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Was ist neu? Risikofaktoren für eine gastrointestinale Ulkusblutung Die Helicobacter-pylori-Gastritis (H. pylori-Gastritis) und die Therapie mit nicht steroidalen Antirheumatika (NSAR) sind die wichtigsten Risikofaktoren für die Entstehung eines peptischen Ulkus (PUD) und einer Ulkusblutung. Eine Infektion mit H. pylori erhöht das Risiko einer Ulkusblutung bei Patienten mit PUD, die NSAR, Aspirin oder einen anderen Plättchen-Aggregationshemmer einnehmen. H. pylori-positive Patienten unter kombinierter Plättchen-Aggregationshemmung tragen das höchste Blutungsrisiko. Evidenzbasierte interdisziplinäre Behandlungsempfehlungen zur sicheren NSAR-Anwendung aus dem Jahr 2020 berücksichtigen sowohl das kardiovaskuläre als auch das gastrointestinale Risikoprofil der einzelnen Patienten. Für Patienten mit einem moderaten Risiko für die Entstehung eines PUD wird die Therapiekombination aus NSAR und Protonen-Pumpen-Inhibitoren (PPI) oder eine Monotherapie mit selektiven COX-2-Inhibitoren (COX-2: Cyclooxygenase-2) empfohlen. Patienten mit einem hohen Blutungsrisiko dagegen sollten eine Kombinationstherapie aus selektivem COX-2-Inhibitor und PPI erhalten. Bei Patienten mit einem hohen kardiovaskulären Risiko, bei denen auf eine NSAR-Therapie nicht verzichtet werden kann, werden Naproxen oder Celecoxib empfohlen. Die Behandlung der gastrointestinalen Ulkusblutung Die Ulkusblutung geht mit einer erhöhten Letalität einher. Bei hämodynamisch stabilen Patienten mit Zeichen einer oberen gastrointestinalen Blutung und erhöhtem Sterberisiko (Glasgow-Blatchford Score ≥ 12) ist die Durchführung einer Ösophago-Gastro-Duodenoskopie (ÖGD) nach 6–24 Stunden ausreichend, eine Notfall-ÖGD (innerhalb der ersten 6 Stunden) verbessert vergleichsweise die 30-Tage-Letalität nicht. Nach erfolgreicher endoskopischer Hämostase reduziert eine zusätzliche prophylaktische angiografische Embolisation das Risiko einer erneuten Blutung nicht. Die Helicobacter-pylori-Eradikation Eine erfolgreiche H. pylori-Eradikation reduziert das Risiko für die Entwicklung eines Magenkarzinoms bei Verwandten ersten Grades von Patienten mit Magenkarzinom um 73 %. Bei Patienten mit erfolgreicher endoskopischer Behandlung eines Magenfrühkarzinoms ist eine H. pylori-Testung mit anschließender Eradikation ebenfalls sinnvoll, da hierdurch die Rate an metachronen Magenkarzinomen halbiert werden konnte. Die Standard-Triple-Therapie zu der H. pylori-Eradikation zeigt aufgrund zunehmender Antibiotikaresistenzen, insbesondere gegen Makrolide, eine nachlassende Wirksamkeit. Dementsprechend wird die Bismut-haltige Quadrupel-Therapie als empirische Standard-Erstlinientherapie empfohlen.

We study the regularity of solutions of the Poisson equation with Dirichlet, Neumann and mixed boundary values in polyhedral cones [Formula: see text] in the specific scale [Formula: see text] of Besov spaces. The regularity of the solution in these spaces determines theorder of approximation that can be achieved by adaptive and nonlinear numerical schemes. We aim for a thorough discussion of homogeneous and inhomogeneous boundary data in all settings studied and show that the solutions are much smoother in this specific Besov scale compared to the fractional Sobolev scale [Formula: see text] in all cases,which justifies the use of adaptive schemes.

To support the increasing number of older people, new (assistive) technologies are constantly being developed. For these technologies to be used successfully, future users need to be trained. Due to demographic change, this will become difficult in the future, as the resources for training will no longer be available. In this respect, coaching robots could have great potential to support younger seniors in particular. However, there is little evidence in the literature about the perceptions and potential impact of this technology on the well-being of older people. This paper provides insights into the use of a robot coach (robo-coach) to train younger seniors in the use of a new technology. The study was carried out in Austria in autumn 2020, involving 34 participants equally distributed among employees in their last three years of service and retirees in their first three years of retirement (23 female; 11 male). The aim was to assess participants’ expectations and perceptions by examining the perceived ease of use and user experience of the robot in providing assistance during a learning session. The findings reveal a positive impression of the participants and promising results for using the robot as a coaching assistant in daily tasks.

