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The pain quality is stabbing and the pain is typically evoked by sensory stimuli like light touch, brushing teeth, cold wind or eating.

Up to half of the patients also have concomitant persistent pain. A smaller proportion of patients may have sporadic autonomic symptoms. The average age of disease onset is in the early fifties and TN is slightly more prevalent in women than in men. As a general rule, the neurological exam is normal in TN patients.

As objective signs of TN, patients may wince at pain paroxysms and may avoid shaving or brushing their teeth on the affected side. Some studies argue that a proportion of TN patients have subtle sensory abnormalities at bedside exam, primarily hypoesthesia. Studies using quantitative sensory testing also documented sensory changes in TN. Rather than indicating nerve damage, the findings may be explained by functional changes of the nervous system in response to severe pain.

There is widespread consensus that TN is associated to a neurovascular contact between the trigeminal nerve and a blood vessel in the prepontine course of the nerve.

Emerging advanced imaging studies confirms that at the site of a neurovascular contact on the ipsilateral side of pain, there is of demyelination — a process that seems to be reversible in some patients after successful surgery.

Imaging studies also consistently show that TN is strongly associated to a neurovascular contact with morphological changes of the trigeminal nerve, i. Meanwhile, only half of TN patients have morphological changes of the trigeminal nerve and there may be other unknown etiological factors causing TN.

The pearls and pitfalls of TN diagnosis and neuroimaging is discussed from both a clinical and a scientific perspective. The first evidence for potential role of PACAP in pathomechanism of migraine was the intravenous administration of PACAP caused headache and vasodilatation in healthy subjects as well as in migraineurs, and lead to delayed-type migraine-like attacks [2].

Preclinical experiments revealed that both PACAP and PACAP were found elevated in the trigeminal nucleus caudalis of rats following electrical stimulation of the trigeminal ganglion or chemical stimulation by nitroglycerin of the trigeminovascular system [3]. A magnetic resonance imaging MRI angiographic study demonstrated that PACAPinduced headache was associated with prolonged dilatation of the middle meningeal arteries, but not of the middle cerebral arteries in healthy volunteers [4].

The recent functional imaging study pointed that intravenous PACAPinduced migraine attacks was associated with alterations in brain network connectivity [6]. Clinical investigation provided evidence of a clear association between migraine phases during a spontaneous migraine attack versus pain-free period and the alteration of plasma PACAP level [7].

The activation and sensitization of the trigeminovascular system by vasoactive neuropeptides might be crucial factors of the migraine pathogenesis [8]. The recent preclinical and clinical studies suggest the importance of PACAP as a future biomarker of migraine headache. Schytz, H. PACAP38 induces migraine-like attacks in patients with migraine without aura.

Tuka, B. Peripheral and central alterations of pituitary adenylate cyclase activating polypeptide-like immunoreactivity in the rat in response to activation of the trigeminovascular system.

Peptides ; Amin, F. Cephalalgia ; Investigation of the pathophysiological mechanisms of migraine attacks induced by pituitary adenylate cyclase-activating polypeptide Brain ; Neurology ; Alterations in PACAPlike immunoreactivity in the plasma during ictal and interictal periods of migraine patients.

Several studies are found a relationship between headache and psychiatric comorbidity in both children and adolescents []. The most frequently described comorbidities include anxiety, mood disorders [1], sleep disorder [2] and attention hyperactive disorder [3].

The association between headache and comorbidities has been interpreted in the light of different possible causal pathways. Psychiatric comorbidity may represent the consequence of a link between neurotransmitter systems involved in migraine and psychiatric disorder, such as depression and anxiety [4]. A central role is thought to be played by serotonergic receptors, adrenergic and dopaminergic D2 receptor genotype, that seem to be associated with migraine, major depression, generalized anxiety disorder, panic attacks and phobia [5].

It has been suggested that the patient’s vulnerability to anxiety disorders and affective disorders as well as migraine might be attributed to the dysregulation of the serotonergic system [6]. Furthermore, it is possible that each disorder increases the risk of the other [4;7]. Therefore, the relevance of other mediating factors for the co-occurrence of headache and psychiatric comorbidity has to be taken into consideration. Recent research found that an insecure attachment may be a risk factor for an outcome of poor adaptation that includes chronic pain [9] and that pain perception may change in relation with specific attachment styles.

The ambivalent attachment seems to be the most common style among patients reporting high attack frequency and severe pain intensity and in children with this attachment style there is a relationship between high attack frequency and high anxiety levels [10].

Barone et al. Although more studies are needed in order to detect the biological, genetic and environmental mechanisms underlying the relationship between headache and comorbidities, attachment styles can be regarded as one of the factors mediating this association [12]. Anxiety, depression and behavioral problems among adolescents with recurrent headache: the Young-HUNT study. The relationship between sleep and headache in children: implications for treatment. Headache and attention deficit and hyperactivity disorder in children: common condition with complex relation and disabling consequences.

Epilepsy Behav. Migraine and psychiatric comorbidity: a review of clinical findings. Mol Med. Association of 5-HTT gene polymorphisms with migraine: a systematic review and meta-analysis. J Neurol Sci ; : Headache and comorbidity in children and adolescents. J Headache Pain ; Genetic and environmental influences on migraine: a twin study across six countries.

Twin Res. Pain and emotion: a biopsychological review of recent research. J Clin Psychol ; 67 9 : Attachment styles in children affected by migraine without aura. Neuropsychiatr Dis Treat. Behavioural problems in children with headache and maternal stress: is children’s attachment security a protective factor? Dev ; DOI: The role of attachment insecurity in the emergence of anxiety symptoms in children and adolescents with migraine: an empirical study.

