Day: 05/23/2022

Massage Therapy Styles and Health Benefits

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Massage has been practiced for thousands of years. Today, if you need or want a massage, you can choose from about 80 massage therapy styles with a wide variety of pressures, movements, and techniques. These all involve pressing, rubbing, or manipulating muscles and other soft tissues with hands and fingers. Sometimes, even forearms, elbows, or feet are used.

According to the American Massage Therapy Association, in 2018, approximately 19% of Americans had some form of massage.. And, they have a wide range of reasons for doing so. More and more people — especially baby boomers — recognize the health benefits of massage. They choose from among many massage styles to get relief from symptoms or to heal injuries, to help with certain health conditions, and to promote overall wellness.

Here is information you can use to help you decide what types of massage will work best for you.

Which Massage Styles Are Best?

You may have noticed that different massage styles are popular at different times. And you may have wondered whether each was just part of a passing fad or the latest, greatest massage technique? Even more important is how can you tell whether the latest style will actually help you?

Styles used in massage therapy range from long, smooth strokes to short, percussive strokes. Some massage therapists use oils and lotions; others do not. Most massage therapists have clients unclothe for a massage, but some do not. A massage can last anywhere from 5 minutes to 2 hours.

Before you can decide which massage style is best for you, you need to ask yourself a question. Do you simply want a massage for relaxation and stress control? Or do you need symptom relief or help with a certain health condition? Before booking a massage, let the therapist know what you’re looking for and ask which style the therapist uses. Many use more than one style. Or the therapist may customize your massage, depending on your age, condition, or any special needs or goals you have.

What follows is a list of some of the more popular massage therapy styles. The first four are especially popular.

Swedish Massage

The most common type of massage is Swedish massage therapy. It involves soft, long, kneading strokes, as well as light, rhythmic, tapping strokes, on topmost layers of muscles. This is also combined with movement of the joints. By relieving muscle tension, Swedish therapy can be both relaxing and energizing. And it may even help after an injury.

Four common strokes of Swedish massage are:

  • Effleurage: a smooth, gliding stroke used to relax soft tissue
  • Petrissage: the squeezing, rolling, or kneading that follows effleurage
  • Friction: deep, circular movements that cause layers of tissue to rub against each other, helping to increase blood flow and break down scar tissue
  • Tapotement: a short, alternating tap done with cupped hands, fingers, or the edge of the hand

Deep Tissue Massage

Deep tissue massage is best for giving attention to certain painful, stiff “trouble spots” in your body. The massage therapist uses slow, deliberate strokes that focus pressure on layers of muscles, tendons, or other tissues deep under your skin. Though less rhythmic than other types of massage, deep tissue massage may be therapeutic — relieving chronic patterns of tension and helping with muscle injuries, such as back sprain.

Sports Massage

Developed to help with muscle systems used for a particular sport, sports massage uses a variety of approaches to help athletes in training — before, during, or after sports events. You might use it to promote flexibility and help prevent injuries. Or, it may help muscle strains, aiding healing after a sports injury.

Chair Massage

Ever gone to a county fair, music festival, or conference and envied other people getting chair massages? Passed by the chair massage section in an airport? Or, maybe you’re lucky enough to work at a company that offers 15- to 20-minute massages as a regular benefit. Onsite, chair massages are done while you’re seated fully clothed in a portable, specially designed chair. They usually involve a massage of your neck, shoulders, back, arms, and hands.

Shiatsu Massage

In Japanese, shiatsu means “finger pressure.” For shiatsu massage, the therapist uses varied, rhythmic pressure on certain precise points of the body. These points are called acupressure points, and they are believed to be important for the flow of the body’s vital energy, called chi. Proponents say shiatsu massage can help relieve blockages at these acupressure points.\\Thai Massage

During a Thai massage, the therapist uses their body to move the client into a variety of positions. This type of massage includes compression of muscles, mobilization of joints, and acupressure.

Lymphatic Drainage Massage

A lymphatic drainage massage is a gentle massage of your tissues designed to help increase the circulation of lymph fluids in your body.  Lymph is a protein-rich fluid that moves throughout your body in lymph vessels. It scoops up things like bacteria, viruses, and waste, and carries them to your lymph nodes. Your lymph nodes then filter the fluid to get the impurities out of your body. The massage is usually done with light pressure with gentle, long strokes along the skin to increase the movement of lymph through your system.

Hot Stone Massage

For this kind of massage, the therapist places warmed stones on certain areas of the body, such as acupressure points. The stones may be used as massage tools or be temporarily left in place. Used along with other massage techniques, hot stones can be quite soothing and relaxing as they transmit heat deep into the body.

Reflexology

Reflexology uses hand, thumb, and finger techniques to stimulate certain areas of the feet. These areas are believed to correspond to different parts of the body. The massage, then, is expected to promote health and well-being.

Pregnancy Massage

During pregnancy, your body goes through major changes. Pregnancy massage can help with these changes by reducing stress, decreasing arm and leg swelling, and relieving muscle and joint pain. Massage may be particularly helpful during a time when medication and other medical options may be more limited. Using specially designed massage pillows, the massage therapist will help get you into a comfortable position for this type of massage.

What Are the Health Benefits of Massage?

Many types of massage offer benefits beyond simple relaxation. Here are just a few of the health problems that may benefit from massage. Ask your doctor before using massage for any health condition, though.

