Search Results (324)

Background/Objectives: Antimicrobial peptides are promising agents for combating resistant infections. They exhibit bactericidal activity against a wide range of microbes, primarily by disrupting the permeability of the bacterial membrane and ultimately causing cell death. Effective bacterial killing requires a high number of membrane-bound peptide molecules. Therefore, it is conceivable that peptide accumulation on the membrane could also interfere with essential cellular processes by altering bilayer dynamics, a hypothesis referred to as the “sand-in-a-gearbox” model. Methods: We systematically investigated how membrane dynamics is affected by a set of well-characterized yet highly diverse peptides: the natural AMP magainin 2, the toxin melittin, the synthetic peptides LAH4 and Killer-FLIP, and small membrane-active peptidomimetics with bactericidal activity. These effects were examined using fluorescence spectroscopy techniques, by measuring anisotropy, generalized polarization, and excimer formation of specific probes inserted at different depths within the lipid bilayer. Results: The activity of all compounds extends beyond membrane permeabilization, and the perturbation of membrane dynamics, often associated with the so-called “sand-in-a-gearbox” mechanism, is a common feature among all systems analyzed. The membrane-active compounds induced a stiffening of the phospholipid bilayer by reducing lipid lateral mobility and decreasing water penetration, at least on the nanosecond timescale accessible to fluorescence measurements. Conclusions: The concentration range in which this behavior occurred was the same for all compounds studied. This threshold is, generally, higher than that required for membrane permeabilization and reflects near-complete coverage of the bilayer surface. Full article

Background. Sepsis is a leading, time-dependent cause of in-hospital death, and guidelines now prioritize organized care such as code-sepsis protocols. Yet little is known about the long-term activity, organization and outcomes of permanent, hospital-scale programs. We characterized the activity of a hospital-wide multidisciplinary sepsis unit (MSU) over thirteen years and evaluated mortality trends. Methods. Retrospective cohort study using the registry of a hospital-wide MSU (2011–2023). The analysis unit was the sepsis event. Activity, referral pathways, interventions, follow-up and mortality were analyzed; temporal trends used multivariable logistic regression and standardized mortality ratios (SMR). Results. The unit attended 10,874 patients across 15,723 events and 50,925 consultations (median age 67; 59.3% men), referred mainly through the sepsis code (45.0%) and, increasingly, proactive early-warning detection (15.2%). An antibiotic change was recommended in 57.2% of events, and 89.8% of all suggested changes were implemented. Follow-up was sustained (median 3 visits; 61.8%). In-hospital mortality was 7.6%, and 11.8% in protocol-confirmed sepsis. Crude mortality did not fall, but severity rose (organ dysfunctions 1.67 to 2.72; septic shock 8 to 13%; both p < 0.001) with stable age; after adjustment the calendar-year effect disappeared (adjusted OR 1.00/year, p = 0.70) and the SMR stayed near 1.0, including pandemic years. Age, ICU admission (OR 2.65) and organ-dysfunction count (OR 1.37) independently predicted death. Conclusions. Over thirteen years, this hospital-wide MSU delivered large-scale, multi-channel, longitudinal care to an increasingly severe population while maintaining stable risk-adjusted mortality, supporting the long-term feasibility of a model integrating early detection, multidisciplinary decision-making, antimicrobial stewardship and follow-up. Full article

Pediatric oncology nursing is among the highest-intensity care specialties, exposing nurses to repeated child death and sustained emotional investment in family relationships. This occupational burden is a recognized psychosocial risk factor and a driver of compassion fatigue, burnout, and reported intention to leave, yet the organizational and educational determinants of this risk remain poorly captured by existing assessment approaches. This study investigated the lived experiences of nurses caring for terminally ill children in a pediatric onco-hematology unit and hospice ward in central Italy (N = 15), using a qualitative descriptive design, informed by a phenomenological sensibility to lived experience, supported by computer-assisted textual analysis. Structured face-to-face interviews were analyzed through thematic content analysis with stepwise replication, while quantitative textual analysis was performed using T-Lab software to map co-occurrence patterns among key lemmas, providing a frequency-based, semantically grounded picture of nurses’ representations of occupational risk. Seven themes emerged, including quality of nursing care, parental relationships, coping with a child’s death, and impact on personal and professional life. Findings showed that reported intention to leave was associated, in participants’ accounts, with absent psychological debriefing, cumulative emotional burden, inadequate end-of-life training, and a near-total absence of organizational vocabulary for peer-level support—a gap directly visible in the co-occurrence structure of nurses’ language. As a secondary aim, by combining qualitative depth with complementary lexical analysis of thematic patterns, this study also offers a methodological example of how psychosocial risk in high-intensity care settings can be assessed and translated into actionable indicators for organizational climate and workforce well-being. The findings inform concrete prevention strategies and policy recommendations for nursing education and occupational health, consistent with this Special Issue’s focus on methodological innovation for psychosocial risk assessment and public health policy design. Full article

