bluuebunny/crossref_metadata_2025 huggingface dataset:
IDENTIFIKASI POTENSI KESESUAIAN PERAIRAN UNTUK BUDIDAYA RUMPUT LAUT DI TELUK MULUT SERIBU, ROTE NDAO, NUSA TENGGARA TIMUR
Authors: Andayani Ariani , Pamungkas Amin
Published: October 2018

Rumput laut merupakan salah satu komoditas unggulan sektor perikanan. Salah satu sentra budidaya rumput laut yang akan dikembangkan adalah Kabupaten Rote Ndao, yang memiliki ketersediaan perairan potensial untuk pengembangan budidaya rumput laut. Kajian kesesuaian perairan untuk budidaya rumput laut perlu dilakukan untuk keberlanjutan budidaya. Penelitian ini bertujuan untuk mengkaji karakteristik dan kesesuain perairan untuk pengembangan budidaya rumput laut di Teluk Mulut Seribu, Rote Ndao. Pengambilan data kualitas perairan dilakukan dengan pengukuran langsung dan mengambil sampel untuk dianalisis di laboratorium. Distribusi spasial kualitas perairan di area kajian diinterpolasi menggunakan metode IDW dengan perangkat lunak ArcGIS. Ada 4 parameter yang diperhitungkan dalam analisis spasial, yaitu: kedalaman, kecepatan arus, kecerahan dan alur layar, yang ditumpangsusun tanpa pembobotan untuk mendapatkan peta kesesuaian. Sementara itu beberapa parameter lainnya tidak masuk dalam analisis spasial karena kisaran nilainya sudah sesuai untuk budidaya rumput laut. Hasil penelitian menunjukan bahwa kesesuaian lahan untuk budidaya rumput laut di perairan Mulut Seribu mencapai 56% atau 497,68 hektar dari 879,18 hektar area kajian. Area yang sesuai untuk budidaya rumput laut tersebut memiliki potensi panen hingga 50 ton per siklus.Seaweed is one of the leading commodities in fisheries sector. In Rote Ndao regency, plans to develop seaweed aquaculture centers have been advised considering the regency’s potential coastline areas for seaweed farms. However, a site suitability study is needed to determine if the area is suitable for seaweed aquaculture to ensure its long term sustainability. This study was aimed to examine the characteristics and suitability of Teluk Mulut Seribu waters in Rote Ndao for seaweed cultivation. Data collection on water quality parameters was done via in-situ measurement and samples were collected to be analysed ex-situ in the laboratory. The full extent of spatial distributions of water quality parameters was determined using IDW interpolation tool available in ArcGIS. The four parameters used in the spatial analysis, namely: depth, current velocity, brightness, and sea transportation line were overlaid using non-weighted arithmetic mean operation to create a final composite of suitability map. The other measured parameters were not included in the spatial analysis because the value ranges were considered suitable for seaweed cultivation. The results showed that 56% or 497.68 ha from 879.18 ha of seascape in Teluk Mulut Seribu are suitable for seaweed farming.This study recommends that these suitable areas can be used for seaweed aquaculture with a predicted harvest potential up to 50 ton per culture cycle.
DESEMPENHO DE UM SISTEMA DE IRRIGAÇÃO POR GOTEJAMENTO NA CULTURA DA GOIABA
Authors: Carvalho Clayton Moura de , Eloi Waleska Martins , Lima Sílvio Carlos Ribeiro Vieira , Pereira Janeide Maria Guedes
Published: October 2018

DESEMPENHO DE UM SISTEMA DE IRRIGAÇÃO POR GOTEJAMENTO NA CULTURA DA GOIABA  Clayton Moura de Carvalho; Waleska Martins Eloi; Sílvio Carlos Ribeiro Vieira Lima; Janeide Maria Guedes PereiraDepartamento de Tecnologia em Recursos Hídricos, Irrigação, Instituto Centro de Ensino Tecnológico, Juazeiro do Norte, CE,  carvalho_cmc@yahoo.com.br  1 RESUMO Este trabalho foi desenvolvido na Escola Agrotécnica Federal do Crato-CE, com a finalidade de avaliar o desempenho de um sistema de irrigação localizada tipo gotejamento instalado em uma área cultivada com a cultura da goiaba (Psidium guajava L.). Os resultados obtidos mostraram que o sistema avaliado apresentou uma baixa eficiência, de acordo com os valores dos coeficientes de uniformidade e de eficiência de aplicação, que se apresentaram bastante inferiores aos valores recomendados por alguns autores. As diferenças porcentuais encontradas entre os valores dos coeficientes de uniformidade calculados na avaliação e os valores estimados pelas equações mostram-se muito baixas, confirmando a validade das equações propostas. Verificou-se uma diferença em torno de 16,56 pontos percentuais entre os valores encontrados da eficiência de armazenamento utilizando os diferentes coeficientes de uniformidade. Recomenda-se realizar avaliações periódicas no sistema em funcionamento, preferencialmente duas vezes ao ano. Com esta avaliação pode-se evitar os problemas acima citados, obtendo-se assim valores de uniformidade e eficiência da aplicação aceitáveis. UNITERMOS: Avaliação de Sistemas, irrigação localizada, Psidium guajava L.  CARVALHO, C. M. de.; ELOI, W. M.; LIMA, S. C. R. V.; PEREIRA, J. de M. G.;PERFORMANCE OF A DRIPPING IRRIGATION SYSTEM IN A GUAVAPLANTATIONIN CRATO,CE,BRAZIL  2 ABSTRACT This work was developed at the Federal Agrotechnical University of Crato, CE, Brazil, to evaluate the performance of a dripping irrigation system installed in an area cultivated with guava trees (Psidium guajava). Obtained results have shown that the evaluated system presented low efficiency, because its coefficient values for application uniformity and efficiency were quite inferior to the ones recommended by some authors. The percentage differences found between uniformity coefficient values, calculated in this evaluation, and the estimated values from equations were very low, corroborating the validity of proposed equations. There was a 16.56 percentage difference between values found for storage efficiency using different uniformity coefficients. Periodic evaluations of the functioning system should be made, preferably twice a year, in order to prevent and avoid the problems discussed above and, thus, obtain acceptable values for application uniformity and efficiency. KEYWORDS: Evaluation of Irrigation Systems, localized irrigation, Psidium guajava L.
AVALIAÇÃO DE DIFERENTES MÉTODOS DE ESTIMATIVA DA EVAPOTRANSPIRAÇÃO DA CULTURA DO CRISÂNTEMO (Chrisantemum spp.) CULTIVADO EM ESTUFA PLÁSTICA
Authors: Fernandes André Luiz Teixeira , Folegatti Marcos Vinícius , Pereira Antonio Roberto
Published: October 2018