J Headache Pain In Press. Metabolic syndrome and overweight are highly prevalent among migraineurs and the weight-loss was suggested as a useful strategy to improve both migraine and metabolic syndrome.

Recently, we have observed that a particular version of VLCD characterized by very low-carbohydrate intake and Ketone bodies KBs production, named very low-calorie ketogenic diet VLCKD , was able to induce a rapid improvement of headache in migraineurs. To assess if the favorable outcome on migraine was due to the caloric restriction, instead of KBs, we performed a double blind crossover study to compare headache modifications during a VLCD and a VLCKD in a population of overweighed and obese migraineurs.

Among patients referred to the Sapienza University Obesity Clinic, a neurologist specializing in headache recruited 35 migraineurs. To verify variations in headache frequency, we used as baseline the month before the first VLCD and the first transition diet. Headaches are one of the most disabling disorders [1].

Moreover, recent knowledge have suggested that physical examination for provocative procedures should be done on each patient with side- locked headaches as many of these headaches may closely mimic primary headaches [4]. There have been identified eleven physical tests to properly assess cervical disorders.

When these dysfunctions are present, they support a reciprocal interaction between the trigeminal and the cervical systems as a trait symptom in migraine [6, 7]. In this presentation, an evidence based physical protocol of specific tests it will be provided by a physiotherapist to assess musculoskeletal disorders in the most common primary headaches as Migraine and Tension Type Headache. Moreover, the integration of this examination in a multidisciplinary team it will be discussed.

Stovner LJ. Migraine prophylaxis with drugs influencing the renin- angiotensin system. Eur J Neurol. Prevalence of neck pain in migraine and tension-type headache: a population study. Temporomandibular disorders is more prevalent among patients with primary headaches in a tertiary outpatient clinic. Arq Neuropsiquiatr. Prakash S, Rathore C. Side-locked headache: an algorithm based approach. The Journal of Headache and Pain ; doi International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study.

Man Ther. Musculoskeletal dysfunction in migraine patients. The International Classification of Headache Disorders, 3rd edition beta version Jul;33 9 Headache represents the most common neurological symptom in pediatric age. Among the primary headaches, migraine is far more prevalent than tension-type headache and cluster headache. Though extremely rare at this age, also trigeminal autonomic cephalgias have been reported.

The most frequent causes of pediatric secondary headaches are represented by respiratory tract infections, while potentially life-threatening diseases, such as brain tumors, are less common.

However, especially in the emergency setting, the possibility that a headache attack is due to a brain tumor must be always considered. To avoid missing these cases, some headache characteristics red flags have been identified [1]. However, while the most recent ICHD criteria improved the possibility to classify some patients, such as children with migraine with aura [2], they turned out to be unsuitable for others, such as young patients with primary headache.

Several studies have shown the primary role played by psychological factors in determining the severity of migraine in children [4]. Therefore, a psychological examination is often mandatory, as part of the initial assessment of the patient.

Lastly, when assessing a child with primary headache, possible comorbidities should be never forgotten, since addressing them can represent a crucial point for the treatment [5]. Headache as an emergency in children and adolescents. Curr Pain Headache Rep ; Cephalalgia, submitted. Diagnosis of primary headache in children younger than 6 years: A clinical challenge. Cephalalgia ; Chronic Migraine in Children and Adolescents. Headache and comorbidities in childhood and adolescence.

Springer, Whether medication-overuse headache MOH represents a distinct biological entity within the concept of chronic daily headache with specific neurobiological and genetic background is still a matter of debate. A great deal of interest has been directed at understanding the neurophysiological mechanisms that underlie MOH pathogenesis.

Currently, two main, non-mutually exclusive hypotheses have been proposed. The first, stems from the apparent compulsive use of headache medications by MOH patients, and considers this disorder a sort of addiction to symptomatic remedies.

The second shifts the focus from drug addiction to neural sensitization, claiming that triptan overuse triggers adaptations of the trigeminovascular system, thereby facilitating pain transmission and leading to a state of latent sensitization.

Answering these questions might be relevant to better understand the neurochemical mechanisms prompted by acute headache medications that underlie the pathophysiology of MOH and of chronic headache in general. In this presentation, preclinical data will be presented showing that chronic exposure to eletriptan or indomethacin alter trigeminal ganglion gene expression patterns broadly and to a similar extend. Remarkably, qualitative transcriptomic analysis reveals that prolonged exposure to the two different symptomatic drugs triggers almost identical, increased expression of various genes coding for proteins involved in headache pathogenesis such as neuropeptides, their cognate receptors, TRP channels, prostanoid and NO synthesizing enzymes.

These findings will be correlated with the clinical aspects of MOH. The dramatic caloric restriction promotes the fat metabolism, mimicking the starvation, even if meals replacements ad hoc developed accounts for essential nutrients, avoiding the malnutrition.

Because of the extreme caloric restriction, this type of diet is very effective in weight loss, however, that characteristic also is the main limit of VLCD, since it is possible to follow this kind of dietetic regimen for a very limited period usually weeks. Salads are allowed ad libitum dressed with a spoonful of olive oil. Also in this kind of diet, there are meals per day, mainly consisting in meal replacement products.

There is a growing interest in the ketogenic form of the VLCD because several studies have shown a higher compliance of patients with this diet.

The reason of this higher adherence to the diet is still under scrutiny but several reasons are called in cause: an appetite suppression induced by proteins and maybe by ketone bodies KBs , or a modification in hormone secretion insulin, glucagon, ghrelin, adipokines. The real impact of ketogenic diets in weight loss is still disputed; in fact, on the long period there are not differences between low-carb and low-fat diets in terms of weight reduction and regain of lost weight after the diet.

