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At least 127 records · Page 7Linked to original sources

Ultra scale-down approach for the prediction of full-scale recovery of ovine polycolonal immunoglobulins used in the manufacture of snake venom-specific Fab fragment.

In this article, we describe a new approach that allows the prediction of the performance of a large-scale integrated process for the primary recovery of a therapeutic antibody from an analysis of the individual unit operations and their interactions in an ultra scale-down mimic of the process. The recovery process consisted of four distinct unit operations. Using the new approach we defined the important engineering parameters in each operation that impacted the overall recovery process and in each case verified its effect by a combination of modelling and experimentation. Immunoglobulins were precipitated from large volumes of dilute blood plasma and the precipitated flocs were recovered by centrifugal separation from the liquor containing contaminating proteins, including albumin. The fluid mechanical forces acting on the precipitate and the time of exposure to these forces were used to define a time-integrated fluid stress. This was used as a scaling factor to predict the properties of the precipitated flocs at large scale. In the case of centrifugation, the performance of a full-scale disc stack centrifuge was predicted. This was achieved from a computational fluid dynamics (CFD) analysis of the flow field in the centrifuge coupled with experimental data obtained from the precipitated immunoglobulin flocs using the scale-down precipitation tank, a rotating shear device, and a standard swing-out rotor centrifuge operating under defined conditions. In this way, the performance of the individual unit operations, and their linkage, was successfully analysed from a combination of modelling and experiments. These experiments required only millilitre quantities of the process material. The overall performance of the large-scale process was predicted by tracking the changes in physical and biological properties of the key components in the system, including the size distribution of the antibody precipitates and antibody activity through the individual unit operations in the ultra scale-down process flowsheet.

Animals↗

Metric attributes of the unified Parkinson's disease rating scale 3.0 battery: Part I, feasibility, scaling assumptions, reliability, and precision.

This article sought to assess the feasibility, scaling assumptions, reliability, precision, and factor analysis of the three most widely used rating scales in Parkinson's disease (PD): modified Hoehn and Yahr (HY), Schwab and England (SE), and Unified Parkinson's Disease Rating Scale (UPDRS). A multicenter sample of 1,136 PD patients was assessed. The percentage of missing data was 8% for SE, HY, and UPDRS mentation, and almost negligible (<2%) for the other UPDRS subscales. A high floor effect was found for UPDRS mentation (23%) and complications scales (36%). Item content validity, measured by multitrait scaling analysis, was adequate for all UPDRS subscales (scaling successes > 90%). Internal consistency coefficients for the UPDRS scales ranged from 0.79 (mentation) to 0.92 (activities of daily living and motor). Factor structure of the UPDRS mentation, activities of daily living, and complications subscales was replicated. As a whole, the HY, SE, and UPDRS are acceptable, consistent, and potentially sensitive rating scales.

Aged↗

Quality of life 6 months after intensive care: results of a prospective multicenter study using a generic health status scale and a satisfaction scale.

OBJECTIVE: To assess the quality of life of intensive care survivors 6 months after discharge. DESIGN: Multicenter prospective study. SETTING: Medical-surgical intensive care units (ICUs) of four French university hospitals. PATIENTS: Among the 589 patients admitted to the four ICUs between 1 January and 31 March 1989, 329 were investigated. MEASUREMENTS AND RESULTS: A generic scale assessing health-related quality of life, the Nottingham Health Profile (NHP), a satisfaction scale, the Perceived Quality of Life scale (PQOL) and a questionnaire on professional status were sent by mail 6 months after discharge. Data concerning age, severity of acute illness (assessed by the Simplified Acute Physiology Score) and main diagnosis were recorded. A total of 223 questionnaires (67.8 %) were analysable. The professional status remained unchanged in 79.7% of the patients, despite a significant (p < 0.01) increase (15.3 vs 22.1%) in sick leave. Quality of life, assessed with NHP, was fair (50th percentile = 0.73 on a 0 to 1 scale), whereas satisfaction measured by PQOL was lower (50th percentile = 0.61). Both scales correlated well (z = 9.853; p = 0.0001) but with a large dispersion. The NHP scale showed a severe reduction in energy, sleep and emotional reactions, whereas social isolation, pain and physical handicap were infrequent. Family support was rated with the PQOL score as very good, whereas dissatisfaction concerning recreational and professional activities was expressed. Subsequent sick leave was associated with a poor quality of life (p < 0.05). Quality of life was mainly a function of the diagnosis, not of age and severity of illness: patients admitted for suicide attempt or chronic obstructive pulmonary disease fared poorly. CONCLUSIONS: Quality of life measured with a health-related quality of life scale and a satisfaction scale 6 months after an ICU stay depended on the admission diagnosis. Different dimensions of quality of life were variably affected.

