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High-resolution intraoral ultrasonography of the intrinsic tongue muscles: detailed anatomical visualization

2026-05-01T00:00:00Z

Title: High-resolution intraoral ultrasonography of the intrinsic tongue muscles: detailed anatomical visualization Authors: Ji, Hyun-Ju; Heo, Yu-Ran; Piao, Jiong-Zhen; Gil, Young-Chun; Hu, Kyung-Seok; Kim, Hee-Jin Abstract: PurposeThe tongue plays a key role in speech and swallowing, and its intrinsic muscles enable fine coordinated movements. High-resolution ultrasonography is a non-invasive method that allows detailed visualization of tongue structures and blood vessels. This study investigated the morphology of the intrinsic tongue muscles and deep lingual artery by correlating the high-resolution intraoral ultrasonography with known anatomical structures.MethodsUltrasonographic examinations were performed on 33 Korean adults (6 males and 27 females; mean age: 34.9 +/- 12.3 years) using a B-mode system with a 15 MHz hockey-stick transducer. Five predefined areas on the dorsal and lateral tongue surfaces were systematically scanned. A total of 182 images were acquired to evaluate intrinsic tongue structures and the deep lingual artery. Muscle visualization rates were summarized descriptively, and Fisher's exact test was used to examine age-related differences in visualization status.ResultsThe intrinsic tongue muscles (superior longitudinal, transverse lingual, vertical lingual, and inferior longitudinal muscles) were distinctly visualized in layered structure from surface inward. Muscle separation was clear on the dorsal surface, though vertical and transverse lingual muscles appeared in the same layer. Visualization detail decreased slightly in the tongue tip and lateral regions. The deep lingual artery was identified in 70.6% of participants, primarily in the anterior tongue, at a mean depth of 0.9 cm (range, 0.6-1.2 cm). An age-related trend toward lower visibility of the right vertical lingual muscle was observed in older participants (P = 0.123).ConclusionHigh-resolution intraoral ultrasonography successfully provided detailed, anatomically consistent visualization of intrinsic tongue muscles and the deep lingual artery, supporting its utility for both clinical assessment and educational purposes.

A Mobile App-Based Individualized Nonpharmacological Intervention for Behavioral and Psychological Symptoms in Dementia: Pilot Randomized Controlled Trial

2026-04-01T00:00:00Z

Title: A Mobile App-Based Individualized Nonpharmacological Intervention for Behavioral and Psychological Symptoms in Dementia: Pilot Randomized Controlled Trial Authors: Cho, Eunhee; Yang, Minhee; Hwang, Sinwoo; Kim, Eunkyo; Cho, Jungwon; Kim, Min Jung Abstract: Background: Behavioral and psychological symptoms of dementia (BPSD) are common and negatively impact both individuals with dementia and their families. Although nonpharmacological interventions are recommended as the first-line treatments, their use in community settings is limited by access and caregiver resources. Existing approaches are often not individualized and rely on institutional or clinician-led delivery. Objective: We developed a caregiver-initiated and individualized multimodal mobile app. The app delivers tailored nonpharmacological interventions-such as music therapy, exercise, and reminiscence therapy-based on each user's preferences and functional abilities. This study aimed to evaluate the effectiveness of this mobile app-based intervention in reducing BPSD in community-dwelling persons living with dementia. Methods: This study used a single-blinded randomized controlled trial design. Participants were recruited from an outpatient clinic of a tertiary hospital, a dementia care center, and 5 home care service centers. A total of 36 dyads participated, each comprising a community-dwelling person living with dementia aged 60 years or older and their primary family caregiver. The dyads were randomly allocated to either the intervention or control group. The intervention group received a caregiver-initiated, multimodal, mobile app-based individualized intervention for 4 weeks, whereas the control group continued with usual care. The primary outcomes were overall BPSD, agitated behavior, and depression. The secondary outcomes were nighttime sleep efficiency and caregiver competency in managing BPSD. Assessments were conducted at baseline, immediately after the intervention, and at a 2-week follow-up. Results: Of the 36 randomized dyads, 33 were included in the final analysis. Although the intervention group showed greater reductions in overall BPSD, agitated behavior, and depression after the intervention, no significant group-by-time interaction effects were observed in the total sample. In the subgroup analysis of participants with clinically significant baseline BPSD, a statistically significant improvement in overall BPSD was found in favor of the intervention group (beta=-12.885, 95% CI-24.530 to-1.240; P=.03). No significant effects were observed for either nighttime sleep efficiency or competence in the management of BPSD. Conclusions: A mobile app-based individualized intervention may offer a flexible, caregiver-initiated approach to managing BPSD in home-care settings. While overall effects were limited, exploratory subgroup findings provided meaningful insights, indicating potential benefits for those with higher baseline symptom severity. The results highlight the need for further research on adaptive personalization and optimized intervention delivery to enhance the clinical effectiveness of digital dementia care.

Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators

2026-03-01T00:00:00Z

Title: Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators Authors: Park, Sikyeong; Park, Yu Shin; Hong, Dahye; Kang, Bada; 박유신 Abstract: Background: Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a major global health concern, affecting over 30% of adults worldwide. Closely associated with metabolic comorbidities such as obesity, type 2 diabetes, and dyslipidemia, MASLD relies heavily on health behavior modification for effective management. However, sustaining healthy behaviors remains challenging, particularly due to the disease's asymptomatic nature in its early stages and low perceived severity among patients. Thus, understanding patient perceptions and identifying barriers and facilitators are essential for developing effective, patient-centered interventions. Objective: This scoping review protocol aims to systematically map the existing literature on patients' perceptions of MASLD and to identify barriers and facilitators that influence disease management and patient engagement. Methods: This scoping review will follow the Joanna Briggs Institute scoping review methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. A systematic search will be conducted in PubMed, CINAHL, Cochrane Library, and PsycINFO by using MeSH terms and keywords such as "MASLD," "NAFLD," "perception," "awareness," "attitude," "barriers," and "facilitators." Two independent reviewers will screen studies, extract data using a standardized charting form, and resolve discrepancies through discussion or consultation with a third reviewer. Eligible studieswill include adults with MASLD/NAFLD and will focus on patient perceptions, health beliefs, behaviors, or barriers and facilitators to management. Data synthesis will be guided by the socioecological model to categorize findings across individual, interpersonal, organizational, community, and public policy levels. Results: The research protocol was finalized in January 2026. This study received no external funding. A preliminary literature search was conducted by January 30, 2026, and formal screening of titles and abstracts is scheduled to begin in February 2026. Data extraction and synthesis are expected to be completed by April 2026. The final results are anticipated to be submitted for publication in the summer of 2026. Conclusions:This scoping review will offer a comprehensive overview of patients' perceptions of MASLD, as well as the barriers and facilitators that influence its management. The results will inform the development of patient-centered strategies aimed at improving care delivery and reducing disease impact. International Registered Report Identifier (IRRID): DERR1-10.2196/81404

Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study

2026-03-01T00:00:00Z

Title: Dynamic Relationship Between Sleep Patterns and Behavioral and Psychological Symptoms of Dementia: Longitudinal Observational Study Authors: Cho, Eunhee; Hwang, Sinwoo; Yang, Minhee; Kim, Eunkyo; Cho, Jungwon; Park, Chang; 양민희 Abstract: Background: A higher prevalence of behavioral and psychological symptoms of dementia is associated with a greater caregiver burden and increased mortality in people with dementia. Considering the possibility of a reciprocal relationship between sleep disturbances and these symptoms, time series analyses are necessary to explore the associated temporal dynamics. Objective: This study aimed to examine dynamic interdependencies between sleep disturbances and behavioral and psychological symptoms of dementia in older adults. Methods: Daily interactions between sleep patterns and behavioral and psychological symptoms of dementia were analyzed over a 14-day period using a panel vector autoregressive model. Data were collected from June 2018 to June 2020 in community and institutional settings. A total of 154 older adults with dementia wore wrist actigraphy devices continuously for 2 weeks for sleep data, and caregivers recorded behavioral and psychological symptoms of dementia in a daily symptom diary. Results: Using a panel vector autoregressive model, we analyzed data from 154 older adults living with dementia and their caregivers. The results showed unidirectional Granger causality running from the number of awakenings on the previous day to irritability (P=.03) and appetiteor eating disorders (P=.04) on the following day. Conversely, some of the previous day's behavioral and psychological symptoms of dementia temporally preceded subsequent changes in sleep patterns. Specifically, delusions had a Granger-causality effect on total sleep time (P<.001), wake after sleep onset (P=.01), and the number of awakenings (P=.006), while irritability had a Granger causality effect on the number of awakenings (P=.007). Notably, bidirectional Granger causality was observed between irritability and the number of awakenings. Conclusions: This study demonstrates that the relationship between the behavioral and psychological symptoms of dementia and sleep patterns is dynamic and forms a vicious cycle. Consequently, early intervention to alleviate symptoms is imperative, and strategies to enhance sleep quality and address sleep disturbances should be prioritized.