AVALIAÇÃO DE DIFERENTES MÉTODOS DE ESTIMATIVA DA EVAPOTRANSPIRAÇÃO DA CULTURA DO CRISÂNTEMO (Chrisantemum spp.) CULTIVADO EM ESTUFA PLÁSTICA  André Luiz Teixeira Fernandes1; Marcos Vinícius Folegatti2; Antonio Roberto Pereira21Pró Reitoria de Pesquisa e Pós Graduação, Universidade de Uberaba, Uberaba, MG, andré.fernandes@uniube.br2Departamento de Engenharia Rural, Escola Superior de Agricultura "Luiz de Queiroz", Universidade de São Paulo, Piracicaba, SP  1 RESUMO  Com o objetivo de estudar métodos de controle de irrigação numa cultura de crisântemo, instalou-se uma estação agrometeorológica automática, numa estufa de 5600 m2, com  sensores de temperatura do ar, velocidade do vento, umidade relativa do ar, radiação solar global e lisímetro de pesagem com célula de carga, conectados a um coletor de dados. A partir dos dados meteorológicos obtidos, estimou-se a evapotranspiração da cultura utilizando-se os seguintes métodos: Tanque evaporimétrico, Camargo, Makkink, Radiação solar, Jensen-Haise, Linacre, Hargreaves-Samani, Penman, Penman-piche e Penman-Monteith. Os resultados foram comparados com as medições do lisímetro, considerado padrão. Os métodos que obtiveram maiores índices de correlação foram: Jensen-Haise (72,50%); Radiação Solar (71,53%); Makkink (71,53%), Penman-Monteith (71,16%) e Penman (72,09%).UNITERMOS: evapotranspiração, comparação entre métodos, cultura do crisântemo, cultivo protegido.  FERNANDES, A. L. T.; FOLEGATTI, M. V.; PEREIRA, A. R. VALUATION OF DIFFERENT EVAPOTRANSPIRATION ESTIMATE METHODS FOR (Chrysanthemum spp) CULTIVATED IN PLASTIC GREENHOUSE  2 ABSTRACT In order to study some methods to control irrigation of a chrysanthemum crop, an automatic weather station was installed inside a 5600 m2 greenhouse with the following sensors connected to a data logger: air temperature, relative humidity, wind speed, solar radiation and a weighing lysimeter. Evapotranspiration (ET) was estimated by the weather station data using the following methods: Solar Radiation, Pan Evaporation, Camargo, Makkink, Jensen-Haise, Linacre, Hargreaves-Samani, Penman, Penman-piche and Penman-Monteith. The results were compared with the ones from the weighing lysimeter data, which were considered standard. The best correlation indices were obtained by: Jensen-Haise (72.50%); solar radiation (71.53%); Makkink (71.53%), Penman-Monteith (71.16%) and Penman (72.09%). KEYWORDS: evapotranspiration, comparison of methods, chrysanthemum crop, protecting culture
Characterization of the Nasal, Sublingual, and Oropharyngeal Mucosa Microbiota in Cleft Lip and Palate Individuals before and after Surgical Repair
Authors: Cocco J. Faridy , Antonetti John W. , Burns John L. , Heggers John P. , Blackwell Steven J.
Published: October 2018

Objective

To delineate inherent differences in the microbial milieu in cleft palate patients compared with cleft lip patients and to document changes in microbial flora before and after cleft lip and palate repair.

Design

A prospective study of preoperative and postoperative culture results from the nasal, sublingual, and oropharyngeal surfaces of patients undergoing primary cleft lip repair and palate closure.

Setting

Shriners Hospitals for Children, Galveston, Texas, and University of Texas Medical Branch, Galveston, Texas.

