Sexual Dimorphism and Population Affinity in the Human Zygomatic Structure-Comparing Surface to Outline Data

ZSCAN10 deficiency causes a neurodevelopmental disorder with characteristic oto-facial malformations

Neurodevelopmental disorders are major indications for genetic referral and have been linked to more than 1500 loci including genes encoding transcriptional regulators. The dysfunction of transcription factors often results in characteristic syndromic presentations; however, at least half of these patients lack a genetic diagnosis. The implementation of machine learning approaches has the potential to aid in the identification of new disease genes and delineate associated phenotypes. Next generation sequencing was performed in seven affected individuals with neurodevelopmental delay and dysmorphic features. Clinical characterization included reanalysis of available neuroimaging datasets and 2D portrait image analysis with GestaltMatcher. The functional consequences of ZSCAN10 loss were modelled in mouse embryonic stem cells (mESCs), including a knockout and a representative ZSCAN10 protein truncating variant. These models were characterized by gene expression and western blot analyses, chromatin immunoprecipitation and quantitative PCR (ChIP-qPCR) and immunofluorescence staining. Zscan10 knockout mouse embryos were generated and phenotyped. We prioritized bi-allelic ZSCAN10 loss-of-function variants in seven affected individuals from five unrelated families as the underlying molecular cause. RNA-sequencing analyses in Zscan10-/- mESCs indicated dysregulation of genes related to stem cell pluripotency. In addition, we established in mESCs the loss-of-function mechanism for a representative human ZSCAN10 protein truncating variant by showing alteration of its expression levels and subcellular localization, interfering with its binding to DNA enhancer targets. Deep phenotyping revealed global developmental delay, facial asymmetry and malformations of the outer ear as consistent clinical features. Cerebral MRI showed dysplasia of the semicircular canals as an anatomical correlate of sensorineural hearing loss. Facial asymmetry was confirmed as a clinical feature by GestaltMatcher and was recapitulated in the Zscan10 mouse model along with inner and outer ear malformations. Our findings provide evidence of a novel syndromic neurodevelopmental disorder caused by bi-allelic loss-of-function variants in ZSCAN10.

Demonstrating the empirical effect of population specificity of anthropological standards in a contemporary Australian population

The ability to differentiate individuals based on their biological sex is essential for the creation of an accurate anthropological assessment; it is therefore crucial that the standards that facilitate this are likewise accurate. Given the relative paucity of population-specific anthropological standards formulated specifically for application in the contemporary Australian population, forensic anthropological assessments have historically relied on the application of established methods developed using population geographically and/or temporally disparate. The aim of the present paper is, therefore, to assess the accuracy and reliability of established cranial sex estimation methods, developed from geographically distinct populations, as applied to the contemporary Australian population. Comparison between the original stated accuracy and sex bias values (where applicable) and those achieved after application to the Australian population provides insight into the importance of having anthropological standards optimised for application in specific jurisdictions. The sample analysed comprised computed tomographic (CT) cranial scans of 771 (385 female and 386 male) individuals collected from five Australian states/territories. Cranial CT scans were visualised as three-dimensional volume-rendered reconstructions using OsiriX®. On each cranium, 76 cranial landmarks were acquired, and 36 linear inter-landmark measurements were calculated using MorphDB. A total of 35 predictive models taken from Giles and Elliot (1963), Iscan et al. (1995), Ogawa et al. (2013), Steyn and İşcan (1998) and Kranioti et al. (2008) were tested. Application to the Australian population resulted in an average decrease in accuracy of 21.2%, with an associated sex bias range between - 64.0 and 99.7% (average sex bias value of 29.6%), relative to the original studies. The present investigation has highlighted the inherent inaccuracies of applying models derived from geographically and/or temporally disparate populations. It is, therefore, imperative that statistical models developed from a population consistent with the decedent be used for the estimation of sex in forensic casework.

