{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T02:47:48Z","timestamp":1768531668151,"version":"3.49.0"},"reference-count":59,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The prevalence of headache disorders, migraine, chronic daily headache (CDH), and medication-overuse headache (MOH) among the elderly in Japan has not been sufficiently investigated. We performed a questionnaire-based survey and revealed 3-month headache prevalence and headaches\u2019 characteristics. Methods: The population aged over 64 was investigated in Itoigawa during their third coronavirus disease 2019 vaccination. Migraine, MOH was defined as The International Classification of Headache Disorders Third edition. CDH was defined as a headache occurring at least 15 days per month. K-means++ were used to perform clustering. Results: Among 2858 valid responses, headache disorders, migraine, CDH, and MOH prevalence was 11.97%, 0.91%, 1.57%, and 0.70%, respectively. Combined-analgesic and non-opioid analgesic were widely used. Only one migraineur used prophylactic medication. We performed k-means++ to group the 332 MOH patients into four clusters. Cluster 1 seemed to have tension-type headache-like headache characteristics, cluster 2 seemed to have MOH-like headache characteristics, cluster 3 seemed to have severe headaches with comorbidities such as dyslipidemia, stroke, and depression, and cluster 4 seemed to have migraine-like headache characteristics with photophobia and phonophobia. Conclusions: This is the largest prevalence survey in the Japanese elderly. Headache disorders are still the elderly\u2019s burden. Clustering suggested that severe headaches associated with some comorbidities may be unique to the elderly.<\/jats:p>","DOI":"10.3390\/jcm11164707","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T21:15:05Z","timestamp":1660252505000},"page":"4707","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Questionnaire-Based Survey during COVID-19 Vaccination on the Prevalence of Elderly\u2019s Migraine, Chronic Daily Headache, and Medication-Overuse Headache in One Japanese City\u2014Itoigawa Hisui Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0192-5430","authenticated-orcid":false,"given":"Masahito","family":"Katsuki","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5852-0146","authenticated-orcid":false,"given":"Yasuhiko","family":"Matsumori","sequence":"additional","affiliation":[{"name":"Sendai Headache and Neurology Clinic, Sendai 982-0014, Miyagi, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chinami","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihito","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Kashiwagi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohiro","family":"Kito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Nou National Health Insurance Clinic, Itoigawa 949-1331, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Entani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiko","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Nursing, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miyako","family":"Otake","sequence":"additional","affiliation":[{"name":"Department of Nursing, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Itoigawa City, Itoigawa 941-8501, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuminori","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Itoigawa General Hospital, Itoigawa 941-0006, Niigata, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1016\/S1474-4422(08)70062-0","article-title":"Epidemiology and comorbidity of headache","volume":"7","author":"Jensen","year":"2008","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Headache Classification Committee of the International Headache Society (IHS) (2018). The International Classification of Headache Disorders. Cephalalgia, 38, 1\u2013211.","DOI":"10.1177\/0333102417738202"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3811","DOI":"10.1007\/s10072-021-05831-w","article-title":"Questionnaire-based survey on the prevalence of medication-overuse headache in Japanese one city\u2014Itoigawa study","volume":"43","author":"Katsuki","year":"2022","journal-title":"Neurol. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1007\/s40120-021-00305-9","article-title":"Burden of Migraine in Japan: Results of the ObserVational Survey of the Epidemiology, Treatment, and Care of Migraine (OVERCOME [Japan]) Study","volume":"11","author":"Matsumori","year":"2021","journal-title":"Neurol. Ther."