Traumatic Brain Injury News and Information

New Content:Creativity in Caregiving

Mon, 20 May 2013 04:00:00 +0000

Loving wife and elementary educator Abby Maslin continues to put her creativity and teaching skills to good use while helping her husband recover from a severe TBI.

What Kind of Therapies Are Effective for Treating PTSD?

Fri, 17 May 2013 04:00:00 +0000

What kind of therapies are effective for treating PTSD?

Click here to see other video Q&As with Lt. Col. Holcombe.

Click here to return to our BrainLine Military Ask the Expert feature.

What Exactly is Post-Traumatic Stress Disorder?

Fri, 17 May 2013 04:00:00 +0000

What exactly is post-traumatic stress disorder?

Click here to see other video Q&As with Lt. Col. Holcombe.

Click here to return to our BrainLine Military Ask the Expert feature.

What Is the Most Important Thing for a Healthcare Provider to Do When Starting PTSD Treatment?

Fri, 17 May 2013 04:00:00 +0000

What is the most important thing for a healthcare provider to do when starting PTSD treatment?

Click here to see other video Q&As with Lt. Col. Holcombe.

Click here to return to our BrainLine Military Ask the Expert feature.

How Do We Overcome the Stigma of Seeking Help for Psychological Issues?

Fri, 17 May 2013 04:00:00 +0000

How do we overcome the stigma of seeking help for psychological issues?

Click here to see other video Q&As with Lt. Col. Holcombe.

Click here to return to our BrainLine Military Ask the Expert feature.

Why Can Two People Who Have the Same Traumatic Experience Respond and Recover Differently?

Fri, 17 May 2013 04:00:00 +0000

Why can two people who have the same traumatic experience respond and recover differently?

Click here to see other video Q&As with Lt. Col. Holcombe.

Click here to return to our BrainLine Military Ask the Expert feature.

How Do You Use Hypnotherapy to Help Patient with TBI and/or PTSD?

Fri, 17 May 2013 04:00:00 +0000

How do you use hypnotherapy to help patient with TBI and/or PTSD?

Click here to see other video Q&As with Lt. Col. Jeffrey Yarvis, PhD.

Click here to return to our BrainLine Military Ask the Expert feature.

What Should Providers Consider When Developing an Individualized Treatment Plan for a Patient with TBI and/or PTSD?

Fri, 17 May 2013 04:00:00 +0000

What should providers consider when developing an individualized treatment plan for a patient with TBI and/or PTSD?

Click here to see other video Q&As with Lt. Col. Jeffrey Yarvis, PhD.

Click here to return to our BrainLine Military Ask the Expert feature.

How Can Civilian Providers Address Suicide?

Fri, 17 May 2013 04:00:00 +0000

How can civilian providers address suicide?

Click here to see other video Q&As with Lt. Col. Jeffrey Yarvis, PhD.

Click here to return to our BrainLine Military Ask the Expert feature.

As a Psychologist, Do You Treat TBI and PTSD Together or Separately?

Fri, 17 May 2013 04:00:00 +0000

As a psychologist, do you treat TBI and PTSD together or separately?

Click here to see other video Q&As with Lt. Col. Jeffrey Yarvis, PhD.

Click here to return to our BrainLine Military Ask the Expert feature.

Why Is It Important for a Patient to Have a Sense of Control?

Fri, 17 May 2013 04:00:00 +0000

Why is it important for a patient to have a sense of control?

Click here to see other video Q&As with Lt. Col. Jeffrey Yarvis, PhD.

Click here to return to our BrainLine Military Ask the Expert feature.

How Can Service Dogs Help Individuals with TBI and PTSD?

Fri, 17 May 2013 04:00:00 +0000

How can service dogs help individuals with TBI and PTSD?

Click here to see other video Q&As with Kristen Maisano, OTD.

Click here to return to our BrainLine Military Ask the Expert feature.

What Is the Role of the Patient in Occupational Therapy?

Fri, 17 May 2013 04:00:00 +0000

What is the role of the patient in occupational therapy?

Click here to see other video Q&As with Kristen Maisano, OTD.

Click here to return to our BrainLine Military Ask the Expert feature.

How Can Civilian Providers Assess Whether a Patient Needs Occupational Therapy?

Fri, 17 May 2013 04:00:00 +0000

How can civilian providers assess whether a patient needs occupational therapy?

