MUSC Catalyst 11-28-2014

Nov. 28, 2014

MEDICAL UNIVERSITY of SOUTH CAROLINA

Vol. 33, No. 15

Researchers confront complex coastal challenges

By Dawn Brazell Public Relations

N

ot everyone has forgotten the 2010 Deepwater Horizon oil spill.

Certainly not researcher Michael Fulton, Ph.D. The air hangs hot and humid in a marine mesocosm as Fulton tours stacked, rectangular bins of Spartina cordgrass, a patchwork of mini-marsh ecosystems in this greenhouse laboratory. Scientists here at the Center for Coastal Environmental Health & Biomolecular Research drop in oil pollutants. They wait, watch and measure to learn how the simulated coastal ecosystem will respond.

Nearby at the Marine Environmental Specimen Bank, operated by the National Institute of Standards and Technology (NIST), the temperature drops sharply. Research biologist Rebecca Pugh, decked out in Tyvek coveralls, sinks her gloved hands into spiralling mists atop barrel-shaped nitrogen freezers where temperatures at the base sink down to minus 150 degrees Celsius. She pulls out a long tray housing barcoded marine samples.

The scene takes a medical twist at the Marine Biomedicine & Environmental Sciences Center where MUSC researchers Louis J. Guillette, Ph.D., a reproductive endocrinologist and developmental geneticist known for his fieldwork in alligator studies, and Demetri Spyropoulos, Ph.D, a developmental biologist and an expert in the manipulation of embryonic stem cells, pair their talents to investigate marine environmental contaminants and their possible effects on human health.

Meanwhile, Lori Schwacke, Ph.D., chief of the Oceans & Human Health Branch of NOAA/National Centers for Coastal Ocean Science (NCCOS) HML, investigates the impact of environmental contaminants on dolphins in the Gulf.

What pulls these disparate fields and institutions

U.S. Navy photo by Mass Communication Specialist 2nd Class Justin Stumberg

Above, dark clouds of smoke emerge as oil burns during a controlled fire in the Gulf of Mexico May 6, 2010, as part of the Deepwater Horizon oil spill response. Below, an oiled dolphin photographed in Barataria Bay, Louisiana, Aug. 5, 2010. Researchers at Hollings Marine Lab are studying the effects of the spill in numerous projects. See the annual report and cover story on the MUSC News Center at www.musc.edu/pr/newscenter/2014/HMLoverview.html.

“

Louis J. Guillette

See Coastal on page 8

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Day of Caring MUSC employees turn out in big numbers to help the community.

If we’re seeing something going on in the environment, we have to ask is there something going on in ourselves?

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See story page 6

photo provided

Heroes Abound

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DAISY award

Therapy dog Lucky named first canine Health Care Hero.

5

Meet Gwendolyn

9

Gifting Policy

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Applause Program The following employees received recognition through the Applause Program for going the extra mile: Medical Center

Moya McFadden, Radiology; Michelle Vareltzis, Radiology; Jennifer Honeycutt, MeduFlex Team; Gay Martin, Radiology; Lisa Dooley, Radiology; Brenda Campbell, Outpatient Registration; Shunvella Lee, Outpatient Registration; Angela Franklin, Radiology; Whitney Graybill, Obstetrics-Gynecology; Betsy Reid, Medical Records; Taylor Burgess, Control Unit; Brandy Olson, Guest Services; Catina Williams, ART 4 East; Cindy Ferguson, DDC; Catherine Claro, ART 6 West; Karen Adams, ART Pre-Op Surgery; Connie Whitmire, CCU; Jessica Hardy, Women’s Services; Chiffvon Washington, GI Clinic; Cephus Simmons, Radiology; Vicky Crawford, ART PACU; Gabriele Powel, ART PACU; John Toole, Department of Surgery; Brenda Brown, HVC; Monterris Junes, Outpatient Registration; Kate Ryan, ART GI Clinic; Stefanie Owczarski, Department of Surgery; Romica Stephens, Registration Admin; Terra Kirkwood, RT Children’s Lab Support; Loberta Gibbs, ART DDSL; Charlie Smith, Pharmacy; Michelle Hudspeth, Pediatrics Hem/Onc; Danny Williams, Safety & Security; Jennifer Redfern, Child Life; Sandra Buck, RT Urology Clinic; Indrea Singleton, Revenue Cycle Operations; Sharon Dupree-Capers, Revenue Cycle Operations; Julie Blair, Speech Pathology; Annie Williams, Amb Preop Clinic; Charles Greenberg,Hematology/ Oncology;Tronya Johnson; Hollings Clinics; Sadie Burke, 7 West; Megan Ri-

Editorial of fice MUSC Office of Public Relations 135 Cannon Street, Suite 403C, Charleston, SC 29425.

843-792-4107 Fax: 843-792-6723 Editor: Cindy Abole catalyst@musc.edu Catalyst staff: Mikie Hayes, hayesmi@musc.edu Dawn Brazell, brazell@musc.edu Helen Adams, adamshel@musc.edu J. Ryne Danielson, daniejer@musc.edu

pley, Women’s Services; Ana Rosa Virella, Women’s Services; Gweneth Lazenby, Obstetrics-Gynecology; Ernest White, Environmental Service; Ashley Smith, 8D; Ali Golden, Storm Eye Institute; Arem Hernandez, Medical Records; Melyssa Smith, HVC; Justin Ravenel; Guest Services; Haley Pollack, PACU; Emily Eling, Meduflex Team; Megan Summers, Meduflex Team; Megan Minnich, STNICU; Amy DePriest, Women’s Care Services; Libby Yee, Emergency Department; Melvena Nelson, Environmental Services; Tara Parker, Total Joint Replacement Center; Veronica Bello-Ogunu, 6 East; Joanna Fleming, Physical Therapy; Benjamin Woodhouse, Pediatrics – 7 East; Mary Perkings, PCICU; Sarah Francisco; Meduflex Team; Layne Umberger, Child Life; Anne Redick, 2JRU; Vicky Lennen, 2JRU; Cheri Mikell, Storm Eye Institute; Pamela Kinlock, North Are Specialty Clinic; Alisha Hinz, STNICU; Lequandra Royal, Environmental Services; Janet Simmons, Amb PACU; Eva Cuenca, Amb PACU; Betty Pace, Amb PACU; Sandra Smalls, Amb PACU; Lynn Sweatman, Amb PACU; Melanie Feaster, Amb PACU; Eanna Aaron, Social Work Program; Karen Hoover, Pharmacotherapy Clinic; Brooke Marshall, Hollings Clinics; Chirstina Carson, Hollings Clinics; Sarah Mathes, 7 West; Jackie Whelan, Family Medicine James Island; Tammy Burleson, Family Medicine James Island Ann Ginn, Family Medicine James Island Kelsey Strawn, PICU; and Christa Schultz, RT Outpatient Pharmacy University Andy Anderson, OCIO; Lisa Beattie, Human Resources Management; The Catalyst is published once a week.

