The association between time-series milk ß-hydroxybutyrate dynamics and early reproductive performance of dairy cows.

The DeLaval Herd Navigator is an on-farm sensor system that measures on a frequent basis milk progesterone (P4) and ß-hydroxybutyrate (BHB) in individual cows to closely monitor reproductive performance and energy balance. This information provides the opportunity to investigate the dynamics of BHB measured in milk (mBHB) and study the association between mBHB and early reproductive performance. The objectives of the study were (1) to describe mBHB dynamics within the first 20 d in milk (DIM), and (2) to evaluate the association between mBHB dynamics and early reproductive performance at cow-level. Two-year time-series data from 4,133 dairy cows in 38 Dutch dairy farms were available for analysis. Data included information on mBHB, daily milk yield and the indicators of early reproductive performance, days from calving to resumption of cyclicity, days from calving to first estrus, and days from calving to first insemination. The following mBHB dynamic parameters were defined based on the first 20 DIM for each individual cow: average mBHB (AvgBHB), DIM when mBHB was for the first time ≥80 µmol/L (OnsetKeto), the total number of consecutive days a cow had mBHB concentration ≥80 µmol/L, and the number of measurements mBHB concentration was ≥80 µmol/L. Three Cox proportional hazard regression models with random herd effect were developed to evaluate the association between cow level mBHB dynamics and days from calving to resumption of cyclicity, first estrus, and first insemination. Results showed that the mean AvgBHB within 20 DIM among all cows was 73 µmol/L. The mean OnsetKeto within 20 DIM, was 8 DIM. Among all cows having hyperketolactia, 55.8% (1,350/2,419) had OnsetKeto in the first week of lactation. In total, 41.5% (1,714/4,133) of the cows did not have OnsetKeto in the first 20 DIM. An early onset of hyperketolactia was associated with delayed fertility events. Cows with higher AvgBHB have a prolonged time interval from calving to resumption of cyclicity and first estrus. Information on mBHB dynamics and the association with early reproductive performance provides insights that might be helpful to improve reproductive performance of individual dairy cows.

Association between days post conception and lactation persistency in dairy cattle.

Determining the optimal insemination moment for individual cows is complex, particularly when considering the impact of pregnancy on milk production. The effect of pregnancy on the absolute milk yield has already been reported in several studies. Currently, there is limited quantitative knowledge about the association between days post conception (DPC) and lactation persistency, based on a lactation curve model, and, specifically, how persistency changes during pregnancy and relates to the days in milk at conception (DIMc). Understanding this association might provide valuable insights to determine the optimal insemination moment. This study, therefore, aimed to investigate the association between DPC and lactation persistency, with an additional focus on the influence of DIMc. Available milk production data from 2005 to 2022 were available for 23,908 cows from 87 herds located throughout the Netherlands and Belgium. Persistency was measured by a lactation curve characteristic decay, representing the time taken to halve milk production after peak yield. Decay was calculated for 8 DPC (0, 30, 60, 90, 120, 150, 180 and 210 d after DIMc) and served as the dependent variable. Independent variables included DPC, DIMc (< = 60, 61-90, 91-120, 121-150, 151-180, 181-210, > 210), parity group, DPC × parity group, DPC × DIMc and variables from 30 d before DIMc as covariates. The results showed an increase in decay, i.e., a decrease in persistency, during pregnancy for both parity groups, albeit in different ways. Specifically, from DPC 150 to DPC 210, multiparous cows showed a higher decline in persistency compared with primiparous cows. Furthermore, a later DIMc (cows conceiving later) was associated with higher persistency. Except for the early DIMc groups (DIMc < 90), DIMc does not impact the change in persistency by gestation. The findings from this study contribute to a better understanding of how DPC and DIMc during lactation influence lactation persistency, enabling more informed decision-making by farmers who wish to take persistency into account in their reproduction management.

A framework for assessing confidence in freedom from infection in animal disease control programmes.

In the Surveillance Tool for Outcome-based Comparison of FREEdom from infection (STOC free) project (https://www.stocfree.eu), a data collection tool was constructed to facilitate standardised collection of input data, and a model was developed to allow a standardised and harmonised comparison of the outputs of different control programmes (CPs) for cattle diseases. The STOC free model can be used to evaluate the probability of freedom from infection for herds in CPs and to determine whether these CPs comply with the European Union's pre-defined output-based standards. Bovine viral diarrhoea virus (BVDV) was chosen as the case disease for this project because of the diversity in CPs in the six participating countries. Detailed BVDV CP and risk factor information was collected using the data collection tool. For inclusion of the data in the STOC free model, key aspects and default values were quantified. A Bayesian hidden Markov model was deemed appropriate, and a model was developed for BVDV CPs. The model was tested and validated using real BVDV CP data from partner countries, and corresponding computer code was made publicly available. The STOC free model focuses on herd-level data, although that animal-level data can be included after aggregation to herd level. The STOC free model is applicable to diseases that are endemic, given that it needs the presence of some infection to estimate parameters and enable convergence. In countries where infection-free status has been achieved, a scenario tree model could be a better suited tool. Further work is recommended to generalise the STOC free model to other diseases.

