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Henrik Schou Pedersen,1,2 Kaj Sparle Christensen,1,2 Anders Prior1,2 1Research Unit for General Practice, Aarhus, Denmark; 2Department of Public Health, Aarhus University, Aarhus, DenmarkCorrespondence: Henrik Schou Pedersen, Research Unit for General Practice, Bartholins Allé 2, Aarhus, 8000, Denmark, Email henrikp@ph.au.dkObjective: Most mental disorders are diagnosed and treated in general practice. Psychometric tests may help the general practitioner diagnose and treat mental disorders like dementia, anxiety, and depression. However, little is known about the use of psychometric tests in general practice and their impact on further treatment. We aimed to assess the use of psychometric tests in Danish general practice and to estimate whether variation in use is associated with the provided treatment and death by suicide in patients.Methods: This nationwide cohort study included registry data on all psychometric tests performed in Danish general practice in 2007– 2018. We used Poisson regression models adjusted for sex, age, and calendar time to assess predictors of use. We used fully adjusted models to estimate the standardized utilization rates for all general practices.Results: A total of 2,768,893 psychometric tests were used in the study period. Considerable variations were observed among general practices. A positive association was seen between a general practitioner’s propensity to use psychometric testing and talk therapy. Patients listed with a general practitioner with low use had an increased rate of redeemed prescriptions for anxiolytics [incidence rate ratio (95% confidence interval):1.39 (1.23;1.57)]. General practitioners with high use had an increased rate of prescriptions for antidementia drugs [1.25 (1.05;1.49)] and first-time antidepressants [1.09 (1.01;1.19)]. High test use was seen for females [1.58 (1.55; 1.62)] and patients with comorbid diseases. Low use was seen for populations with high income [0.49 (0.47; 0.51)] and high educational level [0.78 (0.75; 0.81)].Conclusion: Psychometric tests were used mostly for women, individuals with a low socioeconomic status, and individuals with comorbid conditions. The use of psychometric tests depends on general practice and is associated with talk therapy, redemptions for anxiolytics, antidementia drugs, and antidepressants. No association was found between general practice rates and other treatment outcomes.Keywords: psychometric tests, registries, general practice, mental disorders, treatment variation

Kristina Laugesen,1 Jonas Mengel-From,2,3 Kaare Christensen,2– 4 Jørn Olsen,1 David M Hougaard,5,6 Lasse Boding,7 Anja Olsen,8,9 Christian Erikstrup,10 Merete Lund Hetland,11,12 Estrid Høgdall,12,13 Alisa D Kjaergaard,14 Erik Sørensen,15 Anja Brügmann,16 Eva Rabing Brix Petersen,17 Ivan Brandslund,17,18 Børge G Nordestgaard,19 Gorm B Jensen,20 Nils Skajaa,1 Frederikke Schønfeldt Troelsen,1 Cecilia Hvitfeldt Fuglsang,1 Lise Skovgaard Svingel,1 Henrik T Sørensen1 1Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; 2Epidemiology, Biostatistics and Biodemography, the Danish Twin Registry, and the Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark; 3Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; 4Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark; 5iPSYCH, Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark; 6Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark; 7The Danish National Biobank, Statens Serum Institut, Copenhagen, Denmark; 8Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark; 9Department of Public Health, Aarhus University, Aarhus, Denmark; 10Department of Clinical Immunology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 11The DANBIO Registry and Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark; 12Department of Clinical Medicine, University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark; 13Bio- and GenomeBank Denmark (RBGB), Molecular Unit, Department of Pathology, Herlev Hospital, Herlev, Denmark; 14Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark; 15Department of Clinical Immunology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; 16Department of Pathology, Aalborg University Hospital, Aalborg, Denmark; 17Department of Clinical Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark; 18Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark; 19The Copenhagen General Population Study, Department of Clinical Biochemistry, Copenhagen University Hospital – Herlev Gentofte, University of Copenhagen, Herlev, Denmark; 20The Copenhagen City Heart Study, Frederiksberg and Bispebjerg Hospital, Frederiksberg, DenmarkCorrespondence: Kristina Laugesen, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus, 8200, Denmark, Tel +45 871 68063, Email Kristina.laugesen@clin.au.dkAbstract: Biobank research may lead to an improved understanding of disease etiology and advance personalized medicine. Denmark (population ~5.9 million) provides a unique setting for population-based health research. The country is a rich source of biobanks and the universal, tax-funded healthcare system delivers routinely collected data to numerous registries and databases. By virtue of the civil registration number (assigned uniquely to all Danish citizens), biological specimens stored in biobanks can be combined with clinical and demographic data from these population-based health registries and databases. In this review, we aim to provide an understanding of advantages and possibilities of biobank research in Denmark. As knowledge about the Danish setting is needed to grasp the full potential, we first introduce the Danish healthcare system, the Civil Registration System, the population-based registries, and the interface with biobanks. We then describe the biobank infrastructures, comprising the Danish National Biobank Initiative, the Bio- and Genome Bank Denmark, and the Danish National Genome Center. Further, we briefly provide an overview of fourteen selected biobanks, including: The Danish Newborn Screening Biobank; The Danish National Birth Cohort; The Danish Twin Registry Biobank; Diet, Cancer and Health; Diet, Cancer and Health – Next generations; Danish Centre for Strategic Research in Type 2 Diabetes; Vejle Diabetes Biobank; The Copenhagen Hospital Biobank; The Copenhagen City Heart Study; The Copenhagen General Population Study; The Danish Cancer Biobank; The Danish Rheumatological Biobank; The Danish Blood Donor Study; and The Danish Pathology Databank. Last, we inform on practical aspects, such as data access, and discuss future implications.Keywords: biobank, research, healthcare system, registries, epidemiology, precision medicine