However, thanks to the higher compliance and the drastic caloric restriction, the VLCKDs seem to be a promising approach in the early management of obesity and in the preparation phase for patients that must undergo to bariatric or other types of surgical procedures.

Temporomandibular disorders TMD represent the main cause of orofacial pain of non-dental origin and comprehend several disturbances of the masticatory system characterized by myofascial pain of masticatory muscles or articular pain localized in the pre-auricular area. Moreover, TMD patients show temporomandibular joint sounds and deviation or limitation of the opening of the mouth.

Myofascial pain is a probable consequence of central nervous system mechanisms of convergence and activation of second order neurons with enlargement of the receptive field, reduced pain threshold and allodinia.

Often there are accompanying symptoms like facial pain and headaches. Headache is the most prevalent neurologic disorder, third most diffused health disturbance and the seventh cause of disability in the world. It can be primary, without apparent organic cause, or secondary to other pathologies. Some epidemiological studies indicates that headache is more prevalent in TMD patients and TMD is more prevalent in subjects affected by headache.

A stronger association exists between TMD and chronic migraine in comparison with other types of headache. Nevertheless the methodological quality of the available studies is not optimal and many of them classify patients with anamnestic questionnaire that tend to overestimate the values of prevalence. A growing body of literature suggests that the association between headache and TMD may be a manifestation of a central sensitization mechanism.

Temporomandibular joint and muscles receive the sensitive innervation of the trigeminal nerve that supply also the cranial vascular structures likely involved in the etiology of the headache. The sensitization of the trigeminal caudate nucleus by the TMD symptoms can favor the triggering of migraine episode. Beside the epidemiological studies and the neurophysiologic hypothesis, there are some initial clinical evidence that show how severity of TMD symptoms parallels an increase of frequency and intensity of migraine and the simultaneous treatment of both conditions results in better outcomes.

From a clinical perspective, a comprehensive assessment based on a biopsychosocial approach can provide relevant information to plan a contemporaneous treatment of TMD and headache, together with an intervention targeted to the reduction of psychosocial conditions that can elicit and maintain mechanisms of central sensitization likely responsible of the comorbidity of TMD and headache.

The exact pathophysiology is still unknown, but evidence supporting both peripheral and central mechanisms i. In fact, the frequency of headache attacks has found to be related to the level of central sensitization [4]. However, not all TTH patients present with the same level of central sensitization and clinical presentation, but subgroups need to be identified in order to offer specific therapeutic programs [5]. Prolonged peripheral nociceptive input from the pericranial, neck, and shoulder regions e.

In fact, it has been found that sustained stimulation of TrPs may induce central sensitization in healthy participants [7]. The number of TrPs seems to be associated with the degree of widespread pressure pain hypersensitivity in TTH patients, supporting the role of TrPs on central sensitization: however the cross-sectional nature of the study does not allow to establish a cause and effect relationship between TrPs and central sensitization, as other variables may influence this association [9].

Physical therapy may be helpful for the management of TTH patients [10,11], as it may decrese the peripheral nociceptive input. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia ;— Tension type headache. Curr Rheumatol Rev ; — Pressure pain thresholds assessed over temporalis, masseter, and frontalis muscles in healthy individuals, patients with tension- type headache, and those with migraine: A systematic review. Pain ; — Frequency of headache is related to sensitization: a population study.

Pain ; Identification of subgroups of patients with tension type headache with higher widespread pressure pain hyperalgesia. J Headache Pain ; 18 1 The role of muscles in tension-type headache. Curr Pain Headache Rep. Sustained nociceptive mechanical stimulation of latent myofascial trigger point induces central sensitization in healthy subjects. J Pain.

Myofascial trigger points and sensitization: An updated pain model for tension-type headache. Trigger Points are associated with widespread pressure pain sensitivity in people with tension-type headache. Cephalalgia [Epub ahead of print]. Muscle trigger point therapy in tension-type headache. Expert Rev Neurother ; 12 3 Effectiveneess of physical therapy in patients with tension-type headache: literature review.

J Jpn Phys Ther Assoc ; 17 1 Migraine is related to the highest disability among headaches. Great efforts are faced to improve the outcome of forthcoming treatments. However, still now, many patients regard as unsatisfactory the low responder rate about the half of patients and adverse effects that current treatments account. Therefore, waiting for innovative, more tolerated and effective treatments, there is a large request for non-pharmacological approaches that in many cases have specific pathophysiological targets.

Among these treatments, nutraceuticals has a leading role. Several nutraceutical products are proposed for migraine and sold around the world, but researchers adequately study only few compounds. Among studied nutraceuticals compounds, only few of them have studies of good quality in support. Moreover, also interactions among different molecules are not studied. We have reviewed literature data in order to find researches that support the use of nutraceutical molecules in migraine management.

Available good quality data support the use of certain nutraceuticals, in particular riboflavin, coenzyme Q10, magnesium, butterbur, feverfew, and omega-3 polyunsaturated fatty acids. Even if not supported by double blind studies, recently some prospective observational studies about fixed combination of nutraceuticals were performed. For instance, it is the case of a combination of coenzyme Q10, feverfew and magnesium for migraine prophylaxis: a prospective observational study. A double blind versus placebo study about the effect of a fixed combination of riboflavin, coenzyme Q10, feverfew, andrographis and magnesium for migraine prophylaxis is currently in progress.

Usually patients appreciate nutraceuticals more than traditional drugs, since they are regarded as safe and of efficacy not inferior to other pharmacological products. Available data seem to support this widespread belief, but some concerns about the regulation of nutraceuticals and quality of some products, still remain. Contrary to what is generally thought of, headaches and algology pain therapy share many aspects.

Headaches and chronic non-oncological pain are two paradigms of chronic illness capable of generating enormous individual and social impact by disabling the sick person not only in the biological, but also in the psychological, professional, social and relational spheres.

