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Recessive variants in the GLDN gene, which encodes the gliomedin protein and is involved in nervous system development, have recently been associated with Arthrogryposis Multiplex Congenita (AMC), a heterogenous condition characterized by congenital contractures of more than one joint. Two cohorts of patients with GLDN-associated AMC have previously been described, evolving the understanding of the condition from lethal to survivable with the provision of significant neonatal support. Here, we describe one additional patient currently living with the syndrome, having one novel variant, p.Leu365Phe, for which we provide functional data supporting its pathogenicity. We additionally provide experimental data for four other previously reported variants lacking functional evidence, including p.Arg393Lys, the second variant present in our patient. We discuss unique and defining clinical features, adding calcium-related findings which appear to be recurrent in the GLDN cohort. Finally, we compare all previously reported patients and draw new conclusions about scope of illness, with emphasis on the finding of pulmonary hypoplasia, suggesting that AMC secondary to GLDN variants may be best fitted under the umbrella of fetal akinesia deformation sequence (FADS).

Action follows from being. One’s way of doing and understanding comparative education follows from one’s being. It springs from the soul. Using [Kim, T., and R. Brooks’ (2013). “Internation...

Background: Removable partial dentures are a frequently used prosthetic treatment in the elderly population, but different types or RPDs might guarantee different chewing capabilities. In many studies, the relationship between chewing and aging has been reported and it has been shown that efficient chewing can improve the overall quality of life. Objectives: In the present study, the relationship between maximum bite force (MBF) and RPDs was studied. A relationship between the body mass index (BMI) and the type of prosthesis was also analyzed. Methods: 240 elderly patients, 120 males and 120 females, with bilateral posterior edentulism (class 1 of Kennedy classification) who had been wearing an RPD for at least a year, were recruited. Patients were divided into two groups: Group 1: male (n = 60) and female (n = 60) patients with bilateral edentulous areas located posterior to the remaining natural teeth and natural teeth in the opposite dental arch. Group 2: male (n = 60) and female (n = 60) patients with maxillary and mandibular bilateral edentulous areas located posterior to the remaining natural teeth. Their Body Mass Index (BMI) and Maximum bite force (MBF) were measured and compared according to the material and design of their RPD. Results: In both Groups, patients wearing cobalt-chrome alloy RPDs (Co-Cr-RPD) (Group 1: 20.25 ± 6.7 MBF, p &lt, 0.001, Group 2: 16.0 ± 5.7 MBF, p &lt, 0.001) had an increased MBF when compared to polymethylmethacrylate RPD (PMMA-RPD) (Group 1: 12.9 ± 3.36 MBF, Group 2: 10.4 + 2.8 MBF), and Valplast RPD (V-RPD) (Group 1: 14.3 ± 4.7 MBF, Group 2: 11.3 ± 3.4 MBF) users. There were no significant differences in bite force between patients wearing PMMA-RPD and V- RPD in both Groups. Patients in Group 2 showed a lower MBF than those in Group 1 (Group 1: 16.05 ± 6.13 MBF, Group 2: 12.6 ± 4.84 MBF, p &lt, 0.001). Conclusions: A reduction in chewing force can lead to choosing softer foods for nutrition, which can lead to an increase in BMI. Our results show that only CoCr-RPD wearers were able to chew consistent food, whereas PMMA- RPD and V-RPD, due to the properties of the materials, their instability, and the possibility of causing pain during mastication, determined a limitation in the choice of food for many of the participants.

With the continuous climate change we are experiencing; extreme heat, drought, and declining water supplies that affect our rain fed and irrigation systems resulting to a higher demand for water for evaporation and evapotranspiration by crops which lead to more frequent soil moisture deficit which is unavoidable and there are still other factors that contributes to water head loss. This mak e it necessary to find out novel ways to resolve the issues regarding irrigation management. Though there are many existing innovative water management ideas available out there, but it takes to shed huge amounts of government funds to implement. This stud y consists of designing a water - recycle model to efficiently use the limited water supply and further attain to serve the total surface area of irrigated rice. The proposed design uses a renewable energy that pumps out water from the cat ch basin back to it s water source, this method entirety use the most out of the water supply to lessen water wastage and water shortage and to maximize water saving in the area.

Because of increasing concern about climate change and carbon emissions as a primary contributor, many companies and organizations are pursuing “carbon footprint” projects to estimate their contributions to global climate change. Calculating the carbon footprint is fundamental to understand how a company or organization’s activities impact global sustainability. The main challenge is how to calculate it when environmental aspects are intangible assets. This study aims to identify the frequency of carbon footprint emitted by geodetic engineers from San Ildefonso, Bulacan when they are conducting site surveying activities. Thus, this study provides a comprehensive review if GE’s from San Ildefonso, Bulacan are high contributors of emitted carbon using statistical data, a review of ground improvement methods that have been studied to reduce the carbon footprint, and the direction in which geodetic engineering should proceed in the future.

The Portable FPV System with Smartaudio is a method used simply to control a radio-controlled vehicle specifically those that use Unmanned Aerial Systems (UAS) or other type of Unmanned Aerial Vehicles (UAV) in the driver or Pilot’s view point. Incorporated to the system is a special feature called Smartaudio. Smartaudio is a type of VTX telemetry protocol in which it is a combination of an audio signal and a digital control signal. The two said signals are combined together to one simple audio signal. This signal can be used to control the VTX or Video Transmitter. And it is a simple serial signal. This basically allows the Pilot of the UAV to change settings for video transmitter via the On Screen Display (OSD) menu. So having Smartaudio feature makes things like switching VTX channels, power levels less difficult for Pilots, with no need to push switches or obscure push button menus. When pilots switched over to this system that supports Smartaudio it is seen just how quickly it can change multiple settings using OSD, giving more freedom and accessibility.

