Endodontics, USU MS Oral Biology Class of 2019) placed 1st overall out of 46 Table Clinics at the 2019 Federal Dental Services Annual Meeting

20 Attachment 5

LT Ryan Kaye (NPDS Periodontics, USU MS Oral Biology Class of 2019) was awarded the Chief of the Dental Corps Award for Excellence as the top graduate across all specialty residency programs at the NPDS

LT Craig Hofferber (NPDS Periodontics, USU MS Oral Biology Class of 2018) was selected as the Leslie Salkin Award Winner for 2019. This award, given annually by the American Board of Periodontology, recognizes the candidate who scored the highest on the Board Certifying Examination of all applicants nationally

Capt Leanne McCarron (AFPDS Travis 2019 graduate) received the Maj Gen Arthur J. Sachsel Award (given to the #1 resident each year at graduation)

CPT Martin Smallidge (APDS Fort Gordon, Prosthodontics, USU MS Oral Biology Class of 2018) - 1st place in the Joseph L. Bernier Research Awards Competition.

Capt Benjamin Bacon (AFPDS PGY1 Eglin AFB) received ‘Best in Session’ during the Hinman Dental Meeting, Atlanta, GA 21-23 Mar 2019 on presentation entitled: Peri-Implantitis: An Overview of Treatment Modalities.

Capt Dennilyn Morell (AFPDS Langley) won first place in the table clinic competition among approximately 20 residents presenting at the Annual Air Force AEGD-1 Practice Management Course

Lt Col Cade Salmon (AFPDS, Associate Professor of Prosthodontics) - USUHS Innovations in Education Award - Jun 2019

Maj Christin Giacomino, Lt Col Jarom Ray, Lt Col (ret) James Wealleans (Lackland Endodontic Program) - Journal of Endodontics Case Report and Clinical Technique of the Year Award for April 2018 Cover Article: Targeted Endodontic Microsurgery: A Novel Approach to Anatomically Challenging Scenarios Using 3-dimensional-printed Guides and Trephine Burs—A Report of 3 Cases. J Endod 2018 44: 671-677.

Maj Julie Anderson, Lt Col (ret) James Wealleans, Lt Col Jarom Ray (AFPDS Endodontics, JBSA-Lackland Endodontic Program) International Endodontic Journal Certificate for “top downloaded article” 2017- 2018. Endodontic Applications of 3D Printing.

Lt Col Emily Ibarra (AFPDS Langley, Assistant Professor of Comprehensive Dentistry) was named the winner of the Lance P. Sijan Leadership Award for the 633rd Medical Group

LT Allison Weinberg (NPDS Periodontics, USU MS Oral Biology Class of 2019) was awarded 2nd place out of 39 Table Clinic entries at the annual Greater Capital Region Tri-Service Dental Symposium

Capt Keaton Forrester (AFPDS Prosthodontics, USU MS Oral Biology Class of 2019) – John J. Sharry Research Competition 2nd place winner for his research, Assessing the Accuracy of Casting and Additive

21 Attachment 5

Manufacturing Techniques for Fabrication of a Complete Palatal Coverage Metal Framework - 2018 American College of Prosthodontics Annual Session, Baltimore, MD

MAJ Parth Mewar, USA (NPDS Oral Pathology, USU MS Oral Biology Class of 2019) placed 2nd overall in the 2019 NPDS Research Competition

MAJ Pamela Cotton (APDS Schofield Barracks, Comprehensive Dentistry, USU MS Oral Biology Class of 2019) – 2nd place overall in the 21st Annual James W. Bass Research Symposium

CPT Nisha Patel (APDS Fort Gordon, Prosthodontics, USU MS Oral Biology Class of 2018) - 2nd place in the Joseph L. Bernier Research Awards Competition.

Capt Dennilyn Morell (AFPDS Langley) won second place in the table clinic competition among approximately 30 residents at the Hampton Roads Federal Services Dental Continuing Education Course

Maj Kimberly N. Tong, USAF (NPDS Oral Pathology, USU MS Oral Biology Class of 2019) placed 3rd overall in the 2019 NPDS Research Competition

MAJ Michael Hoffman (APDS Schofield Barracks, Comprehensive Dentistry, USU MS Oral Biology Class of 2019) – 3rd place overall in the 21st Annual James W. Bass Research Symposium

MAJ Joshua Pruden (APDS Fort Gordon, Periodontics, USU MS Oral Biology Class of 2018) – 3rd Place 2018 Joseph Bernier Research Awards Competition: Immunohistochemical Phenotype Analysis of Cells Associated with Pulpal Mineralized Extracellular Matrix in a Porcine Endodontic Regeneration Model

LCDR Alyse Fleming and LT Blake Donaldson (NPDS Endodontics, USU MS Oral Biology Class of 2019) placed 3rd overall out of 68 Table Clinics presented at the Annual American Association of Endodontists Meeting

Maj Timothy Carlson (AFPDS Endodontics, Keesler AFB, USU MS Oral Biology Class of 2019) - Placed 5th in the Oral Research Presentation Category, American Association of Endodontics Annual Meeting, April 2019, Montreal, Canada

Maj Tyler Hawkins (AFPDS Endodontics, JBSA-Lackland, USU MS Oral Biology Class of 2019) - American Association of Endodontists Oral Research Presentation 8th place winner for Targeted Endodontic Microsurgery vs. EMS: a clinical simulation comparison.