Mapping sexual dimorphism signal in the human cranium

The study of sexual dimorphism in human crania has important applications in the fields of human evolution and human osteology. Current, the identification of sex from cranial morphology relies on manual visual inspection of identifiable anatomical features, which can lead to bias due to user's expertise. We developed a landmark-based approach to automatically map the sexual dimorphism signal on the human cranium. We used a sex-known sample of 228 individuals from different geographical locations to identify which cranial regions are most sexually dimorphic taking into account shape, form and size. Our results, which align with standard protocols, show that glabellar and supraciliary regions, the mastoid process and the nasal region are the most sexually dimorphic traits (with an accuracy of 73%). The accuracy increased to 77% if they were considered together. Surprisingly the occipital external protuberance resulted to be not sexually dimorphic but mainly related to variations in size. Our approach here applied could be expanded to map other variable signals on skeletal morphology.

Gender Facial Affirmation Surgery: Cheek Augmentation

Cheek augmentation is frequently used in facial feminization surgery. Options for augmentation include both surgical and nonsurgical techniques, such as autologous and non-autologous injections, implants, and osteotomies. Cheek augmentation can be combined with other facial procedures. Complications of cheek augmentation include malposition, resorption, asymmetry, and unfavorable cosmetic results. Cheek augmentation should be considered as part of an overall facial feminizing plan.

Assessment of the Relationship between the Total Occlusal Area of the Human Permanent Upper First and Second Molars and the Robusticity of the Facial Skeleton in Sex-Different Cranial Samples of Homo Sapiens: A Preliminary Study

The aim of this study was to establish whether there is a significant relationship between the total occlusal area (TOCA) of two types of permanent upper molars (first-M¹ and second-M²) and facial robusticity, as well as which of the examined facial regions indicate a relationship concerning the grade of their massiveness with the TOCA of analyzed molars in different sex adult Homo sapiens cranial samples. To obtain the values of the TOCA of the molars (n = 145), a morphometric method was performed based on the calibrated digital images of their occlusal surface using ImageJ software. The grades of the massiveness of six facial regions were assessed using qualitative scales of their expression, and an index of general facial robusticity was calculated. Two types of analyses were performed concerning standardized and non-standardized traits to the facial size, including Spearman's/or Pearson's correlations and partial rank correlations. The obtained results indicated the presence of a positive relationship between the relative TOCA of M²s and the relative general facial robusticity, as well as between the TOCA of both types of molars and the massiveness of trigone region of the facial skeleton in male crania. However, most of the obtained results were not consistent with the assumptions of the "localized masticatory stress hypothesis".

A Comparison of Semilandmarking Approaches in the Analysis of Size and Shape

Often, few landmarks can be reliably identified in analyses of form variation and covariation. Thus, ‘semilandmarking’ algorithms have increasingly been applied to surfaces and curves. However, the locations of semilandmarks depend on the investigator’s choice of algorithm and their density. In consequence, to the extent that different semilandmarking approaches and densities result in different locations of semilandmarks, they can be expected to yield different results concerning patterns of variation and co-variation. The extent of such differences due to methodology is, as yet, unclear and often ignored. In this study, the performance of three landmark-driven semilandmarking approaches is assessed, using two different surface mesh datasets (ape crania and human heads) with different degrees of variation and complexity, by comparing the results of morphometric analyses. These approaches produce different semilandmark locations, which, in turn, lead to differences in statistical results, although the non-rigid semilandmarking approaches are consistent. Morphometric analyses using semilandmarks must be interpreted with due caution, recognising that error is inevitable and that results are approximations. Further work is needed to investigate the effects of using different landmark and semilandmark templates and to understand the limitations and advantages of different semilandmarking approaches.

Sex-Related Characteristics of the Face

The face is central to individual identity and gender presentation. Sex-based differences are seen at nearly every component of the face, from craniofacial structure to skin and soft tissue distribution. This article provides a framework for identification and analysis of sex-based differences in facial anatomy. This can then be used to guide individualized approaches to surgical planning to create greater congruence between patients' existing physical features and goals for gender expression.