Adolescent↗

Optimization of culture conditions and scale-up to pilot and plant scales for coenzyme Q10 production by Agrobacterium tumefaciens.

This report describes the optimization of culture conditions for coenzyme Q(10) (CoQ(10)) production by Agrobacterium tumefaciens KCCM 10413, an identified high-CoQ(10)-producing strain (Kim et al., Korean patent. 10-0458818, 2002b). Among the conditions tested, the pH and the dissolved oxygen (DO) levels were the key factors affecting CoQ(10) production. When the pH and DO levels were controlled at 7.0 and 0-10%, respectively, a dry cell weight (DCW) of 48.4 g l(-1) and a CoQ(10) production of 320 mg l(-1) were obtained after 96 h of batch culture, corresponding to a specific CoQ(10) content of 6.61 mg g-DCW(-1). In a fed-batch culture of sucrose, the DCW, specific CoQ(10) content, and CoQ(10) production increased to 53.6 g l(-1), 8.54 mg g-DCW(-1), and 458 mg l(-1), respectively. CoQ(10) production was scaled up from a laboratory scale (5-l fermentor) to a pilot scale (300 l) and a plant scale (5,000 l) using the impeller tip velocity (V (tip)) as a scale-up parameter. CoQ(10) production at the laboratory scale was similar to those at the pilot and plant scales. This is the first report of pilot- and plant-scale productions of CoQ(10) in A. tumefaciens.

Agrobacterium tumefaciens↗

Scaling up from local competition to regional coexistence across two scales of spatial heterogeneity: insect larvae in the fruits of Apeiba membranacea.

Species that live in patchy and ephemeral habitats can compete strongly for resources within patches at a small scale. The ramifications of these interactions for population dynamics and coexistence at regional scales will depend on the intraspecific and interspecific distributions of individuals among patches. Spatial heterogeneity due to independent aggregation of competitors among patchy habitats is an important mechanism maintaining species diversity. I describe regional patterns of aggregation for four species of insect larvae in the fruits of Apeiba membranacea, a Neotropical rainforest tree. This aggregation results from variation in densities at a small scale (among the fruits under a single tree), compounded by significant variation among trees in both mean densities and degrees of aggregation. Both the degrees of aggregation and mean densities are statistically independent within and across species at both spatial scales. I evaluate the regional consequences of these spatial patterns by using maximum likelihood methods to parameterize a model that includes both explicit measures of the strength of competition and spatial variation at both within- and among-tree spatial scales. Despite strong competitive interactions among these species, during 2 years the observed spatial variation at both scales combined was sufficient to explain the coexistence of these species, although other coexistence mechanisms may also operate simultaneously. The observed spatial variation at small spatial scales may not be sufficient for coexistence, indicating the importance of considering multiple sources of spatial heterogeneity when scaling up from experiments that investigate local interactions to regional patterns of coexistence.

Animals↗

Cross-sectional prevalence of helminth infections in cattle on traditional, small-scale and large-scale dairy farms in Iringa district, Tanzania.

A cross-sectional study was carried out to determine the prevalence of gastrointestinal (GI) nematodes and flukes (Fasciola and amphistomes) infection in communally grazed traditional cattle, zero-grazed small-scale dairy cattle and intensively grazed large-scale dairy cattle through examination of helminth eggs in faeces. Results indicated that the type of management, especially the grazing habit, has a significant influence on the prevalence and intensity of GI nematodes and flukes. The prevalence of GI nematodes in traditional, large-scale dairy and small-scale dairy cattle was 67%, 44.4% and 37%, respectively, with the highest faecal egg counts in calves. The overall prevalence of Fasciola gigantica in traditional, large-scale dairy and small-scale dairy cattle was 63.8%, 46.2% and 28.4%, respectively. The prevalence of amphistomes was 81.9%, 55.5% and 41.1% in traditional, large-scale dairy and small-scale dairy cattle, respectively. The high prevalence of flukes in the traditional system was attributed to communal grazing and watering management practices. Stomach flukes recovered in examined cattle at the abattoir were Calicophoron microbothrium and Cotylophoron jacksoni. About 42.1% of infected animals had both Fasciola and amphistomes. The prevalence of both GI nematodes and flukes varied greatly among villages and farms. The prevalence of both Fasciola and amphistomes was higher in adults (58.5%, 75.2%) than in yearlings (36.5%, 51.5%) or calves (24.9%, 47.2%). The variation in the prevalence of both GI nematodes and flukes among management and age groups within systems can be used as an entry point towards rational use of anthelmintics for each management system. More studies on seasonal transmission pattern of all these parasites are required in order to design rational, economic and locally sustainable parasite control programmes.