  • Back pain. More than one study has shown the effectiveness of massage therapy for back pain. 
  • Headache. Another type of pain — headache — also responds to massage therapy. Some studies suggest that massage therapy can reduce the number of migraines a person has and also improve sleep.
  • Osteoarthritis. In the first clinical trial looking at the effectiveness of Swedish massage for knee osteoarthritis, participants who received a one-hour massage either one or two times a week had improvements in pain, stiffness, and function. The control group had no such change.
  • Cancer. Used as a complement to traditional, Western medicine, massage can promote relaxation and reduce cancer symptoms or side effects of treatment. It may help reduce pain, swelling, fatigue, nausea, or depression, for example, or improve the function of your immune system. However, there are specific areas that a massage therapist should avoid in a cancer patient, as well as times when massage should be avoided altogether. Talk to your doctor before getting massage therapy if you have cancer.
  • Depression. A review of 17 clinical trials found that massage therapy may help reduce depression. But for generalized anxiety disorder, it was no more effective than providing a calming environment and deep breathing exercises.

Why Sex Matters in Takotsubo Syndrome

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Introduction

Takotsubo syndrome (TTS) is a condition characterized by acute heart failure and transient ventricular contractile dysfunction that is frequently precipitated by acute emotional or physical stress. Although the precise pathophysiologic mechanism underlying this syndrome remains unknown, enhanced sympathetic stimulation resulting in microvascular dysfunction and/or direct myocyte injury is believed to be central to the syndrome’s pathogenesis.1 Since its original description in the early 1990s, a consistent observation in all series of TTS has been the marked preponderance of older postmenopausal women. Women comprise approximately 90% of the cases reported in the literature with a mean age of 65-75 years in most series, and the risk of developing TTS increases 5-fold in women after the age of 55 years.2 The precise reason that older women are so disproportionately affected remains unknown, but it is believed that the declining beneficial effects of estrogen on cardiac microvascular function as women age make postmenopausal women particularly susceptible to microvascular ischemia and TTS during episodes of excessive sympathetic stimulation. Given the marked female predisposition to TTS, it is not surprising that most of the literature over the past 20 years has focused primarily on women with this disorder, and far less has been written about the clinical features and outcomes of men with TTS. Although men clearly make up the minority of reported cases, the available literature suggests that males with TTS may represent a particularly vulnerable population with increased rates of arrhythmia, cardiogenic shock, and mortality compared with females with the syndrome.3-5

In this issue of the Journal of the American College of Cardiology, Arcari et al6 provide much needed insight into the influence of sex on TTS by presenting a large population of both men and women with TTS enrolled in the GEIST (GErman Italian Spanish Takotsubo) registry. The investigators looked at 2,492 patients enrolled in this registry and compared the clinical features and short- and long-term outcomes between men and women with TTS. After examining sex differences in this large population, they then performed a propensity score analysis by matching men and women 1:1 based on several variables that included age, presence of diabetes, current smoking status, history of malignancy, and the type of trigger precipitating the syndrome (emotional vs physical). Several important observations were made in this study: 1) men comprised 11% of the total TTS population, a prevalence similar to what has been reported in other studies and registries; 2) physical triggers were more frequently reported in male patients, whereas emotional triggers were more common in female patients; 3) men were significantly sicker at the time of initial presentation and were more likely to have cardiogenic shock, to require catecholamine administration, and to require intubation both in the total population and after propensity score matching; 4) in-hospital mortality was significantly higher in men, both in the overall and matched cohorts; and 5) long-term mortality was higher in men in the overall population but was not different between men and women in the matched cohort. Some of these observations can be readily explained by looking at the demographics of the overall GEIST population. Men had a significantly higher prevalence of diabetes mellitus, tobacco use, pulmonary disease, malignancies, and coronary artery disease, comorbidities that one would expect to have an impact on in-hospital complications as well as short- and long-term survival. Men in the overall population were also more likely to develop TTS following physical triggers, which has been previously shown to be associated with worse outcomes compared with emotional triggers.7 Men were also less likely to be discharged from the hospital on beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, which may have also had an impact on long-term outcomes. Although there were significant demographic differences between men and women in the overall population, the study by Arcari et al6 is novel in that the relatively large size of the GEIST registry made it possible for the investigators to account for many of these confounding variables by performing a propensity score matching analysis. Interestingly, even after matching for age, comorbidities, and type of precipitating trigger, men with TTS remained much sicker than women with a higher incidence of cardiogenic shock, in-hospital death, and death at 60 days. Men also had a lower ejection fraction and a higher prevalence of the apical ballooning variant compared with women, echocardiographic features known to be associated with worse short-term outcomes.8 By contrast, long-term mortality was not affected by sex in the matched cohort. This last observation suggests that once left ventricular systolic function recovers, which typically occurs within days to weeks of initial presentation, long-term mortality in TTS is driven primarily by non-cardiac comorbidities and events.

The study by Arcari et al6 shows convincingly that although men are far less likely to develop TTS than women, they have more serious complications and are more likely to die than women presenting with the syndrome. Although these observations may seem paradoxical at first, they may actually provide important clues about the pathophysiologic mechanisms of this disorder. There is increasing evidence that the transient myocardial dysfunction observed in TTS is the result of sympathetically mediated microvascular ischemia.1Figure 1 illustrates how TTS susceptibility may be dependent on the delicate balance between resting sympathetic tone and microvascular function. In this paradigm, individuals with normal basal sympathetic tone and normal microvascular function may be at low risk for developing TTS, whereas individuals with elevated resting sympathetic tone and significant microvascular dysfunction may be highly vulnerable. This paradigm helps to explain why older women are particularly susceptible to TTS. Resting sympathetic tone appears to be particularly elevated in older women,9 and as women age, there are significant decreases in cardiac vagal tone and baroreflex sensitivity with an associated increase in sympathetic activation.10 Estrogen is also an important regulator of endothelial function and vasomotor tone, and can attenuate catecholamine-mediated vasoconstriction, making older postmenopausal women potentially more susceptible than men to stress-related microvascular ischemia.11Figure 1 further illustrates that the sympathetic stimulus required to precipitate TTS is inversely related to susceptibility. Only mild sympathetic stimulation may be needed to precipitate TTS in highly susceptible individuals such as older women, and whereas older women may be more likely to develop the syndrome following acute stress, the smaller sympathetic stimulus may result in less myocardial injury and fewer cardiac complications. By contrast, significant noradrenergic stimulation may be necessary to precipitate TTS in men who have lower resting sympathetic tone and less microvascular dysfunction, thus resulting in more myocardial injury (eg, higher troponin, more contraction band necrosis, lower ejection fraction) and a higher incidence of cardiovascular complications and death in the acute period.