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University (con’t.)

Stephanie Brown, Parking Management; Greg Buck, Gastroenterology & Hepatology; Evola Dawson, Parking

Management; Monica Eberhardt, Pediatric Dentistry; Patrice Gordon, Human Resources Management; and

Cardio nurse receives DAISY from program co-founder

By J. ryne Danielson Public Relations Eileen Sandlin, R.N., wore a quizzical expression as she rounded the corner onto 5 East, her floor at Ashley River Tower. Her friends and colleagues lined the corridor, trying to maintain the guise of business as usual. Sandlin's husband and two daughters, hiding in a doorway, were also there. Everyone had gathered for a surprise ceremony to honor Sandlin, the latest recipient of the DAISY award.

Established in 1999 by the family of J. Patrick Barnes, of Amarillo, Texas, the award is part of the DAISY Foundation's program to recognize the superhuman feats nurses perform every day. Each month, at participating health care organizations, one nurse is selected to receive the award. More than 400,000 individuals have been nominated worldwide, but fewer than 10 percent of them have been chosen.

Barnes died at the age of 33 from idiopathic thrombocytopenic purpura, an autoimmune disease. “We were absolutely devastated,” his wife, Tena Barnes, explained. “He was young. We had just started a family.”

“There wasn't a whole lot positive about the experience,” she continued.

Nonetheless, as the family sought a way to channel their grief into something positive, they kept coming back to his nurses. Not only did Patrick Barnes' nurses demonstrate great clinical skill, Tena Barnes told those gathered, but also selflessness and compassion, day in and day out, even when he was completely sedated. “They really took care of me and my family. We wanted a way to thank them.”

Each year Tena Barnes attends four DAISY ceremonies, and this year included Sandlin’s. “Nurses do so many things that are extraordinary — and you

photo by J. Ryne Danielson, Public Relations

5East ART nurse Eileen Sandlin is the newest DAISY winner. just do it every day because it's who you are,” she told Sandlin and her colleagues directly.

The acronym DAISY, which stands for Diseases Attacking the Immune System, was chosen to bring attention to Patrick Barnes' illness. Almost 1,800 health care providers participate in the program, in the United States and 14 other countries.

“This is truly international recognition,” Tena Barnes said.

Participating organizations establish their own merit — based criteria for determining which nurses are eligible to be presented with the DAISY award.

At MUSC, nurses may be nominated by colleagues, patients, visitors, physicians, staff, or volunteers; winners are selected by blind vote by the Nurse Alliance Leadership Council at MUSC Health.

Sandlin was nominated by MUSC’s Tracy Fields, R.N. Fields related the story of a 27–year–old heart transplant

See DAISY on page 11

The CaTalysT, Nov. 28, 2014 3

MUSC employees donate time, energy in Day of Caring activities

By J. ryne Danielson Public Relations

O

n Nov. 14, all across the Lowcountry, thousands of volunteers came together to serve their communities in Trident United Way’s 15th annual Day of Caring.

Whitney McLuen, employee campaign coordinator with MUSC’s Office of Development, coordinates Trident United Way’s activities on campus. “This event really showcases our tremendous number of generous, caring, and philanthropic — minded employees,” she said. “They’re not only committed to making MUSC a better place — but also the entire Lowcountry.”

MUSC has partnered with Trident United Way for the Day of Caring since 2000. This year saw the largest turnout yet. From MUSC alone, 22 groups and more than 400 individuals volunteered for everything from building greenhouses to baking cookies.

One of the groups, the faculty and staff of the Weight Management Center, filled comfort kits for families of intensive care patients. These kits included items such as granola bars, playing cards, dental floss, note pads, and pens. Suzanne Kuker, research coordinator, led the activity. She said she feels it’s important to give back, especially to the MUSC family.

Kuker identifies directly with those she is helping; her mother recently had bypass surgery. “That takes several days of preparation,” she said, “and hours of sitting in a waiting room. I’d have loved to have gotten something like this.”

The Department of Public Safety also lent a hand by gathering “snacks in sacks” for patients at Hollings Cancer Center. These sacks contained lotion, blankets, coffee, tea, cookies, and crackers — things Jennie Sirisky, technology and recruitment coordinator, hopes will make patients more comfortable. “Everyone knows someone who has been affected by cancer,” said Sirisky, who organized the event for her department. She is no exception; Sirisky’s father and brother have both battled cancer. She, along with Glenn Iannuzzi, systems support technician,

photos by J. Ryne Danielson, Public Relations

MUSC’s Weight Management Center’s Jenny Boyce, from left, Lynne Becker, Suzanne Kuker, Tonya F. Turner, Shawn Witherspoon, Dr. Patrick O’Neil, Mary Harley, and Rhonda Ascanio gathered items for the families of ICU patients as part of Trident United Way’s annual Day of Caring. delivered the care packages that morning.

Diane Aghapour, patient services support coordinator, and Kiki Cooper, director of special events, were among Hollings’ staff there to receive the donated items. I can’t thank them enough,” Aghapour said. “We have great, generous people throughout the Charleston area. We love these kinds of connections."

Cooper reiterated the importance of building the types of interdepartmental relationships the Day of Caring promotes.“The patients know that it takes everyone,” she said. “From the nurses and physicians, to the people making sure that they have a safe campus.” She also stressed how much patients enjoy the care packages they receive.