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1526-4610.2004.04004.x","article-title":"Population-Based Door-to-Door Survey of Migraine in Japan: The Daisen Study","volume":"44","author":"Takeshima","year":"2004","journal-title":"Headache J. Head Face Pain"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1046\/j.1468-2982.1997.1701015.x","article-title":"Prevalence of Migraine in Japan: A nationwide survey","volume":"17","author":"Sakai","year":"1997","journal-title":"Cephalalgia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s10194-020-01180-9","article-title":"Burden of migraine among Japanese patients: A cross-sectional National Health and Wellness Survey","volume":"21","author":"Kikui","year":"2020","journal-title":"J. Headache Pain"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"683","DOI":"10.2169\/internalmedicine.53.1700","article-title":"Prevalence and Characteristics of Headaches in a Socially Active Population Working in the Tokyo Metropolitan Area -Surveillance by an Industrial Health Consortium","volume":"53","author":"Suzuki","year":"2014","journal-title":"Intern. Med."},{"key":"ref_10","first-page":"1705","article-title":"Epidemiology of Headache","volume":"63","author":"Okuma","year":"2005","journal-title":"Nihon Rinsho Jpn. J. Clin. Med."},{"key":"ref_11","unstructured":"Japanese Society of Neurology, Japanese Headache Society, Japanese Society of Neurological Therapeutics (2021). Clinical Practice Guideline for Headache Disorders 2021, Igaku-Shoin. (In Japanese)."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1177\/0333102411410082","article-title":"Epidemiology of medication overuse headache in the general Swedish population","volume":"31","author":"Jonsson","year":"2011","journal-title":"Cephalalgia"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1159\/000494758","article-title":"Prevalence of Migraine in the Elderly: A Narrated Review","volume":"52","author":"Wijeratne","year":"2019","journal-title":"Neuroepidemiology"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1136\/jnnp.70.3.377","article-title":"Prevalence of headache in an elderly population: Attack frequency, disability, and use of medication","volume":"70","author":"Prencipe","year":"2001","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1007\/s10072-012-1200-0","article-title":"Epidemiology of headaches in Tehran urban area: A population-based cross-sectional study in district 8, year 2010","volume":"34","author":"Shahbeigi","year":"2012","journal-title":"Neurol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1212\/WNL.0b013e3181c34abb","article-title":"Primary headache disorders in the Republic of Georgia: Prevalence and risk factors","volume":"73","author":"Katsarava","year":"2009","journal-title":"Neurology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1212\/WNL.54.2.314","article-title":"Chronic daily headache in Chinese elderly: Prevalence, risk factors, and biannual follow-up","volume":"54","author":"Wang","year":"2000","journal-title":"Neurology"},{"key":"ref_18","first-page":"e25419","article-title":"The Efficacy of Japanese Herbal Kampo Medicine as an Acute and Prophylactic Medication to Treat Chronic Daily Headache and Medication Overuse Headache: -Single Arm Retrospective Study","volume":"14","author":"Katsuki","year":"2022","journal-title":"Cureus"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/0333102419876909","article-title":"Monitoring chronic headache and medication-overuse headache prevalence in Denmark","volume":"40","author":"Westergaard","year":"2020","journal-title":"Cephalalgia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1306","DOI":"10.1111\/j.1526-4610.2010.01620.x","article-title":"Chronic Headache and Comorbibities: A Two-Phase, Population-Based, Cross-Sectional Study","volume":"50","author":"Costa","year":"2010","journal-title":"Headache"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2005","DOI":"10.1016\/j.pain.2014.07.002","article-title":"Prevalence of chronic headache with and without medication overuse: Associations with socioeconomic position and physical and mental health status","volume":"155","author":"Westergaard","year":"2014","journal-title":"Pain"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"236","DOI":"10.3988\/jcn.2014.10.3.236","article-title":"Chronic Daily Headache in Korea: Prevalence, Clinical Characteristics, Medical Consultation and Management","volume":"10","author":"Park","year":"2014","journal-title":"J. Clin. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3389\/fneur.2019.00092","article-title":"Features of Primary Chronic Headache in Children and Adolescents and Validity of Ichd 3 Criteria","volume":"10","author":"Papetti","year":"2019","journal-title":"Front. Neurol."},{"key":"ref_24","unstructured":"Silberstein, S., Lipton, R., and Dalessio, D. (2001). Chronic Daily Headache, Including Transformed Migraine, Chronic Tension-Type Headache and Medication Overuse. Wolff\u2019s Headache and Other Head Pain, Oxford University Press."