Low concentrate input systems can potentially solve some of the environmental and societal challenges of the current high concentrate input dairy production. This study compared a typical high concentrate proportion (47% on dry matter basis) used in intensive Northern European dairy cow feeding with a low concentrate proportion (22%) on a grass silage-based diet. The study lasted over the whole lactation period and used Holstein (n = 32) and Nordic Red (n = 14) dairy cows. A high concentrate proportion significantly increased feed and nutrient intake, while the breed of the cows did not affect nutrient intake and no concentrate proportion x breed interactions were detected. Increased feed intake was reflected in significant increases in daily milk, energy corrected milk, fat, protein, and lactose production. A high concentrate proportion did not alleviate the negative energy balance in the beginning of lactation. No negative effects on cow health were observed related to the low concentrate proportion and both breeds seemed to adapt equally well to the low concentrate proportion. Based on current feed prices in Finland, a high concentrate proportion was economically more viable.

This study investigated the effects of 25-hydroxycholecalciferol (HyD) supplementation on (1) plasma acute phase reactants, cytokines, and Ig concentrations in colostrum in multiparous Holstein cows from 3 wk prepartum to 21 DIM and (2) plasma concentrations of fat-soluble vitamins, Ig concentrations, minerals, and metabolites of newborn calves. Forty-two cows were assigned to receive either cholecalciferol (D3) or HyD. From 21 d before the expected calving until parturition, the D3 group received 0.475 mg/d (0.035 mg/kg DM) of D3, and the HyD group received 1.45 mg/d (0.108 mg/kg DM) of HyD. From parturition until 21 DIM, the D3 group received 0.625 mg/d (0.024 mg/kg DM) of D3, and the HyD group received 0.625 mg/d (0.024 mg/kg DM) of D3 plus 1.0 mg/d of HyD (0.056 mg/kg DM, equal to 0.080 mg/kg of DM in total). Tail blood samples were collected from cows on d -7 (6 ± 2 d), -3 (2 ± 1 d), 0 (13 ± 8 h postcalving), 1 (36 ± 11 h postcalving), 10 (9 ± 2 d), and 20 (16 ± 2 d) relative to calving for plasma analysis of fat-soluble vitamins (A and E), acute phase proteins (haptoglobin [Hap] and serum amyloid A [SAA]), and cytokines (tumor necrosis-α [TNF-α], IFN-γ, and IL-10). Additionally, a blood sample was taken from a jugular vein of the calves 48 ± 3 (mean ± SD) h after birth. For plasma TNF-α concentration in cows, there was an interaction between treatment and time with lower prepartum concentrations in HyD compared with D3; however, the difference was reduced at calving and reached the same level as D3 group at 20 DIM. No treatment effect was observed for plasma Hap, SAA, IFN-γ, or IL-10. Plasma 25-OH-vitamin D3 (25-OH-D3) concentration of newborn calves in HyD group was higher than in calves from D3 group (13.9 and 8.9 pg/mL, respectively), whereas plasma 25-OH-D2, vitamin A, and vitamin E concentrations were unaffected by the treatment. There was a linear relationship between plasma 25-OH-D3 in calves and in their dams. Colostrum IgA, IgM, and IgG concentrations were not affected by treatment. In line with the colostrum results, plasma IgA, IgM, and IgG of calves were not different between D3 and HyD groups. There was no significant difference in plasma Ca and inorganic P concentrations between D3 and HyD groups in newborn calves. In conclusion, HyD supplementation had limited impact on acute phase reactants and cytokines in transition dairy cows. Dietary supplementation of HyD during the close-up period increased plasma 25-OH-D3 concentrations in the newborn calves without affecting plasma Ca and inorganic P. Additionally, the increased plasma 25-OH-D3 concentrations did not affect Ig concentrations in either colostrum or calf plasma.

General practice provides long-term care for most people living with long-term conditions, but the impact of generic chronic care provision on patient outcomes has not been examined on a national level. We aimed to investigate whether the provision of chronic care services in general practice is associated with potentially inappropriate medications (PIMs) and potentially preventable hospitalisations in listed patients. Nationwide cohort study using linked health registry data covering 4.42 million patients (18 + years) listed with general practices in Denmark in 2019 (n = 1769). The exposure was the patient’s practice listing. Practices were grouped evenly into low, medium, or high level of service provision (chronic care consultations, chronic care procedures, and daytime consultations) after adjustment for patient case-mix and multimorbidity. Sub-group analyses were based on list size, morbidity load, deprivation score, and urbanisation. The outcomes at patient level were number of patient days with PIMs (modified STOPP-START criteria) and number of potentially preventable hospitalisations. In practices providing high levels of chronic care consultations, the listed patients had a 1.2