Dans le cadre du projet européen STOC free (Surveillance Tool for Outcome-based Comparison of FREEdom from infection, outil de surveillance permettant de comparer les probabilités d'absence d'infection sur la base des résultats, https://www.stocfree.eu), un outil de recueil des données a été construit pour faciliter une collecte normalisée des données d'entrée ; un modèle a également été élaboré pour permettre une comparaison normalisée et harmonisée des données sur les résultats des différents programmes de contrôle des maladies des bovins. Le modèle STOC free peut être utilisé pour évaluer la probabilité d'absence d'infection au sein des troupeaux dans le cadre des programmes de contrôle et déterminer si ces programmes sont conformes aux normes définies par l'Union européenne en termes de résultats attendus. L'infection par le virus de la diarrhée virale bovine a été choisie comme maladie d'étude pour ce projet en raison de la diversité des programmes de contrôle dans les six pays participants. Les informations relatives aux programmes de contrôle et aux facteurs de risque d'infection ont été recueillies à l'aide de l'outil de collecte des données. Les aspects clés et valeurs par défaut ont été quantifiés en vue d'être inclus dans le modèle STOC free. Un modèle de Markov caché dont les paramètres sont estimés par inférence bayésienne a été considéré comme le plus adapté et développé pour une application aux données issues des programmes de contrôle de la diarrhée virale bovine. Ce modèle a été testé et validé en utilisant des données réelles des programmes de contrôle du virus de la diarrhée virale bovine des pays participants ; le code informatique correspondant a été rendu public. Le modèle STOC free utilise des données au niveau des troupeaux, même si des données au niveau des animaux individuels peuvent être incluses une fois agrégées au niveau du troupeau. Le modèle STOC free s'applique aux maladies endémiques, puisqu'un certain niveau de présence de l'infection est nécessaire pour estimer les paramètres et permettre la convergence. Dans les pays ayant obtenu le statut indemne d'infection, un modèle du type arbre de scénario pourrait être un outil plus adapté. Des travaux supplémentaires sont recommandés pour généraliser le modèle STOC free à d'autres maladies.

Como parte del proyecto europeo STOC free (Surveillance Tool for Outcome-based Comparison of FREEdom from infection, herramienta de vigilancia para comparaciones por resultados respecto a la ausencia de infecciones, https://www.stocfree.eu), se confeccionó una herramienta de obtención de datos para facilitar la recogida normalizada de datos entrantes y se elaboró un modelo que posibilitara una comparación normalizada y armonizada de los resultados (datos salientes) de distintos programas de control de enfermedades bovinas. El modelo STOC free puede servir para calcular la probabilidad de ausencia de infección en los rebaños como parte de los programas de control y para determinar si estos programas se ajustan a las normas predefinidas de resultados de la Unión Europea. Como ejemplo de estudio para el proyecto se eligió el virus de la diarrea viral bovina (virus DVB) por la diversidad que presentaban los correspondientes programas de control de los seis países participantes. Empleando la herramienta de obtención de datos, se reunió información pormenorizada de los programas de control del virus DVB y los factores de riesgo. Para incluir los datos en el modelo STOC free, se cifraron unos aspectos clave y valores predeterminados Juzgando conveniente el empleo de un modelo oculto de Markov cuyos parámetros se estiman por inferencia bayesiana, se elaboró un modelo de esta índole aplicable a los programas de control del virus DVB. Para ensayar y validar el modelo se utilizaron datos reales de los programas de control del virus DVB de los países participantes, tras lo cual se hizo público el correspondiente código informático. El modelo STOC free trabaja con los datos por rebaño, aunque tras la agregación por rebaños pueden incluirse también datos por individuo. Para que este modelo sea aplicable a una enfermedad es preciso que esta sea endémica, pues el modelo requiere la presencia de cierto nivel de infección para calcular los parámetros y determinar convergencias. En aquellos países donde ya esté reconocida la ausencia de infección, sería más apropiado utilizar como herramienta un modelo de árbol de hipótesis. Los autores recomiendan ahondar en esta línea de trabajo para poder extender a otras enfermedades el uso del modelo STOC free.

M-score and wound healing assessment of 2 nonantibiotic topical gel treatments of active digital dermatitis lesions in dairy cattle.