Figure 1
Download FigureDownload PowerPointFigure 1Proposed Inverse Relationship Between Stimulus Needed to Precipitate TTS and Syndrome SusceptibilityProposed paradigm illustrating the inverse relationship between takotsubo syndrome (TTS) susceptibility and the degree of sympathetic stimulation needed to precipitate the syndrome. Individuals with normal microvascular function and basal sympathetic tone (eg, young healthy individuals) have low susceptibility to TTS and will therefore require a large sympathetic stimulus to precipitate the syndrome. Individuals with mild-to-moderate abnormalities in microvascular function and basal sympathetic tone (eg, middle-aged men) will require at least a moderate amount of sympathetic stimulation to precipitate TTS. The people most susceptible to TTS are those with high resting sympathetic tone and significant microvascular dysfunction (eg, older women) and even mild sympathetic stimulation can precipitate the syndrome in these individuals.

The proposed paradigm in Figure 1 helps to explain an interesting and recurrent theme that has emerged in the Takotsubo literature, and that is that groups with the lowest prevalence of TTS appear to be the sickest at the time of presentation. African Americans made up <10% of the reported cases of TTS in one series but had a greater number of in-hospital complications compared with Caucasians.12 Young individuals (aged <50 years) comprised only 11% of the InterTAK (International Takotsubo) registry but were more likely to have cardiogenic shock and to require inotrope and ventilator support than older patients.13,14 Once again in the current study, men accounted for only 11% of the total GEIST registry but were significantly sicker than their female counterparts. These observations not only shed light on possible pathophysiologic mechanisms of this disorder, but also serve as an important reminder to clinicians that the patients least likely to get TTS are perhaps the most likely to die from it.

Genetically Triggered Aortic Disease Outcomes: On the Long Road to Personalized Medicine∗

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Introduction

Thoracic aortic aneurysm (TAA) is a typically silent disease that might lead to catastrophic consequences. Since the discovery of the familial nature of TAA and dissection almost 2 decades ago, our understanding of the genetics of this disorder has increased significantly. Advances in imaging techniques have enhanced our ability to diagnose this aortic disease, and surgical aortic repair has become significantly safer and more effective. However, our ability to exactly predict when such intervention is required remains limited.

Heritable thoracic aortic disease (HTAD) covers entities caused by genetic defects, with thoracic aortic wall weakness or abnormal aortic hemodynamic profiles predisposing patients to aorta dilatation, aneurysm formation, and acute aortic complications. Inherited aortopathies are categorized as syndromic or nonsyndromic. Syndromic heritable thoracic aortic disease includes a varied group of genetically mediated conditions associated with multisystemic features, and nonsyndromic describes a familial form of aortopathy and dissections at a young age but without systemic features.

Genetic defects identified to date can be categorized as follows: 1) genes encoding components of the extracellular matrix (FBN1, MFAP5, MAT2A); 2) genes encoding components of the TGFβ signaling pathway (TGFBR1/2, TGFB2/3, SMAD2/3); and 3) genes encoding components of the smooth muscle cell contractile apparatus (ACTA2, MYH11, MYLK, PRKG1). Although the number of genes involved in HTAD is continuously increasing, a large number of patients/families with HTAD have no identifiable defect, particularly for nonsyndromic HTAD (nsHTAD), thereby indicating that other genes must be involved.1 In addition, there are other entities included in these genetic disorders with a very specific cardiovascular profile, including vascular Ehlers-Danlos, Turner syndrome, and bicuspid aortic valve (BAV).

The mechanisms predisposing to BAV aortopathy are controversial, with evidence supporting both biomechanical and genetic causes. Several studies have demonstrated the significant influence that abnormal hemodynamic flow patterns exert on the underlying aortic wall TGFβ pathway signaling, elastin breakdown, dilation location, and the risk of aortic events. On the other hand, BAV has familial clustering (with 7% of the first-degree relatives having BAV) and male predominance, which, taken together, suggest the presence of an inherited valvular disease but do not necessarily imply a genetic cause of the aorta dilation. By contrast, Turner syndrome is a genetic disease with unusual familial involvement, with a >30% prevalence of aorta dilation and higher risk of aorta dissection when aortic diameter is >27 mm/m2. Another vascular entity with a clearly different profile to the rest of the HTAD is vascular Ehlers-Danlos with a very low prevalence but a high impact on the morbidity and mortality of affected individuals. It remains a high-risk group, marked by the limited effectiveness of medical/surgical strategies for changing its natural history.2

Patients with HTAD have an increased risk of acute aortic complications including aortic dissection or rupture, which carry a higher mortality risk. Considering the low risk of elective surgery, guidelines advocate focusing on early diagnosis, regular monitoring with imaging, medical treatment, and prophylactic replacement of the diseased aortic segment once a threshold diameter is reached. However, even following these recommendations, many patients with HTAD may experience aortic dissection or rupture while still below the threshold diameter, whereas others may undergo surgery for aortic aneurysms that are unlikely to dissect or rupture. Therefore, there is general agreement that the identification and risk stratification of thoracic aortopathy must be improved.