Patients

Seventy-nine patients were included in a 3-year period. Ten patients with isolated cleft lip underwent primary lip repair. Twenty-five patients with cleft lip and palate underwent primary lip repair, and 44 patients underwent palatoplasty.

Results

Cleft palate patients had a significantly higher rate of colonization by staphylococcal species, but not methicillin-resistant Staphylococcus aureus, when compared to cleft lip patients ( p = .0298; chi-square test). Closure of the palatal cleft coincided with significant decline in the prevalence of Klebsiella and Enterobacter species ( p < .05; McNemar test). The only major complication, palatal dehiscence, was believed to be directly related to infection with group A beta-hemolytic streptococci.

Conclusions

Despite a high prevalence of potential pathogenic and enteric flora preoperatively in primary palate repair, postoperative wound infection is rare in the prospective study population. However, the presence of beta-hemolytic streptococci was associated with a higher risk of repair dehiscence; therefore, screening for Streptococci prior to surgery should be performed routinely.
A Comparative Study of Fluctuating Asymmetry in Chinese Families with Nonsyndromic Cleft Palate
Authors: Lu Da-Wei , Shi Bing , Chen Huai-Qing , He Xing , Liao Li-Shu , Zheng Qian
Published: October 2018

Objective

To compare the asymmetry displayed by Chinese patients with nonsyndromic cleft palate (NSCP), their unaffected parents, and a control population.

Method

With rigorous inclusion criteria, a total number of 675 individuals with NSCP, 675 parental pairs of these patients, and 650 control individuals were involved in this case-control study. Size-adjusted fluctuating asymmetry (FA) scores were calculated by data on 10 variables. Analysis of variance was used for a three-way comparison of patients/gender-matched parents/gender-matched controls.

Results

A significant increase in FA for ear length ( p < .05) was noted in NSCP patients when compared with their gender-matched parents. A significant increase in FA for ear length and palpebral fissure width ( p < .05) was observed in NSCP patients when compared with the gender-matched control population. A significant increase in FA for palpebral fissure width ( p < .05) was detected in parents of NSCP patients when compared with a gender-matched control population.

Conclusion

Our results indicated that, when compared with a gender-matched control population, patients with NSCP show significantly increased FA in both ear length and palpebral fissure width, but the parents of patients with NSCP show significantly increased FA only in palpebral fissure width. In general, these characteristics seem to be more distinct in male individuals.
Parental Perspectives of Children Born with Cleft Lip and/or Palate: A Qualitative Assessment of Suggestions for Healthcare Improvements and Interventions
Authors: Knapke Sara C. , Bender Patricia , Prows Cynthia , Schultz Janet R. , Saal Howard M.
Published: October 2018

Objective

To assess parental perspectives on effective interventions and to summarize parents’ suggestions for health care professionals to improve the care provided to their children born with cleft lip and/or palate.

Design

Qualitative interviews.

Setting

Comprehensive craniofacial center at a Midwest pediatric hospital.

Participants

Seventeen parents of children under the age of 1 who were born with CL/P.

Results

Interventions that parents identified as effective included repetition of information, showing pictures of other children (before and after surgery), and anticipatory guidance about surgeries and their child's development. Despite the high level of satisfaction, parents expressed a desire for health care professionals to use more written and visual information, to have more contact with other parents of children born with clefts, and for health care professionals outside the Craniofacial Center to be more knowledgeable about CL/P.

Conclusions

Although parents of children with CL/P were for the most part satisfied with their children's care, the parents who were interviewed for this study suggested attainable changes that may result in more constructive and positive involvement of parents as integral members of the craniofacial team.
A Study of Facial Growth in Patients with Bilateral Cleft Lip and Palate Treated by the Oslo CLP Team
Authors: Semb Gunvor
Published: October 2018

Lateral and frontal cephalometric analysis of a mixed longitudinal survey of 90 individuals with complete bilateral clefts of the lip and palate from the Oslo Growth Archive is described. All subjects were treated and followed-up by the Oslo CLP Team according to strictly defined protocols for treatment and documentation. Craniofacial form in this sample is generally similar to that reported for Caucasian subjects treated for this condition elsewhere.
Craniofacial Morphology in Treacher Collins Syndrome
Authors: Arvystas Michael , Shprintzen Robert J.
Published: October 2018

Treacher Collins syndrome is a rare but well studied autosomal dominant craniofacial malformation syndrome. Most reports to date have focused on the facial morphology of this distinctive syndrome, but several more recent investigations have described abnormalities of the basicranium, mandible, and upper airway. The purpose of this report is to describe craniofacial morphology in a sample population of 12 patients with Treacher Collins syndrome. A special emphasis is placed on cranial base and mandibular structure because of the airway problems often encountered in this syndrome.
Biologic Basis for a Risk Assessment Model for Cleft Palate
Authors: Freni Stan C. , Zapisek William F.
Published: October 2018

