Moisture preferences, growth and reproduction of the African nightcrawler, Eudrilus eugeniae (Oligochaeta)

As part of a comprehensive study of the biology of the economically important earthworm species Eudrilus eugeniae, the water relations of this species were studied. Moisture preferences were studied with the aid of cylindrical moisture towers filled with cattle manure. The cattle manure was dried, ground to a particle size of 500> <1000 (im and moistened. A moisture gradient was allowed to develop in the towers, the worms were added and the towers kept in an environmental control chamber at a temperature of 25°C and a relative humidity of 80%. The moisture preferences of both juvenile and adult worms were studied. The clitellate worms showed a wider preference range than the juveniles and the preference range of the juveniles coincided with the moisture levels at which cocoons were deposited. The highest frequency of occurrence for clitellate worms was between moisture levels of 80 and 82%. For cocoon deposition the highest frequency was at moisture levels between 79 and 80,5% and most juvenile worms showed a preference for a moisture range between 77,5 and 79%. The cocoons produced were incubated and the number of hatchlings per cocoon noted. The biggest number of offspring per cocoon hatched from cocoons originating from the moisture range of 79 to 80,5% coinciding with the highest frequency of cocoon deposition. From the results it appears that this earthworm species could be utilized in organic waste material with a relatively high moisture content

Life-cycle of the African nightcrawler, Eudrilus eugeniae (Oligochaeta)

In order to determine the potential of the earthworm Eudrilus eugeniae as waste processor and protein producer, the life history of this species was studied. The development, growth and reproduction of E. eugeniae were studied. Cattle dung was used as substrate with a moisture content of 70–80% and a temperature of 25°C. Data were gathered over a period of 300 days. It was found that cocoon production started within 24 h after copulation and can be sustained for at least 300 days. Cocoons are produced at an average rate of 1,65 cocoons per worm per day. The mean incubation period of cocoons is 16,6 days with a hatching success of 84% and 2,7 hatchlings per cocoon that hatched. Sexual maturity is attained by the offspring within 40 to 50 days after hatching. E. eugeniae is compared to other vermicomposting species

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

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 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

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

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: 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. Funding: National Institute for Health and Care Research