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Competing Interests: We declare no competing issues.

Competing Interests: KA-M, MM, AR, LT, and DW report support from WHO for travel to attend the Fifth Global Forum on Human Resources for Health held April 3–5, 2023, at WHO Headquarters, Geneva, Switzerland. K A-M is the Minister of Health in Ghana. TAG is the Director-General of WHO and declares no other competing interests. MM is the Minister of Finance in Egypt. AR is the Minister of Health in Romania. LT is the Minister of Health in Papua New Guinea. NTL is the Minister of Health in Brazil. DW is the Minister of Health in Bhutan.

This paper takes the government transition that took place between 2022 and 2023 in Brazil as a case study and aims to analyse how a cycle of radical right-wing populist government acted to dismantle Brazil's national health system foundations. It describes how governance was built based on political-clientelism and market-privatising interests and on the adoption of long-term fiscal austerity policies, whose results are public defunding and weakening and disorganisation of the country's national health system, with a significant worsening of health indicators and the capacity to respond to the population health needs. The lessons from recent experience in Brazil should serve as learning and a source of academic and political reflection, since there is an ongoing international movement and signs of rise of radical right-wing populist regimes in several countries, which endanger the Democratic Rule of Law, institutions, and social policies. It allows putting into perspective how political cycles of this nature can affect national universal health systems, including those that have experienced substantial progress towards universal access and universal health coverage. Keeping in mind the Brazilian experience, it was possible to observe the progressive structuring of a radical right-wing neo-populism and in the sanitarian., (© 2023 John Wiley & Sons Ltd.)

Inflammatory arthritis is the most prevalent chronic inflammatory disease worldwide. The pathology of the disease is characterized by increased inflammation and oxidative stress, which leads to chronic pain and functional loss in the joints. Conventional anti-arthritic drugs used to relieve pain and other arthritic symptoms often cause severe side effects. α-bisabolol (BIS) is a sesquiterpene that exhibits high anti-inflammatory potential and a significant antinociceptive effect. This study evaluates the anti-arthritic, anti-inflammatory and antihyperalgesic effects of BIS alone and in a β-cyclodextrin (βCD/BIS) inclusion complex in a CFA-induced arthritis model. Following the intra-articular administration of CFA, male mice were treated with vehicle, BIS and βCD/BIS (50 mg/kg, p.o.) or a positive control and pain-related behaviors, knee edema and inflammatory and oxidative parameters were evaluated on days 4, 11, 18 and/or 25. Ours findings shows that the oral administration of BIS and βCD/BIS significantly attenuated spontaneous pain-like behaviors, mechanical hyperalgesia, grip strength deficit and knee edema induced by repeated injections of CFA, reducing the joint pain and functional disability associated with arthritis. BIS and βCD/BIS also inhibited the generation of inflammatory and oxidative markers in the knee and blocked MAPK in the spinal cord. In addition, ours results also showed that the incorporation of BIS in cyclodextrin as a drug delivery system improved the pharmacological profile of this substance. Therefore, these results contribute to the pharmacological knowledge of BIS and demonstrated that this terpene appears to be able to mitigate deleterious symptoms of arthritis., (Copyright © 2022 The Authors. Published by Elsevier Masson SAS.. All rights reserved.)

Approaching from the perspective of the history and social studies of science, the article analyses some aspects of the early history of Chagas disease, from its discovery through initial research. It is our goal to show that historians of science can explore this topic as a way not only of remembering and narrating past events but also of examining the processes through which science is produced. To this end, we present five basic precepts that have guided historical and sociological studies of "science in action": science as a collective endeavor, as a social activity, as a set of practices, as a process that involves controversies, and as a formative process. By examining the topic in the light of these five points, we demonstrate how the history of this successful research tradition can lead us to broader reflections about the complex dynamics interweaving science and society.

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Snakebite envenoming affects close to 2.7 million people globally every year. In Brazil, snakebites are reported to the Ministry of Health surveillance system and cases receive antivenom free of charge. There is an urgent need to identify higher risk areas for antivenom distribution, and to develop prevention activities. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible drivers; as well as to create a flowchart tool to support decision-makers identify higher risk areas. An ecological-type study was carried out using data by municipality (2013-2017). Study parts: 1) Create a geocoded database and perform a descriptive and cluster analysis; 2) Statistical analysis to measure the association of snakebite and possible environmental and socioeconomic drivers; 3) Develop a flowchart to support decision-makers and the application of this tool in one state (Rio Grande do Sul) as an example. An average of 27,120 snakebite cases per year were reported at the country level. Clusters of municipalities with high numbers of snakebites are mostly found in the Amazon Legal Region. The negative binomial regression model showed association with the snakebite case count: the type of major habitat, tropical or non-tropical; temperature; percentage of urbanization; precipitation; elevation; GDP per capita; a weaker relation with forest loss; and with venomous snake richness. The state where the instrument was applied reported 4,227 snakebites in the period. Most municipalities were considered as medium risk and 56/496 as high risk according to the tool created. Snakebite cases are distributed across the entire country with the highest concentration in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas. Research into types of antivenom with a longer shelf life without the need for refrigeration is needed., Competing Interests: The authors have declared that no competing interests exist.

An analysis is presented of actions taken by the Brazilian research institution Fiocruz for the communication and popularization of science, from two perspectives. The aim was to investigate how a system for the communication and popularization of science is organized at a large scientific institution and how it is articulated with the institutional discourse. A brief review is presented of how the topic has developed over the history of Fiocruz, followed by a discussion of the way it has been addressed in its official planning documents. The science communication/popularization actions undertaken in 2015 and 2016 were mapped out and classified according to how they interact with the public, giving a better understanding of this area.

