Valid Reference Point Research Articles

Sociopolitical economy and spatial accentuation of neighbourhood gentrification in East Malaysia

The rapid displacement and land expropriation from property owners are generating an imbalance between lower-income households and the developers in many communities in the central area of large cities worldwide. While the need to prevent urban decline, rejuvenate declining/dilapidating neighbourhoods and promote sustainable urban development has always been at the forefront of neighbourhood gentrification, developers are the major beneficiaries of the rapid rise in property prices. This study examines the important drivers of gentrification in East Malaysia from political, economic, social and spatial lenses. This research was analysed using a questionnaire survey data collected from housing developers and other allied professionals with relevant experience in neighbourhood gentrification in East Malaysia. Then, the hierarchical clustering technique followed by the Relative importance index (RII) computation was used to determine the relationship between the identified driving factors, the grouping of drivers into relatable clusters, as well as to determine the most influential cluster and drivers encouraging the course of neighbourhood gentrification. The study uncovers a compelling insight: although political factors exert the greatest influence on neighbourhood gentrification, it is crucial to acknowledge the substantial roles played by economic, social, and spatial drivers in its emergence, albeit to a somewhat lesser degree. Our findings emphasise the pivotal importance of eight political derivatives, which shape and contribute to the complex dynamics of gentrification, underscoring their significance in understanding its multifaceted nature. The findings of this research are a valid reference point for the relevant stakeholders to garner greater insight into the particularities of neighbourhood gentrification in East and Malaysia and many urban communities around the globe.

The maxillary-mandibular planes angle (MM?) bisector: A new reference plane for anteroposterior measurement of dental bases

Diagnosis of an important part of orthodontic treatment. Although many cephalometric analyses have been devised to determine the degree of anteroposterior skeletal discrepancies, effective treatment planning and assessment must be based on accurate measurement using stable and reproducible reference planes.The purpose of study was to evaluate the clinical usefulness of maxillomandibular bisector, its reproducibility, and validity, and relationship to functional occlusal plane, bisecting occlusal pane.Pre-treatment lateral cephalograms of 30 adult patients (age 18 or above) were selected. Various Angular & Linear measurement were recorded. Present study showed MM bisector plane, FOPPM is more reproducible and valid reference point than BOPMM, BOPPM.

Identification of the Challenges of Life Cycle Costing in Green Construction Projects in Malaysia

Concerns on the effect of construction industry to the environment has driven an increase in sustainable construction activities as well as green initiatives. Life cycle costing (LCC) which is a method of assessing the total cost of ownership of an asset or project has been commonly associated with sustainable-related studies and are used around the world for the last few decades. Even though many benefits have been associated with LCC, its implementation in construction industry is still limited, particularly in green construction projects. This paper aimed to identify the main challenges in implementing LCC in Malaysia’s green construction projects. A quantitative approach via questionnaires survey was conducted on 200 respondents from various backgrounds, namely architects, quantity surveyors, engineers and other professionals typically would be involved in LCC preparation for green construction projects in Malaysia. The questionnaires were distributed to the respondents via traditional mail followed by e-mail as well as online platforms in order to increase the response rate. A total of fifty (50) completed and usable questionnaires were collected and analysed based on mean scores and ranking method. It was discovered that the main challenges of LCC in green construction projects were insufficient project or context specific data and difficulties in carrying out LCC calculations due to absent of proper LCC guidelines or framework. The findings serve as a valid point of reference for industry participants concerned with green developments to improve the LCC process and its adoption in Malaysia’s green construction projects. Efforts must be taken to minimize or ease these challenges perhaps by formulating a framework or guideline specifically designed to address the challenges, thus improving the LCC process and encouraging its adoption in Malaysia which will ultimately contribute towards achieving the world’s green construction agenda.