Application of geometric morphometrics for facial congenital anomaly studies

The face is a small complex three-dimensional (3D) structure composed of various bones and essential organs. Congenital anomalies of those organs represent various deformities; therefore, their quantification has been challenging. Linear measurements, such as lengths or angles between landmarks, called conventional morphometrics, have been used to quantify their phenotypes usually using 2D images, such as photographs or X-ray images. During analysis, geometric information, which refers to the relative position of each structure, is lost. Geometric morphometrics (GM) uses shape configurations, including anatomical landmarks, which can retain geometric information throughout analysis and can help visualize the results, making it tremendously advantageous compared to conventional methods. Morphometric studies investigate variations within groups, identification of group differences, simulation of the ontogeny, or association with specific organs or genetic disorders, and GM can be applied to these purposes using multivariate statistical methods. The calculation of high-dimensional data is usually required and has prevented GM from becoming a major morphometric method. However, recent developments in computer technology and software have enabled us to perform it easily with ordinary home computers, and the number of morphometric studies applying GM for facial congenital anomalies has been increasing recently. In this article, we introduce the concept and application of GM and review previous morphometric studies with GM regarding congenital facial anomalies.

Neuroradiology in Transgender Care: Facial Feminization, Laryngeal Surgery, and Beyond

Transgender individuals experience incongruence between their gender identity and the sex assigned to them at birth. This incongruence can cause many transgender individuals to experience distressing physical and mental discord, a diagnosis known as gender dysphoria. Craniofacial structures have distinct anthropometric characteristics that affect perceived masculinity and femininity. The face, neck, and voice are highly exposed anatomic areas that have recognizable gender-specific characteristics that may hinder a transgender individual's successful social integration and public acceptance. Reconstructive facial and laryngeal procedures are among the surgical options transgender persons may elect to undergo to better align their physical appearance with their gender identity. These include feminization surgeries such as facial feminization and reduction chondrolaryngoplasty, as well as masculinizing facial and laryngeal surgeries. Maxillofacial CT is frequently used in the preoperative evaluation of patients before facial feminization surgery (FFS). Several CT measurements guide surgeons to the optimal correction required in FFS to achieve appropriate aesthetic planes. Mapping important craniofacial landmarks to avoid untoward surgical complications is crucial. Transgender patients may encounter other neurologic complications that require neuroimaging evaluation. For example, gender-affirming hormone therapy (eg, estrogen and testosterone) may increase the risk of stroke or may influence growth of various hormone-sensitive tumors such as pituitary adenomas. Radiologists may interpret imaging examinations in transgender patients for routine care or for evaluation before and after facial and laryngeal surgeries and must be aware of the role of neuroimaging in the care of this population. An invited commentary by Callen is available online. The online slide presentation from the RSNA Annual Meeting is available for this article. ^©RSNA, 2022.

Analyzing the Fitting of Novel Preformed Osteosynthesis Plates for the Reduction and Fixation of Mandibular Fractures

Purpose: The known preformed osteosynthesis plates for the midface are helpful tools for a precise and fast fixation of repositioned fractures. The purpose of the current study is to analyze the precision of newly developed prototypes of preformed osteosynthesis plates for the mandible. Methods: Four newly designed preformed osteosynthesis plates, generated by a statistical shape model based on 115 CT scans, were virtually analyzed. The used plates were designed for symphyseal, parasymphyseal, angle, and condyle fractures. Each type of plate has three different sizes. For analysis, the shortest distance between the plate and the bone surface was measured, and the sum of the plate-to-bone distances over the whole surface was calculated. Results: A distance between plate and bone of less than 1.5 mm was defined as sufficient fitting. The plate for symphyseal fractures showed good fitting in 90% of the cases for size M, and in 84% for size L. For parasymphyseal fractures, size S fits in 80%, size M in 68%, and size L in 65% of the cases. Angle fractures with their specific plate show good fitting for size S in 53%, size M in 60%, and size L in 47%. The preformed plate for the condyle part fits for size S in 75%, for size M in 85%, and for size L in 74% of the cases. Conclusion: The newly developed mandible plates show sufficient clinical fitting to ensure adequate fracture reduction and fixation.

Age differences in relation to bone thickness and length of the zygomatic process of the maxilla, infrazygomatic crest, and buccal shelf area

INTRODUCTION

The purpose of this study was to compare the thickness and length of the zygomatic process (ZP) of the maxilla, infrazygomatic crest area, and mandibular buccal shelf by sex and age.

