Capillary growth, ultrastructure remodelling and exercise training in skeletal muscle of essential hypertensive patients

AIM The aim was to elucidate whether essential hypertension is associated with altered capillary morphology and density and to what extent exercise training can normalize these parameters. METHODS To investigate angiogenesis and capillary morphology in essential hypertension, muscle biopsies were obtained from m. vastus lateralis in subjects with essential hypertension (n = 10) and normotensive controls (n = 11) before and after 8 weeks of aerobic exercise training. Morphometry was performed after transmission electron microscopy, and protein levels of several angioregulatory factors were determined. RESULTS At baseline, capillary density and capillary-to-fibre ratio were not different between the two groups. However, the hypertensive subjects had 9% lower capillary area (12.7 ± 0.4 vs. 13.9 ± 0.2 μm(2)) and tended to have thicker capillary basement membranes (399 ± 16 vs. 358 ± 13 nm; P = 0.094) than controls. Protein expression of vascular endothelial growth factor (VEGF), VEGF receptor-2 and thrombospondin-1 were similar in normotensive and hypertensive subjects, but tissue inhibitor of matrix metalloproteinase was 69% lower in the hypertensive group. After training, angiogenesis was evident by 15% increased capillary-to-fibre ratio in the hypertensive subjects only. Capillary area and capillary lumen area were increased by 7 and 15% in the hypertensive patients, whereas capillary basement membrane thickness was decreased by 17% (P < 0.05). VEGF expression after training was increased in both groups, whereas VEGF receptor-2 was decreased by 25% in the hypertensive patients(P < 0.05). CONCLUSION Essential hypertension is associated with decreased lumen area and a tendency for increased basement membrane thickening in capillaries of skeletal muscle. Exercise training may improve the diffusion conditions in essential hypertension by altering capillary structure and capillary number.

Complejidad Esencial: Un argumento por la complementariedad entre ciencia y sensibilidad = Essential Complexity: An argument for complementarity between science and sensibility