1. Julia M. Rosenberg, MD*,† 2. Camille Brown, MD* 3. Michele J. Spencer-Manzon, MD*,‡ 1. *Department of Pediatrics, Yale New Haven Children’s Hospital, New Haven, CT 2. †National Clinician Scholars Program, 3. ‡Yale School of Medicine, Department of Genetics, Yale University, New Haven, CT 1. Address correspondence to Julia M. Rosenberg, MD, National Clinician Scholars Program, PO Box 208088, New Haven, CT 06510. E-mail: julia.rosenberg{at}yale.edu A 6-year-old girl presents to the pediatric refugee clinic for her initial refugee health assessment shortly after arrival from Syria. Her past history is notable for a seizure disorder of unknown etiology and global developmental disability. After an uncomplicated prenatal and postnatal course, the patient’s seizures and developmental delays reportedly first manifested at 7 months of age. At that time, the family attributed the seizure to a fall from a stroller. After this event, she had a total of 4 more lifetime seizures, which were characterized by eye rolling, clonic posturing, and left arm jerking. Her only medications are clobazam and valproic acid. Her family history is negative for known seizures or genetic disorders, although her parents are consanguineous (first cousins). Her review of systems is otherwise negative, and her family denies previous infectious diseases nor exposure to individuals with tuberculosis. At presentation to our clinic, her estimated developmental age is ∼9 months; her global developmental deficiencies include speech, fine motor, and gross motor delays. She is nonverbal, has poor receptive language skills, and is unable to follow commands. She can scoot but is nonambulatory. She cannot feed herself and is not toilet-trained. On examination, the patient has no dysmorphic features. She demonstrates intermittent posturing and rocking movements and has generalized hypotonia and motor weakness; she can maintain sitting and standing positions only with support. She was found on ophthalmologic examination to have myopia. Cranial nerves II-XII are intact. Strength is III/V in both upper and lower extremities. She does not have neurocutaneous markings nor abnormal odors. Initial refugee screening laboratory results, which are expanded to include a complete metabolic …

(1) Background: This study aimed to investigate maximum bite force (MBF) in elderly patients with natural full dentition (FD), patients rehabilitated with Traditional Complete Dentures (CD), with overdentures (IRO) and edentulous patients (ED). We also tested whether MBF changes are associated with gender, age of the patients and body mass index (BMI) as result of altered food, (2) Methods: Three hundred and sixty-eight geriatric patients were included. We studied two types of prostheses: (a) IRO with telescopic attachments. (b) CD (heat polymerized polymethyl methacrylate resin). The MBF was measured using a digital dynamometer with a bite fork., (3) Results: We found that MBF is higher in males than females, regardless of teeth presence or absence (p &lt, 0.01). In patients with CD or IRO, there are no differences between males and females, prostheses improve MBF compared to edentulous patients (p &lt, 0.0001) and this effect is greater with IRO prostheses (p &lt, 0.0001), the chewing force of FD subjects remains greater (p &lt, there are no differences among chewing strength based on different BMI categories, although FD subjects have a reduced incidence of obesity, there is a significant negative correlation between MBF and age (p = 0.038, R = 0.145), and no correlation between MBF and BMI., (4) Conclusions: This study showed that MBF improves more in patients using IRO prostheses, although not reaching the MBF of FD subjects. MBF does not correlate with BMI, although we found increased percentages of obesity in edentulous subjects or those with prostheses. Thus, old people wearing prostheses require special attention by a nutritionist to avoid risk of malnutrition.

Liver and biliary pathology in the neonate are rare and include a broad range of structural, neoplastic, infectious, genetic, and metabolic diseases. While most conditions present postnatally, antenatal detection is increasing given recent advances in antenatal imaging capabilities. In certain structural or obstructive liver diseases, antenatal detection now proves essential to help guide treatment and prevent morbidity. We review the epidemiology, pathophysiology, common antenatal diagnostic findings, and recommendations for surgical liver and biliary pathology in the neonate.

Heterozygous variants in the DYNC1H1 gene have been associated chiefly with intellectual disability (ID), malformations in cortical development (MCD), spinal muscular atrophy (SMA), and Charcot-Marie-Tooth axonal type 20 (CMT), with fewer reports describing other intersecting phenotypes. To better characterize the variable syndromes associated with DYNC1H1, we undertook a detailed analysis of reported patients in the medical literature through June 30, 2019. In sum we identified 200 patients from 143 families harboring 103 different DYNC1H1 variants, and added reports for four unrelated patients identified at our center, three with novel variants. The most common features associated with DYNC1H1 were neuromuscular (NM) disease (largely associated with variants in the stem domain), ID with MCD (largely associated with variants in the motor domain), or a combination of these phenotypes. Despite these trends, exceptions are noted throughout. Overall, DYNC1H1 is associated with variable neurodevelopmental and/or neuromuscular phenotypes that overlap. To avoid confusion DYNC1H1 disorders may be best categorized at this time by more general descriptions rather than phenotype-specific nomenclature such as SMA or CMT. We therefore propose the terms: DYNC1H1-related NM disorder, DYNC1H1-related CNS disorder, and DYNC1H1-related combined disorder. Our single center's experience may be evidence that disease-causing variants in this gene are more prevalent than currently recognized.

In a forensic context, identification of skeletal injuries’ and traumas’ timing may be of fundamental relevance to understand the events related to the life and death of an individual. In this study, we propose a new evaluation form to facilitate the detection of traumas and interpret them as ante-, peri- or post-mortem injuries. We describe the use of this form with the analysis of two skeletonized individuals. Bone injuries on their skeletons were caused by diverse sharp weapons and differed for the timing they have occurred, as revealed by macroscopic, radiographic and microscopic assays. Thanks to its completeness and user-friendly approach, the evaluation form here proposed may greatly facilitate the analysis and interpretation of injuries found on skeletons under forensic investigation.

Background Ischemic time duration is one of the most important determinants of infarct size in patients with ST-segment elevation myocardial infarction (STEMI). An early reperfusion with percutaneous coronary intervention (PCI) therapy reduces the adverse events and mortality. It also influences the wall motion abnormalities and left ventricular ejection fraction (LVEF), which can be easily detected by a standard transthoracic echocardiogram (TTE). Purpose Aim of our study was to assess the immediate effects of an early percutaneous revascularization in STEMI patients on variations of the left ventricle (LV) global and regional function. Methods The study population consists of 141 consecutive patients with STEMI undergoing PCI from January to June 2018. The population was divided into two groups basing on first medical contact-to-balloon time (C2B), respectively ≤90 minutes and >90 minutes. Cardiac biomarkers were obtained uniformly. A standard TTE was performed in all patients, at moment of in-hospital admission and at the time of discharge, recording the LV wall motion abnormalities and LVEF, using the wall motion score index (WMSI) and modified Simpson’s rule, respectively. Finally, we performed a sub-analysis in the group of patients who showed an improvement of the LVEF ≥10% at discharge. Results In both groups at baseline, patients suffered from a moderately reduced LVEF (41 ± 8.3% in ≤90 min group vs 40.97 ± 8.91% in >90 min group, p = ns). A WMSI >1 was recorded uniformly: 1.78 ± 0.39 in patients with C2B ≤90 min and 1.81 ± 0.40 in patients with C2B >90 min, without significant differences between the two groups. At the time of discharge, a significant improvement of LVEF (from 41 ± 8% to 44 ± 9%, p = 0.013) and WMSI (from 1.78 ± 0.39 to 1.64 ± 0.38, p = 0.036) exclusively emerged in the ≤90 min group. Furthermore, we identified 37 patients who experienced, at the time of discharge, an improvement of the LVEF ≥10% compared to baseline values. In these patients the C2B time resulted significantly shorter, when compared with patients with LVEF improvement Conclusion Our study shows the immediate effects of an early revascularization. In particular, the duration of C2B time influences the recovery of ventricular function, in terms of ejection fraction and parietal kinetics. A standard TTE is a low cost and easily available examination, which may provide immediate results without impacting significantly on health costs.

