Market structure and horizontal growth strategies – A case study of the container shipping industry

This article aims to review the structural transformation in the container shipping industry from 1995 to 2020 and identify the growth strategies of global carriers to enhance their market presence. Along with large investments in mega vessels, the growing deployment of charter capacity in all ship sectors has been a prominent trend in fleet expansion. The waves of mergers/acquisitions and bankruptcies have narrowed the group of global carriers. In addition to internal and external growth, they have been increasingly involved in strategic alliances to expand service coverage and compete well with powerful rivals. A few mega carriers have progressively captured the industry. In 2020, the Top 12 controlled 88 % of the global supply, and nearly 56 % was in the hands of the Top 4. Besides the substantial expansion of the four biggest carriers, we can identify the de-concentration within this gigantic group through the less inequality between their market shares.

Influence of facial type on attractiveness of vertical canine position from the perspective of orthodontists and laypeople

ABSTRACT Objectives To evaluate the attractiveness of changes in vertical position of maxillary canines in frontal smiles of different facial types, and to evaluate the esthetic perceptions of orthodontists and laypeople, and the influence of facial type on these perceptions. Materials and Methods Three adult female volunteers were selected as individuals with normal, vertical, and horizontal growth patterns. Frontal posed smile photographs were digitally altered by adjusting vertical positions of the maxillary canines above, below, or coincident with the incisal line in increments of 0.5 mm within a range of 1 mm of extrusion and intrusion. For assessment, a web-based survey was formed with 18 images (six images for each model). A scale was present underneath each image, graded from 0 to 10 (0: unattractive; 10: the most attractive). Images were rated by 233 participants (105 orthodontists; 128 laypeople). Results Orthodontists scored 0-mm images significantly as the highest in all groups. Laypeople scored significantly higher for −0.5 mm images regardless of facial type. The lowest scored images were −1 mm (except for horizontal pattern) and +1 mm images. Mean values of scores given by men were higher (P < .05). Conclusions Orthodontists favored ideal dental alignment and preferred the incisal edges of central and canine teeth to be at the same level. Laypeople preferred a smoother smile arc than orthodontists and found harmony with the soft tissue more attractive. Facial type affected perceptions of the vertical changes of maxillary canines.

Indian Board of Orthodontics Case Report: Management of Class II Skeletal Malocclusion Using 2-Phase Treatment

KL, a 12-year-old boy, presented with a class II Div I malocclusion on a class II skeletal base (retrognathic mandible) with a 7-mm overjet and a horizontal growth pattern. He had a convex profile, incompetent lips, lip trap, deep mentolabial sulcus, everted lower lip, and positive visual treatment objective (VTO). KL had a CS2 cervical maturation stage, which indicates 65% to 85% adolescent growth remaining. Treatment involved growth modification using a removable Twin Block with midpalatal expansion screw. This was followed by upper and lower fixed appliance using 0.022” × 0.028” slot Mclaughlin Bennet and Trevisi (MBT) prescription. The retention protocol involved upper wrap around and lower lingual bonded retainer.

Vertical Proportion of the Face: A Cephalometric study

Introduction: Balance in vertical facial proportion is an important criteria for good esthetics. Variations in vertical growth are common and have certain orthodontic implications. The objectives of this study were to determine mean upper anterior facial height and lower anterior facial height, ratio between UAFH to LAFH and their difference among genders in skeletal Class I patients with different vertical growth pattern among patients visiting department of Orthodontic and Dentofacial orthopedics, Tribhuvan University Dental Teaching Hospital, Kathmandu. Materials and Method: This study was descriptive observational cross sectional study with 105 sample aged from 18-25 years. Pretreatment cephalometric radiograph of Skeletal Class I patients were taken and divided into three growth patterns as group I (normal growth pattern), group II (horizontal growth pattern ) and group III (vertical growth pattern ). Upper anterior facial height (N-ANS) and lower anterior facial height (ANS-Me) of all samples were measured on lateral cephalogram with cephalometric tracing ruler parallel to true vertical line. Descriptive statistics was used to calculate mean, minimum, and maximum values standard deviations with p value <0.05. Result: The upper anterior facial height (UAFH) and lower anterior facial height (LAFH) measurements in normal growth pattern was 52.37 and 64.4 , in horizontal growth pattern was 53.0 and 62.2, in vertical growth pattern was 53.37 and 64.42 respectively. The mean ratio of upper and lower anterior facial height in normal, horizontal and vertical growth pattern was 0.81, 0.85 and 0.79 respectively. There was no statistically significant difference in upper and lower facial heights between males and females. There was no statistically significant difference in UAFH between normal, horizontal and vertical growth pattern but statistically significant difference was observed in LAFH between groups. Conclusion: The cephalometric values for different vertical groups in skeletal class I can be used more specifically for diagnosis and treatment planning of Nepali population.