Esta investigación recoge un cúmulo de intereses en torno a un modo de generar arquitectura muy específico: La producción de objetos con una forma subyacente no apriorística. Los conocimientos expuestos se apoyan en condiciones del pensamiento reciente que impulsan la ilusión por alimentar la fuente creativa de la arquitectura con otros campos del saber. Los tiempos del conocimiento animista sensible y el conocimiento objetivo de carácter científico son correlativos en la historia pero casi nunca han sido sincrónicos. Representa asimismo un intento por aunar los dos tipos de conocimiento retomando la inercia que ya se presentía a comienzos del siglo XX. Se trata por tanto, de un ensayo sobre la posible anulación de la contraposición entre estos dos mundos para pasar a una complementariedad entre ambos en una sola visión conjunta compartida. Como meta final de esta investigación se presenta el desarrollo de un sistema crítico de análisis para los objetos arquitectónicos que permita una diferenciación entre aquellos que responden a los problemas de manera completa y sincera y aquellos otros que esconden, bajo una superficie consensuada, la falta de un método resolutivo de la complejidad en el presente creativo. La Investigación observa tres grupos de conocimiento diferenciados agrupados en sus capítulos correspondientes: El primer capítulo versa sobre el Impulso Creador. En él se define la necesidad de crear un marco para el individuo creador, aquel que independientemente de las fuerzas sociales del momento presiente que existe algo más allá que está sin resolver. Denominamos aquí “creador rebelde” a un tipo de personaje reconocible a lo largo de la Historia como aquel capaz de reconocer los cambios que ese operan en su presente y que utiliza para descubrir lo nuevo y acercarse algo al origen creativo. En el momento actual ese tipo de personaje es el que intuye o ya ha intuido hace tiempo la existencia de una complejidad creciente no obviable en el pensamiento de este tiempo. El segundo capítulo desarrolla algunas Propiedades de Sistemas de actuación creativa. En él se muestra una investigación que desarrolla un marco de conocimientos científicos muy específicos de nuestro tiempo que la arquitectura, de momento, no ha absorbido ni refleja de manera directa en su manera de crear. Son temas de presencia casi ya mundana en la sociedad pero que se resisten a ser incluidos en los procesos creativos como parte de la conciencia. La mayoría de ellos hablan de precisión, órdenes invisibles, propiedades de la materia o la energía tratados de manera objetiva y apolítica. La meta final supone el acercamiento e incorporación de estos conceptos y propiedades a nuestro mundo sensible unificándolos indisociablemente bajo un solo punto de vista. El último capítulo versa sobre la Complejidad y su capacidad de reducción a lo esencial. Aquí se muestran, a modo de conclusiones, la introducción de varios conceptos para el desarrollo de un sistema crítico hacia la arquitectura de nuestro tiempo. Entre ellos, el de Complejidad Esencial, definido como aquella de carácter inevitable a la hora de responder la arquitectura a los problemas y solicitaciones crecientes a los que se enfrenta en el presente. La Tesis mantiene la importancia de informar sobre la imposibilidad en el estado actual de las cosas de responder de manera sincera con soluciones de carácter simplista y la necesidad, por tanto, de soluciones necesarias de carácter complejo. En este sentido se define asimismo el concepto de Forma Subyacente como herramienta crítica para poder evaluar la respuesta de cada arquitectura y poder tener un sistema y visión crítica sobre lo que es un objeto consistente frente a la situación a la que se enfrenta. Dicha forma subyacente se define como aquella manera de entender conjuntamente y de manera sincrónica aquello que percibimos de manera sensible inseparable de las fuerzas ocultas, creativas, tecnológicas, materiales y energéticas que sustentan la definición y entendimiento de cualquier objeto construido. ABSTRACT This research includes a cluster of interests around a specific way to generate architecture: The production of objects without an a priori underlying form. The knowledge presented is based on current conditions of thought promoting the illusion to feed the creative source of architecture with other fields of knowledge. The sensible animist knowledge and objective scientific knowledge are correlative in history but have rarely been synchronous. This research is also an attempt to combine both types of knowledge to regain the inertia already sensed in the early twentieth century. It is therefore an essay on the annulment of the opposition between these two worlds to move towards complementarities of both in a single shared vision. The ultimate goal of this research is to present the development of a critical analysis system for architectural objects that allows differentiation between those who respond to the problems sincerely and those who hide under an agreed appearance, the lack of a method for solving the complexity of the creative present. The research observes three distinct groups of knowledge contained in their respective chapters: The first chapter deals with the Creative Impulse. In it is defined the need to create a framework for the creative individual who, regardless of the current social forces, forebodes that there is something hidden beyond which is still unresolved. We define the "rebel creator" as a kind of person existing throughout history who is able to recognize the changes operating in its present and use them to discover something new and get closer to the origin of creation. At present, this type of character is the one who intuits the existence of a non obviable increasing complexity in society and thought. The second chapter presents some systems, and their properties, for creative performance. It describes the development of a framework composed of current scientific knowledge that architecture has not yet absorbed or reflected directly in her procedures. These are issues of common presence in society but are still reluctant to be included in the creative processes even if they already belong to the collective consciousness. Most of them talk about accuracy, invisible orders, properties of matter and energy, always treated from an objective and apolitical perspective. The ultimate goal pursues the approach and incorporation of these concepts and properties to the sensible world, inextricably unifying all under a single point of view. The last chapter deals with complexity and the ability to reduce it to the essentials. Here we show, as a conclusion, the introduction of several concepts to develop a critical approach to analyzing the architecture of our time. Among them, the concept of Essential Complexity, defined as one that inevitably arises when architecture responds to the increasing stresses that faces today. The thesis maintains the importance of reporting, in the present state of things, the impossibility to respond openly with simplistic solutions and, therefore, the need for solutions to complex character. In this sense, the concept of Underlying Form is defined as a critical tool to evaluate the response of each architecture and possess a critical system to clarify what is an consistent object facing a certain situation. The underlying form is then defined as a way to synchronously understand what we perceive sensitively inseparable from the hidden forces of creative, technological, material and energetic character that support the definition and understanding of any constructed object.

Specific atomic groups and RNA helix geometry in acceptor stem recognition by a tRNA synthetase

Oligonucleotides that recapitulate the acceptor stems of tRNAs are substrates for aminoacylation by many tRNA synthetases in vitro, even though these substrates are missing the anticodon trinucleotides of the genetic code. In the case of tRNAAla a single acceptor stem G⋅U base pair at position 3·70 is essential, based on experiments where the wobble pair has been replaced by alternatives such as I⋅U, G⋅C, and A⋅U, among others. These experiments led to the conclusion that the minor-groove free 2-amino group (of guanosine) of the G⋅U wobble pair is essential for charging. Moreover, alanine-inserting tRNAs (amber suppressors) that replace G⋅U with mismatches such as G⋅A and C⋅A are partially active in vivo and can support growth of an Escherichia coli tRNAAla knockout strain, leading to the hypothesis that a helix irregularity and nucleotide functionalities are important for recognition. Herein we investigate the charging in vitro of oligonucleotide and full-length tRNA substrates that contain mismatches at the position of the G⋅U pair. Although most of these substrates have undetectable activity, G⋅A and C⋅A variants retain some activity, which is, nevertheless, reduced by at least 100-fold. Thus, the in vivo assays are much less sensitive to large changes in aminoacylation kinetic efficiency of 3·70 variants than is the in vitro assay system. Although these functional data do not clarify all of the details, it is now clear that specific atomic groups are substantially more important in determining kinetic efficiency than is a helical distortion. By implication, the activity of mutant tRNAs measured in the in vivo assays appears to be more dependent on factors other than aminoacylation kinetic efficiency.