LCDR Michael Lewis and LCDR Kathy Ligon (NPDS Endodontics, USU MS Oral Biology Class of 2019) placed 8th overall out of 68 Table Clinics presented at the Annual American Association of Endodontists Meeting

22 Attachment 5

CPT Scott Otterson (APDS Fort Gordon, Endodontics, USU MS Oral Biology Class of 2019) –Top 10 Poster Presentation at American Association of Endodontists 2019 Annual Session: Surface Integrity of Root Ends Following Apical Resection with Targeted Trephine Burs

Military Teaching/Clinician Awards (7)

Lt Col Brian Alent (AFPDS Lackland, Assistant Professor of Periodontics) – 2019 American Academy of Periodontology Outstanding Teaching and Mentoring in Periodontics Award Lt Col Brian Alent (AFPDS Lackland, Assistant Professor of Periodontics) – 2019 AFPDS Outstanding New Educator Award Lt Col Emily Ibarra (AFPDS Langley, Assistant Professor of Comprehensive Dentistry) – 2019 Air Combat Command Educator of the Year Maj Caleb English (AFPDS Langley, Assistant Professor of Oral Surgery) – 2019 Air Combat Command Clinical Dentist of the Year Lt Col Rachel Weber (AFPDS, Assistant Professor of Periodontics) - 2018 Air Force Global Strike Command Educator of the Year Lt Col Brent Winward (AFPDS, Assistant Professor of Endodontics) - 2018 Keesler AFB Dental Educator of the Year LTC Brian Stancoven (APDS, Assistant Professor of Periodontics) – awarded an American Academy of Periodontology Foundation Scholarship to attend the 2019 Institute for Teaching and Learning (ITL) Maj Tom Heidenreich (AFPDS Scott Assistant Professor of Oral and Maxillofacial Surgery) was selected as the Air Force Air Materials Command Educator of the Year

23 Attachment 4

Interprofessional Education Activities

Maj Preston Duffin, (AFPDS Lackland, Assistant Professor of Orofacial Pain) presented two workshops to DoD physicians at the 2019 Pain Care Skills Course held at SOUTHCOM Conference Center of the Americas, Miami, Florida. The Pain Care Skills Course provides pain management training and hands-on skills training to DoD providers with the overall goals to promote readiness, restoration of function, and relief of pain while decreasing the use of opioids.

Major Hannah Colburn (AFPDS Lackland, Assistant Professor of Prosthodontics) lectured to the Army Institute of Surgical Research Army Burn and Multiple Trauma Symposium on Maxillofacial Prosthetics: Medical and Surgical Support Services.

Col Stephen Chartier (AFPDS, Nellis, Associate Professor of Comprehensive Dentistry) provided two hours of didactic and clinical training in Management of Dental Emergencies and Local Anesthesia Administration to 16 family medicine, physician assistant, and IDMT technicians, residents, and providers of the 99th Medical Group.

Orofacial Pain Course taught at AFPDS Eglin was attended by Dental PGY-1 students along with the 1st year Family Medicine Residents.

Battlefield Acupuncture taught at Eglin Orofacial Pain course by Lt Col Dillon Savard (Director of GME) and Lt Col Shawn McMahon (AFPDS Eglin, Assistant Professor of Orofacial Pain).

AFPDS Wright Patterson Program Director and 8 Residents, will be presenting to the Kettering College Physician Assistants Program (approx. 60 PA students) on Management of Dental Emergencies via Lecture Lab.

CDR Laleh Abdolazadeh (NPDS Associate Professor of Maxillofacial Prosthetics)

Member, WRNMMC Head and Neck Tumor Board (ENT, OMFS, Oncology, Maxillofacial Prosthetics)

Virtual Surgical Planning Collaboration with Medical Team for Treatment Planning of Head and Neck Surgery Patients

Member, WRNMMC Craniofacial Board (ENT, OMFS, Maxillofacial Prosthetics)

Member, Orthognathics Board (OMFS, Maxillofacial Prosthetics)

TEAM STEPs OR Surgical Treatment: with Prosthodontics/Maxillofacial Prosthetics Residents/Staff, OMFS Residents/Staff, Anesthesiologist, Surgical Technicians, and Nurses

Nine NPDS Comprehensive Dentistry residents and six PGY-1 students presented four hands-on dental skills laboratories for 200 USUHS medical students participating in the annual Military Contingency Medicine (MCM) course.

Two NPDS PGY-1 residents participated in triage, dental sick-call and mass casualty scenarios as part of USUHS Operation Bushmaster field exercise in Ft. Indiantown Gap, PA. This year, they took on an expanded role, working shoulder-to-shoulder with 8 AFPDS Air Force PGY-1 residents from Andrews-

1 Attachment 4

Bolling and USU School of Medicine students to complete 8 training modules over 5 days at the Military Field Practicum 101 Course at Fort Indiantown Gap in Lebanon, PA.

CDR Daniel Honl (NPDS, Assistant Professor of Oral and Maxillofacial Surgery) serves as the Medical Emergencies Course, Director, WRNMMC.

Endodontics Residents (APDS Fort Bragg) provided 3 root canal procedures on military working dogs and attempted to teach Veterinary colleagues to be able to perform the procedure if needed.

MAJ Ross Cook/CPT(P) Adam Bennett (APDS, Fort Bragg Comprehensive Dentistry, USU Masters in Oral Biology Class of 2020) provided over 10 hours of dental module instruction to the 18D course at the Special Operations Warfare Center and School, Fort Bragg NC.

2 TAB 28 College of Allied Health Sciences Report Uniformed Services University of the Health Sciences Board of Regents

Board Brief

Submitted by: Mitchell J. Seal, EdD, MEd-IT, BSN, AS, RN Date: November 6th, 2019

Title & Department: Dean, College of Allied Health Sciences Phone: 210-299-8522

Purpose: Information X Action X

Subject: CAHS Brief

Significant Issues:

Information:

Education & Training:

Total enrollment stabilized at roughly an average daily census of 750 – 800 with calendar year throughput of roughly 1300 students as follows: -Education and Training Administration and Leadership (A, N, AF) -Preventive Medicine Technician (A, N) -Nuclear Medicine Technician (A, N, AF) -Medical Laboratory Technician (A, N) -Histology Technician (AF, N) -Urology Technician (AF, N) -Neurology Technician (AF, N) -Nutrition Science (A, AF) -Cytology Technician (A) -Occupational Therapy Technician (A, N) -Radiologic Technician (A, N, AF) -Critical Care Air Transport (AF) -Health Physics (A)

Total faculty appointment has eclipsed 225 -4 Professors (< 1.8% of faculty) -1 Associate Professor -204 Assistant Professors and below

Total degrees awarded/recommended is 118 -72 Army; 43 Navy; 1 Air Force -84 ASHS and 34 BSHS degrees Research & Scholarship:

CAHS continues to be invited frequently by industry leading entities and individuals for presentation and discussion of our innovative educational administration model. Conference & Presentations this period included the following:

- August 7 – White House Executive Office of the President, Microsoft Military Workforce Development, EdEx, and LinkedIn (DC) - August 27 – 29 – National Credentialing Summit (Indianapolis) - September 11 – DASD FE&T Credentialing Roundtable (CAHS) - September 12 – DADS FE&T MilGears Beta & Development (CAHS) - September 26 – Veterans Education Project (CAHS) - September 27 – Army North: Transition Planning (Ft Sam) - October 1 – 3 – Army University (Ft Leavenworth) - October 7 – 8 – AACRAO Comprehensive Learner Record Showcase (Dallas) - October 9 – Dallas Community College District (Dallas) - October 17 – 18 – National Health Science Apprenticeship Model (Chicago) - October 23 – ASVAB Outcomes-Based General Education Summit (Hollywood)

Leadership & Service

CAHS continues as a charter member of DoD Credentialing and Transition Taskforce. Multiple meetings have occurred that focus on how CAHS provides credit for readiness- relevant DoD training. The model continues to be studied by DoD for application to DoD writ large as it appears value-added credentialing required of readiness training is the nexus around which the Services can unite for recruitment, retention, resilience, and transition.

Section 735 NDAA FY19 SOF Medic to PA Pilot: the graduate-level PA portion of the program itself has been designed since Spring of 2019. The host civilian school is the provider of all PA studies. CAHS is standing by for provision of requested support pending determination of funding.

d. Other areas of Service Support interest in various stages of exploration are:

METC Phase II (DHA) CHAMP Warrior Nutrition (USU) Special Forces Medic and Corpsman (JSOMTC) Army Licensed Vocational Nurse (MEDCoE) Veterinary Technician (MEDCoE) Veterinary Food Inspection Specialist (MEDCoE)

Action:

In accordance with USU PPM 008-2019 Establishment of New Academic Programs, and as detailed in the supplemental information of this report, two new programs are proposed for implementation at the next available iteration. These are:

a. Army Critical Care Flight Paramedic (paramedic portion only) – ASHS degree b. Navy Independent Duty Corpsman (surface and submarine) – BSHS degree

a. Paramedic program – The Board will recall this program originally came to us as a ‘hot’ request in January. CAHS and USU responded with an expedited review of the program that progressed through the first three steps of the 7-step PPM for New Program Approval. Army then paused for further review, delaying any further steps in the process.

Army recently re-energized their request to include commitment of funds, which was positively received by President Thomas at a site visit to CAHS and MEDCoE.

At the time of this report draft, the plan was to refresh the Deans’ Quarterly Council on this proposal in early October and conclude the formal review per the PPM and discuss at the Cabinet by late October in order to present to the November BOR. All supporting documents will be included in the supplemental information to this report, assuming all the planned steps have occurred. If not, this topic will be addressed in an out-of-cycle electronic Board session.

It is requested that the BoR concur with the recommendation to implement the Army Paramedic program at the next available iteration, which is projected to be in January of 2020.

b. Independent Duty Corpsman program (Surface and Submarine) – A formal request to support these IDC programs (and others) came from NMETLC in April 2018 and a curriculum review by qualified Navy faculty (physicians, nurses and IDCs) occurred earlier this year. Anticipating USU support of these programs, the Navy has elected not to renew the use of ACE for credit recommendations, which expires in December of 2019.

At the time of this report draft, the plan was to refresh the Deans’ Quarterly Council in early October after significant background information provided to the DQC in August and September. After the DQC, the plan is to conclude the formal review per the PPM and discuss at the Cabinet by late October in order to present to the November BOR. All supporting documents will be included in the supplemental information to this report, assuming all the planned steps have occurred. If not, this topic will be addressed in an out- of-cycle electronic Board session.

It is requested that the BoR concur with the recommendation to implement the Navy IDC program at the next available iteration, which is projected to be in January of 2020.

Current & Future Concerns: No significant concerns at the time of submission. Funding/Budget Estimate/Fiscal Impact: NMETLC funding of IDC is pending. Staffing Impact: No significant concerns at the time of submission. Board Action Requested: Paragraph 4a and 4b. CAHS-METC Undergraduate Enrollment UNCLASSIFIED

Train the World’s Finest Medics, Corpsmen, and Technicians

USU/CAHS/ Update

Dr. Mitchell J. Seal Dean, CAHS

Train for the Mission…..Educate for a Lifetime! UNCLASSIFIED 1 UNCLASSIFIED USU / CAHS Status Update Train the World’s Finest Medics, Corpsmen, and Technicians

• ETAL (Education, Training Administration, and Leadership), the Faculty Development Program, for new instructors producing ASHS degrees for NCOs in ~ 6 months time on podium.

• Ten Initial Entry Training / Advanced Individual Training programs. • 90+ ASHS / BSHS graduates, to date.

• USU BoR to be briefed on Pharmacy Technician, 4 Nov 19. Subsequent implementation proposed for January 2020.

Train for the Mission…..Educate for a Lifetime! UNCLASSIFIED 2 UNCLASSIFIED CAHS/USU Status Update Train the World’s Finest Medics, Corpsmen, and Technicians

Program Proposed Implementation Date Student Load Army Navy Air Force FY 17 ETAL 17-Apr-17 60 35 20 5 FY 18 Nuc Med Tech 11-Jul-18 22 8 4 10 Med Lab Tech 27-Jul-18 650 443 207 0 Neurodiagnostic Tech 27-Mar-19 10 0 5 5 Surg Tech 1-Aug-21 534 283 165 86 Students from SCR 1216 FY 19 Prev Med 13-Mar-18 233 147 86 0 Histotechnician 7-Jan-19 13 0 6 7 Urology Tech 20-Mar-19 19 0 12 7 Nutrition Care 28-May-19 144 113 0 31 Cytotechnologist 31-Jul-19 7 7 0 0 Occupational Therapy 5-Aug-19 39 35 4 0 Radiology Tech 26-Aug-19 423 229 90 104 Incremental New Student Load for FY 19 878