Click here to see other video Q&As with Kristen Maisano, OTD.

Click here to return to our BrainLine Military Ask the Expert feature.

How Do You Help Service Members Transition from the Military to the Civilian Lifestyle?

Fri, 17 May 2013 04:00:00 +0000

How do you help service members transition from the military to the civilian lifestyle?

Click here to see other video Q&As with Kristen Maisano, OTD.

Click here to return to our BrainLine Military Ask the Expert feature.

How Do You Set Goals in Occupational Therapy?

Fri, 17 May 2013 04:00:00 +0000

How do you set goals in occupational therapy?

Click here to see other video Q&As with Kristen Maisano, OTD.

Click here to return to our BrainLine Military Ask the Expert feature.

Homeless People Have 400 Times Higher Risk of Head Injuries, Say Statistics

Fri, 17 May 2013 04:00:00 +0000

Shocking statistics from Canadian researchers indicate that chronically homeless men who drink heavily have 400 times the number of head injuries as the general population. What's more, the rate of traumatic brain injuries with internal bleeding is 300 times higher than among average Canadian men, and the rate of severe head injuries is 170 times as high. In a study published in the Emergency Medicine Journal, researchers led by Dr. Tomislav Svoboda, of St. Michael's Hospital in Toronto, detail findings about head injuries in the general homeless population and among those who live in low-income housing. "We were shocked by the number if [sic] head injuries," said Dr. Tomislav in a news release. "In medicine, we worry when something occurs two or three times more often in a particular patient group, but to talk about magnitudes of 300 or 400 is unheard of."

Aiming at the Top, Again

Fri, 17 May 2013 04:00:00 +0000

On Wall Street, the wheel of fortune can spin around and around, from enormous cash bonuses and luxurious perks one year to the unemployment line the next. Then there is Fred Eckert, a onetime Goldman Sachs partner who soared as a star in “vulture” investing in ailing companies. But in the turmoil of the financial crisis, his business and wealth came crashing down. By 2011, he was bankrupt, divorced and, for two months, in a coma. Today, he is in better shape, earning $1 million a year from a consulting job, although that expires next year. But most of his income is dedicated to paying leftover debts — he says he is running at “break-even at best” after expenses.

New Content:Caregiving for Someone Whose Nose Doesn't Always Know

Thu, 16 May 2013 04:00:00 +0000

Traumatic brain injury makes quirky seem quirkier, especially when a person is in the initial months of recovery. Rosemary learned that Hugh's loss of his sense of smell came with both dangers and quirkiness.

A New Link Between Traumatic Brain Injury and Suicide

Thu, 16 May 2013 04:00:00 +0000

A new study finds for the first time that military members with multiple traumatic brain injuries are more likely to be at risk for suicide, not only in the short term, but throughout their lifetime. The study found that often they sustained some of those head injuries earlier in life — usually while playing sports like football — the impact of which are then compounded by injuries sustained in combat. The study was conducted by Craig Bryan, assistant professor of psychology at the University of Utah and associate director of the National Center for Veterans Studies.

Baffling Rise in Suicides Plagues the US Military

Thu, 16 May 2013 04:00:00 +0000

After Specialist Freddy Hook, a medic with the Army’s 82nd Airborne Division, killed himself in 2010, the trail of possible causes seemed long. He had used illegal drugs: Was it the demons of addiction? His rocky relationship with his fiancée? A wrenching deployment to earthquake-ravaged Haiti or the prospect of an impending tour in Afghanistan? As with most of suicides plaguing the military today, no one will know for sure. “There are so many factors,” said his mother, Theresa Taylor, of Lafayette, La. “Everything that was important to him was having problems.”

New Technology Uses Wireless Signals to Diagnose Traumatic Brain Injury

Thu, 16 May 2013 04:00:00 +0000

New technology is using wireless signals to provide real-time, noninvasive diagnoses of brain swelling or bleeding. The device analyzes data from low-energy electromagnetic waves, similar to the kind used to transmit radio and mobile signals. "Our goal is inexpensive medicine for Mexico," said Boris Rubinsky, a professor at UC Berkeley's Department of Mechanical Engineering. He led the research team along with César A. González, a professor at the Instituto Politécnico Nacional, Escuela Superior de Medicina (National Polytechnic Institute's Superior School of Medicine) in Mexico. The authors noted that in Mexico, 40.7 percent of the population is lacking access to health services; medical imaging in particular is not available to over 60 percent of the world population.