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1258","DOI":"10.1111\/head.12407","article-title":"Operational Diagnostic Criteria for Chronic Migraine: Expert Opinion","volume":"54","author":"Silberstein","year":"2014","journal-title":"Headache"},{"key":"ref_26","unstructured":"Arthur, D., and Vassilvitskii, S. (2007, January 7\u20139). K-means++: The advantages of careful seeding. Proceedings of the 18th Annual ACM-SIAM Symposium on Discrete Algorithms SODA \u201907, New Orleans, LA, USA."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"Koudstaal","year":"1988","journal-title":"Stroke"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1007\/s11940-010-0104-7","article-title":"Update on Chronic Daily Headache","volume":"13","author":"Couch","year":"2011","journal-title":"Curr. Treat. Options Neurol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","article-title":"No adjustments are needed for multiple comparisons","volume":"1","author":"Rothman","year":"1990","journal-title":"Epidemiology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Katsuki, M., Narita, N., Matsumori, Y., Ishida, N., Watanabe, O., Cai, S., and Tominaga, T. (2022). Kampo (Japanese herbal) medicine for primary headache as an acute treatment\u2014A retrospective investigation in Kesennuma City Hospital during five years. J. Neurosurg. Kampo Med., 7, in press.","DOI":"10.21203\/rs.3.rs-1825118\/v1"},{"key":"ref_31","first-page":"e16800","article-title":"Medication Overuse Headache Successfully Treated by Three Types of Japanese Herbal Kampo Medicine","volume":"13","author":"Katsuki","year":"2021","journal-title":"Cureus"},{"key":"ref_32","first-page":"525","article-title":"Headache Characteristics and Clinical Features of Elderly Migraine Patients","volume":"58","author":"Resseguier","year":"2017","journal-title":"Headache"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Togha, M., Karimitafti, M.J., Ghorbani, Z., Farham, F., Naderi-Behdani, F., Nasergivehchi, S., Vahabi, Z., Ariyanfar, S., and Jafari, E. (2022). Characteristics and comorbidities of headache in patients over 50 years of age: A cross-sectional study. BMC Geriatr., 22.","DOI":"10.1186\/s12877-022-03027-1"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1177\/0333102411408626","article-title":"Triptan overuse in the Dutch general population: A nationwide pharmaco-epidemiology database analysis in 6.7 million people","volume":"31","author":"Dekker","year":"2011","journal-title":"Cephalalgia"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s10194-018-0864-0","article-title":"Use and overuse of triptans in Austria\u2014A survey based on nationwide healthcare claims data","volume":"19","author":"Zebenholzer","year":"2018","journal-title":"J. Headache Pain"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1007\/s11916-022-01029-7","article-title":"Episodic Migraine and Older Adults","volume":"26","author":"Riggins","year":"2022","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/ncn3.12374","article-title":"Beat the stigma of primary headache disorders: Activities of JPAC and GPAC","volume":"8","author":"Sakai","year":"2020","journal-title":"Neurol. Clin. Neurosci."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1526-4610.1994.hed3401001.x","article-title":"Classification of Daily and Near-Daily Headaches: Proposed Revisions to the IHS Criteria","volume":"34","author":"Silberstein","year":"1994","journal-title":"Headache"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0733-8619(05)70302-9","article-title":"Transformed Migraine, Analgesic Rebound, and Other Chronic Daily Headaches","volume":"15","author":"Mathew","year":"1997","journal-title":"Neurol. Clin."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1111\/head.12409","article-title":"Chronic Migraine and Medication Overuse Headache","volume":"54","author":"Tepper","year":"2014","journal-title":"Headache"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/j.1526-4610.2005.05006.x","article-title":"Low Income and Education Levels May Cause Medication Overuse and Chronicity in Migraine Patients","volume":"45","author":"Atasoy","year":"2005","journal-title":"Headache J. Head Face Pain"},{"key":"ref_42","first-page":"e18326","article-title":"Medication Overuse Headache Successfully Treated by Japanese Herbal Kampo Medicine, Yokukansan","volume":"13","author":"Katsuki","year":"2021","journal-title":"Cureus"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"640574","DOI":"10.3389\/fnhum.2021.640574","article-title":"Pathophysiological Bases of Comorbidity in Migraine","volume":"15","author":"Altamura","year":"2021","journal-title":"Front. Hum. Neurosci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1046\/j.1526-4610.1999.3903181.x","article-title":"Use of Cluster Analysis to Validate IHS Diagnostic Criteria for Migraine and Tension-Type