SCR – Substantive Change Request Train for the Mission…..Educate for a Lifetime! UNCLASSIFIED 3 UNCLASSIFIED Proposed New Academic Programs Train the World’s Finest Medics, Corpsmen, and Technicians

Student Program Proposed BoR Date Army Navy Air Force Load FY 20 Respiratory Specialist 4-Feb-20 119 90 29 0 Cardiopulmonary (CVT & RT) 4-Feb-20 57 0 0 57 Cardiovascular Specialist 4-Feb-20 40 20 20 0 Dental Laboratory (Basic) 15-May-20 90 21 28 41 Dental Assistant (AF) 15-May-20 288 0 0 288 Ophthalmic Tech 15-May-20 92 45 0 47 Pharm Tech 4-Aug-20 346 142 96 108 Med Lab Assistant (MLA) 4-Aug-20 157 0 0 157 Incremental New Student Load for FY 20 1189 FY 21 Surgical Tech 3 Nov 20 510 259 165 86

Incremental New Student Load for FY 21 510

Train for the Mission…..Educate for a Lifetime! UNCLASSIFIED 4 College of Allied Health Sciences JBSA-Fort Sam Houston, TX 78234

Purpose: To update the USU President on the status of the Resources: Army’s Paramedic (F1) Program. This program is fully resourced by the TRADOC & MEDCoE. MEDCoE as submitted DD 1144 to USU, funding the course. Bottom Line: - CAHS is preparing to implement the Army F1 program. Value Proposition: - The F1 program is critical to the Army meeting a FY 19 Projected Student load is 210 students Congressionally directed medical / readiness capability. F1 fracked curriculum is 24 semester hours/student - USU/CAHS academic sharing model preserves programmatic Vol Ed value / sem hour is $250 / sem hr accreditation with the Commission on Accreditation of Allied 24 x 210 = 5,040 sem hours Health Education Programs (CAAHEP) & the Committee on 5,040 sem hrs x $250 / sem hr = $1.426M in Vol Ed (USD Accreditation of Educational Programs for the Emergency P&R) value provided at minimal cost. Medical Services Professions (CoAEMSP). - The Paramedic portion of the national standard curriculum Accreditation & Credentialing: places the is assessed at 24 sem hrs. This program is accredited by the Commission on - Paramedic is advanced practice for Army Medics, producing Accreditation of Allied Health Education Programs (CAAHEP) a National Registry Certified Paramedic with credentials in and the Committee on Accreditation of Educational Programs Basic Life Support, Advanced Cardiac Life Support and for the Emergency Medical Services Professions (CoAEMSP). Pediatric Advanced Life Support (BLS, ACLS, & PALS.) The “Paramedic” credentialing comes via the National Registry Way Ahead: CAHS continues phasing in Sec 724 of the 2017 of Emergency Medical Technicians. NDAA, awarding undergraduate credit to enlisted programs.

POC: Student Population: Mr. Dennis Kilian /ADUS/ CAHS (210) 299-8526 Army students must hold the MOS 68W, Combat Medic, in the E-3 to E-7 range, from the Active, Reserve and National Guard Components. Upon completion of the Army F1 program, only a math course transferred into CAHS will be needed for degree completion.

30 September 2019 MCCS-WBC

MEMORANDUM FOR Vice Provost of Academic Affairs, Directorate of Training and Academic Affairs, U.S. Army Medical Department Center and School, U.S. Army Health Readiness Center of Excellence (AMEDDC&S HRCoE) (MCCS-H)

SUBJECT: Feasibility Review for Academic Collaboration with Uniformed Services University

1. This is a decision paper.

2. PURPOSE. Request permission to conduct a feasibility review for potential academic collaboration between the Critical Care Flight Paramedic Program (CCFPP), Center for Pre- Hospital Medicine (CPHM), Uniformed Services University (USU) Southern Region Campus and the Department of Preventive Health Services, AMEDDC&S HRCoE.

3. DISCUSSION. The proposed collaboration will explore the feasibility to grant undergraduate credits to Critical Care Flight Paramedics (68WF1) completing the Health and the In-house Critical Care Course (68WF2). There are no current external academic reviews or affiliations, to include the American Council on Education. The CCFPP agrees to appoint instructors for consideration as members of the USU faculty.

4. CONCLUSION. An academic collaboration with USU may present a tremendous opportunity for students and instructors to earn additional undergraduate credits.

5. RECOMMENDATION. Approve request to conduct feasibility review for potential academic collaboration between USU and CCFPP.

a. FUNDING IMPACT: None

b. PERSONNEL IMPACT: None

6. The point of contact for this memorandum is MAJ Sabas Salgado, Deputy OIC, CCFPP, CPHM, at (210) 295-2757 or e-mail at [email protected].

ROBERTO V. HENNESSY Colonel, MC Director, Center for Pre-Hospital Medicine/ Medical Director, Army EMS

Approved/Disapproved

TANYA A. PEACOCK Colonel, MS Vice Provost of Academic Affairs, Directorate of Training and Academic Affairs Critical Care Flight Paramedic (CCFP) Program

Projected starts: 6 programed for FY 20 Projected students per start: 187Army for FY 20

Services: Army

Program length: ATRRS currently lists 26 weeks, but the length is adjusting to 30 weeks, per the MEDCoE.

FY 2020

Location(s): Army – SATX Admissions requirements:

Degree level: undergraduate (ASHS / BSHS)

Degree requirements: None. External credentials: Commission on Accreditation of Allied Health Education Programs (CAAHEP) Committee on Accreditation of Educational Programs for Emergency Medical Service Professions (CoAEMSP) (accreditation)

National Registry of Emergency Medical Technicians (NREMT) (credentialing). Feasibility Analysis

Student Projection

Projected Iterations per year: 6 Army Projected Students per Iteration: --=32=---

FacultyProjection

Ratios: Didactic: max of 32:1 Laboratory: max of 6:i+ Clinical/Internship: max of 2:1+ +Progrommatic accreditation requirements supersedethe established CAHSrequired student-facultyratios

Faculty: 2 s 2 13 Didactic Laboratory Clinical/Internship Total

Explain: Instructors for this program are resourced thru the Army,adjusted regularly. via the Training Resources Arbitration Panel (TRAP) & Structure Manning Decision Review (SMDR), supporting Service requirements. As Service requirements adjust, so do available instructors and associated clinical training facilities. There are 13 instructors on hand.

