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Making A Difference
Innovative Approaches
to Concussion and
TBI Treatment
April
Issue 02
2023
Aviv Clinics
TBI & Post-Concussion Syndrome
Treating Long-Term Complications and Improving Quality of Life
Dr. Shai Efrati
Chair, Medical Advisory
Board of Aviv Scientific
Aviv Clinics
10 Specialized Traumatic
B
Injury Treatment
Providers 2023
Meeting Unique Needs
Personalized Treatment for
Concussion and TBI
08
Page No.
Editor’s
Note
raumatic brain injuries are a significant public
Thealth concern, and specialized traumatic brain
injury treatment providers play an important role to
help patients recover and regain their quality of life. As
technology advances, these providers find innovative ways
to improve patient outcomes and expand access to
specialized care.
One area of focus for specialized traumatic brain injury
treatment providers is using technology to enhance patient
care. Advanced neuroimaging techniques and specialized
tools for cognitive rehabilitation have significantly
improved diagnostic accuracy and allowed for more
effective rehabilitation and recovery. Telemedicine has also
made specialized care more accessible, mainly for patients
in rural or underserved areas.
Collaborative efforts between specialized traumatic brain
injury treatment providers and other healthcare
professionals have also played a vital role in improving
patient outcomes. By working together, these providers can
provide comprehensive care that addresses both physical
and cognitive impairments. Additionally, research
partnerships between providers and academic institutions
can lead to advancements in TBI treatment and improve
patient outcomes in the future.
However, despite the importance of specialized traumatic
brain injury treatment providers, access to these services
remains challenging for many patients. Barriers such as
cost, insurance coverage and geographic location can
prevent patients from receiving the necessary care. To
address these issues, increased funding and expanded
insurance coverage are needed to ensure all patients have
access to specialized traumatic brain injury treatment.
Therefore, specialized traumatic brain injury treatment
providers are crucial in helping patients recover from this
devastating condition. The use of technology and
collaborative care efforts have led to significant
advancements in TBI treatment, and continued innovation
in these areas will be key to improving patient outcomes in
the future. However, addressing barriers to access is crucial
to ensure that all patients can benefit from specialized
traumatic brain injury treatment.
Insights Care's latest edition, 10 Specialized Traumatic
Brain Injury Treatment Providers 2023, walks you
through the expertise and dedication of healthcare
professionals in providing specialized care and support the
patients need to overcome the challenges of this devastating
condition.
Hope you have an amazing read!
- Pooja Shah
The Vital Role of
Specialized TBI Treatment
Providers
Mitochon Pharmaceuticals
Channeling the Ability of Mitochondria
to Create Resilient, Protec ve Cells in
Neurodegenera on and Aging
26
32
40
18
Rehabilitation Institute
of Washington PLLC
Empowering Recovery,
Transforming Lives
Suicidal Ideation
among Youths in India
Ctts
The Barnes Firm
Personal Injury Attorneys
Advocates for Vic ms of Brain Injury
CXO
Aviv Clinics
TBI & Post-Concussion Syndrome
Cov
Sty
08
Trea ng Long-Term Complica ons
and Improving Quality of Life
Innova ve Approaches to
Concussion and TBI Treatment
Making A Difference
22
Aicl
36
Personalized Treatment for
Concussion and TBI
Meeting Unique Needs
Copyright © 2023 Insights Success Media and Technology Pvt. Ltd., All rights reserved. The content and images used in this magazine should not be reproduced or
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Reprint rights remain solely with Insights Success Media and Technology Pvt. Ltd. Insights Care is powered by Insights Success Media and Technology Pvt. Ltd.
April, 2023
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Editor-in-Chief
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Senior Editor
Anish Miller
Managing Editor
Pooja Shah
Assisting Editor
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Visualiser
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Tanaji Fartade
Description
Person name
Company Name
Aviv Clinics
aviv-clinics.com
Shai Efrati
Co-Founder and
Chairman of the
Medical Advisory
Board
Aviv Clinics’s number-one mission is to improve the
aging process by optimizing cognitive and physical
performance.
Brainwave
brainwave.org.uk
Joanne Freeman
Mkt
Brainwave is committed to helping children with
disabilities reach their potential through specialist Therapy
Programmes, delivered by qualified therapists
Baptist Health
baptisthealth.com
Kit Fullenlove
PR
The Baptist Health family consists of more than 400 points of
care, including outpatient facilities, physician practices and
services, urgent care clinics, outpatient diagnostic and
surgery centers, home care, fitness centers, and occupational
medicine and physical therapy clinics.
Mitochon
Pharmaceuticals
mitochonpharma.com
John Geisler
CSO
Mitochon Pharmaceuticals is a start-up biotech company
that focuses on developing drugs that target the
mitochondria for a host of serious diseases with
significant unmet medical needs.
National
Organization for
Rare Disorders
rarediseases.org
Lisa Sencen
MM
The National Organization for Rare Disorders, is an
independent patient advocacy organization dedicated to
helping individuals with rare diseases and the organizations
that serve them.
One Rehabilitation
Service
onerehabilitationservice.com.au
Megan Tan
Managing Director
One Rehabilitation Service provides rehabilitation and
disability services to people with brain injuries, stroke or other
neurological conditions.
NeuroRestorative
neurorestorative.com
Lisa Collins
CEO
NeuroRestorative is a leading provider of subacute and post-
acute rehabilitation services for people of all ages with brain,
spinal cord and medically complex injuries, illnesses and other
challenges.
Rehabilitation
Institute of
Washington
rehabwashington
Heather Kroll
MD
Rehabilitation Institute of Washington offers
comprehensive interdisciplinary rehabilitation for injured
workers with chronic pain and traumatic brain injury.
The Barnes Firm
Injury Attorneys
thebarnesfirm.com
Erica Burzynski
Marketing Director
The experienced personal injury attorneys at the Barnes
Firm Injury Attorneys focus on helping innocent victims
who have been injured in accidents.
The Children's Trust
thechildrenstrust.org
Michelle Lopez
MM
The Children's Trust’s ambition is for all children with
brain injury to have the opportunity to live the best life
possible.
10 Specialized Trauma c Brain Injury Treatment Providers 2023
Aviv Clinics
Treating Long-Term Complications
and Improving Quality of Life
TBI & Post-Concussion Syndrome
It is more likely for an athlete that has suffered a
head injury to quickly return to the game than an
athlete who has sprained an ankle.When a brain
injury happens, it is imperative that the person rest
and monitor their symptoms, just as they would
with a physical injury.When symptoms persist,
medical attention should be sought, and that’s
where Aviv Clinics steps in.
over
Story
C
Dr. Shai Efrati
Chair, Medical Advisory
Board of Aviv Scienti c
Aviv Clinics
Throughout time, scientific discoveries, new
understandings and inventions have allowed
humans new ways to heal, making them better and
stronger. With such dimensions of the scientific community
in general and the healthcare community in particular, the
human brain remains revered as the most complex,
mysterious and studied human organ through research and
development.
Aviv Clinics has run the scientific principle at the core of its
operations since 2017. Through its healthy brain
performance programs, the clinic performs individually
tailored treatments to help its clients heal from brain-related
digression or injury, while exceeding new levels of brain
and body function standards.
Through the leadership of Dr. Shai Efrati, the Chair of
Medical Advisory Board for Aviv Scientific, the clinic has
successfully treated over 10,000 clients under Aviv
protocols. Consequently, a majority of them have marked
an improvement in their cognitive function post-Aviv
treatment.
Challenges Faced due to Insufficient Oxygen and
Damage to the Brain
Most of the damage to the brain is ultimately caused by a
decrease in blood flow resulting from the injury. Decreased
blood flow means insufficient oxygen delivery to the
damaged tissue. In these situations, the brain cannot
properly heal on its own.
Brain injuries can be complex to diagnose without the
correct tools. The damage appears clearly in scans in
instances resulting in moderate to severe brain injury.
However, in cases where the damage is mild, the
anatomical scans show a “normal” brain which is
misleading. This can lead to misdiagnosis of the brain
injury or of the severity of the injury and create more
difficulties for the patient because the cause of their
symptoms is misunderstood.
It is not uncommon to see issues like irritability, anxiety,
difficulty focusing, memory problems, restlessness, and
more written off as behavioral conditions without
acknowledging a brain injury as the root cause. In these far
too frequent instances, people, including children, go
without proper treatment to address the brain injury
directly and are often prescribed medication for these
symptoms that they do not need.
Following a Three-Month Mark to Address Brain
Injury Due to Concussion
The benchmarks for recognizing symptoms of
damage from concussion or brain injury are
dependent on the patient. However, if physical
and cognitive functions have not recovered after
To accurately determine if post-concussion syndrome
is happening, the patient should seek an advanced,
high-resolution scan like Single Photo Emission
Computerized Tomography (SPECT) and MRI with
Diffusion Tensor Imaging (DTI).These tests are among
those done at Aviv Clinics, where our team of brain
experts are able to assess the extent of the injury and
create a plan to treat the damage in the brain, as well
as improve and enhance the patients’ overall cognitive
and physical performance.
10 Specialized Trauma c Brain Injury Treatment Providers 2023
Our research demonstrates that HBOT, when
administered with precise uctuations in oxygen
levels, can also induce angiogenesis and neurogenesis, the
development of new blood vessels and neurons in the brain.
Most importantly, our clinical work suggests that our
unique HBOT treatment can improve cognitive abilities,
including memory, learning, concentration, attention,
and decision-making, as well as quality of life,
even years after a brain injury.
three months following the injury, the patient is
experiencing what is referred to as a post-concussion
syndrome.
Some of the most common symptoms include physical
concerns like headaches, dizziness, blurred or double
vision, and light sensitivity, as well as behavioral
indications like problems with concentration and/or
memory, thinking or speaking more slowly, depression,
anxiety, and irritability.
In general, any symptoms that occur or persist after the
three-month period following the initial injury are signs that
further functionality testing is required. The three-month
mark is important because it is unlikely that these
neurocognitive functions will return to normal if they have
not already. At this point, a person should visit an
experienced brain clinic, like Aviv Clinics, to get the best
possible diagnosis and treatment.
“To accurately determine if post-concussion syndrome is
happening, the patient should seek an advanced, high-
resolution scan like Single Photo Emission Computerized
Tomography (SPECT) and MRI with Diffusion Tensor
Imaging (DTI),” suggests Dr. Efrati.
He adds, “These tests are among those done at Aviv Clinics,
where our team of brain experts is able to assess the extent
of the injury and create a plan to treat the damage in the
brain, as well as improve and enhance the patients’overall
cognitive and physical performance.”
An Alarming Discovery by Dr. Efrati
Underdiagnosis occurs because medical professionals are
not conditioned to look at the brain to solve the problem at
the source, especially in youth patients. When children are
brought into the emergency room or the physician’s office,
their symptoms are typically written off as other conditions
without consideration of post-concussion syndrome.
In a recent study conducted by Dr. Efrati, alongside his
colleagues – they explored the diagnosis of post-concussive
syndrome in children. By comparing children who had been
admitted to the emergency room for head injuries to a
control group of children who visited the ER because of
wrist fractures, they found that 25% of those who had
suffered a head injury reported post-concussion symptoms
months or even years later, while just over 2% of the
control group did.
After evaluating each child’s electronic medical records,
Dr. Efrati and his colleagues determined that none of
the pediatric patients with persistent post-concussion
symptoms were categorized or diagnosed. The
diagnosis was missed more often than not in these
children with brain injury – which is an alarming
discovery.
Awareness can be supported with appropriate
solutions, starting with implementing proper
screening guidelines, including brain scans. “It
also comes down to treating the wound. Wounds
It also comes down to treating
the wound.Wounds in the brain should be
treated as any other wound on the body.We are
too quick to diagnose brain wounds in children
as psychological issues rather than as a result
of brain injury.
in the brain should be treated as any other wound on the
body. We are too quick to diagnose brain wounds in
children as psychological issues rather than as a result of
brain injury,” states Dr. Efrati.
Treating Brain Health in the Same Way as Physical
Health
When a brain injury is left untreated, a person’s overall
functionality declines over time, and s/he cannot live life
the way s/he used to. The overall quality of life is at risk, as
well as independence and cognitive function.
People with persistent post-concussive symptoms can be
impacted in many ways. Some will struggle to think clearly
or have memory issues. Some will be unable to sleep, while
others will constantly be fatigued and sleep 12 hours a day
or more. They can have pain, headaches, vision problems
and emotional and psychological symptoms, all of which
can inhibit their work, school and interpersonal
relationships.
“It’s important that brain health is treated the same way as
physical health is treated. But right now, that is not
happening,” puts Dr. Efrati.
He shares a good example of how concussions are handled
in athletes. He notes, “It is more likely for an athlete that
has suffered a head injury to quickly return to the game
than an athlete who has sprained an ankle. When a brain
injury happens, it is imperative that the person rest and
monitor their symptoms just as they would with a physical
injury. When symptoms persist, medical attention should be
sought, and that’s where Aviv Clinics steps in.”
Healing Damage and Achieving Peak Performance – An
Objective
Aviv Clinics is a place that is committed to its goal of
providing patients with the best quality of care to heal
damage and achieve peak brain and body performance. In
order to attain its objective, Aviv considers the full health
picture of each patient. Aviv’s world-class team of
physicians, dietitians, neuropsychologists, physiotherapists,
and clinical staff remains the priority.
From start to finish, Aviv’s medical program starts with a
pre-assessment, which includes an extremely thorough
physical assessment, cellular testing, a cognitive evaluation
and high-resolution brain imaging, which can include an
MRI, SPECT scan, or a combination of both. Based on the
results, Aviv’s team of mulit-disciplined clinicians
determine whether the patient is a suitable candidate for
the program. For those who are, their individual needs
will be addressed in a tailored treatment protocol, which
can consist of cognitive therapy, nutritional coaching, a
physiotherapy program and Hyperbaric Oxygen
Therapy (HBOT).
The treatment helps to revive the damaged tissue
from traumatic experiences that affect the brain by
increasing the supply of oxygen to those areas.