Immune checkpoint inhibitors (ICIs) have improved clinical outcomes in recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), including oral squamous cell carcinoma (OSCC). However, many patients eventually develop resistance to systemic therapy, highlighting the need for novel strategies that can restore or sustain antitumor immunity. Near-infrared photoimmunotherapy (PIT) has emerged as a tumor-selective locoregional treatment that not only induces targeted tumor cell death but also promotes antitumor immune activation through immunogenic cell death. This narrative review summarizes current evidence regarding PIT for recurrent oral cancer and explores the immunological rationale for sequential ICI–PIT–ICI therapy (ICI–PIT–ICI sequence). Within this framework, PIT-induced tumor antigen release and inflammatory activation may reinitiate elements of the cancer-immunity cycle, whereas continued PD-1 blockade may help sustain newly activated tumor-reactive T-cell responses. To illustrate this concept, we present two cases of recurrent oral cancer treated with the ICI–PIT–ICI sequence. Both patients achieved durable clinical and radiological complete responses following PIT and subsequent nivolumab continuation. Longitudinal analyses of peripheral immune surrogate markers demonstrated a biphasic temporal pattern characterized by transient increases in inflammatory markers, including neutrophil-to-lymphocyte ratio, C-reactive protein, platelet-to-lymphocyte ratio, and systemic immune-inflammation index, followed by recovery trends in absolute lymphocyte count and lymphocyte-to-monocyte ratio during continued PD-1 blockade. These observations support the biological plausibility of PIT as an immune-modulating intervention with potential immune-reprogramming effects. Although hypothesis-generating, the ICI–PIT–ICI sequence may represent a promising strategy integrating locoregional tumor destruction with systemic immune modulation in recurrent oral cancer. Further prospective studies incorporating peripheral and tissue-based immune profiling are warranted. Full article

Brain injury after hypoxia–ischemia (HI) is the leading cause of morbidity and mortality in term and near-term neonates worldwide. The ferret is a promising translational model to study HI due to its gyrified brain and white-to-gray matter ratio that more closely resembles humans compared to rodents. Caffeine, an adenosine A2A receptor (A2AR) antagonist, shows neuroprotective potential after HI, but its effects have not been fully characterized. We sought to evaluate caffeine’s effect on neuronal cell death, cytotoxicity, and inflammatory and oxidative stress markers in a term-equivalent ferret organotypic brain slice model of HI. Slices were cultured for 72 h, exposed to two hours of oxygen–glucose deprivation (OGD), and randomized to OGD alone, OGD with caffeine (20 or 50 mg/L), or OGD with caffeine and an A2AR agonist. Healthy slices served as controls. Outcomes included global cell death, regional cell death, microglial morphology, and expression of inflammatory and oxidative stress genes (46–48 slices/group for cell death assays and 18 slices/group for imaging, balanced by sex). Caffeine 50 mg/L significantly reduced global cell death compared to OGD (p = 0.02), and this effect persisted despite co-administration of an A2AR agonist (p = 0.01), suggesting that protection was not primarily mediated through A2AR signaling. Caffeine also did not change regional pyknotic nuclei counts (p > 0.05). Caffeine altered microglial morphology, increasing the proportion of microglia with features characteristic of control conditions. OGD significantly increased expression of inflammatory and oxidative stress-related genes (p < 0.05) compared with control slices, whereas caffeine did not significantly alter gene expression. In summary, caffeine partially reversed global cell death after OGD and altered microglial morphology. Larger, higher-powered studies are needed to further investigate caffeine’s effects on neonatal HI. Full article