A biologic model for palatogenesis is presented, intended as a basis for risk assessment. It comprises a sequence of developmental stages: growth and migration of neural crest cells, downward growth of palatal buds, elevation of palatal shelves, and differentiation of the epithelium followed by shelf fusion. Several events representing these stages and amenable to mathematical translation may be measurable in the form of biomarkers such as DNA and protein synthesis, phospholipid metabolism, and signal transducing systems. Interrupting components of the model will result in cleft palate. Teratogens with known mechanisms of action are compared with the model. The quantitative risk of cleft palate is conceived as a sequence of mathematical probabilities that any stage of the model runs an abnormal course. Stage-specific probabilities are determined by a chemical's potency and dose, and by duration of exposure and gestational age. Species or strain sensitivity may be expressed as quantitative differences in model parameters. Although the model is designed for cleft palate, the risk model may also estimate a multiple response risk to the same exposures.
Development of a Method for Rating Nasolabial Appearance in Patients with Clefts of the Lip and Palate
Authors: Asher-Mcdade Catherine , Roberts Christopher , Shaw William C. , Gallager Conor
Published: October 2018

Comparison of the outcome of treatment of patients with clefts of the lip and palate can yield valuable pointers for discriminating between beneficial and harmful procedures. The development of a standardized rating scheme to assess the facial appearance of these patients is described. The rating scheme can be used in conjunction with conventional cephalometric analysis and dental arch evaluation. A method is described in which the nasolabial area is masked, thus reducing the influence of the surrounding facial features since it is shown that judges are influenced by general facial attractiveness. An ordinal scale has been evaluated in which four features of the nose and lip are assessed separately and in total by a panel of judges. The nasolabial profile, the nasal symmetry, the nasal form, and vermilion border were assessed using a 5-point scale. Acceptable pooled levels of reliability and reproducibility were obtained. This standardized rating system may be used to differentiate treatment outcome in patients from different treatment centers.
Postnatal Craniofacial Skeleton Development following a Pushback Operation of Patients with Cleft Palate
Authors: Viteporn Smorntree , Enemark Hans , Melsen Blrte
Published: October 2018

A longitudinal growth study of the craniofacial skeleton in 52 (19 males, 33 females) Danish individuals with cleft palates was performed. Thirty (13 males, 17 females) had clefts of the soft palate only or clefts extending into the posterior third of the hard palate. Twenty-two (6 males, 16 females) had more extensive clefts including up to two-thirds of the hard palate. The cleft was closed with a pushback operation at 22 months of age. Orthodontic treatment was included in the early mixed dentition. Lateral cephalometries were obtained at 5, 8, 12, 16, and 21 years of age. Twenty-four variables were digitized and analyzed. The results indicated that patients with more extensive clefts demonstrated significantly smaller anterior cranial base length (N-S), total cranial base length (N-Ba), maxillary dentoalveolar base length (A-PMP), mandibular length (Cd-Pgn), upper anterior and posterior facial heights (N-ANS and P-PMP), and total facial height (N-Gn). Patients with the more extensive clefts reached maximum growth spurt later than patients with less extensive clefts in all dimensions except the A-PMP and the lower and total facial heights.
Mandible, Tongue, and Airway in Pierre Robin Sequence: A Longitudinal Cephalometric Study
Authors: Figueroa Alvaro A. , Glupker Timothy J. , Fitz Martin G. , Begole Ellen A.
Published: October 2018

The purpose of this retrospective longitudinal cephalometric study was to analyze size, growth, and relations of the mandible, tongue, and airway in the isolated, nonsyndromic Pierre Robin Sequence (PRS) infant. The objective was to understand better the early morphologic changes that occur in these structures. The data were obtained from lateral cephalometric radiographs taken in the first 2 years of life on 17 PRS infants, 26 isolated cleft palate (CP), and 26 normal control (N) infants. Mean values of each variable were compared using a univariate analysis of variance. A multivariate discriminant function analysis (DFA) was also used to characterize group differences. The three groups were distinct throughout the period of study. Differences were greater at the earliest age and the distinction was greater between the PRS and N infants with the CP infant in between, but having more similarity to the PRS infant. Initially, the PRS infant had a shorter tongue and mandibular length, narrower airway, smaller tongue area and the hyoid position was more posterior and inferior as compared to N. The tongue shape and position were specific to the PRS infants. This group distinction diminished with age and resulted from an increased mandibular growth rate in the PRS infant. These findings support the hypothesis of “partial mandibular catch-up growth” in the PRS infant. The increased growth rate in the PRS infant improved the airway dimension, which might be partly responsible for the natural resolution of the respiratory distress. This increased growth rate did not allow for the various structures to reach values equal to normal.
Prevalence of Cleft Uvula among School Children in Kindergarten through Grade Five
Authors: Wharton Paul , Mowrer Donald E.
Published: October 2018

The purpose of this study was to determine the prevalence of bifid uvula among elementary school children in grades K through 5. Three examiners performed independent intraoral examinations of 709 children enrolled in a Jacksonville, Florida metropolitan public school. The structure of the uvula was evaluated as normal or bifid. If bifid, the cleft was classified as: (a) notched, (b) extending up to ¼ the length of the uvula, (c) extending from ¼ to ¾ 4 of the length of the uvula, or (d) extending the full length of the uvula. Prevalence of some form of uvular cleft was observed among 16 (2.26%) of the children while full length uvular cleft was found in only two (0.3%) of the children. These findings are congruent with percentages reported in other studies. It is recommended that speech-language pathologists identify children with bifid uvulas and provide appropriate counseling and follow-up study.
A Questionnaire Survey of Attitudes and Concerns of Three Professional Groups Involved in the Cleft Palate Team
Authors: Noar Joseph H.
Published: October 2018