This open-label, randomized clinical trial with positive control compared the treatment of active digital dermatitis (DD) lesions (stages M1, M2, and M4.1) on dairy cattle hind feet with an enzyme alginogel or a copper and zinc chelate gel (coppergel). Upon recruitment (d 0), active DD lesions were cleaned, photographed, treated, and bandaged. This procedure was repeated on d 3 and d 7, with treatment and bandaging discontinued for those lesions that had transitioned to the M0, M3, or M4 stage on d 7. Day 10 was considered the end of the treatment trial, and all recruited feet were cleaned and photographed. Treatment effect of the 2 products was assessed not only using the M-score but also using general wound healing progress criteria. Improvement of M-score was defined as transition to M0, M3, or M4 stages, or to lesions with a smaller ulcerative area (e.g., M2 stage to M1 stage). Lesions with improved wound healing had at least one of the following criteria when compared with the previous observation: decreased defect size, healthier granulation tissue color (pink-red instead of purple-grayish), more regular aspect of granulation tissue surface, wound contraction, or epithelization starting from the surrounding skin. Both primary outcomes were assessed using a multivariable logistic regression analysis. Lesions treated with the enzyme alginogel had a decreased adjusted odds ratio for M-score improvement (aOR: 0.04; 95% confidence interval: 0.01-0.11). Lesions treated with the coppergel mostly transitioned to chronic lesions, whereas lesions treated with the enzyme alginogel mostly remained active lesions. The wound healing progress of almost 70% of the lesions treated with coppergel could not be scored, for the greater part due to the presence of crust materials. With these unscorable lesions classified as "improved," there was no treatment effect on wound healing progress (aOR: 0.99; 95% confidence interval: 0.34-3.05), whereas with unscorable lesions classified as "not improved," the enzyme alginogel outperformed the coppergel with regard to wound healing progress (aOR: 2.48; 95% confidence interval: 1.07-5.79). None of the products used in our study achieved high cure rates (transition to the M0 stage) for active DD lesions. Low cure rates of topical treatment of DD, together with the important role of chronic lesions in the epidemiology of DD, indicate that future research should investigate how to achieve successful wound management of DD lesions, thereby mitigating pain associated with the lesions and reducing both transmission and prevalence of DD within herds.

Heat stress in a temperate climate leads to adapted sensor-based behavioral patterns of dairy cows.

Most research on heat stress has focused on (sub)tropical climates. The effects of higher ambient temperatures on the daily behavior of dairy cows in a maritime and temperate climate are less studied. With this retrospective observational study, we address that gap by associating the daily time budgets of dairy cows in the Netherlands with daily temperature and temperature-humidity index (THI) variables. During a period of 4 years, cows on 8 commercial dairy farms in the Netherlands were equipped with neck and leg sensors to collect data from 4,345 cow lactations regarding their daily time budget. The time spent eating, ruminating, lying, standing, and walking was recorded. Individual cow data were divided into 3 data sets: (1) lactating cows from 5 farms with a conventional milking system (CMS) and pasture access, (2) lactating cows from 3 farms with an automatic milking system (AMS) without pasture access, and (3) dry cows from all 8 farms. Hourly environment temperature and relative humidity data from the nearest weather station of the Dutch National Weather Service was used for THI calculation for each farm. Based on heat stress thresholds from previous studies, daily mean temperatures were grouped into 7 categories: 0 = (<0°C), 1 = (0-12°C, reference category), 2 = (12-16°C), 3 = (16-20°C), 4 = (20-24°C), 5 = (24-28°C), and 6 = (≥28°C). Temperature-humidity index values were grouped as follows: 0 = (THI <30), 1 = (THI 30-56, reference category), 2 = (THI 56-60), 3 = (THI 60-64), 4 = (THI 64-68), 5 = (THI 68-72) and 6 = (THI ≥72). To associate daily mean temperature and THI with sensor-based behavioral parameters of dry cows and of lactating cows from AMS and CMS farms, we used generalized linear mixed models. In addition, associations between sensor data and other climate variables, such as daily maximum and minimum temperature, and THI were analyzed. On the warmest days, eating time decreased in the CMS group by 92 min/d, in the AMS group by 87 min/d, and in the dry group by 75 min/d compared with the reference category. Lying time decreased in the CMS group by 36 min/d, in the AMS group by 56 min/d, and in the dry group by 33 min/d. Adaptation to daily temperature and THI was already noticeable from a mean temperature of 12°C or a mean THI of 56 or above, when dairy cows started spending less time lying and eating and spent more time standing. Further, rumination time decreased, although only in dry cows and cows on AMS farms. With higher values for daily mean THI and temperature, walking time decreased as well. These patterns were very similar for temperature and THI variables. These results show that dairy cows in temperate climates begin to adapt their behavior at a relatively low mean environmental temperature or THI. In the temperate maritime climate of the Netherlands, our results indicate that daily mean temperature suffices to study the effects of behavioral adaptation to heat stress in dairy cows.

Dry period management and new high somatic cell count during the dry period in Dutch dairy herds under selective dry cow therapy.

The aim of this study was to describe the current management practices that could influence udder health during the dry period and to investigate the associations between management and new high SCC during the dry period. In 2008 the Netherlands started to improve transparency and decrease the use of antimicrobials in animal husbandry. Prevention of new high SCC during the dry period via antimicrobial dry cow treatment (DCT) was no longer allowed in animals with a low SCC before the dry period. An increase of new high SCC during the dry period was expected in dairy cows without antimicrobial protection, but was not observed. In 2018 an online questionnaire was conducted among 1,942 Dutch dairy farms using 12 different veterinary clinics. The questionnaire asked about the management of dry cows at the start of and during the dry period, and around calving, considerations in the use of DCT, and knowledge of the 2012 guidelines for selective DCT. A total of 690 farmers (36%) responded to the questionnaire. Data on new high SCC during the dry period, use of antimicrobials for intramammary DCT and mastitis treatment, herd size, and milking system were available from other sources. Descriptive statistics were used to evaluate the associations between the different variables. For analysis of new high SCC on herd level, explanatory variables were analyzed using a generalized linear mixed model. Respondents indicated that the most important management factor to reduce the risk of new high SCC was reduction of milk yield before dry-off. The variables associated with a lower proportion of new high SCC on herd level during the dry period were the use of dip or spray after drying off, a higher animal-defined daily dose of intramammary antimicrobials for DCT, the use of DCT in low-SCC cows based on SCC or mastitis history, correct knowledge of the guideline, and awareness of importance of low infection rate and good hygiene during dry-off. The variables associated with a higher proportion of new high SCC on herd level were dry cow housing other than cubicles and a higher animal-defined daily dose for intramammary antimicrobials for mastitis. This research clearly indicates that farmers can balance limited use of antimicrobials at dry-off with management measures to maintain good udder health during the dry period.