“Our research demonstrates that HBOT, when
administered with precise fluctuations in oxygen
levels, can also induce angiogenesis and
neurogenesis, the development of new blood
vessels and neurons in the brain. Most
importantly, our clinical work suggests that
our unique HBOT treatment can improve
cognitive abilities, including memory,
learning, concentration, attention, and
decision-making, as well as the quality of
life, even years after a brain injury,”
concludes Dr. Efrati.
352-750-2848 | info@aviv-clinics.com aviv-clinics.com
"We can't help you."
It's a heartbreaking phrase that Linden Perry and her mother
Carissa heard repeatedly from doctors who couldn't treat Linden's
post-concussion symptoms.
Their concussion journey began with a seemingly minor bump on
the head at a soccer practice and a fall the next week playing
basketball. Carissa anxiously watched Linden's symptoms grow
from dizziness, nausea and light sensitivity to difficulty
concentrating, short term memory issues and double vision.
Even after a few weeks, Linden didn't feel better. She was unable
to pass the cognitive tests needed to return to sports. Worse, she
began to struggle in school, something uncommon for the
advanced placement honors student.
Soon, visiting medical specialists became a full-time job for
Carissa and Linden. Linden was seeing a neurologist, an
ophthalmologist, a chiropractor and a neuro- ophthalmologist
while also undergoing vestibular rehab, occupational therapy and
vision therapy, often with multiple appointments in a single day.
Yet improvements were minimal at best. Doctors suggested that
there may not be an answer for Linden, and recommended
therapy and antidepressants.
"She stopped believing she was ever going be who she was
before," Carissa explains. "That's really hard as a parent to
watch."
A family acquaintance with connections to the NFL suggested
that they contact Dr. Joseph Maroon, the team neurosurgeon for
the Pittsburgh Steelers and a specialist in concussion prevention
and treatment. After Dr. Maroon told Carissa about Aviv Clinics,
mother and daughter made the decision to enroll Linden in home
school so they could travel to Florida for a 12-week treatment
program.
Linden's customized Aviv Medical Program included physical
therapy, cognitive training and nutritional coaching, all with
expert clinicians. She also spent two hours a day with other Aviv
clients in a unique hyperbaric oxygen suite, making new friends
while working to recover the areas of her brain that were
damaged.
With her balance back to normal, her headaches and brain fog
dissipated, and her vision improved, Linden was back on the field
with her teammates within days of completing the Aviv Medical
Program. She is excited to re-enroll in school in the fall, and is
thrilled to finally feel like herself again.
Mitochon
Pharmaceuticals
Channeling the Ability of Mitochondria to Create
Resilient, Protective Cells in Neurodegeneration and Aging
Mitochon Pharmaceuticals was launched in
November 2014 with joint seed money from
Ben Franklin Technology Partners and private
investors. Mitochon was founded by Robert Alonso, MBA,
and John Geisler, Ph.D., with the goal of creating disease-
modifying treatments for a variety of neurological
conditions with unmet medical needs, such as ALS,
Huntington's disease, and traumatic brain injury (TBI). The
thesis of Mitochon's approach is that if you bolster
mitochondrial health through a mechanism known as
mitochondrial uncoupling, meaningful pro-survival benefits
occur and brain cells are protected from damaging disease
processes.
Dr. Geisler's post-doctoral work at Pfizer and Yale
University in metabolic disease, taught him that there are
master switches (proteins to target with medicines) that can
have a profound effect on disease progression. This
knowledge became the theme of his subsequent work in
drug discovery working at the roots of problems. By
removing fat from the liver and muscle cells that cause
insulin resistance, the aim was to wean individuals off the
insulin and cure their diabetes.
Under the leadership of John G. Geisler, Chief Scientific
Officer and Co-founder, Mitochon is working on
developing two drugs, MP101 for rare diseases (orphan
indications) and MP201 for larger markets such as
Alzheimer's, Parkinson's, TBI, etc. MP101 has ongoing
clinical studies now, whereas MP201 is just starting the
GLP toxicology studies to work towards an FDA-approved
open IND.
Below are highlights of the interview that give insights
about Mitochon Pharmaceuticals' work resolving major
health complications with the help of modern technological
advancements.
What are the core values that Mitochon
Pharmaceuticals stands by? What is its mission and
vision statement?
Coming from working at a number of pharmaceutical
companies, I think that there are two major themes we
established at Mitochon.
1) We have "no silos" in that we go after any indication
(neuro, cancer, pulmonary, pain, ataxia, muscular
dystrophies, trauma, etc.) as long as it is rooted in
mitochondrial dysfunction and truly an insidious (time-
sensitive) diseases.
2) We are not worried about how big the market is for the
indication we are pursuing; rather, we want to fill a need for
doctors to help their patients. For instance, my expertise is
diabetes and obesity, but we have not pursued these
indications as there are a lot of medicines to treat these
diseases, but there is a great need in neurodegeneration in
areas such as ALS, Huntington's disease, MS, TBI,
Parkinson's disease, Alzheimer's disease, etc. We are keenly
interested in this area because our platform appears to be
pan-neuroprotective by modulating the entire mitochondrial
physiology of this organelle, which is central to the health
of all cells.
How is your company incorporating advancing
technology in providing the Concussion and TBI
treatment to further customer reach as well as chart its
growth upwards?
Mitochon's concerns with TBI is that "today's concussion
patient often becomes tomorrow's dementia patient." It may
appear bleak, but there is a real link with aging, and a need
for an early- immediate treatment that is brain penetrant and
10 Specialized Trauma c Brain Injury Treatment Providers 2023
April 2023
18|www.insightscare.com
quiets down the mitochondria post-trauma. After trauma,
the cells are under enormous stress that sets up programmed
cell death through the mitochondria, which requires
immediate attention, not only from the area of direct impact
but also from the neighboring cells under attack that I call
the "threatened tissue." There is also a need for those who
don't get treatment, but are now older and need a treatment
to push-off dementia. One of our first studies was in a
model of Alzheimer's Disease (AD) with 4 months of
treatment with Mp101.
This proof-of-concept study was critically important
because it showed that this oral once-per-day treatment
enhanced cognition, as the AD mice learned faster to find
the hidden platform in the Morris Water Maze, and when
the platform was removed for the final exam, they became
obsessed for three days with where it used to be. Loss of
short-term memory is the hallmark of AD and arrows are
pointing at the mitochondrial dysfunction as an early
Mitochon's concerns with
TBI is that "today's concussion
patient often becomes tomorrow's
dementia patient." It may appear
bleak, but there is a real link
with aging, and a need for
an early-immediate treatment
that is brain penetrant and
quiets down the mitochondria
post-trauma.
John G. Geisler
Chief Scientific Officer
and Co-founder
Mitochon Pharmaceuticals
April 2023
19|www.insightscare.com
up-stream event triggering progression. Therefore,
resolving this dysfunction with our mitochondrial specific
drugs, MP101 or MP201, they may curb subsequent
memory loss and perhaps even enhance cognition!
Because of this combination of the work in AD and TBI, it
has helped secure joint funding from the BrightFocus
Foundation, specialized in AD research and Medical
Technology Enterprise Consortium (MTEC), military
focused, to look closer at an issue particular to the military
population that largely goes unnoticed by the civilian
population, namely the damage caused by repetitive blast
wave trauma.
When a soldier throws a hand grenade, breaches a wall, or
pulls the trigger on a howitzer, there is a shock wave of air
that penetrates the organs, spinal fluid up to the brain, the
ears, eyes and lungs, and rattles the whole brain, causing
initially mild damage, but more penetrating and lasting
issues with repetition. However, we also have TBI work in
what we call "classical" TBI, which looks more like a car
crash or clunk on the head. Acute head injury is associated
with very high mitochondrial-derived free radical
production that damages proteins, lipids and chromosomes
and toxicity due to calcium overload that causes cell death
(apoptosis).
Mitochon's objectives are to complete GLP toxicology
studies with our second drug, MP201, with enhanced
pharmacology and to begin clinical studies for TBI at
trauma units in all major cities across the United States. We
will also seek approval to conduct clinical studies on
military patients who have experienced repetitive blast
wave trauma. This can significantly impact the field for
optimal outcome measures during an unfortunate event by
providing soldiers an immediate delivery of an injectable
MP201 formulation in remote locations, while buying time
to get transported to a clinical unit.
What are the key products and services of the company,
and how is it impacting the demographic concerned?
Mitochon is in Phase I clinical studies now in the USA with
MP101 and gearing up for a Phase I/IIa "basket study" in
Europe scheduled for the summer of 2023 in three different
indications: ALS, MS and Huntington's disease, but
uniquely all treated with MP101 as one indication. Most, if
not all, neurodegenerative diseases have a central issue that
is rooted in mitochondrial dysfunction, and MP101 appears
to resolve this problem. In fact, not only neurodegenerative
diseases, but we are finding that many diseases (cancer,
heart, pulmonary, intestinal, etc.), in general, appear to have
mitochondrial dysfunction.
Dr. Geisler grew up in St. Clair Shores, a suburb of
Detroit, Michigan. After graduating from Michigan
State University with a B.S. in biochemistry, he took a
job to get his "sea legs," first as a technician at Abbott
Laboratories in Diagnostic Discovery in Chicago for 5-
year-olds, before returning to graduate school for a
Ph.D. in genetics at Oak Ridge National Laboratories
(ORNL) from the University of Tennessee.
A dueling postdoctoral fellowship at Pfizer (Groton)
and Yale University pulled Dr. Geisler into applying his
skills to metabolic disease and his interests in whole
body flux. Isis (now Ionis) San Diego recruited him for
drug discovery and the inception of new targets
starting at the mRNA level with this platform based on
antisense oligonucleotides (ASOs). Much of the focus
was on targeting fat transporters to attempt to
partition fat out of the liver.
Subsequently, Dr. Geisler was recruited to join the
newly established diabetes team at Johnson &
Johnson Pharmaceutical Research and Development
(JnJ PRD) in Spring House, PA. Much of the work at
JnJ was in small molecules, but from the prior work at
Ionis, he was pulled into a new collaboration with JnJ
and Ionis using ASOs for diabetes targets. The
overarching theme of Dr. Geisler's work was to push
for "disease modifying" therapies vs. "incremental"
medicine. Raised in a family of five siblings on a
modest means, by parents who grew up during the
Great Depression, served in WWII, and worked hard,
whom themselves came from Swiss/German
immigrants, inspired Dr. Geisler not to squander the
gifts provided and push the boundaries with the time
provided of finding meaningful medicines. This is what
he believes is the essence of Mitochon. The idea may
appear unorthodox, but the pharmacology is spot-on
physiologically.
About the Leader
About the Leader
April 2023
20|www.insightscare.com
What, according to you, are the challenges faced in
supplying specialized services in the industry you are
serving? How is the company, with your able guidance,
turning them into opportunities?
Mitochondria are in all cells, and there are thousands per
cell. As you age, the population moves from being
homogenous to being heterogenous, or, as we like to say,
mosaic. Some mitochondria produce a lot of energy (ATP)
and low amounts of free radicals that can damage DNA,
proteins, and lipids. In contrast, other mitochondria produce
low amounts of ATP, but are high producers of damaging
free radicals. Our drugs are unique in shifting the
mitochondrial population from mosaic to homogenous.
Since the health of the mitochondrial “population” is
critical for the health of the cell in this symbiotic
relationship, our platform appears to be beneficial for a host
of diseases.
As an experienced leader, what advice would you like to
give to aspiring entrepreneurs and enthusiasts who wish
to venture into the competitive industry that you are
serving?
Young scientists will accumulate knowledge from reading
literature, hands-on experiments that are successful and fail,
and from colleagues, mentors and conferences. These
acquired experiences then propel you toward the formation
of new, original ideas of your own. You have to know when
your ideas have merit, even though others may tell you they
do not. Papers from high impact-factor journals and
"thought leaders" can be complete rubbish, establishing
scientifically untrue dogmas that move the direction of
research for 10–20 years in the wrong direction. So it
becomes tricky to get off that track and back onto the
direction of science again.
Working in big pharma taught me that there are a lot of
decisions made on the direction of research that have
nothing to do with science. If leadership is selling you on
what can and cannot be done, determine if it is rooted in
science or other things like risk adversity, politics, a lack of
sophistication, knowledge or all of the above. If you are in
"discovery", the inception of new ideas, it is critical that the
tone of the team's brainstorming sessions be inviting for
everyone in the room to share ideas, especially for the
brilliant, but more reserved minds. There is a great benefit
to initially working for big companies. So, go to big
companies to learn about the industry, but know when it is
time to leave if you are pushed to bury your ideas or work
on incremental projects. You don't want all of your time
absorbed with nothing to show, and we need really fresh
minds working on the hard stuff that are inspired. Question
everything, read a lot, mull over ideas often, and stay on
track to enable your ideas!
What are the future goals of your company and how has
it envisioned to scale its operations and reach in 2022
and beyond?
Our immediate goals are to complete Phase I in humans and
get into all the proof-of-concept studies in patients with a
host of diseases to open the box completely. We need to
complete the MP101 long toxicology package to get into
critical long-term chronic studies for patients with ALS,
Huntington's, etc. These are all very expensive studies, so
we are looking for investors to help us accelerate these
programs and others.
We are excited about some new work in cystic fibrosis
(funded by Emily’s Entourage) that appears to be promising
and will hopefully lead to a clinical study. The ongoing
work in TBI (severe head concussions) is quite robust in
that we have projects focused on classic TBI at the
University of Kentucky and Children's Hospital of
Philadelphia (CHOP). Still, we also have blast wave trauma
research focused on the brain, eyes and hearing. This
research involves MP201, a slow-release drug similar to
MP101. Our goals are to complete the preclinical packages
and the GLP toxicology work to get an FDA-approved open
IND to subsequently test patients with severe concussions.
Of course, the ultimate goal is to obtain FDA approval for
these drugs as a once-daily oral drug that activates
compensatory pathways for survival as a disease-modifying
agent for truly insidious diseases.