Due to population aging, the need for home care has increased. This leads not only to staff shortages, but also to planning challenges for care organizations. Rescheduling home visits places a strain on everyone involved in care provision. Above all, it is a difficulty for care-service users and their relatives that the only way of getting information about changes in care visits is to call the care organization. These additional phonecalls add to the stress ofcare workers. This paper presents an ICT service that allows home-care service users to request the arrival time for a care worker’s next visit using a voice-based approach. The voice-supported service, ‘notification of care workers’ arrival time’, uses two-stage data processing to predict the time of the visit the closer it gets. In the first step, staff-scheduling data is used; in the second step, the data is enriched with the individual care worker’s current movement data. This approach was tested in a pilot in 2021 and validated using data for 174 care-service users and 26 care workers. Improvements for future research aresuggested.

"An infinite number of fitness apps are available on various app stores. However, hardly any of them are fitted to the needs and requirements of care-dependent peo-ple. This paper investigates the effectiveness of a customised fitness-app prototype for increasing physical activity in home care service users. Home care service users from Austria and Italy were randomly assigned to two groups. In total, 216 partici-pants were involved in the field trial, 104 received a tablet with the fitness app and an activity tracker (treatment group), 112 did not (control group). Regularity of physical activity, frequency of fitness exercises and walking behaviour were self- reported by participants at baseline, after 4 months and after 8 months. In addition, the frequency of using the prototype was assessed based on the fitness app's logged usage data. We estimated multilevel mixed-effects ordered logistic models to examine the effects of the intervention. After 4 months, the intervention increased the home care users’ probability of agreeing strongly with being physically active on a regular basis by 28 percentage points (p< 0.001; 95% CI: 0.20, 0.36) and their probability of reporting to exercise more than once a week by 45 percentage points (p< 0.001; 95% CI: 0.32, 0.57). Walking behaviour was not affected on group- level but improved for frequent users of the activity tracker. Frequent and regular users of the fitness app benefited most and effects persisted until the end of the 8 months controlled trial. Tailoring a fitness-app prototype to the needs of care-dependent people has the potential to support people with functional limitations to engage in a more active lifestyle. Future research is encouraged to seek further insights into how new technologies can sup-port physical activities in people with long-term care needs."

Removing cellular material from a tissue, a process called decellularization, reduces the risk of adverse host reactions, allows for efficient decontamination, and extends the shelf-life of the matrix. It facilitates the use of cartilage tissue as human-derived allograft, thus providing the field of cartilage regeneration with a biomaterial unmatched in its similarity to native cartilage in terms of structure, composition, and mechanical properties.The dense extracellular matrix of articular cartilage requires a particularly thorough process to achieve the removal of cells, cell debris, and reagents used in the process. In our studies (Nürnberger et al., EBioMedicine 64:103196, 2021; Schneider et al., Tissue Eng Part C Methods 22(12):1095-1107, 2016), we have successfully developed a protocol for achieving decellularization via physical, chemical, and enzymatic steps. Combining freeze-thaw cycles for devitalization, hydrochloric acid as decellularization agent and the enzymatic removal of glycosaminoglycans, results in an acellular scaffold that is fully biocompatible and promotes cellular attachment. The structure and sophisticated architecture of collagen type II is left intact.This chapter provides a comprehensive guide to the steps and reagents needed to decellularize articular cartilage. In addition to the standard decell-deGAG protocol, a fast option is given which is suitable for thin specimen. Histological evaluation is presented to illustrate treatment success.

We study approximation classes for adaptive time-stepping finite element methods for time-dependent partial differential equations. We measure the approximation error in $L_2([0,T)\times \varOmega )$ and consider the approximation with discontinuous finite elements in time and continuous finite elements in space, of any degree. As a by-product we define anisotropic Besov spaces for Banach-space-valued functions on an interval and derive some embeddings, as well as Jackson- and Whitney-type estimates.

