Netherlands Leprosy Relief

Liquid imbibition into coated paper is a complex process that strongly depends on the specific liquid and porous substrate of interest. Without coating, the timescales of capillary liquid uptake and paper swelling will be separated. However, a coupling between imbibition and swelling is expected in the presence of a coating. Understanding how liquid imbibes and how it reacts to different liquids is crucial to control liquid-substrate interactions. For the first time, a systematic study of the imbibition of water-glycerol mixtures into a complex layered porous medium like coated paper is performed using the Ultra Fast Imaging Nuclear Magnetic Resonance (UFI-NMR) method. This method allows to follow the in-situ liquid distributions over time. The effect of the coating is investigated by comparing the imbibition processes into paper with and without a coating. Liquid imbibition into coated paper is different from paper without a coating due to the flow resistance induced by the low permeability of the coating layer. It was concluded that liquid uptake and paper swelling are synchronized, and occurs locally at the tip of the liquid front. This is significantly different from liquid imbibition in uncoated paper, where liquid penetrates quickly and later swelling occurs more homogeneously throughout the paper. Moreover, it has been shown that both the imbibition and swelling speed are determined by viscosity. Consequently, Darcy's law for unsaturated flow still holds in this complex layered medium. This knowledge gets us a step closer to controlling liquid-media interactions in many different applications.

One of the most severe and least understood forms of cutaneous leishmaniasis (CL) is leishmaniasis recidivans (LR), a chronic variant in which lesions reappear months or years after apparent healing. This review aimed to consolidate fragmented information to clarify LR's epidemiological scope, diagnostic methods, and treatment strategies. A comprehensive literature search according to PRISMA guidelines was conducted across multiple databases, with the final search completed on November 15, 2025. Risk of bias was assessed using JBI checklists. A study protocol for this review was registered with OSF (10.17605/OSF.IO/6NFT3). Data were synthesized narratively as meta-analysis was not feasible. Forty-three papers were included, thirty-two from the Old World and eleven from the New, representing seventeen countries. LR primarily affected children, and factors such as trauma, immunosuppression, or irregular treatment were stated as triggers. Cases tended to be geographically restricted, with L. tropica most frequently reported. Both the lesion morphology and the latency period varied widely. Microscopy and histology gave poor accuracy, limited by low parasite loads and overlapping diagnoses. Isoenzyme analysis identified distinct LR strains. Pentavalent antimonials (PA) were the main treatment, and combination regimens showed promise in overcoming LR persistence. LR remains modestly recognized, with considerable overlap with classical CL. The evidence points to species-level differences in recurrence, compounded by the role of host factors and parasite diversity. Consistent adherence to therapy is a decisive element in managing LR. Without broader, more systematically coordinated data, both clinical guidance and effective public health strategies will not be possible.

The advent of opaque assistive AI in courtrooms has raised concerns about the contestability of these systems, and their impact on procedural justice. The right to an explanation under the GDPR and the AI Act could address the inscrutability of judicial AI for litigants. To substantiate this right in the domain of justice, we examine utilitarian, rights-based (including dignitarian and Dworkinian approaches), and relational theories of procedural justice. These theories reveal diverse perspectives on contestation, which can help shape explainability rights in the context of judicial AI. These theories respectively highlight different values of litigant contestation; it has instrumental value in error correction, and intrinsic value in respecting litigants’ dignity, either as rational autonomous agents or as socio-relational beings. These insights help us answer three central and practical questions on how the right to an explanation should be operationalized to enable litigant contestation: should explanations be general or specific, to what extent do explanations need to be faithful to the system’s internal behavior or merely provide a plausible approximation, and should more interpretable systems be used, even at the cost of accuracy? These questions are not strictly legal or technical in nature, but also rely on normative considerations. Finally, this paper also evaluates what theory of procedural justice could best safeguard contestation effectively in the age of judicial AI. Thereto, it provides the first building blocks of an AI-responsive theory of procedural justice.

Anandabhairava Rasa (ABR) is an Ayurvedic herbo-mineral formulation traditionally used to treat fever and diarrhea. It contains Vatsanabha (Aconitum ferox Wall.), a highly toxic herb. In Ayurveda, Śodhana (purification) is a process that renders toxic substances safe and therapeutically effective. This study investigates the effects of two distinct Śodhana media-cow urine (Gomutra) and cow milk (Godugdha) on the physicochemical properties of Vatsanabha and the final ABR formulations. Materials and Methods: Vatsanabha tubers was separately purified using classical (Śodhana) methods using cow urine and cow milk. Subsequently, the two distinct batches of ABR were prepared by triturating the ingredients and compressing them into tablets. The raw materials were and final products were subjected to analytical study, including organoleptic characterization, physicochemical parameter assessment and chromatographic profiling. The Thin Layer Chromatography (TLC) of unpurified Vatsanabha and purified Vatsanabha and High-Performance Thin Layer Chromatography (HPTLC) of Anandabhairava Rasa (ABR) prepared from both types of purified Vatsanabha. Results and Discussion: The purification of Vatsanabha using cow urine and cow milk resulted in notable physicochemical alterations, including a significant shift in pH, differences in water-soluble extracts, and distinct TLC patterns. Although the resulting Anandabhairava Rasa (ABR) formulations exhibited similar size and texture, slight differences were observed in hardness and disintegration time. Conclusion: The study demonstrates that the use of cow urine and cow milk as Śodhana media for Vatsanabha results in two chemically distinct Anandabhairava Rasa formulations. Further quantitative and clinical studies are necessary to evaluate the precise therapeutic implications of these variations.

ABSTRACT Two common consequences among persons with a physical health condition are internalised stigma associated with the physical illness and depression. Increased awareness and knowledge of both concepts might help professionals to better diagnose and deploy interventions that best suit the needs of people who experience these phenomena. Therefore, this study aimed to investigate to what extent and how internalised stigma and depression overlap. A Delphi study was conducted to create understanding and build consensus among experts. Over three survey rounds, experts in the field of stigma and depression (n = 24) were asked to determine whether signs/behaviours, symptoms/experiences, external factors and strategies or interventions were associated with internalised stigma, depression or both. Consensus was reached that internalised stigma and depression are common consequences of physical health conditions and are two separate but overlapping phenomena. The main difference between both were external factors, such as environmental (e.g. weather-driven mood fluctuations), or therapeutic (e.g. medication) aspects of depression. This study highlights the importance of raising awareness among professionals that internalised stigma and depression can co-occur, and that strategies and interventions are available for both. Improved awareness will lead to care that is more suitable to the individual’s needs, therewith improving quality of life.

<title>Abstract</title> Background The use of ad-hoc staff to boost TB notification rates is becoming more significant, and its effect has been observed in certain settings. This study aimed to assess the impact of engaging temporary staff on TB notification at health facilities where intensified TB case-finding efforts were implemented in Kano State, Nigeria, from January 2022 to December 2023. Methods This observational, descriptive, cross-sectional study retrospectively examined data from the Outpatient Department (OPD) TB Screening program implemented in Kano State, Nigeria. Data collection and reporting followed the national TB program's data flow and management system. Quarterly TB care cascade and key efficiency metrics were displayed in numbers and proportions to identify gaps along the TB care continuum for the intervention. An unpaired t-test was used to determine whether the quarterly average TB case notification rates differed between intervention and non-intervention sites during the study period. The significance level was set at 5%. Results From January 2022 to December 2023, 832,658 people visited the OPD at the 40 health facilities selected for the PQE intervention, with a TB screening rate of 67%, a presumptive yield of 5.1%, a TB yield of 3.4%, NNS of 658, NNT of 30, and an enrolment rate of 99%. The quarterly number of TB cases notified increased from zero at the start of the intervention to 133 in the last quarter, with periods of rise and fall. The quarterly percentage contribution of the PQE intervention to TB notifications grew from 0% (January – March 2022) to 38% (October – December 2023). The intervention facilities had a mean TB case notification of 23.0, compared to 13.2 for non-intervention facilities, with a marginally significant p-value of approximately 0.063. Conclusions The study found that deploying ad-hoc staff to support TB service delivery in health facilities with high patient volumes can increase TB case notifications and improve overall TB services in Kano State, Nigeria. It underscores the importance of focusing on the design, implementation, and monitoring of the intervention.

ABSTRACT Efforts to address gender‐based violence in humanitarian settings increasingly call for recognition of and funding to local women‐led organizations and women's rights organizations for long‐term response. The Empowered Aid initiative seeks to address sexual exploitation and abuse by working with local organizations as well as the refugee women and girls most affected by this type of abuse, to undertake participatory action research and apply the findings to aid programming. This paper examines the ways in which Union of Relief and Development Associations (URDA), a local, women‐led organization in Lebanon, engaged in this initiative and tested measures to reduce risk of sexual exploitation and abuse in their programming. It applies a critical feminist lens to examine URDA's experiences of power to address a type of violence perpetrated by aid actors, often with very little accountability. This paper describes how participatory approaches serve to co‐create knowledge and center contextual expertise.

This study examines the impact of leprosy on those affected by leprosy in Sindh, Pakistan, exploring their care-seeking behavior, treatment experiences, well-being, stigma and coping mechanisms. By highlighting the lived experiences of persons affected by leprosy (PAL), this study aims to inform strategies that address not only the biological aspects of leprosy, but also the social and psychological challenges faced by this marginalized population. Fifteen in-depth interviews were conducted with persons affected by leprosy from Sindh, Pakistan. A combined inductive and deductive thematic analysis approach was applied inspired by the “conceptual framework of the bio-psycho-social impact and coping mechanisms of patients” by Han et al. Participants reported delays in diagnosis of up to twenty years, significantly influenced by limited awareness and socio-economic barriers. These delays increased the risk of physical disability and worsened mental health problems such as depression and anxiety, largely fueled by stigma and misinformation. While both genders experienced stigma, women were more likely to express their mental health problems, highlighting gender differences in discussing such issues. Peer support and community storytelling emerged as effective strategies to mitigate stigma, while the role of religious beliefs shaped both societal perceptions and personal coping mechanisms. The findings highlight the need for comprehensive, culturally sensitive interventions that address the bio-psycho-social challenges faced by PAL. Implementing people-centered strategies that use storytelling, community engagement and digital health tools are essential to reduce delays in diagnosis and improve the overall well-being of PAL. Further research is needed to refine these interventions and ensure that they are aligned with the needs and beliefs of those affected by leprosy.

Background: Tuberculosis (TB) constitutes one of the leading causes of morbidity and mortality worldwide. Due to adopted prevention measures, good public health practices, and better treatment, its incidence, prevalence, and case fatality rates steadily fell. Objectives and Methods: Following a case–control research design, this study aimed to explore the risk factors of pulmonary TB among patients registered in the Aseer Region, Saudi Arabia. This study included 105 active TB cases (study group) and 143 (control group) who were randomly recruited from those attending the vaccination units at Primary Healthcare Centers in Aseer. Results: Participants differed significantly according to their nationality (with 65.7% being Saudi in the TB group compared with 89.5% Saudi nationals in the control, p < 0.001); educational status (with 27.6% being university graduates in the TB group compared with 53.8% in the control, p < 0.001); marital status, with most TB patients being single, compared with control (70.5%, and 44.1%, p < 0.001); monthly income, with lower income <5000 Saudi Riyals (SRs), among TB patients than control subjects (80% and 44.1%, p < 0.001); and body mass index (20% of the TB patients were underweight, compared with 6.3% in the control, p < 0.001). Also, participants differed significantly according to their residence, with more rural residence among TB patients than control (18.1% and 7%, p = 0.007), and type of houses, with 84.8% of TB patients living in apartments, compared to 68.5% of the control (p < 0.001). The binary logistic regression model of the possible risk factors related to pulmonary TB revealed that nationality, residence, and body mass index were the only significant independent risk factors (p < 0.001, p = 0.007, and p < 0.001). Conclusions: Personal characteristics of pulmonary TB patients include being non-Saudi, less educated, not married, unemployed, with a low monthly income, and being underweight. Risk factors related to place included residing in rural areas and living in the basement of a rented apartment.