Background There are few reported cases in the literature of spinal injuries from the past, and all of them resulted in the death of the individual or led to severe health consequences. From the historical record, it is well known there were no cures or treatments for spinal lesions in the past. Given the paucity of historical documents focused on this topic, anthropological research on spinal injuries can contribute with important information regarding the medical history of this kind of trauma. Moreover, skeletal trauma and occupational markers may be crucial for the reconstruction of habitual behaviors and the identification of causes and timing of death. We report results of an anthropological study of a case of vertebral injury discovered in an individual from the Italian Iron Age that highlights this important topic. The aim of this study was to assess the habitual activity pattern and manner of death of an ancient inhabitant of Spina in Padanian Etruria (northeastern Italy). Methods We performed a detailed anthropological and paleopathological analysis of skeletal remains. Results The unknown individual was identified as a middle-aged man characterized by a particular trauma to the spine. Lesion analysis revealed a perimortem injury at the L2-L3 level. Characteristic markers on the bones indicated intense physical activity carried out during his life. Conclusions This Etruscan, in all likelihood a sailor according to the occupational markers, did not survive a stabbing attack with a bladed weapon.

Barotrauma causes stress and impairment in fish and can cause mortality after catch and release. Relief of barotrauma symptoms is necessary to reduce mortality, but we currently know little about sublethal effects associated with relief methods. Here, we assess the condition and behavior of tournament-caught Walleye Sander vitreus with barotrauma by using three popular relief methods: 1) swim bladder venting, 2) deep-water release (descending), and 3) livewell reorientation with fin weights. In a short-term ex situ experiment, 50% of untreated fish with barotrauma did not recover sufficiently to be released after 20 h. Fin weighting immediately improved condition by enabling fish to regain correct orientation; however, only 53% of fin-weighted fish recovered sufficiently to be released. All vented fish were negatively buoyant, but 73% were releasable after the holding period. In a concurrent in situ study, acoustic telemetry showed that Walleye without barotrauma (controls) made variable postrelease movements (total distance: 5.1–27.6 km), descended fish behaved similarly to controls (4.7–28.6 km), and vented fish made the shortest movements (2.6–16.7 km). However, there were no statistically significant differences in distance metrics among groups. Control and descended fish used larger areas and volumes of the lake than vented fish. Descended fish also used significantly deeper depths than vented fish, and control fish were intermediate in the depth used. Telemetry did not indicate mortality of any fish in the in situ study. Our data suggest that without treatment, mortality of Walleye with barotrauma could be as high as 50%. Fin weighting is not an effective catch-and-release aid for Walleye with moderate-to-severe barotrauma, and swim bladder venting may alter short-term, postrelease movements and habitat use. The consequences of these short-term changes to Walleye behavior from a fisheries management perspective are unclear. Eliminating catch-and-release angling in deep water is the best means of managing barotrauma in Walleye. If deep-water angling cannot be avoided, we recommend noninvasive descending over venting.

Trepanation is one of the most ancient and applied surgical treatments; several archaeologically documented cases are known, dated back from prehistory to the Middle Ages. This case study reports the anthropologic analysis of the skeletal remains of a young medieval woman and a fetus (Imola, Italy). The fetal remains were laid between her pelvis and lower limbs. A perforating injury was observed to her frontal bone. After assessing biologic profiles, we attempted to interpret the injury and to reconstruct possible circumstances of death. The lesion seems commensurate with a surgical intervention; signs of an osteogenic reaction were detected at its edges. It can be hypothesized that the survival of the woman undergoing the surgery was approximately 1 week and the fetus extruded after the burial. Thus, this case represents a unicum, spreading more light on the history of neurosurgery during the Early Middle Ages in Europe.

Masticatory performance is directly correlated with masticatory muscle work to grind and cut the food. Chewing efficacy is decisive to eating a variety of foods needed maintain general health status at all ages. Older people have oral problems that get worse with age. Elders have more pathologies such as periodontal diseases, caries, tooth loss and inadequate dental prostheses than younger subjects. Objectives: to investigate the correlation between masticatory bite force (MBF) and body mass index (BMI) vs. aging and sex. Methods: This study was performed on 426 subjects (213 females plus 213 male) assigned into five different groups by age. Group “A” aged from 20 to 35 years, group “B” aged 45–59 years, group “C” aged 60–69 years, group “D” aged 70–79 years, and group “E” aged more than 79 years. Results: There were not statistically significant differences in right-side MBF versus left-side MBF. The differences between sex were statistically significant with a stronger bite in males than females (p &lt, 0.05). At the same time, younger subjects had a stronger bite than elders (p &lt, 0.05). In group “E”, more corpulent subjects (BMI &gt, 25) had an MBF higher than less corpulent subjects (BMI &lt, 25, p &lt, 0.05). The analysis of mean MBF showed a statistically significant difference within all groups stratified by BMI with mean values inversely proportional with age (p &lt, 0.001). Conclusion: The results in our study confirm data from many scientific papers. The importance of the present paper was to correlate data between and within a large sample with a wide range of ages. Our sample subjects had a 31%–33% decrease in MBF from group “A” to group “E” group, but they all had full permanent dentation and they preserved a valid MBF.

