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CONTEXT: Nitrogen (N) and phosphorus (P) imbalances from dairy farming systems (DFSs) lead to environmental problems, such as eutrophication. OBJECTIVE: This study aimed to quantify nutrient deficits and losses from DFSs with different manure management systems (MMSs) at the farm level and at the levels of its sub-systems. METHODS: We compared N[sbnd]P balances of 30 farms with four different MMSs: applying manure directly on forage land, without treatment (ADL), selling or exporting manure (SEL), using manure for anaerobic digestion (ADI), and discharging manure (DIS). N[sbnd]P balances were calculated based on differences between in- and outflows. RESULTS AND CONCLUSIONS: Results showed that N balances at DFS averaged 222 kg N farm−1 yr−1 and did not differ between MMSs. Average P balances at DFS differed between MMSs; balances were highest for DIS (83 kg P farm−1 yr−1), and lowest for SEL (−25 kg P farm−1 yr−1). Soil P balances did not differ between MMSs and were mostly negative, except for four ADL farms. Annually, all dairy farms in Lembang region are estimated to cause a nutrient loss of ∼1061 tons of N and ∼ 290 tons of P, and extract 8 tons of P from soils. Overall, high NP imbalances are caused by discharging manure into the environment. SIGNIFICANCE: To reduce imbalances, collection and on-farm use of manure must be improved, and excess manure needs to be sold to crop farms. The carrying capacity for high-input high-output dairy farming is determined by the capacity of arable farms to apply the manure surpluses.

The objective of this study was to examine social networks in dairy value chains (DVCs) in Kenya and understand how DVC actors' power relationships and trust influence their behaviour regarding milk quality. We conducted a stakeholder analysis using the Net-Map tool in Laikipia, Nakuru and Nyandarua counties in Kenya. VisuaLyzer software was used to analyse the social networks. Thematic content analysis of the discussions, recorded during the mapping exercise, was undertaken using ATLAS.ti. Formal DVC had more actors and dense social networks characterised by vertical and horizontal integration, high levels of power asymmetries between actors, limited trust and short-term contractual arrangements. Informal DVC was characterised by fewer actors and less dense social networks, low levels of power asymmetries between actors and a high level of trust due to the existence of reciprocal personal relationships. Milk was perceived to be of higher quality in the formal value chain reflecting top-down enforcement of milk standards, bottom-up collective action, power asymmetries and contractual relationships. Poor milk quality management in the informal DVC underscores the need for powerful actors, e.g. regulatory agencies, and buyers such as processors, to influence other DVC actors' behavioural change. Understanding and leveraging DVC social networks and actors' power and addressing power asymmetries and enhancing trust between actors will increase compliance with milk quality standards. There is an urgent imperative to design policies and interventions which empower DVC actors, by providing economic incentives, enhancing their skills and knowledge and their access to infrastructure which facilitates milk quality improvement.

CONTEXT: The livestock sector in Sub-Saharan Africa (SSA) is under increasing pressure to define its role in jointly addressing food security and climate change. Climate-smart agriculture (CSA) has been widely leveraged as an approach to achieving both food security and climate change outcomes through suites of interventions that maximize synergies and reduce tradeoffs among three pillars: productivity, climate change resilience, and climate change mitigation. However, operationalization of the CSA approach in the livestock sector is hindered by a lack of clarity around what the pillars mean for livestock systems, given their fundamental attributes compared to crops and the spatial and temporal dimensions of these attributes. A conceptual framework is also lacking for assessing and comparing the potential CSA synergies and tradeoffs that different livestock systems and interventions may generate. OBJECTIVE: In this paper we aim to offer guidance on the operationalization of the CSA approach in the livestock sector. METHODS: We draw on a literature review to explore the essential attributes of livestock systems in SSA as they relate to CSA objectives over different temporal and spatial scales. Based on this review, we propose a practical and flexible framework for assessing and comparing the synergies and tradeoffs that different livestock systems may generate among food security and climate change objectives over different spatial and temporal scales. The framework consists of four elements: CSA pillars, spatial-temporal scales, CSA objectives mapped to each spatial-temporal scale, and indicator guidance. Using farm survey data and national statistics, an illustrative application of the framework to two dairy farms in Rwanda is presented and discussed. RESULTS AND CONCLUSIONS: The illustrative application demonstrates how the framework can be used to identify important, spatial-temporal CSA synergies and tradeoffs that otherwise may go unrecognized. Additional appli