The monetary policy during shocks: an analysis of large Asian economies’ response to COVID-19

The economies all over the world that have been adversely affected by the COVID-19 pandemic have recently started to devise different strategies to mitigate its consequences. Therefore, in order to dwell deeper into the measures taken by the policy makers around the world, this paper specifically analyzes how the monetary policies have been devised, in response to COVID-19. For this purpose, this paper has taken into consideration a panel of 8 Asian economies that have been affected the most acutely by the virus, have faced multiple lockdowns, and have also experienced other economic restraints, due to this very phenomenon. In order to compare the possible monetary policy options, and their outcomes during the COVID-19 pandemic, this paper refers to the global recession shock, as a valid point of reference. In addition to this, in order to gain access to the empirical evidence, the ARDL methodology has been applied on the quarterly data from 2005Q3 to 2020Q3. The results of the study have indicated that various plans have been taken into consideration, so as to lessen the consequences of these shocks that have trickled down into the respective economies of these countries. That is to put forth that, in the incidence of global recession, the monetary authorities have resorted to a less prudent stance. Whereas, more flexibility, through a persistent decrease in the policy rate has been observed since the pandemic first hit the world. In this regard, our results imply that a successful, efficient and effective response to the economic consequences of COVID-19, would ideally entail a set of remedial policies and structural reforms.

Multiple Reference Points and Length of Ownership in the Housing Market

Reference-dependent utility has been shown to have a significant influence on housing market activity. Sellers facing a nominal loss on their home due to market conditions, tend to inflate the asking price and thus the transaction price of their home, indicative of loss aversion. However, the original purchase price of a home may lose influence as a reference-point as the period of ownership increases, while homeowners rely increasingly on other benchmarks such as neighboring homes’ sales prices as reference points. In other words, a homeowner may have multiple reference points in their underlying utility function, whose relative influences shift in importance over time. We use comprehensive administrative data on residential real estate transactions in Singapore’s private housing market to test the influences of original purchase price and recent neighborhood price as reference points over the length of homeownership. Purchase price and neighborhood price are each valid reference points based on established empirical methods in the behavioral and housing economics literature. By testing for their relative influences as a function of length of ownership, we find that prior purchase price is more influential for the first years of ownership, while neighborhood price becomes more influential during the subsequent holding years. Finally, we provide a theoretical framework for understanding the relative influences of multiple reference points over time, which supports the empirical findings.

Comparison of Experimentally Determined Two-Dimensional Strain Fields and Mapped Ultrasonic Data Processed by Coda Wave Interferometry.

Due to the high sensitivity of coda waves to the smallest structural alterations such as strain, humidity or temperature changes, ultrasonic waves are a valid means to examine entire structures employing networks of ultrasonic transducers. In order to substantiate this ex ante assessment, the viability of measuring ultrasonic waves as a valid point of reference and inference for structural changes is to be further scrutinized in this work. In order to investigate the influence of mechanical strain on ultrasonic signals, a four-point bending test was carried out on a reinforced concrete beam at Ruhr University Bochum. Thus, measurements collected from a network of selected transducer pairings arranged across the central, shear-free segment of the test specimen, were correlated to their respective strain fields. Detected ultrasonic signals were evaluated employing Coda Wave Interferometry. Such analysis comprised the initial non-cracked state as well as later stages with incremental crack depth and quantity. It was to ascertain that the test specimen can in fact be qualitatively compartmentalized into areas of compression and tension identified via Relative Velocity Changes presented in Attribute Maps. However, since results did not entail a zero crossing, i.e., neither positive nor negative values were to be calculated, only relative changes in this work displayed staggered over the height of the object under test, are discussed. Under the given methodological premises, additional information is currently required to make quantitative assertions regarding this correlation of ultrasonic and strain results. This holds true for the comparability of the ultrasonic and strain results for both non-cracked and even the cracked state.