Warrior Games Hits Recovery Bull's Eye

Thu, 16 May 2013 04:00:00 +0000

The slow, smooth pull of string, a moment to sight in on the bull’s eye 18 meters away, and like lighting an arrow thuds into its target. Although British archers were present, it was not Robin Hood and his band of merry men stealing riches, it was a collection of wounded, ill and injured veterans at this year’s Warrior Games held in Colorado Springs, Colo. “I did the trial last year and I loved it,” said Richard Stalder, a Marine team archer. “ I since have gotten out of the Marine Corps and coming back to see my brothers and compete is awesome.”

Former Patriots, Redskins Linebacker Timothy Petersen Adds Name to Growing List of NFL Concussion Plaintiffs

Wed, 15 May 2013 04:00:00 +0000

A former NFL linebacker who played the game in the 1970s and ‘80s has become one of the latest retired football players to sue the league over claims that it intentionally misled athletes on the long-term health risks associated with repeated on-the-field head trauma. Timothy Petersen, a Colorado resident who had a career with the New England Patriots and the Washington Redskins, claims the repeated hits and blows to the head he suffered during his playing years led to present-day health problems. As a result of the head trauma, his lawsuit claims, Petersen suffers from symptoms associated with multiple traumatic brain injury and CTE, including lesions on his brain that have adversely impacted his memory.

New Technology Uses Wireless Signals to Diagnose Traumatic Brain Injury

Wed, 15 May 2013 04:00:00 +0000

Bryce Harper Gives the Nationals Another Scare

Tue, 14 May 2013 04:00:00 +0000

The first thing Bryce Harper wanted to know was, “Is it bad?” That’s what he kept asking Denard Span, the first person who reached Harper last night after he ran into the right field wall. As Harper lay motionless, his manager was concerned he had a concussion. Blood started to trickle down Harper’s neck. Span would later thank God that Harper was not carried off the field on a stretcher, that he had 11 stitches and no concussion, and could walk off without assistance. When he rose to his feet, though, Harper did the kind of thing that defines him. In a 6-0 game in mid-May, as blood formed a morbid necklace under his chin, Harper pleaded with Davey Johnson to let him keep playing.

Eyes May Provide NewInsight into Brain Problems

Tue, 14 May 2013 04:00:00 +0000

The eyes may be the window to the soul, but researchers are finding they also provide a view into the brain that could help detect neurological damage from bomb blasts, sports concussions and a wide range of diseases, including Alzheimer’s and multiple sclerosis. If initial results are borne out, it might eventually be possible to use simple eye tests to evaluate soldiers, athletes or accident victims and to monitor the effectiveness of drugs and other treatments, several scientists said Sunday in Seattle at a meeting of the world’s largest vision-research organization.

New Content:Starting or Nourishing Romantic Relationships After TBI

Mon, 13 May 2013 04:00:00 +0000

Every relationship has its ups and downs, but when a partner or spouse sustains a brain injury, other problems can arise, too.

Texas May Begin Restricting Contact in High School Football Practices

Mon, 13 May 2013 04:00:00 +0000

High school football coaches in Texas could soon be facing restrictions on the amount of full contact allowed in practices per week, assuming the University Interscholastic League medical advisory committee has its way. Last month, the UIL committee unanimously recommended limiting high school teams to 90 minutes of full-contact, game-speed practices per week during the regular season and the playoffs, according to the Fort Worth Star-Telegram. Such practices would be defined as those that include tackling and blocking to the ground. The UIL Legislative Council will consider the proposal in June. If approved, state commissioner of education Michael L. Williams would be the one responsible for signing the proposal into effect.

Hidden Threats to Young Athletes

Mon, 13 May 2013 04:00:00 +0000

In February, hundreds of youth sports safety advocates convened at a Washington hotel. They were determined to talk about something other than concussions, a counterintuitive ambition considering the rampant worry about the effects of head trauma in young athletes. But the Washington group knew something most do not: the No. 1 killer of young athletes is sudden cardiac arrest, typically brought on by a pre-existing, detectable condition that could have been treated. Another substantial yet hidden lethal threat is heat stroke, a condition considered completely preventable. Concussions are receiving attention nationwide, but death from a blow to the head is exceedingly rare. In contrast, a young athlete dies from a cardiac incident once every three days in the United States, researchers say. In hot months like August, heat stroke often causes the death of a young athlete every other day on average.