Helicobacter pylori (H. pylori) gastritis and non-steroidal anti-inflammatory drug (NSAID) intake are the most important risk factors for peptic ulcer disease (PUD) and ulcer bleeding. H. pylori infection was shown to increase the risk of ulcer bleeding in patients with PUD who are taking NSAID, aspirin, or another antiplatelet drug. H. pylori-positive patients on combined platelet aggregation inhibition are at the highest risk of bleeding. Evidence-based interdisciplinary treatment recommendations for the safe use of NSAID have been released. For patients with a moderate risk of PUD, the combination of NSAID and a proton pump inhibitor (PPI) or a monotherapy with a selective cyclooxygenase-2 (COX-2) inhibitor is recommended, whereas patients with a high risk of bleeding should receive a combination of a selective COX-2 inhibitor and a PPI. According to a recent randomized trial, hemodynamically stable patients with signs of upper gastrointestinal bleeding and an increased risk of death (Glasgow-Blatchford Score ≥ 12) undergoing endoscopy 6-24 after consultation do not have any disadvantage in terms of 30-day mortality compared to patients receiving endoscopy within 6 hours. After successful endoscopic hemostasis, additional prophylactic angiographic embolization does not reduce the risk of recurrent bleeding. Successful H. pylori eradication reduces the risk of developing gastric cancer (GC) in first-degree relatives of patients with GC by 73 %. In patients with successful endoscopic treatment of early GC, H. pylori testing with subsequent eradication also halves the rate of metachronous GC. Clarithromycin-based triple therapy for H. pylori eradication shows a decreasing effectiveness due to increasing antibiotic resistance, especially against macrolides. Accordingly, bismuth-containing quadruple therapy is widely recommended as the standard empiric first-line therapy.RISIKOFAKTOREN FüR EINE GASTROINTESTINALE ULKUSBLUTUNG: Die

This paper is concerned with the regularity of solutions to linear and nonlinear evolution equations extending our findings in [22] to domains of polyhedral type. In particular, we study the smoothness in the specific scale $B^r_{\tau,\tau}$, $\frac{1}{\tau}=\frac rd+\frac 1p$ of Besov spaces. The regularity in these spaces determines the approximation order that can be achieved by adaptive and other nonlinear approximation schemes. We show that for all cases under consideration the Besov regularity is high enough to justify the use of adaptive algorithms., Comment: arXiv admin note: substantial text overlap with arXiv:1811.09428

Nina L Wittwer,1,2 Christoph R Meier,1– 3 Carola A Huber,4 Henriette E Meyer zu Schwabedissen,1 Samuel Allemann,1,&ast; Cornelia Schneider1,2,&ast; 1Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland; 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland; 3Boston Collaborative Drug Surveillance Program, Lexington, MA, USA; 4Department of Health Sciences, Helsana Insurance Group, Zürich, Switzerland&ast;These authors contributed equally to this workCorrespondence: Samuel Allemann, Pharmaceutical Care Research Group University of Basel, Department of Pharmaceutical Sciences, Klingelbergstrasse 50, Basel, 4056, Switzerland, Tel +41 61 207 61 76, Email s.allemann@unibas.chPurpose: In Switzerland 167 drugs on the market contain information about pharmacogenetics in their drug label (PGx drug). Preemptive pharmacogenetic testing is reimbursed by health care insurance for only seven drugs (abacavir, carbamazepine, 6-mercaptopurine, azathioprine, 5-fluorouracil, capecitabine, and irinotecan) although, it is proposed to be a cost-effective approach to personalized medicine. The aim of this study was to describe the use of PGx drugs and their corresponding genes in Switzerland.Methods: We identified 90 drugs with dosing recommendations from the Pharmacogenetic Knowledgebase involving 24 genes. We assessed the utilization of those drugs between 2016 and 2020, using claims data from a large Swiss insurance company (Helsana).Results: Of 841 491 persons with drug claims during the whole study period, 78.7% were exposed to PGx drugs. Ibuprofen, pantoprazole, and tramadol had the highest number of users. Seven genes (CYP2C19, CYP2C9, CYP2D6, SLCO1B1, HLA-B, MT-RNR1, and VKORC1) were responsible for over 95% of all potential drug-gene interactions.Conclusion: The prevalence of PGx drug prescriptions is high in the Swiss population. Therefore, intensified preemptive testing may be a useful option as a substantial amount of the Swiss population might benefit.Keywords: PGx, drug use, claims data, pharmacoepidemiology

ZusammenfassungIn den nächsten Jahren gehen geburtenstarke Jahrgänge in Pension. Dadurch steigt der Bedarf an alters- und bedarfsgerechten digitalen Lösungen für diese mittlerweile technikvertrautere Zielgruppe. Soziale Roboter bieten hier eine Möglichkeit der digitalen Unterstützung. Dieser Beitrag beschäftigt sich mit einem Kriterienkatalog, der eine systematische Auswahl von sozialen Robotern ermöglicht.