METHODS

Cone-beam computed tomography images of 128 subjects were divided into 3 groups: (1) 22 female and 19 male subjects aged 9-13 years, (2) 27 female and 20 male subjects aged 14-23 years, and (3) 20 female and 20 male subjects aged 24-50 years. A previously calibrated operator was used to take all measurements of the zygomatic process vertical bone thickness, zygomatic process horizontal bone length, zygomatic process/cementoenamel length (ZP/CEJL), infrazygomatic crest region bone thickness (IZCBT), infrazygomatic crest region bone length (IZCL), and mandibular buccal shelf bone thickness. Analysis of variance and Kruskal-Wallis tests were used for statistical analyses. Two-way analysis of variance was used for variables with significant differences by sex (P <0.002 as determined by Bonferroni correction for multiple comparisons).

RESULTS

Differences by sex were only found for IZCL in the maxillary second premolar and first molar (U5-U6) and the maxillary first molar (U6). Significant differences were observed among age groups for ZP/CEJL, IZCBT in U5-U6 and U6, and IZCL in U6-distal.

CONCLUSIONS

The results suggest that ZP/CEJL and IZCL are larger in adults than in younger subjects, whereas IZCBT is smaller in adults than in younger subjects.

Population affinity and variation of sexual dimorphism in three-dimensional facial forms: comparisons between Turkish and Japanese populations

Examining the extent to which sex differences in three-dimensional (3D) facial soft tissue configurations are similar across diverse populations could suggest the source of the indirect evolutionary benefits of facial sexual dimorphism traits. To explore this idea, we selected two geographically distinct populations. Three-dimensional model faces were derived from 272 Turkish and Japanese men and women; their facial morphologies were evaluated using landmark and surface-based analyses. We found four common facial features related to sexual dimorphism. Both Turkish and Japanese females had a shorter lower face height, a flatter forehead, greater sagittal cheek protrusion in the infraorbital region but less prominence of the cheek in the parotid-masseteric region, and an antero-posteriorly smaller nose when compared with their male counterparts. The results indicated the possible phylogenetic contribution of the masticatory organ function and morphogenesis on sexual dimorphism of the human face in addition to previously reported biological and psychological characteristics, including sexual maturity, reproductive potential, mating success, general health, immune response, age, and personality.

Sternal human variability and population affinity: Frequency of discrete traits and their relationship with sex and age

Sternal morphological variations differ among populations and are influenced by the interaction between inheritance, development, and environment. There are currently no studies that include all variability from a morphogenesis approach following a homogeneous definition. The aims of this study were (a) to develop a standardized method for the anatomical study of the sternum; (b) to analyze the prevalence of the morphological variations and their relationship between sex and age; (c) to compare the results with other populations. The sterna of 155 skeletons from a Spanish population were studied. The age at the time of death was 17 to 97 years. We analyzed two metric and 22 sternal morphological variations described in the literature and designed an illustrated atlas. The atlas was validated using the intraclass correlation coefficient (ICC). A descriptive statistical analysis was conducted to measure the prevalence and relationship between sex and age. To analyze the interpopulation variability, we compared our results with those from other authors. The atlas with definitions and reference images improves the observation and detection of all morphological variations of the sternum (ICC = 0.90). The dependence between the morphological traits and sex was significant for the variations in the sternal angle, the number of esternebra, and the development of the xiphoid process. No significant differences were found between age group and morphological traits. The expression of the sternal morphological variation and sex are population-specific. The results will help standardize future studies and provide valuable information on the variability of the sternal morphological variation.

Advanced procedures for skull sex estimation using sexually dimorphic morphometric features

This paper introduces an automated method for estimating sex from cranial sex diagnostic traits by extracting and evaluating specialized morphometric features from the glabella, the supraorbital ridge, the occipital protuberance, and the mastoid process. The proposed method was developed and evaluated using two European population samples, a Czech sample comprising 170 crania reconstructed from anonymized CT scans and a Greek sample of 156 crania from the Athens Collection. It is based on a fully automatic algorithm applied on 3D models for extracting sex diagnostic morphometric features which are further processed by computer vision and machine learning algorithms. Classification accuracy was evaluated in a population specific and a population generic 2-way cross-validation scheme. Population-specific accuracy for individual morphometric features ranged from 78.5 to 96.7%, whereas population generic correct classification ranged from 71.7 to 90.8%. Combining all sex diagnostic traits in multi-feature sex estimation yielded correct classification performance in excess of 91% for the entire sample, whereas the sex of about three fourths of the sample could be determined with 100% accuracy according to posterior probability estimates. The proposed method provides an efficient and reliable way to estimate sex from cranial remains, and it offers significant advantages over existing methods. The proposed method can be readily implemented with the skullanalyzer computer program and the estimate_sex.m GNU Octave function, which are freely available under a suitable license.