We describe a case of succinyl-CoA:3-oxoacid CoA transferase (SCOT) deficiency in an otherwise healthy 14 month-old female. She presented with lethargy, tachypnea, and hyperpnea with hypoglycemia and a severe anion gap metabolic acidosis. Early management included correction of the acidosis and metabolic support with dextrose and insulin. Inborn errors of metabolism are rare outside the neonatal period. However, SCOT deficiency may present at older ages. Maintaining a high index of suspicion, immediate transfer to a pediatric intensive care unit, and prompt metabolic support are key to achieving a favorable outcome.

Comparative education in Asia is witnessing changing discourses, structural opportunities, and invigorated leadership. This article will review the institutionalization of comparative education in ...

Students can become disengaged from marketing material if they cannot see the direct application. Marketing material needs to be applied to a meaningful business task to engage and motivate students. This article introduces the Kickstarter Active Learning Project—an innovative semester-long project in which students create a Kickstarter crowdfunding website. The key pedagogical innovation is that student knowledge is applied immediately to the real-world task of creating a Kickstarter website leading to increased engagement.

Objective(s): Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation). Study design: The study was conducted on 11 OSAS young subjects (mean age 6.9±1.04 years), all treated with rapid maxillary expansion (RME). Cardio-respiratory monitoring (8-channel Polymesam) was performed at the beginning (diagnostic, T0) and after 12 months of treatment. Results: The mean values of cardio-respiratory parameters at TO were: AHI=6.09±3.47; SAO2=93.09%±1.60. After 12 months of treatment, the mean values of the same polysomnographic parameters were: AHI=2.36 ± 2.24;SAO2=96.81% ±1.60. These changes were associated with an improvement in clinical symptoms, such as reduction of snoring and sleep apnea. Conclusion(s): This study confirms the therapeutic efficacy of RME in OSAS young patients. This orthopedic-orthodontic treatment may represent a good option in young patients affected by this syndrome.

Background: Array comparative genomic hybridization (aCGH), karyotyping and fluorescence in situ hybridization (FISH) analyses have been used in a clinical cytogenetic laboratory. A systematic analysis on diagnostic findings of cytogenomic abnormalities in current prenatal and pediatric settings provides approaches for future improvement. Methods: A retrospective analysis was performed on abnormal findings by aCGH, karyotyping, and FISH from 3,608 prenatal cases and 4,509 pediatric cases during 2008–2017. The diagnostic accuracy was evaluated by comparing the abnormality detection rate (ADR) and the relative frequency (RF) of different types of cytogenomic abnormalities between prenatal and pediatric cases. A linear regression correlation between known prevalence and ADR of genomic disorders was used to extrapolate the prevalence of other genomic disorders. The diagnostic efficacy was estimated as percentage of detected abnormal cases by expected abnormal cases from served population. Results: The composite ADR for numerical chromosome abnormalities, structural chromosome abnormalities, recurrent genomic disorders, and sporadic pathogenic copy number variants (pCNVs) in prenatal cases were 13.03%, 1.77%, 1.69%, and 0.9%, respectively, and were 5.13%, 2.84%, 7.08%, and 2.69% in pediatric cases, respectively. The chromosomal abnormalities detected in prenatal cases (14.80%) were significantly higher than that of pediatric cases (7.97%) (p < 0.05), while the pCNVs detected in prenatal cases (2.59%) were significantly lower than that of pediatric cases (9.77%) (p < 0.05). The prevalence of recurrent genomic disorders and total pCNVs was estimated to be 1/396 and 1/291, respectively. Approximately, 29% and 35% of cytogenomic abnormalities expected from the population served were detected in current prenatal and pediatric diagnostic practice, respectively. Conclusion: For chromosomal abnormalities, effective detection of Down syndrome (DS) and Turner syndrome (TS) and under detection of sex chromosome numerical abnormalities in both prenatal and pediatric cases were noted. For pCNVs, under detection of pCNVs in prenatal cases and effective detection of DiGeorge syndrome (DGS) and variable efficacy in detecting other pCNVs in pediatric cases were noted. Extend aCGH analysis to more prenatal cases with fetal ultrasonographic anomalies, enhanced non-invasive prenatal (NIPT) testing screening for syndromic genomic disorders, and better clinical indications for pCNVs are approaches that could improve diagnostic yield of cytogenomic abnormalities.

Reduced representation (RRL) sequencing approaches (e.g., RADSeq, genotyping by sequencing) require decisions about how much to invest in genome coverage and sequencing depth, as well as choices of values for adjustable bioinformatics parameters. To empirically explore the importance of these "simple" methodological decisions, we generated two independent sequencing libraries for the same 142 individual lake whitefish (Coregonus clupeaformis) using a nextRAD RRL approach: (1) a larger number of loci at low sequencing depth based on a 9mer (library A); and (2) fewer loci at higher sequencing depth based on a 10mer (library B). The fish were selected from populations with different levels of expected genetic subdivision. Each library was analyzed using the STACKS pipeline followed by three types of population structure assessment (FST, DAPC and ADMIXTURE) with iterative increases in the stringency of sequencing depth and missing data requirements, as well as more specific a priori population maps. Library B was always able to resolve strong population differentiation in all three types of assessment regardless of the selected parameters, largely due to retention of more loci in analyses. In contrast, library A produced more variable results; increasing the minimum sequencing depth threshold (-m) resulted in a reduced number of retained loci, and therefore lost resolution at high -m values for FST and ADMIXTURE, but not DAPC. When detecting fine population differentiation, the population map influenced the number of loci and missing data, which generated artefacts in all downstream analyses tested. Similarly, when examining fine scale population subdivision, library B was robust to changing parameters but library A lost resolution depending on the parameter set. We used library B to examine actual subdivision in our study populations. All three types of analysis found complete subdivision among populations in Lake Huron, ON and Dore Lake, SK, Canada using 10,640 SNP loci. Weak population subdivision was detected in Lake Huron with fish from sites in the north-west, Search Bay, North Point and Hammond Bay, showing slight differentiation. Overall, we show that apparently simple decisions about library construction and bioinformatics parameters can have important impacts on the interpretation of population subdivision. Although potentially more costly on a per-locus basis, early investment in striking a balance between the number of loci and sequencing effort is well worth the reduced genomic coverage for population genetics studies. More conservative stringency settings on STACKS parameters lead to a final dataset that was more consistent and robust when examining both weak and strong population differentiation. Overall, we recommend that researchers approach "simple" methodological decisions with caution, especially when working on non-model species for the first time.

