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Summary: Obstructive sleep apnea is a common disorder that leads to sleep fragmentation and is potentially bidirectionally related to a variety of comorbidities, including an increased risk of heart failure and stroke. It is often considered a consequence of anatomical abnormalities, especially in the head and neck, but its pathophysiology is likely to be multifactorial in origin. With geometric morphometrics, and a large sample of adults from the Study for Health in Pomerania, we explore the association of craniofacial morphology to the apnea–hypopnea index used as an estimate of obstructive sleep apnea severity. We show that craniofacial size and asymmetry, an aspect of morphological variation seldom analysed in obstructive sleep apnea research, are both uncorrelated to apnea–hypopnea index. In contrast, as in previous analyses, we find evidence that brachycephaly and larger nasal proportions might be associated to obstructive sleep apnea severity. However, this correlational signal is weak and completely disappears when age‐related shape variation is statistically controlled for. Our findings suggest that previous work might need to be re‐evaluated, and urge researchers to take into account the role of confounders to avoid potentially spurious findings in association studies. [ABSTRACT FROM AUTHOR]

Summary: Obstructive sleep apnea is known to be an overall public health problem that, among other things, increases morbidity and mortality. Risk factors as well as symptoms of this multidimensional sleep‐related breathing disorder negatively affect quality of life. With our study we aimed to expose the association between obstructive sleep apnea and quality of life in the population of Pomerania, Germany. We utilized data from the population‐based Study of Health in Pomerania (SHIP). Information on health status and risk factors about 4420 participants (2275 women) were gathered within the cohort SHIP‐TREND, of which 1209 (559 women) underwent an overnight polysomnography and completed sleep questionnaires. The quality of life of the participants was measured using the Short‐Form 12 questionnaire. For our study, an ordinal regression analysis with age, sex, body mass index and the Short‐Form 12 health survey as predictors for apnea–hypopnea index was computed. The potential factors affecting quality of life are different between physical and mental dimensions of quality of life. Significant effects were found regarding age, sex, body mass index and the Short‐Form 12 Mental Component Score, but not the Physical Component Score. [ABSTRACT FROM AUTHOR]

Objective: To develop and test self-administered satisfaction questionnaires for patients with removable dental prostheses (RDPs) in the German language. Method and Materials: A three-phase methodology was used. A pilot questionnaire was developed in phase one. At the end of phase two, the final version of the questionnaires were reached. In phase three, 192 questionnaires were distributed to evaluate the psychometric properties of the final version of the questionnaires. Construct validity, content validity from the patients' perspective, and questionnaire reliability were estimated. Results: At the end of phase two, the final versions of the questionnaires were defined as instruments with good face validity. At the end of phase three, content validity from the patients' perspective was assessed and found to be good. Exploratory factor analysis identified a one-factor model for each questionnaire. Consequently, each questionnaire was summed to create a single index. Internal consistency of the indexes was assessed using Cronbach's α and found to be excellent (α > 0.9). A high repeatability of all the items was identified through a test-retest. Intra-class correlation coefficient (ICC) values ranged from 0.80 to 0.99. Conclusion: The questionnaires and indexes are valid and highly reliable instruments, and can be used to measure patient satisfaction with RDPs. [ABSTRACT FROM AUTHOR]

Inter-individual variation in facial shape is one of the most noticeable phenotypes in humans, and it is clearly under genetic regulation; however, almost nothing is known about the genetic basis of normal human facial morphology. We therefore conducted a genome-wide association study for facial shape phenotypes in multiple discovery and replication cohorts, considering almost ten thousand individuals of European descent from several countries. Phenotyping of facial shape features was based on landmark data obtained from three-dimensional head magnetic resonance images (MRIs) and twodimensional portrait images. We identified five independent genetic loci associated with different facial phenotypes, suggesting the involvement of five candidate genes--PRDM16, PAX3, TP63, C5orf50, and COL17A1--in the determination of the human face. Three of them have been implicated previously in vertebrate craniofacial development and disease, and the remaining two genes potentially represent novel players in the molecular networks governing facial development. Our finding at PAX3 influencing the position of the nasion replicates a recent GWAS of facial features. In addition to the reported GWA findings, we established links between common DNA variants previously associated with NSCL/P at 2p21, 8q24, 13q31, and 17q22 and normal facial-shape variations based on a candidate gene approach. Overall our study implies that DNA variants in genes essential for craniofacial development contribute with relatively small effect size to the spectrum of normal variation in human facial morphology. This observation has important consequences for future studies aiming to identify more genes involved in the human facial morphology, as well as for potential applications of DNA prediction of facial shape such as in future forensic applications. [ABSTRACT FROM AUTHOR]

