Central Jutland Research Articles

Fuel use in medieval iron production in central Jutland, Denmark

Fuel use in medieval iron production in central Jutland, Denmark

Data assimilation for noise mapping using CNOSSOS - A Danish Case Study

Noise maps play a significant role in developing noise mitigation policies. However, maps based on noise simulation models are likely to be uncertain due to underlying model uncertainties and parameterization. This research work explores the feasibility of data assimilation techniques to address this issue. A noise measurement campaign was carried out at two locations in the Central Jutland Region of Denmark. Consequently, 76 days (1 September-15 November 2019) (N = 1824 hours) of measured hourly A-weighted, energy equivalent, sound pressure level data (LAeq1h in dBA) was available for this case study. In addition, traffic counting data was available. The LAeq1h (dBA) levels were then simulated using the EU noise prediction standard, CNOSSOS. The comparison of daily averaged measured and simulated noise levels reveals the Root Mean Squared Error (RMSE) in the range of 1.4 - 2.8 dBA. Subsequently, data assimilation techniques, such as the Best Linear Unbiased Estimator (BLUE) and Bayesian Inverse Inference, are used to produce improved, hourly, so-called analysis maps with the minimum error covariance. The oral presentation and short article will present details of model inputs and simulations, data assimilation as well as the strengths and limitations of this research.

Performance Evaluation of Nord2000, RTN-96 and CNOSSOS-EU against Noise Measurements in Central Jutland, Denmark

This article aims to assess the performance of Nord2000, RTN-96, and CNOSSOS-EU, the Nordic and European noise prediction standards, in predicting daily LAeq24h and Lden levels (dBA), by comparing them with measurements gathered over 76 days from the E45 motorway in Helsted, Central Jutland, Denmark. In addition, the article investigates the potential viability of utilizing Confidence-Weighting Average (CWA) for data fusion to enhance noise estimation accuracy. The results showed highly positive Spearman’s correlations (RS), reflecting strong agreements between observed and predicted data, Nord2000 = 0.85–0.98, CNOSSOS-EU = 0.79–0.92 and RTN-96 = 0.86–0.91. Model differences, RMSE = 0.4–3.3 dBA (Nord2000), 1.4 = 2.8 dBA (CNOSSOS) and 1.3–4.2 dBA (RTN-96), were mainly due to underlying model parametrization and uncertainties in model inputs. Overall, Nord2000 outperformed CNOSSOS and RTN-96 in reproducing observed noise levels. Moreover, CNOSSOS agreed well with the measured data and exhibited a high potential for noise mapping and health assessments. Likewise, the CWA is found to be a promising, forward-looking data fusion approach to improve noise estimates’ accuracy. More research is required to further evaluate the models in greater detail over a larger geographical area and across varied temporal scales (e.g., hourly, yearly).

Influence of maternal body mass index on human milk composition and associations to infant metabolism and gut colonisation: MAINHEALTH – a study protocol for an observational birth cohort

IntroductionHuman milk provides all macronutrients for growth, bioactive compounds, micro-organisms and immunological components, which potentially interacts with and primes infant growth and, development, immune responses and the gut microbiota of...

Positive predictive value of congenital heart disease diagnostic codes in the Danish National Patient Registry

BackgroundCongenital heart disease (CHD) is a public health concern as the most common birth defect with growing prevalence in adults. Valid CHD data are critical in clinical epidemiological CHD research. ObjectivesTo evaluate the positive predictive value (PPV) of having a CHD diagnosis and related surgery registered in the population-based Danish National Patient Registry (DNPR) according to the International Classification of Diseases, 8th and 10th revision, using predefined exclusion criteria to increase diagnostic validity. MethodsUsing medical record review as reference standard, we computed the PPV of registered diagnostic codes for CHD and CHD subtypes including 95% confidence intervals (CIs) as well as the PPV of presence of CHD-related surgery. A sample of 480 patients diagnosed with CHD at any hospital in the Central Jutland region, during 1977–2013, was randomly selected for the medical record review. Reviews were performed by two paediatric cardiology nurses, blinded to the specific CHD diagnosis, and a paediatric cardiologist was consulted in cases of uncertainty. ResultsWe located medical records of 463 of the 480 patients included (96%), and found an overall PPV of the CHD diagnosis of 95.5 (95%CI: 93.3–97.1). Subtype specific PPVs were generally lower. In example PPV for atrial septal defect was 69%. It increased to 78% after inclusion of persistent foramen ovale in the reference standard subtype definition. The overall PPV of CHD-related surgery codes was 92.7% ConclusionsThe overall PPV of CHD diagnoses in the DNPR is high. Data indicated lower PPVs for CHD subtypes.

Land conversion from annual to perennial crops: A win-win strategy for biomass yield and soil organic carbon and total nitrogen sequestration

How much can we increase biomass yield by promoting land conversion from annual to perennial crops? Will increased biomass extraction for biorefineries reduce soil organic carbon (SOC) and total nitrogen (TN) stock? Which cropping system is more stable for biomass production over time? To our knowledge, no study has concurrently investigated the effects of land conversion from annual to perennial crops on biomass yield, yield stability, and changes in SOC and TN stock, which limits the understanding and application of sustainable agroecosystems producing biomass for biorefineries. Based on five-year continuous observations in central Jutland Denmark, our results showed that perennial crops significantly increased biomass yield by 19% and yield stability by 88% compared to annual crops. Perennial crops significantly increased SOC content by 4% and SOC stock by 11% at 0–100 cm depth across the five years. The opposite responses of SOC content and stock under annual and perennial crops led to even more significant differences between the crop types. Perennial crops had no effect on soil TN content and increased soil TN stock to one meter depth by 22%, whereas continuous annual crops had no effect on it. Neither annual nor perennial crops had effects on SOC and TN stock when estimated based on equivalent soil mass because the soil density increased under perennial crops. Our results showed that changes in SOC and TN stock between annual and perennial crops varied with the specific calculating methods (fixed depth/equivalent mass), thus the selected methods should be clearly defined in the future research. Increases in SOC content at one meter depth were positively correlated with biomass yield and yield stability, suggesting a win-win strategy for climate mitigation and food security. Altogether, our results highlight the potential to redesign the current cropping system for sustainable intensification by selecting proper perennial crops for green biorefineries.

Cryoneurolysis\u2019 outcome on pain experience (COPE) in patients with low-back pain: study protocol for a single-blinded randomized controlled trial

BackgroundLow-back pain, including facet joint pain, accounts for up to 20 % of all sick leaves in DenmarkA proposed treatment option is cryoneurolysis. This study aims to investigate the effect of cryoneurolysis in lumbar facet joint pain syndrome.Methods A single-center randomized controlled trial (RCT) is performed including 120 participants with chronic facet joint pain syndrome, referred to the Department of Neurosurgery, Aarhus University Hospital. Eligible patients receive a diagnostic anesthetic block, where a reduction of pain intensity ≥ 50 % on a numerical rating scale (NRS) is required to be enrolled. Participants are randomized into three groups to undergo either one treatment of cryoneurolysis, radiofrequency ablation or placebo. Fluoroscopy and sensory stimulation is used to identify the intended target nerve prior to administrating the above-mentioned treatments. All groups receive physiotherapy for 6 weeks, starting 4 weeks after treatment. The primary outcome is the patients’ impression of change in pain after intervention (Patient Global Impression of Change (PGIC)) at 4 weeks follow-up, prior to physiotherapy. Secondary outcomes are a reduction in low-back pain intensity (numeric rating scale) and quality of life (EQ-5D, SF-36) and level of function (Oswestry Disability Index), psychological perception of pain (Pain Catastrophizing Scale) and depression status (Major Depression Inventory).Data will be assessed at baseline (T0), randomization (T1), day one (T2), 4 weeks (T3), 3 (T4), 6 (T5) and 12 months (T6).DiscussionThis study will provide information on the effectiveness of cryoneurolysis vs. the effectiveness of radiofrequency ablation or placebo for patients with facet joint pain, and help to establish whether cryoneurolysis should be implemented in clinical practice for this patient population.Trial registrationThe trial is approved by the ethical committee of Central Jutland Denmark with registration number 1-10-72-27-19 and the Danish Data Protection Agency with registration number 666,852. The study is registered at Clinicaltrial.gov with the ID number NCT04786145.

Semi-automated classification of colonial Microcystis by FlowCAM imaging flow cytometry in mesocosm experiment reveals high heterogeneity during seasonal bloom

A machine learning approach was employed to detect and quantify Microcystis colonial morphospecies using FlowCAM-based imaging flow cytometry. The system was trained and tested using samples from a long-term mesocosm experiment (LMWE, Central Jutland, Denmark). The statistical validation of the classification approaches was performed using Hellinger distances, Bray–Curtis dissimilarity, and Kullback–Leibler divergence. The semi-automatic classification based on well-balanced training sets from Microcystis seasonal bloom provided a high level of intergeneric accuracy (96–100%) but relatively low intrageneric accuracy (67–78%). Our results provide a proof-of-concept of how machine learning approaches can be applied to analyze the colonial microalgae. This approach allowed to evaluate Microcystis seasonal bloom in individual mesocosms with high level of temporal and spatial resolution. The observation that some Microcystis morphotypes completely disappeared and re-appeared along the mesocosm experiment timeline supports the hypothesis of the main transition pathways of colonial Microcystis morphoforms. We demonstrated that significant changes in the training sets with colonial images required for accurate classification of Microcystis spp. from time points differed by only two weeks due to Microcystis high phenotypic heterogeneity during the bloom. We conclude that automatic methods not only allow a performance level of human taxonomist, and thus be a valuable time-saving tool in the routine-like identification of colonial phytoplankton taxa, but also can be applied to increase temporal and spatial resolution of the study.

Fra grænselandet mellem to kulturer

Fra grænselandet mellem to kulturer

Tension tests on bored instrumented piles installed in marine Eocene clay

This paper presents parts of the results from two full-scale loading tests (tension) on bored cast-in-place piles installed in high plasticity marine Eocene clay at a test site in Hinge, central Jutland, Denmark. Testing was carried out to investigate the development and distribution of shaft resistance on the test piles. Each test pile was instrumented with distributed fiber-optic strain and temperature cables, in addition to traditional vibrating wire strain gauges and tell tales. Selected examples of retrieved data are presented. The measured shaft resistance is compared to an analytical method based on the Danish National Annex to Eurocode 7, part 1 which represents a conservative estimate for the shaft resistance of bored piles. The results from the two full-scale loading tests (tension) on bored cast-in-place piles in marine Eocene clay show that the Danish code-requirement, concerning shaft resistance, is too conservative.

Strontium Is Released Rapidly From Agricultural Lime–Implications for Provenance and Migration Studies

The use of strontium isotopes in pre-historic mobility studies requires accurate isoscapes for evaluating whether pre-historic individuals are local to the areas in which they were buried or not. Isoscapes are often based on modern-day samples, commonly surface waters. There is, however, growing evidence that modern-day farming has a significant impact on the strontium isotopic composition of surface waters and farmed soils, mainly due to the use of agricultural lime for soil improvement. In this paper, we investigate the fate of strontium from agricultural lime in an experimentally-manipulated field in central Jutland, Denmark. Agricultural limestone was added to this field at very high rates in 2012 and 2013 to investigate CO2 storage in soils. Strontium was first measured from the site in 2014. In 2019 we reevaluated strontium concentrations and found that 80–100% of the strontium from the agricultural lime had leached out of the organic-rich topsoil, and likely seeped into the underlying groundwater and nearby surface waters. In both the sandy soils of the liming test site and farmed soils and heathland in the adjacent area, Sr exhibits a degree of mobility similar to that of calcium, which is in agreement with data for other soil types and what is predicted by the size of its hydrated ions. Strontium isotopic compositions of unfarmed heathland samples show much higher 87Sr/86Sr ratios, and so are not influenced by carbonates, suggesting that the limestone 87Sr/86Sr signature seen in the farmland and in streams and rivers in contact with this comes from agricultural lime, and not from natural carbonate relicts occasionally found in the area. This suggests that the 87Sr/86Sr signatures of the area were higher in pre-historic times, and that an isoscape map based on samples from modern-day farmland is inappropriate for application to provenance and mobility studies of pre-historic people. Thus, it is critical that the possible impact of farming is evaluated when conducting provenance and mobility studies, especially in areas with Sr-poor soils and where agricultural lime is used for soil improvement. Overlooking this can result in significant overestimation of the degree of pre-historic mobility.

Homogeneous Glacial Landscapes Can Have High Local Variability of Strontium Isotope Signatures: Implications for Prehistoric Migration Studies

Increasingly, strontium (Sr) isotopes are used to distinguish locals and migrants in prehistoric studies, by measuring87Sr/86Sr in human remains and comparing these values to the distribution of the bioavailable87Sr/86Sr in the study area, often in surface water. However, it has recently been shown that agricultural lime can have a substantial impact on the87Sr/86Sr ratio and strontium concentration in surface water in areas where soils are low- to non-calcareous. Agricultural lime is rich in strontium with low87Sr/86Sr ratios, such that interpretations of prehistoric migration based on surface waters affected by agricultural lime often overestimate the number of migrants in a given area. However, the impact of agricultural lime was questioned in a new study, which argues that strontium derived from agricultural lime is retained in the topsoil of the fields and therefore do not contaminate the surface water. In the present study and in a companion study in this volume, we show that strontium derived from agricultural lime is highly mobile in soils, and so contaminate surface waters extensively. We also show that the87Sr/86Sr ratios are consistently higher in waters from “pristine areas” (where no agricultural lime has been applied within a distance of 150 m from the sample locality) than in water from farmland, thus confirming that it is of vital importance for accurate mapping of isoscapes to avoid sampling waters contaminated by agricultural lime. Our new measurements of87Sr/86Sr ratios in central Jutland, Denmark, raise the highest measured values to 0.7186. High values between 0.7140 and 0.7156 occur repeatedly and it is apparent that nearly all prehistoric human finds in Jutland, previously believed to have journeyed from afar are more likely of local origin. Furthermore, we show that carbonate-rich areas along the coast of southwest Zealand carry high87Sr/86Sr values (0.7112–0.7132), where we would expect low values. This surprising result indicates that nearly all humans buried at the Viking Age site, Trelleborg could well have originated locally, in contrast to past studies, which have suggested that about 50% of the burials were of individuals who came from afar.

Olaparib treatment in older patients with ovarian cancer: need for ‘real-world’ data beyond clinical trials

BackgroundAgeing is a risk factor for cancer. Worldwide, the number and proportion of adults aged ≥65 will increase, along with the incidence of ovarian cancer. Older adults are under-represented in randomised clinical trials (RCTs), and those who are enrolled have a good performance status and no major health issues. These patients are not representative of older patients seen in everyday clinical practice; therefore, age-specific data on efficacy and toxicity of olaparib in the ‘real-world’ setting are lacking.MethodsThis observational study was conducted in the Central Jutland Region in Denmark. Data in unselected older (≥65) patients with known BRCA mutation receiving olaparib maintenance treatment for platinum-sensitive relapsed ovarian cancer were registered between 2015 and 2019. Toxicity and progression-free survival (PFS) were registered. No geriatric assessment has been performed.ResultsIn total, 20 consecutive patients ≥65 years were included with a median age of 75 years (range: 65–85). Most of the patients (18/20) had ECOG PS: 0–1. Treatment interruption and dose reduction occurred in 65% of the patients. Toxicities of any grade occurred in 18 (90%), whereas grade 3/4 toxicities occurred in 6 patients (30%). Treatment was terminated due to disease progression or unacceptable toxicity in 13 (65%) patients. The median PFS was 6 months (range: 2–31), and the median follow-up was 15 months (range: 3–30).DiscussionOur ‘real-world’ experience shows that unselected older patients represent a significant larger proportion in real life than in RCTs; furthermore, older patients in a real-world setting may experience more side effects possibly affecting the quality of life. The median PFS data suggest that older patients may not derive the same clinical benefit than their fit and younger counterparts.There is a need to enrol vulnerable/frail older patients into RCTs, ensuring that data will also be applicable in standard clinical settings. Incorporating geriatric assessment into these trials should be encouraged.