Background Continuity of care in general practice has been associated with improved patient outcomes, but the influence of being listed with the same clinic over time has not been thoroughly studied on a national level. We aimed to evaluate whether clinic continuity in general practice was associated with patient outcomes in Denmark. Methods We conducted a population-based cohort study using data from multiple Danish national registers from Jan 1, 2006, to Dec 31, 2021, including all citizens aged 18 years or older who were listed with a general practice clinic on Jan 1, 2022. During 12-month follow-up from Jan 1, 2022, until Dec 31, 2022 (ie, end of study), emigration, or death, whichever came first, we examined the association of duration of current clinic listing and number of previous clinic changes with risk of all-cause mortality via a Cox regression model, with low cross-sectoral continuity of care via a logistic regression model, and with unplanned hospital contacts and out-of-hours contacts via negative binomial regression models. These models were adjusted for demographic characteristics, socioeconomic factors, and comorbidities. Findings The study population comprised 4 530 293 adults (2 305 856 [50·9%] female, 2 224 437 [49·1%] male; 546 753 [12·1%] immigrants or descendants of immigrants). In fully adjusted models, shorter clinic listing duration was associated with worse patient outcomes. Compared with a patient listed with the same general practice clinic for 10 years or longer, a patient listed for 0–1 years had a higher risk of all-cause mortality (hazard ratio 1·21, 95% CI 1·17–1·25), lower degree of cross-sectoral continuity of care (odds ratio 1·20, 95% CI 1·13–1·27), more unplanned hospital contacts (incidence rate ratio 1·25, 95% CI 1·21–1·30), and more out-of-hours contacts (1·21, 1·17–1·26). More previous clinic changes were also associated with increased risk of these four outcomes. Some associations between frequent clinic changes and health outcomes were mitigated by long-term listing with the current clinic. Interpretation Our study suggests that longitudinal continuity at the clinic level in general practice can potentially reduce adverse patient outcomes and improve continuity across health-care sectors. Our findings support initiatives to sustain continuity in general practice and raise the question of whether clinic switching should prompt increased clinical attention. Funding The General Practice Research Foundation of the Central Denmark Region and the Danish Foundation for General Practice.

Background: Research focusing on health care in end-of-life among cancer patients with mental disorders is limited and presents inconsistent findings. Aim: To investigate disparities in health care in end-of-life among patients who died from lung cancer according to pre-existing mental disorders. Design: A Danish nationwide cohort study linking nationwide registries on health care in end-of-life including specialist palliative care (including hospice admissions), ‘drug reimbursement for terminal illness’, high-intensity-treatment during the last 30 days before death and death at hospital, analysed using Poisson regression, adjusted for sociodemographic and clinical factors. Setting/participants: All adult decedents who died of lung cancer in Denmark from 2011 through 2020, including individuals with mental diagnoses prior to their cancer diagnosis. Results: Among 36,323 patients dying from lung cancer, 12% had pre-existing mental disorders. Patients with mental disorders were less likely to receive specialist palliative care (adjusted risk ratio (RR) 0.90; 95% CI: 0.87; 0.94), hospice admissions (RR: 0.86; 95% CI: 0.80; 0.94), chemotherapy (RR: 0.66; 95% CI: 0.57; 0.76), radiotherapy (RR: 0.82; 95% CI: 0.74; 0.92), surgery (RR: 0.47; 95% CI: 0.22; 1.00), hospital admissions (RR: 0.96; 95% CI: 0.92; 0.99) and to die in a hospital (RR: 0.88; 95% CI: 0.85; 0.91), compared to patients without mental disorders. No disparities were observed in receiving drug reimbursement, admissions to intensive care units or emergency care. Conclusion: Pre-existing mental disorders were associated with a lower probability of specialist palliative care, but also some high-intensity-treatments in end-of-life. These patients may be deprived of optimal palliative care but also appeared less subjected to possible overtreatment in end-of-life compared to patients without mental disorders.

Calves are born agammaglobulinemic and depend on transfer of passive immunity from colostrum. Failure of transfer of passive immunity (FTPI) and adequate transfer of passive immunity (ATPI) are defined as serum immunoglobulin G (IgG) levels < 10 and ≥ 10 mg/mL, respectively. The objective of this study was to evaluate the level of passively transferred immunity in Danish dairy calves measured with Enzyme-linked immunosorbent assay (ELISA) and Brix refractometer. Blood samples from 834 calves (430 bull calves and 404 heifer calves) aged two to nine days were included in the study. Serum IgG concentration was determined by ELISA and percentage Brix (%Brix) with a digital refractometer. Median serum IgG concentration was 17.05 mg/mL and mean %Brix was 8.5%. A total of 592 (71.0%) and 242 samples (29.0%) had a serum IgG concentration ≥ 10 mg/mL and < 10 mg/mL, respectively. For %Brix 541 (64.9%) and 293 (35.1%) was ≥ 8.1 and < 8.1%, respectively. Serum IgG concentrations and %Brix measurements were highly correlated (r = 0.88). The level of passive immunity in Danish dairy calves seems low and does not meet new recommendations. However, applying cut-offs based on radial immunodiffusion to serum IgG concentrations derived from ELISA are not straightforward and determination of new cut-off values for FTPI based on ELISA are recommended.