Trident United Way, founded in 1944, is in the seventieth year of its mission, bringing individuals together with businesses and government to build stronger communities. “The skills, expertise and enthusiasm of volunteers are among our greatest resources,”

said Barry Waldman, vice president of communications and marketing at the nonprofit. “With hundreds of Day of Caring volunteers from two dozen departments, MUSC is a key partner with Trident United Way.” Partnerships and strategic volunteerism are important tools for accomplishing the organization’s goals of increasing

Volunteers stage an assembly line to fill comfort kits with the items gathered. high school graduation rates, fostering financial stability and improving community health. “We’re making progress on all three,” Waldman said, “but we have a long way to go.”

Trident United Way’s 2014 fundraising campaign continues through December; donations can be made online at www. tuw.org/give.

2014 MUSC Angel Tree Event & Parade Noon to 2 p.m., Friday, Dec. 5 Parade: Ehrhardt Street to MUSC Horseshoe Come celebrate the 10th anniversary of MUSC’s support of this annual holiday community program. Cheer on and support patients, fellow MUSC employees and friends in the community as participants bring their bagged and tagged toy or gift to the Horseshoe.

After Dec. 5, Angel Tree gifts can be brought to any Lowcountry Walmart location until Dec. 12. For information, call 792-8382.

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Schnoodle, others named as 2014 MUSC Health Care Heroes

By Mikie hayes Public Relations

A

s the woman sat in the Emergency Department waiting to be examined, Lucky, an MUSC therapy dog, moseyed over to say hello. She petted the curly, five–year–old white “schnoodle’s” head and the two became fast friends.

Suddenly, Lucky backed away from her and looked to his handler–owner, Al Hoffman, who recognized this as strange behavior for his dog. As such, Hoffman brought the situation to a nurse’s attention. Hoffman later learned the patient’s blood sugar was at a dangerous level.

This behavior, Hoffman said, is not unusual for Lucky. Therapy dogs routinely call attention to health issues, sometimes saving the lives of humans, by alerting others to problems before they even occur.

Dogs like Lucky have a superior sense of smell, and often, before a person even begins to feel physical symptoms, dogs can pick up on an odor released when there is a change in a person’s blood sugar levels. This happens, according to Nicholas H. Dodman, BVMS, program director of the Animal Behavior Department of Clinical Sciences at Tufts Cumming School of Veterinary Medicine, because the body releases chemicals, like ketones, in response to hypoglycemia. And similar to narcotic dogs that sniff out drugs or search–and– rescue dogs that detect people, some dogs appear to be able to recognize the unique odor of certain chemicals released by the body.

Remarkable contributions like this resulted in the Charleston Regional Business Journal adding service and therapy animals as a new category to the annual Health Care Heroes awards.

Lucky was honored as the organization’s first non–human recipient.

In years past, men, women and organizations that contributed to the health and well–being of the Charleston community were recognized. This year, animals were included because of the impact they have on the lives of the people they touch. The Journal

photo provided

MUSC President David Cole, far left, joins 2014 Health Care Hero winners Kahlil Demonbreun, Al Hoffman and Lucky, Dr. Michelle Hudspeth, Towanda Ross (for Zion Thomas), Caroline DeLongchamps and Dr. Jimmy McElligott. celebrated Lucky and the other honorees during an event on Nov. 20 at the Francis Marion Hotel.

Lucky and Hoffman have been volunteering at MUSC since February of 2013 and have logged nearly 1,100 hours of service. Melissa Kubu, manager of Volunteer & Guest Services for the MUSC Children’s Hospital, presented Lucky with his Health Care Hero award.

She said, “Their work here has made a tremendous impact on our patients, families and staff. Most of their work has been in the ICUs working with trauma patients, chronically ill patients, and end-of-life care. Their passion for what they do shows in their everyday interactions. The happiness they bring means everything during these highstress situations encountered every day.

Parents of patients can be having the worst day and that all changes when they see Lucky walking in the door.”

The reasons patients rely on Lucky for comfort are many. Recently, a young boy in the Children’s Hospital would not get out of bed and walk. His doctors and nurses tried to get him to take steps with his walker, but he would cry, sometimes scream, and refuse. Lucky and Hoffman were called in to help. Lucky spent

some time earning the boy’s trust, then Hoffman showed him how to hold the lead on Lucky’s leash while he held the other lead. Because the little guy really wanted to take Lucky for a walk, he gingerly got out of bed, and flanked by three nurses and Hoffman, slowly walked Lucky down the hall, going further than anyone thought he could. It wasn’t long until the little patient was walking normally again.

Hoffman recounted about a boy admitted to the Children’s Hospital, following a near–drowning. Doctors tried to get him to speak to them, but he was suffering from post–traumatic stress disorder and wouldn’t utter a word to anyone. Lucky came for a visit and sat right next to the boy for almost 20 minutes. Hoffman said: “Once I saw that the young boy was responding to Lucky’s presence, I asked his name. He opened up and told me his whole life’s story,” Hoffman said. “Lucky has that effect on people; they feel safe with him.”

Because of his signature brand of comfort and encouragement, Lucky is often called in for end–of–life concerns.

He visited a stroke patient recently who greatly enjoyed his company. Soon thereafter, the patient lapsed

into a coma. Lucky’s impact had been so great during his first visit with them, the family made a special request for him to spend time with them in the ICU. Family members came and went during Lucky’s visit; other times all eight were all in the room at the same time.

Lucky stayed right by the patient with his fuzzy head resting on the man’s arm. The family was comforted by the fact Lucky was there; his very presence lessening the stress a bit, Hoffman shared.

After spending nearly seven hours in the ICU with the family, the medical situation changed. Lucky’s senses are so keen that as the patient passed, Lucky lifted his head from the man’s arm and looked at Hoffman, as if to share the sad news. Hoffman explained that it’s not unusual for therapy dogs to know when a human passes. As they left to allow the family to grieve privately, they thanked Lucky and Hoffman for their kindness and support.

