Digital clinics for diagnosing and treating migraine.

PURPOSE OF REVIEW: Several innovative digital technologies have begun to be applied to diagnosing and treating migraine. We reviewed the potential benefits and opportunities from delivering migraine care through comprehensive digital clinics. RECENT FINDINGS: There are increasing applications of digitization to migraine diagnosis and management, including e-diaries, and patient self-management, especially after the COVID-19 pandemic. Digital care delivery appears to better engage chronic migraine sufferers who may struggle to present to physical clinics. SUMMARY: Digital clinics appear to be a promising treatment modality for patients with chronic migraine. They potentially minimize travel time, shorten waiting periods, improve usability, and increase access to neurologists. Additionally, they have the potential to provide care at a much lower cost than traditional physical clinics. However, the current state of evidence mostly draws on case-reports, suggesting a need for future randomized trials comparing digital interventions with standard care pathways.

Search for 22Na in novae supported by a novel method for measuring femtosecond nuclear lifetimes.

Classical novae are thermonuclear explosions in stellar binary systems, and important sources of 26Al and 22Na. While γ rays from the decay of the former radioisotope have been observed throughout the Galaxy, 22Na remains untraceable. Its half-life (2.6 yr) would allow the observation of its 1.275 MeV γ-ray line from a cosmic source. However, the prediction of such an observation requires good knowledge of its nucleosynthesis. The 22Na(p, γ)23Mg reaction remains the only source of large uncertainty about the amount of 22Na ejected. Its rate is dominated by a single resonance on the short-lived state at 7785.0(7) keV in 23Mg. Here, we propose a combined analysis of particle-particle correlations and velocity-difference profiles to measure femtosecond nuclear lifetimes. The application of this method to the study of the 23Mg states, places strong limits on the amount of 22Na produced in novae and constrains its detectability with future space-borne observatories.

Report of five rare or previously unknown amyloidogenic transthyretin mutations disclosed in Sweden.

The number of amyloidogenic transthyretin (TTR) mutations described in the literature is more than 100. However, for several mutations, the phenotype has been described in a few individuals only; thus, the knowledge of the clinical course and the outcome after therapeutical interventions such as liver transplantation is limited. We describe the phenotype associated with five rare amyloidogenic TTR mutations that lately were discovered in Sweden: ATTR Val30Leu, Ala45Ser, Leu55Gln, Gly57Arg and Tyr69His of which ATTR Gly57Arg is previously unknown. The symptoms at onset differed, but cardiomyopathy and peripheral neuropathy were observed in all except the ATTR Tyr69His mutation. Likewise, carpal tunnel syndrome was found or had been present in all cases except the case with the ATTR Val30Leu mutation. The phenotype of the ATTR Tyr69His mutation was characterised by oculo-meningeal symptoms with seizures and a steadily progressing dementia, symptoms rarely found in ATTR amyloidosis, but similar to those previously described for this mutation, where all cases appear to originate from one Swedish family. Two patients with the ATTR Leu55Gln and Ala45Ser mutations have been subjected to liver transplantation, but echocardiographic examination has revealed an increasing cardiomyopathy after transplantation in both cases, the ATTR Leu55Gln patient succumbed 2 years after transplantation from progressive disease.

Low Atlantic hurricane activity in the 1970s and 1980s compared to the past 270 years.

Hurricane activity in the North Atlantic Ocean has increased significantly since 1995 (refs 1, 2). This trend has been attributed to both anthropogenically induced climate change and natural variability, but the primary cause remains uncertain. Changes in the frequency and intensity of hurricanes in the past can provide insights into the factors that influence hurricane activity, but reliable observations of hurricane activity in the North Atlantic only cover the past few decades. Here we construct a record of the frequency of major Atlantic hurricanes over the past 270 years using proxy records of vertical wind shear and sea surface temperature (the main controls on the formation of major hurricanes in this region) from corals and a marine sediment core. The record indicates that the average frequency of major hurricanes decreased gradually from the 1760s until the early 1990s, reaching anomalously low values during the 1970s and 1980s. Furthermore, the phase of enhanced hurricane activity since 1995 is not unusual compared to other periods of high hurricane activity in the record and thus appears to represent a recovery to normal hurricane activity, rather than a direct response to increasing sea surface temperature. Comparison of the record with a reconstruction of vertical wind shear indicates that variability in this parameter primarily controlled the frequency of major hurricanes in the Atlantic over the past 270 years, suggesting that changes in the magnitude of vertical wind shear will have a significant influence on future hurricane activity.

Luminescence intensity in coral skeletons from Mona Island in the Caribbean Sea and its link to precipitation and wind speed.

This study investigates the potential of using changes of interannual luminescence intensity in hermatypic Montastraea coral skeletons in the northeastern Caribbean as a proxy of precipitation and (trade) wind speed. In order to find wavelength pairs that are well suited to detect variations in the concentration of incorporated terrestrial humic substances in coral skeletons, and thus to reconstruct past run-off and rainfall, three-dimensional excitation-emission matrix fluorescence spectra of seawater samples were investigated on their relationships to local precipitation. Three prominent excitation-emission peaks at 310/430, 425/480 and 390/530 nm were identified. The fluorescence intensities of the wavelength pair 310/430 nm showed a weak relationship, while the wavelength pairs at 425/480 and 390/530 nm showed strong relationships with local precipitation. Variations in luminescence intensities from scans on the coral surface along the growth axis using the wavelengths identified were then compared with instrumental records of regional precipitation and wind speed. In the coral skeleton as well, the wavelength pairs at 425/480 and 390/530 nm were more strongly correlated with regional precipitation and wind speed. This indicates that these two wavelength pairs are well suited to reconstruct past precipitation and wind speed. In order to evaluate the use as a proxy of trade wind variability in the Caribbean, tropical Atlantic region, variations in luminescence intensity were compared with a record of trade wind variability from the southern Caribbean. The two records are strongly correlated, which suggests that luminescence intensity in coral skeletons, at least from Mona Island, can be used as proxy of trade wind variability and precipitation.