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A timely detection of visual hemifield deficits (VHFDs; hemianopias or quadrantanopias) is critical for both the diagnosis and treatment of stroke patients. The present study determined the sensitivity and specificity of four qualitative visual field tests, including face description, confrontation tests (finger wiggle), and kinetic boundary perimetry, to screen large and dense VHFDs in right-brain-damaged (RBD) stroke patients. Previously, the accuracy of qualitative visual field tests was examined in unselected samples of patients with heterogeneous aetiology, in which stroke patients represented a very small fraction. Building upon existing tests, we introduced some procedural ameliorations (incl. a novel procedure for kinetic boundary perimetry) and provided a scoresheet to facilitate the grading. The qualitative visual field tests’ outcome of 67 consecutive RBD stroke patients was compared with the standard automated perimetry (SAP; i.e., reference standard) outcome to calculate sensitivity and specificity, as well as positive and negative predictive values (PPV and NPV), both for each individual test and their combinations. The face description test scored the lowest sensitivity and NPV, while the kinetic boundary perimetry scored the highest. No test returned false positives. Combining the monocular static finger wiggle test (by quadrants) and the kinetic boundary perimetry returned the highest sensitivity and specificity, in line with previous studies, but with higher accuracy (100% sensitivity and specificity). These findings indicate that the combination of these two tests is a valid approach with RBD stroke patients, prompting referral for a formal visual field examination, and representing a quick, easy-to-perform, and inexpensive tool for improving their care and prognosis.

The present study aims at defining the economic and organizational impacts of the introduction of chimeric antigen receptor T-cell therapy (CAR-T) in Italy, for the management of diffuse large B-cell lymphoma (DLBCL) patients in third-line therapy, defining the overall level of sustainability for both hospitals and the National Healthcare System (NHS). The analysis focused on CAR-T and Best Salvage Care (in the following BSC), assuming the Italian hospital and NHS perspectives, over a 36-month time horizon. Process mapping and activity-based costing methodologies were applied to collect the hospital costs related to the BSC and CAR-T pathways, including adverse event management. Anonymous administrative data on services provided (diagnostic and laboratory examinations, hospitalizations, outpatient procedures, and therapies) to 47 third-line patients with lymphoma, as well as any organizational investments required, were collected, in two different Italian Hospitals. The economic results showed that the BSC clinical pathway required less resources in comparison with CAR-T (excluding the cost related to the therapy) (BSC: 29,558.41 vs. CAR-T: EUR 71,220.84, −58.5%). The budget impact analysis depicts that the introduction of CAR-T would generate an increase in costs ranging from 15% to 23%, without considering treatment costs. The assessment of the organizational impact reveals that the introduction of CAR-T therapy would require additional investments equal to a minimum of EUR 15,500 to a maximum of EUR 100,897.49, from the hospital perspective. Results show new economic evidence for healthcare decision makers, to optimize the appropriateness of resource allocation. The present analysis suggests the need to introduce a specific reimbursement tariff, both at the hospital and at NHS levels, since no consensus exists, at least in the Italian setting, concerning the proper remuneration for the hospitals who guarantee this innovative pathway, assuming high risks related t

Aims: The aim of the study was to investigate the physiological mechanisms of Jatropha curcas seedlings exposed to drought and the possible influence of seedling age. Study Design: A pot experiment was carried out using a completely randomized design with two seedling ages (2- and 3-month-old seedlings), two treatments per age (Watered: fully irrigated, and Unwatered: Not irrigated), six replicates (24 pots). Place and Duration of Study: The experiment was performed in a greenhouse facility located at the Experimental Station “Mauro Deidda” (Department of Agriculture of University of Sassari) at Ottava (Sassari, Italy) between June and September 2011. Methodology: To investigate the responses of 2- and 3-month-old J. curcas seedlings exposed to drought stress on 4th, 8th, 12th, 19th, and 26th day from treatment’s beginning, leaf and soil water content, biometric, gas exchange, and chlorophyll a fluorescence measurements were performed; on 26th day from treatment’s beginning, biometric destructive measurements were carried out. Results: Results support the hypothesis that J. curcas is appropriate to be cultivated in areas with limited water availability or prolonged periods of drought and highlight that mechanisms of drought response are highly influenced by seedling age. J. curcas seedlings maintained a good leaf water status by means of an effective stomatal closure, associated with a reduced aboveground growth and an increased root:shoot ratio. Under drought stress, 2-month seedlings showed a higher allocation of resources to roots compared to 3-month seedlings. Drought resulted in more detrimental effects on the photosynthetic response of 3-month seedlings, inducing the reduction of stomata conductance and the loss of photosystem II integrity. 2-month seedlings were instead able to activate mechanisms of drought tolerance through the activation of excess energy dissipation mechanisms. Conclusion: In the early stage of crop establishment, the transplanting of J. c