Facility Projection

Total Facility Requirement: 3 ___ 3 __ 2 ___ Didactic Laboratory Clinical/Internship Classroom(s) Facility(s) Facility(s) MOU MOU Explain: All didactic and laboratory training facilities for this program were constituted via AMEDC&S resourcing in 2015. These facilities are budgeted via Army'sTitle X authorities. Clinical sites are funded via the DHP budget at clinic sites, here in San Antonio, TX

Funding Projection

Funding: □ CAHS/USU x Other ___�A=rm�------

Adequate: XYes □ No

Explain: Funding comes via the Service requirements. The FY 12 NOAA directed the Army to establish this program. Army has used contract dollars with civilian universities to fulfill the legislation. USU Process of Agreement initiated on 7 March 7, 2019

Feasible: Student Faculty Facility Funds XYes □ No XYes □ No XYes □ No XYes □ No

I have reviewed the Curriculum Planning Document and the Feasibility Analysis and find this proposal to be: )("Acceptable pending app oval of coursework by the CAHS Curriculum Committee. ce table as rt � if/21ate Curriculum Planning Document

Title: ______Paramedic___

Scope: x New x Undergrad ฀ Grad ฀Modify ฀ Undergrad ฀ Grad x Degree ฀ Degree x Major (15 – 30 sem hr) ฀Major (15 – 30 sem hr) ฀ Minor (12 – 15 sem hr) ฀ Minor (12 – 15 sem hr) ฀Course(s) ฀Course(s)

Magnitude: Total Courses __10____ Total Semester Hours __24____

Description: Instruction will be provided and conducted at a local (Fort Sam Houston/San Antonio) college affiliated EMT-Paramedic training facility. Students will receive both didactic and clinical training required for application and testing as an NREMT-Paramedic. .

Design: Select all the following that apply to this curriculum proposal:

Didactic Laboratory Clinical/Internship ฀ Traditional X Traditional ฀ Traditional 2 hrs out:1 hr in Some preparation required No preparation required Factor = 14 Factor = 28 Factor = 45* X Modified ฀ Modified X Modified 1hr out:1 hr in No preparation required Some preparation required Factor = 28 Factor = 42 Factor = 30 ฀ Highly Modified ฀ Simulated ฀ Simulated No preparation required Factor = 28 with some prep Factor = 45* with no prep Factor = 42 = 42 with no prep Factor = 30 with some prep x Blended / On-line Alternative Instructional Equivalents must be identified Factor = 15 *in some circumstances, the federal definition of a credit hour allows a factor of 30 for clinical courses that require a minimum number of clock hours of student participation.

Prefix # Title Design Factor *EMSA 1204 Clinical AEMT Mod Didactic 28 *EMSA 1301 Patient Assessment & Airway Management Blended 15 *EMSA 1303 Trauma Management Mod Didactic 28 *EMSA 1401 Anatomy & Physiology I w/ Lab Mod Didactic 28 *EMSA 1402 Introduction to Advanced Practice Blended 15 *EMSA 2301 Technical Writing Blended 15 *EMSA 2401 Anatomy and Physiology II w/ Lab Mod Didactic 28 EMSP 2106 Advanced Cardiac Life Support Mod Didactic 28 EMSP 2107 Assessment Based Management Mod Didactic 28 EMSP 2109 Clinical II - Paramedic Mod Clinical 30 EMSP 2201 Emergency Pharmacology Mod Didactic 28 EMSP 2210 Practicum - Paramedic Mod Clinical 30 EMSP 2302 EMS Operations Mod Didactic 28 EMSP 2305 Clinical I - Paramedic Mod Clinical 30 EMSP 2308 Special Populations Mod Didactic 28 EMSP 2403 Cardiology Mod Didactic 28 EMSP 2402 Medical Emergencies Mod Didactic 28

*indicates a transfer credit from an essentialist curriculum delivered at MEDCoE

Uniformed Services University

COLLEGE OF ALLIED HEALTH SCIENCES

DEGREE PLAN & COMPLETION PATHWAY

Degree: Associate of Science in Health Sciences (ASHS) Major: Emergency Medical Services (Army Paramedic)

The ASHS degree requires at least 60 semester hours with:  GPA of at least 2.0 and a grade of C or better in all courses  Residence of at least 25% of the degree plan  General Education of at least 30 semester hours  Major Technical Field of Study of at least 15 semester hours  General Electives (if needed to achieve 60 semester hours) Prerequisite:  68W with current EMT-B certification

General Education Requirements (30) Hours Major Requirements (30) Hours Communication (6) Major Technical Field of Study (24) Oral Transfer Coursework 3 EMSP 2106 * Advanced Cardiac Life Support 1 Written Transfer Coursework 3 EMSP 2107* Assessment Based Management 1 Quantitative Science (9) EMSP 2305* Clinical I - Paramedic 3 Math Transfer Coursework 3 EMSP 2109* Clinical II - Paramedic 1 Natural Sci 1 Transfer Coursework 4 EMSP 2201* Emergency Pharmacology 2 Health Sci 1 Transfer Coursework 3 EMSP 2302* EMS Operations 3 Human Science (6) EMSP 2210* Practicum - Paramedic 2 Humanity Transfer Coursework 3 EMSP 2308* Special Populations 3 Social Sci 1 Transfer Coursework 3 EMSP 2403* Cardiology 4 General Education (8) EMSP 2402* Medical Emergencies 4 Gen Ed 1 Transfer Coursework 3 General Electives (6) Gen Ed 2 Transfer Coursework 4 Gen Elec 1 Transfer Coursework 3 Gen Ed 3 Transfer Coursework 1 Gen Elec 2 Transfer Coursework 3

General Education Requirements Total (min 30) 30 Major Requirements Total (min 30) 30 *These courses are the EMSP core requirement for all Army personnel.