Exploring sexual dimorphism of the modern human talus through geometric morphometric methods

Sex determination is a pivotal step in forensic and bioarchaeological fields. Generally, scholars focus on metric or qualitative morphological features, but in the last few years several contributions have applied geometric-morphometric (GM) techniques to overcome limitations of traditional approaches. In this study, we explore sexual dimorphism in modern human tali from three early 20th century populations (Sassari and Bologna, Italy; New York, USA) at intra- and interspecific population levels using geometric morphometric (GM) methods. Statistical analyses were performed using shape, form, and size variables. Our results do not show significant differences in shape between males and females, either considering the pooled sample or the individual populations. Differences in talar morphology due to sexual dimorphism are mainly related to allometry, i.e. size-related changes of morphological traits. Discriminant function analysis using form space Principal Components and centroid size correctly classify between 87.7% and 97.2% of the individuals. The result is similar using the pooled sample or the individual population, except for a diminished outcome for the New York group (from 73.9% to 78.2%). Finally, a talus from the Bologna sample (not included in the previous analysis) with known sex was selected to run a virtual resection, followed by two digital reconstructions based on the mean shape of both the pooled sample and the Bologna sample, respectively. The reconstructed talus was correctly classified with a Ppost between 99.9% and 100%, demonstrating that GM is a valuable tool to cope with fragmentary tali, which is a common occurrence in forensic and bioarchaeological contexts.

Analysis of the accuracy of a novel preformed osteosynthesis plate for the reduction and fixation of zygomaticomaxillary complex fractures

INTRODUCTION

There has been a shift toward surgical treatment of ZMC (zygomaticomaxillary complex) fractures with open reduction and subsequent fixation in the past decades. Anatomically preformed osteosynthesis plates, already used in the field of craniomaxillofacial surgery for the treatment of fractures of the mandible and the orbit, might be a suitable option for ZMC fractures as well.

MATERIAL AND METHODS

A statistical shape model was created from 179 cranial CT scans. Based on this surface model, an anatomically preformed plate for the reduction and fixation of ZMC fractures was developed in 3 sizes (S, M, L). Virtual analysis of the accuracy of the plate was performed on a dataset consisting of 120 CT scans.

RESULTS

Within a determined tolerance range of 0-1.5 mm, analysis revealed a high accuracy of the plate in 70-87 % of the CT scans. The S-sized plate has the highest overall accuracy, whereas the L-sized plate has highest accuracy at the "base" region which is essential for the placement of the plate.

DISCUSSION

The newly developed plate can be placed via an intraoral approach and analysis of the plate has confirmed its accuracy to be sufficient to ensure an adequate fracture reduction and fixation. It thus might allow for a less extensive approach and less approaches/incisions necessary overall to reduce and fixate ZMC fractures.

Using the zygomatic arch as a reference line for clinical applications and anthropological studies

PURPOSE

The Frankfurt line is the most frequently and widely used reference line in cephalometric analysis, but has shortcomings including the difficulty of landmark identification. This study investigated using the superior border of the zygomatic arch as a new external bony landmark, including measuring the angle between the new reference line and the Frankfurt line.

METHODS

Facial computed tomography scans were obtained from 170 patients (100 males and 70 females) hospitalized at Konkuk University Chungju Hospital. After three-dimensional reconstruction, the locations of the porion and the inferior orbital rim and the superior border of the zygomatic arch were identified twice by two observers using software. A horizontal line parallel to the superior border of the zygomatic arch was established. The angle between the Frankfurt line and new reference line was then measured on each side.