Therapy dogs routinely spend two hours at a time with patients. Seven hours, however, is a very long day for a pup. Hoffman said, “He does fine, but I can tell when he’s getting tired.

Sometimes it’s not the physical part, more it’s the emotional part.” Therapy dogs can feel the stress of a situation, just like humans, and some get over–stressed and need time to recuperate.

Because of his good nature, Lucky is able to endure more time around difficult cases than some dogs. Still, he needed time to decompress after such an exhausting experience. Knowing the dog’s needs and cues comes down to the nature of the relationship between the dog and the handler.

Hoffman said, “The combination of the right dog with the right handler is critical. Lucky is a calm and dedicated dog. I know his moods, and I can anticipate his behavior. At home, he is more energetic, but the minute he puts on his bright yellow service vest, he knows he it’s time to go to the hospital and do his job. The handler also needs to be as comfortable in hospital settings as the therapy dog — around hospital

See Heroes on page 12

The CaTalysT, Nov. 28, 2014 5

Meet Gwendolyn

Gwendolyn Fleming Department Ambulatory Services How you are changing what’s possible at MUSC By remembering in our industry that people do remember what you say what you do and how we make them feel.

How long at MUSC Just a few days....one week What music is in your player now Latch (featuring Sam Smith) Beach or pool La Jolla Beach for sure — San Diego, Ca. Best thing about living in Charleston Food, fun, festivals, and fashion. We’re No. 1 and I get it!

What food is a must in the pantry Coffee beans Greatest moment in your life My 25th wedding anniversary celebrated in the Bahamas How would you spend $1 million Donate to causes benefiting kids and travel

6 The CaTalysT, Nov. 28, 2014

By Dawn Brazell Public Relations

Fishing for environmental impacts on human health photo by Dr. Louis J. Guillette

Researchers join forces to find clues from the Deepwater Horizon oil spill

By Dawn Brazell Public Relations

single–component testing may be misleading as far as determining safe levels of exposures.

“Dispersant was deemed non–toxic at low “working” dilutions. It’s been sold as something that allows for easier breakdown of crude oil by microorganisms, but it also makes oil components more bioavailable to people and aquatic organisms, including seafood. So crude oil components or the detergent — and solvent– type components of dispersant, may not be toxic individually, but combined, impact long–term health.

We’re trying to find out how that works, and we’re now trying to break apart the dispersant into its components and test new combinations of components.”

I

t may be decades before researchers will truly know how the Deepwater Horizon (DWH) oil spill will affect human health.

Four researchers at MUSC, from four varying specialties, hope to speed up that timetable and use the spill to reveal other secrets in how the environment and genetics interact to cause disease.

The researchers all have unique views into the problem. q Louis J. Guillette, Ph.D. is a reproductive endocrinologist and developmental geneticist known for his fieldwork in alligator studies and a professor of obstetrics and gynecology at MUSC. q Demetri Spyropoulos, Ph.D., is a developmental biologist and an expert in the manipulation of embryonic stem cells and an associate professor in MUSC’s Department of Pathology and Laboratory Medicine with expertise in gene targeting. q Satomi Kohno, Ph.D., is a research assistant professor in MUSC’s Department of Obstetrics and Gynecology, specializing in environmental impacts on endocrine systems. q John Baatz, Ph.D, is a professor in MUSC’s Department of Pediatrics and serves as director of the Gel Proteomics facility.

The group’s major focus is to determine if exposure to crude oil — specifically the mixture represented by the DWH oil spill — affects long-term human health.

photo provided Dr. Louis Guillette (right) works with Ph.D. student James Nifong using National Geographic’s Crittercams to capture alligator video footage. The study results were published in the January 2014 issue (Volume 9) of PLOS One. To see the HML annual report and the full DWH cover story, visit www.musc.edu/pr/ newscenter/2014/HMLbiology.html.

The other critical question is does the dispersant used on the spill to break down the oil also have detrimental health effects.

In other words, is the ‘cure’ causing more harm?

Spyropoulos said diluted mixtures of substances might be just as potent as more concentrated single components of those mixtures, suggesting that

engineereD Cell sysTeM If you want to really see Spyropoulos light up, bring up how the researchers are doing just that by taking adult cells and making stem cells out of them. “The stem cells are seen as surrogates for fetal growth. We have whale, dolphin, alligator and human cells. We’ve focused on human health, but we need to know how these other top, trophic predators are faring as well, partly because we share common food sources with shared exposure histories,” he said.

Guillette said the problem with long-term studies or even large — scale studies based on epidemiological approaches in such a large area as was affected in the Gulf is the complexity of sorting out one factor — the oil spill — versus so many other factors affecting human health, such as smoking, diet and stress.

See Spill on page 7

The CaTalysT, Nov. 28, 2014 7

sPill Continued from Page Six “We decided to use the power of in vitro systems and either stem cells or ‘engineered cells’ to approach the question of potential detrimental health effects.”

The lab groups of the four researchers have extensive experience working with engineered cells and using them to examine environmental factors. In this case, they are culturing engineered cells from humans and other organisms to determine if exposure to oil changes the fate of the cell.

“That is, can we change a cell’s fate by exposure to crude oil or dispersant or a mixture of components of the two?”

Guillette said. “In our case, we are finding exposure to crude oil alters development so that stem cells are more likely to become fat cells versus bone or connective tissue.

This has serious implications as the fate of these cells is critical for future embryonic health, and more fat cells lead to obesity.”

The researchers outlined a way they could test oil and oil components on surrogates for developing embryos without manipulating the embryos. They are using an “engineered cell” system that’s exciting in two ways, he said. It spares research animals’ lives, for one, given how the technology works, and it provides a high–end biotechnology model that can be used to test hundreds of substances to determine potency of suspected environmental contaminants, he said.

“We suspected that, like in a lot of environmental health studies, the developing embryo is a major target because it’s at a sensitive stage of development. We can’t expose human embryos –before we even get to exposing other kinds of embryos, we thought, there’s a mechanism that we can actually start to use, kind of this high-end biotechnology that we have to try and assess what’s going on.”

Guillette and his colleagues work closely with scientists at the Hollings Marine Laboratory, including ones with The National Institute of Standards and Technology (NIST).