Animal Husbandry↗

Functional scale discrimination at admission and discharge: Rasch analysis of the Level of Rehabilitation Scale-III.

OBJECTIVE: To determine the construct validity of the Level of Rehabilitation Scale-III (LORS-III) with a special focus on this instrument's capability to discriminate rehabilitation inpatient activities of daily living (ADL)/mobility and communication/cognition ability at admission and discharge. DESIGN: Rasch analysis of existing data sets in the LORS-III American Data System (LADS). PATIENTS: Existing admission and discharge data from 3056 rehabilitation inpatients (musculoskeletal injury, cerebrovascular accident, multiple injuries/diseases, brain injury, neuromuscular disorder, and spinal cord injury) entered into LADS between April 1992 and January 1993. MAIN OUTCOME MEASURE: LORS-III consists of 17 measurement areas representing abilities in ADL, mobility, communication, cognition, and memory. Fourteen of the measurement areas are concurrently scored by a nurse and a specified rehabilitation therapist, resulting in a total of 31 items. RESULTS: Consistent with findings reported for other functional status measures, the analysis indicated that the LORS-III consists of two unidimensional scales, an ADL/mobility scale, and a communication/cognition scale. Although all scales fit the Rasch measurement model, the ADL/mobility scale used at admission was most appropriately targeted to the ability level of the sample. At discharge, the ADL scale was generally too easy because the ability level of the sample moved upward towards functional independence. The communication/cognition scale at both admission and discharge showed a similar "ceiling" effect. CONCLUSIONS: These findings indicate the importance of determining the measurement qualities of functional status measures for both admission and discharge ratings. Analyses, such as Rasch, can provide a logical direction for instrument refinement.

Activities of Daily Living↗

A rating scale for fibromyalgia and chronic fatigue syndrome (the FibroFatigue scale).

OBJECTIVE: To construct an observer's rating scale sensitive to change for measuring severity and treatment outcome in fibromyalgia (FM) and chronic fatigue syndrome (CFS) patients. METHODS: A selection of items from the Comprehensive Psychopathological Rating Scale (CPRS) were repeatedly rated and used as outcome measure of a 24-week treatment study. In the study 100 women, fulfilling the criteria for both FM and CFS, received intermittent injections of a staphylococcus toxoid or placebo. Nine CPRS-items with high baseline incidence (cutoff 70%) were extracted and validated against global ratings and the Fibromyalgia Impact Questionnaire (FIQ). The fibromyalgia and chronic fatigue syndrome rating scale (the FibroFatigue scale) was thereafter formed based upon the extracted items and three supplemented ones. The interrater reliability was tested in 27 consecutive patients of both sexes. RESULTS: The FibroFatigue scale is an observer's rating scale with 12 items measuring pain, muscular tension, fatigue, concentration difficulties, failing memory, irritability, sadness, sleep disturbances, and autonomic disturbances (items derived from the CPRS) and irritable bowel, headache, and subjective experience of infection (new items). There was a statistically significant correlation between the CPRS-extracted items and global ratings as well as with the FIQ. The interrater reliability of the new scale was excellent (correlation coefficient.98), irrespective of the patients' gender. CONCLUSION: The FibroFatigue scale seems to be a reliable and valid measuring instrument with capacity to monitor symptom severity and change during treatment of FM/CFS patients.

Adult↗

Development of four self-report measures of job stressors and strain: Interpersonal Conflict at Work Scale, Organizational Constraints Scale, Quantitative Workload Inventory, and Physical Symptoms Inventory.