ZusammenfassungFitness-Apps gibt es viele. Auf die Bedürfnisse älterer Menschen sind nur wenige zugeschnitten. Dieser Beitrag stellt den Innovationsprozess vor, der die Entwicklung des app-basierten Bewegungsprogramms für älterer Menschen „Fit-mit-ILSE“ geleitet hat. Von der Idee bis zum Prototyp werden jene Schritte beschrieben, die zu richtungsweisenden Impulsen durch potenzielle Nutzer*innen für die Entwicklung von „Fit-mit-ILSE“ führten.

Deterioration of diabetes control can be the first harbinger of pancreatic cancer. However, little is known about how to distinguish patients with pancreatic cancer-related diabetes deterioration from those with type 2 diabetes progression. We aimed to characterize the glycated hemoglobin (HbAUsing data from the UK-based Clinical Practice Research Datalink (CPRD) GOLD, we established a study population including pancreatic cancer patients with diabetes deterioration in the0.5-3 years before the cancer diagnosis and non-cancer patients with deterioration of type 2 diabetes (comparison group). Patients were considered to have diabetes deterioration if their glucose-lowering treatment was intensified. We characterized the longitudinal trajectories of HbAThe mean absolute increase in HbAPancreatic cancer-related diabetes deterioration may frequently be characterized by pronounced increases in HbA

The identification and application of biomarkers in the clinical and medical fields has an enormous impact on society. The increase of digital devices and the rise in popularity of health-related mobile apps has produced a new trove of biomarkers in large, diverse, and complex data. However, the unclear definition of digital biomarkers, population groups, and their intersection with traditional biomarkers hinders their discovery and validation. We have identified current issues in the field of digital biomarkers and put forth suggestions to address them during the DayOne Workshop with participants from academia and industry. We have found similarities and differences between traditional and digital biomarkers in order to synchronize semantics, define unique features, review current regulatory procedures, and describe novel applications that enable precision medicine.

Objectives To evaluate the potential of blood glucose levels and weight change before the onset of diabetes as predictors of pancreatic cancer among subjects with new-onset diabetes, that is, cancer-related diabetes versus normal type 2 diabetes. Methods We conducted a case-control study among subjects with new diabetes in the United Kingdom-based Clinical Practice Research Datalink. Cases were pancreatic cancer subjects with diabetes for ≤2 years before the cancer diagnosis (i.e., cancer-related diabetes). Controls were cancer-free, type 2 diabetic subjects matched to cases on age, sex, and diabetes duration. We calculated adjusted odds ratios (aORs) for pancreatic cancer as a function of both weight change and blood glucose before the onset of diabetes. Results Weight loss of 10.0%–14.9% at diabetes onset was associated with an aOR for pancreatic cancer of 3.58 (95% CI 2.31–5.54), loss of ≥15.0%, with an aOR of 4.56 (95% CI 2.82–7.36), compared with stable weight. Blood glucose levels of ≤5.1 mmol/L or 5.2–5.6 mmol/L before diabetes onset were associated with an increased risk of a pancreatic cancer diagnosis, with aORs of 2.42 (95% CI 1.60–3.66) and 2.20 (95% CI 1.45–3.35), respectively, when compared with blood glucose levels ≥6.3 mmol/L within >2–3 years before cancer detection. Conclusions Weight loss as well as blood glucose levels in the normal range (and thus rapid development of hyperglycemia) before diabetes onset may be predictive of pancreatic cancer-related diabetes and may help target which subjects with new diabetes to refer for pancreatic cancer screening examinations.

We study traces on the boundary of generalized smoothness Morrey spaces on C k domains Ω . These spaces are equipped with three parameters s , p , q and a function parameter φ . Our results remain valid for the usual Besov–Morrey spaces N u , p , q s ( Ω ) , Triebel–Lizorkin–Morrey spaces E u , p , q s ( Ω ) , and Triebel–Lizorkin type spaces F p , q s , τ ( Ω ) , which are all included in our scales as special cases. Moreover, to complete our investigation, we also study traces of Besov-type spaces B p , q s , τ ( Ω ) , which are not covered by our approach and give some applications in terms of a priori estimates generalizing results from El Baraka (2005).

There is evidence that training for strength and balance prevents decline in physical function in old age when the training is personally instructed. It is an open question whether interventions that deliver training via up-to-date technologies can achieve long-term effects. This study examined the effects of an 8-month fitness training program delivered via information and communication technology (ICT) on lower-body strength and balance in female home care users (n = 72) aged 75 years on average. For statistical analysis, the test group was divided into two subgroups, one who used the program at least 8 times per month (n = 26) and another one who used the program less often (n = 17) compared with a control group that received no exercise program (n = 29). It was found that regular ICT-exercisers exhibited positive effects over time on lower-body strength and balance compared to a decrease in both indicators in irregular exercisers and the control group. The authors see potential in offering exercise programs to people of advanced age via ICT to counteract physical decline in old age.

