The Use of Infliximab to Control Recurrent Cytokine Storms in EBV-Associated Angioimmunoblastic Lymphoma and Hemophagocytic Syndrome

Introduction: Chronic active Epstein-Barr virus infection (CAEBV) has been implicated in several diseases including hemophagocytic lymphohistiocytosis (EBV-HLH) and lymphomas including Angioimmunoblastic T cell lymphoma. The exact mechanism by which EBV infection causes these complications is currently not well understood. EBV-HLH is a syndrome in which T-cells, NK cells and macrophages are aberrantly activated. Cytokine storms play a major role in cellular damage and organ dysfunction. In the event that the body is unable to clear the EBV viremia, dysregulated T, NK cells and macrophages continue to release cytokines leading to the accumulation of lymphohistiocytic infiltrates into organs and organ damage. Cytokine storms can lead to death from multi-organ failure. During a cytokine storm, levels of several cytokines are elevated including TNF-a, IFN-g, sCD25, IL-12, IL-1, IL-10 and IL-18.1–3 Current lines of therapy of EBV-HLH include steroids, etoposide, cyclosporine, ATG and hematopoietic stem cell transplantation. We report successfully controlling frequent cytokine storms in a patient with EBV induced angioimmunoblastic lymphoma and HLH with weekly infliximab after failure to do so with chemotherapy (CHOP-E; cyclophosphamide, daunorubicin, vincristine, prednisone, etoposide), rituximab and bortezomib

Numerical modelling of monorail support requirements in decline development

This paper discusses support requirements for the proposed monorail system to be used in decline development. The monorail drilling and loading systems are systems that move on the rail (monorail) installed in the roof of the decline and supported by roof bolts, suspension chains and steel supports. However, due to the weight of the components of the two systems, it is imperative that the force in each roof bolt, suspension chain and steel support capable of suspending the weight of the heaviest component is determined. Numerical models that relate the weight of the monorail drilling and loading components to the required strength in the support system have been developed. Using these developed models, numerical values of the forces in each roof bolt, suspension chain and steel support, required to suspend the weight of the heaviest component of the monorail drilling and loading systems are determined

Overweight and Obesity in Kaoma and Kasama Rural Districts of Zambia: Prevalence and Correlates in 2008-2009 Population Based Surveys

Background: Overweight and obesity (overweight/obesity) is associated with hypertension. Low- and middleincome countries are experiencing an obesity epidemic. There is growing evidence that the epidemic is on the increase in urban settings of developing countries. However, there is scanty information on the magnitude of this epidemic and its correlates in rural settings. The objective of the current study was to establish levels of overweight/obesity and its correlates in rural areas of Zambia. Designing interventions based on the correlates for overweight/obesity to reduce its prevalence may in turn lead to a reduction in the prevalence of hypertension. Methods: Cross sectional studies using a modified WHO Stepwise questionnaire were conducted. Logistic regression analyses were used to determine factors that were associated with overweight/obesity. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) and their 95% confidence intervals are reported. Results: Totals of 895 participants from Kaoma and 1198 from Kasama took part in the study. Altogether, 7.6% of the participants were overweight and 2.5% were obese, with a combined prevalence of overweight/obesity of 10.1%. Factors that were independently associated with overweight/obesity were sex, education, vegetable consumption, smoking and hypertension. Female participants were 78% (AOR=1.78, 95% CI [1.46, 2.17]) more like to be overweight/ obese compared to males. Participants with secondary or higher education level were 2.04 (95% CI [1.56, 2.67]) times more likely to be overweight/obese compared to participants with lower levels of education. Participants who consumed vegetables 5 to 7 days in a week were 35% (AOR=1.35, 95% CI [1.06, 1.72]) more likely to be overweight/ obese compared to participants who ate vegetables less than 5 days in a week. Non smokers were 2.06 (95% CI [1.42, 2.98]) times more likely to be overweight/obese than smokers. Participants who were non hypertensive were 30% (AOR=0.70, 95% CI [0.59, 0.82]) less likely to be overweight/obese compared to participants who were hypertensive. Conclusions: Prevalence of overweight/obesity was low and this is the time to start instituting interventions to control the obesity epidemic in rural districts of Zambia

Cannabis Use and its Socio-demographic Correlates among in-School Adolescents in Zambia

