Survival analysis of dairy cows in the Netherlands under altering agricultural policy

Culling of underperforming dairy cows by replacement heifers is a fundamental part of Dutch dairy farm management. Changes in national agricultural policies can influence farmers' culling decisions. The objective of this study was to analyse the relevancy of cow-level risk factors for survival of Dutch dairy cows under perturbations due to national policy changes related to the -milk quota abolishment of 2015 and the phosphate regulations since 2017. For this purpose, an accelerated failure time model was fitted on-longitudinal dairy cows' data at national level covering the period 2009-2019. The associated cow-level risk factors for culling such as lactation value (relative production level), parity number, rolling average of inseminations over all parities, very high fat-protein ratio (highFPR) and very low fat-protein ratio (lowFPR) in early lactation, test-day somatic cell count, were fitted in the model. Along with these, a factor representing three target policy periods, namely Milk Quota period (MQ), Post-Milk Quota period (PMQ) and Phosphate regulation period (PH) were fitted. The mean survival age for all producing cows was 441 weeks overall. The predicted median survival time for the policy periods MQ, PMQ and PH were 273 weeks, 271 weeks and 256 weeks, respectively. Risk factors such as lactation value, parity and highFPR, rolling average of inseminations over all parities were positively associated with survival time in all three policy periods. Risk factors such as test-day somatic cell count and lowFPR were negatively associated with survival time in all three policy periods. In conclusion, this study demonstrated the differences in survival of Dutch dairy cows in response to changing agricultural policy. The association of cow-level risk factors for culling was consistent across the three evaluated policy periods

Survival analysis of dairy cows in the Netherlands under altering agricultural policy

Culling of underperforming dairy cows by replacement heifers is a fundamental part of Dutch dairy farm management. Changes in national agricultural policies can influence farmers' culling decisions. The objective of this study was to analyse the relevancy of cow-level risk factors for survival of Dutch dairy cows under perturbations due to national policy changes related to the -milk quota abolishment of 2015 and the phosphate regulations since 2017. For this purpose, an accelerated failure time model was fitted on-longitudinal dairy cows' data at national level covering the period 2009-2019. The associated cow-level risk factors for culling such as lactation value (relative production level), parity number, rolling average of inseminations over all parities, very high fat-protein ratio (highFPR) and very low fat-protein ratio (lowFPR) in early lactation, test-day somatic cell count, were fitted in the model. Along with these, a factor representing three target policy periods, namely Milk Quota period (MQ), Post-Milk Quota period (PMQ) and Phosphate regulation period (PH) were fitted. The mean survival age for all producing cows was 441 weeks overall. The predicted median survival time for the policy periods MQ, PMQ and PH were 273 weeks, 271 weeks and 256 weeks, respectively. Risk factors such as lactation value, parity and highFPR, rolling average of inseminations over all parities were positively associated with survival time in all three policy periods. Risk factors such as test-day somatic cell count and lowFPR were negatively associated with survival time in all three policy periods. In conclusion, this study demonstrated the differences in survival of Dutch dairy cows in response to changing agricultural policy. The association of cow-level risk factors for culling was consistent across the three evaluated policy periods

Relationship Between Postoperative Pain and Overall 30-Day Complications in a Broad Surgical Population: An Observational Study

OBJECTIVE: The aim of this study was to establish the relationship between postoperative pain and 30-day postoperative complications. BACKGROUND: Only scarce data are available on the association between postoperative pain and a broad range of postoperative complications in a large heterogeneous surgical population. METHODS: Having postoperative pain was assessed in 2 ways: the movement-evoked pain score on the Numerical Rating Scale (NRS-MEP) and the patients' opinion whether the pain was acceptable or not. Outcome was the presence of a complication within 30 days after surgery. We used binary logistic regression for the total population and homogeneous subgroups to control for case complexity. Results for homogeneous subgroups were summarized in a meta-analysis using inverse variance weighting. RESULTS: In 1014 patients, 55% experienced moderate-to-severe pain on the first postoperative day. The overall complication rate was 34%. The proportion of patients experiencing postoperative complications increased from 0.25 [95% confidence interval (CI) = 0.21-0.31] for NRS-MEP = 0 to 0.45 (95% CI = 0.36-0.55) for NRS-MEP = 10. Patients who found their pain unacceptable had more complications (adjusted odds ratio = 2.17 (95% CI = 1.51-3.10; P < 0.001)). Summary effect sizes obtained with homogeneous groups were similar to those obtained from the total population who underwent very different types of surgery. CONCLUSIONS: Higher actual postoperative pain scores and unacceptable pain, even on the first postoperative day, are associated with more postoperative complications. Our findings provide important support for the centrality of personalized analgesia in modern perioperative care

Dietary Protein Intake and Incidence of Type 2 Diabetes in Europe: The EPIC-InterAct Case-Cohort Study

OBJECTIVE The long-term association between dietary protein and type 2 diabetes incidence is uncertain. We aimed to investigate the association between total, animal, and plant protein intake and the incidence of type 2 diabetes. RESEARCH DESIGN AND METHODS The prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from eight European countries, with an average follow-up time of 12.0 years. Pooled country-specific hazard ratios (HRs) and 95% CI of prentice-weighted Cox regression analyses were used to estimate type 2 diabetes incidence according to protein intake. RESULTS After adjustment for important diabetes risk factors and dietary factors, the incidence of type 2 diabetes was higher in those with high intake of total protein (per 10 g: HR 1.06 [95% CI 1.02-1.09], P-trend 30 kg/m(2) (per 10 g animal protein: 1.19 [1.09-1.32]), and nonsignificant in men. Plant protein intake was not associated with type 2 diabetes (per 10 g: 1.04 [0.93-1.16], P-trend = 0.098). CONCLUSIONS High total and animal protein intake was associated with a modest elevated risk of type 2 diabetes in a large cohort of European adults. In view of the rapidly increasing prevalence of type 2 diabetes, limiting iso-energetic diets high in dietary proteins, particularly from animal sources, should be considered