An observational study on the management of digital dermatitis through a repeated risk assessment on 19 Dutch dairy herds.

The etiopathogenesis of bovine digital dermatitis (DD) is not well understood, but its risk factors on dairy farms have been studied extensively. The objective of this study was to identify associations between a DD risk score [determined by a DD risk assessment questionnaire (RAQ)] and DD prevalence (determined by an in-parlor M-score). We also investigated whether feedback for farmers on their DD management using the DD RAQ resulted in changes that decreased DD prevalence in their herds. The DD RAQ consisted of multiple-choice questions related to foot health, housing, and general management that were used to create a total risk score (TRS). In 2016 and 2018, the DD RAQ-together with a DD prevalence determination in the lactating herd-was used on 19 Dutch dairy farms from 1 veterinary practice. After each visit, farmers and their consulting veterinarians received a 1-page summary that identified herd-specific strengths and weaknesses in DD management. In 2018, the summary included suggestions for improvement. In 2019, farmers and veterinarians were contacted to ask whether the use of the DD RAQ and the 1-page summary had led them to implement changes in their DD management in 2016 and 2018. We tested the association between TRS and DD prevalence using linear mixed model analysis. The TRS ranged from 13 to 65% and 20 to 68% in 2016 and 2018, respectively. Herd DD prevalence ranged from 15 to 59% and 27 to 69% in 2016 and 2018, respectively. For both years, the DD RAQ identified that DIM, herd size, and breed were often present in a manner associated with increased risk for DD. The linear mixed model analysis identified that each 10-point increase in TRS was associated with an increase in herd DD prevalence of less than 1%. The association between TRS and herd DD prevalence was caused mainly by risk factors related to housing. We found no important relationship between change in TRS and change in DD prevalence between the 2 visits. Only a few farmers indicated some form of change in their DD management following a visit. Veterinarians in general said that they discussed the 1-page summaries and DD control with farmers during a routine visit, but the majority admitted a lack of follow-up. We propose that the DD RAQ could be used as a tool to start a discussion on DD control on farm, but simply undertaking a DD RAQ and providing a 1-page summary of the results was insufficient to initiate behavioral change that led to a decrease in DD prevalence.

Associations between body condition score, locomotion score, and sensor-based time budgets of dairy cattle during the dry period and early lactation.

Lameness, one of the most important disorders in the dairy industry, is related to postpartum diseases and has an effect on dairy cow welfare, leading to changes in cows' daily behavioral variables. This study quantified the effect of lameness on the daily time budget of dairy cows in the transition period. In total, 784 multiparous dairy cows from 8 commercial Dutch dairy farms were visually scored on their locomotion (score of 1-5) and body condition (score of 1-5). Each cow was scored in the early and late dry period as well as in wk 4 and 8 postpartum. Cows with locomotion scores 1 and 2 were grouped together as nonlame, cows with score 3 were considered moderately lame, and cows with scores 4 and 5 were grouped together as severely lame. Cows were equipped with 2 types of sensors that measured behavioral parameters. The leg sensor provided number of steps, number of stand-ups (moving from lying to standing), lying time, number of lying bouts, and lying bout length. The neck sensor provided eating time, number of eating bouts, eating bout length, rumination time, number of rumination bouts, and rumination bout length. Sensor data for each behavioral parameter were averaged between 2 d before and 2 d after locomotion scoring. The percentage of nonlame cows decreased from 63% in the early dry period to 46% at 8 wk in lactation; this decrease was more severe for cows with higher parity. Cows that calved in autumn had the highest odds for lameness. Body condition score loss of >0.75 point in early lactation was associated with lameness in wk 4 postpartum. Moderately lame cows had a reduction of daily eating time of around 20 min, whereas severely lame cows had a reduction of almost 40 min. Similarly, moderately and severely lame dry cows showed a reduction of 200 steps/d, and severely lame cows in lactation showed a reduction of 600 steps/d. Daily lying time increased by 26 min and lying bout length increased by 8 min in severely lame cows compared with nonlame cows. These results indicate a high prevalence of lameness on Dutch dairy farms, with an increase in higher locomotion scores from the dry period into early lactation. Time budgets for multiparous dairy cows differed between the dry period and the lactating period, with a higher locomotion score (increased lameness) having an effect on cows' complete behavioral profile. Body condition score loss in early lactation was associated with poor locomotion postpartum, whereas lameness resulted in less eating time in the dry period and early lactation, creating a harmful cycle.

