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A comparison of symptom checklist 90-revised profiles from patients with chronic pain from whiplash and patients with other musculoskeletal injuries.

STUDY DESIGN: A quasi-experimental design was used to compare the Symptom Checklist 90-Revised profiles (SCL-90-R) from a group of patients with whiplash injuries (n = 67) and a group with mixed musculoskeletal pain (n = 91). OBJECTIVES: To test the discriminant validity of the characteristic SCL-90-R whiplash profile as proposed by Wallis and Bogduk using a multivariate statistical technique. SUMMARY OF BACKGROUND DATA: On the basis of two studies by themselves and their colleagues, Wallis and Bogduk proposed a characteristic SCL-90-R profile evident in samples of patients with whiplash injuries. Their assertion has not been tested empirically in any published studies. METHODS: The participants in this study consisted of 158 patients at a rehabilitation hospital who completed the SCL-90-R under standard instructions and subsequently were diagnosed by a team comprising a chiropractor, physical therapist, and physician. The participants were categorized as having whiplash-associated disorders or pain caused by other musculoskeletal injuries. A profile analysis following Hotelling's method was used to determine the comparability of SCL-90-R profiles from the two groups. RESULTS: The profile analysis showed no statistically significant differences between the groups with regard to either the shape or the overall elevation of their psychological profiles. The SCL-90-R profiles from both groups were similar to those reported from other chronic pain syndromes, with elevations on the Somatization, Depression, Obsessive-Compulsive, and Psychoticism scales. CONCLUSIONS: The current study failed to support the validity of a distinctive SCL-90-R profile for patients with whiplash injuries. Instead, the results suggest that the psychological consequences of experiencing chronic pain from whiplash-associated disorders are similar to the psychological consequences of chronic pain from other musculoskeletal injuries.

Adult↗

Balanced angular profile analysis.

To evaluate current preferences and ethnic differences of female soft-tissue profiles, 71 profile photographs of famous female models were collected from Internet Web pages and divided into four groups (Korean, 22; Japanese, 15; Chinese, 16; and Western, 18). Eleven soft-tissue landmarks were recorded on each photograph and 16 angular measurements were made by using V-ceph (CyberMed, Inc., Seoul, Korea). Data from each group are presented to show the means, ranges, p and F values, standard deviations, and standard errors of each measurement. In addition, individual measurements for each group were compared with those of the other groups by one-way analysis of variance using a p value corrected for multivariable testing. Between-group mean value differences were calculated using a Tukey's studentized range test (HSD), at a significance level of p = 0.05. Most of the variables were similar in the groups. Significant between-group differences (p < 0.05) were found for angle of alar curvature point, profile convexity, interlabial contour, and nasolabial contour. In addition, we divided all data into two groups (Western and Asian). The t test (with significance level set to p = 0.05) was performed to compare the two. Significant between-group differences (p < 0.05) were found for angle of alar curvature, angle of labiale inferius, profile convexity, and lower lip projection angle, but no significant racial differences were found in terms of several profile angles. These findings suggest that point of ala curvature point, subnasale, and the labiale inferius of Asian models may differ from those of Western models. These peculiar angular patterns of Asian models led the authors to create a new characteristic angular concept, termed the "ethnic pyramid," which is composed of soft-tissue profile points of alar curvature point, subnasale, pronasale, and labiale inferius. This ethnic pyramid describes the characteristic patterns of the ethnic differences. The results of this study suggest that the soft-tissue profiles of famous female models have some common features but also show differences among ethnic groups and races. This simple method of profile analysis may provide aesthetic surgeons with a simple formula and reference data for creation and application of an attractive face. On the basis of their balanced angular profile analysis data, the authors suggest that appropriate and harmonious aesthetic operations reflecting these differences should be considered.

Adult↗

Stabilization of nonlinear velocity profiles in athermal systems undergoing planar shear flow.

