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There is evidence that anxiety and avoidance toward close relationships (i.e., insecure attachment orientations), as well as posttraumatic stress symptoms (PTSSs), are linked to a poor quality of life. The current study aimed to investigate the potential mediating effects of PTSSs on the associations between insecure attachment orientations and domains of quality of life. A convenience sample of 497 adults (375 females, 75.5%), ranging in age between 18 and 65 years old (M = 32.48, SD = 13.26), was recruited. Participants were administered self-report instruments assessing attachment anxiety and avoidance, PTSSs, and domains of quality of life, including physical health, psychological status, social relationships, and environment. A series of mediation analyses were performed to test the mediating role of PTSSs in the relationships between attachment orientations and domains of quality of life. Results showed that attachment anxiety was related to decreased levels of quality of life in all domains, and that their associations were mediated by PTSSs. Also, attachment avoidance was related to a worse quality of psychological status and social relationships, and PTSSs were a significant mediating variable in these associations. Prevention programs and clinical interventions focused on promoting effective strategies for managing distress might be critical in reducing the impact of distressing events on the quality of life of individuals with insecure attachment.

Mitogen-activated protein 3 kinase 7 (MAP3K7) encodes the ubiquitously expressed transforming growth factor β-activated kinase 1, which plays a crucial role in many cellular processes. Mutationsin the MAP3K7 gene have been linked to two distinct disorders: frontometaphyseal dysplasia type 2 (FMD2) and cardiospondylocarpofacial syndrome (CSCF). The fact that different mutations can induce two distinct phenotypes suggests a phenotype/genotype correlation, but no side-by-side comparison has been done thus far to confirm this. Here, we significantly expand the cohort and the description of clinical phenotypes for patients with CSCF and FMD2 who carry mutations in MAP3K7. Our findings support that in contrast to FMD2-causing mutations, CSCF-causing mutations in MAP3K7 have a loss-of-function effect. Additionally, patients with pathogenic mutations in MAP3K7 are at risk for (severe) cardiac disease, have symptoms associated with connective tissue disease, and we show overlap in clinical phenotypes of CSCF with Noonan syndrome (NS). Together, we confirm a molecular fingerprint of FMD2- versus CSCF-causing MAP3K7 mutations and conclude that mutations in MAP3K7 should be considered in the differential diagnosis of patients with syndromic congenital cardiac defects and/or cardiomyopathy, syndromic connective tissue disorders, and in the differential diagnosis of NS.

This article provides an overview of the psychological dynamics associated with torture and examines its consequences on the victims. Initially, we investigate the psychological processes driving torturers to engage in extreme violence and brutality. Central to this exploration are the concepts of dehumanization and desensitization, which allow torturers to emotionally distance themselves from their victims and enact their aggressive behaviors. We elucidate how dehumanization and desensitization are often associated with the presence of a disordered personality, such as psychopathy, antisocial personality disorder, and narcissistic personality disorder. Subsequently, we delve into the complex interplay of survival and defense mechanisms utilized by victims during the traumatic experience of torture. We examine how victims may form a traumatic bond with their tormentors as a coping mechanism for their physical and psychological suffering—a bond that may persist even after their release. This bond may manifest as a heteronomous will, in which victims continue to adhere to the torturer’s demands even after liberation, resulting in a deconstruction of their identity and a profound sensation of existing as “living dead.” This enduring bound can profoundly impact victims’ emotions, behaviors, and relationships, contributing to the onset of severe clinical conditions, with evidence showing increased prevalence of post-traumatic stress disorder, anxiety, depression, and somatic symptoms among survivors. Finally, we evaluate therapeutic interventions that have demonstrated effectiveness in treating individuals who have endured torture. Drawing from a diverse range of therapeutic approaches, such as psychodynamic psychotherapy, trauma-focused cognitive-behavioral therapy, narrative exposure therapy, and the wraparound approach, clinicians can address the multifaceted psychological needs of torture survivors. Through empathetic and respectful therapeutic interventions, torture victims can receive the necessary support to navigate through the processing of their traumatic experiences. Consequently, they can regain a sense of agency and restore their self-esteem, thereby progressing along the trajectory towards achieving healing and recovery.