April 2023
21|www.insightscare.com
Concussion
and TBI Treatment
Innovative
Approaches to
oncussions and traumatic brain injuries (TBI) are a
Cgrowing concern worldwide, with an estimated 69
million cases occurring annually. While most
people recover fully from a concussion or mild TBI, others
may experience long-term effects that can impact their
quality of life. Innovative approaches to concussion and
TBI treatment are helping to address this issue, offering
new hope for patients and their families.
Let's understand in detail the various innovative
approaches!
Virtual Reality Therapy
Virtual reality therapy is an innovative approach to
concussion and TBI treatment that uses technology to create
immersive environments that can help patients recover. This
therapy works by stimulating the brain in a way that can
promote healing and improve cognitive function.
Virtual reality therapy can be used in several ways. For
example, patients may be immersed in a virtual
environment that simulates real-world experiences, such as
walking in a park or driving a car. This can help patients
regain cognitive and physical abilities that may have been
lost due to their injury. Virtual reality therapy may also
simulate cognitive tasks, such as memory games or
problem-solving exercises, to help patients regain cognitive
function.
Virtual reality therapy is effective in improving cognitive
function in patients with TBI. A recent study found that
Making A Difference
April 2023
22|www.insightscare.com
April 2023
23|www.insightscare.com
patients who received virtual reality therapy significantly
improved their cognitive function compared to traditional
therapy. Virtual reality therapy may also be more engaging
and enjoyable for patients, making it a more effective
therapy overall.
Neurofeedback
Neurofeedback is another innovative approach to
concussion and TBI treatment that uses technology to
promote healing and improve cognitive function. This
therapy gives patients real-time feedback about their brain
activity, allowing them to learn how to control their
brainwaves and improve their cognitive function.
During a neurofeedback session, patients wear a cap with
sensors that measure their brainwaves. The information is
then displayed on a computer screen in real-time, allowing
patients to see how their brainwaves change. Patients can
then learn to control their brainwaves using relaxation,
visualization and mindfulness techniques.
Neurofeedback is effective in improving cognitive function
in patients with TBI. A recent study found that patients who
received neurofeedback significantly improved their
cognitive function compared to traditional therapy.
Neurofeedback may also be more engaging and enjoyable
for patients, making it a more effective therapy overall.
Hyperbaric Oxygen Therapy
Hyperbaric oxygen therapy (HBOT) is an innovative
approach to concussion and TBI treatment that involves
breathing pure oxygen in a pressurized chamber. This
therapy can help improve cognitive function and promote
healing by increasing oxygen levels in the brain.
During an HBOT session, patients breathe pure oxygen
while lying in a pressurized chamber. This increases the
amount of oxygen in the blood, which can help promote
healing and improve cognitive function.
HBOT is effective in improving cognitive function in
patients with TBI. A recent study found that patients who
received HBOT significantly improved their cognitive
function compared to traditional therapy. HBOT may also
help reduce inflammation in the brain, which can contribute
to long-term effects of TBI.
Functional Medicine
Functional medicine is an innovative approach to
concussion and TBI treatment that focuses on the
underlying causes of a patient's symptoms, rather than just
treating them. This approach considers the patient's unique
medical history, lifestyle factors and genetic makeup to
develop a personalized treatment plan.
Functional medicine may involve a combination of
therapies, such as diet and nutrition counseling,
detoxification and lifestyle changes. By addressing the
underlying causes of a patient's symptoms, functional
medicine can help improve overall health and reduce the
risk of long-term effects of concussion and TBI.
Conclusion
Concussions and TBI are serious injuries that can long-term
affect a patient's cognitive and physical abilities. However,
innovative concussion and TBI treatment approaches, such
as virtual reality therapy, neurofeedback, hyperbaric oxygen
therapy and functional medicine, offer new hope for
patients and their families.
These innovative therapies use technology and a
personalized approach to promote healing, improve
cognitive function and reduce the risk of long-term effects.
Virtual reality therapy and neurofeedback use technology to
provide patients with engaging and enjoyable therapies that
effectively improve cognitive function. Hyperbaric oxygen
therapy increases oxygen levels in the brain to promote
healing and reduce inflammation. At the same time,
functional medicine takes a personalized approach to
address the underlying causes of a patient's symptoms.
As research into concussion and TBI continues, even more
innovative treatment approaches will likely be developed.
However, these current therapies offer new hope for
patients who may have previously had limited options for
treatment.
It is important for patients and their families to work closely
with healthcare providers to determine the best course of
treatment for their individual needs. By taking advantage of
innovative concussion and TBI treatment approaches,
patients can improve their cognitive and physical abilities,
reduce the risk of long-term effects and enhance their
quality of life.
-Pooja Shah
April 2023
24|www.insightscare.com
Heather Kroll
MD
Rehabilita on Ins tute
of Washington PLLC
Rehabilitation Institute
of Washington PLLC
Empowering Recovery, Transforming Lives
When caring for a patient recovering from
traumatic brain injury, patient-centeredness and
compassion is the key. At the Rehabilitation
Institute of Washington PLLC—a leading provider of
specialized traumatic brain injury (TBI) treatment—the
team of clinicians and specialists strive to understand
the patients' experience of TBI, their journeys and
the biological, psychological and social factors that
are involved in shaping their experience. The
team works tirelessly to create a personalized
treatment plan that would help patients regain
their independence and improve their quality
of life.
Recovery is progress that takes time. Thus, at RIW, not only
are the patients supported in their recovery journeys
through the latest evidence-based therapies and cutting-
edge technologies, but their pain, frustration and
disappointment are also acknowledged in a way that they
feel heard and experience a sense of hope.
Through its commitment to innovation, patient-centered
care and excellence in clinical practice, RIW has earned a
reputation as a premier provider of TBI rehabilitation
services in the region, improving the lives of countless
patients and their families.
In an interview with Insights Care, Heather Kroll, MD
talks about RIW's commitment to helping patients recover
from traumatic brain injuries and improve their quality of
life. She emphasizes its focus on providing patients with the
tools and resources they need to regain their independence,
while "transforming lives" which speaks to the profound
impact that RIW's work can have on patients and their
families.
Following are the excerpts from the interview:
Kindly, brief us about your company and its inception.
Rehabilitation Institute of Washington PLLC specializes in
the comprehensive rehabilitation of injured workers with
traumatic brain injuries, post-concussion syndrome and
chronic pain from musculoskeletal or neurological injuries.
The Institute was founded in 2005 when a core group of
providers left a large medical center in Seattle after our
multidisciplinary program was discontinued. We loved
helping those with disabilities return to active and
productive lives and community stakeholders valued the
care we provided.
We are dedicated to
providing compassionate,
pa ent-centered, and
cost-effec ve care of the
highest quality. We offer
comprehensive interdisciplinary
treatment programs for those
with complex disabili es,
but also strive to provide
less intensive, focused care
when that is sufficient to
resolve a problem.
10 Specialized Trauma c Brain Injury Treatment Providers 2023
April 2023
27|www.insightscare.com
Three months after leaving the medical center, we opened
the Institute and were immediately busy. Since then we
have grown, expanded services, and moved to a larger
facility.
Please tell us about yourself and your professional
journey so far.
Initially, I brought a love of movement (dance) and science
together into a physical therapy career. After eight years as
a physical therapist treating adults and children with
neurological injuries, I entered medical school, choosing
physiatry to continue helping people improve their function
and their lives. (After a going away party from my physical
therapy job, my fellow therapists talked about how I would
build "Heather's House of Health"). After completing
medical school and Residency in Rehabilitation Medicine at
the University of Washington School of Medicine, I became
an attending physician in Rehabilitation Medicine at UW
and another medical center working in multidisciplinary
pain clinics.
While I had not taken the "Heather's House of Health" idea
seriously, an opportunity arose when I and Dr. James Moore
partnered to start the Rehabilitation Institute of Washington,
PLLC. Our goal was to form a free-standing rehabilitation
center providing multidisciplinary care for people with
disabilities.
Over the last nearly 20 years, as the organization grew, I
have had the privilege to work with and learn from, an
amazing team of professionals to provide comprehensive
care for people with concussions, more serious brain
injuries, long COVID-19, musculoskeletal injuries, and
chronic pain. I have been particularly pleased to have been
able to explore ways of educating each patient about their
health, their body and their brain to empower them to make
meaningful changes in their lives.
What are the core values that the organization stands
by? What is its mission and vision statement?
We are dedicated to providing compassionate, patient-
centered and cost-effective care of the highest quality. We
offer comprehensive interdisciplinary treatment programs
for those with complex disabilities but also strive to provide
less intensive, focused care when that is sufficient to resolve
a problem.
At RIW, we pledge to provide the highest quality
rehabilitation to assist patients to maximize function in all
areas of life; physical, emotional, occupational, recreational
April 2023
28|www.insightscare.com
and social, and to provide unparalleled customer service to
gain the respect and trust of our patients, referral sources
and payers of services.
How is your company incorporating advancing
technology in providing the Concussion and TBI
treatment to further customer reach as well as chart its
growth upwards?
We use telehealth services to improve accessibility and
generalization of rehabilitation into the home environment.
We provide practice with tools to support cognition
including phone apps, calendars, alarms, screen trackers,
dictation tools, and notetaking devices like smart pens.
Accessibility features are also used to improve access to
these tools.
Computerized cognitive activities like Attention Process
Training III are also used to support metacognitive
awareness. These tools provide practice opportunities when
engaged in metacognitive strategy training before
transitioning the strategies to more complex functional
activities. ImPACT computerized cognitive testing will be
used in concussion screening.
What are the key products and services of the company
and how is it impacting the demographic concerned?
The unique service we provide is comprehensive
interdisciplinary rehabilitation. Under one roof we
provide integrated, collaborative care from physicians,
neuropsychologists, speech-language pathologists, physical
and occupational therapists, and vocational rehabilitation
counselors.
Current standards for cognitive rehabilitation support
metacognitive strategy implementation focused on
functional tasks. Collaboratively defined goals and
treatment plans specific to each individual are developed.
Massed practice of specific skills allows meaningful
reintegration into the community.
What, according to you, are the challenges faced in
supplying specialized services in the industry you are
serving? How is the company, with your bale guidance,
turning them into opportunities?
One challenge is education. Many misconceptions about
TBI, particularly mTBI/concussion, exist, even within the
medical community. Patients may not understand their
recovery process or may get conflicting messages about
recommendations for recovery. To support community
education, RIW has partnered with community outreach
programs like BIAWA to support community education.
Additionally, RIW trains students from local universities
across disciplines to improve their understanding of TBI.
Another challenge is reimbursement. Stakeholders may not
understand the benefits of intensive multidisciplinary care
when faced with the cost outline. To improve access to
services to reduce disability, RIW is developing acute and
subacute concussion programs to provide an abbreviated
form of the expert services provided by the Brain Injury
Rehabilitation Program.
What are the future goals of your company and how has
it envisioned to scale its operations and reach in 2023
and beyond?
We want to make our services available to more
individuals. Because funding for comprehensive
rehabilitation is not always available, we are developing
more focused treatments to provide help for those with
persistent symptoms or disabilities.
Give us a few testimonials from your clients or
customers, and awards or recognition that accurately
highlight your company's position in the market.
I have been greatly blessed and humbled by the way the
RIW team goes to great lengths to create an environment
for healing. To be witnessed and guided through such an
integrative program along with others who are also in
recovery is an experience I won't soon forget. I'm taking the
tools and strategies I learned here into the rest of my life."
- Tiana P.
April 2023
29|www.insightscare.com
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SUICIDAL
IDEATION
AMONG
YOUTHS
IN
INDIA
– Priscillia Stephen U.
April 2023
32|www.insightscare.com
ife is full of uncertainties; youths must be cautious
Labout the amount of danger to which they expose
themselves. There are several determinants that
could combine to influence suicidal ideation among youths.
They include psychiatric, physical, social and familial
determinants, self-esteem, school stress, autonomy, affairs,
vulnerability, impulsivity, and thrill-seeking activity. Youths
are particularly vulnerable to suicide on account of their
emotional immaturity and temperamental instability; rapid
additions to knowledge, intense competition, examinations,
and poor results expose students to tremendous stress and
trigger off depression. Often, high expectations of parents
can frustrate them and add to their depression if they are
unable to live up to these expectations.
Awareness At School and Media Can Help:
Suicidal prevention through awareness among youths is,
therefore, a high priority, given the fact that in many
regions, most people in this age group attend school; this
appears to be an excellent place to develop appropriate
preventive action.
Need for Active outreach and traditional and public
campaign to promote mental health and reduce distress
is necessary, especially for youths with a history of
psychiatric disorder or previous suicidal attempts.
According to WHO, suicide is the fourth leading cause of
death among those aged 15-29; more than 700 000 people
die due to suicide every year. 77% of global suicides occur
in low-and-middle-income-counties (LMIC) like India,
among the other 218 countries. A prior suicide attempt is
the single most important risk factor for suicide in the
general population. Ingestion of pesticides, hanging and
firearms are among the most common methods of
suicide globally.
Suicide Rate in India, 2021
In India, according to the National Crimes Record
Bureau (NCRB), in 2021, 1,65,033 suicides were reported,
and more than 1.39lakh Indians died by suicide in the year
2019, 67% of which were youths (93,061). Compared to
2018 numbers were (89,407). Youth suicide in India has
risen by 4%. The overall suicide figures rose by 3.4 % at the
same time. Hanging was found to be the most common
method of attempting suicide. Around 74,629 people
hanged themselves in the year 2019.
The Cause of Suicide in India, including Covid-19
Stressors
Further reports by NCRB reveals that family issues, love
affairs, drug abuse and mental illness (and recently is,
COVID-19 Stressor) appear to be the top cause of suicide
among youths in India. Major variations are noticed across
India, probably related to reporting practices. In 2022
Maharashtra reported the most suicide cases at 22,2027,
followed by 18,925 suicides in Tamil Nadu and 14,965
suicides in Madhya Pradesh, all accounting for 50.4% of
the total suicides in the country.
