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.

Background: This study examines the relationship between obstructive sleep apnea severity, sleep position, and body weight, particularly focusing on the negative impact of sleeping in a supine position combined with being overweight in a population-based sample. Methods: The Apnea-Hypopnea Index (AHI) was utilized as a marker of OSA severity and sleep position from a standardized overnight polysomnography. Participants were categorized by body mass index (BMI) (kg/m2) into normal weight/underweight (<25) and overweight (≥25). Results and Conclusions: The results indicated a higher mean Apnea-Hypopnea Index for those sleeping in the supine position compared to other positions, with overweight individuals experiencing a proportionally greater impact from sleep position than their normal-weight counterparts.

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.

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.

INTRODUCTION The number of mentally altered patients a dentist meets in practice is increasing and interaction with them can be very challenging. As a baseline for an interventional study, we want to assess the attitude of dental students and identify areas of improvement in patient communication. This work compares the attitude of dental students towards people suffering from dementia to the attitudes of trained medical caregivers and the general population. Our aim is to use the results to assess the need for training in communicating with mentally altered patients. MATERIALS AND METHODS Fourth-year dental students attended two lectures on dementia given by a psychiatrist as part of the geriatric dentistry lecture and were questioned afterwards using the Dementia Attitude Scale. In 2016 and 2017, 73 students at the University of Greifswald were interviewed. The response rate was 84%. Using a factor analysis, the Dementia Attitude Scale's validated questions were interpreted and compared with data from nursing staff from Switzerland and the USA. RESULTS The factor analysis of the data showed the same two-factor loadings as the comparative groups, and that dental students' attitude is more comparable to the general population than to medically trained nursing staff. CONCLUSION Given the results, we conclude that the implementation of a communication module can serve in improving the attitude of dental students towards patients with dementia.

Multimedia multi-device measurement platforms may make the assessment of prevention-related medical variables with a focus on cardiovascular outcomes more attractive and time-efficient. The aim of the studies was to evaluate the reliability (Study 1) and the measurement agreement with a cohort study (Study 2) of selected measures of such a device, the Preventiometer. In Study 1 (N = 75), we conducted repeated measurements in two Preventiometers for four examinations (blood pressure measurement, pulse oximetry, body fat measurement, and spirometry) to analyze their agreement and derive (retest-)reliability estimates. In Study 2 (N = 150), we compared somatometry, blood pressure, pulse oximetry, body fat, and spirometry measurements in the Preventiometer with corresponding measurements used in the population-based Study of Health in Pomerania (SHIP) to evaluate measurement agreement. Intraclass correlations coefficients (ICCs) ranged from .84 to .99 for all examinations in Study 1. Whereas bias was not an issue for most examinations in Study 2, limits of agreement for most examinations were very large compared to results of similar method comparison studies. We observed a high retest-reliability of the assessed clinical examinations in the Preventiometer. Some disagreements between Preventiometer and SHIP examinations can be attributed to procedural differences in the examinations. Methodological and technical improvements are recommended before using the Preventiometer in population-based research.

Purpose Socioeconomic factors are known to modulate health. Concerning sleep apnea, influences of income, education, work, and living in a partnership are established. However, results differ between national and ethnic groups. Results also differ between various clinical studies and population-based approaches. The goal of our study was to determine if such factors can be verified in the population of Pomerania, Germany. Methods A subgroup from the participants of the population-based Study of Health in Pomerania volunteered for an overnight polysomnography. Their data were subjected to an ordinal regressions analysis with age, sex, body mass index (BMI), income, education, work, and life partner as predictors for the apnea–hypopnea index. Results Among the subgroup (N = 1209) from the population-based study (N = 4420), significant effects were found for age, sex, and BMI. There were no significant effects for any of the socioeconomic factors. Conclusion Significant effects for well-established factors as age, sex, and BMI show that our study design has sufficient power to verify meaningful associations with sleep apnea. The lack of significant effects for the socioeconomic factors suggests their clinical irrelevance in the tested population.

The spotlight on large population-based studies is growing within the research community. Epidemiological studies, amassing extensive data through questionnaires and check-ups, often include imaging data like magnetic resonance imaging (MRI) or ultrasonography from numerous participants. This article offers an exploration of several recent epidemiological studies conducted in Germany, addressing not only the intriguing research tasks but also the multifaceted perspectives and challenges of analyzing image data. This includes potential enhancements in imaging technologies, machine learning applications for data analysis, and collaboration between different research disciplines. Key insights into the methodologies, algorithms, and techniques used for processing and interpreting complex imaging data are detailed. The potential of epidemiological image analysis to guide clinical practices and contribute to personalized medicine is also discussed.

Objective: Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample. Methods: For a subsample (N = 1209) of the Study of Health in Pomerania (N = 4420), complete polysomnography data was available. Of these, 559 females completed a structured interview about their menstrual cycle. Splines and ordinal regression analysis were used to analyze the resulting data. Results: In the ordinal regression analysis, a significant association between the apnea–hypopnea index (AHI) and menopause indicated that post-menopausal women had a substantially higher risk of OSA. In accordance with previous studies, risk indicators such as body mass index (BMI), age, and the influence of hysterectomies or total oophorectomies were included in the model. Conclusions: Our results clearly confirmed the assumed connection between menopause and OSA. This is important because OSA is most often associated with male patients, and it warrants further research into the underlying mechanisms.