Both cause alterations in psychological equilibrium, secondary depression, loss of social and professional roles, which, in the most serious cases, can cause loss of work. Literature documents in both cases, headaches and chronic pain, a rise in direct costs but above all of the indirect ones with a huge burden of disease. Both are capable of generating a marked drop in the quality of life associated with a serious bio-psycho-social disability.

Headaches and chronic pain, although distinct according to a topographical criterion, share many mechanisms and physiopathogenetic steps. One of the most current fields in which neurologists and pain therapists converge is the focus on neuroinflammation [3] and central sensitization[4], two key mechanism for triggering, maintaining, and subsequent perpetuation of pain: the pain as a symptom, filogenetically responsible for maintaining homeostasis of the organism against actual or potential damage, becomes unnecessary illness without any protective meaning.

Another important shared pathogenetic passage is that of neuroimmune mechanisms, which interlink the immune system with the central nervous system[4].

Furthermore, numerous contribution to the scientific international literature highlight the need to modify the therapeutic approach, directing it towards a semeiotic criterion pain phenothype: specific sign and symptoms of a certain type of pain in a specific moment , which is an epiphenomenon of underlyng pathogenetic mechanism, instead of basing it on a etiologic criterion[5].

This would enable a more appropriate prescription and greater efficiency, taking into primary consideration the possibility of getting back to everyday life rather than obtaining complete analgesia. All the above mentioned aspects are equally important but one of them can prevail over the others depending on patient characteristics and background.

In conclusion it can be stated that the aspects of sharing between headaches and chronic non-oncological pain are significantly greater than those that clearly divide them.

World Health Organization. International classification of functioning, disability and health ICF. Geneva, World Health Organization, Steiner T. J Lifting the burden: The global campaign against headache. Ru-Rong Ji Emerging targets in neuroinflammation-driven chronic pain. Nat Rev Drug Discov.

Baron R Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. Headache is a common clinical feature in neurological patients. Usually, neuroimaging is unnecessary in patients with episodic migraine or tension type headache with typical headache features and with a normal neurological examination. These patients do not have a higher probability of a relevant brain pathology compared to the general population.

A recent study, however, reported that neuroimaging is routinely ordered in outpatient headache even if guidelines specifically recommend against their use. Brain MRI with detailed study of the pituitary area and cavernous sinus, is recommended for all trigeminal autonomic cephalalgias TACs.

Neuroimaging should be considered in patients presenting with atypical headache features, a new onset headache, change in previously headache pattern, headache abruptly reaching the peak level, headache changing with posture, headache awakening the patient, or precipitated by physical activity or Valsalva manoeuvre and abnormal neurological examination.

A recent consensus recommends brain MRI for the case of migraine with aura that persists on one side or in brainstem aura. According the same consensus, fFor primary cough headache, exercise headache, headache associated with sexual activity, thunderclap headache and hypnic headache apart from brain MRI additional tests may be required [3]. Particularly in emergency room it is mandatory to exclude a secondary headache that requires special attention and further diagnostic workup.

CT scan is the first line neuroimaging examination. MRI offers a greater resolution and discrimination and might therefore be the preferred method of choice in non acute headache.

In addition, radiation due to CT scanning may be avoided. Neuroimaging non conventional techniques are of little or no value in the clinical setting. Headache neuroimaging: Routine testing when guidelines recommend against them. European Headache Federation consensus on technical investigation for primary headachedisorders.

Migraine frequency fluctuates over time. In the literature, the most important recognized factors associated to chronic migraine are overuse of acute migraine medication, ineffective acute treatment, obesity, depression, presence of allodynia and stressful life events.

Other factors reported in studies are age, female sex and low educational status. Very recently, a large population study suggested that the presence of additional noncephalic pain site is a risk factor for migraine chronification.

For many of these factors the relationship with migraine chronification may however be bi-directional. For instance, in the case of depression, it is possible that depression may negatively affect the response of migraine to acute and prophylactic treatments, but it is also true the opposite: i.

In the case of obesity, the association with chronic migraine may simply be ascribed to the effect of fat tissue in drug distribution. Beside and beyond the putative biological factors that may cause a worsening of disease, several lines of evidence suggest that the progression from episodic to chronic migraine is associated to a progressive increase and stabilization of functional and anatomical changes associated to chronic sensitization.

In this frame, it appears obvious that an additional cause for chronic migraine is quite likely represented by the low rate of prescription of preventive medications. The underutilization of preventive drugs has several explanations ranging from drug-associated issues limited efficacy, poor tolerability profile to education of practitioners, pharmacists and patients, and it also involve the limited access to qualified care.

Underutilization of preventative drugs also translate into a higher recourse to acute drugs, thus feeding on a vicious cycle that leads to negative consequences.

CT has participated in advisory boards for Allergan and electroCore; she has lectured at symposia sponsored by Allergan; she is PI or collaborator in clinical trials sponsored by Alder, electroCore, Eli-Lilly and Teva. Prevalence of migraine sufferers who are candidates for preventive therapy: results from the American migraine study AMPP study. Headache ; — The added value of an electronic monitoring and alerting system in the management of medication-overuse headache: A controlled multicentre study.

To date, the majority of clinical studies concerning primary headaches and their comorbidities are focused on migraine. Comorbidities of migraine may include neurological and psychiatric conditions, as mood disorders depression, mania, anxiety, panic attacks , epilepsy, essential tremor, stroke, and the presence of white matter abnormalities [2].

Particularly, a complex and bidirectional relation between migraine and stroke has been described, including migraine as a risk factor for cerebral ischemia, migraine caused by cerebral ischemia, migraine mimicking cerebral ischemia, migraine and cerebral ischemia sharing a common cause, and migraine associated with subclinical vascular brain lesions [2].