We perform molecular dynamics simulations of model frictionless granular systems undergoing boundary-driven planar shear flow in two spatial dimensions with the goal of developing a more complete understanding of how dense particulate systems respond to applied shear. In particular, we are interested in determining when these systems will possess linear velocity profiles and when they will develop highly localized velocity profiles in response to shear. In previous work on similar systems we showed that nonlinear velocity profiles form when the speed of the shearing boundary exceeds the speed of shear waves in the material. However, we find that nonlinear velocity profiles in these systems are unstable at very long times. The degree of nonlinearity slowly decreases in time; the velocity profiles become linear when the granular temperature and density profiles are uniform across the system at long times. We measure the time t(l) required for the velocity profiles to become linear and find that t(l) increases as a power law with the speed of the shearing boundary and increases rapidly as the packing fraction approaches random close packing. We also performed simulations in which differences in the granular temperature across the system were maintained by vertically vibrating one of the boundaries during shear flow. We find that nonlinear velocity profiles form and are stable at long times if the difference in the granular temperature across the system exceeds a threshold value that is comparable to the glass transition temperature in an equilibrium system at the same average density. Finally, the sheared and vibrated systems form stable shear bands, or highly localized velocity profiles, when the applied shear stress is lowered below the yield stress of the static part of the system.

Journal Article↗

Visual classification of banded human chromosomes ii. classification and karyotyping of integrated density profiles.

Visual classification and karyotyping of 897 integrated density profiles generated from straight and non-overlapping chromosomes from 22 trypsin-banded metaphases of average quality was carried out and evaluated. The results were compared with visual classification of photographic prints of the same 897 chromosomes. The experiments were carried out by one observer. About 5% errors were made in classification of isolated profiles; 0-5% errors were made in karyotyping profiles and about 3% errors were made in classification of isolated chromosome prints. The reason for the small error rate obtained by karyotyping profiles as compared to the error rate when classifying isolated profiles was assumed to be the use of a priori knowledge of the composition of (normal) metaphases and the possibility of making appropriate comparisons between the individual profiles within the metaphase. Comparison between classification of isolated prints and of profiles showed different error patterns on the basis of which it was assumed that prints constitute a better basis for visual classification than profiles. The results seemed to indicate two ways of improving computer classification of banded chromosomes: (1) information of value in the chromosomes (band pattern, shape etc.) should be extracted from the digitized chromosome image in a manner superior to the simple integration by which profiles are produced; (2) computer karyotyping should simulate the human method, thus taking advantage of a priori knowledge of the composition of the metaphases and being able to make appropriate comparisons between individual chromosomes.

Chromosomes↗

Measurement of CT radiation profile width using CR imaging plates.

This paper describes the procedure for using a Fuji computed radiography (CR) imaging plate (IP) for the measurement of computed tomography (CT) radiation profiles. Two sources of saturation in the data from the IP, signal and quantization, were characterized to establish appropriate exposure and processing conditions for accurate measurements. The IP generated similar profiles compared to those obtained from digitized ready-pack films, except at the profile edges, where the exposure level is low. However, when IP pixel values are converted to exposure, CR and digitized film profiles are in agreement. The full width at half maximum (FWHM) of the CT radiation profile was determined from the relationship between pixel value and exposure and compared to FWHM of the digitized optical density profile from film. To estimate the effect of scattering by the cassette material, radiation profiles were acquired from IPs enclosed in a cassette or in a paper envelope. The presence of the cassette made no difference in the value determined for FWHM. With proper exposure and processing conditions, the FWHM of 5, 10, and 15 mm collimated beams were measured using IPs to be 7.1, 11.9, and 17.0 mm and using film to be 7.2, 12.2, and 16.8 mm, respectively. Our results suggest that, under appropriate conditions, the estimation of the width of the CT radiation profile using Fuji CR is comparable to the measurement from film density described in American Association of Physicists in Medicine (AAPM) Report No. 39. Although our experiment was conducted using Fuji CR, we anticipate that CR plates from other vendors could be successfully used to measure CT beam profiles because of similar empirical relationships between pixel value and exposure.

Radiation Dosage↗

Sources of variation in profile analysis. II. Component spacing, dynamic changes, and roving level.

Profile-analysis experiments have typically employed static profiles with constant frequency components spaced at equal intervals along a logarithmic frequency axis. Most periodic, naturally occurring stimuli, however, have components that are harmonically related and vary dynamically in time. One goal of these studies was to determine whether amplitude-increment detection thresholds are different in dynamic, harmonically spaced profiles compared to those for static-log profiles, and why such differences might exist. A second goal was to determine the impact of roving levels (within-trial variation of level). Thresholds for static-log profiles were, on average, 8.7 dB lower than for static-harmonic profiles. A traditional filter-bank model could not account for this result. No consistent effect of dynamic contour (an exponential rising frequency glide) was observed. Thresholds were consistently poorer by 4 to 7 dB when the level was roved, but the differences in thresholds among the different profiles varied little. It is proposed that the higher thresholds observed in static-harmonic profiles may be accounted for by the more intense pitch strength associated with the harmonic profiles.