Degree Completion Plan: Requirement Recommended Coursework Hours Needed** Pathway Oral Comm Public Speaking 3 Transfer (CLEP, AP, DANTES, TA, etc.) Written Comm Composition I 3 EMSA 2301 Technical Writing Math College Algebra 3 Transfer (CLEP, AP, DANTES, TA, etc.) Natural Sci 1 Anatomy & Physiology, Biology, Chemistry 4 EMSA 1401 Anatomy & Physiology I w/Lab Health Sci 1 Trauma Management 3 EMSA 1303 Trauma Management Humanity Ethics, Philosophy, Fine Art, Religion 3 Transfer (CLEP, AP, DANTES, TA, etc.) Social Science 1 Military Science I 3 ACE: AR-2201-0399 V04 Gen Education 1 Military Science II 3 ACE: AR-2201-0399 V04 Gen Education 2 Anatomy & Physiology II 4 EMSA 2401 Anatomy & Physiology II w/Lab Gen Education 3 Structured Self Development I 3 ACE: AR-0702-0030 Gen Elective 1 AEMT Clinical 2 EMSA 1204 Clinical Practicum Gen Elective 2 AEMT Introduction to Advanced Practice 4 EMSA 1402 Introduction to Advanced Practice Equivalent coursework will also be considered. This includes CLEP, DANTES, College Board, and other mechanisms. **One class minimum

To receive the ASHS Emergency Medical Services diploma, all CAHS students must:

1) Complete all coursework above and send official transcript(s) to CAHS.

2) Submit CAHS request for graduation. DEANS’ QUARTERLY COUNCIL COORDINATION SHEET FOR NEW PROGRAMS/ACTIONS

DATE OF PROPOSAL TO DQC: ______October 9th, 2019______

BRIEF SUMMARY OF PROPOSAL (1-3 LINES): The Paramedic portion of the Critical Care Flight Paramedic program is a 30-week, MOS producing course at MEDCoE. Specialized accreditation is CAAHEP and credentialing is through CoAEMSP.

CONCURRENCE TO PROCEED PER PPM-004-2018 (PRS), ESTABLISHMENT OF NEW ACADEMIC PROGRAMS (PLEASE INITIAL):

SOM YES ______NO ______

GSN YES ______NO ______

PDC YES ______NO ______

CAHS YES ______NO ______

COMMENTS:

TAB 29 Supplement (GSN)

PROPOSED FACULTY RECOMMENDATIONS November 5, 2019 BOR LIST - Supplemental Entry 10/28/19 DEPARTMENT/NAME PROPOSED RANK ACTION/CURRENT DUTY STATION

Primary Appointment (Billeted)

GRADUATE SCHOOL OF NURSING

KOSTAS-POLSTON, Elizabeth Associate Professor Promotion/ PhD Tenure - Track USUHS CURRICULUM VITAE (abbreviated) ELIZABETH A. KOSTAS-POLSTON, PhD, APRN, WHNP-BC, FAANP, FAAN

CURRENT POSITION Assistant Professor, Doctor of Philosophy in Nursing Science Program Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences; Bethesda, MD Phone: 301.295.1531 Email: [email protected]

EDUCATION YEAR DEGREE INSTITUTION/LOCATION/FOCUS 1985 Bachelor of Science in Nursing Arizona State University; Tempe, AZ 1996 Master of Science in Nursing University of Florida; Gainesville, FL; Specialty as Women’s Health Nurse Practitioner: Obstetrics, Gynecology, and Primary Care of Women 1997 Postgraduate Colposcopy Training The University of Texas, M. D. Anderson Cancer Center 2007 Doctor of Philosophy Loyola University Chicago; Chicago, IL; Nursing Research 2009 Post-Doctoral Fellowship National Institutes of Health/National Institute of Nursing Research; Bethesda, MD; Summer Genetics Institute; Human Molecular Genetics, Genomics, and Molecular Biology Intramural Research Training Award 2010 Non-Traditional Post-Doctoral University of Pittsburgh School of Nursing; Pittsburgh, PA; Fellowship “Targeted Research and Academic Training of Nurses in Genomics” (T32NR009759)

PROFESSIONAL EXPERIENCE (SELECTED) ACADEMIC APPOINTMENT Assistant Professor and Special Projects Coordinator for the Dean; Robert Wood Johnson 2011-2014 Foundation Nurse Faculty Scholar (2010-2014); Faculty Appointment, University of South Florida College of Nursing; Tampa, FL; Research Appointment, Saint Louis University School of Medicine, Department of Otolaryngology, Head & Neck Surgery; St. Louis, MO.

Assistant Professor and Director, Perinatal Nursing Graduate Program; Robert Wood Johnson 2007-2011 Foundation Nurse Faculty Scholar (2010-2014); Faculty Appointment, Saint Louis University School of Nursing; St. Louis, MO; Research Appointment, Saint Louis University School of Medicine, Department of Otolaryngology, Head & Neck Surgery; St. Louis, MO.

NON-ACADEMIC APPOINTMENTS (SELECTED) Women’s Health Nurse Practitioner. Holy Cross Germantown Hospital; Germantown, MD (Hospital Practice) 2015-present Women’s Health Nurse Practitioner/Colposcopist. Women’s Care Florida, Lakeland OB-GYN; Lakeland, 2011-2014 FL (Private practice) Women’s Health Nurse Practitioner. Howell County Health Department; West Plains, MO (Public Health Dept) 2003-2011 United States Air Force Inactive Reserves 1991-2005 Officer-Nurse (O-3); General Medical Unit & Obstetric Service Coordinator. USAF Hospital Iraklion, 1990-1991 Iraklion Air Station; Crete, Greece PROFESSIONAL HONORS, AWARDS, AND RECOGNITION (SELECTED) Invited National Mentor, Fellows of the American Association of Nurse Practitioners Mentor Fellowship 2019 Program. Mentee: Major Heather Hubbard, University of Nebraska College of Nursing. Chair-Elect, American Academy of Nursing Women’s Health Expert Panel. 2017 Invited National Member, American Cancer Society/Centers for Disease Control National HPV 2016 Vaccination Roundtable Expert Healthcare Provider Working Group. Invited Guest, The White House Dialogue on Men’s Health. The White House; Washington, D.C. 2016 Elected Faculty Senator, Daniel K. Inouye Graduate School of Nursing, Uniformed Services University 2016 of the Health Sciences; Bethesda, MD. Invited National Member, American Cancer Society/Centers for Disease Control National HPV 2015 Vaccination Roundtable Expert School-Based Parent Education Working Group. Inducted as Fellow of the American Academy of Nursing. 2015 Inducted as a Fellow of the American Association of Nurse Practitioners. 2013