This study Investigated the opinions of three of the professional groups who treat cleft lip and palate patients in the United Kingdom. Plastic surgeons, orthodontists, and speech therapists were asked to give their opinions regarding adolescents with a unilateral cleft of the lip and palate. A mail questionnaire investigating four main areas: treatment, facial appearance and speech, social and emotional aspects, and the perceived success of the specialists was sent to each subject. Nearly all the subjects reported that they worked as part of a cleft palate team and there was good agreement among the three groups. Although the professionals felt that they have been successful, they were not satisfied with the results of their treatment nor with the patients’ overall facial appearance or speech. They also felt that the patients are emotionally and socially affected by their cleft and are teased. The subjects noted that they think patients feel similarly to themselves on all aspects. The significance of the results is discussed.
Craniofacial Skeletal Measurements Based on Computed Tomography: Part I. Accuracy and Reproducibility
Authors: Waitzman Ariel A. , Posnick Jeffrey C. , Armstrong Derek C. , Pron Gaylene E.
Published: October 2018

Computed tomography (CT) is a useful modality for the management of craniofacial anomalies. A study was undertaken to assess whether CT measurements of the upper craniofacial skeleton accurately represent the bony region imaged. Measurements taken directly from five dry skulls (approximate ages: adults, over 18 years; child, 4 years; infant, 6 months) were compared to those from axial CT scans of these skulls. Excellent agreement was found between the direct (dry skull) and indirect (CT) measurements. The effect of head tilt on the accuracy of these measurements was investigated. The error was within clinically acceptable limits (less than 5 percent) if the angle was no more than + 4° from baseline (0°). Objective standardized information gained from CT should complement the subjective clinical data usually collected for the treatment of craniofacial deformities.
Pierre Robin: A Personal Diary
Authors: Perlman Carol
Published: October 2018

This personal diary of the birth and subsequent management of a child with Robin sequence secondary to Stickler syndrome Is written by a mother who also has Stickler syndrome. Her discussion of the case Illustrates the importance of reaching a primary diagnosis In order to deliver good patient care.
Habilitation of Patients with Clefts: Parent and Child Ratings of Satisfaction with Appearance and Speech
Authors: Broder Hillary L. , Smith Fraser B. , Strauss Ronald P.
Published: October 2018

This study examined ratings regarding satisfaction with facial appearance and speech performance from 495 parent-child pairs. Data were obtained from school-aged children (5–18 years old) and their parents using standardized independent interviews. Results revealed that 54 percent of the children with cleft lip (CL) or cleft lip and palate (CLP) were very pleased with their appearance, and 62 percent of the cleft palate or CLP subjects were very pleased with speech. Low, but statistically significant correlations exist between the female subjects and their parents in satisfaction with appearance. Although older cleft lip and/or palate patients reported increased satisfaction with speech, no age differences in patient satisfaction with appearance were observed in subjects with CL/CLP. Parents of females expressed more concern about their daughters' appearance than parents of males, while parents of males were more concerned about speech. Implications for craniofacial habilitation teams and research suggestions are discussed.
Soft Palate Reflex: Technical Requirements and First Results
Authors: Godbersen Godber S. , Schneider-Littfeld Johannes , Werner Jochen A. , Wolters Sönke , Pellner Axel
Published: October 2018

The present study describes technical prerequisites for soft palate reflex measurements and first results. Reflex measurements can be done using standard electromyographic methods. The data-processing system that records and processes the electromyographic signals was activated when the soft palate was stimulated by a newly developed device. The first results of objective soft palate reflex measurements in 15 healthy subjects show that the musculus levator veli palatini reacts to a mechanical stimulation of the soft palate with a contraction that can be measured electromyographicslly. The response latencies were constant in the individual subjects. In 12 subjects a minimum of 30 ms and a maximum of 61 ms was recorded. In one healthy subject, the reflex was activated only after 167 ms. No reflex could be evoked in two subjects. The stimulus was always supraliminal. Reaction time was longer following surface anesthesia of the oral mucosa.
Self-Perception, Social Skills, Adjustment, and Inhibition in Young Adolescents with Craniofacial Anomalies
Authors: Kapp-Simon Kathy A. , Simon Dennis J. , Kristovich Sharon
Published: October 2018

This study examines the relationships between self-perception, social skills, overall adjustment, and social inhibition in 45 young adolescents with craniofacial anomalies (CFA). Self-perception, social skills, and inhibition scores are within the normal range while the average adjustment is 1.5 SD below the average. Regression analyses were conducted. Social skills and athletic competence are the best predictors of adjustment and accounted for 73.5% of the variance in adjustment. Adjustment of adolescents is associated with degree of inhibition, with more poorly adjusted adolescents displaying greater inhibition. Self-esteem did not predict to adjustment. The theoretical and clinical implications of these findings are discussed.
Maxillary Lateral Incisors of Subjects with Cleft Lip and/or Palate: Part 2
Authors: Suzuki Akira , Watanabe Mieko , Nakano Masayuki , Takahama Yasuhide
Published: October 2018