PURPOSE To evaluate several clinical and functional parameters by administration of specific questionnaires to an elderly patient's cohort wearing three different types of removable partial denture (RPD): VALPLAST-RPD (Polyamide VALPLAST), CoCr-RPD (cobalt-chromium alloy), and PMMA-RPD (heat polymerized polymethyl methacrylate). MATERIALS AND METHODS One hundred twenty patients (mean age 73 years) were included in this study. All patients were treated with a removable partial denture for the maxillary arch. After 1 year of use, patients and clinicians were asked to compile specific questionnaire on patient satisfaction, including aesthetic, functional, and clinical outcomes. It was also evaluated whether the localization of the missing teeth according to Kennedy classification may affect these parameters. Categorical data obtained from the questionnaires were analyzed by chi-squared test. RESULTS VALPLAST-RPD was the most satisfactory aesthetically. Nevertheless, patients of VALPLAST-RPD group reported increased difficulty in cleaning the prosthesis, roughness perceived by the tongue, and increased retention loss (p < 0.001). Patients with PMMA-RPD claimed a higher level of encumbrance (p < 0.001) and increased speech difficulties (p = 0.002). Clinically, patients of VALPLAST-RPD and PMMA-RPD groups displayed redness of the mucosa area around abutment teeth (p < 0.001). Patients of VALPLAST-RPD group had four cases of artificial teeth loss and two cases of discoloration. The position of missing teeth did not significantly influence any parameter. CONCLUSIONS Each RPD material utilized may present advantages and disadvantages in an elderly population. VALPLAST-RPD may be recommended to older patients with non-extensive edentulous areas supported by anterior and posterior teeth, and not subjected to strong chewing loads. The main advantages are aesthetic satisfaction and easiness to insert and remove it.

Mutations in Kelch-like family member 7 (KLHL7) have recently been described as a cause of a constellation of clinical findings with descriptions of both a Crisponi syndrome (CS)/cold-induced sweating syndrome type 1 (CISS1)-like, as well as a Bohring-Opitz syndrome (BOS)-like presentation. Here we report two siblings of Guatelmalan descent with a novel homozygous nonsense mutation (p.Arg326*) in KLHL7. These children have multiple dysmorphic features and developmental delay. Interestingly, their clinical traits inconsistently overlap both the CS/CISS1-like and BOS-like phenotypes, and the siblings also have subtle differences from each other, suggesting that clinicians need to be aware of the degree of variability in the presentations of these patients. Still, there is enough in common between patients with recessive KLHL7 mutations to define a novel multisystem disease that features various neurodevelopmental, musculoskeletal, dysmorphic, and other unique components. This report adds to the clinical features and disease-associated variants of the newly-recognized spectrum of KLHL7 mutations, and offers a new description, PERCHING, for the resulting syndrome.

Oral diseases have been adversely associated with cardiovascular diseases (CVD), which are also the most frequent cause of death in older population. The aim of this study was to investigate the association among oral status indexes and CVD in patients aged more than 65 years attending in the Oral department of a public hospital Policlinico Umberto 1 of Rome. The study population consisted of 533 patients. Dental status was detected measuring the Decayed, Missing, and Filled Teeth (DMFT) and Community Periodontal Index (CPI) indexes. The chi-square test with a 95% confidence level was used to assess qualitative variables. Odds ratios (ORs) and stepwise logistic regression were used to calculate risk estimates; the independent variables: age, gender, DMFT, CPI index, Geriatric Oral Health Assessment Index (GOHAI) score, and tooth loss were included in the statistical model. P value

Introduction Many studies on removable retainers have focused on retention efficacy and characteristics. However, studies on plaque accumulation, periodontal health, breakages, and patient compliance are still lacking. Thus, in this study, we aimed at evaluating these parameters in 2 groups of young patients wearing Essix or Hawley retainers for a 6-month period. Methods Seventy subjects were included. Periodontal health was investigated by measuring the plaque, gingival, calculus, and bleeding on probing indexes. Evaluations were performed at 1, 3, and 6 months of wearing. Accumulation of plaque on the retainers was also evaluated. Furthermore, compliance on wearing retainers and breakage data were collected by specific questionnaires. Results Subjects wearing Essix retainers had significantly higher levels of plaque, gingival, and calculus indexes and increased percentages of bleeding sites, compared with subjects wearing Hawley retainers. The Essix group also had increased accumulations of plaque and calculus on the retainers. Nonetheless, subjects of the Essix group had better overall experiences, self-perceptions, and comfort compared with those of the Hawley group. Essix retainers had higher incidences of little and serious breakages compared with Hawley retainers. Conclusions Our results suggest that Essix retainers are well accepted by patients for their esthetic and oral comfort characteristics. However, Essix retainers may cause greater accumulations of plaque on both teeth and retainers, presumably because of inhibition of the cleaning effect of saliva caused by the thermoplastic material or the reduced opportunity for good hygiene on the retainer.

A sample of 303 skeletons from the Etruscan necropolis of Spina (Ferrara, Italy, 6th-3rd centuries BC) was ex- amined for paleopathological lesions in order to assess the general health, diseases and quality of life of this Iron Age population. The observed pathologies included porotic hyperostosis, specific and aspecific infec- tions, metabolic and endocrine disorders, tumours and osteoarthritis. A total of 46.7% of adults and 7.7% of subadults showed at least one pathological lesion. Statistical comparisons were made between sexes and adult-age classes (20-35years and >35years) to analyse the prevalence of the lesions. The analysis of porotic hyperostosis and osteoperiostitis allowed to determine the general health status of this group, and the analysis of osteoarthritis allowed to hypothesise a gender division of labour. The results suggest a relatively high-life expectancy for the time as well as good health and quality of life. The few specific infections and metabolic disorders indicate fairly good nutrition, while the high frequency of porotic hyperostosis can be partly linked to some type of hereditary anaemia. Copyright © 2015 John Wiley & Sons, Ltd.