The link between surface water and groundwater-based drinking water – strontium isotope spatial distribution patterns and their relationships to Danish sediments

The hydrological relationship between surface waters and groundwaters in many regions of the world is well known and the effects of their mutual interaction and interaction with the soils and bedrocks, with respect to resulting changes in their chemical composition, are well studied. In this study we add to this knowledge by comparing the distributional patterns of strontium (Sr) isotopes in previously published 192 surface water samples with those of newly acquainted Sr isotope data from groundwater-based drinking water samples extracted from 163 of the major waterworks in Denmark. The aim is to investigate potential compositional changes that might derive from the interaction with the aquifer lithology or overlying sediments and soils. The average Sr isotope signatures of surface and groundwater-based drinking waters define 87Sr/86Sr values of 0.7096 ± 0.0015 (2σ) and 0.7088 ± 0.0013 (2σ), respectively. The skewed distribution of Sr isotope compositions in groundwaters towards lower 87Sr/86Sr values indicates enhanced contribution of natural carbonate-derived strontium with depth, while slightly elevated 87Sr/86Sr signatures in surface waters may reflect the diminished contribution of Sr from carbonates in the glaciogenic sediments due to their progressive acid dissolution. Strontium concentrations [Sr] in groundwater-based drinking water from the participating major waterworks define a country-wide average of 1.17 mg/L and the distributional pattern shows an East – West decreasing trend. Lowest concentrations are found in the West Jutland glaciogenic province (WJGP; average [Sr] = 0.36 mg/L) and in the northernmost tip of Jutland. A corresponding pattern, although less pronounced, is also depicted by the 87Sr/86Sr signatures of groundwater-based drinking water, whereby increasing 87Sr/86Sr values from Zealand through Funen into the Jutland peninsula correspond with increasing thickness of glaciogenic overburden providing (though mass-balance wise subordinate) radiogenic Sr to the natural carbonate-dominated groundwaters. The highest 87Sr/86Sr values are recorded in waters from northern Jutland, possibly reflecting the admixture of radiogenic strontium from late glacial and post-glacial glacio-isostatic adjustment-related marine aquifers. Generally, the surprisingly rather homogeneous and similar distributional patterns of 87Sr/86Sr signatures of Danish aquifers and surface waters implies a strong and dominant control of Sr by natural clastic (reworked) carbonate components in the Quaternary, Miocene and Holocene sediments, and to lesser degree (with the exception of northern central Jutland and Eastern Zealand) from the pre-Quaternary limestone dominated “basement” directly. Our results are consistent with a tight hydrological and geochemical interrelationship between surface waters and groundwaters in Denmark. There is a need for further investigations of the effects of advanced treatment of soft (acidic) groundwater-based drinking water on the concentrations and isotopic signatures of trace elements such as Sr. However, our study lends support for the adequate use of Sr isotope signatures of either of these waters to characterize the isotope compositional range of bioavailable fractions relevant for authenticity identification, forensic studies, and for prehistoric and modern human and animal proveniencing.

Access and Use of Device‐Aided Therapies for Parkinson’s Disease in Denmark

In Denmark's five regions, there is potential inequality in access to device-aided therapy (DAT) for Parkinson's disease (PD) based on structural or socioeconomic factors. It is unclear how long DAT is maintained and affects concomitant medication. To investigate access to DAT by comparing the proportion of patients with DBS, subcutaneous apomorphine infusion (SCAI), or levodopa/carbidopa intestinal gel (LCIG) in Danish regions 2008-2016 and describe demographics of patients, changes in use of comedication, and maintenance of DAT. This work is a retrospective nationwide population-based registry analysis generated by combining various registries and statistics in Denmark. From 2008 to 2016, 612 patients started DAT. There were statistically significant differences in the number of patients starting DAT between the Capital Region (99.5 per 1,000) and both Central Jutland (66.6 per 1,000) and North Jutland (70.6 per 1,000; P < 0.05). Among DBS and LCIG patients, respectively, 4% and 42% were aged ≥70 years, 68% and 63% were men (vs. 59% in the general PD population; P < 0.05 for DBS), 73% and 63% had a partner (vs. 62% in the general PD population), and 73% and 71% had a qualifying education (vs. 63% in the general PD population; P < 0.05). Use of PD-related medication decreased significantly from 4 years before to 4 years after DAT. Eighty-one percent of the patients who started LCIG, alive 4 years later, had maintained this treatment. There is unequal access to DAT in the Danish regions, and political and social considerations are warranted to address structural and socioeconomic causes.