Maxillary lateral incisors on the alveolar cleft were investigated in 431 cleft children registered in the Department of Orthodontics, Kyushu University Dental Hospital. The majority of primary maxillary lateral incisors were located on the distal side of the alveolar cleft in both unilateral cleft lip and alveolus (UCLA) and unilateral cleft lip and palate (UCLP) subjects. Permanent teeth in UCLA tend to be located distally, but in UCLP they tend to be congenially absent (p < .01). The majority of primary teeth had normal shapes; the majority of permanent teeth were of intermediate type or were missing congenially. One third of the UCLA and one half of the UCLP subjects who had primary maxillary lateral incisors were not followed by permanent replacements. The location of the majority of permanent maxillary lateral incisors tallied with that of the primary ones except in four UCLA, ten UCLP, and two bilateral cleft lip and palate (BCLP) subjects. Four UCLA and ten UCLP subjects who had primary lateral incisors on the distal side were followed by their permanent successors on the mesial side. Three UCLP and one BCLP subjects had permanent maxillary lateral incisors even though they had no temporary predecessors.
A Six-Center International Study of Treatment Outcome in Patients with Clefts of the Lip and Palate: Part 2. Craniofacial Form and Soft Tissue Profile
Authors: Mølsted Kirsten , Asher-Mcdade Catherine , Brattström Viveca , Dahl Erik , Mars Michael , Mcwilliam John , Plint Dennis A. , Prahl-Andersen Birte , Semb Gunvor , Shaw William C. , The Ralph P.S.
Published: October 2018

The craniofacial morphology and the soft tissue profile were evaluated in this part of the intercenter study of the European Cleft Lip and Palate Research Group. The sample was comprised of cephalometric x-rays of the full cohort of 151 cases from the six European cleft palate centers. The facial morphology in complete unilateral cleft lip and patate patients was evaluated by means of roentgen cephalometry. Approximately 25 consecutive cases from each of six European cleft palate centers were compared. Only one center showed notable and consistent differences from the others. A contributing factor for these differences may be an inconsistent treatment regimen with many surgeons involved. Analysis of the soft tissue profile between the centers showed more pronounced differences than analysis of the skeletal profile. The treatment outcome in centers with more complex or expensive programs was no better than those centers using simpler management approaches.
Dental Implants to Rehabilitate a Patient with an Unrepaired Complete Cleft of the Hard and Soft Palate: A Clinical Report
Authors: Harrison John W.
Published: October 2018

Prosthetic rehabilitation of an edentulous adult with a complete residual cleft of his palates is presented. Lack of retention of his prosthesis made speech and eating difficult. Four osseointegrated dental implants were used to join the right and left maxillae and to provide mechanical retention for a complete overdenture obturator to improve function.
Clinician Activism and Ethical Restraints in Providing Treatment: Preventive as Opposed to Reconstructive Approaches
Authors: Saal Howard M.
Published: October 2018

There is seldom controversy when faced with treatment decisions for a child born with a birth defect. Occasionally, the situation arises in which a decision to withhold treatment must be made. Under most circumstances the responsibility for making such decisions rests with the child's parents or guardians, since it is generally felt that these individuals are the best advocates for the child's best interests. In order to make such difficult decisions, the parents are dependent upon the guidance and counseling of health professionals, especially the physicians most closely involved in each case. The ultimate decisions made by parents are dependent upon open and unambiguous communication with their children's clinicians as well as open communications among the caregivers themselves. The role of the clinician as an advocate for treatment and nontreatment of children is dependent upon clear unbiased communication and the desire to do what is in the best interest for each patient.
Data Analysis in Craniofacial Biology with Special Emphasis on Longitudinal Studies
Authors: Kowalski Charles J.
Published: October 2018

Recommendations are made for strengthening data description and analysis in craniofacial biology. Special emphasis is placed on longitudinal data, and PC programs for accomplishing appropriate analyses in this context are described and made available to interested readers. Some more general recommendations are treated in less detail. These include the effective description of data using stem-and-leaf displays and/or boxplots, the use of decision-analytic methods in the management of patients with dentofacial deformities, and the valid application of certain statistical methods in single-subject studies. Finally, it is conjectured that computer-intensive methods such as randomization tests and jackknifing will play an increasingly prominent role in craniofacial research.
Congenital Bilateral Coronal Suture Synostosis in a Rabbit and Craniofacial Growth Comparisons with Experimental Models
Authors: Mooney Mark P. , Losken H. Wolfgang , Tschakaloff Alexander , Siegel Michael I. , Losken Albert , Lalikos Janice F.
Published: October 2018

Experimental rabbit models of postnatal coronal suture (CS) synostosis have helped make significant contributions towards the understanding and surgical management of human congenital craniosynostosis. The present study compares craniofacial growth patterns in animals with experimental CS immobilization and in a rabbit born in our laboratory with congenital CS synostosis. The study sample consisted of 10 sham controls, 14 experimental animals with bilateral CS immobilization, and one animal with congenital, bilateral CS synostosis. At 1.5 weeks of age, all animals had amalgam markers placed on either side of the frontonasal, coronal, and anterior lambdoid sutures. At this time, the experimental animals had bilateral CS immobilization using methyl-methacrylate. Serial lateral head x-rays were taken at 1.5, 6, 12, and 18 weeks of age. Results revealed that by 1.5 weeks of age the congenital animal already exhibited changes in the cranial vault, cranial base, midface, and orthocephalic cranial base angles compared to controls. By 6 weeks of age, animals with experimental immobilization showed compensatory growth patterns similar to the congenital animal, particularly at the calvarial sutures and upper midface. This pattern continued through 18 weeks. Results showed that experimental, postnatal CS immobilization produced similar craniofacial growth patterns to those observed for our single congenital animal, but to a lesser degree, and therefore validates, in part, findings from experimental rabbit models of synostosis.
Hypernasality in the Presence of “Adequate” Velopharyngeal Closure
Authors: Warren Donald W. , Dalston Rodger M. , Mayo Robert
Published: October 2018