Purpose To analyze sleep characteristics as measured with polysomnography (PSG) in adults from the general population with and without physician-diagnosed atopic dermatitis (AD). Methods We analyzed data from participants from the German population-based Study of Health in Pomerania (SHIP) TREND-0. AD was diagnosed in a standardized skin examination. The following polysomnographic parameters were measured: total sleep duration (min), sleep latency (min), wake after sleep onset (WASO; min), rapid eye movement (REM) latency (min), sleep efficiency (%), total number of wakefulness and movement episodes, stages of sleep (%), and apnea-hypopnea index (AHI). Additionally, the subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). We compared sleep characteristics of participants with and without AD. Results Among 1187 participants, 47 (4.0%) had AD. We found no differences between participants with and without AD in any of the analyzed PSG parameters except for the total number of wakefulness and movement episodes and the percentage of REM sleep. Participants with AD had a higher number of wakefulness and movement episodes, and a lower proportion of REM sleep compared to those without AD. Regarding subjective sleep parameters, no significant differences were found between participants with and without AD. Conclusion Our data do not provide evidence for poor sleep quality in individuals with AD. Major limitations of the study include the unavailability of data on AD severity and the small number of participants with AD. Larger-scaled longitudinal studies considering disease severity and specific AD symptoms with an effect on sleep are required.

dataquieR is an R package to conduct data quality assessments in data collections designed for research. It makes strong use of metadata that specify the requirements of the study data. Spreadsheet tables can be used to collect this information in a standardized manner. dataquieR starts with checking the formal compliance of study data with expectations defined in the metadata, such as the data type, during integrity analyses. Depending on available metadata, further data quality assessments cover the dimensions completeness, consistency, and accuracy as proposed by the framework of Schmidt et al. (2020). Three dataquieR functions investigate the completeness of data within and across observational units. Consistency-related analysis comprises two aspects. First, depending on the data type, the compliance of data elements with either user-defined limits or the adherence to expected value lists is investigated. Second, contradictions between data values of two data elements can be identified by using one of eleven logical comparisons, e.g., if systolic blood pressure is lower than diastolic blood pressure whereas the opposite is expected. Eight dataquieR functions support accuracy-related analyses by aiming at unexpected distributions of single or multiple data elements. Particular focus is placed on the influence of observers, examiners, and devices on the measurement process.

BACKGROUND:We previously reported on a pilot study to assess the incorporation of a novel wellness assessment device, the Preventiometer (iPEx5 GmbH, Greifswald, Germany), into an academic medical practice. The present follow-up study expands on those data and evaluates the acceptability of the assessment process in a larger sample population.OBJECTIVE:The aim of this study was to evaluate participant satisfaction with the Preventiometer wellness assessment.METHODS:A total of 60 healthy volunteers participated. Each participant underwent a comprehensive wellness assessment with the Preventiometer and received data from more than 30 diagnostic tests. A 32-question survey (with a numeric rating scale from 0 to 10) was used to rate the wellness assessment tests and participants' impressions of the wellness assessment.RESULTS:Each assessment had a significantly higher rating than 7 (P < .001), and the majority of participants agreed or strongly agreed that they were satisfied (98.3%), and they strongly agreed that they were engaged the entire time (93.2%), and liked the instant test results feature of the Preventiometer device (93.2%).CONCLUSION:This study confirms findings from our previous pilot study regarding the feasibility of the Preventiometer as a wellness assessment tool. The study further demonstrated that 98% of participants were satisfied with the assessment and that all of them would recommend it to others.

Mainly for methodological reasons, little is known about the course of development of early cognitive competencies diagnosed with the violation of expectation (VoE) method in infants. The goal of this research was to evaluate the use of pupillometry as a unified approach to assess expectancy violations during and beyond the “dark ages” between 1 and 3 years. We tested children aged 1–6 years and adults (N = 279) with pictures of animals combined with matching or mismatching animal sounds. All age groups exhibited significantly greater pupil dilation in mismatched than matched trials. We conclude that pupillometry is a viable alternative to the VoE method that, by contrast to the latter, can be used throughout the life span.

Previous studies measuring looking-time suggested that already infants possess intuitive knowledge about physical support. The aim of the present study was to investigate whether children were able to apply this knowledge in an active search task. Two- to five-year-olds (N = 105) were presented with pairs of identical blocks positioned on the left- and right-hand side of an elevated platform with only one of the blocks sufficiently supported. At test, one of the blocks fell into one of two chutes adjacent to the platform out of children's view. Children's task was to retrieve the block they thought had fallen. Results revealed that while children aged 3 years or older searched reliably in the correct chute with symmetrically-shaped blocks, only 4- and 5-year-olds did so with asymmetrical blocks. Thus, intuitions about support do not appear to become accessible in action before children can use them to make verbal predictions.