A recent meta-analysis pointed out that migraine is associated with increased ischemic stroke risk [3], and according to a systematic review and meta-analysis [4] the risk of hemorrhagic stroke in migraineurs is increased with respect to non-migraineurs. Besides, the risk of transient ischemic attack seems to be increased in migraineurs, although this issue has not been extensively investigated [5].

A recent systematic review and meta-analysis also describes an increased risk of myocardial infarction and angina in migraineurs compared to non-migraineurs [6]. Concerning the association between migraine and vascular risk factors arterial hypertension, diabetes mellitus, dyslipidemia, obesity, alcohol consumption, family history of cardiovascular disease , a recent review [7] showed no solid evidence of an increased burden of conventional vascular risk factors in migraineurs, with the only exceptions of dyslipidemia and cigarette smoking, while a systematic review and meta-analysis regarding migraine and body mass index categories [8] found an increased risk of having migraine in underweight subjects and in obese women as compared with normal-weight subjects.

Few studies investigated the comorbidities of tension-type headache TTH , despite the fact that tension-type headache TTH is highly prevalent, and may be as debilitating as migraine [9].

It is noteworthy that, according to a review, TTH is associated with increased rate of affective distress [9]. Furthermore, some medical disorders may worsen a preexisting TTH, and it has been described the comorbidity of TTH with psychiatric disorders and fibromyalgia [10].

The International Classification of Headache Disorders, 3 rd edition beta version. Comorbid neuropathologies in migraine. Migraine headache and ischemic stroke risk: an updated meta-analysis.

Am J Med. Migraine and hemorrhagic stroke: a meta-analysis. Sacco S, Kurth T. Migraine and the risk for stroke and cardiovascular disease.

Curr Cardiol Rep. Migraine and risk of ischaemic heart disease: a systematic review and meta-analysis of observational studies. The cost is based per organization and is very reasonable. If there is an interest let us know. The system works in an A. If you got an email from us regularly, but one email originated from a country in Europe not our usual IP address it would flag it.

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With this best practice, you can have your meeting almost anywhere, and disguise whatever happens in the background around you. Naturally, Microsoft Teams offers custom backgrounds for meetings. Speaker View and Gallery View: essentially, you can see the person talking right now or see everyone at once.

Microsoft Teams adds another: Together Mode. This is optional, and turning it on only changes things on your screen. Is this useful? Will it make you feel slightly less alone during a year in which in-person interaction is rare? Is it somewhat amusing? Zoom offers a closed captioning feature, but someone has to manually type them out.

Live captions can make your meeting more inclusive to participants who are deaf or hard-of-hearing, people with different levels of language proficiency, and participants in loud places by giving them another way to follow along. Microsoft Teams is included with every version of Microsoft for business. This means that, if your company pays for a Microsoft Office subscription, you already have access to Teams.

Features Group and private chat. Video calling, audio calling, and screen sharing. Schedule video calling. Thread messaging. Works seamlessly with any other Office app. Up to people per video call. Over integrations. Available in 53 languages. Best for Microsoft-centric teams.

Organizations that want to keep ideas organized and compartmentalized. Computer security threats are relentlessly inventive. Masters of disguise and manipulation, these threats constantly evolve to find new ways to annoy, steal and harm. Arm yourself with information and resources to safeguard against complex and growing computer security threats and stay safe online. Examples of Online Cybersecurity Threats Computer Viruses Probably the most eminent computer security threat, a computer virus is a program written to alter the way a computer operates, without the permission or knowledge of the user.

A virus replicates and executes itself, usually doing damage to your computer in the process. What can you do to avoid computer viruses? Carefully evaluate free software, downloads from peer-to-peer file sharing sites, and emails from unknown senders. These things are critical to avoiding viruses. Most web browsers have security settings which can be configured for top defense against online threats. Spyware Threats A serious computer security threat, spyware is any program that monitors your online activities or installs programs without your consent for profit or to capture personal information.

As always, if a company you do not recognize is advertising for a deal that seems too good to be true, be sure you have an internet security solution in place and click with caution. Hackers and Predators People, not computers, create computer security threats and malware. Hackers and predators are programmers who victimize others for their own gain by breaking into computer systems to steal, change, or destroy information as a form of cyber-terrorism.

These online predators can compromise credit card information, lock you out of your data, and steal your identity. As you may have guessed, online security tools with identity theft protection are one of the most effective ways to protect yourself from this brand of cybercriminal. Phishing Masquerading as a trustworthy person or business, phishers attempt to steal sensitive financial or personal information through fraudulent email or instant messages. Phishing attacks are some of the most successful methods for cybercriminals looking to pull off a data breach.

Antivirus solutions with identity theft protection can be taught to recognize phishing threats in fractions of a second. Cyber Safety Tips Keep software systems up to date and use a good anti-virus program. Examine the email address and URLs in all correspondence.

Scammers often mimic a legitimate site or email address by using a slight variation in spelling. If an unsolicited text message, email, or phone call asks you to update, check, or verify your account information, do not follow the link provided in the message itself or call the phone numbers provided in the message.

Scrutinize all electronic requests for a payment or transfer of funds. Be extra suspicious of any message that urges immediate action.

Confirm requests for wire transfers or payment in person or over the phone as part of a two-factor authentication process. Do not verify these requests using the phone number listed in the request for payment.

The good news is that you have options. What Does End of Support Mean? Microsoft Office has been a popular version of the application over the last decade.

The unfortunate news is that support for it ends this fall — on October 13, , to be exact. All of your Office apps will continue to function. However, using an unsupported version of any software exposes your computer to serious and potentially harmful security risks. Microsoft will no longer provide technical support, bug fixes, or security fixes for Office vulnerabilities that may be subsequently reported or discovered.