Mismatch between self-perceived and calculated cardiometabolic disease risk among participants in a prevention program for cardiometabolic disease: a cross-sectional study.

BACKGROUND: The rising prevalence of cardiometabolic diseases (CMD) calls for effective prevention programs. Self-assessment of CMD risk, for example through an online risk score (ORS), might induce risk reducing behavior. However, the concept of disease risk is often difficult for people to understand. Therefore, the study objective was to assess the impact of communicating an individualized CMD risk score through an ORS on perceived risk and to identify risk factors and demographic characteristics associated with risk perception among high-risk participants of a prevention program for CMD. METHODS: A cross-sectional analysis of baseline data from a randomized controlled trial conducted in a primary care setting. Seven thousand five hundred forty-seven individuals aged 45-70 years without recorded CMD, hypertension or hypercholesterolemia participated. The main outcome measures were: 1) differences in cognitive and affective risk perception between the intervention group - who used an ORS and received an individualized CMD risk score- and the control group who answered questions about CMD risk, but did not receive an individualized CMD risk score; 2) risk factors and demographic characteristics associated with risk perception. RESULTS: No differences were found in cognitive and affective risk perception between the intervention and control group and risk perception was on average low, even among high-risk participants. A positive family history for diabetes type 2 (ß0.56, CI95% 0.39-0.73) and cardiovascular disease (ß0.28, CI95% 0.13-0.43), BMI ≥25 (ß0.27, CI95% 0.12-0.43), high waist circumference (ß0.25, CI95% 0.02-0.48) and physical inactivity (ß0.30, CI95% 0.16-0.45) were positively associated with cognitive CMD risk perception in high-risk participants. No other risk factors or demographic characteristics were associated with risk perception. CONCLUSIONS: Communicating an individualized CMD risk score did not affect risk perception. A mismatch was found between calculated risk and self-perceived risk in high-risk participants. Family history and BMI seem to affect the level of CMD risk perception more than risk factors such as sex, age and smoking. A dialogue about personal CMD risk between patients and health care professionals might optimize the effect of the provided risk information. TRIAL REGISTRATION: Dutch trial Register number NTR4277, registered 26th Nov 2013.

Quantification of risk factors for bovine viral diarrhea virus in cattle herds: A systematic search and meta-analysis of observational studies.

Bovine viral diarrhea virus (BVDV) is endemic in many parts of the world, and multiple countries have implemented surveillance activities for disease control or eradication. In such control programs, the disease-free status can be compromised by factors that pose risks for introduction or persistence of the virus. The aim of the present study was to gain a comprehensive overview of possible risk factors for BVDV infection in cattle herds in Europe and to assess their importance. Papers that considered risk factors for BVDV infection in cattle were identified through a systematic search. Further selection of papers eligible for quantitative analysis was performed using a predefined checklist, including (1) appropriate region (i.e., studies performed in Europe), (2) representativeness of the study population, (3) quality of statistical analysis, and (4) availability of sufficient quantitative data. In total, 18 observational studies were selected. Data were analyzed by a random-effects meta-analysis to obtain pooled estimates of the odds of BVDV infection. Meta-analyses were performed on 6 risk factors: herd type, herd size, participation in shows or markets, introduction of cattle, grazing, and contact with other cattle herds on pasture. Significant higher odds were found for dairy herds (odds ratio, OR = 1.63, 95% confidence interval, CI: 1.06-2.50) compared with beef herds, for larger herds (OR = 1.04 for every 10 extra animals in the herd, 95% CI: 1.02-1.06), for herds that participate in shows or markets (OR = 1.45, 95% CI: 1.10-1.91), for herds that introduced cattle into the herd (OR = 1.41, 95% CI: 1.18-1.69), and for herds that share pasture or have direct contact with cattle of other herds at pasture (OR = 1.32, 95% CI: 1.07-1.63). These pooled values must be interpreted with care, as there was a high level of heterogeneity between studies. However, they do give an indication of the importance of the most frequently studied risk factors and can therefore assist in the development, evaluation, and optimization of BVDV control programs.

A description and qualitative comparison of the elements of heterogeneous bovine viral diarrhea control programs that influence confidence of freedom.

For endemic infections in cattle that are not regulated at the European Union level, such as bovine viral diarrhea virus (BVDV), European Member States have implemented control or eradication programs (CEP) tailored to their specific situations. Different methods are used to assign infection-free status in CEP; therefore, the confidence of freedom associated with the "free" status generated by different CEP are difficult to compare, creating problems for the safe trade of cattle between territories. Safe trade would be facilitated with an output-based framework that enables a transparent and standardized comparison of confidence of freedom for CEP across herds, regions, or countries. The current paper represents the first step toward development of such a framework by seeking to describe and qualitatively compare elements of CEP that contribute to confidence of freedom. For this work, BVDV was used as a case study. We qualitatively compared heterogeneous BVDV CEP in 6 European countries: Germany, France, Ireland, the Netherlands, Sweden, and Scotland. Information about BVDV CEP that were in place in 2017 and factors influencing the risk of introduction and transmission of BVDV (the context) were collected using an existing tool, with modifications to collect information about aspects of control and context. For the 6 participating countries, we ranked all individual elements of the CEP and their contexts that could influence the probability that cattle from a herd categorized as BVDV-free are truly free from infection. Many differences in the context and design of BVDV CEP were found. As examples, CEP were either mandatory or voluntary, resulting in variation in risks from neighboring herds, and risk factors such as cattle density and the number of imported cattle varied greatly between territories. Differences were also found in both testing protocols and definitions of freedom from disease. The observed heterogeneity in both the context and CEP design will create difficulties when comparing different CEP in terms of confidence of freedom from infection. These results highlight the need for a standardized practical methodology to objectively and quantitatively determine confidence of freedom resulting from different CEP around the world.