Spatial and semantic effects of LUCAS samples on fully automated land use/land cover classification in high-resolution Sentinel-2 data

In this study, we test the use of Land Use and Coverage Area frame Survey (LUCAS) in-situ reference data for classifying high-resolution Sentinel-2 imagery at a large scale. We compare several pre-processing schemes (PS) for LUCAS data and propose a new PS for a fully automated classification of satellite imagery on the national level. The image data utilizes a high-dimensional Sentinel-2-based image feature space. Key elements of LUCAS data pre-processing include two positioning approaches and three semantic selection approaches. The latter approaches differ in the applied quality measures for identifying valid reference points and by the number of LU/LC classes (7–12). In an iterative training process, the impact of the chosen PS on a Random Forest image classifier is evaluated. The results are compared to LUCAS reference points that are not pre-processed, which act as a benchmark, and the classification quality is evaluated by independent sets of validation points. The classification results show that the positional correction of LUCAS points has an especially positive effect on the overall classification accuracy. On average, this improves the accuracy by 3.7%. This improvement is lowest for the most rigid sample selection approach, PS2, and highest for the benchmark data set, PS0. The highest overall accuracy is 93.1% which is achieved by using the newly developed PS3; all PS achieve overall accuracies of 80% and higher on average. While the difference in overall accuracy between the PS is likely to be influenced by the respective number of LU/LC classes, we conclude that, overall, LUCAS in-situ data is a suitable source for reference information for large scale high resolution LC mapping using Sentinel-2 imagery. Existing sample selection approaches developed for Landsat imagery can be transferred to Sentinel-2 imagery, achieving comparable semantic accuracies while increasing the spatial resolution. The resulting LC classification product that uses the newly developed PS is available for Germany via DOI: https://doi.org/10.15489/1ccmlap3mn39.

Antimicrobials Used for the Therapy of Necrotic Enteritis and Coccidiosis in Broiler Chickens and Turkeys in Canada, Farm Surveillance Results (2013-2017).

Since 2013, the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) has collected antimicrobial use (AMU) and antimicrobial resistance data from sentinel broiler chicken flocks (Br, five provinces) and sentinel turkey flocks (Tk, one province 2013-2015, three provinces 2016-2017). The objectives of this paper were to describe various preventive strategies aimed at controlling necrotic enteritis (NE) and coccidiosis in the broiler chicken and turkey flocks participating in CIPARS and FoodNet Canada Farm Surveillance Program between 2013 and 2017, to quantify and identify trends in antimicrobials used in feed, and to describe temporal changes in the diagnoses of bacterial and protozoal diseases in relation to antimicrobial use in feed. Comprehensive data were collected (by questionnaire) enabling AMU assessment by various count-based metrics (i.e., frequency and number of medicated rations), weight-based metrics (i.e., inclusion rate in feed and kilograms consumed), and technical indicators (i.e., milligrams per population correction unit [mg/PCU]). Qualitative information such as reasons for use and frequency of diagnosed diseases provided context to the trends in AMU. Between 2013 and 2017, 646 broiler flocks (14.9 million kg biomass) and 234 turkey flocks (12.4 million kg biomass) were surveyed. Overall, antimicrobials used for the prevention of Clostridium perfringens infections (NE) contributed to 85% (109/128 mg/PCUBr) and 95% (59/62 mg/PCUTk) of the quantity of antimicrobials administered via feed in broiler chickens and turkeys, respectively. Three NE programs were used: either 1, 2, or ≥3 antimicrobials administered throughout the production cycle. The treatment protocol in which a single antimicrobial was used throughout the cycle was the most frequent NE preventive program for broiler chickens (58%) and turkeys (76%). Bacitracin and virginiamycin were the top two most frequently used antimicrobials in both species for NE. For coccidiosis control, ionophores and chemical coccidiostats contributed to 66% (3091 kg) and 68% (1561 kg) of the total feed antimicrobial exposures in broiler chickens and turkeys, respectively. Documented coccidiosis programs included continuous or straight (1 drug/cycle), shuttle or dual control (≥2 drugs/cycle), and vaccination. Variations in coccidiosis programs between species were noted: broiler chickens frequently used a shuttle or dual-control program (68%), whereas turkey flocks used primarily a continuous or straight program (74%). Flocks raised without antibiotics and organic farms (10.3% of broiler chickens and 9.8% turkey flocks) used vaccines to prevent coccidiosis. A small number of broiler flocks (n = 6) used a combination of a vaccination and a coccidiostat during the cycle. During the surveillance timeframe used for this paper, the total feed AMU decreased over time in broiler chickens from 136 to 120 mg/PCUBr and in turkeys from 85 to 62 mg/ PCUTk, with no remarkable changes in the frequency of flocks diagnosed with bacterial and protozoal diseases. Surveillance findings such as these will be used as valid reference points in light of the upcoming changes in Canadian federal AMU regulations and industry-led initiatives aimed at reducing AMU.