This includes security updates that help protect your PC from harmful viruses, spyware, and other malicious software. No further updates to support content will be provided, and most online help content will be retired.

Another difficulty you may face is incompatibility with some of the newer programs and file formats. The best part about cloud-based applications is that you no longer have to worry about retirements, patches, and end of support.

Cloud licenses are automatically updated with new features, new applications, and security updates. Many cloud subscriptions also include installed or desktop versions of the application, so you can have the same look and feel of the Office applications you are accustomed to using, but built with more robust features and benefits. Microsoft Office Standard Microsoft Office Standard is the latest version of the on-premises version of the office suite and is a good option for you if you are not ready for the cloud version at this time.

In addition to being an investor and a judge on the hit ABC show, Corcoran formerly owned the global real estate agency that shares her name. Corcoran fell for a phishing scam. Phishing attacks are common methods of stealing usernames, passwords and money. Hackers pretend to be a trustworthy source to convince you to share personal data.

Google has rolled out security protections that warns people of potential unsafe emails. If you or your team have any questions or concerns please contact support at We are proud to announce that due to our business growth we will be moving to a new location in For the past two years we have been working with our township and service professionals to rezone and prepare to rehab a property to allow our business to continue to grow for the forseeable future.

Contact us, we can help! The Mineola School District was also attacked by the same virus. What are some tips to avoid having to pay the ransomware The nefarious ransomware business model has turned out to be a lucrative industry for criminals. Over the years its ill repute has made law enforcement team up with international agencies to identify and bring down scam operators. Most of the ransomware attacks that have taken place in the past have been linked to poor protection practices by employees and businesses.

There are ways to prepare and steps you can take to avoid the nuances these hackers are causing. Do not pay the ransom. It only encourages and funds these attackers. Even if the ransom is paid, there is no guarantee that you will be able to regain access to your files. Restore any impacted files from a known good backup.

Restoration of your files from a backup is the fastest way to regain access to your data. Do not provide personal information when answering an email, unsolicited phone call, text message or instant message. Phishers will try to trick employees into installing malware, or gain intelligence for attacks by claiming to be from IT.

Be sure to contact your IT department if you or your coworkers receive suspicious calls or emails. Use reputable antivirus software and a firewall.

Maintaining a strong firewall and keeping your security software up to date are critical. Do employ content scanning and filtering on your mail servers. Inbound e-mails should be scanned for known threats and should block any attachment types that could pose a threat. Do make sure that all systems and software are up-to-date with relevant patches.

Exploit kits hosted on compromised websites are commonly used to spread malware. Regular patching of vulnerable software is necessary to help prevent infection. Ransomware criminals often attack small and medium sized businesses. Among other cyber attacks, ransomware is one criminal activity that can be easily worked around with the above-mentioned solutions. The next update is scheduled to start on August 5, Fixed an issue related to the OS feature on the agent, which was randomly failing with a medium severity while applying the Management policy.

The event is now removed and will not be displayed in the console. Enhancement to process HTTP error status code request. The SEP Cloud agent will not attempt to connect with the cloud when the status code is returned, but instead, try to connect based on the timeout information. If the timeout information is not available, then the product will retry to connect in 15 minutes by default.

This update does not affect the security of your devices. To start, the update is distributed to a small set of clients over the first seven days of the release, and then the remaining clients will get the update.

Action Required Windows device restart All users with Windows devices will be prompted to restart their devices after the update. Even if they delay the restart, their Windows clients remain Protected. If no user is logged on the device when the upgrade is made available, then the prompt is provided until the user logs on.

The product update will not force the restart of the device. Windows installation package refreshAdministrators who created a Windows installation package before August 5 should create and distribute a new one after August 5 to use for new Windows package deployments.

Effectively engaging alumni brothers and community members to generate new volunteers and donors to support the chapter. Consistent communications and events, a visible and engaged Alumni and Volunteer Corporation, and active volunteer recruitment leads to a well-cultivated alumni base and a lasting affinity for SigEp NC Iota.

Located in South Jersey easily accessible from all major highways and an easy detour on the way to the shore. They are on a secured 1. Your buddy will be treated like one of their own. They will never be at a loss for play time, with 6 trained Labradors there is always something to do.

Newport Construction Corporation is a multi-faceted construction management and general contracting firm that is defined by its committed principals, professionals, and core values. What does that mean for you?

First, security patches and updates will no longer be implemented, leaving Windows 7 workstations and servers susceptible to security breaches. On January 13, , Microsoft ended mainstream support for Windows 7, but now extended support is ending as well.

Extended support is still safe to use until currently. Normally Microsoft would add new features during the mainstream support phase, but they will not be being doing this anymore. They will however, continue to patch any security treats. What are the next steps for your business? Many of our clients are starting to upgrade now or are planning to include the upgrades in their budget.

Send us an email or give us a call and we will evaluate your line of business software for Windows 10 and upgraded server compatibility. You can have peace of mind knowing your old data will be securely erased and destroyed. Unsure if this deadline will affect your business? If you have any questions or concerns about your office and the end of support date, please give us a call today: Whether you are upgrading an existing device, buying a new one, or just need support deploying, we have the help you need.

Contact Us For More Information Comfort Callers was founded and is managed by a team comprised of Paramedics, Emergency Medical Technicians, Police Officers and Home Care workers who wanted to bridge the gap between those who want to remain at home and independent and their family and friends who are concerned about their well being.