COVID-19 stressor is an important suicidal
determinant; mental health consequences of the COVID-
19 crisis, including suicide ideation, are likely to be present
for a long time and peak later than the actual pandemic. The
Hindu reported what is possibly the first case of COVID-
19-related suicide, which occurred in Kerala (India) on June
2nd, 2020. There was a significantly higher rate of suicidal
ideation among youth, increased stress, anxiety, fears, and
loneliness among the youth, due to Covid-19, which
appears to correspond with times when Covid-19 stressors
and community responses (e.g., stay-at-home orders and
school closures) were heightened, and indicating that youth
experienced elevated distress.
How to Detect Suicide Behavior Before It Happens
Warning signs of suicidal ideation among youths include
behavioral, verbal and non-verbal cues. It is important to
observe these warning signs early and seek immediate help
to be able to save lives.
Ÿ Talking about: wanting to die, having great guilt or
shame, and being a burden to others.
Ÿ Feelings: empty, hopeless, trapped or having no reason to
live, feeling extreme sadness, anxiety, agitated or full of
range, unbearable emotional or physical pain.
Ÿ Change in behavior such as: making plans to die,
isolating from friends, giving away important items or
making a will or suicidal notes, taking a dangerous risk,
mood swings substance abuse.
To anyone out there who's hurting, it's not a sign of weakness to ask for help. It's a sign of
strength. ~~~ BARACK OBAMA
April 2023
33|www.insightscare.com
Ÿ Verbal cues like—Passing a negative statement”
Ÿ “I want to die, end my life,”
Ÿ “I am going to kill myself,”
Ÿ “It's too much to bear,”
Ÿ “You would be better without me,”
Ÿ “I am not useful,”"
Ÿ “I don't want life anymore" should be taken seriously,
and urgent help or referral should be done.”
Preventing suicide requires strategies at all levels; this
includes preventive and protective strategies for
individuals, families and communities.
The following ways can help to prevent suicide such as:
Ÿ Improving coping and problem-solving skills,
Ÿ Self-awareness and emotional regulation,
Ÿ Interpersonal relationships with peers, family and mental
health and medical provider,
Ÿ Stress and Anger management,
Ÿ Concentration during class hours,
Ÿ Avoid bullying and substance abuse,
Ÿ Reach out for help immediately.
Note: Youths who feel suicidal are not likely to seek help
directly; however, friends, peers and school personnel
can recognize the warning signs and take immediate
action to keep the youth safe.
The following actions should be taken if youths
demonstrate signs of suicide:
Ÿ Remain calm,
Ÿ Speak directly about feelings,
Ÿ Assured them that there was help and that they would not
feel like this forever,
Ÿ Be present and listen,
Ÿ Keep them away from means of harm,
Ÿ Get help from a psychologist/ psychiatrist/ caregiving
adult.
Management of suicidal ideation includes a thorough
assessment of the individual's Current risk of imminent
harm and creating a treatment plan in collaboration
with the patient and any involved supports.
This process needs to be individualized, collaborative, and
completed using a calm, cooperative and curious interview
style. Improving the self-confidence and character of the
youth will help improve positive behavior. Skill
development programs and encouraging more connections,
caring and compassion among youths can help reduce the
incidence of suicidal ideation. Most people can be treated
with a combination of anti-depressant medication and
cognitive behavioral therapy; contact your
guardian/psychologist/psychiatrist in case of suicidal
ideation.
In conclusion, we should recognize that suicide has a
powerful effect on the individual's family, school and
community. We must deal with it as a public health crisis in
our schools, clinics and society. The high suicide rate
among youths emphasizes the need for urgent intervention.
Suicide is a result of a complex dynamic and the unique
interplay between numerous contributing determinants. The
youths lack the effort to predict and prevent suicide and
tend to fail.
On the other hand, Improving the knowledge regarding
determinants of suicidal ideation and making the youth
understand the consequences, will help them to avoid
extreme stress; creating awareness among youths
regarding determinants of suicidal ideation will
substantially decrease the amount of suicide among
youth.
Priscillia Stephen U
I am Priscillia Stephen U., United States Registered Nurse, MSN, BSN. A mental
health advocate with First-Class Degree in Nursing from Dr. NTR University, India,
and a Postgraduate Degree holder in Psychiatric Nursing. A seasoned professional
Nurse, with mul -year experience working with People Tree Hospitals, one of
India's Best Performing Hospitals.
People Tree Hospitals, India
About the Author
April 2023
34|www.insightscare.com
April 2023
36|www.insightscare.com
Treatment for
Personalized
Concussion and
TBI
Meeting Unique Needs
Mild traumatic brain injury
(TBI), also known as a
concussion, is a common
occurrence in sports and daily life. It is
caused by a blow to the head or body that
causes the brain to shake inside the skull.
From mild to severe, concussion symptoms
might include headaches, nausea, dizziness,
blurred vision, and sensitivity to light and
sound. While most concussion victims bounce
back within a few weeks, some may experience
long-term consequences that require specialized
care.
The traditional approach to concussion and TBI
treatment has been a "one size fits all" approach, with
standard protocols and timelines for recovery. However,
research has shown that individualized treatment plans
can be more effective in helping patients recover from
concussion and TBI. This approach considers each
patient's unique needs, including their symptoms, medical
history and lifestyle factors.
Assessment and Diagnosis
The first step in creating a personalized treatment plan for
concussion and TBI is a thorough assessment and diagnosis.
This may include a physical exam, neurological exam,
imaging tests such as MRI or CT scans, and cognitive tests.
These tests can help determine the extent of the injury and
the severity of the symptoms.
Once a diagnosis is made, the healthcare provider can work
with the patient to develop a personalized treatment plan.
This plan includes a combination of therapies, such as
physical therapy, cognitive rehabilitation and medication.
Physical Therapy
Physical therapy can be an essential part of concussion and
TBI treatment, particularly in cases where there is a
April 2023
37|www.insightscare.com
significant loss of balance, strength, or coordination.
Physical therapy can help improve balance, coordination
and strength and reduce symptoms such as dizziness and
headaches. To develop a personalized exercise plan
addressing their needs therapist will work with the patient.
Cognitive Rehabilitation
Cognitive rehabilitation is a therapy that focuses on
improving cognitive function, such as memory, attention
and executive function. This therapy exercises to improve
memory, concentration and strategies to help patients
manage their symptoms. Cognitive rehabilitation can
benefit patients experiencing long-term effects of
concussion or TBI, such as difficulty with memory or
concentration.
Medication
In some cases, medication may be used to manage
symptoms of concussion or TBI. For example, anti-
inflammatory drugs may reduce swelling and inflammation
in the brain, while pain medication can help relieve
headaches and other pain symptoms. Sometimes,
antidepressant or anti-anxiety medication may be prescribed
to help patients manage the emotional effects of concussion
or TBI.
Lifestyle Changes
In addition to these therapies, lifestyle changes can be
essential to personalized treatment for concussion and TBI.
This may include changes to diet and exercise habits and
modifications to work or school activities. For example,
patients may need to take a break from work or school
activities to allow time for rest and recovery, or they may
need to modify their work or school environment to reduce
the risk of further injury.
Patients may benefit from counseling which helps them
cope with the emotional effects of concussion or TBI. This
may include anxiety, depression, or post-traumatic stress
disorder (PTSD).
Benefits of Personalized Treatment
Personalized treatment for concussion and TBI offers
several benefits over traditional, one-size-fits-all treatment
approaches. By tailoring the treatment plan to each patient's
unique needs, healthcare providers can help improve patient
outcomes and reduce the risk of long-term effects. Patients
may also experience faster and more complete recovery and
can return to work or school more quickly.
In addition, personalized treatment can help healthcare
providers identify patients at risk for the long-term effects
of concussion or TBI. This can help healthcare providers
develop strategies to prevent or mitigate these effects, such
as monitoring for signs of cognitive decline or providing
ongoing therapy to avoid emotional problems.
Challenges of Personalized Treatment
While personalized treatment for concussion and TBI has
many benefits, it also presents several challenges. One of
the biggest challenges is the lack of standardized protocols
for diagnosis and treatment. This can make it difficult to
compare outcomes across patients and may make it more
difficult for healthcare providers to develop effective
treatment plans.
In addition, personalized treatment can be more time-
consuming and costly than traditional approaches. It may
require additional testing, consultation with multiple
healthcare providers, and ongoing monitoring to ensure that
the treatment plan is effective.
Finally, personalized treatment requires a multidisciplinary
approach involving healthcare providers from multiple
specialties. This can make coordination and communication
between providers more difficult, particularly if patients see
providers in different locations or healthcare systems.
Conclusion
Personalized treatment for concussion and TBI is a
promising approach that offers several benefits over
traditional, one-size-fits-all treatment approaches. By
tailoring the treatment plan to each patient's unique needs,
healthcare providers can help improve patient outcomes and
reduce the risk of long-term effects. However, personalized
treatment also presents several challenges, including the
lack of standardized protocols and the need for a
multidisciplinary approach. Despite these challenges,
personalized treatment offers a promising way to improve
the care of patients with concussions and TBI.
-Pooja Shah
April 2023
38|www.insightscare.com
Rich Barnes
President
The Barnes Firm
The Barnes Firm
Personal Injury Attorneys
Advocates for Vic ms of Brain Injury
There’s a good chance that someone you know will
be involved in a car accident, pedestrian accident,
construction accident, or medical malpractice
which could result in a personal injury. In these types of
situations, victims—besides suffering from physical
pain—are likely to experience psychological anguish
because of the defendant's negligence.
The Barnes Firm is here to help. Being one of America's
largest personal injury law firms, the experienced team of
attorneys at The Barnes Firm will help you navigate your
personal injury claim. One of the Firm's areas of focus is
helping those who suffer from brain injuries, which can
range from a complete loss of conscience to a mild form of
traumatic brain injury, or TBI. Regardless of the type of
injury, the Firm is prepared to assist victims.
In an interview with Insights Care, Rich Barnes, President
of The Barnes Firm, emphasizes that not only do victims
worry about recovering physically, but also face uncertainty
about their rights and if they can be compensated for
hardships as a result of someone else's negligence. Thus,
through his leadership, the Firm's mission is to provide
justice for its clients with outstanding legal service and to
fight for the maximum recovery possible in the shortest
period of time.
Following are the excerpts from the interview:
Kindly, brief us about the Barnes Firm and its
inception.
The Barnes Firm was founded by Steve Barnes with offices
located in Buffalo, Rochester, Manhattan, Long Island, San
Francisco, Los Angeles, and San Diego. After his
unexpected passing in 2020, Steve's brother and
distinguished attorney Rich Barnes was appointed President
of The Barnes Firm.
Please tell us about yourself and your professional
journey so far.
I bring over 40 years of legal experience as a trial lawyer,
senior assistant District Attorney, private practice lawyer,
and served as President of the WNY Trial Lawyers
Association.
Our Firm helps those who
have been injured by someone else's
negligence. As one of Americas' largest
personal injury law firms, we help with
several types of physical injury, yet we
are keenly focused on helping those
who have suffered from a brain injury.
Whether it is a severe trauma c
brain injury with complete loss of
conscience or a mild TBI, we offer
our experience to assist them with
many areas a er the accident, including
experts, social programs, insurance,
and so on.
10 Specialized Trauma c Brain Injury Treatment Providers 2023
April 2023
41|www.insightscare.com
Client Reviews
"I was in a car accident and called The Barnes Firm for
help. My a orney encouraged me to seek medical
a en on immediately when he realized I was in a lot
of pain and couldn't remember what happened. A er
being seen by medical professionals at a nearby
emergency room, I was told I had a concussion and
mul ple herniated discs. Over the next few weeks, I
no ced that my memory was failing me and that my
speech was impaired – there was hesita on with
being able to form sentences and I began to stu er,
and my words came out mixed up, which was very
unusual for me. My a orney supported my decision to
pursue more tests and get second and third opinions,
as did my care team. I am grateful for the support and
a en on I received from my a orney at The Barnes
Firm. With the Firms help and guidance, I was able to
get the tests I needed and con nue with the
appropriate medical care. I am s ll on the road to
recovery but the se lement my a orney was able to
nego ate for me will help with covering the addi onal
costs to extend my ongoing medical care." -Erica B.
"The Barnes Firm did an
excellent job on my car accident
case. Jade was extremely
helpful at answering all of my
ques ons."-Ghyar. A
"The Barnes Firm was very
friendly, always quick to
respond to our calls and emails.
When we had any ques ons or
concerns, they were there to
walk us through everything. I
would recommend them to
anyone that is looking for an
a orney that will honestly fight
for you and has your best
interest in mind." -Nichole W.
"They handled everything with my accident and got me
the maximum amount of money back, more than I
thought I would get! Thanks!"-Philip H.
April 2023
42|www.insightscare.com
What are the core values that the Firm stands by? What
is its mission and vision statement?
At The Barnes Firm, we are driven by a shared passion for
justice and a commitment to honor the legacy of Steve
Barnes. Our attorneys are dedicated to obtaining the best
possible outcome for every client in every case, no matter
the size, severity, or opposition. We are proud to be able to
provide our clients with the sense of justice and satisfaction
that they deserve.
How is your Firm incorporating advancing technology
to provide concussion and TBI treatments to help
clients?
We work with top experts and specialists in their respective
fields, whether that be neuroradiologists, neurologists,
psychiatrists, neuropsychologists, and related professionals
who are on the vanguard in using advanced technology for
treatment and diagnosis.
What are the key products and services of the Firm and
how is it impacting the demographic concerned?
Our Firm helps those who have been injured by someone
else's negligence. As one of America's largest personal
injury law firms, we assist victims who have experienced
various types of physical injury, yet we are keenly focused
on helping those who have suffered from a brain injury.
Whether it's a severe traumatic brain injury with complete
loss of conscience or a mild concussion, we offer our
experience to assist them with many areas after the
accident, including experts, social programs, insurance, and
so on.
What, according to you, are the challenges faced in
supplying specialized services when navigating personal
injury? How is the Firm, with your guidance, turning
them into opportunities?
Many industries need to continue to develop their
companies' products and services to target and support
individual customers. The Barnes Firm takes a similar
approach to helping our injured clients, especially those
with TBI, because it is completely dependent on
individualized service.