Role of adenine functional groups in the recognition of the 3′-splice-site AG during the second step of pre-mRNA splicing

The AG dinucleotide at the 3′ splice sites of metazoan nuclear pre-mRNAs plays a critical role in catalytic step II of the splicing reaction. Previous studies have shown that replacement of the guanine by adenine in the AG (AG → GG) inhibits this step. We find that the second step was even more severely inhibited by cytosine (AG → CG) or uracil (AG → UG) substitutions at this position. By contrast, a relatively moderate inhibition was observed with a hypoxanthine substitution (AG → HG). When adenine was replaced by a purine base (AG → PG) or by 7-deazaadenine (AG → c7AG), little effect on the second step was observed, suggesting that the 6-NH2 and N7 groups do not play a critical role in adenine recognition. Finally, replacement of adenine by 2-aminopurine (AG → 2-APG) had no effect on the second step. Taken together, our results suggest that the N1 group of adenine functions as an essential determinant in adenine recognition during the second step of pre-mRNA splicing.

Essential role of Glu-C66 for menaquinol oxidation indicates transmembrane electrochemical potential generation by Wolinella succinogenes fumarate reductase

Quinol:fumarate reductase (QFR) is a membrane protein complex that couples the reduction of fumarate to succinate to the oxidation of quinol to quinone, in a reaction opposite to that catalyzed by the related enzyme succinate:quinone reductase (succinate dehydrogenase). In the previously determined structure of QFR from Wolinella succinogenes, the site of fumarate reduction in the flavoprotein subunit A of the enzyme was identified, but the site of menaquinol oxidation was not. In the crystal structure, the acidic residue Glu-66 of the membrane spanning, diheme-containing subunit C lines a cavity that could be occupied by the substrate menaquinol. Here we describe that, after replacement of Glu-C66 with Gln by site-directed mutagenesis, the resulting mutant is unable to grow on fumarate and the purified enzyme lacks quinol oxidation activity. X-ray crystal structure analysis of the Glu-C66 → Gln variant enzyme at 3.1-Å resolution rules out any major structural changes compared with the wild-type enzyme. The oxidation-reduction potentials of the heme groups are not significantly affected. We conclude that Glu-C66 is an essential constituent of the menaquinol oxidation site. Because Glu-C66 is oriented toward a cavity leading to the periplasm, the release of two protons on menaquinol oxidation is expected to occur to the periplasm, whereas the uptake of two protons on fumarate reduction occurs from the cytoplasm. Thus our results indicate that the reaction catalyzed by W. succinogenes QFR generates a transmembrane electrochemical potential.

Metabolic engineering of essential oil yield and composition in mint by altering expression of deoxyxylulose phosphate reductoisomerase and menthofuran synthase

Peppermint (Mentha × piperita L.) was independently transformed with a homologous sense version of the 1-deoxy-d-xylulose-5-phosphate reductoisomerase cDNA and with a homologous antisense version of the menthofuran synthase cDNA, both driven by the CaMV 35S promoter. Two groups of transgenic plants were regenerated in the reductoisomerase experiments, one of which remained normal in appearance and development; another was deficient in chlorophyll production and grew slowly. Transgenic plants of normal appearance and growth habit expressed the reductoisomerase transgene strongly and constitutively, as determined by RNA blot analysis and direct enzyme assay, and these plants accumulated substantially more essential oil (about 50% yield increase) without change in monoterpene composition compared with wild-type. Chlorophyll-deficient plants did not afford detectable reductoisomerase mRNA or enzyme activity and yielded less essential oil than did wild-type plants, indicating cosuppression of the reductoisomerase gene. Plants transformed with the antisense version of the menthofuran synthase cDNA were normal in appearance but produced less than half of this undesirable monoterpene oil component than did wild-type mint grown under unstressed or stressed conditions. These experiments demonstrate that essential oil quantity and quality can be regulated by metabolic engineering. Thus, alteration of the committed step of the mevalonate-independent pathway for supply of terpenoid precursors improves flux through the pathway that leads to increased monoterpene production, and antisense manipulation of a selected downstream monoterpene biosynthetic step leads to improved oil composition.