In some instances, hypernasality occurs despite an instrumental assessment of “adequate” velopharyngeal closure. The pressure-flow technique was used to assess the timing characteristics associated with velopharyngeal closure in 11 such subjects. The group's performance was compared to the aerodynamic characteristics of two other subject groups. One was comprised of 13 cleft palate subjects with adequate closure and normal nasal resonance, while the second group consisted of 16 noncleft subjects who also manifested normal speech. The data indicate that there are several unique timing features that differentiate the hypernasal but “adequate” group from the two control groups. These include a delay of about 50 ms in achieving closure, a longer interval of nasal emission, and a shorter duration of actual closure. Hypernasality seems to be associated with the actual time the velopharyngeal mechanism is open, rather than the volume of air escaping from the nasal chamber.
Accurate and Systematic Numerical Recording System for the Identification of Various Types of Lip and Maxillary Clefts (RPL SYSTEM)
Authors: Schwartz Stephane , Kapala Jon T. , Rajchgot Harry , Roberts Gordon L.
Published: October 2018

Inaccuracies exist in identifying and recording various types of oral cleft. One of the major reasons for this problem is that no efficient or universally accepted recording system presently exists. The RPL system introduced in this article provides an accurate and systematic numerical recording for the identification of various types of lip and maxillary clefts. The simplicity of the system allows quick and efficient data storage and retrieval.
Use of Osseointegrated Implants to Support a Maxillary Denture for a Patient with Repaired Cleft Lip and Palate
Authors: Lund Todd W. , Wade Marshall
Published: October 2018

Although many cleft lip and palate patients retain their dentition, some develop partial or complete edentullsm. The configuration of the residual maxillary alveloar ridge may provide little support for a complete or partial maxillary denture. The success of the Branemark dental implant has been well established, and although placement of implants in the maxilla may present a surgical challenge, implants are very effective in providing support and, therefore, retention and stability. Application of implants to the cleft palate maxilla is particularly valuable because of the difficulty in constructing well-fitting conventional dentures for CLP patients, and the relatively compromised nature of the prostheses when made. This report presents the prosthetic treatment of a nearly edentulous cleft lip and palate patient.
Unilateral Absence of the Soft Palate: Case Report of Reconstruction with a Mucoperiosteal Island Flap
Authors: Mavili M. Emin , Gucer Tacettin , Erk Yucel
Published: October 2018

Congenital absence of half of the soft palate Is a rare deformity. There is little in the literature about its definition and management. This article presents a case with velopharyngeal insufficiency caused by unilateral absence of the soft palate. The patient was treated with a modification of the mucoperiosteal Island flap, first designed by Millard, to provide nasal lining during pushback lengthening of a short cleft palate. The speech quality of the patient Improved noticeably after the operation. Although island flap has limited use in primary cleft palate surgery, It may be effective in reconstruction of soft palate defects, when standard pushback procedures are not adequate for solving the problem.
The Velopharyngeally Inadequate Child: Phonologic Change with Intervention
Authors: Broen Patricia A. , Doyle Shirley S. , Bacon Catherine K.
Published: October 2018

Diagnostic therapy is often recommended for children before physical management of the velopharyngeal structures. There Is, however, limited Information about the effectiveness of such intervention programs. This study describes the changes that occurred In a 3-year-old child's production of speech during a period of diagnostic therapy, and the changes that occurred following the fitting of a prosthesis. The mother served as the primary Intervener, guided by a speech-language pathologist. The mother was able to change the child's speech so that more of her productions were at a correct place of articulation. After structural management, nasal and glottalized productions disappeared from the child's speech, but glottal stops did not.
Developmental Approach to the Psychology of Craniofacial Anomalies
Authors: Speltz Matthew L. , Greenberg Mark T. , Endriga Marya C. , Galbreath Holly
Published: October 2018

This article outlines a developmental perspective on psychosocial maladjustment and Its implications for the psychological study and treatment of Individuals with craniofacial anomalies. A developmental theory of attachment is described and used to formulate hypotheses about the developing parent-child relationship during the first 5 years of life and its influence on the child's subsequent social and emotional growth. Preliminary research Involving Infants with clefts and other craniofacial anomalies is reviewed with respect to hypothesized points of vulnerability in the attachment process. Two major points are made: (1) developmental theory provides a framework for the early identification of children in this population with elevated risk of subsequent psychosocial problems, and (2) among the multiple child and family variables associated with elevated risk, a craniofacial anomaly Is unlikely to produce maladjustment in the absence of one or more other risk conditions such as family adversity, insecure attachment, or compromised child characteristics.
Achondroplasia: Pre- and Postsurgical Considerations for Midface Advancement
Authors: Barone Constance M. , Eisig Sidney , Jimenez David F. , Argamaso Ravelo V. , Shprintzen Robert J.
Published: October 2018