All the members of our team must have the knowledge and
the skill set to help each TBI client with their specific
requirements and needs. Our Firm is built on being able to
provide specialized services for this very reason, allowing
us to remain laser focused on serving the needs of each
client. If you do an outstanding job of truly helping each
client, your business will be built upon a strong foundation
and will be able to grow organically.
What are the future goals of your Firm and how has it
envisioned to scale its operations and reach in 2023 and
beyond?
We plan on continued growth in 2023 and 2024. The Firm
will stay focused on developing systems to improve our
services and implement AI strategies that will allow our
clients to have the best results possible.
April 2023
43|www.insightscare.com
10 Specialized Traumatic Brain Injury Treatment Providers 2023V3 1.pdf
10 Specialized Traumatic Brain Injury Treatment Providers 2023V3 1.pdf
10 Specialized Traumatic Brain Injury Treatment Providers 2023V3 1.pdf

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10 Specialized Traumatic Brain Injury Treatment Providers 2023V3 1.pdf

  • 1. Making A Difference Innovative Approaches to Concussion and TBI Treatment April Issue 02 2023 Aviv Clinics TBI & Post-Concussion Syndrome Treating Long-Term Complications and Improving Quality of Life Dr. Shai Efrati Chair, Medical Advisory Board of Aviv Scientific Aviv Clinics 10 Specialized Traumatic B Injury Treatment Providers 2023 Meeting Unique Needs Personalized Treatment for Concussion and TBI 08 Page No.
  • 2.
  • 3.
  • 5. raumatic brain injuries are a significant public Thealth concern, and specialized traumatic brain injury treatment providers play an important role to help patients recover and regain their quality of life. As technology advances, these providers find innovative ways to improve patient outcomes and expand access to specialized care. One area of focus for specialized traumatic brain injury treatment providers is using technology to enhance patient care. Advanced neuroimaging techniques and specialized tools for cognitive rehabilitation have significantly improved diagnostic accuracy and allowed for more effective rehabilitation and recovery. Telemedicine has also made specialized care more accessible, mainly for patients in rural or underserved areas. Collaborative efforts between specialized traumatic brain injury treatment providers and other healthcare professionals have also played a vital role in improving patient outcomes. By working together, these providers can provide comprehensive care that addresses both physical and cognitive impairments. Additionally, research partnerships between providers and academic institutions can lead to advancements in TBI treatment and improve patient outcomes in the future. However, despite the importance of specialized traumatic brain injury treatment providers, access to these services remains challenging for many patients. Barriers such as cost, insurance coverage and geographic location can prevent patients from receiving the necessary care. To address these issues, increased funding and expanded insurance coverage are needed to ensure all patients have access to specialized traumatic brain injury treatment. Therefore, specialized traumatic brain injury treatment providers are crucial in helping patients recover from this devastating condition. The use of technology and collaborative care efforts have led to significant advancements in TBI treatment, and continued innovation in these areas will be key to improving patient outcomes in the future. However, addressing barriers to access is crucial to ensure that all patients can benefit from specialized traumatic brain injury treatment. Insights Care's latest edition, 10 Specialized Traumatic Brain Injury Treatment Providers 2023, walks you through the expertise and dedication of healthcare professionals in providing specialized care and support the patients need to overcome the challenges of this devastating condition. Hope you have an amazing read! - Pooja Shah The Vital Role of Specialized TBI Treatment Providers
  • 6. Mitochon Pharmaceuticals Channeling the Ability of Mitochondria to Create Resilient, Protec ve Cells in Neurodegenera on and Aging 26 32 40 18 Rehabilitation Institute of Washington PLLC Empowering Recovery, Transforming Lives Suicidal Ideation among Youths in India Ctts The Barnes Firm Personal Injury Attorneys Advocates for Vic ms of Brain Injury CXO
  • 7. Aviv Clinics TBI & Post-Concussion Syndrome Cov Sty 08 Trea ng Long-Term Complica ons and Improving Quality of Life Innova ve Approaches to Concussion and TBI Treatment Making A Difference 22 Aicl 36 Personalized Treatment for Concussion and TBI Meeting Unique Needs
  • 8. Copyright © 2023 Insights Success Media and Technology Pvt. Ltd., All rights reserved. The content and images used in this magazine should not be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without prior permission from Insights success. Reprint rights remain solely with Insights Success Media and Technology Pvt. Ltd. Insights Care is powered by Insights Success Media and Technology Pvt. Ltd. April, 2023 sales@insightscare.com Contact Us: Follow us on : www.facebook.com/InsightsCare/ https://twitter.com/Insightscare Insights Success Media Tech LLC 555 Metro Place North, Suite 100, Dublin, OH 43017, United States Phone - 302-319-9947 Email: info@insightscare.com For Subscription: www.insightscare.com Insights Success Media and Technology Pvt. Ltd. Survey No.133/134, Brand Square, Office No. 512, Kunjir Chowk, Pimple Saudagar, Pune, Maharashtra 411027. Phone - India: 7410033802, 74100058552 Email: info@insightscare.com For Subscription: www.insightscare.com We are also available on : Editor-in-Chief Merry D'souza Senior Editor Anish Miller Managing Editor Pooja Shah Assisting Editor Saloni Agrawal Visualiser David King Art & Design Head Mrunalinee Deshmukh Co-designer Paul Belin Art & Picture Editor Sonia Raizada Business Development Manager Amy Jones Marketing Manager John Smith Business Development Executives Sarah Wilson, John Smith, Alex Vincent Sales Executives Kelli, Bill, Anna Technical Head Jacob Smile Assistant Technical Head Prachi Mokashi Technical Consultants David, Robert Digital Marketing Manager Alina Sege Assistant Digital Marketing Manager Renuka Kulkarni SME-SMO Executives Gemson Research Analyst Eric Smith Circulation Manager Tanaji Fartade
  • 9. Description Person name Company Name Aviv Clinics aviv-clinics.com Shai Efrati Co-Founder and Chairman of the Medical Advisory Board Aviv Clinics’s number-one mission is to improve the aging process by optimizing cognitive and physical performance. Brainwave brainwave.org.uk Joanne Freeman Mkt Brainwave is committed to helping children with disabilities reach their potential through specialist Therapy Programmes, delivered by qualified therapists Baptist Health baptisthealth.com Kit Fullenlove PR The Baptist Health family consists of more than 400 points of care, including outpatient facilities, physician practices and services, urgent care clinics, outpatient diagnostic and surgery centers, home care, fitness centers, and occupational medicine and physical therapy clinics. Mitochon Pharmaceuticals mitochonpharma.com John Geisler CSO Mitochon Pharmaceuticals is a start-up biotech company that focuses on developing drugs that target the mitochondria for a host of serious diseases with significant unmet medical needs. National Organization for Rare Disorders rarediseases.org Lisa Sencen MM The National Organization for Rare Disorders, is an independent patient advocacy organization dedicated to helping individuals with rare diseases and the organizations that serve them. One Rehabilitation Service onerehabilitationservice.com.au Megan Tan Managing Director One Rehabilitation Service provides rehabilitation and disability services to people with brain injuries, stroke or other neurological conditions. NeuroRestorative neurorestorative.com Lisa Collins CEO NeuroRestorative is a leading provider of subacute and post- acute rehabilitation services for people of all ages with brain, spinal cord and medically complex injuries, illnesses and other challenges. Rehabilitation Institute of Washington rehabwashington Heather Kroll MD Rehabilitation Institute of Washington offers comprehensive interdisciplinary rehabilitation for injured workers with chronic pain and traumatic brain injury. The Barnes Firm Injury Attorneys thebarnesfirm.com Erica Burzynski Marketing Director The experienced personal injury attorneys at the Barnes Firm Injury Attorneys focus on helping innocent victims who have been injured in accidents. The Children's Trust thechildrenstrust.org Michelle Lopez MM The Children's Trust’s ambition is for all children with brain injury to have the opportunity to live the best life possible. 10 Specialized Trauma c Brain Injury Treatment Providers 2023
  • 10. Aviv Clinics Treating Long-Term Complications and Improving Quality of Life TBI & Post-Concussion Syndrome It is more likely for an athlete that has suffered a head injury to quickly return to the game than an athlete who has sprained an ankle.When a brain injury happens, it is imperative that the person rest and monitor their symptoms, just as they would with a physical injury.When symptoms persist, medical attention should be sought, and that’s where Aviv Clinics steps in.
  • 11. over Story C Dr. Shai Efrati Chair, Medical Advisory Board of Aviv Scienti c Aviv Clinics
  • 12. Throughout time, scientific discoveries, new understandings and inventions have allowed humans new ways to heal, making them better and stronger. With such dimensions of the scientific community in general and the healthcare community in particular, the human brain remains revered as the most complex, mysterious and studied human organ through research and development. Aviv Clinics has run the scientific principle at the core of its operations since 2017. Through its healthy brain performance programs, the clinic performs individually tailored treatments to help its clients heal from brain-related digression or injury, while exceeding new levels of brain and body function standards. Through the leadership of Dr. Shai Efrati, the Chair of Medical Advisory Board for Aviv Scientific, the clinic has successfully treated over 10,000 clients under Aviv protocols. Consequently, a majority of them have marked an improvement in their cognitive function post-Aviv treatment. Challenges Faced due to Insufficient Oxygen and Damage to the Brain Most of the damage to the brain is ultimately caused by a decrease in blood flow resulting from the injury. Decreased blood flow means insufficient oxygen delivery to the damaged tissue. In these situations, the brain cannot properly heal on its own. Brain injuries can be complex to diagnose without the correct tools. The damage appears clearly in scans in instances resulting in moderate to severe brain injury. However, in cases where the damage is mild, the anatomical scans show a “normal” brain which is misleading. This can lead to misdiagnosis of the brain injury or of the severity of the injury and create more difficulties for the patient because the cause of their symptoms is misunderstood. It is not uncommon to see issues like irritability, anxiety, difficulty focusing, memory problems, restlessness, and more written off as behavioral conditions without acknowledging a brain injury as the root cause. In these far too frequent instances, people, including children, go without proper treatment to address the brain injury directly and are often prescribed medication for these symptoms that they do not need. Following a Three-Month Mark to Address Brain Injury Due to Concussion The benchmarks for recognizing symptoms of damage from concussion or brain injury are dependent on the patient. However, if physical and cognitive functions have not recovered after To accurately determine if post-concussion syndrome is happening, the patient should seek an advanced, high-resolution scan like Single Photo Emission Computerized Tomography (SPECT) and MRI with Diffusion Tensor Imaging (DTI).These tests are among those done at Aviv Clinics, where our team of brain experts are able to assess the extent of the injury and create a plan to treat the damage in the brain, as well as improve and enhance the patients’ overall cognitive and physical performance. 10 Specialized Trauma c Brain Injury Treatment Providers 2023
  • 13.
  • 14. Our research demonstrates that HBOT, when administered with precise uctuations in oxygen levels, can also induce angiogenesis and neurogenesis, the development of new blood vessels and neurons in the brain. Most importantly, our clinical work suggests that our unique HBOT treatment can improve cognitive abilities, including memory, learning, concentration, attention, and decision-making, as well as quality of life, even years after a brain injury. three months following the injury, the patient is experiencing what is referred to as a post-concussion syndrome. Some of the most common symptoms include physical concerns like headaches, dizziness, blurred or double vision, and light sensitivity, as well as behavioral indications like problems with concentration and/or memory, thinking or speaking more slowly, depression, anxiety, and irritability. In general, any symptoms that occur or persist after the three-month period following the initial injury are signs that further functionality testing is required. The three-month mark is important because it is unlikely that these neurocognitive functions will return to normal if they have not already. At this point, a person should visit an experienced brain clinic, like Aviv Clinics, to get the best possible diagnosis and treatment. “To accurately determine if post-concussion syndrome is happening, the patient should seek an advanced, high- resolution scan like Single Photo Emission Computerized Tomography (SPECT) and MRI with Diffusion Tensor Imaging (DTI),” suggests Dr. Efrati. He adds, “These tests are among those done at Aviv Clinics, where our team of brain experts is able to assess the extent of the injury and create a plan to treat the damage in the brain, as well as improve and enhance the patients’overall cognitive and physical performance.” An Alarming Discovery by Dr. Efrati Underdiagnosis occurs because medical professionals are not conditioned to look at the brain to solve the problem at the source, especially in youth patients. When children are brought into the emergency room or the physician’s office, their symptoms are typically written off as other conditions without consideration of post-concussion syndrome. In a recent study conducted by Dr. Efrati, alongside his colleagues – they explored the diagnosis of post-concussive syndrome in children. By comparing children who had been admitted to the emergency room for head injuries to a control group of children who visited the ER because of wrist fractures, they found that 25% of those who had suffered a head injury reported post-concussion symptoms months or even years later, while just over 2% of the control group did. After evaluating each child’s electronic medical records, Dr. Efrati and his colleagues determined that none of the pediatric patients with persistent post-concussion symptoms were categorized or diagnosed. The diagnosis was missed more often than not in these children with brain injury – which is an alarming discovery. Awareness can be supported with appropriate solutions, starting with implementing proper screening guidelines, including brain scans. “It also comes down to treating the wound. Wounds
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  • 16. It also comes down to treating the wound.Wounds in the brain should be treated as any other wound on the body.We are too quick to diagnose brain wounds in children as psychological issues rather than as a result of brain injury. in the brain should be treated as any other wound on the body. We are too quick to diagnose brain wounds in children as psychological issues rather than as a result of brain injury,” states Dr. Efrati. Treating Brain Health in the Same Way as Physical Health When a brain injury is left untreated, a person’s overall functionality declines over time, and s/he cannot live life the way s/he used to. The overall quality of life is at risk, as well as independence and cognitive function. People with persistent post-concussive symptoms can be impacted in many ways. Some will struggle to think clearly or have memory issues. Some will be unable to sleep, while others will constantly be fatigued and sleep 12 hours a day or more. They can have pain, headaches, vision problems and emotional and psychological symptoms, all of which can inhibit their work, school and interpersonal relationships. “It’s important that brain health is treated the same way as physical health is treated. But right now, that is not happening,” puts Dr. Efrati. He shares a good example of how concussions are handled in athletes. He notes, “It is more likely for an athlete that has suffered a head injury to quickly return to the game than an athlete who has sprained an ankle. When a brain injury happens, it is imperative that the person rest and monitor their symptoms just as they would with a physical injury. When symptoms persist, medical attention should be sought, and that’s where Aviv Clinics steps in.” Healing Damage and Achieving Peak Performance – An Objective Aviv Clinics is a place that is committed to its goal of providing patients with the best quality of care to heal damage and achieve peak brain and body performance. In order to attain its objective, Aviv considers the full health picture of each patient. Aviv’s world-class team of physicians, dietitians, neuropsychologists, physiotherapists, and clinical staff remains the priority. From start to finish, Aviv’s medical program starts with a pre-assessment, which includes an extremely thorough physical assessment, cellular testing, a cognitive evaluation and high-resolution brain imaging, which can include an MRI, SPECT scan, or a combination of both. Based on the results, Aviv’s team of mulit-disciplined clinicians determine whether the patient is a suitable candidate for the program. For those who are, their individual needs will be addressed in a tailored treatment protocol, which can consist of cognitive therapy, nutritional coaching, a physiotherapy program and Hyperbaric Oxygen Therapy (HBOT). The treatment helps to revive the damaged tissue from traumatic experiences that affect the brain by increasing the supply of oxygen to those areas. “Our research demonstrates that HBOT, when administered with precise fluctuations in oxygen levels, can also induce angiogenesis and neurogenesis, the development of new blood vessels and neurons in the brain. Most importantly, our clinical work suggests that our unique HBOT treatment can improve cognitive abilities, including memory, learning, concentration, attention, and decision-making, as well as the quality of life, even years after a brain injury,” concludes Dr. Efrati.