RESEARCH (SELECTED) YEAR SPONSORED PROJECTS AMOUNT $1,237,906 2017-2021 Principal Investigator. Military readiness in active duty service women: The impact of the availability of water and basic sanitation on hygiene practices and urogenital health. Department of Defense/ Uniformed Services University of the Health Sciences, Military Women’s Health Research Award. $225,000 2018-2020 Principal Investigator. In search of novel biomarkers for triaging risk for and early detection of HPV-positive oropharyngeal squamous cell carcinoma. Uniformed Services University of the Health Sciences. $350,000 2010-2014 RWJF Nurse Faculty Scholar. Genomic Instability: Oncogenic Mechanisms of HPV Oncoproteins. Robert Wood Johnson Foundation Nurse Faculty Scholars Fellowship. $43,000 2009-2011 Principal Investigator. An investigation of the effectiveness of molecular assays and sampling methods for the detection of oral cavity and oropharyngeal HPV infection (Arm I). E.R. Murphy Charitable Lead Trust Research Award, Saint Louis University Cancer Center.

PUBLICATIONS AND PRESENTATIONS Peer reviewed publications # 24 Peer reviewed, data-based publications # 7 Manuscripts in review # 2 Technical & Health Policy Reports # 5 US National Guidelines # 1 Book chapters # 7 Media # 19 Peer reviewed podium presentations (7 International; 36 National, 1 Regional; and 3 Local) # 47 Invited podium presentations (1 International; 34 National; 2 Regional; and 6 Local) # 43

PUBLICATIONS (SELECTED) PEER REVIWED JOURNAL ARTICLES 1. Kostas-Polston, E. A., Braun, L. A., & Miedema, J. (In-Review, 2019). Promoting military women’s self- maintenance of urogenital health and operational readiness: A qualitative study using the inductive thematic analysis method. Submitted to the Journal of Midwifery & Women’s Health. 2. Phillips, A. K. & Kostas-Polston, E. A. (In-Review, 2019). Menstrual suppression in US military women: Literature review and gap analysis. Submitted to the Journal of Nursing Scholarship. 3. Kostas-Polston, E. A., Rawlett, K., Miedema, J., & Dickens, K. (2018). An integrative review of nurse practitioner education models: Part three of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda. Journal of the American Association of Nurse Practitioners, 30(12), 696-709. doi: 10.1097/JXX.0000000000000150 4. Kostas-Polston, E. A. (2016). Prenatal screening and diagnosis: Key clues to antepartum surveillance. Journal for Nurse Practitioners, 12(5), E239-E242. doi: 10.1016/j.nurpra.2016.02.003 5. Kostas-Polston, E. A. & Johnson-Mallard, V. (2015, March). Protruding mass. The Journal for Nurse Practitioners, 11(3), 373-376. doi: 10.1016/j.nurpra.2014.11.026 (*Data-based). 6. Kostas-Polston, E. A., Thanavaro, J., Arvidson, C., & Taub, L. F. M. (On behalf of the FAANP Health Policy Work Group) (2015, January). Advanced practice nursing: Shaping health through policy. The Journal of the American Association of Nurse Practitioners, 27(1): 11–20. doi: 10.1002/2327- 6924.12192 BOOKS AND BOOK CHAPTERS (SELECTED) 1. Alexander, I., Johnson-Mallard, V., Kostas-Polston, E. A., Fogel, C. I., & Woods, N. F. (Editors) (2017). Women’s Health Care in Advanced Practice Nursing. New York: Springer Publishing Company, LLC. 2. Johnson-Mallard, V. & Kostas-Polston, E. A. (2017). Well Women’s Health. In Alexander, I., Johnson- Mallard, V., Kostas-Polston, E. A., Fogel, C. I., & Woods, N. F. (Eds.), Women’s Health Care in Advanced Practice Nursing. New York: Springer Publishing Company, LLC. 3. Kostas-Polston, E. A., Johnson-Mallard, V., & Jay, N. (2017). Human Papillomavirus. In Alexander, I., Johnson-Mallard, V., Kostas-Polston, E. A., Fogel, C. I., & Woods, N. F. (Eds.), Women’s Health Care in Advanced Practice Nursing. New York: Springer Publishing Company, LLC. TECHNICAL AND HEALTH POLICY REPORTS AND U.S. NATIONAL GUIDELINES 1. Assuring TRICARE Coverage of Preventive Health Services for Women; Co-Lead, Uniformed Services University Defense Health Horizons Military Women’s Health Project. Kostas-Polston, E. A., Witkop, C. T., Degutis, L., & the DHH Steering Committee (June 2018). A comparison and analysis of women’s reproductive healthcare coverage under TRICARE with coverage available to women enrolled in civilian health insurance plans subject to the 2010 Patient Protection and Affordable Care Act (ACA). Based on the conduct of our review, analysis, and findings, recommendations for health policy change were created and submitted for consideration and adoption by the Defense Health Agency (DHA) senior leadership. INVITED PRESENTATIONS (SELECTED) 1. Kostas-Polston, E. A. (August, 2019). A checklist for survey questionnaire development: A case study for military women’s urogenital health and operational readiness through the Lens of the IBM-WASH Model. Peer- reviewed, scientific paper, podium presentation at the 2019 Military Health System Research Symposium (MHSRS); Kissimmee, FL. 2. Kostas-Polston, E. A. (May, 2019). Promoting military women’s self-maintenance of urogenital health and operational readiness: A qualitative study using the inductive thematic analysis method. Peer-reviewed, scientific paper, podium presentation at the TriService Nursing Research Program Dissemination Course; San Diego, CA. 3. Kostas-Polston, E. A. (July 2019). HPV Cancer Prevention and Disease Management. On behalf of the American Cancer Society’s National HPV Vaccination Roundtable, invited oral presentation at the 2019 Missouri Academy of Physicians Assistants Annual Primary Care Meeting; Branson, MO. 4. Kostas-Polston, E. A. (January, 2019). Call to action: Promoting military women’s self-maintenance of urogenital health and operational readiness. Invited podium presentation at the 2019 USU Vice President of Research Intramural Investigator’s Meeting; Bethesda, MD. (EAKP, 10.15.2019) Tab 30 Supplement (CAHS) College of Allied Health Sciences JBSA-Fort Sam Houston, TX 78234