Despite the widespread use of self-report measures of both job-related stressors and strains, relatively few carefully developed scales for which validity data exist are available. In this article, we discuss 3 job stressor scales (Interpersonal Conflict at Work Scale, Organizational Constraints Scale, and Quantitative Workload Inventory) and 1 job strain scale (Physical Symptoms Inventory). Using meta-analysis, we combined the results of 18 studies to provide estimates of relations between our scales and other variables. Data showed moderate convergent validity for the 3 job stressor scales, suggesting some objectively to these self-reports. Norms for each scale are provided.

Affect↗

A comparison of the visual analogue scale and modified Borg scale for the measurement of dyspnoea during exercise.

1. The intensity of breathlessness during exercise was measured in ten normal subjects using a visual analogue scale (VAS) and a Borg scale to compare the use of the scales and their repeatability, both within the duration of a period of exercise and between tests. For each scale, subjects performed two exercise tests separated by a period of 2-6 weeks. Each exercise test consisted of two cycles of progressively increasing and decreasing workload. 2. All subjects felt confidently able to use both scales to quantify their feelings of breathlessness exclusively of other sensation. Equal preference was expressed for use of a particular scale. 3. With both scales there was a large intersubject variation in the relationship between dyspnoea score and minute ventilation (VE) (P less than 0.01), and in the range of the scale used. 4. There was a good correlation between the VAS and Borg scores at each level of VE (r2 = 0.71), but the VAS score was used over a wider range than the Borg score. 5. The relationship between VE and the dyspnoea score measured by the two techniques was predominantly linear. The mean r2 for VAS score/VE was 0.68 (SD 0.19) and for Borg score/VE the mean r2 was 0.75 (SD 0.13). 6. The relationships VAS score/VE and Borg score/VE were unaffected by the direction in which the workload was varied (P greater than 0.05). 7. VE, measured at each work rate, did not differ between the two cycles (P greater than 0.05) or between the 2 days (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Developing a scale for measuring expectancy of retaining natural teeth for life and comparison of results obtained using a global item and a multi-item scale of measurement.

OBJECTIVE: To develop and test a scale for measuring expectancy of retaining teeth for life and to compare the estimates when using a global item with those obtained with a multi-item scale of measurement. MATERIAL AND METHODS: The design of the study was cross-sectional selected and random sample surveys using a self-administered questionnaire or interview. There were two groups of patients and a national sample aged 16-79 years (n=1274); response rate 64%. The main results pertain to dentate subjects in a global group (n=615) and in a scale group (n=609). The outcome measure was expectancy of retaining natural teeth for life. Results. When using the global item, 92% (95% CL 89.8, 94.1) of the respondents believed they would definitely or possibly retain their natural teeth for life, significantly higher than the 81% (95% CL 77.6, 84.0) obtained with the 4-item conditional scale. Cronbach's alpha was 0.89 for the 4-item scale and the test-retest reliability moderate (kappa = 0.51; 0.77 for +/-1). The adults' belief in retaining teeth for life was significantly associated with having a live-in partner (p = 0.009) when the global question was the dependent variable; and sex (p = 0.000) and education (p = 0.004) when the 4-item scale was the dependent variable. Explained variance was 3.8% and 4.5%, respectively. Conclusions. The internal reliability of the 4-item scale was high. A significantly lower proportion of people reported belief in retaining natural teeth for life when employing the 4-item conditional scale than when the unconditional global question was used.

Adolescent↗

A comparison of Likert scale and visual analogue scales as response options in children's questionnaires.

AIM: To examine which response options children prefer and which they find easiest to use, and to study the relative reliability of the different response options. METHODS: A consecutive group of unselected children (n = 120) filled out three questionnaires in a paediatric outpatient clinic. Each questionnaire included seven similar questions, but had different response options: the Likert scale, the Visual Analogue Scale (VAS) and the numeric VAS. In general, the questions were not related to the children's particular diseases, but dealt with the frequency of simple activities, their feelings and opinions. The pages with the three different response options were offered in random order. Afterwards, the children rated their preference and ease of use of the different response options on a scale from one to 10. RESULTS: Children preferred the Likert scale (median mark 9.0) over the numeric VAS (median mark 8.0) and the simple VAS (median 6.0). They considered the Likert scale easiest to fill out (median mark 10 vs 9 and 7.5 for the numeric and simple VAS, respectively). Results of the different response options correlated strongly with each other (rho = 0.67-0.90, p < 0.05). CONCLUSION: Children prefer the Likert scale over the numeric and simple VAS and find it easiest to complete. The Likert scale, the simple VAS and the numeric VAS are of comparable reliability. The Likert scale is recommended for use in questionnaires for children, although research into larger and more diverse samples is needed.

