Predictors and outcomes in primary depression care (POKAL) – a research training group develops an innovative approach to collaborative care

BACKGROUND: The interdisciplinary research training group (POKAL) aims to improve care for patients with depression and multimorbidity in primary care. POKAL includes nine projects within the framework of the Chronic Care Model (CCM). In addition, POKAL will train young (mental) health professionals in research competences within primary care settings. POKAL will address specific challenges in diagnosis (reliability of diagnosis, ignoring suicidal risks), in treatment (insufficient patient involvement, highly fragmented care and inappropriate long-time anti-depressive medication) and in implementation of innovations (insufficient guideline adherence, use of irrelevant patient outcomes, ignoring relevant context factors) in primary depression care. METHODS: In 2021 POKAL started with a first group of 16 trainees in general practice (GPs), pharmacy, psychology, public health, informatics, etc. The program is scheduled for at least 6 years, so a second group of trainees starting in 2024 will also have three years of research-time. Experienced principal investigators (PIs) supervise all trainees in their specific projects. All projects refer to the CCM and focus on the diagnostic, therapeutic, and implementation challenges. RESULTS: The first cohort of the POKAL research training group will develop and test new depression-specific diagnostics (hermeneutical strategies, predicting models, screening for suicidal ideation), treatment (primary-care based psycho-education, modulating factors in depression monitoring, strategies of de-prescribing) and implementation in primary care (guideline implementation, use of patient-assessed data, identification of relevant context factors). Based on those results the second cohort of trainees and their PIs will run two major trials to proof innovations in primary care-based a) diagnostics and b) treatment for depression. CONCLUSION: The research and training programme POKAL aims to provide appropriate approaches for depression diagnosis and treatment in primary care

Analysis of Epithelial and Mesenchymal Markers in Ovarian Cancer Reveals Phenotypic Heterogeneity and Plasticity

Peer reviewe

Integrating Frames, Rules and Uncertainty in a Database-Coupled Knowledge-Representation System

This paper describes a knowledge-representation system IFS (Intelligent Framework Services) being developed as a part of the JESSI CommonFrame project. The system is based on a combination of frames and rules, which are integrated through the object-oriented view with multiple approaches to uncertainty processing, and coupled to an object-oriented database. Keywords: knowledge representation, object-oriented paradigm, frames, rules, uncertain knowledge, uncertainty processing, KBS -- DB coupling 1 Introduction Knowledge-based and knowledge-representation systems belong to the most intensively developing areas of computer science. Their development is a crossroad of many different approaches and paradigms -- logic, theory of probability, semantic networks, frames and scripts, production systems and artificial neural networks being only several important among them. On the other hand, their development is at the same time a supply of real problems, such as the mappings between knowledg..

SSIOUX – Space simulation for investigating organics, evolution and exobiology

Ground based experiments, conducted in advanced space environment simulation facilities, complement the exo/astrobiological experiments in Low Earth Orbit (LEO). For example, the in-orbit ESA-facility EXPOSE on the International Space Station ISS can only accommodate a limited number of experiments for exposure to the space parameters high vacuum, intense radiation of galactic and solar origin and microgravity. Ground based experiments in carefully equipped and monitored simulation facilities allow necessary experiment preparation and additional investigation of a much wider variety of samples. In the ESA accepted experiment SSIOUX, ESA-RA-LS-01-PREP, an international consortium of 14 prime investigators will expose organic compounds and a wide range of microorganisms, from bacterial spores to complex microbial communities, to simulated space environment parameters in pursuit of exobiological questions on their resistance to space environment and the origin and distribution of life. The experiments will be conducted in the Planetary and Space Simulation Facilities of the Institute of Aerospace Medicine at DLR in Köln, Germany, where the simulated space parameters vacuum with controlled residual composition, ionizing radiation, polychromatic UV radiation and selected UV ranges from vacuum-UV to UVA, VIS and IR or individual monochromatic UV wavelengths, and temperature control at the sample site are provided individually or in selected combinations in 9 facilities of varying sizes. Parameters are constantly measured and data are available in real time online during the exposure. Experiments in these facilities discriminate between the effects of individual space parameters and selected combinations. In addition, they serve as ground experiments defining interesting and suitable biological samples for future space experiments and compliment the data of executed space experiments and those in progress. As 1 x g controls, they also enable the identification of microgravity effects when compared to the space experiments. Here, the SSIOUX consortium and their experiments will be presented as well as the ground based Planetary and Space Simulation Facilities at DLR. The results of the SSIOUX experiments will be directly comparable and are designed to lead to further understanding of adaptation and evolution of life