Sinus augmentation procedure has been demonstrated to be a highly predictable treatment in posterior maxilla atrophy. All the surgical interventions in the maxillary region require deep knowledge of anatomy and possible anatomical variations. In this article, pre-operative and post- operative assessments of sinus cavity as well as novel approaches to deepen our knowledge of the behavior of bone substitute materials are described. The awareness of the patient's morphologic conditions enables exact planning of invasive surgery and aids to avoid complications. Pre- operative radiologic evaluation of the region before sinus lift is advisable both for a planning of the sinus augmentation and for selection and alignment of the optimum placement of implants. On the orthopantomography it is possible to measure the vertical dimension of graft, but not the volume and 3D changes. Cone-beam computed tomography (CBCT) has become the "gold standard" to plan a comprehensive implant treatment and to achieve a post-operative assessment. A computer-aided design/computer-aided manufacturing (CAD/CAM) technique is proposed to produce custom-made block grafts for sinus lift procedure, and a customized cutting guide to accurately place the lateral wall and ease membrane elevation. This procedure allows to reduce intervention time, to precisely adapt the scaffold, to reduce risk of complications and to improve operation quality. Recently, a novel approach has been used to deepen our knowledge of the behavior of BSBs: by means of synchrotron micro-tomography (SCT). It is a 3-D analyzing method, suitable to examine the dynamic and spatial arrangement of regenerative phenomena in complex anatomical structures such as bone, where tissues with several morphologies (alveolar process, unmineralized extracellular matrix, regenerated vessels, etc.) compete to achieve the final goal of bone regeneration.

Private supplementary tutoring, also widely known as shadow education, is becoming a global phenomenon and an object of international scholarship. Private tutoring has multiple forms and positions across educational systems and levels, thus the term “shadow educations”. Asia is a notable location of shadow education activity. This editorial article maps the global discourse on shadow educations, using an expanded framework for analysis based on the Bray and Thomas cube. Against this backdrop, Asian research on shadow education presented in this special issue is introduced and its contribution to the global discourse is highlighted. A possible global research agenda is offered with the hope that new understandings derived from scholarly research may aid stakeholders in achieving the aims of education.

Patients with problems related to central nervous system dysfunctions are often treated with psychotropic drugs. These include antipsychotics, antidepressants, mood stabilizers, anticonvulsants, and drugs blocking specific receptors in the brain such as anticholinergics or beta-blockers. However, these medications have serious side effects affecting the oral health. In addition, many dental patients make use of psychoactive drugs, such as amphetamine, ecstasy, and cocaine. This article aims to review data on the psychotropic drugs being used in the last 30 years, their pharmacological profile, with special attention to the side effects related to the oral health. Oral diseases such as bruxism, orofacial dystonia, oromandibular dyskinesia, and rabbit syndrome are related to extrapyramidal effects of antipsychotic drugs because of their antagonist activity on the dopaminergic receptors. Drugs with anticholinergic and/or antiadrenergic effects such as tricyclic antidepressants may cause dry mouth and related complications such as candidiasis and other oral infections. Among mood stabilizers, lithium treatment induces a wide range of side effects on oral system including dry mouth, sialorrhea, infections, and ulceration of the oral cavity. Psychostimulants may instead provoke xerotomia, gingival enlargements, bruxism, dental erosion, mucosal ulceration, and oral/nasal lesions. This literature review supports the idea that the higher prevalence of oral diseases among patients with mental disorders may be attributed to the side effects of their medications mediated by complex interactions between different targeted receptors. Thus, dentists must be aware of the possible risks of these medications in order to take appropriate precautions in treating these patients.

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an adverse drug reaction described as the progressive destruction and death of bone tissue of the mandible or maxilla, in the course of bisphosphonate therapy. Orally administered bisphosphonates, widely used for the treatment of osteoporosis, are rarely associated with BRONJ. Instead, the risk greatly increases whether the patient is concomitantly taking steroid and/or immunosuppressant agents. The aims of this paper are to briefly discuss the evidence of the associations between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors such as the presence of rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. In particular, we present the case of an elderly woman with BRONJ suffering from rheumatoid arthritis, with a recent dental extraction and with a very unusual complication: a temporal abscess, who was successfully treated.

A self-contained, small-scale research hatchery was constructed in a modified chromatography refrigerator equipped with a filtered and UV-sterilized water recirculation system. Lake Whitefish Coregonus clupeaformis embryos were raised in conventional upwelling hatching jars, in dishes with a continuous slow “drip feed,” and in a variety of static water incubation systems in petri dishes and multiwell plates. The optimal rearing density for petri dishes was found to be 50 embryos per dish, with weekly water changes. The highest survival in multiwell plates was seen in the 6- and 24-well sizes. Survival rates in most multiwell plates and petri dishes, as well as in the hatching jar incubators, were between 40% and 60%, which is in line with survival rates seen in commercial large-scale rearing. Overall, these techniques permitted the rearing of large numbers of whitefish in separate batches and under controlled conditions, while greatly reducing space requirements and material costs. Our system is w...

L’assistance respiratoire dans le cadre du syndrome de detresse respiratoire aigue (SDRA) tend a se developper depuis ces dernieres annees. Les algorithmes de prise en charge des patients au cours de cette pathologie commencent a voir le jour. Les reponses therapeutiques en fonction du type de SDRA devront etre differentes. En effet, les contraintes techniques differeront selon les objectifs therapeutiques : soit des objectifs d’oxygenation predominants, soit des objectifs de decarboxylation prioritaires, soit mixtes. Les progres techniques actuels couples a une rationalisation de l’utilisation des techniques d’extracorporeal membrane oxygenation (ECMO) dans le SDRA permettront de contribuer sans doute a l’amelioration du pronostic de cette pathologie.