The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to (1) examine the cross-sectional area (CSA) of the masseter muscle in relation to bruxism and (2) investigate if there are gender-related differences in the masseter muscle in a population-based magnetic resonance imaging (MRI) study., Methods: The study included 720 subjects aged 30-89 years (391 women and 329 men) from the Study of Health in Pomerania, a cross-sectional population-based study assessing the prevalence and incidence of common population-relevant diseases and their risk factors in Northeastern Germany. The participants underwent both a whole-body MRI and a full oral examination. The CSAs of the masseter muscles on both sides were measured from MRI images. The presence or absence of awake and/or sleep grinding and clenching, unilateral chewing, and other parafunctional activities were obtained from the dental interview. Linear and ordinal logistic regression models were used to examine the associations between the CSAs of the masseter, bruxism, and gender., Results: The frequency of bruxism and reports of muscle or joint pain were significantly higher in women. The analysis revealed that a larger masseter CSA was significantly associated with bruxism only in men. The larger CSA was manifested only in the higher frequency bruxers., Conclusions: Bruxism had heterogeneous effects on the masseter muscle between genders. Although a higher prevalence of bruxism was reported by women, the larger CSA of the masseter muscle was significantly higher in bruxing men but not in women. This study emphasizes the need for a gender-specific approach when evaluating the clinical implications of bruxism on the masseter muscle., (Copyright © 2024 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Background: The external auditory canal (EAC) exhibits a complex morphology and strong inter-individual variations. However, these have not yet been comprehensively described in the literature., Purpose: This study aims to determine the width, height and cross-sectional area of the cartilaginous portion of the EAC and to describe the three-dimensional morphology and variability of different EACs., Methods: Magnetic resonance imaging was performed on 870 subjects (401 male, 469 female, resulting in 1740 EACs) who participated in the longitudinal, population-based cohort study 'Study of Health in Pomerania-START-3'. The height and width were measured in the cartilaginous part of the EAC, between the first and second bend. The variability of the EAC morphology was visualized in three-dimensional models., Results: The mean height (vertical length) of the EAC was 8.62 mm (SD = 2.42) on the right, 8.47 mm (SD = 2.36) on the left. The width (horizontal length) was 4.08 mm (SD = 1.6) on the right, 3.93 mm (SD = 1.64) on the left. The EAC cross-section was 28.6 mm 2 (SD = 15.19) on the right, 27.15 mm 2 (SD = 14.33) on the left. The average cross-sectional area of the EAC in men was higher than in women. Subjects with larger body size had larger cross-sectional areas. Subjects with higher body mass index tended to have smaller cross-sections. Although the average EAC had an oval shape, a three-dimensional comparison of different EACs revealed strong individual variation in morphology., Conclusion: This study enhances the understanding of otolaryngologists and anatomists regarding the complex morphology and variability of the cartilaginous portion of the EAC., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: The present work has been supported by a joint grant from Siemens Healthcare (Siemens, Erlangen, Germany) and the Federal State of Mecklenburg-West Pomerania. The University of Greifswald is a member of the ‘Center of Knowledge Interchange’ program of Siemens AG. A whole-body 1.5 Tesla MR system (Magnetom Avanto; Siemens Medical Solutions, Erlangen, Germany) was used in this study. There are no further patents, products in development or marketed products to declare. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript., (Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)