Lau Caspar Thygesen,1 Kaare Christensen,2 Mikael Rørth,3,4 Henrik Toft Sørensen,3,4 Jan P Vandenbroucke,3,5,6 Rudi GJ Westendorp7 1National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; 2The Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark; 3Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; 4Aarhus University Hospital, Aarhus, Denmark; 5Department of Medical Statistics and Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; 6Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands; 7Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Lau Caspar ThygesenNational Institute of Public Health, University of Southern Denmark, Studiestræde 6, Copenhagen, DK-1455, DenmarkTel +45 65 50 77 71Email lct@sdu.dkAbstract: Aging of the population is a pressing challenge for healthcare systems and knowledge of a patient’s prognosis is a key to shaping effective interventions. As the prevalence of multimorbidity strongly increases with age, the prognostic value of multiple disease diagnoses for survival among older people may diminish, whereas other measures of health, such as functional status (defined as a measure of an individual’s ability to perform activities of daily living), may become more important. In this commentary, the impact of age on the prognostic value of multimorbidity is discussed, with the aim of identifying relevant alternative risk indicators for different age groups. The key question is to determine at what age the prognostic value of multimorbidity for meaningful clinical outcomes decreases and is overridden by the prognostic value of functional status. This tipping point likely depends on age, calendar time, and birth cohort. The public health and clinical implications of these tipping points are important. Among younger and middle-aged persons, interventions could be directed towards prevention and treatment of specific diseases, while among older persons efforts should focus more on improving functional levels that include physical, emotional, and social dimensions.Keywords: chronic disease, health services, public health, aged, multimorbidity

Spiders have become a model group for sexual selection and mating system studies, but our understanding of courtship behavior in the group is heavily biased towards the infraorder Araneomorphae ('modern' spiders, such as orb weavers, jumping spiders, wolf spiders, crab spiders and many more). In the Mygalomorphae (tarantulas, trapdoor spiders, funnel‐web spiders and relatives), only a few descriptions of courtship are available and recent developments in the phylogenetics of the group offer an opportunity to remap and investigate the evolution of mating behaviors. Using 81 trials filmed in captivity, we report on the courtship behaviors of the iconic Sydney funnel‐web spider (Atracidae: Atrax robustus), which belongs to a large clade of biologically understudied mygalomorphs. Thirteen distinct behaviors are described for males, out of which at least two seem new to mygalomorphs, while four female behaviors are described. Moreover, the sequences of male behaviors are presented for when they come into contact with females inside or outside of their burrows. The mating positions of the pair, including details of how males use their legs and clasping spurs to grasp the females, are also presented. We discuss our results in a modern phylogenetic context, filling a gap in the understanding of sexual selection in the Mygalomorphae where such studies are rare and biased towards tarantulas. Finally, we attempt to consolidate descriptions of potentially homologous behaviors from several families in the group and offer insights into the evolution of cannibalism, male clasping spurs and female catalepsis (quiescence while mating). [ABSTRACT FROM AUTHOR]

Sand patches are one of the precursors to early stage protodunes and occur widely in both desert and coastal aeolian environments. Here we show field evidence of a mechanism to explain the initiation of sand patches on non‐erodible surfaces, such as desert gravels and moist beaches. Changes in sand transport dynamics, directly associated with the height of the saltation layer and variable transport law, observed at the boundary between non‐erodible and erodible surfaces lead to sand deposition on the erodible surface. This explains how sand patches can form on surfaces with limited sand availability where linear stability of dune theory does not apply. This new mechanism is supported by field observations that evidence both the change in transport rate over different surfaces and in situ patch formation that leads to modification of transport dynamics at the surface boundary. Plain Language Summary: Sand patches can be observed in various environments such as beaches and gravel plains in deserts. Expected to be precursors of dunes when sediment supply is limited, these bedforms are typically a few centimeters high and present a reverse longitudinal elevation profile, with a sharp upwind edge and a smooth downwind tail. Based on field measurements, we propose a formation mechanism for these patches associated with the sensitive nature of wind‐blown sand transport to changing bed conditions: sand saltation is reduced at the transition from a solid to an erodible surface, hence favoring deposition on the patches. This allows us to explain their typical meter‐scale length as well as their asymmetric shapes. Key Points: Sand patches can emerge on non‐erodible surfacesDiffering surfaces characteristics control particle behaviorField measurements demonstrate the key role of sand transport in bedform initiation [ABSTRACT FROM AUTHOR]