Dear editor We read with great interest the case report concerning a patient with bisphosphonate-related osteonecrosis of the jaw (BRONJ) reported by Manzon et al.1 In this report, they describe BRONJ complicated by a temporal abscess in an elderly woman with rheumatoid arthritis. We congratulate Manzon et al on their successful treatment of this patient. They briefly discussed the evidence for the relationship between bisphosphonate therapy and BRONJ, and the effects of co-occurring factors, such as rheumatoid arthritis, dental surgery, and concomitant corticosteroid therapy. We would also like to add our experience of treating pain in a patient with BRONJ. A 71-year-old woman weighing 50 kg was referred to our hospital in February 2015 with difficulty opening her mouth, trismus, fever, headache, and severe pain. The patient’s past medical history was relevant for rheumatoid arthritis, treated from 1995 with methotrexate, leflunomide, daily oral calcium, and vitamin D3 for 20 years and oral prednisone 0.1 mg/kg was added for the last 10 years. After a vertebral fracture caused by severe osteoporosis, the patient started treatment with alendronate sodium 10 mg daily in tablet form. In March 2014, the patient underwent a lower right first molar extraction following development of an abscess. The patient had a noticeable right-sided mandibular abscess with a right-sided soft temporal swelling and redness, and severe pain on mouth opening. Oral examination revealed an abscess in the posterior mandible, in the area of the recent extraction, with pus leaking from the previous surgical site. Infection and swelling was extending distally to the lower right first molar. We examined the patient and detected no laboratory abnormalities in liver and kidney function. She reported that her pain persisted throughout the day and that she was unable to eat due to pain. We ordered paracetamol 10 mg/kg intravenous and tramadol 1 mg/kg intravenously, four times daily. At the end of the 1st day, her pain resolved and she was able to return to her daily routines. The etiopathogenic mechanism of BRONJ remains unclear, and no universally accepted therapeutic protocol is known to eradicate it; however, the treatment goal should be focused on eliminating pain and preventing progression to bone infection and necrosis.2 Rheumatoid arthritis is considered an important contributing factor for BRONJ, even though the relationship between the two diseases is not yet fully understood. Bone tissue damage and bone loss are typical features of rheumatoid arthritis.3 Osteonecrosis may develop for local or multifocal reasons. Malnutrition and general malaise can be found due to pain in elderly patients with BRONJ. These patients must be carefully evaluated, and weak narcotics like tramadol can be used safely.

Small bowel dysfunction in critically ill patients is frequent, underdiagnosed, and associated with poor prognosis. Intestinal fatty acid-binding protein is a marker of enterocyte damage, and plasma citrulline concentration is a marker of functional enterocyte mass. Primary objective was to identify factors associated with intestinal fatty acid-binding protein in critically ill patients. Secondary objectives were to study factors associated with plasma citrulline concentration and its correlation with intestinal fatty acid-binding protein.Prospective observational study.ICU in a University HospitalCritically ill patients 18 years old or older with an expected length of ICU stay 48 hours or more, without pregnancy, chronic small bowel disease, or chronic renal failure.None.Plasma intestinal fatty acid-binding protein and citrulline concentrations, and variables relating to prognosis and treatment, were measured at admission to the ICU. One hundred and three patients were included. Intestinal fatty acid-binding protein elevation at admission to the ICU was associated with catecholamine support, higher lactate concentration, higher Sequential Organ Failure Assessment score, and higher international normalized ratio (all p≤0.001). Plasma citrulline concentration less than or equal to 10 μmol/L at admission to the ICU was associated with higher intra-abdominal pressure, higher plasma C reactive protein concentration, and more frequent antibiotic use (all p≤0.005). There was no correlation between plasma levels of intestinal fatty acid-binding protein and citrulline. At ICU admission, Sequential Organ Failure Assessment score≥12, plasma citrulline≤12.2 μmol/L, and plasma intestinal fatty acid-binding protein concentration≥355 pg/mL were all independently associated with 28-day mortality (odds ratio, 4.39 [1.48-13.03]; odds ratio, 5.17 [1.59-16.86]; and odds ratio, 4.46 [1.35-14.74], respectively).In critically ill patients, enterocyte damage is frequent, and it is significantly associated with shock and 28-day mortality. The link between intestinal fatty acid-binding protein and plasma citrulline concentrations in critically ill patients needs to be further evaluated.

Identifying spinal landmarks by palpation is a prerequisite to many manual therapy procedures. Understanding if landmark depth changes with a subject's body mass index (BMI) may help clinicians attribute importance to their palpation findings. In this study, 105 consecutive subjects were referred for lumbar magnetic resonance imaging (MRI) in a hospital setting. Four blinded examiners measured T1-weighted MRI images to quantify the depth of spinous and transverse processes in the lumbar spine. For each process, a linear mixed-effects model was carried out by gender with depth as the outcome and BMI as a covariate. The average BMI for males ( n = 57) was 27.52 kg/m 2 and 27.02 kg/m 2 for females. The mean landmark depth was 22.77 mm, 23.00 mm, 27.40 mm, 33.40 mm, 36.65 mm for spinous processes L1–L5 respectively and 69.35 mm and 69.41 mm for the left and right L4 transverse processes. The inter-evaluator, intra-class correlation coefficient averaged 0.98 for all depth measurements. The linear relationship between depth and BMI was statistically significant for all landmarks in females and only for spinous processes in males. In conclusion, the strength of the correlations observed suggests that although landmark depth increases with subject BMI, other factors may influence this correlation.

Small bowel functions are more complex than colon functions, and short bowel conditions are associated with increased mortality. Gastrointestinal dysfunction in critically ill patients is common, probably underestimated, and associated with a poor prognosis. However, a validated definition of acute intestinal failure is lacking, in absence of a marker to measure it. Consequently, small bowel dysfunction is not clearly integrated into the overall approach used to treat ICU patients.Review of the literature on gastrointestinal dysfunction in critically ill patients, and proposition of a definition of acute intestinal failure.On the one hand, small bowel ischemia is related to acute reduction of enterocyte mass and loss of gut barrier function by epithelial lifting of villi. On the other hand, systemic inflammatory response syndrome (SIRS) and sepsis could be linked to an acute dysfunction of enterocytes without enterocyte reduction. Citrulline is an amino acid mainly synthesized by small bowel enterocytes. Various contexts of chronic and acute reduction of enterocyte mass have been correlated with low plasma citrulline concentration. Critically ill patients with shock have an acute reduction of enterocyte mass and reduced gut citrulline synthesis, leading to a low plasma citrulline concentration. Acute intestinal failure could be defined as an acute reduction of enterocyte mass and/or acute dysfunction of enterocytes, associated or not with loss of gut barrier function. The influence of SIRS and acute renal failure on plasma citrulline concentration and the value of this concentration as an indicator of acute intestinal failure in critically ill patients must be further evaluated.

Background: Bone substitutes, such as allografts, xenografts, and alloplasts, have been proposed in several augmentation procedures. Purpose: The aim of the present study was a histologic and histomorphometric evaluation of specimens retrieved 4 or 6 months after sinus augmentation using cortical porcine bone augmentation material. Materials and Methods: A total of 77 specimens, retrieved after 4 and 6 months from augmented sinuses, were used in this study. The specimens were processed to be observed under light microscopy. Histomorphometric measurements were presented as means ± standard deviations. Results: Most of the particles were surrounded by newly formed bone with large osteocyte lacunae. Histomorphometry showed that, after 4 months, the newly formed bone represented 28%, marrow spaces 36%, the residual graft material 37%, while, after 6 months, the newly formed bone represented 31%, marrow spaces 34%, while the residual graft material was 37%. Conclusion: The present results show that cortical porcine bone is a biocompatible, osteoconductive biomaterial that can be used for maxillary sinus augmentation procedures without interfering with the normal reparative bone processes.