AIMS:Low and high body weight present significant global health challenges and may be linked to specific mental disorders. Thus, we aimed to examine the associations between body mass index (BMI) and specific mental disorders. MATERIALS AND METHODS:In this Danish, population-based cohort study using questionnaire and registry data, we included participants (N = 290 468, 18-79 years of age, 49.8% male) in the Danish National Health Survey (2010/2013). BMI was modelled as a cubic spline and a categorical variable (underweight <18.5 kg/m2, normal weight 18.5 to <25 kg/m2 [reference], overweight 25 to <30 kg/m2, and obesity ≥30 kg/m2). Participants were followed up until December 2018 and the median follow-up time was 5 years. Incidence rates per 1000 person-years and adjusted hazard ratios (aHRs) were estimated for specific mental disorders using cause-specific Cox proportional hazard regression. RESULTS:We found U-shaped associations of BMI with schizophrenia, mood disorders, anxiety, stress-related, and somatoform mental disorders, eating disorders, and personality disorders. For people with low but not high BMI (≥25 kg/m2), we observed associations with organic and substance use disorders. All associations were more prominent among women than men, and most associations attenuated with advancing age. CONCLUSIONS:Both underweight and obesity were associated with elevated risk of mental disorders, although the patterns of specific mental disorders differed. Our findings underscore the importance of monitoring mental health in people with underweight and obesity.

The objective was to determine the effects of three different milk feeding strategies with varying levels of iron (Fe) and copper (Cu) on calves' hematocrit (Hct), hemoglobin (Hb), Cu status and plasma enzyme markers. The treatments were whole milk (CONTROL, <4 mg Fe per day, <1 mg Cu per day in milk), whole milk supplemented with iron (IRON, 110 mg Fe per day,<1 mg Cu per day) and milk replacer (MR, 152 mg Fe per day, 14.3 mg Cu per day). At birth Hct was 30.4 +/- 0.7% in average. CONTROL had decreasing Hct levels with nadir in week 5 of 22.5 +/- 0.8%. IRON and MR had increasing Hct levels, with zenith at 38.4 +/- 1.3% in week 5 and 34.7 +/- 0.8% in week 2, respectively. Hepatic Cu concentrations were greater (636 +/- 46 mg/kg DM) in MR compared with IRON and CONTROL (172 and 163 +/- 46 mg kg DM, respectively).

Milk production and overall dairy farm economics depend on rearing dairy heifers. This study investigated the presence of a genotype by environment interaction in Holstein (HOL), Nordic Red Dairy Cattle (RDC), and their F1 crossbreeds (HOLxRDC) when provided different feed rations. The aim of our study was to assess how different energy concentrations in feed rations affect growth, body condition scores, feed intake, and feed efficiency in the 3 groups during the prepubertal period. The 3 breed groups were randomly allocated to receive either a standard or a low energy feed ration. HOL heifers exhibited reduced growth and a lower body condition score when they were fed the low energy feed ration. In contrast, the RDC heifers demonstrated similar growth rates with the different feed rations and maintained similar body condition scores irrespective of feed energy concentration. HOLxRDC crossbred heifers performed as an intermediate between the HOL and RDC groups. There were significant differences in dry matter intake and energy intake in the HOL and HOLxRDC groups depending on feed ration treatment. The RDC heifers had similar feed intake irrespective of treatment. There were no significant differences in the feed conversion ratio between breeds and feed treatments. These results indicate the presence of a genotype by environment interaction in prepubertal HOL and RDC heifers in response to differences in feed ration treatment. Due to the influence of prepubertal growth on future milk production, reproduction, and health status, it is important to be aware of breed-specific requirements during the prepubertal period, particularly in mixed-breed and crossbred groups, to optimize growth rates and production potential.