Three-year-olds and 4-year-olds have severe difficulties solving standard mental rotation tasks. Only 5-year-olds solve such tasks above chance reliably. In contrast studies relying on simplified mental rotation tasks indicate that infants discriminate between an object and its mirror image. Furthermore in another simplified mental rotation task with 3-year-olds, a linear relation between angular disparity and reaction time typical for mental rotation was revealed. Therefore it was assumed that 3-year-olds' capabilities are underestimated. In the current study, 3-year-olds were trained in two isolated sessions to solve standard mental rotation tasks and were tested in a third session. Three-year-olds solved this test above chance as a group - a substantial number of them doing so on an individual level. However, a linear relation between angular disparity and reaction time, that would indicate an analog mental transformation, was not discernable. Nevertheless, these findings are in accordance with a continuous line describing mental rotation in infants and older children. And, these also indicate that children's mental rotation capabilities might be underestimated.

With the Mental Rotation Test (MRT), large and reliable sex differences are found. Used with children younger than about 9 or 10 years, MRT performance is at chance level. Simpler tasks used with younger children have revealed inconclusive results. Moore and Johnson (2008, 2011) observed sex differences in infants using a habituation task with 3D cube figures rotating back and forth in depth through a 240° angle. Thereafter, female infants treated similarly the original figure and a mirror-image cube figure presented revolving through the previously unseen 120° angle, whereas male infants behaved as if they recognized the familiar object. In the present study, 256 adults participated in the MRT as well as in a modified two-alternative forced-choice dynamic version of the infants’ task. Sex differences were present for both tasks. More importantly, there was a positive correlation in performance across both tasks for both women and men. Since the new task turned out to be simpler, it might be suitable also for children. We present the first, although indirect, evidence that the sex effects reported by Moore and Johnson might indeed reflect early sex differences in mental rotation.

Adults' mental rotation performance with body-like stimuli is enhanced if these stimuli are anatomically compatible with a human body, but decreased by anatomically incompatible stimuli. In this study, we investigated these effects for kindergartners and first-graders: When asked to mentally rotate cube configurations attached with human body parts in an anatomically compatible way, allowing for the projection of a human body, children performed better than with pure cube combinations. By contrast, when body parts were attached in an anatomically incompatible way, disallowing the projection of a human body, children performed worse than with pure combinations. This experiment is of specific interest against the background of two different theoretical approaches concerning imagery and the motor system in development: One approach assumes an increasing integration of motor processes and imagery over time that enables older children and adults to requisition motor resources for imagery processes, while the other postulates that imagery stems from early sensorimotor processes in the first place, and is disentangled from it over time. The finding that children of the two age groups tested show exactly the same effects as adults when mentally rotating anatomically compatible and incompatible stimuli is interpreted in favour of the latter approach. Statement of contribution What is already known on this subject? In mental rotation, adults perform better when rotating anatomically possible stimuli as compared to rotating standard cube combinations. Performance is worse when rotating anatomically impossible stimuli. What does this study add? The present study shows that children's mental transformations mirror those of adults in these respects. In case of the anatomically impossible stimuli, this highlights an inflexible use of embodiment in both age groups. This is in line with the Piagetian assumption of imagery being based on sensorimotor processes.

Recent studies have ascertained a link between the motor system and imagery in children. A motor effect on imagery is demonstrated by the influence of stimuli-related movement constraints (i.e., constraints defined by the musculoskeletal system) on mental rotation, or by interference effects due to participants' own body movements or body postures. This link is usually seen as qualitatively different or stronger in children as opposed to adults. In the present research, we put this interpretation to further scrutiny using a new paradigm: In a motor condition we asked our participants (kindergartners and third-graders) to manually rotate a circular board with a covered picture on it. This condition was compared with a perceptual condition where the board was rotated by an experimenter. Additionally, in a pure imagery condition, children were instructed to merely imagine the rotation of the board. The children's task was to mark the presumed end position of a salient detail of the respective picture. The children's performance was clearly the worst in the pure imagery condition. However, contrary to what embodiment theories would suggest, there was no difference in participants' performance between the active rotation (i.e., motor) and the passive rotation (i.e., perception) condition. Control experiments revealed that this was also the case when, in the perception condition, gaze shifting was controlled for and when the board was rotated mechanically rather than by the experimenter. Our findings indicate that young children depend heavily on external support when imagining physical events. Furthermore, they indicate that motor-assisted imagery is not generally superior to perceptually driven dynamic imagery.

We investigated whether individuals used mental rotation and embodiment for arm laterality judgments of human figures that were stepwise rotated from back view to front view along a vertical axis. In Experiment 1, figures' heads were always shown in profile, while only the bodies were rotated. Judgments were faster and more correct when figures were presented in back view compared to front view, but the relation between reaction times (RTs) and rotation angles was not strictly linear. In addition, judgments on figures in anatomically possible postures were better than on figures in impossible postures. In Experiment 2, figures' heads were turned together with their body. RTs and rotation angles were linearly related. Results suggest that individuals use both mental rotation and a more direct matching between their own body and that of the figures, when making arm laterality judgments of human figures that are rotated along a vertical axis.