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  • 18. 352-750-2848 | info@aviv-clinics.com aviv-clinics.com "We can't help you." It's a heartbreaking phrase that Linden Perry and her mother Carissa heard repeatedly from doctors who couldn't treat Linden's post-concussion symptoms. Their concussion journey began with a seemingly minor bump on the head at a soccer practice and a fall the next week playing basketball. Carissa anxiously watched Linden's symptoms grow from dizziness, nausea and light sensitivity to difficulty concentrating, short term memory issues and double vision. Even after a few weeks, Linden didn't feel better. She was unable to pass the cognitive tests needed to return to sports. Worse, she began to struggle in school, something uncommon for the advanced placement honors student. Soon, visiting medical specialists became a full-time job for Carissa and Linden. Linden was seeing a neurologist, an ophthalmologist, a chiropractor and a neuro- ophthalmologist while also undergoing vestibular rehab, occupational therapy and vision therapy, often with multiple appointments in a single day. Yet improvements were minimal at best. Doctors suggested that there may not be an answer for Linden, and recommended therapy and antidepressants. "She stopped believing she was ever going be who she was before," Carissa explains. "That's really hard as a parent to watch." A family acquaintance with connections to the NFL suggested that they contact Dr. Joseph Maroon, the team neurosurgeon for the Pittsburgh Steelers and a specialist in concussion prevention and treatment. After Dr. Maroon told Carissa about Aviv Clinics, mother and daughter made the decision to enroll Linden in home school so they could travel to Florida for a 12-week treatment program. Linden's customized Aviv Medical Program included physical therapy, cognitive training and nutritional coaching, all with expert clinicians. She also spent two hours a day with other Aviv clients in a unique hyperbaric oxygen suite, making new friends while working to recover the areas of her brain that were damaged. With her balance back to normal, her headaches and brain fog dissipated, and her vision improved, Linden was back on the field with her teammates within days of completing the Aviv Medical Program. She is excited to re-enroll in school in the fall, and is thrilled to finally feel like herself again.
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  • 20. Mitochon Pharmaceuticals Channeling the Ability of Mitochondria to Create Resilient, Protective Cells in Neurodegeneration and Aging Mitochon Pharmaceuticals was launched in November 2014 with joint seed money from Ben Franklin Technology Partners and private investors. Mitochon was founded by Robert Alonso, MBA, and John Geisler, Ph.D., with the goal of creating disease- modifying treatments for a variety of neurological conditions with unmet medical needs, such as ALS, Huntington's disease, and traumatic brain injury (TBI). The thesis of Mitochon's approach is that if you bolster mitochondrial health through a mechanism known as mitochondrial uncoupling, meaningful pro-survival benefits occur and brain cells are protected from damaging disease processes. Dr. Geisler's post-doctoral work at Pfizer and Yale University in metabolic disease, taught him that there are master switches (proteins to target with medicines) that can have a profound effect on disease progression. This knowledge became the theme of his subsequent work in drug discovery working at the roots of problems. By removing fat from the liver and muscle cells that cause insulin resistance, the aim was to wean individuals off the insulin and cure their diabetes. Under the leadership of John G. Geisler, Chief Scientific Officer and Co-founder, Mitochon is working on developing two drugs, MP101 for rare diseases (orphan indications) and MP201 for larger markets such as Alzheimer's, Parkinson's, TBI, etc. MP101 has ongoing clinical studies now, whereas MP201 is just starting the GLP toxicology studies to work towards an FDA-approved open IND. Below are highlights of the interview that give insights about Mitochon Pharmaceuticals' work resolving major health complications with the help of modern technological advancements. What are the core values that Mitochon Pharmaceuticals stands by? What is its mission and vision statement? Coming from working at a number of pharmaceutical companies, I think that there are two major themes we established at Mitochon. 1) We have "no silos" in that we go after any indication (neuro, cancer, pulmonary, pain, ataxia, muscular dystrophies, trauma, etc.) as long as it is rooted in mitochondrial dysfunction and truly an insidious (time- sensitive) diseases. 2) We are not worried about how big the market is for the indication we are pursuing; rather, we want to fill a need for doctors to help their patients. For instance, my expertise is diabetes and obesity, but we have not pursued these indications as there are a lot of medicines to treat these diseases, but there is a great need in neurodegeneration in areas such as ALS, Huntington's disease, MS, TBI, Parkinson's disease, Alzheimer's disease, etc. We are keenly interested in this area because our platform appears to be pan-neuroprotective by modulating the entire mitochondrial physiology of this organelle, which is central to the health of all cells. How is your company incorporating advancing technology in providing the Concussion and TBI treatment to further customer reach as well as chart its growth upwards? Mitochon's concerns with TBI is that "today's concussion patient often becomes tomorrow's dementia patient." It may appear bleak, but there is a real link with aging, and a need for an early- immediate treatment that is brain penetrant and 10 Specialized Trauma c Brain Injury Treatment Providers 2023 April 2023 18|www.insightscare.com
  • 21. quiets down the mitochondria post-trauma. After trauma, the cells are under enormous stress that sets up programmed cell death through the mitochondria, which requires immediate attention, not only from the area of direct impact but also from the neighboring cells under attack that I call the "threatened tissue." There is also a need for those who don't get treatment, but are now older and need a treatment to push-off dementia. One of our first studies was in a model of Alzheimer's Disease (AD) with 4 months of treatment with Mp101. This proof-of-concept study was critically important because it showed that this oral once-per-day treatment enhanced cognition, as the AD mice learned faster to find the hidden platform in the Morris Water Maze, and when the platform was removed for the final exam, they became obsessed for three days with where it used to be. Loss of short-term memory is the hallmark of AD and arrows are pointing at the mitochondrial dysfunction as an early Mitochon's concerns with TBI is that "today's concussion patient often becomes tomorrow's dementia patient." It may appear bleak, but there is a real link with aging, and a need for an early-immediate treatment that is brain penetrant and quiets down the mitochondria post-trauma. John G. Geisler Chief Scientific Officer and Co-founder Mitochon Pharmaceuticals April 2023 19|www.insightscare.com
  • 22. up-stream event triggering progression. Therefore, resolving this dysfunction with our mitochondrial specific drugs, MP101 or MP201, they may curb subsequent memory loss and perhaps even enhance cognition! Because of this combination of the work in AD and TBI, it has helped secure joint funding from the BrightFocus Foundation, specialized in AD research and Medical Technology Enterprise Consortium (MTEC), military focused, to look closer at an issue particular to the military population that largely goes unnoticed by the civilian population, namely the damage caused by repetitive blast wave trauma. When a soldier throws a hand grenade, breaches a wall, or pulls the trigger on a howitzer, there is a shock wave of air that penetrates the organs, spinal fluid up to the brain, the ears, eyes and lungs, and rattles the whole brain, causing initially mild damage, but more penetrating and lasting issues with repetition. However, we also have TBI work in what we call "classical" TBI, which looks more like a car crash or clunk on the head. Acute head injury is associated with very high mitochondrial-derived free radical production that damages proteins, lipids and chromosomes and toxicity due to calcium overload that causes cell death (apoptosis). Mitochon's objectives are to complete GLP toxicology studies with our second drug, MP201, with enhanced pharmacology and to begin clinical studies for TBI at trauma units in all major cities across the United States. We will also seek approval to conduct clinical studies on military patients who have experienced repetitive blast wave trauma. This can significantly impact the field for optimal outcome measures during an unfortunate event by providing soldiers an immediate delivery of an injectable MP201 formulation in remote locations, while buying time to get transported to a clinical unit. What are the key products and services of the company, and how is it impacting the demographic concerned? Mitochon is in Phase I clinical studies now in the USA with MP101 and gearing up for a Phase I/IIa "basket study" in Europe scheduled for the summer of 2023 in three different indications: ALS, MS and Huntington's disease, but uniquely all treated with MP101 as one indication. Most, if not all, neurodegenerative diseases have a central issue that is rooted in mitochondrial dysfunction, and MP101 appears to resolve this problem. In fact, not only neurodegenerative diseases, but we are finding that many diseases (cancer, heart, pulmonary, intestinal, etc.), in general, appear to have mitochondrial dysfunction. Dr. Geisler grew up in St. Clair Shores, a suburb of Detroit, Michigan. After graduating from Michigan State University with a B.S. in biochemistry, he took a job to get his "sea legs," first as a technician at Abbott Laboratories in Diagnostic Discovery in Chicago for 5- year-olds, before returning to graduate school for a Ph.D. in genetics at Oak Ridge National Laboratories (ORNL) from the University of Tennessee. A dueling postdoctoral fellowship at Pfizer (Groton) and Yale University pulled Dr. Geisler into applying his skills to metabolic disease and his interests in whole body flux. Isis (now Ionis) San Diego recruited him for drug discovery and the inception of new targets starting at the mRNA level with this platform based on antisense oligonucleotides (ASOs). Much of the focus was on targeting fat transporters to attempt to partition fat out of the liver. Subsequently, Dr. Geisler was recruited to join the newly established diabetes team at Johnson & Johnson Pharmaceutical Research and Development (JnJ PRD) in Spring House, PA. Much of the work at JnJ was in small molecules, but from the prior work at Ionis, he was pulled into a new collaboration with JnJ and Ionis using ASOs for diabetes targets. The overarching theme of Dr. Geisler's work was to push for "disease modifying" therapies vs. "incremental" medicine. Raised in a family of five siblings on a modest means, by parents who grew up during the Great Depression, served in WWII, and worked hard, whom themselves came from Swiss/German immigrants, inspired Dr. Geisler not to squander the gifts provided and push the boundaries with the time provided of finding meaningful medicines. This is what he believes is the essence of Mitochon. The idea may appear unorthodox, but the pharmacology is spot-on physiologically. About the Leader About the Leader April 2023 20|www.insightscare.com
  • 23. What, according to you, are the challenges faced in supplying specialized services in the industry you are serving? How is the company, with your able guidance, turning them into opportunities? Mitochondria are in all cells, and there are thousands per cell. As you age, the population moves from being homogenous to being heterogenous, or, as we like to say, mosaic. Some mitochondria produce a lot of energy (ATP) and low amounts of free radicals that can damage DNA, proteins, and lipids. In contrast, other mitochondria produce low amounts of ATP, but are high producers of damaging free radicals. Our drugs are unique in shifting the mitochondrial population from mosaic to homogenous. Since the health of the mitochondrial “population” is critical for the health of the cell in this symbiotic relationship, our platform appears to be beneficial for a host of diseases. As an experienced leader, what advice would you like to give to aspiring entrepreneurs and enthusiasts who wish to venture into the competitive industry that you are serving? Young scientists will accumulate knowledge from reading literature, hands-on experiments that are successful and fail, and from colleagues, mentors and conferences. These acquired experiences then propel you toward the formation of new, original ideas of your own. You have to know when your ideas have merit, even though others may tell you they do not. Papers from high impact-factor journals and "thought leaders" can be complete rubbish, establishing scientifically untrue dogmas that move the direction of research for 10–20 years in the wrong direction. So it becomes tricky to get off that track and back onto the direction of science again. Working in big pharma taught me that there are a lot of decisions made on the direction of research that have nothing to do with science. If leadership is selling you on what can and cannot be done, determine if it is rooted in science or other things like risk adversity, politics, a lack of sophistication, knowledge or all of the above. If you are in "discovery", the inception of new ideas, it is critical that the tone of the team's brainstorming sessions be inviting for everyone in the room to share ideas, especially for the brilliant, but more reserved minds. There is a great benefit to initially working for big companies. So, go to big companies to learn about the industry, but know when it is time to leave if you are pushed to bury your ideas or work on incremental projects. You don't want all of your time absorbed with nothing to show, and we need really fresh minds working on the hard stuff that are inspired. Question everything, read a lot, mull over ideas often, and stay on track to enable your ideas! What are the future goals of your company and how has it envisioned to scale its operations and reach in 2022 and beyond? Our immediate goals are to complete Phase I in humans and get into all the proof-of-concept studies in patients with a host of diseases to open the box completely. We need to complete the MP101 long toxicology package to get into critical long-term chronic studies for patients with ALS, Huntington's, etc. These are all very expensive studies, so we are looking for investors to help us accelerate these programs and others. We are excited about some new work in cystic fibrosis (funded by Emily’s Entourage) that appears to be promising and will hopefully lead to a clinical study. The ongoing work in TBI (severe head concussions) is quite robust in that we have projects focused on classic TBI at the University of Kentucky and Children's Hospital of Philadelphia (CHOP). Still, we also have blast wave trauma research focused on the brain, eyes and hearing. This research involves MP201, a slow-release drug similar to MP101. Our goals are to complete the preclinical packages and the GLP toxicology work to get an FDA-approved open IND to subsequently test patients with severe concussions. Of course, the ultimate goal is to obtain FDA approval for these drugs as a once-daily oral drug that activates compensatory pathways for survival as a disease-modifying agent for truly insidious diseases. April 2023 21|www.insightscare.com
  • 24. Concussion and TBI Treatment Innovative Approaches to oncussions and traumatic brain injuries (TBI) are a Cgrowing concern worldwide, with an estimated 69 million cases occurring annually. While most people recover fully from a concussion or mild TBI, others may experience long-term effects that can impact their quality of life. Innovative approaches to concussion and TBI treatment are helping to address this issue, offering new hope for patients and their families. Let's understand in detail the various innovative approaches! Virtual Reality Therapy Virtual reality therapy is an innovative approach to concussion and TBI treatment that uses technology to create immersive environments that can help patients recover. This therapy works by stimulating the brain in a way that can promote healing and improve cognitive function. Virtual reality therapy can be used in several ways. For example, patients may be immersed in a virtual environment that simulates real-world experiences, such as walking in a park or driving a car. This can help patients regain cognitive and physical abilities that may have been lost due to their injury. Virtual reality therapy may also simulate cognitive tasks, such as memory games or problem-solving exercises, to help patients regain cognitive function. Virtual reality therapy is effective in improving cognitive function in patients with TBI. A recent study found that Making A Difference April 2023 22|www.insightscare.com