In postweaning calves, it is a challenge to maintain the plasma vitamin E level at or above the recommended level (3 µg/mL), which is linked to a good immune response. It has been unclear until now why the provision of solid feed with concentrations below 200 mg/kg feed of vitamin E is ineffective in maintaining the plasma vitamin E level of calves above the recommended plasma level postweaning. The present study was conducted to investigate if a high fat to vitamin E ratio in the concentrate could protect and improve the delivery of the natural form of vitamin E (RRR-α-tocopherol) to calves postweaning. Thirty calves were included in the experiment from 2 weeks preweaning until 2 weeks postweaning (Weeks -2, -1, 0 [weaning], 1, and 2 relative to weaning) and fed one of three concentrates in which lecithin mixture provided the fat supplement: control (77 mg/kg of vitamin E and 4.9% DM of crude fat; CONT), medium level of vitamin E supplemented (147 mg/kg of vitamin E and 7.7% DM of crude fat; MedVE) or high level of vitamin E supplemented (238 mg/kg of vitamin E and 12.4% DM of fat; HiVE). Thus, there was a comparable ratio of fat to vitamin E (520-630) in the three concentrates. During the 2 weeks postweaning, final body weight (92 ± 2 kg), average daily gain (917 ± 51 g/day) and concentrate intake (2.2 ± 0.09 kg/day; mean of treatment ± standard error) were unaffected by treatment and the interaction between treatment and week. There was an interaction between treatment and week for vitamin E intake pre- (p < 0.001) and postweaning (p < 0.001). There was an interaction between treatment and week (p < 0.001) for plasma vitamin E level postweaning, and it was 2.5, 3.1, and 3.8 µg/mL in CONT, MedVE, and HiVE, respectively, at Week 1 postweaning. In addition, plasma vitamin E levels at Week 2 postweaning were 2.6, 3.6 and 4.8 µg/mL in CONT, MidVE and HiVE respectively. The results show that 147 mg/kg of lecithin-protected vitamin E in the concentrate is needed to secure a plasma vitamin E level well above the recommended level. In addition, lecithin-protected vitamin E elevated the plasma level of triglycerides and nonesterified fatty acids.

In Denmark, organic male calves from the dairy system are typically raised as steers leading to a high carbon footprint per kg meat produced, compared to other types of rearing. Therefore, there is a need to find mitigation options and develop future production systems with a lower climate impact. The aim of this study was to develop strategies for the rearing of organic bull calves considering the following factors: season of birth, feeding strategy, age at slaughter, and breed-type, where all strategies focus on achieving the lowest possible carbon footprint per kg carcass. A total of 10 strategies were compared for each of three breed types: Holstein, Charolais x Holstein, and Angus x Holstein.The carbon footprint was estimated using Life Cycle Assessment including all emissions until the animals leave the farm for slaughter and expressed per kg carcass taking into account different dressing percentages due to breed and age at slaughter. The carbon footprint per kg carcass including contribution from soil carbon changes was 18-32% lower for raising organic young bulls compared with that of organic steers. The strategy with a high feeding intensity and a slaughter age of 13 months had the lowest carbon footprint per kg carcass due to the lowest feed consumption per kg live weight gain (4.9 kg DM compared to 7.4 kg DM for the steer) and use of a high proportion of concentrated feed in the ration. In the strategy with slaughter age of 17 months, but the same high feeding intensity, carbon footprint per kg carcass increased around 6%. This was due to an increase in feed consumption and reduction in feed conversion due to the increasing age at slaughter. The strategy with a low feeding intensity and a high slaughter age (17 months) gave the highest carbon footprint per kg carcass amongst the rearing strategies compared for organically produced bulls, as a greater proportion of roughage in the ration increases enteric methane production from the digestion of the feed. The crossbred bulls compared to purebred dairy bulls had a lower carbon footprint (4-7%) due to higher dressing percentage, higher carcass weight (both types of crosses), and higher growth rates (Charolais crosses).

Native livestock breeds are part of the history of the Nordic people and comprise a resource for future food production. In this study, net gain and carcass characteristics of two Danish, three Finnish, one Icelandic, six Norwegian and five Swedish native cattle breeds were retrieved and compared to commercial breeds: two beef breeds and two dairy breeds. Breed data were collected from national databases and sorted into six animal categories: young bull, bull, steer, heifer, young cow and cow, for which means and standard deviations were calculated within each country. The native breeds ranged from small-sized milking type breeds with low net gain, carcass weights and EUROP classification to larger multipurpose breeds with high net gains, carcass weights and EUROP classification. All Finnish and most of the Norwegian and Swedish native breeds had lower net gain and carcass weight than the dairy breeds in the same category and country, but with similar carcass conformation and fatness scores. The two Danish native breeds had higher net gain, carcass weight and conformation class than the reference dairy breed, but lower than the reference beef breeds. The net gain and carcass traits of the Icelandic native breed were similar to the smallest-sized native breeds from the other countries. The carcass traits of the native breeds indicate that they have comparative advantages in an extensive production system based on forage and marginal grasslands. They may also succeed better in the value-added markets than in mainstream beef production.