Background/Aims Hepatocellular carcinoma (HCC) most often occurs within hepatocellular adenomas (HCAs) in glycogen storage disease Ia (GSD Ia) patients. The objective of this retrospective study is to assess outcomes after liver transplantation (LT) for GSD Ia where the principal indication for transplantation was prevention of HCC. Methods Petitions to the United Network for Organ Sharing region 11 review board for additional model for end-stage liver disease listing points were made on behalf of GSD Ia patients. Demographics, pre-operative comorbidity, and outcomes for GSD Ia patients who underwent LT were reviewed. Results Between 2004 and 2006, five GSD Ia patients underwent LT. Multiple HCAs with focal hemorrhage and/or necrosis but without histological evidence of malignancy were identified in all explanted specimens. Four of five patients had complications after LT, including cytomegalovirus (CMV) infections and steroid responsive allograft rejection. Hemoglobin levels and serum triglyceride, total cholesterol, blood glucose, and lactic acid concentrations improved in all patients after LT. Corn starch feeding was not required in any patient after LT. Renal function worsened in three patients despite modifications to primary immunosuppressive medications. All patients are alive at last follow-up (range 25–48 months) and all post-transplant complications have resolved. Conclusions By removing all possible adenomatous tissue and reversing the underlying hepatic enzymatic deficiency, LT provides definitive prevention against HCC and correction of most metabolic derangements in GSD Ia patients. Renal dysfunction secondary to GSD Ia persists—underscoring the need for further studies to better understand the mechanisms of renal dysfunction in these patients.

The aim of this study was to determine whether not treating chronic dental infection during the admission for cardiac valve surgery would increase the morbidity and mortality of patients. Patients were divided into three groups: dentally unhealthy and untreated (Group A), dentally healthy not requiring treatment (Group B), and dentally unhealthy and treated (Group C). Hospital computer records and phone interviews were used to assess morbidity and mortality as assessed through the Social Security Death Index. Ninety-eight patient charts were reviewed. Patients in Group A (n = 47)were not at a significantly greater risk for developing infective endocarditis (IE) within 6 months of cardiac surgery compared to patients in Groups B (n = 17) and C (n = 34). Also, patients in Group A did not have a significantly higher rate of mortality compared to other groups (p= .09). The results suggest that there is no need to treat chronic oral infections in patients with compromised cardiac function within 24 to 48 hours prior to cardiac valve replacement surgery since this will not lower the risk of IE and death following cardiac valve surgery. Multicenter prospective case-controlled studies are needed to address this question definitively.

Legg-Calve-Perthes is a very rare disease involving childhood osteochondrosis of the femoral head due to interruption of its blood supply. The etiology is unknown. The signs of the pathology are well described in the literature but few paleopathological cases have been reported, mostly dating from Late Antiquity to Early Middle Ages. Here we report on morphometric and radiological analyses of a skeleton from the Etruscan necropolis of Spina (Ferrara, Italy, 6th-3rd century BCE), to our knowledge the most ancient case of Legg-Calve-Perthes disease published thus far.

Relocation, what are the advantages of relocating a company? What are the disadvantages? Who will benefit from relocation and who will be harmed? What factors are to be considered when thinking about moving a company? What about production operations, marketing and distribution, human resources, stakeholder groups, a unionized workforce and even local and state governments? In the Halsey-Evans case, is relocation the answer?

Background Recent studies have shown that body image perception is an important factor in weight control and may be influenced by culture and ethnicity. The aim of the present study was to assess the relationship between immigrant status of the mother and weight status and body image perception of the child. Methods In total, 2706 schoolchildren (1405 boys and 1301 girls) aged 8–9 years and their mothers participated in a cross-sectional survey in Emilia-Romagna region (northern Italy). Weight and height of the children were measured and Body Mass Index (BMI) was calculated. Actual and ideal body image perception by the children and by the mothers with respect to their children was evaluated according to Collins’ body image silhouettes. Results The BMI values were significantly lower in children of immigrants than in children of Italian mothers (F:17.27 vs 17.99 kg/m2; M:17.77 vs 18.13 kg/m2). The prevalence of overweight/obesity was lower, and the prevalence of underweight higher, in children of immigrant mothers than in those of Italian mothers (overweight- F:21.3 vs 29.1%; M. 28.3 vs 31.4%; underweight- F:5.16 vs 3.84%; M:6.63 vs 2.82%). The children's body image perception was consistent with the differing pattern of nutritional status. In the comparison between actual and ideal figures, the Feel-Ideal Difference Index (FID) scores resulted different between the subsample with foreign-born mother in comparison to the native one (significantly lower in daughters of immigrants) (FID- F: 0.31 vs 0.57; M: 0.35 vs 0.32). There were significant differences in the choice of the ideal figure of the child between immigrant mothers and Italian mothers (FID- F: -0.05 vs 0.19; M: -0.35 vs −0.03): the ideal figure values were higher in the immigrant mothers of male children and lower in the Italian mothers of female children. Conclusion Our results suggest that cultural and behavioral factors linked to ethnicity play an important role in the nutritional status of children and in the perceived and ideal body image.

For the industrial adoption of laser welding technology, it is important that the yards achieve full control of the process and that they and the classification societies reach a level of confidence in the technology to permit a reduced level of quality controls after the welds have been performed. This would lead to a practicable and easier implementation of the technology in the industrial field. This is the approach that two EU yards, Odense Steel Shipyard and Fincantieri, had in mind while developing, with the partnership of important EU research institutes and classification societies, the EU-supported research project Shipbuilding Laser Welds: An Integrated System for Assurance and Control of Quality (SHILWACQ). The author, who was the coordinator of the project, explains, from the point of view of an end user shipyard, how this approach was implemented following two main research lines:the quality assurance line, focusing on the "defect avoidance" criterion and the "defect acceptance" (fitness for purpose) criterion;the quality control line, concentrating on the on-line process monitoring and automated not-destructive-test inspection systems. The CO2 laser welding technology for small/medium-thickness steel hull components is addressed. The article explains the activity development and the scientific results achieved by the two research lines, as well as how these results have been tested and validated in the industrial environment.