Background Cannabis dependence in adolescents predicts increased risks of using other illicit drugs, poor academic performance and reporting psychotic symptoms. The prevalence of cannabis use was estimated two decades ago in Zambia among secondary school students. There are no recent estimates of the extent of the problem; further, correlates for its use have not been documented in Zambia. The objective of study was to estimate the current prevalence of cannabis use and its socio-demographic correlates among in-school adolescents. Methods We conducted secondary analysis of data that was obtained from the 2004 Zambia Global School-Based Health Survey. Logistic regression analysis was conducted to identify the socio-demographic factors associated with cannabis use. Results A total of 2,257 adolescents participated in the survey of which 53.9% were females. The overall prevalence of self reported ever-used cannabis was 37.2% (34.5% among males and 39.5% among females). In multivariate analysis, males were 8% (AOR = 0.92; 95% CI [0.89, 0.95]) less likely to have ever smoked cannabis. Compared to adolescents aged 16 years or older, adolescents aged 14 years were 45% (AOR = 1.45; 95% CI [1.37, 1.55]) more likely, and those aged 15 years were 44% (AOR = 0.56; 95% CI [0.53, 0.60]) less likely to report to have ever smoked cannabis. Other factors that were significantly associated with cannabis use were history of having engaged in sexual intercourse (AOR = 2.55; 95% CI [2.46, 2.64]), alcohol use (AOR = 4.38; 95% CI [4.24, 4.53]), and having been bullied (AOR = 1.77; 95% CI [1.71, 1.83]). Adolescents who reported being supervised by parents during free time were less likely to have smoked cannabis (AOR = 0.92; 95% CI [0.88, 0.95]). Conclusions The use of cannabis is prevalent among Zambian in-school adolescents. Efforts to prevent adolescents’ psychoactive drug use in Zambia should be designed considering the significant factors associated with drug use in the current study

Problem Of Artisanal Gold Mining In The Mining Area Of Mangi, Tshopo Province In The Democratic Republic Of Congo

Objective: assess the environmental and health risks generated by artisanal gold mining in the community of MANGI.Methods: This is a descriptive cross-sectional study carried out from October 2021 to June 2022. Data collection was done through direct observations and survey questionnaires. ArcGIS software was used to carry out our cartographic analyses. Landsat images from 2003 and 2023 were used to assess the deforestation rate of the mining area. Of the 362 questionnaires distributed to various artisanal miners and other stakeholders, 229 responses were collected, representing a response rate of 63.26%. Data analysis is done with Epi-info 7.2.5 software and Excel 2016 software.Results: The area generally suffered deforestation of 2.3% and particularly forest degradation of around 10.9% due to artisanal gold mining over a period of twenty years. Mercury is the only chemical element used by gold miners in the processing of gold. A presence of minors on operating sites estimated at 9.2%. The level of ignorance of operators on the health impacts of the use of mercury was estimated at 96.5% and that of knowledge on the environmental impacts was at 64.6%. Deforestation was 100% certified. It was also noted the pollution of waterways and a disappearance of fish criticized by 92.6%; also the presence of rock debris in all sites studied with abandoned gaping holes. 91% of respondents experienced accidents/incidents during the activity. 94% of operators complained of lower back pain due to activity, 67% of chest pain, 62% of chronic cough, 21% of chronic digestive disorders, 81% of insomnia, 67% of persistent headaches, 13% of cases of memory loss, 39% of respondents presenting limb tremors. This study also reports 86% of cases of permanent conflicts linked to the activity with excessive alcohol consumption noted among the majority of operators (86%).Conclusion: Gold panning has promoted the economic stability of several households in the region, but unfortunately, it is the basis of several health and environmental risks that it is essential to manage effectively. Raising awareness among operators and rigorous control over the application of texts are alternatives to be considered by the political-administrative authorities in this sector

Monorail technology - A rapid and cost effective method of decline development

E Chanda and B Besahttp://www.ausimm.com.au/publications/epublication.aspx?ID=431

Application of electro-monorail mine haulage systems in underground decline development

This study compares the electrical monorail transport system (EMTS) with the conventional truck haulage system in decline development. The study examines decline geometry, cycle times and cost and productivity in relation to the two haulage systems. Results show that productivity of the monorail is affected by loader cycle time to fill the monorail containers. Hence, to increase the productivity of the monorail a continuous loading system has been proposed in this paper. The operating costs of the monorail were found to be the same as the truck haulage system. However, if the cost of electricity is lower than 30¢ (Australian) per kilowatt hour, the operating cost for the monorail would be significantly lower than that of a comparable truck haulage system. The capital costs for the monorail are slightly higher than a comparable truck. However, the monorail’s lower operating costs plus environmental benefits make it more attractive than truck haulage