Calves often face a lower plasma vitamin E level than the recommended level (3 µg/ml for adult cows) after weaning, a level which has been related to a good immune response. Two experiments were performed to determine the most effective source and level of vitamin E to be included in a calf starter to maintain the plasma vitamin E level above the recommended level after weaning. Experiment 1 (Exp 1) and experiment 2 (Exp 2) included a total of 32 and 40 calves, respectively, from 2 weeks before weaning until 2 weeks after weaning. In Exp 1, calves were orally injected a daily dose of different vitamin E sources including, no α-tocopherol (0 dose; Control), 200 mg/d of RRR-α-tocopherol (ALC), 200 mg/d of RRR-α-tocopheryl acetate (ACT), or 200 mg/d of all-rac-α-tocopheryl acetate (SYN). In Exp 2, a dose response study was carried out with 0, 60, 120, and 200 mg/kg of ALC in a pelleted calf starter. Final BW (100 ± 16 and 86 ± 11 kg) and average daily gain (956 ± 303 and 839 ± 176 g/d in Exp 1 and 2, respectively; mean ± SD) were unaffected by either source or level of α-tocopherol. In Exp 1, the plasma RRR-α-tocopherol level was affected by α-tocopherol source (P < 0.001), week (P < 0.001), and interaction between them (P < 0.001). At weaning time, the plasma RRR-α-tocopherol was 2.7, 2.1, 1.1, and 0.8 μg/ml in ALC, ACT, SYN, and Control, respectively. In Exp 2, the plasma α-tocopherol level was affected by ALC dose (P = 0.04), week (P < 0.001), and a tendency for an interaction between them was observed (P = 0.06). At weaning, a 36, 31, and 28% reduction in plasma α-tocopherol level was observed compared to the beginning of the experiment with 0, 60, and 120 mg/kg of ALC, respectively; however, with 200 mg/kg of ALC, a 9% increase in the plasma α-tocopherol level was observed. In addition, 200 mg/kg of ALC was able to maintain plasma α-tocopherol after weaning higher than the recommended level. The results showed that the ALC was the most efficient source of α-tocopherol supplementation to be used in a calf starter. In addition, the 200 mg/kg of ALC in the calf starter was the only effective dose to maintain the postweaning plasma vitamin E concentration at the recommended level after weaning and α-tocopherol similar to that observed before weaning.

The importance of drinking water for production and animal welfare is widely recognized, but surveys and animal welfare assessment schemes suggest that many dairy calves and dairy cows do not have sufficient access. Limit milk-fed calves drink more water than calves fed milk ad libitum, but ad libitum milk-fed calves also require access to drinking water, as milk does not meet the animal's requirement for water. At hot ambient temperatures and when calves are sick, access to water is especially important and should be provided at all times. Many young calves do not have access to water throughout 24 h, and whether healthy young calves require free access to water at all times, or from which age, is not clear and requires further study. Dairy cow free water intake (FWI) is largely determined by milk yield, and high-yielding dairy cows may drink up 100 L of water per day. Dry matter, crude protein, and salt content of feed, as well as ambient temperature, have considerable effects on dairy cow water intake. Deprivation of water affects meal patterning for the cow, as well as increased subsequent rate of drinking and compensatory water intake. Although dairy cow ad libitum water intake may exceed the water provision necessary to maintain production, offering water for ad libitum intake may be necessary to safe guard animal welfare. Cattle are suction drinkers that prefer to drink from large open water surfaces, and Holstein dairy cows can drink at a rate of up to 24 L/min. Research on the effect of design and placement of water troughs for indoor-housed dairy cows on their drinking behavior and water intake is limited. Access to a water source at pasture increases the time cows spend there, and access to shade reduces water requirements during periods of warm weather. In both indoor and pastured cattle, there is a lack of knowledge about the effect of stocking of water troughs on competition, drinking behavior, and intake in dairy cows. Studies on the effect of available water trough length and placement, and of the number of cows being able to drink from the same trough of a given dimension, are needed to evaluate current recommendations.

