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Background: Transformative experiences (TEs) have been conceptualized in many ways, contexts, magnitudes, and durations, but at their heart, they entail some manner of adjustment, which contributes to changing individuals' worldviews, actions, views of others and/or their own feelings, personality, and identity. Among the many elicitors identified as being able to foster TEs, an emerging body of literature has suggested that TEs might be prevalent in aesthetics or emerged from encounters with human art. Beyond denoting ordinary moments characterizing our daily lives, art and aesthetics could occasionally represent profound changes, causing shifts in our perceptions, beliefs and understanding of the world. However, in the realm of psychological inquiry, the extent to which art and aesthetics can be considered potential catalysts for transformation remains a topic of debate. Furthermore, a comprehensive identification of the key psychological components that contribute to the process of transformation before, during, and after aesthetic engagement is still missing., Aims: This systematic review endeavors to address these gaps by synthesizing literature on aesthetic transformative experiences either from the field of psychology or explicitly delving into the psychological impact of transformative experiences within the realm of art and aesthetics. It encompasses both theoretical and empirical papers to determine key aspects and psychological components that characterize TEs., Methods: Two major electronic databases were systematically searched. The review was conducted in accordance with Liberati et al. (2009) and PRISMA guidelines. All stages of the review were conducted independently by three researchers, and the protocol was published on PROSPERO (Registration no.: CRD42022298655)., Results: Although 39.440 studies were identified, only 23 peer-reviewed articles were included in this review, as most studies did not explicitly delve into the long-lasting psychological impact of art and aesthetics., Discussion: The results confirm the potential of art and aesthetics as elicitors of transformation regardless of the type of artwork and the usage context. Moreover, it also identifies some psychological components necessary for transformation in the realm of art and aesthetics, including facilitating conditions/pre-expectations, cognitive discrepancy, epiphany and insight, and several after-effects on the recipient., Conclusion: The review aids in refining and enriching the concept of transformative experience, paving the way for further research and applications in various fields, including not only psychology but also education and therapeutic interventions., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022298655., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Pizzolante, Pelowski, Demmer, Bartolotta, Sarcinella, Gaggioli and Chirico.)

Over the last two decades, awe has attracted the attention of an increasing number of researchers. The use of virtual reality has been identified as one of the most effective techniques for eliciting awe, in addition to more personalized methods for inducing emotion, such as autobiographical recall. However, previous measures of awe were unable to uncover the hidden structure of this experience. Awe experience scale (AWE-S) has been validated as a comprehensive measure of contingent awe in English, providing new opportunities for analysis. In this two-phases study, we investigated whether the latent structure of the experience of awe evoked by the autobiographical recall technique (Study 1) overlapped with that induced by exposing participants to a validated virtual reality awe-eliciting training (Study 2). The original English AWE-S structure held both in autobiographical recall induction and virtual reality-based elicitation. Despite evidence of overlap between English and Italian structures, low correlations were found between Italian trait measures used to test the concurrent validity of the AWE-S in the Italian sample and AWE-S state dimensions. This study highlights cultural differences in awe experience, trait, and state variations, and provides new insights into the standardized induction of this emotion through simulated environments., (© 2024. The Author(s).)

Epigenetics, the study of heritable changes in gene expression without altering the DNA sequence, has gained significant attention due to its implications for gene regulation and chromatin stability. Epigenetic mechanisms play a fundamental role in gene-environment interactions, shaping individual development and adaptation. DNA methylation, histone modifications, and non-coding RNAs are key epigenetic regulators. Epigenetic changes can be triggered by environmental factors, including stress, toxins, and social interactions, influencing health and well-being. Positive experiences, such as engagement with the arts, have been linked to emotional responses and neurotransmitter release. While the impacts of detrimental factors on epigenetics have been widely studied, the effects of positive influences are less explored. Specifically, visual art and music have profound effects on emotions, cognition, and mood regulation. Exposure to arts enhances memory, reduces stress, and fosters social inclusion. Recent research has begun to explore the links between positive experiences and epigenetic modifications, suggesting that aesthetic experiences, including visual art and music fruition, might induce dynamic and/or stable changes in gene expression profiles. However, this field is in its infancy, and more research is needed to establish clear connections. Collaborative efforts among genetics, epigenetics, neuroscience, psychology, and the arts are essential for a comprehensive understanding. Longitudinal studies tracking sustained exposure to positive experiences and examining the influence of childhood artistic education on the biological bases of therapeutic effects of art and music are promising avenues for future research. Ultimately, understanding how positive experiences influence epigenetics could provide insights into the long-term enhancement of human well-being., Competing Interests: None declared., (© The Author(s) 2024. Published by Oxford University Press.)