The Team Climate Inventory (TCI): a psychometric test on a Taiwanese sample of work groups

Understanding the feasibility of applying the Team Climate Inventory (TCI) in non-Western cultures is essential for researchers attempting to understand the influence of culture on workers' perceived climate. This study describes the application of the TCI in such a setting using data from 203 administrators employed in a Taiwanese medical center. Reliability and factor analyses were performed to establish the feasibility and psychometric properties of the TCI Taiwan version. Reliabilities of both the four- and five-factor solutions exceeded .80. Factor analyses indicated a satisfactory four-factor structure, despite some variations in comparison with the U.K. version. The TCI Taiwan version is feasible and has acceptable psychometric properties. Further research is warranted regarding the degree to which disparities result from cultural differences and the specific nature of organizational systems in Chinese communities.

Basisdiskothek Rock und Pop:Essential collection rock and pop

Was darf in einem gutsortierten Plattenschrank aus den Bereichen Rock und Pop nicht fehlen? Uwe Schütte beantwortet diese drängende Frage. Inzwischen hat er seine erfolgreiche Empfehlungsliste überarbeitet und den Band um fünf Klassiker sowie Entdeckungen in neuen Einzelartikeln ergänzt: von Abba über Burial, Death Cab For Cutie und Tocotronic bis hin zu Wilco. Register der Platten und Gruppen erleichtern die Orientierung in diesem für den Musikfan unentbehrlichen Band. What may be missing in a well-stocked record collection from the fields of rock and pop not? Uwe Schütte answers this pressing question. Since then he has revised his successful referral list and the band around five classics and new discoveries, supplemented in individual articles: Abba on Burial, Death Cab For Cutie and Plumb to Wilco. Register of the panels and groups to facilitate the orientation in this indispensable volume for the music lover.

Nurturing health-related online support groups:exploring the experience of patient moderators

The aim of this study was to examine the views of moderators across a diverse and geographically broad range of online support groups about their moderator experiences and to explore both the personal benefits as well as challenges involved. Thirty-three patient moderators completed an online questionnaire which included a series of open-ended questions. Thematic analysis identified three themes: emergence, empowerment, nurturing. Several moderators declared their own diagnosis and for some, being able to share personal insights motivated them to establish the group and in turn offered validation. They felt empowered by helping others and learned more about the condition through accessing the "communal brain". Some felt the group aided patients' access to health services and their ability to communicate with health professionals while others worried about them becoming over-dependent. Moderators described needing to nurture their group to ensure it offered a safe space for members. Clear rules of engagement, trust, organisation skills, compassion and kindness were considered essential. Patient moderated online support groups can be successfully developed and facilitated and can be empowering for both the group member and moderator alike.© 2013 Elsevier Ltd. All rights reserved.

Perceptions of beginning teachers in Florida regarding their preparation as it relates to the Florida Essential Generic Competencies

The purpose of the study is to investigate how beginning teachers in the state of Florida perceive their preparation to demonstrate the 27 Florida Essential Generic Competencies.^ The basic research question of this study was: How do beginning teachers perceive their level of preparation regarding their implementation of the Florida Essential Generic Competencies? This study identified and categorized the perceived degree of preparation for each of the competencies. Also, elementary, middle, and high school beginning teachers were compared to find significant differences and similarities in their perception of their preparation. A comparison was also done for graduates from in-state versus out-of-state and private versus public institutions.^ A survey developed in collaboration with the Department of Education, Florida State University, members of the Professional Orientation Program (POP) Coordinators, and the Project Director of Program Review in the College of Education at the University of South Florida, was sent to 5,076 beginning teachers. A total of 1,995 returned the survey in February of 1993. The Multivariate Analysis of Variance (MANOVA) procedure was used (Alpha =.05). Statistical analysis of the data involved a comparison of the different groups of beginning teachers by school level and kind of graduating institutions. The dependent variables analyzed were the responses to all items representing the generic competencies.^ The study identified and categorized the degree of preparation for each competency. The competencies receiving the lowest ratings for degree of preparation were: integrate computers in instruction; manage situations involving child abuse and/or neglect; severe emotional stress; alcohol and drug abuse.^ The Wilkes lambda and the Hotellings multivariate tests of significance were used to examine the differences among the groups. The competency items were further analyzed by a univariate F test. Results indicated that: (1) significant differences were found in nine competency items in which elementary teachers felt better prepared than middle and high school beginning teachers, (2) graduates from a Florida teacher education program felt they were better prepared in demonstrating the competencies than those from out-of-state schools, and (3) no significant difference was found in the perceptions of those who graduated from public versus private institutions.^ Based on the findings of this study, the following recommendations are made: (1) Florida's institutions responsible for teacher preparation programs need to focus on those competencies receiving the lowest ratings, (2) Districts should provide an orientation program for out-of-state beginning teachers, and (3) The survey instrument should be used annually to evaluate teacher education programs. ^