Calves are often lower in plasma vitamin E concentration than the recommended level (3 mg/L) after weaning, which seems to be a challenge for a good immune response. Two studies were performed investigating if a natural vitamin E supplement in the starter concentrate could increase the plasma vitamin E concentration of calves around weaning. Each study was conducted at three Danish farms producing rose ' veal calves. Studies 1 and 2 included a total of 318 and 421 calves, respectively, from at least 3 weeks pre-weaning until at least 2 weeks after weaning. In study 1, the standard concentrate used at the farm was fed either unsupplemented (CON) or supplemented with 490 +/- 24 (Means +/- SD) mg of RRR-alpha-tocopherol (RRR-alpha-T)/kg of diet by mixing a vitamin E-enriched pellet with the standard concentrate pellet in the ratio of 1:10. In study 2, calves were fed either a common concentrate pellet with 48 +/- 8 mg/kg all-rac-alpha-tocopheryl acetate (CON) or a common concentrate pellet with 245 +/- 30 (Means +/- SD) mg/kg RRR-alpha-T with a similar dietary composition. Performance data were analyzed for each farm per study; however, plasma parameters were analyzed across the three farms in each study. In both studies, the plasma vitamin E concentration was analyzed at start (approximately 3 weeks preweaning), at weaning, and 2 to 3 weeks after weaning; however, the concentrate intake and thus vitamin E intake was not recorded. In both studies, the overall average daily gain (ADG) from start to weaning was not affected by vitamin E supplementation. In study 1, the plasma vitamin E concentration at weaning in RRR-alpha-T calves (5.09 +/- 0.58, LSmeans +/- SEM) was higher (P = 0.01) than in CON calves (3.35 +/- 0.55, mg/L). Similarly, the plasma vitamin E concentration post-weaning in RRR-alpha-T calves (3.71 +/- 0.27) was markedly higher (P < 0.001) than in CON calves (1.27 +/- 0.29 mg/L). In study 2, the plasma vitamin E concentration at weaning in RRR-alpha-T calves (4.9 +/- 0.4) was higher (P = 0.003) than in CON calves (3.6 +/- 0.4 mg/L). Similarly, post-weaning, the plasma vitamin E concentration in RRR-alpha-T calves (4.1 +/- 0.5) was higher (P = 0.004) than in CON calves (1.6 +/- 0.5 mg/L). At post-weaning, serum amyloid A (SAA; P = 0.02) and cortisol concentration (P = 0.04) were lower in RRR-alpha-T calves than in CON calves. In conclusion, regardless of the approach used for preparing the concentrate pellets, supplementation with a high amount of natural vitamin E (RRR-alpha-T) significantly increased the plasma vitamin E concentration above 3 mg/L at weaning and post-weaning and decreased the plasma cortisol and SAA concentration in calves post-weaning.

Emerging knowledge shows the importance of preweaning nutrition on programming the gastrointestinal microbiome and development of the gut barrier function. The aim of this study was to assess the effects of supplementing cow milk with either intact dried Ulva sp., Ascophyllum nodosum, or Saccharina latissima on growth performance and several gut health parameters of preweaning dairy calves. Forty male Holstein calves were selected based on birth weight (41 ± 4 kg) and plasma Brix percentage (≥8.7%) at d 2 of life. From d 2 to d 42 of life, the control calves (n = 10) were fed with cow milk (8 L/d) without seaweed supplementation, and the experimental calves were fed with cow milk (8 L/d) supplemented with either Ulva sp. (n = 10), A. nodosum (n = 10), or S. latissima (n = 10) at a concentration of 50 g/8 L of cow milk per day (i.e., 5% on a dry matter basis). Calves were weighed every week, and body weight gain and calf starter intake were monitored weekly. At d 42 ± 3 of life, calves were slaughtered. The organ weights and digesta pH from the reticulorumen, mid- and end small intestine, and mid-colon were recorded. A tissue sample (5 cm) collected from the mid-small intestine was analyzed for histomorphology. Digesta from the mid-small intestine and mid-colon were analyzed for lactobacilli, Escherichia coli, and Enterobacteriaceae, and short-chain fatty acid profile. Weight gain of the calves was not affected by seaweed supplementation. Proportional organ weights were not affected by seaweed supplementation except for reticulorumen weight, which was higher in calves fed Ulva sp. Both the mid-small intestinal and mid-colonic digesta populations of lactobacilli, Enterobacteriaceae, and E. coli, as well as the mid-small intestinal histomorphology in seaweed-supplemented calves were not different from control calves. However, acetic acid proportion in mid-colonic digesta was increased in calves fed Ulva sp. and A. nodosum, whereas butyric acid proportion was decreased compared with the control calves. Digesta pH in mid- and end small intestine and mid-colon were not affected, whereas ruminal pH was increased in calves fed Ulva sp. compared with the control calves. In conclusion, intact dried seaweed supplementation did not improve the growth or selected gut health parameters (i.e., histomorphology, digesta pH, bacteria, and short-chain fatty acids) in preweaning Holstein calves.