GenTAC (Genetically Triggered Thoracic Aortic Aneurysm and Cardiovascular Conditions) is a longitudinal observational cohort study consisting of patients with conditions related to genetically-induced TAA.3 In previous studies, GenTAC showed that the risk of aortic dissection persisted even after TAA surgery (52% of affected patients had undergone previous aortic graft implantation) and that dissection could occur within native aortic segments proximal or distal to prosthetic grafts. Furthermore, aortic dissection occurred in at-risk patients even when aorta size was normal or minimally dilated (among patients with type A aortic dissection, only 1 of 9 had an aorta diameter ≥5.0 cm in either the root or ascending aorta).4 These findings confirmed that patients with genetically-associated TAA remain at risk for aortic dissection in the current era even if they are medically treated, maximum aorta size is monitored, and they are indicated for preventive surgery.

In this issue of the Journal of the American College of Cardiology, Holmes et al5 compared the frequency and age distribution of elective proximal aortic aneurysm surgery, emergent aortic dissection surgery, and cardiovascular death in a large series of patients enrolled in GenTAC. This study had several interesting findings. The 25% probability of elective proximal aortic aneurysm surgery was at age 30 years for Loeys-Dietz syndrome, age 34 years for Marfan syndrome, age 52 years for nsHTAD, and age 55 years for BAV. These results underlined the high impact of syndromic diseases on the indication of surgical treatment. The similar age at surgical treatment between BAV and nsHTAD patients might be related to the surgical valvular dysfunction indication in BAV with extended ascending aorta replacement when the diameter is >45 mm. Inter-entity differences were more evident when the comparison was focused on any dissection surgery, with probability of 25% of patients being the highest in Loeys-Dietz syndrome (age 38 years; 95% CI: 33-53 years) followed by Marfan syndrome (age 51 years, 95% CI: 46-57 years), and nsHTAD (age 54 years, 95% CI: 51-61 years). One interesting way to analyze the cardiovascular burden of these entities was to use the ratio of elective vs dissection surgical treatment, which was higher for BAV (7.7), probably related to both its higher frequency of diagnosis before complications and its lower risk for dissection compared with Marfan syndrome (2.4), Loeys-Dietz (2.2), or nsHTAD (1.1). The low ratio reported in nonsyndromic HTAD might be caused by the difficulty in diagnosing these patients before aortic complications.

In contrast, patients with vascular Ehlers-Danlos had the highest frequency of cardiovascular mortality, although aortic dissection was rare and replacement was not reported. This might be the consequence of a different pattern of cardiovascular complications in these patients, with the extra-aortic vascular complications being more prevalent and aortic surgeries rare.

These results, along with other data, suggest that Loeys-Dietz syndrome is a more severe disorder than Marfan syndrome and nonsyndromic aortic diseases, with elective aortic replacement (generally recommended at a lower threshold) and required dissection surgery at an earlier age and smaller size. The incidence of any aortic dissection surgery per 10,000 patient-years was the highest in Loeys-Dietz syndrome at 54.2, followed by nsHTAD at 46.3 and Marfan syndrome at 39.2.5

This GenTAC study had some limitations, such as the lack of differentiation between probands and relatives and the absence of genetic information, because aortopathy gene panels were not available at the time of the study (2007-2016), and systematic genotyping was not performed because of funding limitations. In recent years, a growing body of evidence has shown that specific gene mutations confer a specific increased risk for adverse outcomes, even with small aorta enlargement.6

Despite all of the merits of the present work regarding the definition of the aortic impact of different genetic entities, the reality is even more complex. Patients with entities other than BAV and Turner syndrome are frequently affected by not only one event but by consecutive events that impact their quality of life even more. Moreover, despite the relatively controlled risk of ascending aorta complications with the current strategies, these patients present distal aortic dissection even without advanced aortic dilation.

The current management of HTAD entities relies on aortic diameter, along with a few clinical risk factors, to decide whether surgical intervention is required. Advances in genotype-phenotype correlations and alternative imaging markers such as aortic stiffness may provide a better risk stratification of patients and improve personalized medicine.

First ever HR image of Earth’s interior, 3,000 KM below surface, captured; may unravel mystery of earthquakes, volcanoes

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We do get new updates and unseen visuals almost on a daily basis for outer Space including galaxies, formation of stars, black holes, asteroids, comets and more. But when it comes to knowing about our own planet Earth and its interior, then there is a scarcity of visuals of any kind. However, that may have changed as a joint research project from the UK has published a study into one of the least known parts of the Earth’s interior – the core, mantle, and boundary. The research has shared the highest quality image of the Earth’s interior so far!

The research on Earth’s interior has made interesting and valuable observations into the ultra-low velocity zone that lies around 3,000 KM below the Earth’s surface using new imaging techniques. So far, we just have an idea about this untraveled area of Earth from analyzing seismic waves that flow through the planet. Without any proper visual, it has been difficult to make much more sense of the layers of Earth beyond some grainy images which make it difficult to analyse.

Thanks to the new study by the University of Cambridge, now the study of the mantle below Hawaii has produced more high-definition images. It is said to be the first detailed ‘image’ of an unusual pocket of rock at the boundary layer with Earth’s core, some three thousand kilometres beneath the surface of Earth. “Of all Earth’s deep interior features, these are the most fascinating and complex. We’ve now got the first solid evidence to show their internal structure – it’s a real milestone in deep earth seismology,” Zhi Li, the lead author and PhD student at Cambridge University said.

How researchers snapped the FIRST detailed image of Earth’s core

The team built new computational models to generate the images, which collect high-frequency data from the study region and construct a clear image. Using this technique, researchers were able to construct a kilometer-scale view of the rock pocket with resolutions that had been magnitudes better than traditional methods. This approach is presently being used to investigate the border between the Earth’s iron-nickel core and surrounding mantle in order to better understand one of the key engines for plate tectonics, volcano building, and other related phenomena like earthquakes.