BACKGROUND The ageing worldwide population involves an increase of multiple chronic diseases and the consequent demand for healthcare services by older people, thus challenging the healthcare systems’ sustainability and older people’s quality of life. In order to postpone older adults’ need for care, the promotion of healthy ageing is a key action that can be favored today by embodied conversational agents. Nevertheless, the role and benefit of this technology is still relatively ignored by the literature, especially when being applied to older workers and new retirees, and from a preventive perspective. OBJECTIVE This study wants to answer two research questions: 1) What are the user requirements of a virtual coaching based on an Embodied Conversational Agent for motivating older adults in transition to retirement to adopt a healthy lifestyle? 2) How could a virtual coaching system address the active and healthy ageing dimensions, especially during COVID-19 times? METHODS To answer the questions above, according to the User Centered Design approach, two-wave cross-national focus-groups with 60 end-users aged 55 and over and follow-up telephone interviews to 27 end-users were carried out in Austria, Italy and the Netherland between Spring 2019 and January 2021. Qualitative data were analysed through the Framework Analysis in order to highlight cross-country commonalities and national peculiarities. RESULTS End-users suggest the virtual coach motivates older workers and retirees to practice physical activity, maintain social contacts and provide them with practical activities to improve their mental and emotional well-being. It can be used every day based on users’ time, mood, family relationships and social condition. The embodied conversational agent should be reactive, customizable, expected to be expressive, sympathetic, not directive nor patronizing and its language should be appropriate, pleasant and motivating. The COVID-19 outbreak accelerated the acceptance of the system by increasing the users’ need for functions that boost community, physical and emotional well-being activities. CONCLUSIONS The study shows that the virtual coaching system can be one of the solutions that can best address the active and healthy ageing dimensions by suggesting activities that can improve individuals’ physical activity, mental well-being and socialisation. especially in the current worldwide epidemiological situation. Nevertheless, to be fully effective, it has to have a pleasant appearance and voice to motivate users without being patronising nor directive. Moreover, it should be customisable, yet non stigmatising, and should be able to adapt to the ageing process and to the evolution of the retirement transition.

Function spaces will play a major role in our later investigations in Parts I and II of this thesis. It is our intention in Chap. 2 to systematically study all relevant function spaces needed later on, which are of interest for their own sake. The material is presented according to our needs. In some parts we merely collect what is needed avoiding detailed proofs but providing references for further reading. At other places we develop the existing theory further and present new properties and tools for the function spaces. In this case, of course, we provide detailed proofs of our new results in order to shed light on the basic concepts and methods we pursue.

In the final chapter of this manuscript we turn our attention towards traces on submanifolds N in fractional Sobolev, Besov- and Triebel-Lizorkin spaces defined on noncompact Riemannian manifolds M. Here M is of dimension d and N of dimension k with k < d, respectively. Usually, these spaces are defined via geodesic normal coordinates. However, for our investigations we require more flexibility in the choice of coordinates and therefore rely on the results obtained in Chap. 2, where we studied which conditions are sufficient such that different local coordinates give equivalent norms and therefore yield the same spaces.

This chapter surveys the principal theoretical issues concerning the solving of partial differential equations (PDEs). In the first section we recall the notions of elliptic, parabolic, and hyperbolic PDEs, since we are going to study the regularity of solutions for all these types of equations in Chaps. 4– 6. In the subsequent sections we study weak formulations of our PDEs. In a weak formulation an equation is no longer required to hold absolutely and has instead weak solutions only with respect to certain ‘test functions’. We present the Lax-Milgram Theorem theorem which guarantees the existence and uniqueness of such a weak solution. In particular, it turns out that for elliptic problems with zero Dirichlet boundary conditions, the Sobolev spaces Open image in new window (and appropriate generalizations for parabolic and hyperbolic problems) are ‘good’ spaces among which we can look for weak solutions to a given PDE. Furthermore, we provide sufficient conditions on the coefficients of the involved differential operators and the functions on the right hand side of our equations, which guarantee the existence and uniqueness of a weak solution.

In this chapter we study linear hyperbolic equations (6.1.1) of second order on special Lipschitz domains according to Definition 2.1.8. For these kinds of equations regularity estimates in Kondratiev spaces were derived in which enable us to treat these equations in a similar way as the parabolic problems in Chap. 5.