Sugarcane-derived animal feed

Sugarcane cultivation in the tropics and subtropics has been a matter of record for as long as written and pictorial records have survived the ravages of time, and it is undoubtedly true that the crop was cultivated by primitive humans long before. It is also undoubtedly true that cultivated sugarcane has been part of the diet of domesticated animals for a similar period of time and, to this day, crop residues from cultivated sugarcane are an important source of forage or supplementary fodder in the tropics and subtropics (Peacock 1996, Aregheore 2005). In contrast, commercial sugarcane production now occurs in more than 100 countries in an area of more than 26 million hectares (FAOSTAT 2014), and its cultivation generates the highest annual tonnage of biomass of any crop, approximately 1.84 billion tons (FAOSTAT 2014).With an increasing global demand for meat, milk, dairy, and other products derived from domesticated animals, there is an increasing demand for animal feed and an increasing need to integrate existing crop residues and processing products into animal feed. Given the prominence of sugarcane in global plant biomass production, it is clear that sugarcane has a significant role to play in increasing global animal production. Furthermore, modeling of integrated sugarcane and animal production shows that the approach can have substantial economic advantages (Gradiz et al. 2007). Sugarcane has significant advantages as a forage crop in the tropics and subtropics including - (i) adaptation to tropical and subtropical conditions; - (ii) reduced sensitivity to poor soil fertility, heat and humidity, and insect and disease pressures compared with other crops; - (iii) existing technology for production and processing at industrial scale; - (iv) high biomass yields can be achieved, and; - (v) the unusual ability to maintain consistent quality as a standing crop in the field (Pate et al. 2002). Indeed, there are examples of sugarcane cultivars that have been specifically bred to provide animal feed and thrive under region-specific environmental conditions (Suzuki et al. 2014). This chapter provides an overview of how sugarcane crop residues, the products of sugarcane processing, and the products of raw sugar production are being used to support animal production and describes technologies available to enhance them for this purpose

Effect of COVID-19 pandemic lockdowns on planned cancer surgery for 15 tumour types in 61 countries: an international, prospective, cohort study

Background: Surgery is the main modality of cure for solid cancers and was prioritised to continue during COVID-19 outbreaks. This study aimed to identify immediate areas for system strengthening by comparing the delivery of elective cancer surgery during the COVID-19 pandemic in periods of lockdown versus light restriction. Methods: This international, prospective, cohort study enrolled 20 006 adult (≥18 years) patients from 466 hospitals in 61 countries with 15 cancer types, who had a decision for curative surgery during the COVID-19 pandemic and were followed up until the point of surgery or cessation of follow-up (Aug 31, 2020). Average national Oxford COVID-19 Stringency Index scores were calculated to define the government response to COVID-19 for each patient for the period they awaited surgery, and classified into light restrictions (index <20), moderate lockdowns (20–60), and full lockdowns (>60). The primary outcome was the non-operation rate (defined as the proportion of patients who did not undergo planned surgery). Cox proportional-hazards regression models were used to explore the associations between lockdowns and non-operation. Intervals from diagnosis to surgery were compared across COVID-19 government response index groups. This study was registered at ClinicalTrials.gov, NCT04384926. Findings: Of eligible patients awaiting surgery, 2003 (10·0%) of 20 006 did not receive surgery after a median follow-up of 23 weeks (IQR 16–30), all of whom had a COVID-19-related reason given for non-operation. Light restrictions were associated with a 0·6% non-operation rate (26 of 4521), moderate lockdowns with a 5·5% rate (201 of 3646; adjusted hazard ratio [HR] 0·81, 95% CI 0·77–0·84; p<0·0001), and full lockdowns with a 15·0% rate (1775 of 11 827; HR 0·51, 0·50–0·53; p<0·0001). In sensitivity analyses, including adjustment for SARS-CoV-2 case notification rates, moderate lockdowns (HR 0·84, 95% CI 0·80–0·88; p<0·001), and full lockdowns (0·57, 0·54–0·60; p<0·001), remained independently associated with non-operation. Surgery beyond 12 weeks from diagnosis in patients without neoadjuvant therapy increased during lockdowns (374 [9·1%] of 4521 in light restrictions, 317 [10·4%] of 3646 in moderate lockdowns, 2001 [23·8%] of 11 827 in full lockdowns), although there were no differences in resectability rates observed with longer delays. Interpretation: Cancer surgery systems worldwide were fragile to lockdowns, with one in seven patients who were in regions with full lockdowns not undergoing planned surgery and experiencing longer preoperative delays. Although short-term oncological outcomes were not compromised in those selected for surgery, delays and non-operations might lead to long-term reductions in survival. During current and future periods of societal restriction, the resilience of elective surgery systems requires strengthening, which might include protected elective surgical pathways and long-term investment in surge capacity for acute care during public health emergencies to protect elective staff and services. Funding: National Institute for Health Research Global Health Research Unit, Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, Medtronic, Sarcoma UK, The Urology Foundation, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research