“Because we also have NIST here and their principal chemists involved with analytical chemistry, we could marry this kind of world-class analytical chemistry with our biology.”

FaT Cells It’s been a formula for success in how the research is developing.

Guillette said they know if a developing embryo is exposed to certain compounds, that will alter its development and in many — if not most — case, will establish a predisposition for disease. “We are now collecting data. It took us a year to establish and validate our assays and approaches for use with crude oil and its fractions and the surfactants used during the oil spill. Early data suggests that there are components of crude oil — dispersant mixtures that are obesogenic — driving the fate of stem cells toward fat cells. Work over the next year or two will further these initial observations.”

Though the DWH spill provided the impetus for their research, which is funded by the BP/The Gulf of Mexico Research Initiative, the results will go far beyond the spill.

“It accelerates the work in this area and fosters the science,” he said of the DWH spill research. “Here’s a component we use every day, and it’s forcing us to look in very different ways, at an oil spill, and because of its scale, because it was so massive, it demanded a massive response.

There are tankers that hit shoals every day and spill 100,000 gallons of oil, and everybody goes ‘well that’s just modern society.’ But the fact is that oil has an impact on those systems and quite bluntly, we don’t understand them. We still don’t understand all the ramifications of Exxon Valdez, which was ‘just’ an oil spill off the Alaskan coast.”

PowerFul CollaBoraTion Another beneficial effect is how the DWH research was put together so that scientists from different areas were encouraged to collaborate. Guillette said in his past 30 years experience as a scientist, he has found the greatest discoveries take place at the interfaces of science fields.

When this kind of complex problem presents itself, that’s where the solutions will appear. The DWH spill is requiring people with different skill sets to work together to try and understand the impacts.

“Chemists can fractionate oil, but they can’t do what we do with those fractions in our engineered cells. By working together, we’re actually going to make much bigger discoveries, and that’s the model of the HML. All of the faculty members who are a part of the central mission of HML are, in fact, interested in that interface between environment and health. Whether it’s chemists, biologists, molecular biologists or managers who are trying to understand how you manage food or the other resources that the state is going to use, that’s how it all links together.

That’s the bigger picture.”

Spyropoulos agrees, noting the wealth of individuals with warehouses of data, samples and technology at HML. “There’s a huge amount of measurements on toxic exposures in different regions and sentinel organisms. I can go and talk to a host of HML partners involved in water, sediment and marine organism tissue acquisition, contaminant analysis and fractionation, and they can tell me what I need to know. For example, if organisms in those areas carry such contamination, I can go to HML partners that have been conducting health assessments on coastal dolphins and get cells from individual dolphins that have been tracked since 2005.”

Guillette said all these researchers are tied together by the marine environment, where sentinel organisms, such as alligators and dolphins, reveal important clues about human health and the growing field of epigenetics. It’s why a place such as HML, with such diverse groups, has such cohesion. They all are tied together by a similar mantra.

“The mantra that we always have is, ‘if it’s not healthy for this organism living out there, it’s probably not healthy for us. If it’s not healthy for their kids, it’s probably not healthy for our kids.’ Now, is it always a one-to-one relationship?

Of course not, but a red flag is a red flag. So if we’re seeing something going on in the environment, we have to ask is there something going on in ourselves?”

photo provided by NOAA

This mesocosm was used to test the effects of crude oil and dispersants on a simulated saltmarsh ecosystem.

Mesocosm targets treating future spills

Wetland destruction and pollution leave lasting legacies on salt marshes, so the first thought of researcher Michael H. Fulton, after the 2010 Deepwater Horizon (DWH) oil spill was to see what his “mini” marsh mesocosm would reveal about conditions in the contaminated wetlands in the Gulf of Mexico.

NOAA’s Environmental Sensitivity Index maps list salt marshes as the most vulnerable habitat in the Gulf of Mexico. Researchers at the Center for Coastal Environmental Health & Biomolecular Research at the Hollings Marine Lab undertook a mesocosm study to assess potential impacts of crude oil and dispersants in a simulated coastal ecosystem.

Fulton, Ph.D., a specialist in aquatic toxicology and physiology of marine organisms and faculty member in MUSC’s Marine Biomedicine and Environmental Sciences, said the use of chemical dispersants to mitigate oil spills has been a controversial issue for many years since dispersants do not reduce the amount of oil in the environment, but rather alter the chemical and physical properties of oil, which affects transport and possible bioeffects, he said.

“We saw that the oil plus dispersant caused more of an effect and was quicker to affect the water quality than the oil alone.

Reduced dissolved oxygen can lead to a negative impact on the health of a variety of species in the ecosystem.”

To see the full story about the mesocosm, visit MUSC News Center at www.musc.edu/ pr/newscenter/2014/HMLmesocosm.html.

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Dolphins’ well-being clue to human health B eyond the cuteness factor, bottlenose dolphins draw the interest of researcher Lori Schwacke for their role as a top level predator.

Schwacke, Ph.D., chief of Oceans & Human Health Branch of the National Oceanic and Atmospheric Administration (NOAA), began researching the health of bottlenose dolphins in the Gulf of Mexico following the Deepwater Horizon (DWH) oil spill.

Schwacke said the dolphin health assessments in the aftermath of the DWH were only possible because of the long-term research her team had been conducting to understand the health of marine mammals in coastal waters, and the factors that influence their health.

CoasTal

Though her group at the Hollings Marine Lab (HML) also does research with other marine animals, dolphins hold a particular allure for her.

“These dolphins are top level predators in coastal ecosystems in the Gulf, and the loss of a top level predator can have cascading effects within that ecosystem. Also, the health of the dolphins reflects the condition of the broader ecosystem. Our dolphin health research is critical so that we are not only prepared to assess the impacts of events, such as the DWH spill, but also so that we can understand effects of more gradual, but long-term environmental changes.”

HML researchers continued efforts in

See Dolphin on page 9

photo provided by NOAA

Dr. Jean Hermann takes a dental X-ray of a dolphin onboard the RV Megamouth during dolphin health assessments in Barataria Bay, Louisiana. To see the full story and HML’s annual report, visit www. musc.edu/pr/newscenter/2014/HMLdolphin.html.

Continued from Page One

together in a creative, scientific stew is the Hollings Marine Laboratory (HML), where they are all housed, and that they are part of MUSC’s Marine Biomedicine and Environmental Sciences program. The other unifying factor is the Deepwater Horizon (DWH) oil spill, aka BP oil spill, an event called one of the worst oil disasters in history. All of the groups, using their distinctive skill sets, are investigating the environmental effects of the spill that began April 20, 2010, in the Gulf of Mexico and was capped 87 days later. It impacted about 500 miles of the Gulf’s shoreline and caused approximately five million gallons of oil to gush into the Gulf.

Jeffrey King, Ph.D., HML’s acting director, said it’s amazing to have one event being looked at from so many different angles. “Who would have ever thought that there would have been so many unique individuals from all of our different partners working on the same project?” he said. “It speaks to what we have in the way of talented individuals with diverse skill sets and expertise. They were asked to be a part of something that was important to our nation at a time when things were getting out of hand and out of control.”

King said the National Oceanic and Atmospheric Administration (NOAA) looked to the National Centers for Coastal Ocean Science (NCCOS) to come up with solutions for a very difficult problem that was happening in the Gulf, knowing that it wasn’t going to be a quick fix. HML is one of five centers within NCCOS, and the laboratory hosts five primary research partners that include: NOAA, the National Institute of Standards and Technology (NIST), the South Carolina

Department of Natural Resources, MUSC, and the College of Charleston.“They understood this event was something we’d have to deal with for many years. We have to know what those long–term impacts are now. In fact, there are effects we probably won’t see for another 10 to 15 years.”

In what might seem to be a bureaucratic nightmare of partnering organizations, researchers find that’s not the case at all. HML provides a laboratory of collaboration and cooperation. It’s an environment Guillette, who has conducted research worldwide, has found nowhere else. Although the agencies may have different missions, the scientists working together can have the same mission: trying to understand how the environment influences the health of the organisms that live in that environment, he said.

“I’ve spent years doing environmental health.

I’ve never been at a place where more than one or two people were interested in what I was doing, intellectually. Here, there are 20 or 30 people interested, so the difference is astronomical.”

King agrees. He recalls bringing all the principle investigators together in spring 2013. The first agenda item had everyone introducing themselves and their work. “I swear we couldn’t make it around the table because people were already starting to ask questions and form partnerships. What was supposed to be an hour-long conversation became a 2.5–hour conversation filled with brainstorming on possible projects.”

The difference goes beyond the collection of intellectual capital, though.

King said HML has an unusual pool of partners.

Take NIST for example, which sets the gold standard in measurement, bringing to the table vast analytical capabilities. With a focus on the development of tools and very precise measurement that can be offered to other academic institutions, the federal government and other stakeholders, NIST sets important benchmarks with its rigorous standards.

“Because of NIST’s capabilities, you know that the technology, new methods, or resulting data have been tested and verified on many different levels. It gives the HML partners that one extra step of validation as our products and results go forward towards application,” he said.

Add to that base the extra dimension of having a medical university in the research mix, and it creates a synergy hard to find anywhere else.

“There’s no other entity such as HML that’s partnered with a medical university,” King said. “That’s the whole idea behind it. Back in the late ‘90s, the partner institutions were present at the Fort Johnson Campus, but they existed in their own individual buildings until former U.S. Senator Fritz Hollings, local stakeholders, the partners and the community recognized how valuable it would be to bring all these entities together under one roof,” he said.

“You can have a fisheries biologist working side by side with M.D.’s or Ph.D.’s who are investigating issues concerning human health. With these scientists working together, we can answer complex questions originating in estuaries and ocean–based environments, and link them to issues concerning human health and communities.”

The CaTalysT, Nov. 28, 2014 9

MUSC, Capella form new initiative Staff Reports Capella Healthcare and MUSC Health have announced the development of a clinically integrated network and a clinical affiliation agreement that will enable the organizations to partner to enhance the health and wellness of the families and communities they serve in South Carolina.

MUSC’s academic expertise and commitment to education and research, combined with Capella’s proven expertise in running community-based hospitals have come together to create a transformational opportunity with the formation of a regionally–based health care delivery network — Midlands HealthONE Network.

The clinically integrated network will enable partner facilities to share and better align resources to improve access to higher levels of care, jointly implement and monitor clinical protocols, and to collaborate on clinical workforce development and training to achieve the highest quality of care in the most efficient manner possible – all closer to home.

The strengths of both Capella and MUSC — serving those in need, training the next generation of health care professionals, and investing in quality improvement – are enhanced through closer alignment under the Midlands HealthONE Network.

Midlands HealthONE is preparing to launch in early 2015 with its first hospital, Carolina Pines Regional Medical Center, once it is officially part of the Capella network of hospitals.

“As a part of Midlands HealthONE, MUSC Health is proud to serve as Carolina Pines Regional Medical Center’s and the Midlands HealthONE Network’s preferred partner for complex tertiary and quaternary care, giving patients seamless access to care for these services when needed, and ensuring that as much care as possible is delivered close to where patients live and work,” said Patrick J. Cawley, vice president for clinical affairs and MUSC Health executive director and CEO. Benefits of the initiative include, but are not limited to: q Increased access to high–quality, advanced local care through affiliated hospitals; q Mutual development and sharing of clinical best practices; q MUSC Health–affiliated specialist and medical resident rotations at affiliated community hospitals; q Shared physician recruitment and placement efforts at affiliated hospitals; q Value–added advanced tele–health services including tele–stroke, tele–neurology and E–ICU services;

DolPhins Continued from Page Eight 2013 to assess injuries to dolphins in the Gulf of Mexico as a result of the DWH oil spill, expanding health assessment studies to include dolphins in Mississippi and Alabama waters in addition to the previously sampled dolphin population in Barataria Bay, Louisiana.

