{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:08:57Z","timestamp":1790622537251,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T00:00:00Z","timestamp":1424822400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01 AA11685"],"award-info":[{"award-number":["R01 AA11685"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["RO1\/UO1 AA01115134"],"award-info":[{"award-number":["RO1\/UO1 AA01115134"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>The adverse effects of maternal alcohol use during pregnancy represent a spectrum of growth restriction, facial dysmorphology, and neurocognitive challenges in the offspring. The continuum of diagnoses is referred to as fetal alcohol spectrum disorders (FASD). Short palpebral fissures, a smooth philtrum, and a thin vermilion border of the upper lip comprise the three cardinal facial features of FASD. Early attempts to define a smooth philtrum and thin vermilion border of the upper lip were subjective. Astley and colleagues introduced a 5\u2010point Likert\u2010scaled lip\/philtrum guide based on Caucasian North American subjects as an objective tool for the evaluation of the facial dysmorphology in FASD. This Caucasian guide has been incorporated into all current diagnostic schemes for FASD. However, broad international clinical experience with FASD indicates racial and ethnic differences with respect to the facial morphology. Because of the substantial number of children with FASD in South Africa among the Cape Coloured (mixed race) population in the Western Cape Province, we developed a specific lip\/philtrum guide for that population. The guide incorporates a 45\u2010degree view of the philtrum that enables an enhanced 3\u2010dimensional evaluation of philtral height not possible with a frontal view alone. The guide has proven to be a more specific and sensitive tool for evaluation of the facial dysmorphology of FASD in the Cape Coloured population than the use of the previous North American Caucasian guide and points to the utility of racial and ethnic\u2010specific dysmorphology tools in the evaluation of children with suspected FASD. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajmg.a.37023","type":"journal-article","created":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T06:41:39Z","timestamp":1424846499000},"page":"752-755","source":"Crossref","is-referenced-by-count":25,"title":["A South African mixed race lip\/philtrum guide for diagnosis of fetal alcohol spectrum disorders"],"prefix":"10.1002","volume":"167","author":[{"given":"H. Eugene","family":"Hoyme","sequence":"first","affiliation":[{"name":"Sanford Research Sioux Falls South Dakota"},{"name":"Department of Pediatrics Sanford School of Medicine University of South Dakota Sioux Falls South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek B.","family":"Hoyme","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Iowa Iowa City Iowa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy J.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Sanford Research Sioux Falls South Dakota"},{"name":"Department of Pediatrics Sanford School of Medicine University of South Dakota Sioux Falls South Dakota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Blankenship","sequence":"additional","affiliation":[{"name":"Center on Alcoholism Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy O.","family":"Kalberg","sequence":"additional","affiliation":[{"name":"Center on Alcoholism Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Buckley","sequence":"additional","affiliation":[{"name":"Center on Alcoholism Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abdul\u2010Rahman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Mississippi Jackson Mississippi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret P.","family":"Adam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luther K.","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics State University of New York at Buffalo Buffalo New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Manning","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Pediatrics Stanford University Stanford California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidre","family":"Bezuidenhout","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology and Human Genetics Stellenbosch University Tygerberg South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth L.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of California San Diego La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"May","sequence":"additional","affiliation":[{"name":"Center on Alcoholism Substance Abuse and Addictions (CASAA) University of New Mexico Albuquerque New Mexico"},{"name":"Department of Nutrition Gillings School of Global Public Health Nutrition Research Institute University of North Carolina at Chapel Hill Chapel Hill North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,2,25]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1995.tb01025.x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)70187-7"},{"key":"e_1_2_6_4_1","unstructured":"AstleySK.2004. FASD 4\u2010Digit Diagnostic Code TM. FAS Diagnostic and Prevention Network.https:\/\/depts.washington.edu\/fasdpn\/htmls\/4\u2010digit\u2010code.htm. Accessed on January 11 2015."},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00439-010-0836-1"},{"key":"e_1_2_6_6_1","unstructured":"Genographic Project The National Geographic Society.https:\/\/genographic.nationalgeographic.com. Accessed on January 11 2015."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-0259"},{"key":"e_1_2_6_8_1","volume-title":"IBM SPSS Statistics for Windows [computer program]. 2011. 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