Achondroplasia, the most common type of dwarfism, Involves several physical characteristics that can cause pre- and intraoperative respiratory problems. The characteristics Include rib-cage deformities, midface hypoplasia, choanal stenosis, muscular hypotonia, foramen magnum compression, and cervical abnormalities. Specific pre- and postoperative strategies for dealing with achondroplastic dwarfs are discussed.
Lateral Videofluoroscopy: A Modification to Aid in Velopharyngeal Assessment and Measurement
Authors: Sommerlad Brian , Rowland Nan , Harland Kim
Published: October 2018

To overcome the difficulty of obtaining adequate videofluoroscopic images with small children because of lack of cooperation and their inability to keep their heads still and correctly rotated, a 3D View-Master was attached to the x-ray table. Its use greatly increased the ability to conduct lateral videofluoroscopies of small children by improving patient complience, stabilizing rotation and reducing unwanted head movement, and by standardizing magnification.
Incisai Overjet as an Outcome Measure in Unilateral Cleft Lip and Palate Management
Authors: Morris Tim , Roberts Chris , Shaw William C.
Published: October 2018

The Goslon Yardstick is a clinical tool used to rank dental study casts of persons with cleft lip and palate in the late mixed or early permanent dentition into one of five categories. It has been successfully used to investigate the outcomes of the surgical treatment of these anomalies as well as the effects of these deformities on untreated individuals. In this study, 40 study casts ranked by the Goslon Yardstick were digitized using a reflex metrography. The overjet, overbite, and incisal angulation, and the crossbites of the canines and molars were calculated for each of the sets of casts. Multiple regression analysis was used to determine the predictive value of these variables upon the Goslon scores. The overjet was found to explain 87% of the variance of the Goslon score (p < .0001). No other component had a significant predictive value. The range of overjet associated with the different Goslon scores was calculated from the regression equation. In conclusion, the advantages of using overjet as an Indicator of outcome as an alternative to the Goslon Yardstick were discussed.
Maxillary Dental Arch Affected by Different Sleep Positions in Unilateral Complete Cleft Lip and Palate Infants
Authors: Huang Chiung-Shing , Cheng Hsin-Chung , Chen Yu-Ray , Noordhoff M. Samuel
Published: October 2018

The development of the dental arch is well designed for adaptive and compensatory growth. In this study, the relationship between the sleep position and dental arch development was Investigated. A group of 42 infants with unilateral complete cleft lip and palate with either prone (16) or supine (26) sleep position were seen in the craniofacial center. All infants were less than 1 month of age at the initial visit. Dental impressions of the maxillary arch were taken at the initial visit and just before cheiloplasty. Ten arch dimensions were measured in each dental cast and the longitudinal change in each dimension was compared between the prone sleep group and the supine sleep group. Statistically significant changes were detected in the growth rate of the following dimensions: intercanine width, intertuberosity width, alveolar cleft width, anterior cleft width, and posterior cleft width. This study indicated that sleep position affected maxillary arch development. Infants sleeping in the prone sleep position tended to have narrower arch width and cleft width.
Anatomy and Significance of the Temporal Fat Pad in Apert Syndrome
Authors: Smith Rick J. , Jackson Ian T.
Published: October 2018

Abnormal temporal region anatomy In Apert syndrome described in the literature includes inferior and lateral displacement of the middle cranial fossa, effacement of the temporal fossa, and thinning of the temporalis muscle. Four patients with Apert syndrome were noted to have hyperplasia of the bilateral superficial temporal fat pads, which could be contoured surgically. A case is presented with reformatted three-dimensional computed tomography (3-D CT) scans with intraoperative documentation of Increased temporal fat as compared to normal controls.
Treatment of Asymmetric Velopharyngeal Insufficiency with Skewed Pharyngeal Flap
Authors: Argamaso Ravelo V. , Levandowski Gerald J. , Golding-Kushner Karen J. , Shprintzen Robert J.
Published: October 2018

Twenty-two patients, with hypernasal speech and asymmetric velopharyngeal insufficiency (VPI) identified preoperatively by multi-view videofluoroscopy and nasopharyngoscopy, were managed with superiorly based pharyngeal flaps skewed to the side with reduced lateral pharyngeal wall movement. Patient age ranged from 5 to 58 years. The etiology of the VPI included cleft palate with or without cleft lip, neurogenic VPI, velocardiofacial syndrome, tumor resection or latrogenic causes, submucous cleft palate, neurofibromatosis, and hemifacial microsomia. Follow-up, at 1 year and thereafter, showed resolution of VPI in all but two patients. An auxiliary flap to augment the primary flap was added on the side of diminished lateral pharyngeal wall motion which corrected the residual VPI. Three patients developed hyponasality. One was a child whose symptoms improved with time and growth. Two were adults, but the hyponasal resonance was mild and required no further Intervention. The advantage of skewing flaps is that at least one port functions adequately for ease in respiration and for drainage of secretions, thus reducing the risk of nasal obstruction. One open port also allows access for nasoendotracheal intubation should anesthetic be required for future operations.