Carrot processing for juice generates substantial pomace residues rich in bioactive compounds, which represent both an environmental challenge and an unexploited resource. This study investigated the protective effects of a polyphenolic extract derived from carrot pomace (CP) against Escherichia coli lipopolysaccharide (LPS)-induced damage. For that, we used IPEC-1 (Intestinal Porcine Epithelial Cells) as an in vitro model of the intestinal epithelium. The total phenolic content of the CP polyphenolic extract (CPE) was 1.017 mg GAE/mL, with flavan-3-ols (epicatechin, catechin, epigallocatechin) accounting for 71.3% of that value. Before being exposed to LPS (10 μg/mL) for 24 h, the cells were pre-treated with CP extract (20.34 µg and 10.17 µg polyphenols/mL of extract corresponding to 1/50 and 1/100 dilution) for 4 h. Epithelial renewal (cell viability, cell proliferation and apoptosis), monolayer/barrier integrity (TEER, FD4 permeability, LDH release), as well as epithelial functionality (synthesis of pro-inflammatory cytokines: TNF-α, IL-1β, IL-6, reactive oxygen species (ROS), nitric oxide (NO) production), MAPK signalling and mitochondrial morphology and function were assessed. The results showed that CP extract had no cytotoxic effects and successfully counteracted LPS-induced loss of cell viability and proliferation. The pre-treatment with CPE at both dilutions significantly reduced LPS-induced apoptosis and cell death. Barrier integrity was preserved with TEER values maintained near baseline: −0.43% and −0.24% for 1/50 and 1/100 dilutions of CPE vs. −53.47% at 72 h for LPS alone, and paracellular FD4 passage was restored to control levels. At the molecular level, CP extract reduced pro-inflammatory cytokine gene expression (IL-6 by 40%, TNF-α by 50–56%) and suppressed LPS-induced MAPK activation by 62.9% and 46.5%, for 1/50 and 1/100 dilutions of CPE, respectively. The pre-treatment of cells with CP extract normalised LPS-induced ROS production and protected mitochondrial morphology and function. These in vitro findings demonstrate that CP extract exerts a protective effect on intestinal epithelial cells, acting through anti-inflammatory, antioxidant and barrier-preserving mechanisms. This supports the hypothesis for valorisation of carrot agro-industrial by-products as functional feed additives for promoting intestinal health. Further in vivo studies are needed to validate this hypothesis and to establish the concentration/rate of inclusion of carrot by-products to achieve the maximal positive effects. Full article

Achieving optimal therapeutic efficacy in colorectal cancer (CRC) remains challenging, highlighting the need for novel treatment strategies. This study evaluated whether radiofrequency (RF) hyperthermia enhances the anticancer effects of sunitinib malate and a newly synthesized tyrosine kinase (TK) inhibitor (compound 4). HCT116 CRC cells and BEAS-2B normal epithelial cells were treated with increasing concentrations of both agents in the presence or absence of RF exposure using a mobile RF device. Cell viability and death were assessed by MTT assay and flow cytometry (Annexin V/PI). RF exposure was associated with reduced viability and increased cell death in HCT116 cells (p < 0.05). Flow cytometric analysis confirmed that RF exposure may contribute to the observed reduction in viability. Notably, the findings suggest a possible beneficial contribution of RF hyperthermia to the observed cytotoxic effects, particularly near the IC50 concentration. In contrast, BEAS-2B cells maintained high viability with no significant changes (p > 0.05). These findings suggest that RF exposure may contribute to the observed cytotoxic responses in CRC cells while exerting limited effects on non-malignant cells, suggesting a promising strategy for targeted therapy. Full article