Cue abstraction and ideal prototype abstraction in estimation tasks

ABSTRACTThis study investigates abstracted processes and introduces a new prototype abstraction model adapted to estimation tasks. This prototype abstraction model assumes that the processing of whole exemplar patterns supports the detection of the underlying statistics necessary for the abstraction of two extreme prototypes on the continuous criterion dimension of the task. The prototypes are stored in memory as valid reference points for future similarity-based judgments. This prototype model was compared with the cue abstraction model, which assumes that people abstract cue weights in learning and add the cue information from exemplars to infer their criterion values varying on the continuous dimension. This study hypothesises that the training mode and the number of exemplars in training interact and affect subsequent model performance at test. The results from an experiment confirmed this hypothesis and showed that observational training supports an efficient prototype abstraction and feedback training supports an efficient cue abstraction.

Two ways of combining philosophy and psychopathology of time experiences

In this paper the author presents two different modes of relationship between phenomenological psychopathology and philosophy. The dominant mode conforms to the medical-psychiatric discourse which takes pathological time experiences as negative deviations from the ‘normal’ and ‘adequate’ equivalent. In this mode phenomenological description of ‘disturbed’ time experiences requires philosophy to provide an insight into the ‘essence’ of time and an essentially adequate experience of time. Only such a philosophical insight can deliver a valid reference point for investigating what is really missing in pathological time experiences. This philosophical reference point can either consist in a metaphysical-normative concept of time and time experiences (Bergson), or in a transcendental concept of how normal and abnormal time experiences are constituted in the inner consciousness of time (Husserl). There is another mode of relationship which conforms to Freud’s discovery that pathological symptoms are not just negative alterations of the ‘normal’ but hide an own ‘meaning’. The author makes the case for the use of philosophy to unveil the specific kind of meaning in pathological experiences of time. She refers to existential philosophy in this respect, and in particular to its concept of Angst as a fundamental philosophical experience. This allows for a hermeneutic approach to ‘disturbed’ time experiences. What looks from a pure psychiatric perspective to be a mere ‘disorder’ of the ‘normal’, becomes understandable as a specific form of ‘suffering from one’s own temporality’. She argues that people with disturbed time experiences are especially sensitive to anxiety-laden experiences of what it means to be temporal, whilst ‘normal’ people can screen them out in favor of a ‘mentally undisturbed’ everyday life.

Cultural Differentiation and Social Integration in Complex Modern Societies Reflections on Cultural Diversity Management Strategies from a Sociological Point of View