Prescription patterns of lipid lowering agents among older patients in general practice: an analysis from a national database in the Netherlands.

BACKGROUND: Dutch cardiovascular risk management guidelines state almost every older adult (≥70 years) is eligible for a lipid lowering drug (LLD). However, life expectancy, frailty or comorbidities may influence this treatment decision. OBJECTIVE: investigate how many older adults, according to age, frailty (Drubbel-frailty index) and comorbidities were prescribed LLDs. METHODS: data of 244,328 adults ≥70 years from electronic health records of 415 Dutch general practices from 2011-15 were used. Number of LLD prescriptions in patients with (n = 55,309) and without (n = 189,019) cardiovascular disease (CVD) was evaluated according to age, frailty and comorbidities. RESULTS: about 69% of adults ≥70 years with CVD and 36% without CVD were prescribed a LLD. LLD prescriptions decreased with age; with CVD: 78% aged 70-74 years and 29% aged ≥90 years were prescribed a LLD, without CVD: 37% aged 70-74 years and 12% aged ≥90 years. In patients with CVD and within each age group, percentage of LLD prescriptions was 20% point(pp) higher in frail compared with non-frail. In patients without CVD, percentage of LLD prescriptions in frail patients was 11pp higher in adults aged 70-74 years and 40pp higher in adults aged ≥90 years compared to non-frail. Similar trends were seen in the analyses with number of comorbidities. CONCLUSION: in an older population, LLD prescriptions decreased with age but-contrary to our expectations-LLD prescriptions increased with higher frailty levels.

Interobserver agreement of digital dermatitis M-scores for photographs of the hind feet of standing dairy cattle.

Digital dermatitis (DD) is the leading infectious cause of lameness in dairy cattle, and it affects their welfare and productivity worldwide. At the herd level, DD is often assessed while cows are standing in a milking parlor, and lesions are most commonly evaluated using the M-score. The objective of this study was to examine the interobserver agreement for M-scores of the feet of standing cattle, based on digital color photographs of dairy cattle hind feet. A total of 88 photographs and written descriptors of the M-score were sent to 11 scorers working at 10 different institutions in 5 countries. The scorers received no formal training immediately before scoring the photographs; however, all regularly used the M-score to score DD. The answers for 36 photographs were excluded from the analysis because the photograph either had more than 1 M-stage as mode or not all scorers assigned an M-score to it. The M-scores of the 11 scorers from 52 photographs were available for analysis. Interobserver agreement was tested using Gwet's agreement coefficient (AC1) and the mode was assumed correct. Overall, moderate agreement emerged for the M-score (AC1 = 0.48). For the individual M-stages, almost perfect agreement existed for M0 (AC1 = 0.99), M1 (AC1 = 0.92), and M3 (AC1 = 0.82), and substantial agreement for M2 (AC1 = 0.61), M4 (AC1 = 0.65), and M4.1 (AC1 = 0.71). This outcome indicates the degree of individual variation in M-scoring in this context by unstandardized, experienced European observers, particularly for the M2, M4, and M4.1 stages. Standardized training is likely to improve the consistency of M-scoring and thus the generalizability of future DD research results on this important endemic disease.

Prevalence of bovine tuberculosis in cattle, goats, and camels of traditional livestock raising communities in Eritrea.

BACKGROUND: The aim of the current study was to assess the prevalence of bovine tuberculosis (BTB) in cattle, goats, and camels, and its zoonotic potential within the traditional livestock raising communities in four regions of Eritrea. The Single Intradermal Comparative Tuberculin Test (SICTT) as indicator of M. bovis infection was conducted on 1077 cattle, 876 goats, and 195 camels. To elucidate possible risk factors for BTB transmission between animals and its potential zoonotic implication, questionnaire based face-to-face interviews were conducted in households of which 232 raised cattle, 128 goats, and 29 camels. RESULTS: The results of the SCITT were interpreted using the OIE standard (> 4 mm cut-off) for positive responses. In cattle, individual animal (n = 1077) and herd (n = 413) prevalences were 1.2% (n = 13) [Confidence Interval (CI) 95% CI, 1.0-1.3%] and 3.2% (n = 13) (95% CI, 3.0-3.4%), respectively. In goats (n = 876), none of the animals was positive. In camels, individual animal (n = 195) and herd (n = 70), BTB prevalences were 1.5% (n = 3) (95% CI,1.4-1.6%) and 2.9(n = 2) (95% CI, 0.9-4.6%), respectively. Overall, male animals were more at risk (OR = 2.6; 95% CI:1.0-8.7) when compared to females. Sharing of water points, introduction of new animals into herds and migration of animals over large distances were common events that may contribute to intra and inter-species transmission of BTB. Consumption of raw milk, lack of BTB transmission awareness, and low levels of education were common in the farming communities. CONCLUSION: The current study highlighted a low prevalence of M. bovis in cattle, goats and camels in extensive traditional livestock in Eritrea. Despite this, the spatial distribution of affected animals across most of the sampled regions and consumption of unpasteurized milk warrants surveillance, cautious and timely control measures for the disease.