Adolescent↗

Visualization and quantification of transmural concentration profiles of macromolecules across the arterial wall.

Transport parameters that describe a macromolecule entering the arterial wall from plasma can be obtained from concentration profiles of the labeled macromolecule entering the tissue. A new technique has been developed for measuring such concentration profiles, which offers spatial resolution superior to methods that measure profiles of radiolabeled macromolecules by serially sectioning tissue in planes parallel to the endothelium. In addition, this new method preserves cellular organization and tissue structure and permits measurement of concentration profiles underlying focal endothelial injuries or vascular lesions. The technique quantifies the concentration of a protein by measuring associated peroxidase activity. Although the present study was performed using horseradish peroxidase (HRP), the same principles can be applied to other macromolecules linked to HRP or microperoxidase. The colored reaction product of HRP was detected in transverse aortic sections using an image processing system. In the present study, profiles obtained by this new method were validated by comparison with HRP concentration profiles in rat aortas obtained by a serial slicing technique using radiolabeled HRP. We used the technique to measure high-resolution HRP concentration profiles in the intima and media of normal animals. These concentration profiles suggest that the internal elastic lamina acts as a major barrier to transport of macromolecules across the wall of the normal rat aorta. The new method should allow concentration profiles for macromolecules to be quantified in tissue surrounding vessels in the microcirculation, within the thickened intima of large vessels, and across coronary artery walls.

Animals↗

An empirical assessment of content in criminal psychological profiles.

Although criminal psychological profiling has been in use by law enforcement agencies for almost three decades, there is a paucity of empirical research examining the technique. A fundamental issue that has received little attention is the empirical evaluation of information contained in profiles composed by professional profilers. In this study, a group of profilers, police officers, psychologists, college students, and self-declared psychics were given information from a solved murder investigation, after which the participants composed a written profile predicting the probable offender. Professional profilers tended to write more lengthy profiles that contained more information about the nonphysical attributes of the offender and more information about the crime scene or the offender's behavior before, during, and after the crime. These results are discussed in terms of their implication for our broader understanding of the technique of profiling and future directions for research into profiling.

Crime↗

Normal range MMPI-A profiles among psychiatric inpatients.

The present study examined the base rates of normal range Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A) profiles in an inpatient sample and examined the differences between adolescents with apparently valid normal range profiles (all clinical scale T-scores < 60) and those with elevated profiles on prior interventions, reported internalizing and externalizing symptoms, and MMPI-A validity scale scores and other indexes of underreporting. Normal range profiles cannot be adequately explained by a less pathological history prior to hospitalization or by defensiveness. Thirty percent of male and 25% of female adolescents produced valid MMPI-A profiles in which none of the clinical scales were elevated. Both male and female adolescents with normal range profiles were generally less likely to report internalizing symptoms than those with elevated profiles, but both groups report externalizing symptoms. Neither the standard MMPI-A validity scales nor additional validity scales discriminated between profile groups. Clinicians should not assume that normal range profiles indicate an absence of problems.

Adolescent↗

A format for databasing and comparison of AFLP fingerprint profiles.