A dolphin health assessment study in 2011 led by HML researchers found that dolphins in Barataria Bay, an area that received significant and prolonged oiling from the DWH spill, suffered from a number of disease conditions. Barataria Bay dolphins showed symptoms of hypoadrenocorticism, consistent with adrenal toxicity previously described in experimental studies of mink exposed to oil. “Cortisol, produced by the adrenal gland, is essential for responding to stressful conditions.

Barataria Bay dolphins had abnormally low cortisol concentrations and this could ultimately lead to a number of complications and in some situations even death.”

The Barataria Bay dolphins also were five times more

A Letter to the MUSC Community, As the holidays approach, we all look forward to the season of gift-giving and celebrations. It is also a time when many employees seek guidance on how to appropriately handle gifts given to them by industry/ vendors without violating State and Institutional policies.

Please keep in mind that faculty, staff, students and trainees of the MUSC enterprise may not accept industry gifts of more than nominal value ($10; See Industry Relations Policy, http://preview.tinyurl.com/ me914vl). In the event that a company sends a gift Elliott of greater value, as is frequently the case during the holidays, then you may use the following guidelines: q You may remove any logos or branding from the item and place it in a communal area for your entire unit or department to share. q You may donate the item to MUSC Volunteer Services or to a local charity.

Thank you very much for all that you do to serve MUSC and the Charleston community. If you have any questions, please contact the Conflict of Interest Office (Mary Evelyn Armstrong at conflicts@musc. edu).

Regards, Bruce M. Elliott, M.D., Interim Vice President for Medical Affairs Chair, University Conflict of Interest Committee q Specialized training for local clinical staff through jointly developed and shared educational resources; and q Streamlined tertiary and quaternary referral processes when care cannot be best delivered locally.

“We are proud that they have chosen to partner with Capella and look forward to expanding the benefits of this unique partnership to other area providers by changing what’s possible, together.”

likely to have moderate to severe lung disease, sometimes characterized by lung masses.

The findings surprised them because of the severity of the disease in the animals.

The health assessment study was repeated in June 2013 to examine whether the health of Barataria Bay dolphins had improved. Researchers from the HML Genomics Core joined the collaboration and sampling was conducted to examine how gene expression profiles may differ among dolphins with different disease conditions.

New field–based techniques for dental examination, including radiographs, also were added.

Sampling also was expanded to include Mississippi and Alabama coastal waters, and improved satellite– linked tags were used to monitor dolphin movements for several months following their evaluation.

Laboratory analyses of samples and follow–up photographic monitoring in the study sites will continue in 2014, she said. The potential population–level impacts of the DWH spill are still being assessed, but the high

prevalence and severity of disease conditions and an ongoing rise in dolphin deaths in the northern Gulf of Mexico raise significant concern and suggest the need for continued monitoring, she said.

“This is the first peer–reviewed publication to come out on what we’re finding in the Gulf with regard to mammals following the DWH oil spill. We are seeing significant health issues in the dolphins,” she said.“The issues are consistent with the effects you might expect to see after exposure to oil. Particularly with marine mammals, which are long–lived species, if there are health effects, it may take years to fully quantify the ultimate impacts on survival and reproduction.”

That ties into work being done in other labs, such as that of MUSC researcher Louis Guillette, Ph.D. Schwacke, who is a part of MUSC’s Marine Biomedicine and Environmental Sciences program, said the HML collaborative environment is a scientific catalyst.

“Having someone down the hall who you can bounce ideas off of is fantastic.”

10 The CaTalysT, Nov. 28, 2014

The CaTalysT, Nov. 28, 2014 11

A letter to MUSC cemployees:

Furniture

Furniture

A-Queen Pillowtop that is King Size Plush Set Brand New in Plastic. Will take New, will sacrifice for $275 843-270-4283 $150. Please call 843-270-4283

Daisy

Continued from Page Two

Sandlin joins DAISY founder Tena Barnes. patient in Sandlin's care. Recognizing that the patient was afraid, Sandlin went out of her way to provide emotional support, Fields said. According to Fields, Sandlin also demonstrated exceptional clinical skill by catching some concerning lab work that might otherwise have gone unnoticed.

Fields went on to quote a letter from the wife of a patient for whom Sandlin had cared: “She [Sandlin] is an extraordinary,

knowledgeable, loving and caring nurse. I would venture to say she is certainly working in her calling.”

“She'll stick up for any of us,” Fields said of Sandlin, who is known as a “mama bear” on the floor. “She amazes me every day. No matter what kind of day she is having, her compassion for her patients, as well as her coworkers, is seen and felt.”

Overhearing the sentiments being shared, Dan Lehman, a patient on 5East, felt moved to step out of his nearby room and add his own thoughts.

“I've been in and out of hospitals for over 40 years,” he said. “The attitude of this hospital is completely different from

any I've ever been in. All the nurses here are great.”

In addition to a framed certificate, Sandlin received a DAISY award pin and a one–of–a–kind African sculpture, known as “A Healer’s Touch,” hand crafted by a member of the Shona tribe of Zimbabwe. Bearing the name of the carver on its base, each sculpture is created specially for a DAISY award winner as a personal expression of thanks.

“Eileen is an inspiration and mentor to me,” Fields concluded, as tears began to well up in Sandlin's eyes. “She is the most amazing nurse I know.”

Sandlin had recently nominated several others in her unit for the award and said she was very surprised at being chosen herself. “To know that someone thought enough about me to nominate me for it, it's overwhelming,” she said. “I'm so honored.

I'm so proud to be part of this unit and now proud to be part of this little group of nurses that get to wear that pin. The fact that my husband drove two hours to be here for it, and my girls are here — it just blows me away.

I'm so lucky to have such a supportive family. I couldn't do it without all these guys.”

MUSC strives to be a good neighbor and a responsible business partner to the surrounding Tricounty region. As one of the area’s largest employers, we understand the economic impact we have on South Carolina and the Lowcountry. Since much of our business is with the federal government, we strictly adhere to federal laws and regulations dealing with the workplace, including nondiscrimation.