Background: Virtual Reality (VR) has already emerged as an effective instrument for simulating realistic interactions, across various domains. In the field of User Experience (UX), VR has been used to create prototypes of real-world products. Here, the question is to what extent the users' experience of a virtual prototype can be equivalent to that of its real counterpart (the real product). This issue particularly concerns the perceptual, cognitive and affective dimensions of users' experiences., Methods: This exploratory study aims to address this issue by comparing the users' experience of a well-known product, i.e., the Graziella bicycle, presented either in Sumerian or Sansar VR platform, or in a physical setting. Participants' Emotional Engagement, Sense of Presence, Immersion, and Perceived Product Quality were evaluated after being exposed to the product in all conditions (i.e., Sumerian, Sansar and Physical)., Results: The findings indicated significantly higher levels of Engagement and Positive Affect in the virtual experiences when compared to their real-world counterparts. Additionally, the sole notable distinction among the VR platforms was observed in terms of Realism., Conclusions: This study suggests the feasibility and potential of immersive VR environments as UX evaluation tools and underscores their effectiveness in replicating genuine real-world experiences., (© 2024. The Author(s).)

Virtual nature exposure has emerged as an effective method for promoting pro-environmental attitudes and behaviors, also due to the increased emotional connection with nature itself. However, the role played by complex emotions elicited by virtual nature, such as awe, needs to be fully elucidated. Awe is an emotion stemming from vast stimuli, including nature, and virtual reality (VR) emerged as an effective medium to elicit it. One hundred nineteen participants were exposed to either one of four VR environments: (a) an awe-inspiring virtual nature , (b) a non-natural awe-inspiring virtual scenario , (c) a non-awe-inspiring virtual nature , (d) a non-natural non-awe-inspiring scenario . Pro-environmental attitudes, intentions, discrete emotions, and affect were measured and compared across the different conditions. Two ad hoc tasks were developed to measure two pro-environmental behaviors after each VR exposure. Participants were invited to sign a real petition against plastic production, consumption, and in favor of plastic recycling (a personally engaging behavior), and to take flyers to spread the word on the petition to friends and acquaintances (a socially engaging behavior). Awe-inspiring virtual nature resulted in a significantly increased number of flyers taken by participants (vs. control). Disposition toward the protection of the environment, positive emotional affect, and condition significantly correlated with the number of flyers taken. These results indicated that awe-inspiring virtual nature can influence socially engaging pro-environmental attitudes and behaviors but not personally engaging ones.

The concept of transformative experience (TE) has been widely explored by several disciplines from philosophy to neurobiology, and in different domains, from the spiritual to the educational one. This attitude has engendered heterogeneous models to explain this phenomenon. However, a consistent and clear understanding of this construct remains elusive. The aim of this work is to provide an initial comprehensive interdisciplinary, cross-domain, up-to-date, and integrated overview on the concept of TEs. Firstly, all the models and theories on TEs were reviewed to extract and analyze TEs' main components emerging from different disciplines. Then, this preliminary analysis was integrated with an in-depth examination of redundancies and particularities across domains and disciplines, to provide an integrated theoretical framework of TEs and a preliminary interdisciplinary operational definition of TEs. This examination, in turn, can help organize current research and theories, thus providing suggestions for operationalizing TEs as well as encouraging new interdisciplinary research endeavors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Chirico, Pizzolante, Kitson, Gianotti, Riecke and Gaggioli.)

