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Background: Retention of participants in cohort studies is a major challenge. A better understanding of all elements involved in participation and attrition phenomena in particular settings is needed to develop effective retention strategies. The study aimed to achieve an in-depth understanding of participant retention in longitudinal cohorts focusing on participants’ and researcher’s perspectives, across three diverse socio-geographic and cultural settings. Methods: This study used a triangulation of multi-situated methods to collect data on cohort studies of children born with less than 32 weeks of gestation in Denmark, Italy and Portugal. It included focus groups and individual semi-driven interviewing with involved key actors (i.e. parents, staff, healthcare professionals, researchers) and a collaborative visual methodology. A purposive sample of 48 key actors (n = 13 in Denmark; n = 13 in Italy; n = 22 in Portugal) was collected. A triangulation of phenomenological thematic analysis with discourse analysis was applied. Cross-contextual and context-specific situational elements involved in participation and attrition phenomena in these child cohorts were identified at various levels and stages. Results: Main findings included: situational challenges affecting potential and range of possibilities for implementation strategies (geopolitical environment, societal changes, research funding models); situational elements related to particular strategies acting as deterrents (postal questionnaires) and facilitators (multiple flexible strategies, reminders, regular interaction); main motivations to enrol and participate (altruism/solidarity and gratitude/sense of duty to reciprocate); main motivational deterrents to participate to follow-up waves (lack of bonding, insufficient feedback); entanglement of clinical and research follow-up as facilitator and deterrent. Conclusions: The multi-situated approach used, addressing the interplay of the lived experience of individuals, was of most value to understand participation variability under different implemented strategies in-context. Cross-contextual and context-specific situational elements that have been influential factors towards participation and attrition in the cohorts were identified. RECAP Preterm-WP6 QS Work Group Group authorship collaboration RECAP Preterm-WP6 QS Work Group: Sandra CS Marques (CRIA, Instituto Universitário de Lisboa, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal), Julia Doetsch (EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal), Raquel Teixeira (EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal); Georgia Abate, Grazia Colombo and Marina Cuttini (Clinical Care and Management Innovation Research Area, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy); Anne Brødsgaard (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark; Department of Public Health, HEALTH, Aarhus University, Denmark); Elizabeth S Draper (Department of Health Sciences, College of Life Sciences, University of Leicester, United Kingdom); Sylvia van der Pal and Ilona Wildeman (TNO-Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek, The Netherlands); Pernille Pedersen (Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark); Kari Anne I Evensen, Ann-Mari Brubakk and Marit S Indredavik (Department of Clinical and Molecular Medicine, NTNU–Norwegian University of Science and Technology, Norway); Eero Kajantie (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland; PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Finland; Children’s Hospital, Helsinki University Hospital and University of Helsinki, Finland; Department of Clinical and Molecular Medicine, NTNU-Norwegian University of Science and Technology, Norway); Eeva Virtanen (Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki and Oulu, Finland); Jo Lebeer; Vicky Hennissen; Iemke Sarrechia (Department FAMPOP Family Medicine & Population Health, Faculty of Medicine & Health Sciences University of Antwerp, Belgium) and Henrique Barros (Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Portugal). All named researchers contributed to the development of the study protocol and/or its local implementation.

Purpose Colon carcinoma is a malignant tumor showing a marked preference to metastasize to distant organs. The presence of circulating tumor cells (CTCs) in the peripheral blood is a prerequisite for the formation of distant metastases. However, whether circulating cytokines are linked to the circulation of tumor cells, as individual cells or clusters, remain unclear. In this study, we investigated the circulating levels of TGF-beta, CXCL1, VEGF and PAI-1 as potential bioindicators of the presence of CTCs in patients with metastatic colon cancer.

The frequency of early-onset neonatal sepsis without prophylaxis is 1-5/1.000 live births. Since year '70 the most frequent causative microorganism is the group B Streptococcus (S. agalactiae, GBS), followed by Escherichia coli. The mortality rate is now reduced to 4% due to the improvement of neonatal intensive care. In the USA, the incidence of GBS early-onset neonatal sepsis has been markedly reduced by the application of the guidelines released by the Centers for Disease Control (CDC). This strategy, however, is not effective on occurrence of late-onset neonatal group B streptococcal disease. In Italy, the application of CDC guidelines is not customary, and different, often complex, protocols of obstetrical-neonatological integrated approach are applied. The frequency of infectious risk has made the GBS a paramount problem for the neonatologist, even for the legal responsibility issues resulting from the multiplicity of possible options. To reach the best level of protection of the newborn against early-onset GBS infection, the working group of providers of prenatal, obstetric, and neonatal care of the functional area of Cuneo issued an integrated protocol, in order to perform the GBS screening with the optimal culture method suggested by CDC guidelines in the highest possible number of pregnant women, and to standardize the obstetrical and neonatal management.