In Suit Over Death, Boogaard's Family Blames the NHL

Mon, 13 May 2013 04:00:00 +0000

The family of Derek Boogaard has filed a wrongful-death lawsuit against the National Hockey League. It contends that the N.H.L. is responsible for the physical trauma and brain damage that Boogaard sustained during six seasons as one of the league’s top enforcers, and for the addiction to prescription painkillers that marked his final two years. Boogaard was under contract to the Rangers when he was found dead of an accidental overdose of prescription painkillers and alcohol on May 13, 2011. He was 28. He was posthumously found to have chronic traumatic encephalopathy or C.T.E., a brain disease caused by repeated blows to the head.

Scientists Hunt for Ways to Untangle Damage of Chronic Traumatic Encephalopathy

Mon, 13 May 2013 04:00:00 +0000

Bennet Omalu was the first pathologist in the world to detect CTE in a former football player. The year was 2002, and the player was former Steelers center Mike Webster, who had died of a heart attack at the age of 50. Dr. Omalu was a young pathologist working for former Allegheny County Coroner Cyril H. Wecht. As a Nigerian native, he knew very little about American football, except that it was a brutal head-banging sport. Given the reports he had heard about Webster's erratic behavior before his death, he figured the autopsy might show visible evidence of brain damage.

Grant to Fund Nanotech Therapies for Traumatic Brain Injuries

Mon, 13 May 2013 04:00:00 +0000

The U.S. Defense Advanced Research Projects Agency (DARPA) has awarded $6 million to a team of researchers, including MIT’s Sangeeta Bhatia, to develop nanotechnology therapies for the treatment of traumatic brain injury and associated infections. The award brings together a multi-disciplinary team of renowned experts in laboratory research, translational investigation and clinical medicine led by Michael J. Sailor, a professor of chemistry and biochemistry at the University of California at San Diego (UCSD). The team also includes Erkki Ruoslahti of Sanford-Burnham Medical Research Institute and Clark C. Chen of the UCSD School of Medicine.

New Content:Reflections on Motherhood

Thu, 09 May 2013 04:00:00 +0000

Mother’s Day is a holiday that is meant to be full of love and appreciation, but Rosemary has found that the day itself varies intensely from year to year, depending on family dynamics, age, and life circumstances.

New Content:Brain Injury as a Chronic Disease: An Interview with Brent Masel, MD

Mon, 06 May 2013 04:00:00 +0000

Physicians spend a lot of time in school learning about obscure diseases and yet we’re not taught about a medical condition like TBI that every single medical specialist will encounter over and over. Chronic brain injury MUST be a part of every health care student’s curriculum.

New Content:Here’s What I’ve Learned by Accident … How About You?

Thu, 02 May 2013 04:00:00 +0000

People often ask Rosemary what she has learned from Hugh's traumatic brain injury and all that has come after. In this week's blog post, she shares some of the lessons she has learned along the way.

New Content:Level of Executive Functioning Related to Outcome Post-TBI

Mon, 29 Apr 2013 04:00:00 +0000

Measuring outcome after TBI can be tricky, but oftentimes the state of the injured person’s cognitive abilities can shed the most light.

Level of Executive Functioning Related to Outcome Post-TBI

Mon, 29 Apr 2013 04:00:00 +0000

Measuring outcome after TBI can be tricky, but oftentimes the state of the injured person’s cognitive abilities can shed the most light.

New Content:Five Things Caregivers Wish You Would Say

Thu, 25 Apr 2013 04:00:00 +0000

During Hugh's recovery, Rosemary heard many family and friends say, "Let me know what I can do to help." They meant it, but here Rosemary shares five offers caregivers would be grateful to hear — and accept.

New Content:Challenges with Acts of Daily Living After a Brain Injury

Mon, 22 Apr 2013 04:00:00 +0000

Problems with acts of daily living like dressing or washing can vary greatly and sometimes professional help is necessary.

New Content:Life Out of Order

Thu, 18 Apr 2013 04:00:00 +0000

Rosemary talks with author and caregiver Sally Laux who lost her three brothers — two to death, one to a severe TBI.

