FATORES QUE AFETAM A RENTABILIDADE DA PECUÁRIA DE LEITE

Objetivou-se identificar e quantificar os indicadores associados com o tamanho, com a taxa de giro do capital investido (TGC) e com a lucratividade que afetam a rentabilidade da pecuária de leite. Os dados originaram-se de vinte e sete produtores de leite (213,6 ± 193,9 litros de leite/fazenda/dia) no Estado de Mato Grosso, coletados durante doze meses. Dos fatores associados com a lucratividade, o custo com mão-de-obra relativa à renda com leite e a produtividade da mão-de-obra afetaram negativamente a rentabilidade. O preço do leite, os custos com alimentação concentrada ou volumosa relativos à renda bruta com leite não afetaram a rentabilidade da pecuária.  Os indicadores associados com a produtividade da terra (produção de leite por área e número de vacas em lactação por área usada pelo rebanho) apresentaram maior impacto na rentabilidade da pecuária de leite que os indicadores de produtividade do rebanho. A proporção de vacas em lactação em relação ao rebanho e a produção de leite por total de vacas (mas não por vaca em lactação) são os indicadores de produtividade do rebanho de maior impacto na rentabilidade.Palavras-chave: custo de produção; eficiência; lucratividade. FACTORS AFFECTING THE PROFITABILITY OF DAIRY FARMING  ABSTRACT: The objective was to identify and quantify the impact of indicators associated with size, return on invested capital (ROIC) and profitability on economic performance (rentability) of dairy farms. Data from twenty seven dairy farms (213.6 ± 193.9 liters milk/farm/day) were collected in Mato Grosso State, during twelve months. Of the factors associated with profitability, the labor cost and labor productivity negatively affected rentability. Milk price and concentrate feed cost (in relation with milk gross income) did not affect rentability of dairy farm. Land productivity index (milk yield/dairy farm area; lactating cows/dairy farm area used by dairy herd) had greater impact on economic performance than animal productivity index. Lactating cows/head ratio and milk yield per total cows (but not by lactating cow) are the animal productivity index that had the greatest impact on rentability of dairy farms.Keywords: cost of production; efficiency; profitability

EXTRATO DE MAMONA COMO MANIPULADOR DA FERMENTAÇÃO RUMINAL

Objetivou-se investigar os efeitos da adição do extrato de farelo de mamona (EFM) sobre o perfil da fermentação ruminal in vitro em dietas com alto e baixo teor de forragem. Utilizou-se ensaio de incubação ruminal in vitro com dois controles, um negativo (sem aditivo) e um positivo (monensina sódica) e EFM liofilizado (20, 40 e 60 mg/frasco). Em condições de alto teor de forragem na dieta, a adição do EFM aumentou o pH do meio e a concentração de acetato, reduziu a produção de gás, mas não afetou a produção de gás por unidade de matéria seca (MS) digerida em relação ao tratamento controle. Em comparação com monensina sódica, o EFM reduziu as concentrações de propionato e amônia e aumentou a produção de gás por unidade de MS digerida. Em condições de baixo teor de forragem, a adição do EFM reduziu o pH e potencial redox do meio em relação ao tratamento controle. Em comparação com a monensina sódica, o EFM reduziu o pH do meio e a produção total de gás, mas não afetou a produção de gás por unidade de MS digerida. O extrato de farelo de mamona destoxificado não apresenta potencial como manipulador da fermentação ruminal.Palavras-chave: amônia; digestibilidade; eficiência; metano. CASTOR BEAN EXTRACT AS A MANIPULATOR OF RUMINAL FERMENTATION ABSTRACT: Effects of the castorbean meal extract (CME) on ruminal in vitro were investigate in high and low forage diet conditions. For each dietary condition, one in vitro ruminal incubation experiment was conducted in a completely randomized design, with nine repetitions per treatment (three animal inoculum donators and three 48 hors-incubations). In high forage diet, CME increased ruminal pH acetate concentration, reduced gas production, but it did not affect the gas production per unit of digested dry matter (DM), in relation to control treatment. Compare to monensin sodium, CME reduced propionate and ammonia concentrations and increased gas production per unit of digested DM, indicating that CME reduces ruminal energetic efficiency. In low forage diet, CME reduced pH and redox potential compare to control. Compare to monensin sodium, CME reduced pH and gas production, but it did not affect gas production per unit of digested DM. Castorbean meal extract does not present potential as manipulator of the ruminal fermentation.Keywords: ammonia; digestibility; efficiency; methane