Background: Candidemia remains a major cause of morbidity and mortality among hospitalized patients. The emergence of Candidozyma auris has added further complexity due to its persistence in healthcare settings and its high rates of antifungal resistance. Comparative real-world data between Candidozyma auris and Candida spp. candidemia remain limited. Methods: We conducted a retrospective cohort study that included adult patients with candidemia, admitted to a tertiary infectious diseases hospital in Romania between August 2018 and August 2025. Risk factors, including medical history, previous hospitalizations, clinical characteristics, laboratory parameters, antifungal susceptibility patterns, treatment, and outcomes, were compared in patients with Candidozyma auris- and Candida spp.-positive blood cultures. Overall survival and prognostic factors were evaluated using univariable and multivariable Cox-proportional hazards models. Results: Sixty-one patients with candidemia were included; out of them, 24 (39.3%) had Candidozyma auris-positive blood cultures. Candidozyma auris infections, which emerged later during the study period, occurred after a significantly longer period of hospitalization compared with Candida spp. candidemia (median 52.5 vs. 20 days, p < 0.001). Azole resistance was almost universal among Candidozyma auris isolates (95.8%), whereas Candida species displayed significantly lower resistance rates and a broader susceptibility spectrum (p < 0.001). Inflammatory markers were comparable between groups; however, Candidozyma auris candidemia was associated with lower neutrophil counts and lower neutrophil-to-lymphocyte ratios at diagnosis (p = 0.020). Persistent candidemia at day 7 occurred more frequently in Candidozyma auris infections (6 vs. 2 patients; p = 0.05) and was universally fatal. Overall, in-hospital mortality was high (70.5%) and did not differ between Candidozyma auris and Candida spp. candidemia. In multivariable analysis, thrombocytopenia < 100,000/μL was independently associated with mortality (HR 2.34, 95% C.I. 1.20–4.56; p = 0.012). Conclusions: In this 7-year study at a Romanian tertiary center, Candidozyma auris emerged as a major healthcare-associated pathogen affecting patients with significantly prolonged hospitalization (median 52.5 days). Despite near-universal azole resistance (95.8%), mortality was exceptionally high (70.5%) and was comparable between groups, with pathogen type not independently associated with outcome after multivariable adjustment. Moderate thrombocytopenia (<100,000/μL) and persistent candidemia identified patients at particularly high risk of death, underscoring the need for early risk stratification, optimized antifungal management, and enhanced diagnostic vigilance, both in intensive care and general wards. Full article

Background and Objectives: Appendectomy during pregnancy is associated with preterm birth, but downstream neonatal outcomes, neonatal intensive care resource use, and caregiver-reported psychological symptom burden remain insufficiently characterized. We aimed to compare neonatal infection rates, NICU resource utilization, and caregiver psychosocial outcomes between preterm infants born after maternal appendectomy during pregnancy and preterm controls frequency-matched by gestational-age strata without antecedent non-obstetric surgery. Methods: In this single-center prospective cohort study (March 2023–December 2025), 121 preterm infants were enrolled: 54 born after maternal appendectomy during pregnancy (31 laparoscopic, 23 open) and 67 non-surgical preterm controls. Neonatal outcomes included culture-confirmed infection, death, or major neonatal morbidity, and neonatal intensive care resource metrics. Caregiver outcomes were assessed near discharge using the 36-Item Short Form Survey, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, and Hospital Anxiety and Depression Scale. Group comparisons used normality-guided parametric or non-parametric tests and multivariable logistic regression; subgroup and mediation analyses were exploratory. Mediation analyses explored indirect pathways. Results: Culture-confirmed infection was numerically more frequent in appendectomy-group neonates than in controls (35.2% versus 20.9%; p = 0.078), but this difference was not statistically significant. NICU length of stay was significantly longer (47.3 ± 14.8 vs. 41.2 ± 12.6 days; p = 0.014), and caregiver Patient Health Questionnaire-9 depressive symptom scores were higher (12.4 ± 4.3 vs. 9.6 ± 3.8; p < 0.001). Open appendectomy and negative histopathology subgroups showed the strongest adverse signals. Exploratory mediation analysis suggested that a substantial portion of the appendectomy-caregiver depression association statistically co-varied with prolonged hospitalization (Sobel p = 0.008); this exploratory pathway analysis does not establish a causal mediation pathway. Conclusions: Preterm infants born after maternal appendectomy during pregnancy showed non-significant numerical increases in infection outcomes, significantly higher neonatal intensive care resource use, and higher caregiver-reported psychological symptom scores compared with non-surgical preterm controls, with open surgery and negative appendectomy representing clinically complex subgroups with less favorable exploratory signals. Full article