BACKGROUND: Amplified fragment length polymorphism (AFLP) is a PCR-based technique that involves restriction of genomic DNA followed by ligation of adaptors to the fragments generated and selective PCR amplification of a subset of these fragments. The amplified fragments are separated on a sequencing gel and visualized by autoradiography or fluorescent sequencing equipment. AFLP allows high-resolution genotyping but the lack of a format for databasing and comparison of AFLP fingerprint profiles limits its wider applications in profiling large numbers of biological samples. RESULTS: A scheme is described to represent a DNA fingerprint profile with a nucleotide sequence-like format in which the information line contains the minimal necessary details to interpret an AFLP DNA fingerprint profile. They include technique used, information on restriction enzymes, primer combination, biological source for DNA materials, fragment sizing and annotation. The bodylines contain information on size and relative intensity of DNA fragments by a string of defined alphabets or symbols. Algorithms for normalizing raw data, binning of fragments and comparing AFLP DNA fingerprint profiles are described. Firstly, the peak heights are normalized against their average and then represented by five symbols according to their relative intensities. Secondly, a binning algorithm based loosely on common springs and rubber bands is applied, which positions sequence fragments into their best possible integer approximations. A BLAST-like reward-penalty concept is used to compare AFLP fingerprint profiles by matching peaks using two metrics: score and percentage of similarity. A software package was developed based on our scheme and proposed algorithms. Example of use this software is given in evaluating novelty of a new tropical orchid cultivar by comparing its AFLP fingerprint profile against those of related commercial cultivars in a database. CONCLUSIONS: AFLP DNA fingerprint profiles can be databased and compared effectively with software developed based on our scheme and algorithms. It will facilitate wider use of this DNA fingerprinting technique in areas such as forensic study, intellectual property protection for biological materials and biodiversity management. Moreover, the same concepts can be applied to databasing and comparing DNA fingerprint profiles obtained with other DNA fingerprint techniques.

Algorithms↗

Comparing three new MMPI-2 randomness indices in a novel procedure for random profile derivation.

This study compared three new validity indices; /F-Fb/, VRIN+/F-Fb/, and F+Fb+/F-Fb/; to the F, back-F, and VRIN according to their effectiveness in detecting degrees of profile randomness. Participants completed the Minnesota Multiphasic Personality Inventory-2 (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, and Kaemmer, 1989) according to standardized instructions. All profiles starting at Items 142, 284, or 426 were substituted with computer-generated random responses to produce 75%, 50%, and 25% random profiles, respectively. Twenty-five profiles were derived using 100% computer-generated items. Finally, one unaltered set of profiles was designated as 0% random. This generated five groups of MMPI-2 profiles, differing according to the degree of profile randomness (i.e., 0%, 25%, 50%, 75%, and 100%). Results showed that the F and /F-Fb/ indices were unable to distinguish authentic from all degrees of randomness, whereas the F+Fb+F-Fb scale could reliably distinguish all levels of randomness. The actuarial analysis found back-F and F+Fb+/F-Fb/ misclassified the least number of profiles, suggesting the latter index should be included in the evaluation of MMPI-2 profile randomness.

Journal Article↗

Twenty-four-hour plasma growth hormone (GH) profiles, urinary GH excretion, and plasma insulin-like growth factor-I and -II levels in prepubertal children with chronic renal insufficiency and severe growth retardation.

We studied 24-h plasma GH profiles, maximal GH responses to arginine provocation and insulin-like growth factor-I (IGF-I) and IGF-II levels in plasma in 22 euthyroid prepubertal children (mean age, 9.5 yr) with chronic renal insufficiency (glomerular filtration rate, less than 20 mL/min.1.73 m2) and severe growth retardation [mean (+/- SD) height SD score (SDS), -2.8 (1.1)]. The 24-h GH profiles were analyzed using the Pulsar program. Girls had significantly higher 24-h GH secretion than boys (P less than 0.004). Children with end-stage nephrotic syndrome had higher baseline GH levels and total area under the curve (AUCo) than patients with dysplastic kidneys (P less than 0.05), while the area under the curve above baseline (AUCb) was similar in all types of renal diseases. The type of treatment (conservative, peritoneal, hemodialysis) did not significantly influence the 24-h GH secretion. No correlation was found between 24-h GH profiles and age, height SDS for chronological age, height velocity SDS for bone age, and weight for height. Fourteen children showed a normal 24-h GH profile, defined as a GH profile with well defined, regular GH peaks returning to baseline GH levels and a distinct day and night pattern (AUCb, 90-300 micrograms/L.24 h). Four children had low profiles, with GH peaks below 10 micrograms/L, returning to baseline GH levels and occurring almost exclusively during the night (AUCb, less than 90 micrograms/L.24 h). The remaining four children had elevated 24-h GH profiles, with GH peaks on top of elevated baseline GH levels of more than 3 micrograms/L (AUCb, 35-205 micrograms/L.24 h; AUCo greater than 300 micrograms/L.24 h). In all patients 24-h urinary GH and beta 2-globulin excretion was 100-1000 times higher than that in controls. The urinary GH excretion correlated significantly with all characteristics of the 24-h GH profiles (r = 0.57-0.59; P less than 0.05). The maximal GH response during the arginine tolerance test was normal in 66% of the children. The mean (+/- SD) SDS for bone age for the IGF-I plasma levels was +1.1 (1.9), and that for IGF-II was +3.6 (3.4). IGF-I levels correlated significantly with the AUCb, maximum GH, and GH peak characteristics of the 24-h GH profiles (r = 0.05-0.73; P less than 0.02-0.001). IGF-II levels did not show any correlation with the characteristics of the endogenous GH secretion.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