Perceptions of beginning teachers in Florida regarding their preparation as it relates to the Florida essential generic competencies

The purpose of the study is to investigate how beginning teachers in the state of Florida perceive their preparation to demonstrate the 27 Florida Essential Generic Competencies. The basic research question of this study was: How do beginning teachers perceive their level of preparation regarding their implementation of the Florida Essential Generic Competencies? This study identified and categorized the perceived degree of preparation for each of the competencies. Also, elementary, middle, and high school beginning teachers were compared to find significant differences and similarities in their perception of their preparation. A comparison was also done for graduates from in-state versus out-of-state and private versus public institutions. A survey developed in collaboration with the Department of Education, Florida State University, members of the Professional Orientation Program (POP) Coordinators, and the Project Director of Program Review in the College of Education at the University of South Florida, was sent to 5,076 beginning teachers. A total of 1,995 returned the survey in February of 1993. The Multivariate Analysis of Variance (MANOVA) procedure was used (Alpha = .05). Statistical analysis of the data involved a comparison of the different groups of beginning teachers by school level and kind of graduating institutions. The dependent variables analyzed were the responses to all items representing the generic competencies. The study identified and categorized the degree of preparation for each competency. The competencies receiving the lowest ratings for degree of preparation were: integrate computers in instruction; manage situations involving child abuse and/or neglect; severe emotional stress; alcohol and drug abuse. The Wilkes lambda and the Hotellings multivariate tests of significance were used to examine the differences among the groups. The competency items were further analyzed by a univariate F test. Results indicated that: (1) significant differences were found in nine competency items in which elementary teachers felt better prepared than middle and high school beginning teachers, (2) graduates from a Florida teacher education program felt they were better prepared in demonstrating the competencies than those from out-of-state schools, and (3) no significant difference was found in the perceptions of those who graduated from public versus private institutions. Based on the findings of this study, the following recommendations are made: (1) Florida's institutions responsible for teacher preparation programs need to focus on those competencies receiving the lowest ratings, (2) Districts should provide an orientation program for out-of-state beginning teachers, and (3) The survey instrument should be used annually to evaluate teacher education programs.

Common Bound: The Small Groups of Methodism

The system of small groups John Wesley established to promote a proper life of discipleship in early Methodist converts was, in many respects, the strength of the Methodist movement. Those who responded to Wesley’s initial invitation to “flee the wrath to come” were organized into large gatherings called “societies,” which were then subdivided into smaller bands, class meetings, select societies, and penitent bands. The smaller groups gave Wesley the opportunity, through a system of appointed leaders, to keep track of the spiritual progress of every member in his movement, which grew to tens of thousands by the time of his death in 1791. As Methodism shifted from renewal movement to institutional church in the nineteenth century, however, growth slowed, and participation in such groups declined rapidly. By the early twentieth century, classes and bands were virtually extinct in every sector of Methodism save the African-American tradition. In recent years, scholars in various sectors of the Wesleyan tradition, particularly David Lowes Watson and Kevin Watson, have called for a recovery of these small groups for purposes of renewal in the church. There is no consensus, however, concerning what exactly contributed to the vitality of these groups during Wesley’s ministry.