Tramadol prescribed use in general and chronic noncancer pain: a nationwide register-based cohort study of all patients above 16 years.

Background and aims In the Western world, it has become clear that we are facing a crisis of overuse, abuse and improperly prescribed use of opioids. As part of the ongoing discussion on opioid use, the use and prescription of tramadol have been addressed in recent years. A significant portion of this discussion should adequately address the risk factors for the use of weak opioid products such as tramadol. The risk factors which characterise the long-term tramadol use are still incompletely understood. Thus, we aimed to describe the characteristics of Danish patients using tramadol in more detail, under different scenarios and determinants of subsequent usage patterns. Methods We conducted a nationwide cohort study to identify individuals purchasing tramadol from 01/01/2004 to 31/12/2015 who are age 16 + years old by using data from The Danish National Databases; these databases consist of unique information for all citizens in Denmark. Logistic regression analyses were used to assess the potential risk factors for repeated tramadol use. Results The final cancer-free cohort consisted of N = 941,839 tramadol users: 54.4% women, with a mean age of 53.2 years. The number of chronic noncancer pain (CNCP) was 430,641 individuals, and 56% of the total third who repeated the use of tramadol with two + purchased prescriptions were CNCP patients. The increased risk of repeated use for CNCP was, among others, associated with: male sex (HR 1.21), age 69-110 (HR 1.72), back/spine pain men (HR 1.47), women (HR 1.46), spondylopathies (HR 1.24), male osteoporosis (HR 1.22), multimorbid ulcer/skin (HR 1.28), region of municipality Northern Jutland (HR 1.74), Central Jutland (HR 1.75), number of co-medication 4-9 (HR 1.33), dementia (HR 1.27). Factors associated with decreased risk: co-medication ischemic heart disease (HR 0.85), diagnosis headache (HR 0.70), household income highest tertile (HR 0.81), unknown (HR 0.70), single women (HR 0.96). Conclusions This study proved a widespread prescribed use of tramadol in Denmark, and, as know from the literature, weak opioid use may lead to long-term use of high potent opioids, this usage is inappropriate, in general, but especially for the treatment of CNCP. Implications When striving to reduce the overuse of opioids, focus on the extensive use of tramadol may be essential. The current study indicates an excessive and not appropriately prescribed use of tramadol among Danish CNCP patients. In addition to being inappropriate, such use may also have an impact on the growing problem of an illicit Internet market for this drug. Thus, the situation must be taken seriously. The current study confirms the recent clinical guideline and the National Recommendations in Denmark, which emphasises the risks of problematic use of tramadol. The research may also be relevant in other comparable countries. Caution must especially be taken with CNCP patients with comorbidities like diabetes, lung disease, dementia, and osteoporosis.

Assessment of regional inter-basin groundwater flow using both simple and highly parameterized optimization schemes

The need for regional-scale integrated hydrological models for the purpose of water resource management is increasing. Distributed physically based coupled surface-subsurface models are usually complex and contain a large amount of spatio-temporal information that leads to a relatively long forward runtime. One of the main challenges with regard to regional-scale inverse modeling relates to parameterization and how to adequately exploit the information embedded in the existing observational data while avoiding parameter identifiability issues. This study examined and compared the calibration of a “highly parameterized” model with a “classical” unit-based parameterization scheme in which the dominant geological features were assumed to be known. The physically based coupled surface-subsurface model MIKE SHE was used for conducting the study of five river basins (4,900 km2) in central Jutland in Denmark, characterized by heterogeneous geology and a considerable amount of groundwater flux across topographical catchment boundaries. The results indicated that introducing more flexibility in the parameter estimation process through a regularized approach significantly improved the model performance, in particular head and water balance errors. The highly parameterized calibration results additionally provided very useful insights into the model deficiencies in terms of conceptual model structure and incorrectly imposed boundary conditions. Furthermore, the results from data-worth analysis indicated that the highly parameterized model has more effectively utilized the information in the dataset compared to a traditional unit-based calibration approach.