Adolescent↗

Rating suicidality in schizophrenia: items on global scales (HoNOS and CPRS) correlate with a validated suicidality rating scale (InterSePT).

The use of general scales such as the Health of the Nation Outcome Scale (HoNOS) and the Comprehensive Psychopathological Rating Scale (CPRS) are widespread. Both scales contain non-validated items on suicidality. This study aimed to establish whether an association between these suicidality items and the validated scale, InterSePT exists. Forty patients with a diagnosis of schizophrenia or schizo-affective disorder were assessed using the three scales. A highly significant association between the two items and the validated scale was found. The suicidality items from HoNOS and CPRS appear to be strong indicators of suicidality in this patient population. The findings allow for use of the suicidality items in clinical assessments and re-investigation of suicidality of other studies where these general rating scales have been used.

Humans↗

Scaling linear-model breeding values to the liability scale: an application to pig binary traits.

In commercial pig production, many important traits are recorded as binary phenotypes. For such traits, threshold models offer an appropriate framework but are computationally intensive. Thus, linear models are widely used to obtain genomic estimated breeding values (GEBV); however, these are on the observed scale (phenotypic). This creates the need for a robust method to approximate GEBV from linear models to the liability scale. A recently proposed approximation showed good concordance for low-prevalence traits (<5%) but has not yet been tested for a wider range of prevalence values and for models with more than one random effect. We aimed to evaluate the performance of this approximation for pig binary traits with prevalences ranging from <5% to >86%, in both animal and maternal animal models. Data were available for five fitness traits (FT1-FT5), with up to 233k animals with phenotypes, of which 204k animals were genotyped with a 25k SNP array. Variance component estimates were obtained using threshold models. Classical animal models were used for FT1-FT3, and maternal animal models for FT4 and FT5. Variance components on the observed scale were then obtained by multiplying estimates from a threshold model by the square of the height of the standard normal density evaluated at the threshold. GEBV were predicted using single-step genomic best linear unbiased prediction under both linear and threshold models. The approximation tested involved scaling the GEBV using the height of the ordinate of the standard normal distribution evaluated at the threshold as a scaling factor. The agreement between GEBV from the scaled linear model and the threshold model on the probability scale was evaluated using Pearson and Spearman correlations, mean squared error (MSE), regression parameters, overlapping coefficient (OVL), distribution overlap, and classification accuracy (CACC). Correlations between linear and threshold GEBV ranged from 0.94 (low-prevalence traits) to 0.99 (high-prevalence traits) for the direct GEBV and were 0.99 for the maternal GEBV. MSE were close to zero. The OVL exceeded 0.83 for all traits. CACC ranged from 95.10% to 98.33% for the direct GEBV and from 92.54% to 97.42% for the maternal GEBV. Regardless of model and trait prevalence, this approximation yielded GEBV that are highly consistent with threshold model GEBV, providing a reliable, practical approach for large-scale pig genetic evaluations for binary traits using linear models.

Animals↗

A dimensional structure of nurse-patient interactions from a caring perspective: refinement of the Caring Nurse-Patient Interaction Scale (CNPI-Short Scale).

AIM: This paper reports the development of a short version of the Caring Nurse-Patient Interaction Scale. BACKGROUND: Since the 1980s several instruments have been developed to assess external aspects of caring. They involve using an inductive process of knowledge development to investigate the underlying structure of caring, and few reflect an explicit underlying caring theory. We developed the Caring Nurse-Patient Interactions Scale (CNPI-Long Scale) based on both inductive and deductive processes to assess attitudes and behaviours associated with Watson's 10 carative factors. Two issues led us to abridge our original 70-item scale into a more concise Short Scale (CNPI-Short Scale). First, many of our subscales were moderately to highly correlated, which is an empirical reflection of the theoretical non-independence of the carative factors. Secondly, a 70-item questionnaire was difficult to be deal with in the clinical research setting with severely ill patients because of its length. METHOD: Items selected were determined by factor analysis, with specific theoretical and empirical requirements. Data were collected in September 2003 from 377 nursing students beginning their first, second or third year of a nursing programme. RESULTS: The Short Scale comprises 23 items, reflecting four caring domains: Humanistic Care (four items), Relational Care (seven), Clinical Care (nine) and Comforting Care (three). All items are related to their theoretical domain alone (i.e. factor loading >or=0.40). Alpha coefficients for the four domains were adequate (0.63-0.74, 0.90-0.92, 0.80-0.94 and 0.61-0.76 respectively). CONCLUSIONS: The CNPI-Short Scale, has potential for use in clinical research settings, particularly when questionnaire length is an issue. It is a useful tool for research aimed at demonstrating that caring is indeed fundamental to nursing.