This study aimed to discuss the chemical composition of three seaweed species commonly found in Nordic countries and its potential use in feed rations for pigs and calves. Two brown seaweeds Ascophyllum nodosum, Saccharina lastissima and a green seaweed Ulva sp. harvested from Danish and Icelandic waters were analyzed for proximate, amino acids, minerals, fatty acids and nonstarch polysaccharides composition. All studied seaweeds contained low protein concentrations (i.e. 11.4-15.9 g/100 g DM). The ratio of essential amino acids (EAA) to non-essential amino acids (NEAA) was similar in all studied seaweeds (0.81-0.87). Ulva sp. had the highest ash concentration (48.2-54.4 g/100 g DM), followed by S. latissima (39.9 g/100 g DM) and A. nodosum (29.5 g/100 g DM). The most abundant macrominerals in the seaweeds were Ca, K and Na. Iodine was the most abundant micromineral in brown seaweeds (1.4-2.1 g/kg DM). Moreover, Ulva sp. had the highest Fe (5.1-8.0 g/kg DM), Mn (10.5 g/kg DM) and inorganic As (0.008 g/kg DM) concentrations. Ascophyllum nodosum had the highest crude fat concentration (3 g/100 g DM) and the highest concentration of polyunsaturated fatty acids (FAs) (37.9 g/100 g FA). Eicosapentaenoic acid (EPA) concentration was the highest in A. nodosum (7 g/100 g FA) followed by S. latissima (5 g/100 g FA) and Ulva sp. (2 g/100 g FA). Furthermore, concentration of alpha-linolenic acid, a precursor for EPA, was the highest in Ulva sp. (6.2-14.6 g/100 g FA). Total dietary fiber concentration was higher in the brown seaweeds (27.8-42.6 g/100 g DM) compared to the green seaweeds (17.9-21.5 g/100 g DM), where S. latissima had the highest soluble dietary fiber concentration. The high concentrations of ash and fiber may limit inclusion levels of the analyzed whole seaweeds in feed rations, mainly due to dilution of other nutrients in the feed, reduced digestibility of the feed and possible toxicities (i.e. high inorganic As). On the other hand, high concentrations of essential and valuable microminerals including I, Cu, Fe, Mn, Se were also detected in the studied seaweeds. High soluble dietary fiber concentration in S. latissima can be of interest as a fermentable substrate for probiotic bacteria. The easily digestible nutrients including, crude protein and fat were low in the seaweeds. However, the protein, fat, ash and dietary fiber fractions of the studied seaweeds were characterized by high concentrations of EAA, EFA, essential microminerals and interesting monomers of functional polysaccharides, respectively; which indicate possibilities for future use of seaweed-extracts in feed rations.