Metabolic profile in severely obese women is less deteriorated than expected when compared to moderately obese women.

BACKGROUND: Obesity is well known to be associated with an increased prevalence of metabolic complications. Severe obesity is thus expected to have more important alterations of the metabolic profile than moderate obesity. This study aimed to compare the metabolic profile of pre- and postmenopausal severely obese women with moderately obese women. METHODS: First, the metabolic profile of pre- (n=165) and postmenopausal (n=43) severely obese women (body mass index (BMI) > or =40 kg/m(2)) was compared to that of pre- (n=52) and postmenopausal (n=35) moderately obese women (BMI of 30-40 kg/m(2)). Thereafter, pre- and postmenopausal severely obese women were divided into two subgroups according to the presence/absence of a dysmetabolic profile. We used for comparison, a group of pre- and postmenopausal moderately obese women without a dysmetabolic profile. RESULTS: The metabolic profile of pre- and postmenopausal severely obese women was less deteriorated than expected when compared to moderately obese women. Moreover, severely obese women with or without a dysmetabolic profile displayed comparable or even lower plasma levels of cholesterol, HDL and LDL-cholesterol, and a lower cholesterol/HDL-cholesterol ratio than moderately obese women (P< or =0.05). After menopause, the metabolic profile of severely obese women, dysmetabolic or not, was similar to that of moderately obese women. Blood pressure was, however, higher in severely obese women compared to moderately obese women, only before menopause (P< or =0.0001). CONCLUSION: These results indicate that despite their large accumulation of adipose tissue, most of the severely obese women had a metabolic profile less deteriorated than expected, when compared to moderately obese women.

Adipose Tissue↗

Reproducibility of 24-h growth hormone profiles in children.

The rate of GH secretion and the pattern of GH peaks were compared in a group of nine prepubertal children during their prepubertal period in repeated 24-h GH profiles. At investigation, the children were 6-13 years old (at first profile 6-11 years old) and of normal height (+/- 2 SD). Two profiles were obtained per child, (with a mean time interval of 1.5 years, range 0.7 to 3.5 years. The calculated GH secretions of the first and second profiles were compared. As a group, no significant differences in secreted amount of GH, when expressed as data from the second profile as a percentage of data from the first profile (93 +/- 8%), number of peaks (98 +/- 7%) or mean peak amplitudes (92 +/- 11%), were obtained. Between the repeated curves of an individual child, maximal difference in secretion, number of peaks and mean peak amplitudes ranged around +/- 30%, with a mean intraindividual cv of 12%. The reproducibility in the peak distribution for all profiles was also analysed. The relative frequencies is a percentage of the GH peak amplitudes and peak widths were virtually identical in the repeated profiles. Reproducibility of the temporal pattern of profiles was analysed using time-series analysis (Fourier analysis) and showed no difference in rhythmicity between the different occasions. In conclusion, a high reproducibility of both GH secretion and GH pattern was found for the whole group of prepubertal children.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

The Seattle evaluation of computerized drug profiles: effects on prescribing practices and resource use.

Since 1979, all outpatient pharmacy transactions at the US Public Health Service Hospital in Seattle have been captured in a computer system which generates a profile of each patient's active and previously used drugs. We conducted a controlled trial in which patients were allocated to profile or no-profile groups while the computer continued to collect data on everyone. In all, 41,572 clinic visits made by 6,186 patients were studied. The incidence of preventable drug-drug interactions and redundancies was very low and was unaffected by profiles. For unclear reasons, prescription of two interacting drugs on the same visit was significantly more common for patients with profiles. The duration of drug-drug interaction episodes was significantly shorter for profile group patients, perhaps due to earlier detection of the error on subsequent visits. Profiles had no effect on prescribing volume or coordination of drug refill and visit schedules, but profile group patients made about 5 per cent fewer clinic visits than those in the no-profile group. In this setting, it appears that the prescribing of interacting or redundant drugs is more often due to inadequate provider knowledge than to inaccessible patient-specific drug data. Prevention of such errors would thus require a more active educational or monitoring program.