The Office of Federal Contract Compliance Programs within the U. S. Department of Labor is responsible for ensuring that employers comply with the laws and regulations requiring nondiscrimination. OFCCP administers and enforces several legal authorities that require equal employment opportunity, including Executive Order 11246, as amended, and Section 503 of the Rehabilitation Act of 1973, as amended. These authorities prohibit federal contractors like MUSC and subcontractors from discriminating on the basis of race, color, religion, sex, national origin, disability, and protected veteran status.

Recent updates to these regulations have been made as they relate to the recruitment and employment of qualified individuals with disabilities.

These newly revised regulations, enforced by OFCCP, require us to do more outreach to try to increase the number of qualified individuals with disabilities in our workforce.

We are also required to report to OFCCP the number of qualified individuals that we are able to reach and hire.

Also, as a part of our statistics, current employees are invited to declare their current disability status (not specific disability). This can be done online via “MY RECORDS” at http://academicdepartments.musc. edu/hr/university/emp_corner/ records.htm for University employees or http://mcintranet.musc.edu/hr/

generalinfo/myrecords.htm for Medical Center employees, under the Personal Information Tab. Please complete the update no later than Dec. 31.

Why did OFCCP revise its Section 503 regulations?

OFCCP revised the Section 503 regulations to update and strengthen employers’ affirmative action and nondiscrimination responsibilities.

The framework articulating employers’ Section 503 responsibilities has been in place since the 1970s. However, both the unemployment rate of working age individuals with disabilities and the percentage of those that are not in the labor force remain significantly higher than for those without disabilities. A substantial disparity in the employment rate of individuals with disabilities continues to persist despite years of technological advancements that have made it possible for individuals with disabilities to apply for and successfully perform a broad array of jobs. In addition, we are finding more Section 503 violations during compliance investigations. This seems to indicate that the current compliance framework is not as effective as hoped.

Several factors contribute to limiting the ability of individuals with disabilities to seek, find, keep, and thrive in jobs.

The existence of an outdated framework that does not reflect the realities of today’s workplace or current disability rights law; the persistent unemployment and underutilization of individuals with disabilities; and certain institutional and process barriers are all limiting factors. These factors, and others, highlight the need for new regulations.

The information will not be shared and will be kept confidential, other than for reporting requirements.

Should there be any questions, please contact my office at 792-1568 or via email at bonaparw@musc.edu.

Sincerely, Wallace Bonaparte Director, Office of Equal Employment Opportunity and Affirmative Action Compliance

12 The CaTalysT, Nov. 28, 2014

heroes

retested every two years.

Whether he’s calming a little girl with lupus who shakes uncontrollably, providing a sense of caring for a young patient nearing the end of life, or alleviating anxiety in an agitated patient, Lucky is there for the patients and their families. Hoffman said, “He lies right by them. Most doctors and nurses want Lucky there.

I’m proud that we’ve been able to make such an impact in the lives of the patients and their families.”

Continued from Page Four

equipment, respirators, dialysis machines.”

Hoffman is proud of the fact that Lucky’s calm nature and dependability have earned him the respect of MUSC staff who have no hesitancy allowing Lucky to be present during any challenging situation, even in the ICU. According to nurses they have worked with, Hoffman and Lucky help elevate the level of care they are able to deliver by being present during these stressful times, calming the patients and caregivers.

Considered “a unique pair,” Lucky and Hoffman are able to work with a broader range of patients due to their level of experience and knowledge. Specifically, Hoffman has been able to help the Pediatric ICU better utilize pet therapy with sicker children by incorporating protocols from other hospitals and Centers for Disease Control and Prevention guidelines. Hoffman was called in to help revise MUSC’s Pet Therapy Policy.

The reason Lucky is requested so frequently, according to Kubu, is first because of his experience and predictably cheerful disposition, and secondly, because Al is an understanding, experienced and confident handler.” Hoffman worked in a hospital in Connecticut, as well as at a hospital in Virginia that is considered one of most advanced in the country as it relates to the use of therapy animals.

While patients love Lucky, and he lifts their spirits and helps them forget for a time what they are experiencing, Hoffman explained that therapy dogs are capable of so much more than what they are able to do at MUSC. Hoffman said, “At the hospital in Fairfax, they do some of most amazing things I’ve ever seen. I watched a dog coordinator call an 80–pound Labrador retriever up on the bed of a coma patient. Usually you see a dog lick someone’s hand, but this dog jumped on the bed and walked all over patient. Patients have been revived

Children’s Hospital Volunteer and Guest Services manager Melissa Kubu, left, congratulates Caroline DeLongchamps on her award.

MUSC captures six 2014 HealthCare Heroes Awards (2014 yields the most MUSC honorees to date) photos by Heather Woolwine, Public Relations

MUSC Therapy dog Lucky smiles for the camera.

Lucky has logged more than 1,100 hours since he started volunteering in February 2013. using this technique. At Duke, they had a therapy dog in the operating room as he could detect which particular anesthesia agents a little girl was allergic to.

Incredible.”

Hoffman and Lucky always make themselves available for MUSC patients and work days, nights and even weekends. It’s a labor of love for Hoffman, who volunteers his time to MUSC. Hoffman would like to see more advanced techniques utilized at MUSC and more dogs trained to be therapy dogs. He is in the process of collaborating with a trainer to start a Pet Partners - formerly known as Delta Society — school in Charleston and will serve as the dog evaluator. Lucky is the only Delta dog at MUSC and is

Donate toiletries for Helping Hands MUSC’s Surgery & Medicine Acute Critical Care Service Line is collecting items for Helping Hands of Goose Creek.

The group is accepting new and unopened hygiene items for the holidays and year round.

Items needed include toilet paper, shampoo, deodorant, toothbrush and toothpaste, shaving cream, feminine hygiene items and soap.

Drop off items to the donation box located at the first floor security desk, University hospital entrance.

For information, call 792-8897.

q Community Outreach —

Jimmy McElligott, M.D. Pediatrics q Health Care Professional — Caroline Delongchamps, Children’s Hospital q Nurse — Kahlil Demonbreun, DNP, College of Nursing q Physician — Michelle Hudspeth, M.D., Children’s Hospital q Service/Therapy Animal — Lucky, Children’s Hospital q Volunteer — Zion Thomas, Children’s Hospital