Background. Hematological inflammatory indices from the complete blood count have been proposed as inexpensive prognostic markers in sepsis. The systemic immune-inflammation index (SII) and neutrophil-to-lymphocyte ratio (NLR) are the most studied, but the performance of monocyte-containing alternatives (SIRI, AISI) in the elderly, in whom immunosenescence may alter the leukocyte phenotype, remains poorly characterized. Methods. In a single-center retrospective cohort of patients aged ≥65 years admitted to a tertiary ICU with Sepsis-3-defined sepsis (n = 127, 33 deaths), we compared the discrimination of six indices (NLR, PLR, MLR, SII, SIRI, AISI) for 30-day all-cause mortality using AUROC with bootstrap confidence intervals and pairwise DeLong tests. Independent associations were assessed by logistic regression adjusted for APACHE II and age; incremental value over APACHE II was explored using IDI, cNRI, calibration and decision curve analysis, with bootstrap optimism correction. Results. Thirty-day mortality was 26.0%. The monocyte-containing indices (AISI, SIRI, MLR) discriminated better than SII and NLR, and AISI was significantly superior to SII, NLR and PLR on DeLong testing, though not to SIRI, MLR or APACHE II. After adjustment for APACHE II and age, AISI, SIRI and MLR remained independently associated with mortality, whereas SII and PLR did not. Adding AISI to APACHE II improved reclassification and calibration and yielded higher net clinical benefit across clinically relevant thresholds. Conclusions. In this exploratory, single-center analysis, monocyte-containing indices, particularly AISI, were more strongly associated with 30-day mortality in elderly ICU sepsis than SII or NLR. AISI, SIRI and MLR were strongly intercorrelated and near-equivalent, and AISI did not significantly exceed APACHE II in discrimination. These hypothesis-generating findings require prospective external validation before clinical use. Full article

One to four million annual premature deaths are associated with household air pollution. This indoor pollution is mainly generated by traditional biomass cookstoves. Thus, solar cooking can significantly reduce this toll. Its proliferation would also mitigate deforestation pressures. Additionally, for developing countries, it would alleviate the fuel collection workload, mainly borne by women responsible for fuel collection. Electric cooking provides a clean and controllable alternative to thermal cookers for indoor food preparation, sterilization and heating. This study presents a minimal, off-grid photovoltaic solar cooker that operates without batteries and power electronics. Such a cooker constitutes a low-cost and high-reliability solution for electrically decentralized locations. The system encompassing the cooker is conceived as an accessible entry point for household-level photovoltaic (PV) adoption. So, it offers the potential to catalyze the uptake of clean-energy technologies and to support sustainable development. The proposed design dissipates PV power into heat using commercial positive temperature coefficient (PTC) resistors operating near their Curie temperature. A simplified theoretical model is formulated to easily estimate the thermal power and heat-transfer conductances required for achieving cooking temperatures. An instrumented prototype allows for characterizing the transient temperature evolution during controlled heating and cooling experiments in the laboratory, facilitating development in an initial step avoiding the PV panel. The results demonstrate that the minimal PV configuration is technically feasible, robust, and compatible with low-resource settings. This encourages its adoption in communities experiencing energy poverty. Full article

Stroke causes approximately 12.2 million new cases and 6.5 million deaths annually, with survivors requiring coordinated care across pre-hospital, acute, rehabilitative, and preventive phases. Mobile health (mHealth) technologies, including smartphone applications, wearable sensors, and tablet-based platforms, have shown clinical potential across these contexts, yet a structured mapping of their distribution across the full stroke care continuum is lacking. We searched PubMed, Scopus, and Web of Science for publications from January 2019 to March 2025. Studies evaluated mHealth interventions in which the mobile platform directly performed diagnostic, therapeutic, or rehabilitative functions in stroke populations. Of 4524 records identified, 17 met the inclusion criteria. Studies originated from eight countries and used heterogeneous designs: five randomized controlled trials, five non-randomized studies, four cohort studies, and three diagnostic accuracy studies. Median sample size was 37 participants (range 10–2249). Evidence concentrated at two poles: six studies addressed acute diagnosis and ten addressed rehabilitation, predominantly in the chronic phase. One study addressed secondary prevention; two targeted early rehabilitation, the period of maximum neuroplasticity after discharge. All seventeen studies covered a single care phase. Smartphone platforms dominated acute contexts; wearable and mixed-modality systems were confined to rehabilitation. The mHealth stroke landscape is fragmented and phase-specific, exhibiting a silo effect in which interventions operate as isolated tools rather than components of an integrated care system. An important gap is the near-absence of research in early rehabilitation. Future priorities include cross-continuum design, expansion into cognitive and secondary prevention domains, and progression toward adequately powered trials. Full article