PETscan: measuring incidence of disease phenotypes to prioritize genetic studies in companion animals.

Reliable incidence measurement of diseases is necessary for identification of hereditary diseases in companion animal populations. The data collection system 'PETscan' was developed to facilitate standardized registration of diagnoses in veterinary practice. In the development, we attempted to counter challenges known from other primary practice data systems. PETscan includes a comprehensive list of potential diagnoses and supports the veterinary professionals in the diagnostic process. Demographics, individual data and standardized diagnostic data are collected through practice management software in a central database for epidemiological analysis. A preliminary data analysis from PETscan showed specific health issues in four canine breeds. As a real-time prospective monitoring tool, PETscan summaries can objectively assess the incidence of disorders in companion animal populations and can be used to prioritize disease-gene identification studies and evaluate the effects of breeding strategies, for example, after implementation of a new DNA test in the breeding strategy.

Randomized prospective trials to study effects of reduced antibiotic usage in abdominal surgery in cows.

Societal concerns about antibiotic resistance prompted us to evaluate the use of prophylactic and postoperative antibiotic treatments following cesarean section (CS) and exploratory laparotomy (EL) in a surgery theater within the Farm Animal Health clinic. All procedures were performed by supervised veterinary students for training purposes. Cows undergoing CS (n = 100) received either a prophylaxis with a single 5-g injection of ampicillin-sodium i.v. only (CSL), or in combination with postoperative i.m. injections of ampicillin-trihydrate 20% for 3 d (10 mg/kg, twice a day; CSH). Cows undergoing EL (n = 110) received either no antibiotic prophylaxis (ELN) or were given a single 5-g injection of ampicillin-sodium i.v. (ELL). The primary outcome measure was healthy recovery after surgery, which we assessed according to the need to treat surgery-related complications within a 10-d follow-up period based on daily clinical observations. Cows in all groups had a normal temperature and feed intake, and a satisfying clinical appearance at the end of the follow-up period. The clinical need to treat cows with antibiotics to deal with postoperative complications was higher for the CS groups than the EL groups. Within both CS and EL groups, the number of complications for each protocol was the same. However, in terms of the secondary outcomes, we observed that CSL cows required, for example, more treatments for mastitis and other diseases unrelated to the surgery than CSH cows (odds ratio 2.8; confidence interval 1.2-7.2). The percentage of infected sutures was higher for ELN cows compared with ELL cows (odds ratio 2.6; confidence interval 1.5-4.9). We estimated that 29 CSH treatments were needed to prevent 1 CS cow with serious surgery-related complications in the CSL group. Likewise, 53 ELL treatments would prevent 1 EL cow with surgery-related complications in the ELN group. We therefore concluded that it is possible to reduce antibiotic prophylaxis in CS and EL cows. The low number cows of clinically detected complications were effectively treated with a postoperative antibiotic intervention at the moment of detection.

A randomized clinical trial of topical treatments for mild and severe udder cleft dermatitis in Dutch dairy cows.

Udder cleft dermatitis (UCD) is a skin lesion in dairy cows affecting the anterior parts of the udder, with the lesions often needing a long time to heal. The lesions can be characterized as mild or severe. The etiology of UCD is not fully understood and studies on the effectiveness of topical treatments have not been published. The objective of this study, therefore, was to conduct a randomized clinical trial to investigate the effectiveness of 2 different topical treatments, one for mild and one for severe UCD lesions, compared with untreated control groups. The treatment and control groups were randomized within herd for mild and severe UCD. The treatments were applied for a maximum period of 12 wk on 8 Dutch dairy farms. Mild UCD lesions were treated once a d 3 times a week on fixed days with a non-sting barrier film. Severe UCD lesions were first stratified into class A (lesion length <5 cm) or class B (lesion length ≥5 cm) and then randomly allocated to treatment or control groups within herd. Both severe lesion classes were treated once per day every day with an enzyme alginogel. Every week, the lesions of affected animals were inspected and photographed by the investigator. These photographs were reviewed weekly by an external wound expert who classified the lesions as mild, severe class A, severe class B, or healed. Based on this classification, the investigator judged weekly whether the lesions had improved compared with their classification of the previous week. For mild UCD lesions, improvement was defined as occurring when lesions were healed. For severe UCD lesions, improvement was defined as a transition from class B to class A, transition from any severe UCD lesion (class A or B) to a mild UCD lesion, or when the lesion was defined as healed. Data were analyzed using a discrete time survival analysis with time to first improvement as dependent variable. In total, data from 214 animals were analyzed to estimate the effectiveness of treatment. Results showed that treatment of mild UCD lesions had no influence on improvement compared with untreated lesions. Treated severe lesions, however, showed 3.4 times more improvement compared with the untreated controls. Improvement varied between herds, and cows with a parity of 5 or higher showed significantly less improvement than first parity animals. Early identification of severe UCD lesions followed by prompt treatment with an enzyme alginogel supports the healing process.