New Content:Couples' Relationships After Traumatic Brain Injury

Wed, 17 Apr 2013 04:00:00 +0000

After TBI, many couples find that their relationship with each other changes dramatically. These changes are very personal and can be very emotional for both people in the relationship.

New Content:Sexuality After Traumatic Brain Injury

Wed, 17 Apr 2013 04:00:00 +0000

Learn about the common sexual problems that can occur after a traumatic brain injury and ways to improve sexual functioning.

New Content:Can Hearing Aids Help with Tinnitus?

Mon, 15 Apr 2013 04:00:00 +0000

Tinnitus, or ringing in the ears, is a common symptom of TBI. Learn when hearing aids can help and what other treatments are available.

New Content:Banishing Caregiver’s Remorse

Thu, 11 Apr 2013 04:00:00 +0000

Do you feel like no matter how much time you spend caregiving, you are not doing enough? Rosemary has felt that way, too, but realized she needed to do something about it.

New Content:Superman: Suzanne Laboy's Blog

Fri, 05 Apr 2013 04:00:00 +0000

In February 2013, police officer Peter Laboy was shot in the head. His wife, Suzanne, is chronicling the family's journey.

New Content:Succession Planning

Thu, 04 Apr 2013 04:00:00 +0000

Rosemary talks about how planning for life’s unexpected emergencies is never easy or comfortable, but in the long run, it can save a lot of heartache.

New Content:Extending Use of Biomarkers to Pediatric Population with TBI

Tue, 02 Apr 2013 04:00:00 +0000

Researchers and clinicians hope to make using biomarkers to diagnose TBI in infants or even in pre-natal cord blood a reality.

New Content:What the Future Might Hold for Treating Brain Injury

Tue, 02 Apr 2013 04:00:00 +0000

Neuroscientist Dr. Ronald Hayes talks about how, in the future, doctors will be able to map a person's genome, which could help how treatments are developed for brain injury.

New Content:More Science and Insight into Biomarkers for TBI

Tue, 02 Apr 2013 04:00:00 +0000

The more developed biomarkers become through research, the more clinicians will know about an individual injury — biomechanically in the brain — and then, the better they can develop and offer effective treatments.

New Content:What Exactly Is a Biomarker?

Tue, 02 Apr 2013 04:00:00 +0000

A biomarker is any measurement that provides information on a patient's specific organ or organ system. A simple blood biomarker test like those used to test heart attack or liver function is greatly needed for brain injury.

New Content:The Future of Diagnosing Traumatic Brain Injury

Tue, 02 Apr 2013 04:00:00 +0000

No one can definitively predict the future, but neuroscientist Dr. Ronald Hayes offers his thoughts on how developing research will help diagnosing and treating brain injury more effectively.

New Content:The Need for an Objective TBI Test

Tue, 02 Apr 2013 04:00:00 +0000

Neuroscientist Dr. Ronald Hayes talks about how a blood biomarker would be a powerful adjunct to imaging and in-person evaluations when testing someone for a brain injury.

New Content:Biomarkers for TBI: Still Moving from Bench to Bedside

Tue, 02 Apr 2013 04:00:00 +0000

Getting an effective blood biomarker test for TBI from bench to bedside with FDA-approval along the way is no small feat. Dr. Ronald Hayes talks about two proteins for which researchers have high hopes.

New Content:What Does It Mean to Survive?

Fri, 29 Mar 2013 04:00:00 +0000

"Life and living is the very definition of surviving. It is what the living do. Definitions are meant to change. Able to change. For the brain injured, begging to change. What does it mean to you to have survived?"

New Content:Gifts

Thu, 28 Mar 2013 04:00:00 +0000

"Think for a moment about the best gift you have ever received. What made it so different from all the rest?" Rosemary shares one birthday present she will treasure forever.

New Content:Disability Benefits Through the Social Security Administration Are Available for People with Brain Injury

Tue, 26 Mar 2013 04:00:00 +0000

Careful preparation of the disability application is crucial to obtaining appropriate benefits for people with TBI who cannot work.

New Content:Help for Couples After TBI

Thu, 21 Mar 2013 04:00:00 +0000

Rosemary's sister once told her, “There’s the truth we tell others, the truth we tell ourselves, and the truth we won’t even tell ourselves.”It wasn't until she was in therapy after Hugh's crash that she fully understood her sister's words.

New Content:The Evolution of a Complex Brain

Mon, 18 Mar 2013 04:00:00 +0000

Dr. Van Wedeen explains that evolution of the brain must occur with small changes — from a small change in the genome to a small change in the structure to a small change, ultimately, in function.

New Content:Continuous Connectivity Helps with the Brain's Neuroplasticity

Mon, 18 Mar 2013 04:00:00 +0000

Dr. Van Wedeen explains that unlike a telephone switchboard where each wire is unique with no relation to the wires around it, wires or areas in the brain have similar jobs or functions to their neighboring areas, making neuroplasticity possible.

New Content:The Basic Architecture of the Brain

Mon, 18 Mar 2013 04:00:00 +0000

Dr. Van Wedeen talks about how the brain's cortical areas are arranged like a checkerboard, hierarchic from front to back.

Frequent Binge Drinking After Combat-Related TBI Is Not Uncommon

Mon, 25 Feb 2013 05:00:00 +0000

Studies show that binge drinking after a TBI, especially for active duty and veterans, could be a significant risk

Professional Caregiver Burnout with Patients in Minimally Conscious State

Mon, 28 Jan 2013 05:00:00 +0000

Working with patients with severe brain injury can cause emotional exhaustion.

What Is Constraint-Induced Movement Therapy and How Can It Help Children with TBI?

Mon, 07 Jan 2013 05:00:00 +0000

Constraining an unaffected limb while intensely using an affected limb can help children regain upper limb movement after a brain injury.

Long-Term Issues Post-Brain Injury Can Affect Return to Work

Mon, 19 Nov 2012 05:00:00 +0000

More than half of the people with TBI in this study were employed after three years. However, cognitive skills and psychiatric issues remained significant barriers to employment.

The Ability to Drive Safely After a Severe Brain Injury Is Frequently Compromised

Tue, 30 Oct 2012 04:00:00 +0000

Driving takes a great deal of concentration and coordination. Rehab for this complex activity should be a main goal of certain reintegration programs.

Study to Determine Lifetime Prevalence of Brain Injury Among Prisoners

Tue, 09 Oct 2012 04:00:00 +0000

A substantial proportion of prisoners reported having experienced a TBI during their lifetime, something that could impact their success once released.

Study Suggests "Anger Self-Management Training" Is Beneficial After Brain Injury

Tue, 07 Aug 2012 04:00:00 +0000

People who have both problematic anger and cognitive impairment after TBI may benefit from specific psychoeducational treatment.

Biomarkers in Neuroimaging for TBI

Fri, 20 Jul 2012 04:00:00 +0000

Biomarkers are anything that can measure acutely and then identify the prognosis or future development of a person's brain injury. Neuroimaging is used as a way to measure these biomarkers.

Parenting Practices Affect a Child’s Recovery Post-Brain Injury

Tue, 17 Jul 2012 04:00:00 +0000

More authoritarian parenting practices led to lower adaptive functioning in children post-TBI.

More Reasons to Exercise After a Brain Injury

Mon, 04 Jun 2012 04:00:00 +0000

Improved mood, cardiovascular fitness, and increased self-esteem are some of the main reasons people with a brain injury should partake in regular exercise.

What We Know and Don't Know About Blast-Related TBI

Mon, 21 May 2012 04:00:00 +0000

We know that blast waves alone can damage the human brain. But more research is needed to learn how exactly a blast wave alone damages the brain's cells, blood vessels, and structure as a whole.

See more videos with Dr. Frank Tortella.

Acupuncture Helps Brain Injury-Related Sleep Issues

Mon, 14 May 2012 04:00:00 +0000

Medication and acupuncture both help with sleep issues after brain injury but acupuncture has fewer side effects.

More Injury Prevention Efforts Needed for Veterans with TBI

Sat, 05 May 2012 04:00:00 +0000

Veterans with traumatic brain injury are sustaining new, nonfatal injuries after being discharged from inpatient care.

Hope for Biomarkers to Diagnose Brain Injuries

Sat, 05 May 2012 04:00:00 +0000

Research on the use of blood biomarkers for diagnosing brain injuries — in theater and in the civilian world — is getting closer. The hope is to be able to use it as a standard diagnostic tool.