Mostly low- and very low-quality evidence suggests no clear differences between different stem cell sources and different treatment regimens of autologous cell implantation for outcomes such as all-cause mortality, amputation rate, ulcer healing, and rest pain for 'no-option' CLI patients. Pooled analyses did not show a clear difference in clinical outcomes whether cells were administered via IM or IA routes. High-quality evidence is lacking; therefore the efficacy and long-term safety of autologous cells derived from different sources, prepared using different protocols, administered at different doses, and delivered via different routes for the treatment of 'no-option' CLI patients, remain to be confirmed.Future RCTs with larger numbers of participants are needed to determine the efficacy of cell-based therapy for CLI patients, along with the optimal cell source, phenotype, dose, and route of implantation. Longer follow-up is needed to confirm the durability of angiogenic potential and the long-term safety of cell-based therapy.

No abstract

Currently, the indications to perform reduced-intensity conditioning allogeneic hematopoietic stem cell transplant (RIC-HCT) are based on data derived mainly from large registry and single-centre retrospective studies. Thus, at the present time, there is limited direct evidence supporting the current practice in selecting patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) for RIC versus myeloablative conditioning (MAC) transplants. To determine the relationship between dose intensity of conditioning regimen and survival outcomes after allografting in AML/ALL patients, we performed a meta-analysis of 23 clinical trials reported between 1990 and 2013 involving 15,258 adult patients that compare survival outcomes after RIC-HCT versus MAC-HCT. RIC-HCT resulted in comparable <2-year and 2-6 year overall survival (OS) rates post-transplantation even though the RIC-HCT recipients were older and had more active disease than MAC-HCT recipients. The 2-6 year progression-free survival (PFS), nonrelapse mortality, acute graft-versus-host disease (GvHD) and chronic GvHD rates were reduced after RIC-HCT, but relapse rate was increased. Similar outcomes were observed regardless of disease type and status at transplantation. Odds ratio for all outcomes remained comparable with or without performing separate analyses for the year of HCT and for retrospective versus prospective studies. Among RIC-HCT recipients, survival rates were superior if patients were in CR at transplantation. Significant inter-study heterogeneity for aGvHD data and publication bias for PFS data were observed. This meta-analysis showed no OS benefit of MAC-HCT over RIC-HCT across the entire cohort of patients suggesting that RIC-HCT could be an effective therapeutic option for AML/ALL patients who are ineligible for MAC-HCT and CR status is preferred before RIC-HCT.

Implantation of autologous CBT may be an effective therapeutic strategy for no-option CLI patients. BM-MNC and m-PSBC appear more effective than NCT in improving AR and other limb perfusion parameters. BM-MSC may be beneficial in improving perfusion parameters but not AR, however, this observation needs to be confirmed in a larger population of patients. Generally, treatment using various sources and phenotypes of cell products appeared safe and well tolerated. Large-size RCTs with long follow-up are warranted to determine the superiority and durability of angiogenic potential of a particular CBT and the optimal treatment regimen for CLI.

The aim of this article is to obtain experts' consensus on the need for parental involvement in the effort to inculcate preschool children's attitude, which covers several dimensions namely school-based involvement, home-based involvement and communication between the home and the school. The verification was done by 11 panel members or experts on the survey instrument containing items, and it was analyzed using the Fuzzy Delphi technique template. The study establishes that there is an agreement among the experts on parents' involvement in the formation of preschool children's attitude, be it in the school-based involvement, home-based involvement and communication between the home and the school. All items, totaling 24 items in the dimensions of school-based involvement, home-based involvement and communication between the home and the school, have obtained experts' consensus exceeding 75% with 22 of them obtaining the threshold reading (d) ≤ 0.2. Next, the items involved were arranged by position based on the defuzzification value and improved with some additional items as proposed by the panel of experts.

Currently, there is a lack of high-quality evidence to guide practice on the use of cell-based therapy to treat ALS/MND.We need large, prospective RCTs to establish the efficacy of cellular therapy and to determine patient-, disease- and cell treatment-related factors that may influence the outcome of cell-based therapy. The major goals of future research should be to determine the appropriate cell source, phenotype, dose, and route of delivery, as these will be key elements in designing an optimal cell-based therapy programme for people with ALS/MND. Future research should also explore novel treatment strategies, including combinations of cellular therapy and standard or novel neuroprotective agents, to find the best possible approach to prevent or reverse the neurological deficit in ALS/MND, and to prolong survival in this debilitating and fatal condition.

No abstract

Thematic teaching has been introduced through the Malaysian Preschool Education Curriculum Guidelines (KPM, 1993) since 1993. This research is a preliminary review aimed at looking at the need to conduct further studies on the implementation of thematic teaching and to determine the focus of the research. This research explores the current understanding and practice of eight teachers from eight preschools in Selangor and Negeri Sembilan in implementing thematic teaching. Data collected for this research was based on document analysis, observations, and interviews. Findings of the research show that there were various levels of understanding and methods employed in implementing thematic teaching in the selected preschools. Teachers' understanding is divided into several categories: 1) understanding thematic teaching as curriculum; 2) understanding thematic teaching as an approach; 3) the minimum understanding of thematic teaching; and 4) no understanding of thematic teaching at all. In terms of planning, only two of the teachers integrated thematic teaching in their annual, weekly, and daily lesson plans. The findings on the implementation of thematic teaching also show that teachers: 1) used thematic teaching as the basis of the curriculum; 2) applied thematic teaching as one of the teaching approaches; 3) used thematic teaching based on the requirements of the teaching and learning; and 4) had not used thematic teaching. This finding supports the need for further research on thematic teaching. A detailed research on the implementation of more practical and friendly thematic teaching for teachers that also fulfills the principles of implementation of such teaching and the overall developmental needs of children should be undertaken.