Computers↗

Dietary guidelines in the Czech Republic. II.: Nutritional profiles of food groups.

Modern dietary guidelines set in terms of food groups are easy to use and understand for target populations, but rather complicated from the point of view of quantification, i.e. the correctly set number of recommended servings in different population groups according to age, sex, physical activity and physiological status on the basis of required intake of energy and individual nutrients. It is the use of abstract comprehensive food groups that makes it impossible to use a simple database of food tables based on the content of nutrients in individual foods, rather than their groups. Using groups requires that their nutritional profiles be established, i.e. that an average content of nutrients and energy for individual groups be calculated. To calculate nutritional profiles for Czech dietary guidelines, the authors used three different methods: (1) Simple profiles, with all commodities with significant representation in the Czech food basket represented in equal amounts. (2) Profiles based on typical servings, with the same commodities as in (1) but in characteristic intake quantities (typical servings). (3) Food basket-based profiles with commodities constituting the Czech food basket in quantities identical for that basket. The results showed significant differences in profiles calculated by different methods. Calculated nutrient intakes were particularly influenced by the size of typical servings and it is therefore essential that a realistic size of servings be used in calculations. The consistent use of recommended food items throughout all food groups and subgroups is very important. The number of servings of foods from the five food groups is not enough if a suitable food item is not chosen within individual groups. On the basis of their findings, the authors fully recommend the use of nutritional profiles based on typical servings that give a realistic idea of the probable energy and nutrient content in the recommended daily intake. In view of regional cultural differences, national nutritional profiles play a vital importance. Population studies investigating the size of the typical servings and the most frequently occurring commodities in the food basket should be made every three years. Nutritional profiles designed in this way constitute an important starting point for setting national dietary guidelines, their implementation and revisions.

Czech Republic↗

Decompression profile and bubble formation after dives with surface decompression: experimental support for a dual phase model of decompression.

The present study was initiated in order to determine the effect of decompression profiles on bubble formation following surface decompression using oxygen. Following an air dive to 496 kPa (130 fsw) for 90 minutes, three different profiles were tested in the pig; a USN staged decompression profile, a profile using linear continuous decompression with the same total decompression time as the USN profile (ABI) and a linear profile with half the total decompression time compared to the the first two (ABII). The subsequent surface decompression at 220 kPa lasted 68 minutes for all three schedules. The study demonstrated that, following final decompression, the two linear profiles produced the lowest amount of vascular gas, with the fastest profile producing significantly less bubbles in the Pulmonary artery than the other two. Similar results were obtained in the jugular vein. The results are in qualitative agreement with model simulation using the Reduced Gradient Bubble Model (RGBM), demonstrating that the controlling tissues are reduced from those with a half time of 40 minutes using the USN procedure to 5 minutes using the fastest linear profile.

Animals↗

[Study on perception of Shanghai population with labial profile].

OBJECTIVE: To investigate the perception of Shanghai population with labial profile and evaluate its effect on orthodontic treatment. METHODS: Four facial profiles with different labial convexity were drawn with computer aid on the basis of the pretty Chinese female cephalometric measurements. 650 panelists were selected from Shanghai area including 250 youth with normal profile and 200 adolescents under orthodontic treatment and their parents. Subjects were asked to rank the four facial profiles in descending order of attractiveness. RESULTS: The ranking was as follows: slightly straight style, standard style, straight style and slightly convex style. The normal male youth preferred more convex style than female. Patients with Class profile preferred standard style while Class and patients and the parents were fond of slightly straight style. CONCLUSION: People in Shanghai area tended to prefer straight profile. The perception with labial profile has sex and age difference. It also has difference between non-orthodontic and orthodontic patients and was influenced by the profiles themselves. It was suggested that consultation between orthodontist and patient was essential and more attention should be made on the patient's perception with labial profile.

Adolescent↗