This paper reflects on foundations of integration in our differentiated and globalized society from a sociological point of view, and links this reflection to most recent scientific acquisitions of the New Systems Theory or Complexity Science about how all systems, natural as well as social systems, work and evolve. Incorporating the sociological tradition on differentiation processes as rule of social functioning, the contemporary sociology accepted emergent, far from equilibrium (entropy), self-organization, unpredictable and surprising organizational change processes, operative closure and autopoiesis concepts, as particularly adapting concepts to represent social systems and, above all, our contemporary society characterized by an increase of complexity due to differentiation, individualization and globalization processes. In this regard, strong and permanent migratory waves, due to economic and digital globalization processes, and increasing cultural differentiation processes, have led contemporary western societies to face a serious social organizational problem: how the recognition of cultural difference and the instance of social integration can be reconciled? In this regard, the characterization of all systems as able to adapt to environmental perturbations and survive by self-organizing, balancing organization integrative constraints and emergencies, that is, far from complete differentiation, without being even minimal connection (far from equilibrium or in the edge of the chaos), can constitute a valid point of reference for sociologically reflecting, starting from here, on current integration policies of cultural differences in our complex society (pluralism, multiculturalism, interculturalism) and their implications for social integration. About it, the paper accepts the perspective of those sociological and political theories according to which, from a theoretical and empirical point of view, the sufficiency of procedural foundations seems to show serious limits as integrative constraint. Therefore, the Complexity language can justify the caution with which the normative multiculturalism—which implies it—is believed that should be considered, by anchoring it to the vision of a society conceived so as to dangerously visit that range of maximum differentiation which should be avoided, being identified as the range of ungovernability. Islamic radicalism and nationalistic rejection signs in the West show that this is no a mere theoretical possibility. How to bridge this relationality deficit that normative multiculturalism seems to institute and avoid the risk of a society unable to regain order with coherence? The Complexity framework is where the entire debate must be kept. Here, the integration proposal of interculturalism can gain greater meaning, avoiding the risks of mono-culturalism, on the one hand, and social balkanization, on the other hand.

Estimating basal tear osmolarity in normal and dry eye subjects.

Tear osmolarity (tOsm) is used as a measure of severity in dry eye disease (DED) and has been proposed as an index of body hydration. In DED the level of tear hyperosmolarity is compared with that of a control population. It is proposed here that a better index of body hydration and a more valid reference point in DED can be acquired by measuring the tOsm after a period of evaporative suppression. 8 normal and DED subjects were recruited, their tOsm measured in uncontrolled environmental 'clinic conditions'. Then in experiment 1 they entered a controlled environment chamber and had tOsm measured after 45 minutes of eye closure and then, with the eyes open, at 15 minute intervals for a further 45 minutes, at a relative humidity (RH) of 45%. Alternatively, in experiment 2, they had tOsm measured every 15 minutes for 45 minutes during exposure to 70% RH, as a separate measure to suppress evaporation. A significant decrease in tOsm occurred in both normal and DED subjects after lid closure in experiment 1 (normal RE p=0.015; normal LE p=0.006; DED RE p=0.0002; DED LE p=0.01). The tOsm also fell slightly after exposure to 70% RH in experiment 2 significant in the LE of normal group only (normal LE p=0.045). Suppression of tear evaporation resulted in a fall in tOsm, close to that of plasma osmolarity (285-295mOsm/L). It is proposed that this new measure, termed Basal Tear Osmolarity (BTO), could provide a valuable index of plasma osmolarity and hence of body hydration and in DED, a personal baseline against which to gauge the severity of tear hyperosmolarity.

Estimating basal rear osmolarity in normal and dry eye subjects

PurposeTear osmolarity (tOsm) is used as a measure of severity in dry eye disease (DED) and has also been proposed as an index of body hydration. Currently in DED the level of tear hyperosmolarity is compared with that of a normal population. We propose that a more valid reference point for both DED and body hydration could be acquired by measuring tOsm after a period of evaporative suppression.MethodsEight normal (N) and eight DED subjects were recruited and their tOsm measured with a TearLab® osmometer in uncontrolled environmental conditions. They then entered a controlled environment chamber (CEC) set to 23°C and 0.08 m/s airflow and, either: (1) had tOsm measured after 45 min of eye closure and then at 15 min intervals for a further 45 min at 45% relative humidity (RH), or (2) had tOsm measured every 15 min for 45 min, at 70% RH, to suppress evaporation.ResultsTear osmolality was significantly reduced after eye closure in both N and DED subjects, to levels in the range of plasma osmolarity, between 285 and 295 mOsm/L (N p = 0.03; DED p = 0.006). The tOsm rose towards the start value on eye opening. In subjects exposed to 70% RH, which was not expected to suppress evaporation completely, a fall in tOsm also occurred, but to a lesser extent than achieved with eye closure. This was significant in DED patients (p = 0.026) but not in N subjects (p = 0.12).ConclusionsAs predicted, total suppression of tear evaporation resulted in a fall in tOsm. We hypothesise that complete suppression of evaporation, for a sufficient period, drives down tOsm to a basal tear osmolarity value that will be a better measure of body hydration than tOsm measured in open eye conditions. It will also provide a personal baseline against which to gauge the severity of tear hyperosmolarity in DED patients.