Effects of reduced intramammary antimicrobial use during the dry period on udder health in Dutch dairy herds.

Dry cow therapy (DCT) in the Netherlands changed from mainly blanket to selective antimicrobial DCT. This transition was supported by a national guideline, with the individual somatic cell count (SCC) at the last milk recording before dry-off as the main selection criterion for antimicrobial DCT. The aim of this retrospective observational study is to evaluate the SCC dynamics during the dry period at the herd and individual dry period level following the national transition from mainly blanket to selective antimicrobial DCT. At the herd level, we used 2 data sets to evaluate the SCC dynamics during the dry period: (1) a national data set containing 3,493 herds with data available from 2011 through 2015 and (2) a veterinary practice data set containing 280 herds with data available from 2013 through 2015. The herd level analysis was carried out using key performance indicators provided via milk recording (CRV, Arnhem, the Netherlands): the percentage of cows that developed a new intramammary infection (IMI) during the dry period and the percentage of cows cured of an IMI during the dry period. The effect of DCT at individual dry period level was analyzed with a mixed-effects logistic regression model based on 4,404 dry periods from 2,638 cows in 20 herds within the veterinary practice data set. For these 20 herds, individual SCC data from milk recordings and individual cow DCT were available from 2013 through 2015. No significant changes were observed to the SCC dynamics during the dry period at the herd level. The percentage of cows that developed a new IMI during the dry period ranged between 16 and 18%, and the percentage of cows cured from an IMI during the dry period ranged between 74 and 76%. At the individual dry period level, a low SCC at the first milk recording following a dry period was associated with the use of intramammary antimicrobial DCT with or without the concurrent use of an intramammary teat sealer [odds ratio (OR) = 2.16 and OR = 2.07, respectively], the use of DCT with an intramammary teat sealer only (OR = 1.35), and a low SCC at the last milk recording before dry-off (OR = 1.78). This study demonstrates that the selection of cows for DCT without antimicrobials based on SCC thresholds at the last milk recording is possible without significant changes to udder health and reduced the use of antimicrobials.

Tailoring treatments using treatment effect modification.

BACKGROUND AND OBJECTIVE: Applying results from clinical studies to individual patients can be a difficult process. Using the concept of treatment effect modification (also referred to as interaction), defined as a difference in treatment response between patient groups, we discuss whether and how treatment effects can be tailored to better meet patients' needs. RESULTS: First we argue that contrary to how most studies are designed, treatment effect modification should be expected. Second, given this expected heterogeneity, a small number of clinically relevant subgroups should be a priori selected, depending on the expected magnitude of effect modification, and prevalence of the patient type. Third, by defining generalizability as the absence of treatment effect modification we show that generalizability can be evaluated within the usual statistical framework of equivalence testing. Fourth, when equivalence cannot be confirmed, we address the need for further analyses and studies tailoring treatment towards groups of patients with similar response to treatment. Fifth, we argue that to properly frame, the entire body of evidence on effect modification should be quantified in a prior probability.

Prevalence and risk factors of bovine tuberculosis in dairy cattle in Eritrea.

BACKGROUND: The prevalence of bovine tuberculosis (BTB) in dairy cattle in the three major milk producing regions of Eritrea was assessed by subjecting 15,354 dairy cattle, 50 % of Eritrea's dairy cattle population, to the single intradermal comparative tuberculin test (SICTT). Skin test results were interpreted according to guidelines of the World Organization for Animal Health (OIE) with >4 mm as cutoff in skin thickness increase. In addition, we studied the relation between 'physiological' variables related to pregnancy and lactation, and the variable 'region' on the probability to be skin test positive. RESULTS: The BTB prevalences at animal and herd levels were: 21.5% and 40.9% in Maekel, 7.3% and 10% in Debub, and 0.2% and 1.6% in the Anseba region, respectively. Overall, in the regions included, prevalence was 11.3% (confidence interval (CI) 95% CI, 11.29 - 11.31%) and 17.3% (95% CI, 17.27-17.33%), at animal and herd level, respectively. Considering positive herds only, the animal BTB prevalence was 36.8%, 30.1%, and 1.8%, in Maekel, Debub and Anseba, respectively, and the overall animal prevalence within these herds was 32%. In adult dairy cattle the probability of positive reactivity in the SICTT test was highest in pregnant animals as compared to the other categories. CONCLUSION: This study reports persistent prevalence of BTB as defined by positive SICTT in the dairy sector of Eritrea, especially in the regions of Maekel and Debub that are located in the central highlands of the country. To our understanding this is the first report that has encompassed all the major dairy farms in Eritrea and it will be instrumental in advocating future BTB control programs in the dairy sector.