This study demonstrates the favorable effect of psychiatric intervention in ALD patients with psychiatric comorbidities. These findings emphasize the importance of integrated management for ALD patients to address both their medical and psychiatric aspects. Therefore, we suggest the potential benefits of early psychiatric interventions in improving survival outcomes in ALD.

Heartbeat-evoked response (HER) is considered a neural correlate of interoceptive information processing. While HERs are modulated during interoception tasks, distinguishing the unique contributions of conscious cardiac awareness (the subjective recognition of a heartbeat) from interoceptive attention (the state of focusing on one's heartbeat) remains challenging. To dissociate these processes, we developed a novel task where participants (N = 29) reported the timing of perceived heartbeats using a clock hand, followed by objective feedback. We analyzed electroencephalography data using HERs, phase-based connectivity, and microstate analysis. Our results revealed distinct neural mechanisms underlying conscious cardiac awareness and interoceptive attention. Specifically, conscious cardiac awareness was associated with earlier HER modulation localized to the dorsomedial prefrontal cortex, increased beta synchronization between key nodes of the interoceptive network, and a higher prevalence of microstates involving temporal/opercular regions. Conversely, interoceptive attention modulated HERs at later latencies, localized to the somatosensory cortex and insula, and preferentially engaged microstates associated with the visual and frontoparietal network. These findings confirm the multifaceted nature of HERs. We argue that HER modulations reflect not only the optimization of precision via attention but also the emergence of cardiac awareness through the integration of bottom-up afferent inputs and top-down predictions.

Motivation: Traditional neuroimaging studies have analyzed the effects of cardiometabolic factors on brain structure and cognition but often lack sensitivity to subtle micro-structural changes. Past studies have been limited by small sample sizes and a focus on simple volumetric or circuit-level analyses. Goal(s): To investigate the impact of cardiometabolic disease on the brain at the fixel level using large-scale cohort data. Approach: Using fixel-based analysis, we examined tract- and network-specific fixels affected by metabolic syndrome and analyzed their relationships with cardiometabolic indicators. Results: We identified significant fixel-based metric differences influenced by specific cardiometabolic indicators, leading to improved predictive modeling for cognitive function impacts. Impact: This study aims to capture micro-structural brain changes undetected in prior research. Fixel-based analysis allows precise mapping of cardiometabolic factors' effects on specific tracts and networks, enhancing predictive accuracy for cognitive function correlations at the individual level.

Higher excitatory tone in the AIC appears to enlarge prediction-error weighting, which in turn amplifies a shared anxiety-depression dimension. Dynamic Glx reductions during reward learning suggest acute metabolic demand superimposed on a trait-like baseline that biaes cognition. Targeting insular glutamatergic function-pharmacologically or via neuromodulation-may therefore mitigate maladaptive error processing that underlies internalizing psychopathology.

Objectives This study aims to deeply understand the meaning and essence of healing experiences among residential care workers who nurture and care for children in shelters for abused children. Methods Data were collected through in-depth interviews conducted twice between January and August 2024 with four residential care workers who have worked or are currently working in shelters for abused children. Semi-structured questions were employed, and Giorgi's phenomenological research method was utilized to focus on the workers' experiences. Results The findings revealed five main components and twenty subcomponents. The main components included: “Unintentionally Encountering a Place of Healing”, “Gradual Exposure to Painful Realities”, “The Gradual Sprouting of Love”, “Struggles and Small but Beautiful Fruits for Young Souls” and “The Fulfillment and Sense of Mission Sustaining Heavy Workloads”. Conclusions This study explores the essence of healing experiences among residential care workers in shelters, shedding light on the process through which abused children heal and recover to lead healthy daily lives. These findings contribute to understanding the significance, value, and fulfillment of the healing process in caregiving and serve as a practical foundation for social welfare practices.