The Disposition Effect in Closed-End Fund Market

This paper finds that the disposition effect, well-known in many financial markets, exists in the closed-end fund market, where fundamental values are known, yet the magnitude of the effect varies with the adoption of different reference points. Using the prospect theory explanation to this effect, this paper evaluates the empirical validity of three candidate reference points: last period price, previous extreme price and purchasing price. Under a valid reference point, the disposition effect diminishes as deviations of price from the reference point widen. Knowing the fundamental values, closed-end fund investors exhibit behavior that compromises the disposition effect under certain circumstances.

Bridging rigour and relevance

PurposeThe purpose of this paper is to call for an in‐depth reflection on Weber's research approach based on the notions of adequate causation and objective possibility.Design/methodology/approachThe paper illustrates the main characteristics and premises of the research approach. It further exemplifies its application through a qualitative study that investigates “How” and “Why” knowledge integration occurs in the creative processes of teams spanning over time and space. In so doing, it argues that Weber's epistemology could remain a valid point of reference to shift from the generation of empirical propositions through qualitative research to the quantitative analysis of empirical regularities recurring into a large number of empirical cases.FindingsThis paper shows how Weber's research approach could assist researchers in overcoming the dichotomy between rigour and relevance in qualitative research within organization and management studies.Originality/valueThe work offers new ways of looking at established ideas within organization and management studies, through new lenses as alternative ways of knowing social phenomena available to scholars, to produce theoretical knowledge relevant for and applicable into practice.

Using the OPI to Place Heritage Speakers of Russian

Abstract: This study explored the possibility of using an ACTFL oral proficiency interview (OPI) to assess the spoken proficiency of heritage language speakers of Russian for the purpose of placing them in Russian language classes. The authors also considered whether the norm of an educated native speaker could be used as a valid reference point for Russian heritage speakers. The OPI was administered to a group of college‐age Russian heritage speakers with little or no formal instruction in the language. The results indicated that the ACTFL Proficiency Guidelines could be used to assess oral proficiency of Russian heritage speakers and that the standard of an educated native speaker of Russian could be used as a norm.

A concept of essentially secondary factors central to definitive subtype characterization of Hodgkin’s disease

Conceptually, Hodgkin’s disease would appear to constitute a neoplasm that integrally incorporates responsive cellular elements in terms strictly of morphologic patterns of interaction resulting especially in a predictable scale of therapeutic and prognostic implications as related particularly to pathobiologic course and response to treatment. In this sense, Hodgkin’s disease might in a real sense constitute a valid point of reference in terms of processes not only in the generation of the neoplastic process but particularly in terms of how such a neoplastic process interacts with host systems in specifically characterizing the very nature of the intrinsic neoplastic process itself. In this manner, therefore, it might be valid to consider the totality of manifestations of Hodgkin’s disease as a fundamental series of processes that integrally determines the genesis and nature of the neoplastic process as a function especially of various host systems in response to that neoplasm. In terms strictly related to a viral or Epstein–Barr virus-related development of Hodgkin’s disease, it might perhaps be true that transcription factor NF-κB might induce the signaling of a CD30 receptor pathway that is intrinsically linked with anti-apoptosis of germinal center lymphocytes. In overall terms, perhaps, the Epstein–Barr viral nuclear antigens such as Latent membrane protein 1 would activate NF-κB as a mechanism that induces anti-apoptotic effect by multiple pathways in the added context particularly of a concerted series of cytokines that secondarily regulate T lymphocyte response. Indeed, in simple terms, Hodgkin’s disease would appear to involve a basic mechanism of induced transcription as an effective anti-apoptotic mechanism as exerted on Reed–Sternberg cells. The Epstein–Barr viral nuclear antigens might be pivotal in orchestrating a full series of cytokine and T lymphocyte responses that would perhaps contribute significantly to the effective perpetuation of such anti-apoptotic effect or effects as exerted on the Reed–Sternberg cells.