Not just that, many scientists believe that there is a link between ultra-low velocity zones and volcanic hotspots. And using this new technique, now scientists may be able to better assess whether these hotspots are the reason behind the volcanic eruptions or not.

Graphene May Speed Up Internet 100 Times

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 Using ‘miracle material’ graphene in telecommunications could dramatically make the internet a hundred times faster, a new study has found. 

Graphene May Boost Internet Speed 100 Times


Researchers from the Universities of Bath and Exeter have demonstrated for the first time incredibly short optical response rates using graphene, which could pave the way for a revolution in telecommunications. 

Every day large amounts of information is transmitted and processed through optoelectronic devices such as optical fibres, photodetectors and lasers. Signals are sent by photons at infrared wavelengths and processed using optical switches, which convert signals into a series of light pulses. 

Ordinarily optical switches respond at rate of a few picoseconds – around a trillionth of a second. Through this study physicists have observed the response rate of an optical switch using ‘few layer graphene’ to be around one hundred femtoseconds – nearly a hundred times quicker than current materials. 

Graphene is just one atom thick, but remarkably strong. Scientists have suggested that it would take an elephant, balanced on a pencil to break through a single sheet. 

Already dubbed a miracle material due to its strength, lightness, flexibility, conductivity and low cost, it could now enter the market to dramatically improve telecommunications, researchers said. 

“We’ve seen an ultrafast optical response rate, using ‘few-layer graphene’, which has exciting applications for the development of high speed optoelectronic components based on graphene,” lead researcher Dr Enrico Da Como said. 

“This fast response is in the infrared part of the electromagnetic spectrum, where many applications in telecommunications, security and also medicine are currently developing and affecting our society,” said Da Como. 

“The more we find out about graphene the more remarkable its properties seem to be. This research shows that it also has unique optical properties which could find important new applications,” Co-Director of the Centre for Graphene Science at Bath, Professor Simon Bending added. 

In the long term this research could also lead to the development of quantum cascade lasers based on graphene. 

Quantum cascade lasers are semiconductor lasers used in pollution monitoring, security and spectroscopy. Few-layer graphene could emerge as a unique platform for this interesting application. 

A Graphene Based Filtration Technique May Solve The World’s Drinking Water Problem

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Even in 2017, as many as 1.8 billion people across the world don’t have access to safe drinking water. While seas and oceans are massive reservoirs of salty water, how do we make it less salty and safe for drinking?

Water tanker

That question has kept many of our best minds busy, and scientists from the University of Manchester may have found an ingenious solution to rapidly convert salty water into drinking water — with the help of graphene.

What’s graphene? Graphene is nothing but a single layer of carbon atoms arranged in a hexagonal lattice, and as a material graphene holds a lot of promise because despite its thin layer graphene exhibits amazing tensile strength and is super sensitive in conducting electricity.

How’s graphene helping us solve the world’s drinking water problem?

Graphene, according to the researchers at the University of Manchester, has exhibited another impressive characteristics. Through a graphene-oxide membrane that the researchers have developed, a sieve can be designed with uniform pore size that is capable of filtering out even the smallest salts appearing in sea water — without affecting the flow of water flowing through the sieve.

Empty water vessels

If implemented on a large scale, this graphene-oxide membrane based sieve can be deployed at some of the most remotest parts of the world, where clean and safe drinking water supply doesn’t exist. As long as they’re close to the sea, this graphene-based filtration technique can potentially unlock an unlimited supply of drinking water to anyone in the world.

Reporting their results in the science journal Nature Nanotechnology, the research team who came up with the graphene-based sieve idea claim that the filtration membrane can reject as much as 97 percent of dissolved salt and still allow free flow of water through it.

Scientists For The First Time Create Super Material ‘Graphyne’ That’ll Push Tech To New Heights

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In a major development at the University of Colorado Boulder, researchers have managed to successfully synthesise the long-hypothesised a new ‘wonder material’ dubbed graphyne.

Reported first by SciTechDaily, essentially a form of carbon, graphyne is similar to graphene that’s highly valued by the industry. However, even after decades of research, only a few fragments have been created.

The novel research is expected to unleash new possibilities for electronics, optics as well as semiconducting material research.

Scientists have always strived to construct new forms of carbon, due to carbon’s versatility as well as utility in the industry. There are different ways of creating carbon allotropes based on how hybrids of carbon, sp hybridised carbon and their corresponding bonds are utilised. 

One of the most commonly known carbon forms are graphite, and diamonds that are created out of sp2 carbon and sp3 carbon respectively. By making use of traditional chemistry processes, scientists have managed to create different forms of carbon including fullerene as well as graphene.

However, the methods don’t allow for the different types of carbon to be synthesised together in large capacities — a prerequisite for graphyne — that has left the material to remain a theory. 

However, it was also that need for the nontraditional that led those in the field to reach out to Wei Zhang’s lab group. Zhang, a professor of chemistry at the aforementioned institution studies reversible chemistry — chemistry that allows bonds to self-correct, resulting in the creation of novel ordered structures. 

They made use of a process dubbed alkyne metathesis — essentially an organic reaction that follows the redistribution, cutting or reformation of alkyne chemical bonds, as well as thermodynamics and kinetic control and ended up creating a material that was capable of rivalling the conductivity of graphene but with control.

Wei Zhang explained, There’s a pretty big difference (between graphene and graphyne) but in a good way. This could be the next generation wonder material. That’s why people are very excited.”

The team is now looking into particular details of graphyne such as scaling it up for mass production as well as ways in which it can be manipulated. 

“We are really trying to explore this novel material from multiple dimensions, both experimentally and theoretically, from atomic-level to real devices,” Zhang added.