Being smart, you try to start Word in safe mode by holding down the Ctrl key, but the exact same thing happens. Annoying, when you want to do your work. What is going on? We took a look at a case like this. Two things you should do after the usual reboot : 1. Look in the event viewer. One has expired, the other is fine. The guilty party may or may not be the trial version of Office typically pre-installed with a new PC.

Or it could be a consequence of changing your Office subscription. Solution: we reinstalled Office from the Office portal, and attempted to remove the dud product key with: cscript ospp.

All is well for the moment. Activation and subscription license checking is for the benefit of the vendor, not the user, and should never get in the way like this. Further, cannot Microsoft find some way of informing the user when this happens, and not have Word simply hang on starting?

How difficult is it to check for licensing and activation issues, and throw up a message? Exclusive offer from BigBeagle. Great products just for you. Hurry before the offer expires. Use promo code in your cart when you order. Applicable to new purchases only. Enter promo code into shopping cart to see full details. Offer expires Tuesday, September 11, at midnight Mountain Time. All rights reserved Microsoft last week released the first preview of what will become Windows 10 version , the opening feature upgrade of next year, slated to ship in the spring.

If so, it would be the first time since late that the actual delivery date matched the numerical label. Microsoft uses a yymm labeling system to mark its Windows 10 feature upgrades; should indicate a September release, while would be a March release. When it forks preview code, Microsoft provides the even-further-in-the-future build, in this case, , to Windows Insider participants who earlier volunteered for Skip Ahead. As the current feature upgrade gets close to release, Microsoft switches Skip Ahead users to the following upgrade, so that engineers can start collecting feedback on that version even as they keep polishing the one set to launch soon.

The bulk of Insiders remain on the latter. Windows 10 began its release cycle on Oct. For one estimate of the release date for Windows 10 , Computerworld added 47 days to July 25, arriving at Sept. A second estimate was generated by adding 61 days — the average of the two previous Skip Ahead triggers — to July 25, resulting in a Sept. Because the last three feature upgrades launched on either a Monday or Tuesday — April 11, for version ; Oct.

Version debuted Nov. The four subsequent upgrades, , , and , all missed their release months by between 2 and 30 days. Version came the nearest, releasing Aug. Issuing feature upgrades during the appointed months would be a sign that Microsoft has gotten a better handle on the rapid development tempo it has at times struggled with executing.

It would also be a step toward a more predictable schedule, which was the point of the pledge it made over a year ago to issue a pair of feature upgrades annually If you own a small business or are part of a nonprofit organization, you could be open to several different types of cons without even realizing it. The Federal Trade Commission FTC has put together a list of some of the more common scams and posted them on the website along with plenty of resources to help you spot con artists and keep them from taking advantage of you and your business.

Scammers hope the person who pays your bills will assume the invoices are for things the company actually ordered. Scammers know that when the invoice is for something critical, like keeping your website up and running, you may pay first and ask questions later. Unordered Office Supplies and Other Products Someone calls to confirm an existing order of office supplies or other merchandise, verify an address, or offer a free catalog or sample.

If you say yes, then comes the surprise — unordered merchandise arrives at your doorstep, followed by high-pressure demands to pay for it. Directory Listing and Advertising Scams Con artists try to fool you into paying for nonexistent advertising or a listing in a nonexistent directory. They often pretend to be from the Yellow Pages.

Utility Company Imposter Scams Scammers pretend to call from a gas, electric, or water company saying your service is about to be interrupted. They want to scare you into believing a late bill must be paid immediately, often with a wire transfer or a reloadable card or gift card. Their timing is often carefully planned to create the greatest urgency — like just before the dinner rush in a restaurant.

Some businesses have been scared into buying workplace compliance posters that are available for free from the U. Department of Labor. Others have been tricked into paying to receive nonexistent business grants from fake government programs.

Businesses have received letters, often claiming to be from the U. Tech Support Scams Tech support scams start with a call or an alarming pop-up message pretending to be from a well-known company, telling you there is a problem with your computer security. Their goal is to get your money, access to your computer, or both. They may even access sensitive data like passwords, customer records, or credit card information.

Social Engineering, Phishing and Ransomware Cyber scammers can trick employees into giving up confidential or sensitive information, such as passwords or bank information.

It often starts with a phishing email, social media contact, or a call that seems to come from a trusted source, such as a supervisor or other senior employee, but creates urgency or fear. Scammers tell employees to wire money or provide access to sensitive company information. Other emails may look like routine password update requests or other automated messages but are actually attempts to steal your information.

Business Promotion and Coaching Scams Some scammers sell bogus business coaching and internet promotion services. Using fake testimonials, videos, seminar presentations, and telemarketing calls, the scammers falsely promise amazing results and exclusive market research for people who pay their fees. They also may lure you in with low initial costs, only to ask for thousands of dollars later. In reality, the scammers leave budding entrepreneurs without the help they sought and with thousands of dollars of debt.

Changing Online Reviews Some scammers claim they can replace negative reviews of your product or service, or boost your scores on ratings sites. However, posting fake reviews is illegal.

FTC guidelines say endorsements — including reviews — must reflect the honest opinions and experiences of the endorser. Credit Card Processing and Equipment Leasing Scams Scammers know that small businesses are looking for ways to reduce costs.

Some deceptively promise lower rates for processing credit card transactions, or better deals on equipment leasing. Some unscrupulous sales agents ask business owners to sign documents that still have key terms left blank.

Others have been known to change terms after the fact. Fake Check Scams Fake check scams happen when a scammer overpays with a check and asks you to wire the extra money to a third party. The new dialing procedures will be in effect on August 18th. New phone lines will begin to be issued the area code on September 17th Chrome currently displays a neutral information icon, but starting with version 68, the browser is warning users with an extra notification in the address bar.

