Sustainable P-enriched biochar-compost production: harnessing the prospects of maize stover and groundnut husk in Ghana’s Guinea Savanna

Farmers in resource-poor areas of the Guinea Savanna zone of Ghana often face declining soil fertility due to the continuous removal of nutrient-rich harvested produce from their fields. This study focuses on the Lawra Municipality in the Guinea Savanna zone of Ghana, where low soil fertility, specifically, limits phosphorus (P) bioavailability and hinders crop production. The objective of this research is to formulate P-enhanced biochar-compost from maize stover (MS) and groundnut husk, which abound in the area, to close the nutrient loop. MS was co-composted with groundnut husk biochar at varying rates of 0, 10, 20, 30, and 40% by volume. To facilitate decomposition using the windrow system, the composting heaps were inoculated with decomposing cow dung, and the moisture content was kept at 60% throughout the monitoring period. The addition of biochar shortened the lag phase of composting. However, rates above 20% resulted in reduced degradation of MS. Biochar incorporation enriched the available phosphorus content in the final compost from 286.7 mg kg−1 in the non-biochar-compost to 320, 370, 546, and 840.0 mg kg−1 in the 10, 20, 30, and 40% biochar-compost, respectively

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Short-Term Effect of Biochar on Microbial Biomass, Respiration and Enzymatic Activities in Wastewater Irrigated Soils in Urban Agroecosystems of the West African Savannah

Irrigated urban agriculture (UA) supports the economy and health of urban inhabitants in low-income countries. This system is often characterized by high nutrient inputs and mostly utilizes wastewater for irrigation. Biochar has been proposed to increase crop yields and improve soil properties. In this study, we assessed the transient effect of rice husk biochar (20 t ha−1) and/or fertilizer (NPK: 15-15-15) on microbial respiration, microbial biomass carbon and enzyme activities of irrigated (wastewater and tap water) soil from an UA field experiment in the Guinea savannah zones of Ghana. Our results showed an increase by up to 123% in soil organic carbon (SOC) after a year of biochar application, while hot water extractable carbon (HWEC) was increased by only 11 to 26% and microbial biomass carbon (MBC) by 34%. Basal respiration was significantly increased in mineral fertilized soil by up to 46% but decreased by 12–45% under wastewater irrigation. Overall, the metabolic quotient (qCO2) indicated less stress for the microbial community and increased carbon use efficiency with biochar application and wastewater irrigation. Total enzymes activity was increased under wastewater irrigation and biochar treated soils exhibit a more diverse composition of C-cycling enzymes and a higher activity of aminopeptidases. Biochar and wastewater showed positive effects on biological soil properties and contributed to soil fertility. Our results suggest beneficial effects of biochar on non-biochar SOC stocks in the long term

Short-Term Effect of Biochar on Microbial Biomass, Respiration and Enzymatic Activities in Wastewater Irrigated Soils in Urban Agroecosystems of the West African Savannah

Irrigated urban agriculture (UA) supports the economy and health of urban inhabitants in low-income countries. This system is often characterized by high nutrient inputs and mostly utilizes wastewater for irrigation. Biochar has been proposed to increase crop yields and improve soil properties. In this study, we assessed the transient effect of rice husk biochar (20 t ha−1) and/or fertilizer (NPK: 15-15-15) on microbial respiration, microbial biomass carbon and enzyme activities of irrigated (wastewater and tap water) soil from an UA field experiment in the Guinea savannah zones of Ghana. Our results showed an increase by up to 123% in soil organic carbon (SOC) after a year of biochar application, while hot water extractable carbon (HWEC) was increased by only 11 to 26% and microbial biomass carbon (MBC) by 34%. Basal respiration was significantly increased in mineral fertilized soil by up to 46% but decreased by 12–45% under wastewater irrigation. Overall, the metabolic quotient (qCO2) indicated less stress for the microbial community and increased carbon use efficiency with biochar application and wastewater irrigation. Total enzymes activity was increased under wastewater irrigation and biochar treated soils exhibit a more diverse composition of C-cycling enzymes and a higher activity of aminopeptidases. Biochar and wastewater showed positive effects on biological soil properties and contributed to soil fertility. Our results suggest beneficial effects of biochar on non-biochar SOC stocks in the long term

DataSheet1_Sustainable P-enriched biochar-compost production: harnessing the prospects of maize stover and groundnut husk in Ghana’s Guinea Savanna.docx

Farmers in resource-poor areas of the Guinea Savanna zone of Ghana often face declining soil fertility due to the continuous removal of nutrient-rich harvested produce from their fields. This study focuses on the Lawra Municipality in the Guinea Savanna zone of Ghana, where low soil fertility, specifically, limits phosphorus (P) bioavailability and hinders crop production. The objective of this research is to formulate P-enhanced biochar-compost from maize stover (MS) and groundnut husk, which abound in the area, to close the nutrient loop. MS was co-composted with groundnut husk biochar at varying rates of 0, 10, 20, 30, and 40% by volume. To facilitate decomposition using the windrow system, the composting heaps were inoculated with decomposing cow dung, and the moisture content was kept at 60% throughout the monitoring period. The addition of biochar shortened the lag phase of composting. However, rates above 20% resulted in reduced degradation of MS. Biochar incorporation enriched the available phosphorus content in the final compost from 286.7 mg kg−1 in the non-biochar-compost to 320, 370, 546, and 840.0 mg kg−1 in the 10, 20, 30, and 40% biochar-compost, respectively.</p

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit