The Courts and the Restitution of Indigenous Territories in Malaysia

Despite enjoying distinct and privileged constitutional statuses, the Indigenous minorities of Malaysia, namely, the natives of Sabah, natives of Sarawak and the Peninsular Malaysia Orang Asli continue to endure dispossession from their customary lands, territories and resources. In response, these groups have resorted to seeking justice in the domestic courts to some degree of success. Over the last two decades, the Malaysian judiciary has applied the constitutional provisions and developed the common law to recognise and protect Indigenous land and resource rights beyond the literal confines of the written law. This article focuses on the effectiveness of the Malaysian courts in delivering the preferred remedy of Indigenous communities for land and resource issues, specifically, the restitution or return of traditional areas to these communities. Despite the Courts’ recognition and to a limited extent, return of Indigenous lands and resources beyond that conferred upon by the executive and legislative arms of government, it is contended that the utilisation of the judicial process is a potentially slow, costly, incongruous and unpredictable process that may also not necessarily be free from the influence of the domestic political and policy debates surrounding the return of Indigenous lands, territories and resources

Outcomes of the RAFT Trial: Robotic surgery After Focal Therapy

OBJECTIVES: To report toxicity of treatment observed in men participating in the Robotic surgery After Focal Therapy (RAFT) clinical trial. SUBJECTS/PATIENTS AND METHODS: Men were eligible for this prospective single group interventional study if they had histologically confirmed recurrent/residual prostate adenocarcinoma following primary FT. The short-form Expanded Prostate Cancer Index Composite (EPIC-26) measured prior to salvage robotic prostatectomy (S-RARP) and 3-monthly post-operatively together with Clavien-Dindo complications (I-IV). Secondary outcomes included biochemical recurrence-free survival (BCFS) following surgery and need for salvage treatment after surgery. This study is registered with ClinicalTrials.gov NCT03011606. RESULTS: 24 men were recruited between February 2016 and September 2018. 1 patient withdrew from the trial after consenting and before S-RARP. 23 men completed 12-month post S-RARP follow-up. Median EPIC-26 urinary continence scores initially deteriorated after 3 months (82.4 versus 100) but there was no statistically significant difference from baseline at 12 months (100 versus 100, p=0.31). Median lower urinary tract symptom scores improved after 12 months compared to baseline (93.8 versus 87.5, p=0.01). At 12 months, 19/23 (83%) were pad-free and 22/23 (96%) required 0/1 pads. Median sexual function subscale scores deteriorated and remained low at 12 months (22.2 versus 58.3, p<0.001). Utilising a minimally important difference of 9 points, at 12 months after surgery 17/23 (74%) reported urinary continence to be "better" or "not different" to pre-operative baseline. The corresponding figure for sexual function (utilising a minimally important difference of 12 points) was 7/23 (30%). There was no statistically significant difference on median bowel/hormonal subscale scores. Only a single patient had a post-operative complication (Clavien-Dindo Grade I). BCFS at 12 months after surgery was 82.6% (95% confidence interval [CI]: 60.1% - 93.1%] while 4/23 (17%) received salvage radiation. CONCLUSIONS: The RAFT clinical trial suggests toxicity of surgery after FT is low, with good urinary function outcomes, albeit sexual function deteriorated overall. Oncological outcomes at 12 months appear acceptable

Flexible FETs using ultrathin Si microwires embedded in solution processed dielectric and metal layers

This work presents a novel manufacturing route for obtaining high performance bendable field effect transistors (FET) by embedding silicon (Si) microwires (2.5 μm thick) in layers of solution-processed dielectric and metallic layers. The objective of this study is to explore heterogeneous integration of Si with polymers and to exploit the benefits of both microelectronics and printing technologies. Arrays of Si microwires are developed on silicon on insulator (SOI) wafers and transfer printed to polyimide (PI) substrate through a polydimethylsiloxane (PDMS) carrier stamp. Following the transfer printing of Si microwires, two different processing steps were developed to obtain top gate top contact and back gate top contact FETs. Electrical characterizations indicate devices having mobility as high as 117.5 cm2 V−1 s−1. The fabricated devices were also modeled using SILVACO Atlas. Simulation results show a trend in the electrical response similar to that of experimental results. In addition, a cyclic test was performed to demonstrate the reliability and mechanical robustness of the Si μ-wires on flexible substrates

Adjuvant Intravesical Chemohyperthermia Versus Passive Chemotherapy in Patients with Intermediate-risk Non–muscle-invasive Bladder Cancer (HIVEC-II): A Phase 2, Open-label, Randomised Controlled Trial

Background: Adjuvant intravesical chemotherapy following tumour resection is recommended for intermediate-risk non–muscle-invasive bladder cancer (NMIBC). Objective: To assess the efficacy and safety of adjuvant intravesical chemohyperthermia (CHT) for intermediate-risk NMIBC. Design, setting, and participants: HIVEC-II is an open-label, phase 2 randomised controlled trial of CHT versus chemotherapy alone in patients with intermediate-risk NMIBC recruited at 15 centres between May 2014 and December 2017 (ISRCTN 23639415). Randomisation was stratified by treating hospital. Interventions: Patients were randomly assigned (1:1) to adjuvant CHT with mitomycin C at 43°C or to room-temperature mitomycin C (control). Both treatment arms received six weekly instillations of 40 mg of mitomycin C lasting for 60 min. Outcome measurements and statistical analysis: The primary endpoint was 24-mo disease-free survival as determined via cystoscopy and urinary cytology. Analysis was by intention to treat. Results: A total of 259 patients (131 CHT vs 128 control) were randomised. At 24 mo, 42 patients (32%) in the CHT group and 49 (38%) in the control group had experienced recurrence. Disease-free survival at 24 mo was 61% (95% confidence interval [CI] 51–69%) in the CHT arm and 60% (95% CI 50–68%) in the control arm (hazard ratio [HR] 0.92, 95% CI 0.62–1.37; log-rank p = 0.8). Progression-free survival was higher in the control arm (HR 3.44, 95% CI 1.09–10.82; log-rank p = 0.02) on intention-to-treat analysis but was not significantly higher on per-protocol analysis (HR 2.87, 95% CI 0.83–9.98; log-rank p = 0.06). Overall survival was similar (HR 2.55, 95% CI 0.77–8.40; log-rank p = 0.09). Patients undergoing CHT were less likely to complete their treatment (n =75, 59% vs n = 111, 89%). Adverse events were reported by 164 patients (87 CHT vs 77 control). Major (grade III) adverse events were rare (13 CHT vs 7 control). Conclusions: CHT cannot be recommended over chemotherapy alone for intermediate-risk NMIBC. Adverse events following CHT were of low grade and short-lived, although patients were less likely to complete their treatment. Patient summary: The HIVEC-II trial investigated the role of heated chemotherapy instillations in the bladder for treatment of intermediate-risk non–muscle-invasive bladder cancer. We found no cancer control benefit from heated chemotherapy instillations over room-temperature chemotherapy. Adverse events following heated chemotherapy were low grade and short-lived, although these patients were less likely to complete their treatment

Paradigms to Shape the Holistic Development of Globally-Oriented and Innovative Leaders across Sectors Engaging Pluralist Landscapes in Africa and Beyond

Indigenous reflections on African leadership and its development often reiterate the prevalence of incongruent worldviews, paradigms, training approaches and meaning-making methods. Some foreign and local perspectives conversely attribute African leadership challenges to elements in the latter\u27s indigenous culture. In reviews of indigenous literature across varied African regions and sectors, African scholars consistently echo how inherited and diffused foreign leadership paradigms, educational models, curricula and values do not holistically nor broadly equip African leadership in varied sectors to concretely address and reform dynamically changing African realities in an integrated and contextualized manner. Accordingly, the appreciative inquiry approach was engaged within representative leadership training institutions in Africa to mutually evaluate indigenously meaningful leadership and its development whilst concurrently determining outstanding gaps and opportunities across contexts. This inquiry broadly engaged indigenous participants across linguistic, national, vocational, organizational and denominational boundaries. In light of Africa\u27s placement and functions globally, collective African evaluations were subsequently reviewed alongside evaluations of prevalent leadership development paradigms and approaches in a broader global context embodying complementary ethnic insights and experiences from diverse fields and sectors. Converging African evaluations across literature reviews and field research delineated indigenously meaningful leadership paradigms and formational approaches. Simultaneously, broader global and multidisciplinary evaluations of leadership and its development poignantly echoed convergent African evaluations in several respects. These include (amongst others) evaluations concerning ethnocentric paradigms, sacred-secular dichotomies, parochial specializations emphasizing particularities, pluralism, globalization, institutionally-oriented individual-competency approaches, holistic transformation and proactively innovative leadership in dynamically evolving local and global environments. Fusing converging global and interdisciplinary insights with indigenously meaningful evaluations of leadership development, a vision for change encourages alternative mindsets, attitudes, values and processes to shape a renewed learning culture facilitating the holistic development of globally-oriented and innovative leadership across sectors engaging pluralist landscapes in Africa and beyond. Mentor: Elizabeth L. Glanvill