Importance: Long-term data on dupilumab drug survival in patients with atopic dermatitis (AD) are scarce. Furthermore, little is known about the factors associated with drug survival of dupilumab in AD.Objective: To describe the drug survival of dupilumab in patients with AD and to identify associated predictors.Design, Setting, and Participants: This cohort study was based on data from the multicenter prospective daily practice BioDay registry, in which 4 university and 10 nonuniversity hospitals in the Netherlands participated. Analysis included patients (age ≥18 years) participating in the BioDay registry with a follow-up of at least 4 weeks. The first patient treated with dupilumab was recorded in the BioDay registry in October 2017; data lock took place in December 2020, and data analysis was performed from October 2017 to December 2020.Main Outcomes and Measures: Drug survival was analyzed by Kaplan-Meier survival curves and associated characteristics by using univariate and multivariate Cox regression analysis.Results: A total of 715 adult patients with AD (mean [SD] age, 41.8 [16.0] years; 418 [58.5%] were male) were included with a 1-year, 2-year, and 3-year overall dupilumab drug survival of 90.3%, 85.9%, and 78.6%, respectively. Characteristics associated with shorter drug survival owing to ineffectiveness were the use of immunosuppressant drugs at baseline (hazard ratio [HR], 2.64; 95% CI, 1.10-6.37) and being a nonresponder at 4 weeks (HR, 8.68; 95% CI, 2.97-25.35). Characteristics associated with shorter drug survival owing to adverse effects were the use of immunosuppressant drugs at baseline (HR, 2.69; 95% CI, 1.32-5.48), age 65 years or older (HR, 2.94; 95% CI, 1.10-7.87), and Investigator Global Assessment score of very severe AD (HR, 3.51; 95% CI, 1.20-10.28).Conclusions and Relevance: This cohort study demonstrated a good overall 1-year, 2-year, and 3-year dupilumab drug survival. Patients using immunosuppres

In the discourse about the development of farmed animal production (terrestrial livestock production and aquaculture) in the tropics, two important food system outcomes emerge: (1) to supply animal-sourced food (ASF) at a level that suffices healthy future diets, including for poor people, and (2) to contribute to climate change mitigation and minimize pollution with nitrogen and phosphorus. Livestock production and aquaculture contribute to food security directly by increasing producers' food diversity and availability, but also that of urban consumers, and indirectly through income generation and increased farm resilience. Recently, circularity has come to the fore as an integrated approach to food system development. Circularity has four cornerstones: (1) food crops have highest priority (which implies no food-feed competition), (2) avoid losses, (3) recycle waste and (4) use animals to unlock biomass that humans cannot eat. In this review, the role of farmed animals in circular food systems in the tropics is presented in four case studies and the impacts of circularity on food security and environmental impact mitigation are discussed. The cases are ruminants in grazing systems in West Africa and in Colombia, fish in pond aquaculture in general, and land-limited dairy production in Indonesia. Additionally, options for novel protein sources for use in livestock and fish feeding are presented. It is concluded that farmed animals are important in circular food systems because of their use of land unsuited for crop production, their upgrading of crop residues, and their supply of manure to crop production. Nevertheless, the increasing demand for ASF puts pressure on important characteristics of circularity, such as minimizing food-feed competition, maximization of use of waste streams in feed, and the value of manure for fertilization. Hence, in line with conclusions for Western countries, maximum circularity and sustainability of food systems can only be achieved b

This longitudinal study explored intra-annual variation in feed availability and the chemical composition of milk and feed resources at smallholder dairy farms in Nakuru county, Kenya. Feed and milk samples were collected for a full year, every last week of the month, from 43 purposively selected farms. Feed and milk samples were analysed for nutritional composition using near infrared spectroscopy (NIRS) and Ekomilk milk analyser, respectively. The main basal feeds were indigenous grasses, Napier grass, maize and bean stover and maize silage, which farmers supplemented with purchased commercial concentrates and/or purchased or homemade total mixed rations (TMR). Commercial concentrates had the highest crude protein (CP) content (17.4 ± 3.9)% dry matter (DM), while maize stover had the lowest (8.7 ± 3.3% DM). All the feeds had low metabolisable energy (ME) that ranged from 7.0 ± 0.8 (MJ/kg DM) megajoules per kilogram of dry matter (MJ/kg DM) for maize stover to 8.9 ± 0.8 for dairy meal. Only grasses showed significant seasonal variation in CP and NDF (P > 0.00). Milk physicochemical composition was within the range stipulated by the Kenya Bureau of Standards (KEBS). Milk physicochemical composition showed negligible seasonal variations to significantly affect milk processing, which suggests that farmers can cope with feed scarcity. Nevertheless, seasonal feed availability is a persistent challenge in smallholder dairy farms. There is a need to ensure sufficient feed availability throughout the year in smallholder dairy farms through feed conservation, feeding management and ration preparation to enable consistent milk production and physicochemical composition.