RESULTS

There was no significant intraobserver or interobserver bias. The angle between the Frankfurt line and the superior border of the zygomatic arch was 4.5° ± 2.5° (mean ± SD), and it was somewhat larger in females than males, but the difference was not statistically significant.

CONCLUSIONS

This study demonstrated the good reproducibility of the location of the superior border of the zygomatic arch and found that the angle between the new reference line and the Frankfurt line is relatively constant. The superior border of the zygomatic arch therefore has potential as an alternative reference line to the Frankfurt line in specific clinical applications and anthropological studies, since it is a more accessible bony landmark on the external skull.

Prevalence and characteristics of pneumatizations of the articular eminence and roof of the glenoid fossa on cone-beam computed tomography

OBJECTIVE

The aim of this study was to determine the prevalence and characteristics of pneumatization of the articular tubercle (PAT) and pneumatization of the roof of the glenoid fossa (PRGF) in a large population using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

This study was designed to evaluate the CBCT images of 1000 patients. The prevalences of the pneumatizations by age, sex, locularity, and laterality were determined. The significance of differences between variables was evaluated by the Chi-square test and analysis of variance.

RESULTS

PAT was detected in 28.4% of the zygomatic bone sides and PRGF in 29.6%. Bilateral PAT was detected in 176 (17.6%) patients and bilateral PRGF in 195 (19.5%). The mean age of patients with PAT was 47.33 years and that of patients with PRGF was 45.62 years. Multilocular appearance was observed significantly more often than unilocular type for both pneumatizations (p < 0.01). Unilateral PAT cases were slightly, but significantly, higher than bilateral PAT cases (p = 0.047), while no significant difference was observed between unilateral and bilateral PRGF cases.

CONCLUSIONS

In conclusion, PAT and PRGF can be assessed more accurately on CBCT images than on plain radiographs. During routine radiological investigations, maxillofacial radiologists should be aware of zygomatic air cells.

Evolution of the Jugal/Zygomatic Bones

This issue of the Anatomical Record is the second of a two-volume set on the zygoma (also called the cheek bone, the zygomatic bone, the malar, or the jugal, the latter term being used in vertebrates other than mammals). The zygoma is an important component of the craniofacial skeleton, in which the zygoma is a connection between the midfacial and the cranial skeletons; has a functional role as the origin of one of the masticatory muscles, the masseter muscle, and several facial muscles; has been considered as an essential buttress of the facial skeleton for resisting masticatory forces; and has importance for determining phylogenetic relationships. In humans, the zygoma is also of aesthetic significance for facial appearance, and its restoration following trauma has resulted in a large clinical literature. In this second half of the special issue on the zygoma, a series of papers discuss studies related to evolution of the zygoma and related parts of the craniofacial skeleton throughout the vertebrates, and in particular in human evolution. There are also a series of articles discussing variation of the zygoma in modern humans. This article is an overview in which we discuss the primary findings of these studies and some of their implications. Anat Rec, 300:12-15, 2017. © 2016 Wiley Periodicals, Inc.

Tracing social interactions in Pleistocene North America via 3D model analysis of stone tool asymmetry

Stone tools, often the sole remnant of prehistoric hunter-gatherer behavior, are frequently used as evidence of ancient human mobility, resource use, and environmental adaptation. In North America, studies of morphological variation in projectile points have provided important insights into migration and interactions of human groups as early as 12-13 kya. Using new approaches to 3D imaging and morphometric analysis, we here quantify bifacial asymmetry among early North American projectile point styles to better understand changes in knapping technique and cultural transmission. Using a sample of 100 fluted bifaces of Clovis and post-Clovis styles in the eastern United States ca. 13,100-9,000 cal BP (i.e., Clovis, Debert-Vail, Bull Brook, Michaud-Neponset/Barnes, and Crowfield), we employed two different approaches for statistical shape analysis: our previously presented method for analysis of 2D flake scar contours, and a new approach for 3D surface analysis using spherical harmonics (SPHARM). Whereas bifacial asymmetry in point shape does not vary significantly across this stylistic sequence, our measure of asymmetric flake scar patterning shows temporal variation that may signify the beginning of regionalization among early New World colonists.