Covid-19 pandemic ‘far from over’: WHO chief issues fresh warning

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The head of the World Health Organization (WHO) has once again reiterated that the Covid-19 pandemic “is far from over”. “… the pandemic is far from over. And even as we continue to fight it, we face the task of restoring essential health services, with 90 per cent of member states reporting disruption to one or more essential health services,” WHO Director-General Tedros Adhanom Ghebreyesus said on Monday.

Addressing the 75th World Health Assembly, Ghebreyesus said the Covid-19 pandemic had demonstrated why the world needed the WHO, Xinhua news agency reported.

“We need a stronger and sustainably financed WHO, at the center of the global health security architecture,” he said at the annual assembly. “In ways small and large, seen and unseen, I am proud to say that this organization is making a difference,” he said.

The WHO was still “far behind” to see 1 billion more people benefitting from universal health coverage by next year. Before the pandemic, the WHO estimated that only 270 million more people would be covered by 2023 — a shortfall of 730 million people against the target of 1 billion.

“Disruptions to health services during the pandemic have sent us backwards, and we estimate the shortfall could reach 840 million,” he said.

Ghebreyesus also said governments should put people`s health at the center of their plans. “We are calling on every government to put the health of its people at the center of its plans for development and growth,” he said.

Treatment of Monkeypox

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Treatment

At this time, there are no specific treatments available for monkeypox infection, but monkeypox outbreaks can be controlled.

Smallpox vaccine, cidofovir, ST-246, and vaccinia immune globulin (VIG) can be used to control a monkeypox outbreak. CDC guidance was developed using the best available information about the benefits and risks of smallpox vaccination and drug use for the prevention and management of monkeypox and other orthopoxvirus infections.

Monkeypox and Smallpox Vaccine

One vaccine, JYNNEOSTM (also known as Imvamune or Imvanex), has been licensed in the United States to prevent monkeypox and smallpox. Because monkeypox virus is closely related to the virus that causes smallpox, smallpox vaccine can also protect people from getting monkeypox. Past data from Africa suggests that smallpox vaccine is at least 85% effective in preventing monkeypox. The effectiveness of JYNNEOSTM against monkeypox was concluded from a clinical study on the immunogenicity of JYNNEOS and efficacy data from animal studies. Experts also believe that vaccination after a monkeypox exposure may help prevent the disease or make it less severe.

ACAM2000, which contains a live vaccinia virus, is licensed for immunization in people who are at least 18 years old and at high risk for smallpox infection. It can be used in people exposed to monkeypox if used under an expanded access investigational new drug protocol.

Smallpox vaccine is not currently available to the general public. In the event of another outbreak of monkeypox in the U.S., CDC will establish guidelines explaining who should be vaccinated. For more information about the smallpox vaccine please visit CDC’s Smallpox Vaccination Information for Health Professionals.

Components of a smallpox vaccination kit including the diluent, a vial of Dryvax® smallpox vaccine, and a bifurcated needle.

Smallpox vaccination kit.

Cidofovir and Brincidofovir (CMX001)

Data is not available on the effectiveness of Cidofovir and Brincidofovir in treating human cases of monkeypox.  However, both have proven activity against poxviruses in in vitro and animal studies.

It is unknown whether or not a person with severe monkeypox infection will benefit from treatment with either antiviral, although their use may be considered in such instances. Brincidofovir may have an improved safety profile over Cidofovir.  Serious renal toxicity or other adverse events have not been observed during treatment of cytomegalovirus infections with Brincidofovir as compared to treatment using Cidofovir.

Tecovirimat (ST-246)

Data is not available on the effectiveness of ST-246 in treating human cases of monkeypox.

Studies using a variety of animal species have shown that ST-246 is effective in treating orthopoxvirus-induced disease. Human clinical trials indicated the drug was safe and tolerable with only minor side effects.

Although currently stockpiled by the Strategic National Stockpile, use of ST-246 is administered under an IND.

Vaccinia Immune Globulin (VIG)

Data is not available on the effectiveness of VIG in treatment of monkeypox complications. Use of VIG is administered under an IND and has no proven benefit in the treatment of smallpox complications. It is unknown whether a person with severe monkeypox infection will benefit from treatment with VIG, however, its use may be considered in such instances.

VIG can be considered for prophylactic use in an exposed person with severe immunodeficiency in T-cell function for which smallpox vaccination following exposure to monkeypox is contraindicated.

Monkeypox

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Key facts

  • Vaccines used during the smallpox eradication programme also provided protection against monkeypox. Newer vaccines have been developed of which one has been approved for prevention of monkeypox
  • Monkeypox is caused by monkeypox virus, a member of the Orthopoxvirus genus in the family Poxviridae.
  • Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases can occur. In recent times, the case fatality ratio has been around 3–6%.
  • Monkeypox is transmitted to humans through close contact with an infected person or animal, or with material contaminated with the virus.
  • Monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets and contaminated materials such as bedding.
  • Monkeypox is a viral zoonotic disease that occurs primarily in tropical rainforest areas of central and west Africa and is occasionally exported to other regions.
  • An antiviral agent developed for the treatment of smallpox has also been licensed for the treatment of monkeypox.
  • The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which was declared eradicated worldwide in 1980. Monkeypox is less contagious than smallpox and causes less severe illness.
  • Monkeypox typically presents clinically with fever, rash and swollen lymph nodes and may lead to a range of medical complications.

Introduction

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms similar to those seen in the past in smallpox patients, although it is clinically less severe. With the eradication of smallpox in 1980 and subsequent cessation of smallpox vaccination, monkeypox has emerged as the most important orthopoxvirus for public health. Monkeypox primarily occurs in central and west Africa, often in proximity to tropical rainforests, and has been increasingly appearing in urban areas. Animal hosts include a range of rodents and non-human primates.