Chapter 11. Inherent Disturbance Regimes

Summary A science-based ecosystem management approach requires valid reference points to assess the long-term maintenance of forest systems. Historical range of variability (HRV) in vegetation patterns has served as the initial reference point and has support in the coarse-filter approach to conserving biodiversity (Hunter 1991). The HRV becomes less useful as a reference with increasing human disturbance on the landscape, public aversion to treatments to restore historical states, and continued public expectations for non-historical conditions. The inherent disturbance regime (IDR) is put forward as an alternative or to be used in combination with HRV as a suitable reference point for evaluating long-term maintenance of human-altered ecosystems. The IDR is defined by the types of disturbance; their frequency, intensity, and extent in turn defines the vegetation composition and structure supported over time. Although public expectations for vegetation conditions may differ from historical, these altered states may also be supported by IDR and have long-term maintenance potential. The use of a disturbance reference (IDR) rather than a condition reference (HRV) appears more compatible with the dynamic nature of forests. As an accurate description of historical conditions and disturbance regimes is difficult we recommend that both references be used reiteratively to better refine the other. Increased discontinuity between public expectations for forest conditions and the ability of those conditions to be supported by disturbance regimes may lead to catastrophic disturbance events and a decline in long-term site nutrient capital and biodiversity.

Echocardiographic determination of valid zero reference levels in supine and lateral positions

The phlebostatic axis--the junction of the fourth intercostal space and the midpoint of the anterior-posterior diameter--has been accepted as a reliable external reference point for the mid-right and mid-left atrium. Acceptance of this reference point is based upon research conducted in 1945 that measured venous pressures in the hands of subjects positioned with the head of the bed raised to different levels. The validity of this reference point for intracardiac pressure measurements in supine or laterally positioned patients has not been established. To determine the validity of the phlebostatic axis in the supine and lateral positions. To determine validity in the supine position, we compared the distance from the phlebostatic axis to a fixed external point (the bed surface) and the distance from the right and left atria in the supine position to this same fixed external point. The distances from the right and left atria to the bed surface were determined with echocardiography and were used as the standard for the proper position of external reference points. To determine the validity of the phlebostatic axis in lateral positions, we compared the distances from the right atrium and left atrium to the bed surface in the supine position with those distances in different lateral positions. We analyzed the data of 25 normal, healthy subjects. The study findings show that the phlebostatic axis is a valid reference point for the right atrium, and the phlebostatic axis and midanterior-posterior diameter are valid reference points for the left atrium in the supine position. However, neither is a valid external reference point in the lateral positions. Pressure measurements obtained when patients are in the lateral positions are not accurate. There remains a need to develop valid methods of accurate pressure measurements in various body positions.

14 Parametrial involvement and therapeutic programming in Stage Ib cervical cancer

The philosophical basis of oncological surgery has always been the removal of not only the primary lesion but also of a considerable amount of healthy tissue. In the surgical treatment of cervical cancer, the extensive dissection of the ureter, bladder and rectum facilitates a more complete removal of the parametrium and of the paracervical tissue, but gives rise to a series of bladder and rectal dysfunctions. Complications are certainly taken into account, but more consideration could be given to the cost to the patient in terms of severe disturbances in life-style and to the dysfunctions caused by radical surgery. Unfortunately, we do not know exactly the incidence of this damage since the data available from the literature are not always uniform. In order to overcome this discrepancy we suggest that Rutledge's classification is still the most valid point of reference. We also consider that accurate urodynamic follow-up methodology is necessary to evaluate bladder dysfunctions and to compare data from the different centres. Finally, we propose moderately radical hysterectomy--Rutledge's Class II--with adjuvant therapy in the presence of adverse prognostic factors as the most effective method for controlling the disease and reducing treatment-related side-effects.