Background: The Historical Clinical Risk Management-20 third version (HCR-20V3) is a semi-structured interview for the assessment of past, current, and prospective risk factors for violent behaviors. Accumulating research across various forensic and clinical populations, has found that the HCR-20V3 is a psychometrically robust measure. However, to our knowledge, there is limited data on the use of the HCR-20 among adolescents. This study sought to investigate the psychometric properties of the HCR-20V3 in an Italian teen sample. Methods: Sixty-one male teenagers, aged between 14 and 19, admitted to the Italian juvenile justice system were involved in the study. To assess convergent validity with measures of antisocial traits and personality impairments, the associations between the HCR-20V3, the Psychopathy Checklist: Youth Version (PCL:YV), and the Structured Clinical Interview for DSM-5-Alternative Model of Personality Disorders Module I (SCID-5-AMPD), were examined. Known group validity was assessed by comparing participants with and without recidivism at the 6- and the 12-month follow-up. Results: The HCR-20V3 showed good internal consistency: Cronbach’s alpha (risk presence) = .88; Cronbach’s alpha (risk relevance) .87. The split-half reliability was also good: Spearman-Brown (presence) = .92; Spearman-Brown (relevance) = .92) Convergent validity with the PCL:YV and the SCID-AMPD total score and domains were moderate-to-large in size (Pearson’s r range .34 to .83, and .49 to .69, respectively). Compared to participants who had not been reported for a new crime, those who had a recidivism at the 6- and 12-month follow-up showed higher, albeit non-significant, scores both in the presence (Mann-Whithney’s U = 133, p =.093; U = 243, p =.089, respectively) and the relevance items (U = 131, p =.083; U = 266, p =.185, respectively). Conclusions: Results suggest that the HCR-20V3 is a suitable measure for assessing risk of violence in the juvenile justice systems. Considering the lack of tools for assessing youth violent behavior, HCR-20V3 might significantly contribute to the assessment of critical risk factors for recidivism, potential targets for interventions, and response to treatment.

Therapist expertise is a complex, multifaceted, and continually evolving concept. Defining this construct and its constituent components can yield a substantial contribution to the field of psychotherapy, consequently enhancing the comprehension of the fundamental factors that underlie its effectiveness. Within this framework, the present research aimed at developing and assessing the psychometric properties of the Psychotherapy Expertise Questionnaire (PEQ), a self-report measure to assess therapist expertise. A sample of 260 psychotherapists of various theoretical orientations were involved in this research. They completed a survey that included the PEQ as well as other self-reported measures aimed at evaluating personality traits, self-efficacy, self-esteem, and insight orientation. The analysis provided evidence of a good fit for both a correlational model with eight factors and a higher-order model, where the eight subdimensions were grouped into subjective (performance; cognitive functioning; personal and relational qualities of the therapist; therapist self-assessment) and objective (experience; reputation with clients and colleagues; training and professional updating; deontological ethics and setting rules) factors. The eight dimensions, two higher-order factors, and total score all showed excellent levels of internal consistency. Furthermore, significant associations were found between PEQ scores and insight orientation, general self-efficacy, self-esteem, personality traits, and time exercising clinical practice. To conclude, the Psychotherapy Expertise Questionnaire (PEQ) is a valuable, theoretically guided, and psychometrically robust self-report measure designed to assess therapist expertise and its constitutive dimensions. This measure can have practical applications in guiding tailored training and customised supervision.

Abstract The dynamics shaping the El Niño‐Southern Oscillation's (ENSO) response to present and future climate change remain unclear, partly due to limited paleo‐ENSO records spanning past abrupt climate events. Here, we measure Mg/Ca ratios on individual foraminifera to reconstruct east Pacific subsurface temperature variability, a proxy for ENSO variability, across the last 25,000 years, including the millennial‐scale events of the last deglaciation. Combining these data with proxy system model output reveals divergent ENSO responses to Northern Hemisphere stadials: enhanced variability during Heinrich Stadial 1 (H1) and reduced variability during the Younger Dryas (YD), relative to the Holocene. H1 ENSO likely intensified through meltwater‐induced changes to ocean/atmospheric circulation, a response observed in models, but the lack of a similar response during the YD challenges model simulations. We suggest the tropical Pacific mean state during H1 primed ENSO for larger fluctuations under meltwater forcing, whereas the YD mean state likely buffered against it.

In the current Italian real estate market, estimates of the market value of rural properties are carried out by appraisers mainly using the single-parameter comparison procedure and, less frequently, the income capitalization method. To overcome problems of appraiser subjectivity and other issues related to these methods, and to gradually comply with real estate appraisal standards, this research paper aims to develop and validate a scientifically rigorous method. This article carries out a first attempt to apply the mixed approach based on the integration of Market Comparison Approach (MCA) and General Assessment System (GAS) to agricultural land, currently used only in the field of urban real estate appraisal. The study focuses on the first steps of this valuation procedure: choice of the parameters which characterise the market segment and identification of the land characteristics to be included in the procedure. These two steps are preparatory to the following phase concerning the estimate of marginal prices, which represents the core of the whole valuation procedure. In the current Italian real estate market, estimates of the market value of rural properties are carried out by appraisers mainly using the single-parameter comparison procedure and, less frequently, the income capitalization method. To overcome problems of appraiser subjectivity and other issues related to these methods, and to comply with real estate appraisal standards, this research paper aims to develop and validate a scientifically rigorous method. The Market Comparison Approach (MCA) is used as a starting point for a comparative multiparameter approach, which is currently only used in the field of urban real estate appraisal. This paper carries out a first attempt to apply the MCA to agricultural land, contributing an initial exploration of developing the proposed methodologies. Specifically, this paper reports the first steps that have been carried out in this line of research: choosing the parameters to identify the market segment; identifying the characteristics to include in the procedure for which to determine the respective marginal prices.