Correlation of Growth Pattern and Palatal Rugae Pattern in South Indian Population

Aim: To determine the correlation between palatal rugae (PR) pattern and subjects with vertical, average, and horizontal growth pattern and to determine gender variation if any. Material and Methods: One hundred and twenty study models were divided into horizontal, vertical, and average growth patterns with 40 (20 males and 20 females) samples in each group. The pattern of PR was assessed in each group using a template. Result: Type B (wavy type) PR occurs more often in horizontal and average growth pattern (80% and 72.5% respectively), whereas its occurrence in vertical growth pattern subject is the least among other growth patterns, that is, 42.5% of the total subjects. Type E (curved type) PR has appeared highest in 27.5% of average growth pattern patient followed by 12.5% of vertical growth pattern subjects. The occurrence of type E PR is least in horizontal growth pattern which is just 5% of the total subjects. Conclusion: Curved-type PR was more prevalent in vertical and average growth patterns. Diverging PR pattern was mainly seen in vertical growth pattern. PR also shows sexual dimorphism. The association is clinically significant as it will lead to determination of facial vertical growth pattern at early age; thus, it serves as a diagnostic adjunct for different malocclusions very early in life and aids in preventive or interceptive orthodontic measures to alleviate forthcoming growth pattern.

Low level of awareness among general practitioners – the reason for the late stages of superficial spreading melanoma of the skin

В статье описана клиническая картина поверхностно-распространяющейся меланомы – самой распространенной формы пигментной опухоли. Несмотря на то, что на ранней стадии эта форма опухоли имеет выраженные клинические признаки, поликлинические врачи не могут ее диагностировать своевременно – в фазе горизонтального роста. Врачи общего профиля ошибочно полагают, что меланома возникает в результате травмы доброкачественного невуса, в то время как Кларк в 1969 г. установил, что большинство меланом возникает на неизмененной коже и проходит длительную фазу поверхностного роста. Сделан вывод о том, что повышение уровня знаний поликлинических врачей о ранних симптомах поверхностно-распространяющейся меланомы будет способствовать своевременной диагностике опухоли и снижению смертности от этого заболевания. Существенную помощь в ранней диагностике меланом могут оказать памятки с цветными фотографиями поверхностно-распространяющейся меланомы в фазе горизонтального роста, которыми необходимо снабдить каждого поликлинического врача. Приведены клинические случаи и фотографии поверхностно-распространяющейся меланомы в ранней стадии развития – в фазе горизонтального роста. The article describes the clinical picture of surface-spreading melanoma – the most common form of pigmented tumor. Despite the fact that at an early stage this form of tumor has pronounced clinical signs, polyclinic doctors can not diagnose it in a timely manner - in the phase of horizontal growth. General practitioners mistakenly believe that melanoma occurs as a result of trauma to a benign nevus, while Clark in 1969 established that most melanomas occur on unaltered skin and go through a long phase of superficial growth. It is concluded that increasing the level of knowledge of polyclinic doctors about the early symptoms of surface-spreading melanoma will contribute to the timely diagnosis of the tumor and reduce mortality from this disease. A significant help in the early diagnosis of melanomas can be provided by memos with color photos of surface-spreading melanoma in the horizontal growth phase, which should be provided to each polyclinic doctor. The article presents clinical cases and photos of surface-spreading melanoma in the early stage of development – in the phase of horizontal growth.