The pathogen

Monkeypox virus is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family. There are two distinct genetic clades of the monkeypox virus: the central African (Congo Basin) clade and the west African clade. The Congo Basin clade has historically caused more severe disease and was thought to be more transmissible. The geographical division between the two clades has so far been in Cameroon, the only country where both virus clades have been found.

Natural host of monkeypox virus

Various animal species have been identified as susceptible to monkeypox virus. This includes rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species. Uncertainty remains on the natural history of monkeypox virus and further studies are needed to identify the exact reservoir(s) and how virus circulation is maintained in nature.

Outbreaks

Human monkeypox was first identified in humans in 1970 in the Democratic Republic of the Congo in a 9-year-old boy in a region where smallpox had been eliminated in 1968. Since then, most cases have been reported from rural, rainforest regions of the Congo Basin, particularly in the Democratic Republic of the Congo and human cases have increasingly been reported from across central and west Africa.

Since 1970, human cases of monkeypox have been reported in 11 African countries: Benin, Cameroon, the Central African Republic, the Democratic Republic of the Congo, Gabon, Cote d’Ivoire, Liberia, Nigeria, the Republic of the Congo, Sierra Leone and South Sudan. The true burden of monkeypox is not known. For example, in 1996–97, an outbreak was reported in the Democratic Republic of the Congo with a lower case fatality ratio and a higher attack rate than usual. A concurrent outbreak of chickenpox (caused by the varicella virus, which is not an orthopoxvirus) and monkeypox was found, which could explain real or apparent changes in transmission dynamics in this case. Since 2017, Nigeria has experienced a large outbreak, with over 500 suspected cases and over 200 confirmed cases and a case fatality ratio of approximately 3%. Cases continue to be reported until today.

Monkeypox is a disease of global public health importance as it not only affects countries in west and central Africa, but the rest of the world. In 2003, the first monkeypox outbreak outside of Africa was in the United States of America and was linked to contact with infected pet prairie dogs. These pets had been housed with Gambian pouched rats and dormice that had been imported into the country from Ghana. This outbreak led to over 70 cases of monkeypox in the U.S. Monkeypox has also been reported in travelers from Nigeria to Israel in September 2018, to the United Kingdom in September 2018, December 2019, May 2021 and May 2022, to Singapore in May 2019, and to the United States of America in July and November 2021. In May 2022, multiple cases of monkeypox were identified in several non-endemic countries. Studies are currently underway to further understand the epidemiology, sources of infection, and transmission patterns.  

Transmission

Animal-to-human (zoonotic) transmission can occur from direct contact with the blood, bodily fluids, or cutaneous or mucosal lesions of infected animals. In Africa, evidence of monkeypox virus infection has been found in many animals including rope squirrels, tree squirrels, Gambian poached rats, dormice, different species of monkeys and others. The natural reservoir of monkeypox has not yet been identified, though rodents are the most likely. Eating inadequately cooked meat and other animal products of infected animals is a possible risk factor. People living in or near forested areas may have indirect or low-level exposure to infected animals.

Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person or recently contaminated objects. Transmission via droplet respiratory particles usually requires prolonged face-to-face contact, which puts health workers, household members and other close contacts of active cases at greater risk. However, the longest documented chain of transmission in a community has risen in recent years from 6 to 9 successive person-to-person infections. This may reflect declining immunity in all communities due to cessation of smallpox vaccination. Transmission can also occur via the placenta from mother to fetus (which can lead to congenital monkeypox) or during close contact during and after birth. While close physical contact is a well-known risk factor for transmission, it is unclear at this time if monkeypox can be transmitted specifically through sexual transmission routes. Studies are needed to better understand this risk.

Signs and symptoms

The incubation period (interval from infection to onset of symptoms) of monkeypox is usually from 6 to 13 days but can range from 5 to 21 days.

The infection can be divided into two periods:

  • the invasion period (lasts between 0–5 days) characterized by fever, intense headache, lymphadenopathy (swelling of the lymph nodes), back pain, myalgia (muscle aches) and intense asthenia (lack of energy). Lymphadenopathy is a distinctive feature of monkeypox compared to other diseases that may initially appear similar (chickenpox, measles, smallpox)
  • the skin eruption usually begins within 1–3 days of appearance of fever. The rash tends to be more concentrated on the face and extremities rather than on the trunk. It affects the face (in 95% of cases), and palms of the hands and soles of the feet (in 75% of cases). Also affected are oral mucous membranes (in 70% of cases), genitalia (30%), and conjunctivae (20%), as well as the cornea. The rash evolves sequentially from macules (lesions with a flat base) to papules (slightly raised firm lesions), vesicles (lesions filled with clear fluid), pustules (lesions filled with yellowish fluid), and crusts which dry up and fall off. The number of lesions varies from a few to several thousand. In severe cases, lesions can coalesce until large sections of skin slough off.

Monkeypox is usually a self-limited disease with the symptoms lasting from 2 to 4 weeks. Severe cases occur more commonly among children and are related to the extent of virus exposure, patient health status and nature of complications. Underlying immune deficiencies may lead to worse outcomes. Although vaccination against smallpox was protective in the past, today persons younger than 40 to 50 years of age (depending on the country) may be more susceptible to monkeypox due to cessation of smallpox vaccination campaigns globally after eradication of the disease.  Complications of monkeypox can include secondary infections, bronchopneumonia, sepsis, encephalitis, and infection of the cornea with ensuing loss of vision. The extent to which asymptomatic infection may occur is unknown.

The case fatality ratio of monkeypox has historically ranged from 0 to 11 % in the general population and has been higher among young children. In recent times, the case fatality ratio has been around 3–6%.