Lung cancer remains the leading cause of cancer-related mortality worldwide despite advances in screening, navigational bronchoscopy, and systemic therapies. Diagnostic and therapeutic limitations persist, including uncertainty regarding intraprocedural tissue adequacy during biopsy sampling and constraints of existing ablative modalities for tumors located near critical thoracic structures. This review examines two emerging technologies: Full-Field Optical Coherence Tomography-based Dynamic Cell Imaging (DCI) and monopolar biphasic Pulsed Electric Field (PEF) ablation as complementary emerging technologies that may address these gaps. The Van Gogh™ Microscopy System (CellTivity Scientific, Inc.) utilizes DCI to enable real-time visualization of cellular metabolic activity without tissue destruction, providing functional information regarding tissue viability and microstructural morphology. The Aliya^® PEF ablation system (Galvanize Therapeutics, Inc.) delivers biphasic high-voltage electrical pulses that induce non-thermal tumor cell death while preserving extracellular matrix architecture, potentially allowing treatment near sensitive thoracic structures such as airways, vasculature, and pleura. Early preclinical studies and initial clinical experience suggest that DCI can facilitate rapid intraprocedural assessment of biopsy adequacy, while PEF ablation may provide reproducible focal tumor destruction with a favorable safety profile near critical structures. Although the current evidence base remains limited to early-phase studies and feasibility trials, the convergence of real-time biologic tissue assessment with structurally preserving ablation technologies introduces the possibility of integrating diagnostic confirmation and local therapy within a single procedural workflow. This review summarizes the mechanistic rationale, emerging evidence, and potential clinical applications of these technologies and proposes a conceptual “See and Strike” framework within these two emerging technologies. The methodological limitations, workflow considerations, and future research directions required to validate this approach are also discussed. Prospective multicenter trials and long-term oncologic outcomes will be necessary before widespread clinical adoption. Full article

Cutaneous leishmaniasis remains a major therapeutic challenge due to drug toxicity, resistance, and limited efficacy against intracellular parasites. This study evaluated the therapeutic potential of nanoformulated Walterinnesia aegyptia (WA) venom using hyaluronic acid-based (WA-HA) and silver-based (WA-Ag) nanoparticles. Nanoparticles were synthesized and characterized by scanning and transmission electron microscopy and energy-dispersive X-ray spectroscopy. The antipromastigote activity of crude WA venom was assessed by MTT assay, and apoptosis induction was analyzed using Annexin V-FITC/propidium iodide flow cytometry. In vivo efficacy was evaluated in BALB/c mice infected with Leishmania major, with outcomes assessed by lesion progression, biochemical markers, histopathology, and PCR-based parasite detection. WA venom exhibited potent dose-dependent cytotoxicity (IC50 = 26.73 µg/mL) and induced predominantly apoptotic cell death. In vivo, nanoformulated WA significantly enhanced therapeutic outcomes compared with crude venom, with WA-HA achieving near-complete lesion resolution comparable to Amphotericin B. Treatment also reduced parasite burden, normalized liver enzyme levels, and restored hepatic and splenic architecture. These findings demonstrate that nanocarrier-based delivery markedly improves the therapeutic performance and systemic safety of WA venom, highlighting its potential as a promising nanotherapeutic strategy for cutaneous leishmaniasis. Full article

Mystical experiences are characterized by a profound sense of interconnectedness and transcendence of ordinary reality. These experiences can facilitate feelings of connectedness with oneself and others and have been documented as leading to significant positive changes in thoughts, emotions, and behavior. The purpose of the present study was to evaluate the extent to which the four mindfulness facets of psychological flexibility (i.e., experiential acceptance, present-moment awareness, cognitive defusion, and self-as-context) were associated with self-reported mystical experiences while controlling for established covariates. Using a sample of 150 individuals recruited online, a regularized regression with an elastic net—a computationally efficient machine learning algorithm—was used to model the relationships among mystical experiences, State of Surrender, frequency of psychedelic use, near-death experiences, and facets of psychological flexibility. State of Surrender, experiential acceptance, cognitive defusion, and present-moment awareness emerged as the most robust predictors of mystical experiences. Collectively, these findings underscore the role of psychological processes, including surrender-related processes and facets of psychological flexibility, in predicting mystical experiences. Full article