The aim of this study was to evaluate procalcitonin (PCT), C-reactive protein (CRP), platelet count (PLT) and serum lactate dehydrogenase (LDH) as early markers for diagnosis of SIRS, bacterial sepsis and systemic candidiasis in intensive care unit (ICU) patients. Based on blood culture results, the patients were divided into a sepsis group (70 patients), a SIRS group (42 patients) and a systemic candidiasis group (33 patients). PCT, CRP, LDH and PLT levels were measured on day 0 and on day 2 from the sepsis symptom onset. PCT levels were higher in Gram negative sepsis than those in Gram positive sepsis, although the P value between the two subgroups is not significant (P=0.095). Bacterial sepsis group had higher PCT and CRP levels compared with the systemic candidiasis group, whereas PLT and LDH levels showed similar levels in these two subgroups. The AUC for PCT (AUC: 0.892, P <0.001) was larger than for CRP (AUC: 0.738, P <0.001). The best cut-off values for PCT and CRP were 0.99 ng/mL and 76.2 mg/L, respectively. Diagnostic sensitivity and specificity for PCT were 84.3% and 81.8% whereas CRP showed a sensitivity of 77.2% and a specificity of 63.6%. However, PCT was unable to discriminate between SIRS and systemic candidiasis groups (P=0.093 N.S.). In conclusion, PCT can be used as a preliminary marker in the event of clinical suspicion of systemic candidiasis; however, low PCT levels (<0.99 ng/mL) necessarily require the use of other specific markers of candidaemia to confirm the diagnosis, due to great uniformity of PCT levels in systemic candidiasis and SIRS groups.

Emerging fungal pathogens, such as Geotrichum capitatum, are often associated with poor prognosis and represent a new challenge in modern medicine. Invasive Geotrichum capitatum infection is rare and has been reported exclusively in patients who showed signs of severe immunodeficiency, particularly those affected by haematological malignancies. The optimal therapy against systemic geotricosis has not yet been identified due to limited data about its antifungal susceptibility. The use of several therapeutic strategies and the low number of cases treated does not allow identification of specific therapeutic protocols. Furthermore, in spite of antifungal therapy, mortality rates reach very high levels. We report a case of systemic Geotrichum capitatum infection in a 78-year-old male treated with salvage therapy after acute myeloid leukaemia (AML) relapse. Geotrichum capitatum was isolated from his blood culture and identified by using Vitek 2 and Maldi time-of-flight system (MALDI-TOF). The infection was unsuccessfully treated, despite in vitro susceptibility, with micafungin and liposomal amphotericin B.

Bloodstream infection due to Rhodotorula glutinis is extremely rare and mostly associated with underlying immunosuppression or cancer. Vascular access devices provide the necessary surfaces for biofilm formation and are currently responsible for a significant percentage of human infections. In this work, we describe a rare case of central venous catheter-related Rhodotorula glutinis fungemia in a female patient with acute myelogenous leukemia in remission. The timely removal of central venous catheter was an essential element for overcoming this CVC-related Rhodotorula fungemia.

Scedosporium apiospermum is a saprobic fungus responsible for many different clinical manifestations. Although it affects mostly immunocompromised patients, pulmonary and disseminated scedosporiosis have also been reported in immunocompetent subjects. It often causes subcutaneous mycetoma, despite its preferential tropism to CNS. The authors describe a fatal case of a S. apiospermum brain abscess in a 58-year-old female. She was affected by chronic liver disease and idiopathic pulmonary fibrosis and had been treated with corticosteroid therapy for a long time. She recovered in a neurosurgery unit, wherein TC scan and cerebral MRI revealed an expansive left temporo-parietal process with vasogenic oedema. A stereotactic puncture of the lesion was carried out, and pus of brain abscess was evacuated. Empirical antifungal therapy was initiated with liposomal amphotericine B based on the clinical suspicion of Zygomycetes infection; after 3 days, posaconazole was added. The correct aetiological diagnosis arrived too late and the patient was treated with no specific therapy. This fatal case confirms the necessity of having a fast and correct aetiological diagnosis to improve the patient's outcome.

Castleman's disease is a rare disorder of the lymphoid tissue with a predominantly mediastinic localisation, but possible in any lymph node or extra-lymph node site. The aetiopathogenesis remains to be defined and, in the literature, only just over 500 cases have been reported, with only 57 located in a cervical site. Clinically, a solitary or localised form and a systemic or multicentric form can be distinguished, whilst, from a histological viewpoint, this lesion may be of the hyaline vascular or plasma-cellular type. Even if all the cases localised in a cervical site have been described as a single mass, the case described herein refers to diffuse cervical lymph-node hyperplasia with histological characteristics of the hyaline-vascular type, with the presence of a plasmacellular component. Evolution, over the 7 years following diagnosis, was benign, despite the fact that the patient was not submitted to surgical treatment. The low titre of B and T4 lymphocytes would appear to indicate that Castleman's disease might be an immunological disorder, due to atypical hyperplasia of the lymphoid tissue. It is suggested that Castleman's disease, in the cervical site, be classified into two subtypes: a cervical form, presenting as a single mass, and a multicentric cervical form. Data from a review of the literature are discussed.