Only in these latest years has been possible to consider Hodgkin disease (HD) as a neoplastic syndrome, thank of immunohistochemistry and cytogenetic techniques which have confirmed the monoclonal origin of typical cellular marker of disease: the Reed-Sternberg cell (R-S cell). Interesting associations have been observed between children suffering from HD and the positivity of EBV antigen above all in the socio-economically developed countries. The histopathologic classification of HD is divided in four sub-types, with different incidence in the pediatric age: the nodular sclerosis and the mixed cellularity are more rap-presented than the lymphocyte predominance and mostly the lymphocyte depletion. Histopathologic classification is essential for the prognosis and a correct therapeutic approach to disease. The management of HD is based on chemotherapy and radiotherapy associated; the results of treatment are more and more encouraging with a global survival over 95%. Sequelae of treatment are reduced in modern therapeutic trials: in particularly injury to somatic growth, cardiopulmonary system, gonadal and thyroid functionality is reduced by using low dose and involved fields for the early stage patients. The most important sequela in children treated for HD is the risk to developed a second malignant neoplasm; in particularly acute nonlymphocytic leukemia and non Hodgkin's lymphoma. In patients treated with radiotherapy alone increase the risk to develop solid tumors like sarcomas and carcinomas, which can appears several years after diagnosis.

A methodological approach to software development for real-time systems and its application to a stored-program controlled telephone exchange is described. In particular, the problems which arise from the use of a process structure to represent the switching exchange activities are discussed; the method adopted for defining the number and type of processes, the solution given to the synchronization problems and deadlock prevention are described. Moreover, the techniques adopted for decomposing the software into modules hierarchically organized are presented and their influence on system reliability and flexibility are pointed out. Lastly, the features of the adopted programming language are presented with a special reference to the choice of high-level constructs to reduce the complexity of the control paths within the programs and to facilitate the achievement of a correct cooperation among processes.

A study of the in vitro growth model of human granulo-monopoietic precursors (CFU-GM) before and after cryopreservation using both leukocyte feeder layers and GCT conditioned medium as the source of colony stimulating activity (CSA) is reported. The number of colonies produced with fresh cells was linearly related to the amount of marrow seeded with both CSA sources, whereas after cryopreservation this was true with feeder layers, and with GCT only at relatively high cell concentrations. This might indicate the production of granulopoietic stimulators on the part of a second population that is at least partly resistant to freezing. It seems more likely, however, that these results depend mainly on a sublethal damage to CFU-GM induced by freezing, thus making the cells hyporesponsive to some forms of CSA, such as those contained in GCT conditioned medium.

A total of 17 pediatric patients with pretreated acute lymphoblastic leukemia were included in a phase II study of idarubicin. Four of 16 complete remissions were obtained, confirming the activity of the drug in this indication. Toxicity was acceptable, though caution is needed in patients who have already received high cumulative doses of anthracyclines.

Six children with yolk sac tumor, 3 occurring in gonadal sites and 3 in extragonadal ones, were studied with respect to pathological features, laboratory findings and clinical course. Their histological appearance was similar regardless of the site of origin. The prognosis was poor, but all the cases exhibited objective response to chemotherapy. Two children are alive and off therapy from 27 and 60 months. Three of the six patients in which serum alfa-fetoprotein determinations were performed showed positive results. The demonstration of alfa-fetoprotein in the serum of these patients could prove to be of prognostic value, indicating the presence of residual or recurrent disease. It is advisable to gather cases from many Institutions in order to specify prognostic factors, to know the natural history of this tumor and to prepare an effective therapeutic program.

In this paper are briefly reasumed clinical features and diagnostic procedures for bone tumors. More closely are examinated osteogenic sarcoma and Ewing's sarcoma in childhood and evaluated therapeutical means comparing the achieved results. Particularly are detailed therapeutic protocols proposed by the Italian National Research Council for the project "Control of neoplastic growth".

40 children (23 males, 17 females) have been diagnosed have ANLL during the period from february 1970 to september 1981. According to FAB classification, 24 cases were M1,-M2, 9 M3, 3 M4, 3 M5 and 1 M6. At diagnosis, 20 patients (50%) had leukocytes less than 10.000/mmc, 6 (15%) had leukocytes greater than 50.000mmc. Hb levels was 7 g% in 16 patients (40%); 10 children had hepatosplenomegaly (25%), 7 splenomegaly (18%) and 5 lymphoadenomegaly (13%). 4 patients had cutaneous or mucous infiltrates. None had meningeal involvement at diagnosis. According to the year of diagnosis, 3 groups can be identified. In the group I (1970-73), 11 patients have been treated with not codified combination chemotherapy as ARA-C, 6-TG, DNR, CTX, Metil-GAG. In the group II (1974-76) and in the group III (1977-81), the patients (respectively 12 and 17) have been treated according to the following protocols: LAM-5 (3), TRAP (5), COAP (1), LAM 80 (2), AIL 7402 (8), AIL 7604, AIL 7801 (6). Immunotherapy has been performed in 7 cases. CNS prophylaxis (MTX i.t. +/-ARA-C +/- RT) was given in 5 patients of group II and in 6 of group III. I patients of group I (45%), 6 of group II (50%) and 13 of group III (76%) achieved CR. Median duration of remission was 5 months in the group I and in 17 in group II and III.(ABSTRACT TRUNCATED AT 250 WORDS)