Spatial analysis and temporal trends of antimicrobial use in Danish pig herds following the introduction of the Yellow Card scheme

Spatial analysis and temporal trends of antimicrobial use in Danish pig herds following the introduction of the Yellow Card scheme

A web-based platform to accommodate symptoms of anxiety and depression by featuring social interaction and animated information in patients undergoing lumbar spine fusion: a randomized clinical trial

BACKGROUNDApproximately one-third of patients undergoing spine surgery have symptoms of anxiety and depression that correlate with pain, disability, and lower health-related quality of life. The use of web-based informative strategies before surgery and principles from cognitive behavioral therapy, have been applied in other patient groups, facilitating mobility and encouraging beneficial coping behavior. PURPOSETo examine the effect of a web-based Spine Platform featuring Interaction and Information by Animation (w-SPIINA) on symptoms of anxiety and depression, pain, disability, and health-related quality of life. STUDY DESIGNA single-center, two-arm, randomized controlled trial PATIENT SAMPLEOne hundred fourteen consecutive patients scheduled for instrumented lumbar spine fusion due to degenerative disc disease or spondylolisthesis. OUTCOME MEASURESPrimary outcome was the change in self-reported Hospital Anxiety and Depression Scale (HADS) scores from baseline to 3-month follow-up. Secondary outcomes were change in HADS 1-day before surgery 2days and 6 months after and changes in self-reported disability measured on the Oswestry disability index (ODI), quality of life (EQ-5D-5L questionnaire), and the low back pain rating scale (LBPRS) 2days and 3 and 6 months after surgery. METHODPatients were randomized to either a control group receiving a standard information regimen or an intervention group gaining access to w-SPIINA in addition to the standard regimen. The independent charity Helsefonden contributed $45,000, the Health Research Fund of the Regional Hospital Central Jutland contributed $10,000, and the Toyota foundation contributed $10,000 to remunerate a dedicated investigator. The authors have no conflict of interest to declare. RESULTSThere was no statistically significant difference within the w-SPIINA group and the control group regarding changes in HADS at 3-month follow-up (p≥.37). Approximately 40% reached minimum clinically important difference (MCID) in the w-SPIINA group on the HADS at 3 months. In the control group 50% reached MCID on anxiety subscale and 35% on the depression subscale at 3 months. No statistically significant differences were found between groups with regard to the overall outcomes at any of the predefined time points. CONCLUSIONProviding patients with access to w-SPIINA in addition to a standard information regimen had no additional effect on HADS and patient-reported outcomes1day before, 2days, 3 or 6 months after surgery. However, a high compliance and degree of interaction with w-SPIINA indicates that this mode of web-based support could be applicable in this group of patients.

Fire conditions and source materials recorded in scoria from an intentional fire at Store Tovstrup Iron Age house, Central Jutland, Denmark

The composition, mineralogy, and textures preserved in scoria from ancient fires provide constraints on the firing temperature, the source and nature of the fire, and its potential social and cultural implications. Analyses of four scoria fragments preserved in a posthole of an Iron Age longhouse at Store Tovstrup, West Denmark, by scanning electron microscopy, electron microprobe, and laser ablation ICP-MS show these to consist of rounded quartz and orthoclase grains, gas vesicles, and carbonaceous material bonded together by a silicate- and potassium-rich (SiO2 67–69 wt% and K2O 11–14 wt%) melt (now glass). Given the presence of vesicles and carbonaceous material, the fire is indicated to have occurred under restricted air-flow and to have involved decomposition of biomass and soil. The initiation of melting occurred during what was presumably an event of short duration. Simplified ternary phase equilibria point to localized melting initiated around 700–800 °C and continuing to about 1000 °C. The main structure succumbed to char at lower temperatures. Calculations suggest that a mixture of 50% sandy soil, 41% barley straw, and 9% oak branches best explains the low Al2O3, Fe2O3, and Na2O concentrations in the melt phase. The scoria at Store Tovstrup most likely originated from a short duration burning with restricted air-flow resulting in the collapse and charring of daub walls. The fire was intentional and set after the house had been cleared of household goods.