FATORES QUE AFETAM A RENTABILIDADE DA PECUÁRIA DE LEITE

Objetivou-se identificar e quantificar os indicadores associados com o tamanho, com a taxa de giro do capital investido (TGC) e com a lucratividade que afetam a rentabilidade da pecuária de leite. Os dados originaram-se de vinte e sete produtores de leite (213,6 ± 193,9 litros de leite/fazenda/dia) no Estado de Mato Grosso, coletados durante doze meses. Dos fatores associados com a lucratividade, o custo com mão-de-obra relativa à renda com leite e a produtividade da mão-de-obra afetaram negativamente a rentabilidade. O preço do leite, os custos com alimentação concentrada ou volumosa relativos à renda bruta com leite não afetaram a rentabilidade da pecuária.  Os indicadores associados com a produtividade da terra (produção de leite por área e número de vacas em lactação por área usada pelo rebanho) apresentaram maior impacto na rentabilidade da pecuária de leite que os indicadores de produtividade do rebanho. A proporção de vacas em lactação em relação ao rebanho e a produção de leite por total de vacas (mas não por vaca em lactação) são os indicadores de produtividade do rebanho de maior impacto na rentabilidade.Palavras-chave: custo de produção; eficiência; lucratividade. FACTORS AFFECTING THE PROFITABILITY OF DAIRY FARMING  ABSTRACT: The objective was to identify and quantify the impact of indicators associated with size, return on invested capital (ROIC) and profitability on economic performance (rentability) of dairy farms. Data from twenty seven dairy farms (213.6 ± 193.9 liters milk/farm/day) were collected in Mato Grosso State, during twelve months. Of the factors associated with profitability, the labor cost and labor productivity negatively affected rentability. Milk price and concentrate feed cost (in relation with milk gross income) did not affect rentability of dairy farm. Land productivity index (milk yield/dairy farm area; lactating cows/dairy farm area used by dairy herd) had greater impact on economic performance than animal productivity index. Lactating cows/head ratio and milk yield per total cows (but not by lactating cow) are the animal productivity index that had the greatest impact on rentability of dairy farms.Keywords: cost of production; efficiency; profitability

Capacity of ensilage of Jatropha curcas L. cake to degrade forbol esters

The objective of this study was to evaluate the capacity of the ensilage of Jatropha curcas L. expeller cake to reduce the phorbol esters and its effect on fermentative losses, by adding soluble carbohydrates or microbial inoculants. The design was completely randomized with four replications in a 3 × 2 factorial arrangement, with three sources of soluble carbohydrates (SC, control, 50 g sucrose/kg or 50 g crude glycerin/kg as fed) and two doses of microbial inoculants (MI, 0 or 5 × 10(5) ufc Lactobacillus plantarum + 3.33 × 10(5) ufc Propionibacterium per g as fed). Twenty-four mini-silos (982 cm³) of polyvinyl chloride were created and opened after 60 days of fermentation at room temperature. The pre-hydrated Jatropha curcas L. cake (282 g of water/kg) contained 0.424 mg of phorbol esters/g of dry matter. Ensiling reduced the phorbol esters in 47.4%, on average, regardless of the SC or MI. There was no interaction effect between SC and MI on effluent, gases or total dry matter losses. However, both losses were increased when SC were added, and it was higher with glycerin that than sucrose. The addition of MI reduced all fermentation losses. The process of ensiling, although partially to reduce the phorbol esters of pre-hydrated Jatropha curcas L. cake, is not indicated as a biodestoxification procedure

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings.</p

Association of Country Income Level With the Characteristics and Outcomes of Critically Ill Patients Hospitalized With Acute Kidney Injury and COVID-19

Introduction: Acute kidney injury (AKI) has been identified as one of the most common and significant problems in hospitalized patients with COVID-19. However, studies examining the relationship between COVID-19 and AKI in low- and low-middle income countries (LLMIC) are lacking. Given that AKI is known to carry a higher mortality rate in these countries, it is important to understand differences in this population. Methods: This prospective, observational study examines the AKI incidence and characteristics of 32,210 patients with COVID-19 from 49 countries across all income levels who were admitted to an intensive care unit during their hospital stay. Results: Among patients with COVID-19 admitted to the intensive care unit, AKI incidence was highest in patients in LLMIC, followed by patients in upper-middle income countries (UMIC) and high-income countries (HIC) (53%, 38%, and 30%, respectively), whereas dialysis rates were lowest among patients with AKI from LLMIC and highest among those from HIC (27% vs. 45%). Patients with AKI in LLMIC had the largest proportion of community-acquired AKI (CA-AKI) and highest rate of in-hospital death (79% vs. 54% in HIC and 66% in UMIC). The association between AKI, being from LLMIC and in-hospital death persisted even after adjusting for disease severity. Conclusions: AKI is a particularly devastating complication of COVID-19 among patients from poorer nations where the gaps in accessibility and quality of healthcare delivery have a major impact on patient outcomes

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60&nbsp;years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death.&nbsp;The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death