Google has been nudging users away from unencrypted sites for years, but this is the most forceful nudge yet. Google search began down-ranking unencrypted sites in , and the following year, the Chrome team instituted a similar warning for unencrypted password fields.

Eighty-one of the top sites on the web default to HTTPS, and a strong majority of Chrome traffic is already encrypted. Without that encryption, someone with access to your router or ISP could intercept information sent to websites or inject malware into otherwise legitimate pages. Offer expires Wednesday, August 15, at midnight Mountain Time. In SharePoint Online and on office. Another user will see different results than you, even when you both search for the same words.

The results update as you start typing. Or, if the site you searched from is associated with another site, but you want to search all the associated sites. When you exit a search results page, you return to the page where you started your search Dictate in Word or PowerPoint 1 Turn on your microphone and make sure it works. As you talk, text appears in your document or slide.

Insert punctuation by saying the name of the punctuation mark you want to add. No need to turn off the microphone. Dictate in Outlook 1 Turn on your microphone and make sure it works. As you talk, text appears in your email message. Insert punctuation, by saying the name of the punctuation mark you want to add.

Important information about Dictate Dictate is one of the Office Intelligent Services, bringing the power of the cloud to Office apps to help save you time and produce better results. Your speech utterances will be sent to Microsoft to provide you with this service, and may also be used to improve speech recognition services. For more information see, What are Intelligent Services?

OLD folder in the root of C:. This folder will have a backup of your old program files, appdata and Windows folder… just in case you need to revert back or recover something that might have been lost during the upgrade. Just a small point here, it is generally not recommended to do in-place upgrades on servers.

In fact there are some products e. Exchange, ConfigMgr that explicitly state they do not support upgrading the Operating System. OLD folder of several GB in size sitting there. If all is well, then you might as well just delete it. Command line tools to take ownership and delete the folder. To delete, it is necessary to take ownership of the folder, give administrators full control, then delete.

Click on Add role and Feature Click on add role and feture to launch the add role and feature wizard. Choose installation Type Choose rolebase or feature based installation to install to local machine.

Proceed with the installation and Reboot Make it sure that you reboot the system 6. Verify that the Utility is indeed installed Ready to run diskcleanup. See screen shot below. Disk Cleanup in Action Below is a sample snapshot of disk cleanup in action Foreign cybercriminals have compromised hundreds of thousands of home and office routers and other networked devices worldwide, the FBI said in a May 25 announcement. This may temporarily disrupt the malware and potentially help identify already-infected devices.

Secure the device with a strong, unique, new password. Upgrade firmware to the latest available version. Windows 10 Pro is a dead end for enterprises, a prominent Gartner analyst has argued. Because Enterprise versions of Windows have never been available to computer makers, Pro — sometimes, as in Windows 7, tagged Professional instead — has been the most popular pre-installed OS on new business PCs. Corporations typically re-image new personal computers with Enterprise upon receipt of the devices.

But although Pro or Professional has a long history in business settings, Microsoft has made numerous decisions in its Windows 10 migration campaign to separate Pro and Enterprise even more, pushing them apart. Last year, the Redmond, Wash. There was a catch: Only Windows 10 Enterprise and Windows 10 Education, a similar version for public and private school districts and universities qualified for the extra six months of support. Users running Windows 10 Pro were still required to upgrade to a successor SKU stock-keeping unit within 18 months to continue receiving security patches and other bug fixes.

But Windows 10 Pro runs out of support on April 9, I think that this telegraphed the fact that, for businesses, Pro is being dead-ended. The extra support, which Microsoft will sell at an undisclosed price, is available only to Enterprise and Education customers. Paid supplemental servicing adds 12 months to the 18 months provided free of charge.

In this way, Microsoft is further reinforcing that it expects enterprise customers to move to the Enterprise edition of Windows As business goals and team structures evolve, so too must your sites and the content that lives within them. Ideas must flourish and grow, not become rigid or stale. SharePoint hub sites bring flexible, dynamic building blocks to your company intranet — connecting collaboration and communication. These chapters are underpinned by some excellent tutorials in relevant basics in the physical and life-sciences e.

In areas that I am familiar with, I was impressed by the clarity and depth of this background material. This made me take the treatment of other areas equally seriously. The middle part of the book deals with the phenomenology and application domains of complexity theory; ranging from chemical kinetics to the epidemic propagation of infections and ideas. Some of the examples are a prelude to the final chapters that focus on the complexity of the brain and related models of decision making and prediction.

There is diversity and coherence in these chapters, for example we move gracefully from stock-market crashes to epileptic seizures, which take us straight back to earlier chapters dealing with single-cell modelling in the brain and neuronal rhythms. As with the historical chapters, the coverage was impressive for its balance and breadth. As someone who has dealt with complex systems in a somewhat piece-meal fashion, I was impressed that nearly every relevant contribution I know about was covered in a brief but useful way.

Even in areas I was familiar with, I learned a lot, particularly about the origins of some of the ideas. Most of this was scientific but sometimes it was historical e. It certainly explains the genesis of the complexity sciences with a compelling and useful focus on the history of these ideas and the rhetoric needed to articulate them. This is a very worthwhile read for any student considering an academic career in complexity or, senior scientists who want to place their corner of enquiry in a larger context.

On finishing the book, I wondered whether a better title would have been “Complexity Celebrated”. The References are one indication of his inclusive broad coverage. Wolf, International Journal of General Systems, It is an excellent introduction to CS for specialists in many fields.

I strongly recommend it to anyone who wants to learn CS seriously. At a more advance level, it should be followed by deeper books in individual fields e. CS in biology, CS in social sciences etc… I thank the author for this enjoyable and useful book. Peter Erdi. Book Title : Complexity Explained. Authors : Peter Erdi. Publisher : Springer Berlin, Heidelberg.