Purpose: To update the USU President on the status of the Vol Ed value / sem hour is $250 / sem hr Army’s Paramedic (F1) Program. 24 x 210 = 5,040 sem hours 5,040 sem hrs x $250 / sem hr = $1.426M in Vol Ed (USD Bottom Line: P&R). - MEDCoE has requested CAHS become the college credit granting institution for the Army Paramedic Program. Accreditation & Credentialing: - The F1 program is critical to the Army meeting a This program is accredited by the Commission on Congressionally directed medical / readiness capability. Accreditation of Allied Health Education Programs (CAAHEP) - This program is accredited, with mandatory credentialing on and the Committee on Accreditation of Educational Programs the back end for awarding the ASI. for the Emergency Medical Services Professions (CoAEMSP). - The Paramedic portion of the national standard curriculum was assessed at 24 sem hrs. The “Paramedic” credentialing provided by National Registry of Emergency Medical Technicians. Way Ahead: CAHS continues phasing in Sec 724 of the 2017 NDAA, awarding undergraduate credit to enlisted programs. POC: Mr. Dennis Kilian /ADUS/ CAHS (210) 299-8526 Student Population: Army students must hold the MOS 68W, Combat Medic, in the E-3 to E-7 range, from the Active, Reserve and National Guard Components. Upon completion of the Army F1 program, a math course will be needed for degree completion.

Resources: This program is fully resourced by the TRADOC & MEDCoE.

Value Proposition: FY 20 Projected Student load is 210 students F1 fracked curriculum is 24 semester hours/student

23 October 2019 College of Allied Health Sciences JBSA-Fort Sam Houston, TX 78234

Purpose: To update the USU President on the status of the Value Proposition: Navy Independent Duty Corpsman (IDC) Submarine Program. FY 20 Projected Student load is 45 students (3 iterations @ 15 students, maximum load). Bottom Line: IDC (Submarine) assessed at 58 sem hrs for Navy. - NMETLC has requested CAHS become the college credit granting intuition for the Navy Independent Duty Corpsman (IDC) Submarine program. Vol Ed value of a sem hr is $250 / sem hr. - The Service approved curriculum was assessed at 58 sem hrs 45 Navy students x 58 sem hr / student = 2,610 sem hrs 2,610 for Navy students. sem hrs x $250 / sem hr = $652,500 in Vol Ed - Institutional accreditation is thru the Council on Occupational (USD(P&R)) value. Education (CoE). Specialized Programmatic Accreditation: Way Ahead: CAHS continues phasing in Sec 724 of the 2017 Specialized Accreditation linked to Institutional Accreditation. NDAA, awarding undergraduate credit to enlisted programs. Multiple voluntary credentials available via DoD Degree Granting: Credentialing (trauma & resuscitation). This course is open to Navy students in pay grade E5 – E7, who have completed Basic Corpsman School. ACE recommendation on credit expires in December 2019.

Students will have, typically, at least 80 recommended semester hours for Hospital Corpsman Basic, C-School, and POC by Mr. Dennis Kilian /ADUS/ CAHS (210) 299-8526. various occupational exhibits from their JST. Couple the transfer credit, along with the 58 semester hours from the IDC curriculum and most students will exceed the 120 semester hours needed for degree award of a BSHS, if General Education requirements are met.

Resources: This program is fully resourced by the Navy’s Naval Undersea Medical Institute (NUMI) at the Naval Submarine Base, New London, Groton, CT.

23 October 2019 College of Allied Health Sciences JBSA-Fort Sam Houston, TX 78234

Purpose: To update the USU President on the status of the Value Proposition: Navy Independent Duty Corpsman (IDC) Surface Program. FY 20 Projected Student load is 224 students (7 iterations @ 32 students, maximum load). Bottom Line: IDC (Surface) assessed at 57 sem hrs for Navy. - NMETLC has requested CAHS become the college credit granting intuition for the Navy Independent Duty Corpsman Vol Ed value of a sem hr is $250 / sem hr. (IDC) Surface program. 224 Navy students x 57 sem hr / student = 12,768 sem hrs - The Service approved curriculum was assessed at 57 sem hrs 12,768 sem hrs x $250 / sem hr = $3,192,000 in Vol Ed for Navy students. (USD(P&R)) value. - Institutional accreditation is thru the Council on Occupational Education (CoE). Specialized Programmatic Accreditation / Credentialing: Specialized Accreditation linked to Institutional Accreditation. Way Ahead: CAHS continues phasing in Sec 724 of the 2017 NDAA, awarding undergraduate credit to enlisted programs. Multiple voluntary credentials available via DoD Credentialing (trauma & resuscitation). Degree Granting: This course is open to Navy students in pay grade E5 – E7, ACE recommendation on credit expires in December 2019. who have completed Basic Corpsman School.

Students will have, typically, at least 80 recommended POC by Mr. Dennis Kilian /ADUS/ CAHS (210) 299-8526. semester hours for Hospital Corpsman Basic, C-School, and various occupational exhibits from their JST. Couple the transfer credit, along with the 57 semester hours from the IDC curriculum and most students will exceed the 120 semester hours needed for degree award of a BSHS, if General Education requirements are met.

Resources: This program is fully resourced by the Navy’s Surface Warfare Medical Institute (SWMI) in San Diego, CA.

23 October 2019