  • 26. patients who received virtual reality therapy significantly improved their cognitive function compared to traditional therapy. Virtual reality therapy may also be more engaging and enjoyable for patients, making it a more effective therapy overall. Neurofeedback Neurofeedback is another innovative approach to concussion and TBI treatment that uses technology to promote healing and improve cognitive function. This therapy gives patients real-time feedback about their brain activity, allowing them to learn how to control their brainwaves and improve their cognitive function. During a neurofeedback session, patients wear a cap with sensors that measure their brainwaves. The information is then displayed on a computer screen in real-time, allowing patients to see how their brainwaves change. Patients can then learn to control their brainwaves using relaxation, visualization and mindfulness techniques. Neurofeedback is effective in improving cognitive function in patients with TBI. A recent study found that patients who received neurofeedback significantly improved their cognitive function compared to traditional therapy. Neurofeedback may also be more engaging and enjoyable for patients, making it a more effective therapy overall. Hyperbaric Oxygen Therapy Hyperbaric oxygen therapy (HBOT) is an innovative approach to concussion and TBI treatment that involves breathing pure oxygen in a pressurized chamber. This therapy can help improve cognitive function and promote healing by increasing oxygen levels in the brain. During an HBOT session, patients breathe pure oxygen while lying in a pressurized chamber. This increases the amount of oxygen in the blood, which can help promote healing and improve cognitive function. HBOT is effective in improving cognitive function in patients with TBI. A recent study found that patients who received HBOT significantly improved their cognitive function compared to traditional therapy. HBOT may also help reduce inflammation in the brain, which can contribute to long-term effects of TBI. Functional Medicine Functional medicine is an innovative approach to concussion and TBI treatment that focuses on the underlying causes of a patient's symptoms, rather than just treating them. This approach considers the patient's unique medical history, lifestyle factors and genetic makeup to develop a personalized treatment plan. Functional medicine may involve a combination of therapies, such as diet and nutrition counseling, detoxification and lifestyle changes. By addressing the underlying causes of a patient's symptoms, functional medicine can help improve overall health and reduce the risk of long-term effects of concussion and TBI. Conclusion Concussions and TBI are serious injuries that can long-term affect a patient's cognitive and physical abilities. However, innovative concussion and TBI treatment approaches, such as virtual reality therapy, neurofeedback, hyperbaric oxygen therapy and functional medicine, offer new hope for patients and their families. These innovative therapies use technology and a personalized approach to promote healing, improve cognitive function and reduce the risk of long-term effects. Virtual reality therapy and neurofeedback use technology to provide patients with engaging and enjoyable therapies that effectively improve cognitive function. Hyperbaric oxygen therapy increases oxygen levels in the brain to promote healing and reduce inflammation. At the same time, functional medicine takes a personalized approach to address the underlying causes of a patient's symptoms. As research into concussion and TBI continues, even more innovative treatment approaches will likely be developed. However, these current therapies offer new hope for patients who may have previously had limited options for treatment. It is important for patients and their families to work closely with healthcare providers to determine the best course of treatment for their individual needs. By taking advantage of innovative concussion and TBI treatment approaches, patients can improve their cognitive and physical abilities, reduce the risk of long-term effects and enhance their quality of life. -Pooja Shah April 2023 24|www.insightscare.com
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  • 28. Heather Kroll MD Rehabilita on Ins tute of Washington PLLC
  • 29. Rehabilitation Institute of Washington PLLC Empowering Recovery, Transforming Lives When caring for a patient recovering from traumatic brain injury, patient-centeredness and compassion is the key. At the Rehabilitation Institute of Washington PLLC—a leading provider of specialized traumatic brain injury (TBI) treatment—the team of clinicians and specialists strive to understand the patients' experience of TBI, their journeys and the biological, psychological and social factors that are involved in shaping their experience. The team works tirelessly to create a personalized treatment plan that would help patients regain their independence and improve their quality of life. Recovery is progress that takes time. Thus, at RIW, not only are the patients supported in their recovery journeys through the latest evidence-based therapies and cutting- edge technologies, but their pain, frustration and disappointment are also acknowledged in a way that they feel heard and experience a sense of hope. Through its commitment to innovation, patient-centered care and excellence in clinical practice, RIW has earned a reputation as a premier provider of TBI rehabilitation services in the region, improving the lives of countless patients and their families. In an interview with Insights Care, Heather Kroll, MD talks about RIW's commitment to helping patients recover from traumatic brain injuries and improve their quality of life. She emphasizes its focus on providing patients with the tools and resources they need to regain their independence, while "transforming lives" which speaks to the profound impact that RIW's work can have on patients and their families. Following are the excerpts from the interview: Kindly, brief us about your company and its inception. Rehabilitation Institute of Washington PLLC specializes in the comprehensive rehabilitation of injured workers with traumatic brain injuries, post-concussion syndrome and chronic pain from musculoskeletal or neurological injuries. The Institute was founded in 2005 when a core group of providers left a large medical center in Seattle after our multidisciplinary program was discontinued. We loved helping those with disabilities return to active and productive lives and community stakeholders valued the care we provided. We are dedicated to providing compassionate, pa ent-centered, and cost-effec ve care of the highest quality. We offer comprehensive interdisciplinary treatment programs for those with complex disabili es, but also strive to provide less intensive, focused care when that is sufficient to resolve a problem. 10 Specialized Trauma c Brain Injury Treatment Providers 2023 April 2023 27|www.insightscare.com
  • 30. Three months after leaving the medical center, we opened the Institute and were immediately busy. Since then we have grown, expanded services, and moved to a larger facility. Please tell us about yourself and your professional journey so far. Initially, I brought a love of movement (dance) and science together into a physical therapy career. After eight years as a physical therapist treating adults and children with neurological injuries, I entered medical school, choosing physiatry to continue helping people improve their function and their lives. (After a going away party from my physical therapy job, my fellow therapists talked about how I would build "Heather's House of Health"). After completing medical school and Residency in Rehabilitation Medicine at the University of Washington School of Medicine, I became an attending physician in Rehabilitation Medicine at UW and another medical center working in multidisciplinary pain clinics. While I had not taken the "Heather's House of Health" idea seriously, an opportunity arose when I and Dr. James Moore partnered to start the Rehabilitation Institute of Washington, PLLC. Our goal was to form a free-standing rehabilitation center providing multidisciplinary care for people with disabilities. Over the last nearly 20 years, as the organization grew, I have had the privilege to work with and learn from, an amazing team of professionals to provide comprehensive care for people with concussions, more serious brain injuries, long COVID-19, musculoskeletal injuries, and chronic pain. I have been particularly pleased to have been able to explore ways of educating each patient about their health, their body and their brain to empower them to make meaningful changes in their lives. What are the core values that the organization stands by? What is its mission and vision statement? We are dedicated to providing compassionate, patient- centered and cost-effective care of the highest quality. We offer comprehensive interdisciplinary treatment programs for those with complex disabilities but also strive to provide less intensive, focused care when that is sufficient to resolve a problem. At RIW, we pledge to provide the highest quality rehabilitation to assist patients to maximize function in all areas of life; physical, emotional, occupational, recreational April 2023 28|www.insightscare.com
  • 31. and social, and to provide unparalleled customer service to gain the respect and trust of our patients, referral sources and payers of services. How is your company incorporating advancing technology in providing the Concussion and TBI treatment to further customer reach as well as chart its growth upwards? We use telehealth services to improve accessibility and generalization of rehabilitation into the home environment. We provide practice with tools to support cognition including phone apps, calendars, alarms, screen trackers, dictation tools, and notetaking devices like smart pens. Accessibility features are also used to improve access to these tools. Computerized cognitive activities like Attention Process Training III are also used to support metacognitive awareness. These tools provide practice opportunities when engaged in metacognitive strategy training before transitioning the strategies to more complex functional activities. ImPACT computerized cognitive testing will be used in concussion screening. What are the key products and services of the company and how is it impacting the demographic concerned? The unique service we provide is comprehensive interdisciplinary rehabilitation. Under one roof we provide integrated, collaborative care from physicians, neuropsychologists, speech-language pathologists, physical and occupational therapists, and vocational rehabilitation counselors. Current standards for cognitive rehabilitation support metacognitive strategy implementation focused on functional tasks. Collaboratively defined goals and treatment plans specific to each individual are developed. Massed practice of specific skills allows meaningful reintegration into the community. What, according to you, are the challenges faced in supplying specialized services in the industry you are serving? How is the company, with your bale guidance, turning them into opportunities? One challenge is education. Many misconceptions about TBI, particularly mTBI/concussion, exist, even within the medical community. Patients may not understand their recovery process or may get conflicting messages about recommendations for recovery. To support community education, RIW has partnered with community outreach programs like BIAWA to support community education. Additionally, RIW trains students from local universities across disciplines to improve their understanding of TBI. Another challenge is reimbursement. Stakeholders may not understand the benefits of intensive multidisciplinary care when faced with the cost outline. To improve access to services to reduce disability, RIW is developing acute and subacute concussion programs to provide an abbreviated form of the expert services provided by the Brain Injury Rehabilitation Program. What are the future goals of your company and how has it envisioned to scale its operations and reach in 2023 and beyond? We want to make our services available to more individuals. Because funding for comprehensive rehabilitation is not always available, we are developing more focused treatments to provide help for those with persistent symptoms or disabilities. Give us a few testimonials from your clients or customers, and awards or recognition that accurately highlight your company's position in the market. I have been greatly blessed and humbled by the way the RIW team goes to great lengths to create an environment for healing. To be witnessed and guided through such an integrative program along with others who are also in recovery is an experience I won't soon forget. I'm taking the tools and strategies I learned here into the rest of my life." - Tiana P. April 2023 29|www.insightscare.com
  • 32. Stay in touch. Subscribe to Insightscare Get Insightssuccess Magazine in print, & digital on www.insightscare.com Never Miss An Issue Subscribe Today Corporate Office Insights Success Media Tech LLC 555 Metro Place North, Suite 100, Dublin,OH 43017, United States Phone - (614)-602 - 1754,(302)-319-9947 Email: info@insightscare.com For Subscription : www.insightscare.com Check should be drawn in favor of : INSIGHTS SUCCESS MEDIA TECH LLC www.insightscare.com
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  • 34. SUICIDAL IDEATION AMONG YOUTHS IN INDIA – Priscillia Stephen U. April 2023 32|www.insightscare.com
  • 35. ife is full of uncertainties; youths must be cautious Labout the amount of danger to which they expose themselves. There are several determinants that could combine to influence suicidal ideation among youths. They include psychiatric, physical, social and familial determinants, self-esteem, school stress, autonomy, affairs, vulnerability, impulsivity, and thrill-seeking activity. Youths are particularly vulnerable to suicide on account of their emotional immaturity and temperamental instability; rapid additions to knowledge, intense competition, examinations, and poor results expose students to tremendous stress and trigger off depression. Often, high expectations of parents can frustrate them and add to their depression if they are unable to live up to these expectations. Awareness At School and Media Can Help: Suicidal prevention through awareness among youths is, therefore, a high priority, given the fact that in many regions, most people in this age group attend school; this appears to be an excellent place to develop appropriate preventive action. Need for Active outreach and traditional and public campaign to promote mental health and reduce distress is necessary, especially for youths with a history of psychiatric disorder or previous suicidal attempts. According to WHO, suicide is the fourth leading cause of death among those aged 15-29; more than 700 000 people die due to suicide every year. 77% of global suicides occur in low-and-middle-income-counties (LMIC) like India, among the other 218 countries. A prior suicide attempt is the single most important risk factor for suicide in the general population. Ingestion of pesticides, hanging and firearms are among the most common methods of suicide globally. Suicide Rate in India, 2021 In India, according to the National Crimes Record Bureau (NCRB), in 2021, 1,65,033 suicides were reported, and more than 1.39lakh Indians died by suicide in the year 2019, 67% of which were youths (93,061). Compared to 2018 numbers were (89,407). Youth suicide in India has risen by 4%. The overall suicide figures rose by 3.4 % at the same time. Hanging was found to be the most common method of attempting suicide. Around 74,629 people hanged themselves in the year 2019. The Cause of Suicide in India, including Covid-19 Stressors Further reports by NCRB reveals that family issues, love affairs, drug abuse and mental illness (and recently is, COVID-19 Stressor) appear to be the top cause of suicide among youths in India. Major variations are noticed across India, probably related to reporting practices. In 2022 Maharashtra reported the most suicide cases at 22,2027, followed by 18,925 suicides in Tamil Nadu and 14,965 suicides in Madhya Pradesh, all accounting for 50.4% of the total suicides in the country. COVID-19 stressor is an important suicidal determinant; mental health consequences of the COVID- 19 crisis, including suicide ideation, are likely to be present for a long time and peak later than the actual pandemic. The Hindu reported what is possibly the first case of COVID- 19-related suicide, which occurred in Kerala (India) on June 2nd, 2020. There was a significantly higher rate of suicidal ideation among youth, increased stress, anxiety, fears, and loneliness among the youth, due to Covid-19, which appears to correspond with times when Covid-19 stressors and community responses (e.g., stay-at-home orders and school closures) were heightened, and indicating that youth experienced elevated distress. How to Detect Suicide Behavior Before It Happens Warning signs of suicidal ideation among youths include behavioral, verbal and non-verbal cues. It is important to observe these warning signs early and seek immediate help to be able to save lives. Ÿ Talking about: wanting to die, having great guilt or shame, and being a burden to others. Ÿ Feelings: empty, hopeless, trapped or having no reason to live, feeling extreme sadness, anxiety, agitated or full of range, unbearable emotional or physical pain. Ÿ Change in behavior such as: making plans to die, isolating from friends, giving away important items or making a will or suicidal notes, taking a dangerous risk, mood swings substance abuse. To anyone out there who's hurting, it's not a sign of weakness to ask for help. It's a sign of strength. ~~~ BARACK OBAMA April 2023 33|www.insightscare.com