Parents of children with special healthcare needs search the Internet to learn about and share health-related information. Indeed, online communities (OCs) often increase knowledge and skills, decreasing feelings of isolation and distress. The current study explored the content and functioning of an Italian OC comprising parents of children with Down Syndrome. Following a netnographic method, data were analysed through the Latent Thematic Analysis. Five main themes emerged: the e-group, the child, prescriptive knowhow, being a parent, and personal experience across time. The findings illustrated the complex relationship between parents and children with Down Syndrome within the OC, exploring psychological themes recurring in parents of children with Down Syndrome. Within the e-group, special children and parental challenges can be described, sharing concerns, conflicting emotions, and experience-based information, countering Down Syndrome difficulties and social isolation. Clinicians and healthcare professionals should consider the OCs-related advantages to enhance the healthcare of parents and children with Down Syndrome.

This study aimed to explore the relationships among the variables involved in a Comprehensive Model of Addiction (CMA), which posits that the presence and severity of addictive behaviors are related to the configuration of seven psychological variables, namely childhood trauma, insecure attachment, affect dysregulation, dissociation, impulsivity, compulsiveness, and obsessiveness. A vulnerability model was proposed, in which it was suggested that affect dysregulation and complex trauma mediated the association between insecure attachment and dissociation. Furthermore, a maintenance model was elaborated, in which it was hypothesized that dissociation influenced affect dysregulation via impulsivity, compulsiveness, and obsessiveness. A clinical sample of 430 individuals with substance use disorder was involved. All participants received a DSM-5 clinical diagnosis of Substance-Related and Addictive Disorders and were recruited from the Italian National Health System. A parallel mediation emerged, confirming the vulnerability model, with complex trauma and affect dysregulation mediating the relationship between insecure attachment and dissociation. Furthermore, a mixed serial–parallel mediation described the maintenance model, where impulsiveness, compulsiveness, and obsessiveness significantly mediated the relationship between dissociation and affect dysregulation. Our findings offer a better understanding of the variables associated with addictive disorders, thus providing important indications for both treatment and preventive interventions.

Abstract Background The PI3K/AKT pathway, extensively studied in cancer, is vital for regulating cell metabolism, differentiation, and proliferation. Pathogenic variants in the PIK3R1 gene, which encodes three regulatory units of class IA PI3Ks, have been found in affected tissue of individuals with vascular lesions. These variants predominantly occur in the iSH2 domain, disrupting inhibitory contacts with the catalytic unit and leading to PI3K activation. Germline variants in this gene are also linked to an immunological condition called Activated PI3K delta syndrome type 2 (APDS2). Methods This is a case report and literature review. Clinical data were retrieved from medical records. Results A male patient presented with extensive vascular malformation covering over 90% of his body, along with complete 2–3 toe syndactyly, suggesting a vascular malformation syndrome called PROS. Low levels of IgA and IgG were detected. The patient achieved his developmental milestones and had above‐average weight, height, and head circumference. Exome sequencing of skin and blood DNA revealed a de novo variant in PIK3R1 (c.1746‐2A>G, p.?) in 9% of the patient's blood cells and 25% of cultured fibroblasts. Initially, classified as a variant of uncertain significance, this variant was later confirmed to be the cause. Conclusions This is the first intronic SNV in a canonical splice site within iSH2 described, highlighting the importance of iSH2 in the regulation of the PI3K/AKT pathway and its involvement in the development of vascular overgrowth and antibody deficiency.

MEMS devices are more and more commonly used as sensors, actuators, and microfluidic devices in different fields like electronics, opto-electronics, and biomedical engineering. Traditional fabrication technologies cannot meet the growing demand for device miniaturisation and fabrication time reduction, especially when customised devices are required. That is why additive manufacturing technologies are increasingly applied to MEMS. In this review, attention is focused on the Italian scenario in regard to 3D-printed MEMS, studying the techniques and materials used for their fabrication. To this aim, research has been conducted as follows: first, the commonly applied 3D-printing technologies for MEMS manufacturing have been illustrated, then some examples of 3D-printed MEMS have been reported. After that, the typical materials for these technologies have been presented, and finally, some examples of their application in MEMS fabrication have been described. In conclusion, the application of 3D-printing techniques, instead of traditional processes, is a growing trend in Italy, where some exciting and promising results have already been obtained, due to these new selected technologies and the new materials involved.