Diagnosis

The clinical differential diagnosis that must be considered includes other rash illnesses, such as chickenpox, measles, bacterial skin infections, scabies, syphilis, and medication-associated allergies. Lymphadenopathy during the prodromal stage of illness can be a clinical feature to distinguish monkeypox from chickenpox or smallpox.

If monkeypox is suspected, health workers should collect an appropriate sample and have it transported safely to a laboratory with appropriate capability. Confirmation of monkeypox depends on the type and quality of the specimen and the type of laboratory test. Thus, specimens should be packaged and shipped in accordance with national and international requirements. Polymerase chain reaction (PCR) is the preferred laboratory test given its accuracy and sensitivity. For this, optimal diagnostic samples for monkeypox are from skin lesions – the roof or fluid from vesicles and pustules, and dry crusts. Where feasible, biopsy is an option. Lesion samples must be stored in a dry, sterile tube (no viral transport media) and kept cold. PCR blood tests are usually inconclusive because of the short duration of viremia relative to the timing of specimen collection after symptoms begin and should not be routinely collected from patients.

As orthopoxviruses are serologically cross-reactive, antigen and antibody detection methods do not provide monkeypox-specific confirmation. Serology and antigen detection methods are therefore not recommended for diagnosis or case investigation where resources are limited. Additionally, recent or remote vaccination with a vaccinia-based vaccine (e.g. anyone vaccinated before smallpox eradication, or more recently vaccinated due to higher risk such as orthopoxvirus laboratory personnel) might lead to false positive results.

In order to interpret test results, it is critical that patient information be provided with the specimens including: a) date of onset of fever, b) date of onset of rash, c) date of specimen collection, d) current status of the individual (stage of rash), and e) age.

Therapeutics

Clinical care for monkeypox should be fully optimized to alleviate symptoms, manage complications and prevent long-term sequelae. Patients should be offered fluids and food to maintain adequate nutritional status. Secondary bacterial infections should be treated as indicated.  An antiviral agent known as tecovirimat that was developed for smallpox was licensed by the European Medical Association (EMA) for monkeypox in 2022 based on data in animal and human studies. It is not yet widely available.

If used for patient care, tecovirimat should ideally be monitored in a clinical research context with prospective data collection.

Vaccination

Vaccination against smallpox was demonstrated through several observational studies to be about 85% effective in preventing monkeypox. Thus, prior smallpox vaccination may result in milder illness. Evidence of prior vaccination against smallpox can usually be found as a scar on the upper arm. At the present time, the original (first-generation) smallpox vaccines are no longer available to the general public. Some laboratory personnel or health workers may have received a more recent smallpox vaccine to protect them in the event of exposure to orthopoxviruses in the workplace. A still newer vaccine based on a modified attenuated vaccinia virus (Ankara strain) was approved for the prevention of monkeypox in 2019. This is a two-dose vaccine for which availability remains limited. Smallpox and monkeypox vaccines are developed in formulations based on the vaccinia virus due to cross-protection afforded for the immune response to orthopoxviruses.

Prevention

Raising awareness of risk factors and educating people about the measures they can take to reduce exposure to the virus is the main prevention strategy for monkeypox. Scientific studies are now underway to assess the feasibility and appropriateness of vaccination for the prevention and control of monkeypox. Some countries have, or are developing, policies to offer vaccine to persons who may be at risk such as laboratory personnel, rapid response teams and health workers.

 

Reducing the risk of human-to-human transmission

Surveillance and rapid identification of new cases is critical for outbreak containment. During human monkeypox outbreaks, close contact with infected persons is the most significant risk factor for monkeypox virus infection. Health workers and household members are at a greater risk of infection. Health workers caring for patients with suspected or confirmed monkeypox virus infection, or handling specimens from them, should implement standard infection control precautions. If possible, persons previously vaccinated against smallpox should be selected to care for the patient.

Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories. Patient specimens must be safely prepared for transport with triple packaging in accordance with WHO guidance for transport of infectious substances.

The identification in May 2022 of clusters of monkeypox cases in several non-endemic countries with no direct travel links to an endemic area is atypical. Further investigations  are underway to determine the likely source of infection and limit further onward spread. As the source of this outbreak is being investigated, it is important to look at all possible modes of transmission in order to safeguard public health. Further information on this outbreak can be found here.

 

Reducing the risk of zoonotic transmission

Over time, most human infections have resulted from a primary, animal-to-human transmission. Unprotected contact with wild animals, especially those that are sick or dead, including their meat, blood and other parts must be avoided. Additionally, all foods containing animal meat or parts must be thoroughly cooked before eating.

Preventing monkeypox through restrictions on animal trade

Some countries have put in place regulations restricting importation of rodents and non-human primates. Captive animals that are potentially infected with monkeypox should be isolated from other animals and placed into immediate quarantine. Any animals that might have come into contact with an infected animal should be quarantined, handled with standard precautions and observed for monkeypox symptoms for 30 days.

How monkeypox relates to smallpox

The clinical presentation of monkeypox resembles that of smallpox, a related orthopoxvirus infection which has been eradicated. Smallpox was more easily transmitted and more often fatal as about 30% of patients died. The last case of naturally acquired smallpox occurred in 1977, and in 1980 smallpox was declared to have been eradicated worldwide after a global campaign of vaccination and containment. It has been 40 or more years since all countries ceased routine smallpox vaccination with vaccinia-based vaccines. As vaccination also protected against monkeypox in west and central Africa, unvaccinated populations are now also more susceptible to monkeypox virus infection.

Whereas smallpox no longer occurs naturally, the global health sector remains vigilant in the event it could reappear through natural mechanisms, laboratory accident or deliberate release. To ensure global preparedness in the event of reemergence of smallpox, newer vaccines, diagnostics and antiviral agents are being developed. These may also now prove useful for prevention and control of monkeypox.