Headache","volume":"39","author":"Bruehl","year":"1999","journal-title":"Headache J. Head Face Pain"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1046\/j.1526-4610.1999.3910720.x","article-title":"An Examination of the Validity of the IHS Classification System for Migraine and Tension-Type Headache in the College Student Population","volume":"39","author":"Rokicki","year":"1999","journal-title":"Headache J. Head Face Pain"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1055\/s-0035-1550147","article-title":"Children\u2019s Headache: Drawings in the Diagnostic Work Up","volume":"46","author":"Mazzotta","year":"2015","journal-title":"Neuropediatrics"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"863","DOI":"10.2174\/1871527320666210713114840","article-title":"Migraine and Obesity: Is There a Relationship? A Systematic Review and Meta-Analysis of Observational Studies","volume":"20","author":"Hatami","year":"2021","journal-title":"CNS Neurol. Disord. Drug Targets"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1080\/01616412.2021.1981105","article-title":"The preventive effect of the combination of atorvastatin and nortriptyline in migraine-type headache: A randomized, triple-blind, placebo-controlled trial","volume":"44","author":"Sherafat","year":"2022","journal-title":"Neurol. Res."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Miyamoto, S., Ogasawara, K., Kuroda, S., Itabashi, R., Toyoda, K., Itoh, Y., Iguchi, Y., Shiokawa, Y., Takagi, Y., and Ohtsuki, T. (2022). Japan Stroke Society Guideline 2021 for the Treatment of Stroke. Int. J. Stroke, in press.","DOI":"10.1177\/17474930221090347"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/FJC.0000000000001195","article-title":"Efficacy and Safety of Cilostazol for Atherosclerosis: A Meta-analysis of Randomized Controlled Trials","volume":"79","author":"Wan","year":"2022","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1111\/j.1526-4610.2007.00993.x","article-title":"Comorbidity of Migraine and Psychiatric Disorders\u2014A National Population-Based Study","volume":"48","author":"Jette","year":"2008","journal-title":"Headache"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s10194-019-0988-x","article-title":"Understanding the nature of psychiatric comorbidity in migraine: A systematic review focused on interactions and treatment implications","volume":"20","author":"Dresler","year":"2019","journal-title":"J. Headache Pain"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/j.berh.2004.04.004","article-title":"When to refer to a pain clinic","volume":"18","author":"Nicholas","year":"2004","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1185\/03007995.2013.861349","article-title":"Patients\u2019 and physicians\u2019 perspectives on opioid therapy for chronic cancer and musculoskeletal pain in Germany, Italy, and Turkey: PAin RESearch (PARES) survey","volume":"30","author":"Wimmer","year":"2014","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1185\/03007995.2011.619451","article-title":"Common understanding--the basis of successful pain management","volume":"27","year":"2011","journal-title":"Curr. Med Res. Opin."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3401","DOI":"10.2147\/JPR.S328434","article-title":"Pursuing the Recovery of Severe Chronic Musculoskeletal Pain in Italy: Clinical and Organizational Perspectives from a SIAARTI Survey","volume":"14","author":"Vittori","year":"2021","journal-title":"J. Pain Res."},{"key":"ref_57","first-page":"58","article-title":"Resilience management and personal recovery in pain management","volume":"40","author":"Kawai","year":"2021","journal-title":"J. Jpn. Soc. Study Chronic Pain"},{"key":"ref_58","unstructured":"Kitamura, T. (2022, June 15). Survey on \u201cPain\u201d among Japanese. Available online: https:\/\/www.daiichisankyo-hc.co.jp\/site_loxonin-s\/assets\/images\/understand\/pdf\/research_201202.pdf."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Katsuki, M., Matsumori, Y., Kawahara, J., Yamagichi, C., Koh, A., Kawamura, S., Kashiwagi, K., Kito, T., Oguri, M., and Mizuno, S. (2022). Headache education for general public by leaflets distribution during COVID-19 vaccination and school-based on-demand e-learning in Japanese one city\u2014Itoigawa Geopark Headache Awareness Campaign. Res. Sq., preprint.","DOI":"10.21203\/rs.3.rs-1822180\/v1"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4707\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:07:32Z","timestamp":1760141252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/16\/4707"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,11]]},"references-count":59,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["jcm11164707"],"URL":"https:\/\/doi.org\/10.3390\/jcm11164707","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,11]]}}}