Adolescent↗

The Rutter Parent Scale A2 and Teacher Scale B2 in Chinese. I. Translation study.

The well established child psychiatric epidemiological instruments Rutter Scale A2 and Scale B2 were translated by the author into Chinese. The Chinese and the English versions of both Scales were administered to bilingual Chinese subjects in Hong Kong. The statistics of Cohen's kappa was used to test the item agreement between the two language versions. It was found that most kappas fell within good or excellent ranges. The overall kappa for Scale A2 was 0.81 and for Scale B2 0.71. The correlation between the total scores of both versions for both Scales was very high; for Scale A2 it was 0.94 and for Scale B2 it was 0.93. It was concluded that the Chinese versions were accurate translation of the English versions.

Adolescent↗

A simple 3-item stroke scale: comparison with the National Institutes of Health Stroke Scale and prediction of middle cerebral artery occlusion.

BACKGROUND AND PURPOSE: The purpose of the study was to design a simple stroke scale that requires minimal training but reflects initial stroke severity and is predictive of middle cerebral artery (MCA) occlusion. METHODS: The new stroke scale assessed 3 parameters: (1) level of consciousness, (2) gaze, and (3) motor function. Each item was graded 0 to 2, where 0 indicated normal findings and 2 severe abnormalities (ie, profound drowsiness or worse, forced gaze deviation, and severe hemiparesis, respectively). During a study period of 11 months, patients presenting with acute stroke symptoms (onset < or =6 hours) were examined by a stroke neurologist assessing the new scale as well as the National Institutes of Health Stroke Scale (NIHSS). In addition, 83 patients received acute magnetic resonance angiography (MRA; as part of an acute stroke protocol). RESULTS: The new stroke scale was strongly associated with the NIHSS. Interobserver reliability of the new scale was high (intraclass correlation coefficient 0.947). Using post hoc analysis, a score of > or =4 predicted proximal vessel occlusion (T-segment or M1-segment occlusion of the MCA on MRA) almost as accurately (overall accuracy 0.86) as an NIHSS score of >or =14 (overall accuracy 0.93). CONCLUSIONS: The new stroke scale reflects acute stroke severity well and predicts proximal MCA occlusion with reasonable accuracy. However, the clinical scale needs further evaluation before it can be recommended as a tool for the triage of acute stroke patients.

Aged↗

Variable agreement between visual rating scales for white matter hyperintensities on MRI. Comparison of 13 rating scales in a poststroke cohort.

BACKGROUND AND PURPOSE: Previous reports on the frequency, extent, and clinical correlates of white matter hyperintensities (WMHIs) have been contradictory. The purpose of this study was to test whether part of this variation could be explained by the different properties of the visual WMHI rating scales used. METHODS: The periventricular (PVHIs) and deep white matter (DWMHIs) hyperintensities of 395 poststroke patients were systematically analyzed and transformed to correspond to 13 different rating scales. The scales were compared with the use of Goodman-Kruskal measures of association. The relative frequencies, means, and medians of PVHI and DWMHI grades as well as Spearman rank correlations between WMHI grade and hypertension were calculated. RESULTS: At best more than 80% of the patients received an equivalent WMHI grade by different scales, but at worst the corresponding values were only 0.4% for PVHI and 18% for DWMHI. At best different scales categorized patients similarly in regard to WMHI grade, but at worst the corresponding values were 8% for PVHI and 57% for DWMHI ratings. The distribution of WMHI grades also varied, and when the effect of age on WMHI was assessed, some of the scales had a ceiling effect and some had a floor effect. Only 1 of the 7 PVHI, 5 of the 9 DWMHI, and 1 of the 3 combined rating scales showed a significant correlation with arterial hypertension, a putative risk factor for WMHIs. CONCLUSIONS: Some of the inconsistencies in previous studies of WMHIs are due to differences in visual rating scales. Our findings may warrant international debate regarding harmonization of WMHI ratings.

Aged↗