Over the last century, sociological studies of group dynamics have revealed three common traits that are crucial to highly functioning groups: interdependence created by the existence of a common goal, interaction among group members that is “promotive” or cooperative in nature, and high levels of feedback associated with personal responsibility and individual accountability. All three of these were prevalent in the early Methodist groups. Interdependence existed around a shared goal, which for Wesley and the Methodists was holiness. That interdependence was cooperative in nature; individuals experienced the empowering grace of God as they each pursued the goal in the company of fellow pilgrims. Finally, the groups existed for purposes of feedback and accountability as individuals took responsibility both for themselves and others as they progressed together toward the goal of holy living. Wesley seemed to instinctively understand the essential nature of each of these characteristics in maintaining the vitality of the movement when he spoke of the importance of preserving the “doctrine, spirit and discipline” of early Methodism. Analysis of some of the present-day attempts to restore Wesley’s groups reveals frequent neglect to one or more of these three components. Perhaps most critical to recovering the vitality of the early Methodist groups will be reclaiming the goal of sanctification and coming to a consensus on what its pursuit means in the present day.

Debriefing in simulation conducted in small and large groups : nursing students’ experiences

The debriefing phase in human patient simulation is considered to be crucial for learning. To ensure good learning conditions, the use of small groups is recommended, which poses a major challenge when the student count is high. The use of large groups may provide an alternative for typical lecture-style education and contribute to a more frequently and repeated training which is considered to be important for achieving simulation competency. The purpose of the present study was to describe nursing students’ experiences obtained during the debriefing conducted in small and large groups with the use of a qualitative descriptive approach. The informants had participated in a human patient simulation situation either in large or small groups. Data was collected through the use of five focus-group interviews and analysed by content analysis. The findings showed that independent of group-size the informants experienced the learning strategies to be unfamiliar and intrusive, and in the large groups to such an extent that learning was hampered. Debriefing was perceived as offering excellent opportunities for transferable learning, and activity, predictability and preparedness were deemed essential. Small groups provided the best learning conditions in that safety and security were ensured, but were perceived as providing limited challenges to accommodate professional requirements as a nurse. Simulation competency as a prerequisite for learning was shown not to be developed isolated in conjunction with simulation, but depends on a systematic effort to build a learning community in the programme in general. The faculty needs to support the students to be conscious and accustomed to learning as a heightened experience of learning out of their comfort zone.

Design, Synthesis And Biological Evaluation Of Hybrid Bioisoster Derivatives Of N-acylhydrazone And Furoxan Groups With Potential And Selective Anti-trypanosoma Cruzi Activity.

Hybrid bioisoster derivatives from N-acylhydrazones and furoxan groups were designed with the objective of obtaining at least a dual mechanism of action: cruzain inhibition and nitric oxide (NO) releasing activity. Fifteen designed compounds were synthesized varying the substitution in N-acylhydrazone and in furoxan group as well. They had its anti-Trypanosoma cruzi activity in amastigotes forms, NO releasing potential and inhibitory cruzain activity evaluated. The two most active compounds (6, 14) both in the parasite amastigotes and in the enzyme contain the nitro group in para position of the aromatic ring. The permeability screening in Caco-2 cell and cytotoxicity assay in human cells were performed for those most active compounds and both showed to be less cytotoxic than the reference drug, benznidazole. Compound 6 was the most promising, since besides activity it showed good permeability and selectivity index, higher than the reference drug. Thereby the compound 6 was considered as a possible candidate for additional studies.

Perception Of Oral And Maxillofacial Surgeons, Orthodontists And Laypersons In Relation To The Harmony Of The Smile.

Harmony is one of the main objectives in surgical and orthodontic treatment and this harmony must be present in the smile, as well as in the face. The aim of the present study was to assess the perceptions of professionals and laypersons in relation to the harmony of the smile of patients with or without vertical maxillary alterations. Sixty observers (oral and maxillofacial surgeons, orthodontists and laypersons) reported the degree of harmony of six smiles using an objective questionnaire and the participants indicated if there was a need for corrective surgery or not. The classification of observers was recorded on a Likert scale from 1 to 5. Mixed regression was used to determine differences between the three groups. Statistically significant differences were found only for the harmony of the smile between the oral and maxillofacial surgeons and laypersons, with laypersons being more critical when assessing the smile. There was no statistical difference between the other groups for the harmony of the smile or the indication of corrective surgery. The patterns of greater or lesser harmony determined by observers during the smile were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Laypersons had a tendency to be more critical in relation to facial harmony than surgeons, although no statistical differences were found in the other groups in relation to the harmony of the smile or indication for the corrective surgery. In addition, the patterns of greater or lesser harmony of the smile determined by the participants were similar to those found in the literature as the ideal standard in relation to vertical maxillary positioning. Overall, the present study demonstrates that adequate interaction between surgeons, orthodontists and laypersons is essential in order to achieve facial harmony with orthodontic and/or surgical treatment. Opinion of specialists and laypersons about the smile in relation to the vertical positioning of the maxilla.