Empowerment group therapy for refugees with affective disorders: results of a multi-center randomized controlled trial

Background Against the background of missing culturally sensitive mental health care services for refugees, we developed a group intervention (Empowerment) for refugees at level 3 within the stratified Stepped and Collaborative Care Model of the project Mental Health in Refugees and Asylum Seekers (MEHIRA). We aim to evaluate the effectiveness of the Empowerment group intervention with its focus on psychoeducation, stress management, and emotion regulation strategies in a culturally sensitive context for refugees with affective disorders compared to treatment-as-usual (TAU). Method At level 3 of the MEHIRA project, 149 refugees and asylum seekers with clinically relevant depressive symptoms were randomized to the Empowerment group intervention or TAU. Treatment comprised 16 therapy sessions conducted over 12 weeks. Effects were measured with the Patient Health Questionnaire-9 (PHQ-9) and the Montgomery–Åsberg Depression Rating Scale (MÅDRS). Further scales included assessed emotional distress, self-efficacy, resilience, and quality of life. Results Intention-to-treat analyses show significant cross-level interactions on both self-rated depressive symptoms (PHQ-9; F(1,147) = 13.32, p < 0.001) and clinician-rated depressive symptoms (MÅDRS; F(1,147) = 6.91, p = 0.01), indicating an improvement in depressive symptoms from baseline to post-intervention in the treatment group compared to the control group. The effect sizes for both scales were moderate (d = 0.68, 95% CI 0.21–1.15 for PHQ-9 and d = 0.51, 95% CI 0.04–0.99 for MÅDRS). Conclusion In the MEHIRA project comparing an SCCM approach versus TAU, the Empowerment group intervention at level 3 showed effectiveness for refugees with moderately severe depressive symptoms

Crystal Structures of Malonyl-Coenzyme A Decarboxylase Provide Insights into Its Catalytic Mechanism and Disease-Causing Mutations

Malonyl-coenzyme A decarboxylase (MCD) is found from bacteria to humans, has important roles in regulating fatty acid metabolism and food intake, and is an attractive target for drug discovery. We report here four crystal structures of MCD from human, Rhodopseudomonas palustris, Agrobacterium vitis, and Cupriavidus metallidurans at up to 2.3 Å resolution. The MCD monomer contains an N-terminal helical domain involved in oligomerization and a C-terminal catalytic domain. The four structures exhibit substantial differences in the organization of the helical domains and, consequently, the oligomeric states and intersubunit interfaces. Unexpectedly, the MCD catalytic domain is structurally homologous to those of the GCN5-related N-acetyltransferase superfamily, especially the curacin A polyketide synthase catalytic module, with a conserved His-Ser/Thr dyad important for catalysis. Our structures, along with mutagenesis and kinetic studies, provide a molecular basis for understanding pathogenic mutations and catalysis, as well as a template for structure-based drug design

Wake Vortices of Landing Aircraft, in High Performance Computing in Science and Engineering

As an unavoidable consequence of lift aircraft generate a pair of counter-rotating and long-lived wake vortices that pose a potential risk to following aircraft. The prescribed aircraft separations during landing to avoid wake vortex hazards contribute significantly to capacity restrictions of large airports. Severe encounters of wake vortices have also been reported during cruise. Wake vortex behavior is largely controlled by the prevailing meteorological conditions and the interaction with the ground. The most important meteorological parameters are ambient wind, wind shear, turbulence, and temperature stratification. The Deutsches Zentrum für Luft- und Raumfahrt (DLR) develops wake vortex advisory systems for airports and en route which aim at optimizing the air traffic with respect to the measured and predicted wake vortex behavior. As part of such systems simple probabilistic wake vortex prediction models are required that predict wake vortex behavior accurately, robust, and fast. Highly resolving large eddy simulations (LES) conducted on the SuperMUC supercomputer provide valuable insights in the physics of wake vortex behavior under various atmospheric conditions. These LES contribute indispensable guidance for the development of the real-time/fasttime wake vortex models

Enhanced Wake Vortex Decay in Ground Proximity Triggered by Plate Lines

From pilot reports, field measurements and numerical simulations, it is known that wake vortices may persist within the glide path in ground proximity, leading to an increased encounter risk. This paper aims to investigate wake vortex behaviour during final approach and landing to understand why landings can be safe nevertheless. Further, it is investigated whether and to which extent the installation of plate lines beyond the runway tails may further accelerate wake vortex decay and thus improve safety by reducing the number of wake vortex encounters

Enhanced Wake Vortex Decay in Ground Proximity Triggered by Plate Lines

The highest risk to encounter wake vortices prevails in ground proximity, where the vortices cannot descend below the glide path but tend to rebound due to the interaction with the ground surface. Weak crosswinds may compensate the self-induced lateral propagation of the upwind vortex, such that it may hover over the runway directly in the flight path of the following aircraft. With the installation of plate lines at distances of a few hundred meters from the runway threshold, vortex decay in ground proximity can be substantially accelerated. A new hybrid simulation method is employed to capture wake vortex evolution in ground proximity from early roll-up to final decay. The numerical simulations reveal the nature of the disturbances triggered by the plate line and of so-called end effects driven by the sudden loss of lift during touchdown. Field measurement data gathered during the campaigns WakeMUC at Munich airport and WakeOP at special airport Oberpfaffenhofen corroborate and complement the findings of the simulations. Experiments and simulations demonstrate that plate lines appreciably accelerate wake vortex decay and interfere favorably with the end effects. This way safety can be further increased during the flight phase with most reported encounters

Structural basis for the regulated protease and chaperone function of DegP

All organisms have to monitor the folding state of cellular proteins precisely. The heat-shock protein DegP is a protein quality control factor in the bacterial envelope that is involved in eliminating misfolded proteins and in the biogenesis of outer-membrane proteins. Here we describe the molecular mechanisms underlying the regulated protease and chaperone function of DegP from Escherichia coli. We show that binding of misfolded proteins transforms hexameric DegP into large, catalytically active 12-meric and 24-meric multimers. A structural analysis of these particles revealed that DegP represents a protein packaging device whose central compartment is adaptable to the size and concentration of substrate. Moreover, the inner cavity serves antagonistic functions. Whereas the encapsulation of folded protomers of outer-membrane proteins is protective and might allow safe transit through the periplasm, misfolded proteins are eliminated in the molecular reaction chamber. Oligomer reassembly and concomitant activation on substrate binding may also be critical in regulating other HtrA proteases implicated in protein-folding diseases