  • 36. Ÿ Verbal cues like—Passing a negative statement” Ÿ “I want to die, end my life,” Ÿ “I am going to kill myself,” Ÿ “It's too much to bear,” Ÿ “You would be better without me,” Ÿ “I am not useful,”" Ÿ “I don't want life anymore" should be taken seriously, and urgent help or referral should be done.” Preventing suicide requires strategies at all levels; this includes preventive and protective strategies for individuals, families and communities. The following ways can help to prevent suicide such as: Ÿ Improving coping and problem-solving skills, Ÿ Self-awareness and emotional regulation, Ÿ Interpersonal relationships with peers, family and mental health and medical provider, Ÿ Stress and Anger management, Ÿ Concentration during class hours, Ÿ Avoid bullying and substance abuse, Ÿ Reach out for help immediately. Note: Youths who feel suicidal are not likely to seek help directly; however, friends, peers and school personnel can recognize the warning signs and take immediate action to keep the youth safe. The following actions should be taken if youths demonstrate signs of suicide: Ÿ Remain calm, Ÿ Speak directly about feelings, Ÿ Assured them that there was help and that they would not feel like this forever, Ÿ Be present and listen, Ÿ Keep them away from means of harm, Ÿ Get help from a psychologist/ psychiatrist/ caregiving adult. Management of suicidal ideation includes a thorough assessment of the individual's Current risk of imminent harm and creating a treatment plan in collaboration with the patient and any involved supports. This process needs to be individualized, collaborative, and completed using a calm, cooperative and curious interview style. Improving the self-confidence and character of the youth will help improve positive behavior. Skill development programs and encouraging more connections, caring and compassion among youths can help reduce the incidence of suicidal ideation. Most people can be treated with a combination of anti-depressant medication and cognitive behavioral therapy; contact your guardian/psychologist/psychiatrist in case of suicidal ideation. In conclusion, we should recognize that suicide has a powerful effect on the individual's family, school and community. We must deal with it as a public health crisis in our schools, clinics and society. The high suicide rate among youths emphasizes the need for urgent intervention. Suicide is a result of a complex dynamic and the unique interplay between numerous contributing determinants. The youths lack the effort to predict and prevent suicide and tend to fail. On the other hand, Improving the knowledge regarding determinants of suicidal ideation and making the youth understand the consequences, will help them to avoid extreme stress; creating awareness among youths regarding determinants of suicidal ideation will substantially decrease the amount of suicide among youth. Priscillia Stephen U I am Priscillia Stephen U., United States Registered Nurse, MSN, BSN. A mental health advocate with First-Class Degree in Nursing from Dr. NTR University, India, and a Postgraduate Degree holder in Psychiatric Nursing. A seasoned professional Nurse, with mul -year experience working with People Tree Hospitals, one of India's Best Performing Hospitals. People Tree Hospitals, India About the Author April 2023 34|www.insightscare.com
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  • 39. Treatment for Personalized Concussion and TBI Meeting Unique Needs Mild traumatic brain injury (TBI), also known as a concussion, is a common occurrence in sports and daily life. It is caused by a blow to the head or body that causes the brain to shake inside the skull. From mild to severe, concussion symptoms might include headaches, nausea, dizziness, blurred vision, and sensitivity to light and sound. While most concussion victims bounce back within a few weeks, some may experience long-term consequences that require specialized care. The traditional approach to concussion and TBI treatment has been a "one size fits all" approach, with standard protocols and timelines for recovery. However, research has shown that individualized treatment plans can be more effective in helping patients recover from concussion and TBI. This approach considers each patient's unique needs, including their symptoms, medical history and lifestyle factors. Assessment and Diagnosis The first step in creating a personalized treatment plan for concussion and TBI is a thorough assessment and diagnosis. This may include a physical exam, neurological exam, imaging tests such as MRI or CT scans, and cognitive tests. These tests can help determine the extent of the injury and the severity of the symptoms. Once a diagnosis is made, the healthcare provider can work with the patient to develop a personalized treatment plan. This plan includes a combination of therapies, such as physical therapy, cognitive rehabilitation and medication. Physical Therapy Physical therapy can be an essential part of concussion and TBI treatment, particularly in cases where there is a April 2023 37|www.insightscare.com
  • 40. significant loss of balance, strength, or coordination. Physical therapy can help improve balance, coordination and strength and reduce symptoms such as dizziness and headaches. To develop a personalized exercise plan addressing their needs therapist will work with the patient. Cognitive Rehabilitation Cognitive rehabilitation is a therapy that focuses on improving cognitive function, such as memory, attention and executive function. This therapy exercises to improve memory, concentration and strategies to help patients manage their symptoms. Cognitive rehabilitation can benefit patients experiencing long-term effects of concussion or TBI, such as difficulty with memory or concentration. Medication In some cases, medication may be used to manage symptoms of concussion or TBI. For example, anti- inflammatory drugs may reduce swelling and inflammation in the brain, while pain medication can help relieve headaches and other pain symptoms. Sometimes, antidepressant or anti-anxiety medication may be prescribed to help patients manage the emotional effects of concussion or TBI. Lifestyle Changes In addition to these therapies, lifestyle changes can be essential to personalized treatment for concussion and TBI. This may include changes to diet and exercise habits and modifications to work or school activities. For example, patients may need to take a break from work or school activities to allow time for rest and recovery, or they may need to modify their work or school environment to reduce the risk of further injury. Patients may benefit from counseling which helps them cope with the emotional effects of concussion or TBI. This may include anxiety, depression, or post-traumatic stress disorder (PTSD). Benefits of Personalized Treatment Personalized treatment for concussion and TBI offers several benefits over traditional, one-size-fits-all treatment approaches. By tailoring the treatment plan to each patient's unique needs, healthcare providers can help improve patient outcomes and reduce the risk of long-term effects. Patients may also experience faster and more complete recovery and can return to work or school more quickly. In addition, personalized treatment can help healthcare providers identify patients at risk for the long-term effects of concussion or TBI. This can help healthcare providers develop strategies to prevent or mitigate these effects, such as monitoring for signs of cognitive decline or providing ongoing therapy to avoid emotional problems. Challenges of Personalized Treatment While personalized treatment for concussion and TBI has many benefits, it also presents several challenges. One of the biggest challenges is the lack of standardized protocols for diagnosis and treatment. This can make it difficult to compare outcomes across patients and may make it more difficult for healthcare providers to develop effective treatment plans. In addition, personalized treatment can be more time- consuming and costly than traditional approaches. It may require additional testing, consultation with multiple healthcare providers, and ongoing monitoring to ensure that the treatment plan is effective. Finally, personalized treatment requires a multidisciplinary approach involving healthcare providers from multiple specialties. This can make coordination and communication between providers more difficult, particularly if patients see providers in different locations or healthcare systems. Conclusion Personalized treatment for concussion and TBI is a promising approach that offers several benefits over traditional, one-size-fits-all treatment approaches. By tailoring the treatment plan to each patient's unique needs, healthcare providers can help improve patient outcomes and reduce the risk of long-term effects. However, personalized treatment also presents several challenges, including the lack of standardized protocols and the need for a multidisciplinary approach. Despite these challenges, personalized treatment offers a promising way to improve the care of patients with concussions and TBI. -Pooja Shah April 2023 38|www.insightscare.com
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  • 43. The Barnes Firm Personal Injury Attorneys Advocates for Vic ms of Brain Injury There’s a good chance that someone you know will be involved in a car accident, pedestrian accident, construction accident, or medical malpractice which could result in a personal injury. In these types of situations, victims—besides suffering from physical pain—are likely to experience psychological anguish because of the defendant's negligence. The Barnes Firm is here to help. Being one of America's largest personal injury law firms, the experienced team of attorneys at The Barnes Firm will help you navigate your personal injury claim. One of the Firm's areas of focus is helping those who suffer from brain injuries, which can range from a complete loss of conscience to a mild form of traumatic brain injury, or TBI. Regardless of the type of injury, the Firm is prepared to assist victims. In an interview with Insights Care, Rich Barnes, President of The Barnes Firm, emphasizes that not only do victims worry about recovering physically, but also face uncertainty about their rights and if they can be compensated for hardships as a result of someone else's negligence. Thus, through his leadership, the Firm's mission is to provide justice for its clients with outstanding legal service and to fight for the maximum recovery possible in the shortest period of time. Following are the excerpts from the interview: Kindly, brief us about the Barnes Firm and its inception. The Barnes Firm was founded by Steve Barnes with offices located in Buffalo, Rochester, Manhattan, Long Island, San Francisco, Los Angeles, and San Diego. After his unexpected passing in 2020, Steve's brother and distinguished attorney Rich Barnes was appointed President of The Barnes Firm. Please tell us about yourself and your professional journey so far. I bring over 40 years of legal experience as a trial lawyer, senior assistant District Attorney, private practice lawyer, and served as President of the WNY Trial Lawyers Association. Our Firm helps those who have been injured by someone else's negligence. As one of Americas' largest personal injury law firms, we help with several types of physical injury, yet we are keenly focused on helping those who have suffered from a brain injury. Whether it is a severe trauma c brain injury with complete loss of conscience or a mild TBI, we offer our experience to assist them with many areas a er the accident, including experts, social programs, insurance, and so on. 10 Specialized Trauma c Brain Injury Treatment Providers 2023 April 2023 41|www.insightscare.com
  • 44. Client Reviews "I was in a car accident and called The Barnes Firm for help. My a orney encouraged me to seek medical a en on immediately when he realized I was in a lot of pain and couldn't remember what happened. A er being seen by medical professionals at a nearby emergency room, I was told I had a concussion and mul ple herniated discs. Over the next few weeks, I no ced that my memory was failing me and that my speech was impaired – there was hesita on with being able to form sentences and I began to stu er, and my words came out mixed up, which was very unusual for me. My a orney supported my decision to pursue more tests and get second and third opinions, as did my care team. I am grateful for the support and a en on I received from my a orney at The Barnes Firm. With the Firms help and guidance, I was able to get the tests I needed and con nue with the appropriate medical care. I am s ll on the road to recovery but the se lement my a orney was able to nego ate for me will help with covering the addi onal costs to extend my ongoing medical care." -Erica B. "The Barnes Firm did an excellent job on my car accident case. Jade was extremely helpful at answering all of my ques ons."-Ghyar. A "The Barnes Firm was very friendly, always quick to respond to our calls and emails. When we had any ques ons or concerns, they were there to walk us through everything. I would recommend them to anyone that is looking for an a orney that will honestly fight for you and has your best interest in mind." -Nichole W. "They handled everything with my accident and got me the maximum amount of money back, more than I thought I would get! Thanks!"-Philip H. April 2023 42|www.insightscare.com
  • 45. What are the core values that the Firm stands by? What is its mission and vision statement? At The Barnes Firm, we are driven by a shared passion for justice and a commitment to honor the legacy of Steve Barnes. Our attorneys are dedicated to obtaining the best possible outcome for every client in every case, no matter the size, severity, or opposition. We are proud to be able to provide our clients with the sense of justice and satisfaction that they deserve. How is your Firm incorporating advancing technology to provide concussion and TBI treatments to help clients? We work with top experts and specialists in their respective fields, whether that be neuroradiologists, neurologists, psychiatrists, neuropsychologists, and related professionals who are on the vanguard in using advanced technology for treatment and diagnosis. What are the key products and services of the Firm and how is it impacting the demographic concerned? Our Firm helps those who have been injured by someone else's negligence. As one of America's largest personal injury law firms, we assist victims who have experienced various types of physical injury, yet we are keenly focused on helping those who have suffered from a brain injury. Whether it's a severe traumatic brain injury with complete loss of conscience or a mild concussion, we offer our experience to assist them with many areas after the accident, including experts, social programs, insurance, and so on. What, according to you, are the challenges faced in supplying specialized services when navigating personal injury? How is the Firm, with your guidance, turning them into opportunities? Many industries need to continue to develop their companies' products and services to target and support individual customers. The Barnes Firm takes a similar approach to helping our injured clients, especially those with TBI, because it is completely dependent on individualized service. All the members of our team must have the knowledge and the skill set to help each TBI client with their specific requirements and needs. Our Firm is built on being able to provide specialized services for this very reason, allowing us to remain laser focused on serving the needs of each client. If you do an outstanding job of truly helping each client, your business will be built upon a strong foundation and will be able to grow organically. What are the future goals of your Firm and how has it envisioned to scale its operations and reach in 2023 and beyond? We plan on continued growth in 2023 and 2024. The Firm will stay focused on developing systems to improve our services and implement AI strategies that will allow our clients to have the best results possible. April 2023 43|www.insightscare.com