Suicide is an important public health problem, with nearly 800,000 people dying worldwide every year. The World Health Organization has declared suicide prevention an international priority1. Glucocorticoid treatment is prevalent and beneficial for many chronic diseases2, but also associated with severe psychiatric adverse effects3. Evidence on an association between glucocorticoid treatment and suicide is sparse4, 5. A study conducted in patients registered at UK general practices4 pooled suicides and suicide attempts, although acknowledging that they represent two different phenomena that may or not be related. Persons treated with oral glucocorticoids were 7-fold more likely to attempt or die from suicide shortly after initiation of treatment, compared to persons with the same underlying conditions who did not receive these medications. A Canadian case-control study5, focusing on people aged 66 years or more, found an unadjusted odds ratio of 1.33 (95% CI: 0.88-2.00) for the association of glucocorticoid use and suicide. There is a need to confirm the association between glucocorticoid use and suicide in a large sample representative of the general population, and to evaluate whether the association depends on glucocorticoid administration form, time since initiation of glucocorticoid treatment, and underlying medical conditions and comorbidities. We examined the association between glucocorticoid use and suicide in a registry-based population-based case-control study in Denmark in the period between January 1, 1995 and December 31, 2015 (cumulated population of 7,559,392 persons). From the Danish Register of Causes of Death6, we identified 14,028 suicide cases, and from the Civil Registration System7 we sampled 140,278 population controls using risk-set sampling and matching by birth year and sex. The suicide date served as the index date for cases and controls. We used the Danish National Prescription Registry, covering all Danish pharmacies8, to identify all prescriptions for glucocorticoids redeemed by cases and controls before their index date, and defined present, recent and former users of glucocorticoids as individuals who redeemed their most recent glucocorticoid prescription 0 to 90 days, 91 to 365 days, and more than 365 days before the index date, respectively. We further divided present users into new (individuals who redeemed their first-ever prescription ≤90 days before their index date) and prevalent (individuals who redeemed their most recent prescription ≤90 days before their index date and had a prior prescription redemption ever). The cumulative dose of most recent oral glucocorticoid prescription was calculated to assess a dose-response effect based on prednisolone equivalents. We examined oral glucocorticoids as well as injectable gluco­corticoids, inhaled glucocorticoids, and glucocorticoids administered topically in the intestine. For the locally acting glucocorticoids, we considered only exclusive use of each type. As regard covariates, we used the Danish Health Registries7 to obtain information on treatment indications (obstructive pulmonary disease, rheumatic diseases, renal diseases, inflammatory bowel disease, skin diseases, other autoimmune diseases, and cancer), comorbidities (psychiatric diseases, cardiovascular diseases, diabetes, osteoporosis, alcohol-related disorders), and co-medication use (opioids and antiepileptic medications). We used logistic regression to estimate crude and adjusted incidence rate ratios (IRRs) for suicide among present, new, prevalent, recent and former users of glucocorticoids compared to never users. As we used risk-set sampling, the estimated odds ratios from the logistic regression provided unbiased estimates of the IRRs9. We found that cancer modified the association and therefore stratified our analyses by cancer. We further estimated incidence rate differences using a back-calculation method. Median age for both cases and controls was 53 years, and 72% were men; 10% of cases and 7.3% of controls had a prior cancer diagnosis, and 67% of cases and 20% of controls had a prior psychiatric disease. New use of oral glucocorticoids was associated with a 7-fold increased risk of suicide in individuals with cancer (adjusted IRR=7.2, 95% CI: 5.0-11), and with a 2-fold increased risk in individuals with other treatment indications (adjusted IRR=2.0, 95% CI: 1.5-2.8), compared to never use. The rate differences were 7.6 per 10,000 person years (95% CI: –1.7 to 17) and 1.4 per 10,000 person years (95% CI: –8.9 to 12), respectively. The median cumulative dose of most recent oral glucocorticoid prescription was higher among individuals with cancer than without (2,000 mg vs. 500 mg prednisolone equivalents), and we found a dose-response effect. Adjusted IRRs for suicide according to the prednisolone-equivalent cumulative dose of most recent prescription were 1.2 (95% CI: 0.36-4.0) for dose <250 mg; 3.0 (95% CI: 1.2-7.8) for 250-499 mg; 3.4 (95% CI: 1.9-6.2) for 500-999 mg, and 20 (95% CI: 10-41) for doses ≥1000 mg, compared to never use. The association was consistent across treatment indications and comorbidities, stronger among people below 30 and above 50 years of age, and similar among men and women. Recent and former use of oral glucocorticoids, as well as other administration forms (inhaled, injectable, and topically in the intestine), were not associated with suicide. Other administration forms have lower bioavailability, lower systemic absorption and are often used in lower doses compared to systemic glucocorticoids, which may explain these findings. We conducted several sensitivity analyses. Residual confounding by disease severity cannot be entirely ruled out. However, our results remained robust to confounding by cancer stage and timing. We calculated E-values to examine the impact of potential unmeasured confounding. The E-value indicated that an unmeasured confounding factor needed to be associated with both glucocorticoid use and suicide with a relative risk of 14 and 3.4, in cancer and non-cancer patients respectively, to fully explain our findings (i.e., only strong confounding could explain our data). We concluded that oral glucocorticoid initiation was associated with suicide in a dose-dependent manner, with findings of a 7-fold increased risk in cancer patients and a 2-fold increased risk in patients treated for other medical conditions. The particularly strong association in individuals with cancer may be explained by high-dose treatment. Given the widespread use of glucocorticoids, our study deserves clinical and public health attention. Awareness of the association between new use of oral glucocorticoids and suicide may enhance prevention efforts for an extremely serious global public health problem.

Abstract The role of lifestyle in development of herpes zoster remains unclear. We examined whether smoking status, alcohol consumption, body mass index, or physical activity were associated with zoster risk. We followed a population-based cohort of 101,894 respondents to the 2010 Danish National Health Survey (baseline, May 1, 2010) until zoster diagnosis, death, emigration, or July 1, 2014, whichever occurred first. We computed hazard ratios for zoster associated with each exposure, using Cox regression with age as the time scale and adjusting for potential confounders. Compared with never smokers, hazards for zoster were increased in former smokers (1.17, 95% confidence interval (CI): 1.06, 1.30), but not in current smokers (1.00, 95% CI: 0.89, 1.13). Compared with low-risk alcohol consumption, neither intermediate-risk (0.95, 95% CI: 0.84, 1.07) nor high-risk alcohol consumption (0.99, 95% CI: 0.85, 1.15) was associated with zoster. We also found no increased hazard associated with weekly binge drinking versus not (0.93, 95% CI: 0.77, 1.11). Risk of zoster varied little by body mass index (referent = normal weight) and physical activity levels (referent = light level), with hazard ratios between 0.96 and 1.08. We observed no dose-response association between the exposures and zoster. The examined lifestyle and anthropometric factors thus were not risk factors for zoster.