Background: Neonatal sepsis is defined as a systemic inflammatory response caused by a suspected or proven infection, occurring in the first month of life, and remains one of the main causes of morbidity and mortality in newborn and preterm infants. Frequently, survivors of neonatal sepsis have serious long-term cognitive impairment and adverse neurologic outcomes. There is currently no specific drug treatment for sepsis. Indole-3-guanylhydrazone hydrochloride (LQM01) is an aminoguanidine derivative that has been described as an anti-inflammatory, antihypertensive and antioxidant with potential applicability in inflammatory diseases., Methods: We used a LPS-challenged neonatal sepsis rodent model to investigate the effect of LQM01 on cognitive impairment and anxiety-like behavior in sepsis mice survivors, and examined the possible molecular mechanisms involved., Results: It was found that LQM01 exposure during the neonatal period reduces anxiety-like behavior and cognitive impairment caused by lipopolysaccharides (LPS) in adult life. Additionally, treatment with LQM01 decreased pro-inflammatory cytokine levels and reduced NFκB, COX-2, MAPK and microglia activation in hippocampus of neonatal mice. Furthermore, LQM01 was also able to prevent oxidative damage in hippocampus of neonatal mice and preserve brain barrier integrity., Conclusions: LQM01 attenuated inflammatory reactions in an LPS-challenged neonatal sepsis mice model through the MAPK and NFκB signaling pathways and microglia activation suppression. All these findings are associated with mitigated cognitive impairment in 70 days-old LQM01 treated-mice., General Significance: We revealed the effect of LQM01 as an anti-septic agent, and the role of crucial molecular pathways in mitigating the potential damage caused by neonatal sepsis., (Copyright © 2019. Published by Elsevier Ltd.)

The present study evaluated the effect of the essential oil of Mikania cordifolia (EOMc) and its major constituent limonene alone or associated with antibacterial drugs against Multidrug Resistant Bacteria (MDR). To evaluate the antibacterial activity, the minimum inhibitory concentrations (MIC) of the oil and limonene against Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were determined. The antibiotic-modulating activity was assessed using subinhibitory concentrations (MIC/8) of these substances in combination with conventional antibacterial drugs. Although no relevant antibacterial activity of the natural products was detected, both substances modulated the action of antibiotics against resistant bacteria. The EOMc demonstrated the best modulating effect against P. aeruginosa, presenting synergistic effects when associated with gentamicin and norfloxacin. In addition, the oil reduced the MIC of norfloxacin against E. coli as well as reduced the MIC of gentamicin against S. aureus. On the other hand, the best effect of limonene was obtained against S. aureus. Thus, it is concluded that the essential oil Mikania cordifolia and the isolated compound limonene do not have clinically significant antibacterial effect, but modulate the action of antibiotics against MDR bacteria., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Chronic pain is a continuous or recurring pain which exceeds the normal course of recovery to an injury or disease. According to the origin of the chronic pain, it can be classified as inflammatory or neuropathic. This study aimed to evaluate the antinociceptive and anti-inflammatory effect of (-)-α-bisabolol (BIS) alone and complexed with β-cyclodextrin (βCD) in preclinical models of chronic pain. Chronic pain was induced by Freund's Complete Adjuvant (FCA) or partial lesion of the sciatic nerve (PLSN). Swiss mice were treated with BIS, BIS-βCD (50 mg/kg, p.o) or vehicle (control) and mechanical hyperalgesia, thermal hyperalgesia, muscle strength and motor coordination were evaluated. In addition, levels of TNF-α and IL-10 and expression of the ionized calcium-binding adapter protein (IBA-1) were assessed in the spinal cord of the mice. The complexation efficiency of BIS in βCD was evaluated by High-Performance Liquid Chromatography. BIS and BIS-βCD reduced (p < 0.001) mechanical and thermal hyperalgesia. No alterations were found in force and motor coordination. In addition, BIS and BIS-βCD inhibited (p < 0.05) TNF-α production in the spinal cord and stimulated (p < 0.05) the release of IL-10 in the spinal cord in PLSN-mice. Further, BIS and BIS-βCD reduced IBA-1 immunostaining. Therefore, BIS and BIS-βCD attenuated hyperalgesia, deregulated cytokine release and inhibited IBA-1 expression in the spinal cord in the PLSN model. Moreover, our results show that the complexation of BIS in βCD reduced the therapeutic dose of BIS. We conclude that BIS is a promising molecule for the treatment of chronic pain., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Public policy planning associated with the management of the Science, Technology, and Innovation is decisive to improve public health. It is important to develop novel strategies to plan, supervise, manage, use and evaluate research using indicators that extrapolates metrics in current use. In 2011, the Brazilian government introduced the Brazil Without Extreme Poverty plan (BWEP) that aimed to integrate several conditional cash transfer programs (CCT). The original that aimed to integrate of the CCTs were expanded in order to integrate social justice and dignity that induced several actions towards the promotion of social development of the beneficiaries. An induced action involved a partnership between BWEP (From the Ministry of Social Development), CAPES (Brazilian Higher Education Agency) and The Oswaldo Cruz Foundation (FIOCRUZ, a Public Health Institution), that dedicated scholarships for PhD and postdoc students committed to the BWEP to promote health research in its multiple approaches and the vulnerable associated population. Using the Social Studies of Science and Technology (SSST) framework, this paper analyzes the dynamics of knowledge production in the context of program implementation. Herein, we report on the follow-up activities performed in BWEP Health Action, directing research projects to align with the goals of the program, evaluating the progress of these research, and defining strategies for improved their management. We analyze the advances and difficulties encountered in the implementation, monitoring and evaluation of this innovative program in the academic training level, and we emphasize the critical need to expand and improve similar initiatives aimed at guiding the scientific and technological production in health to meet the social demands., Competing Interests: The authors have declared that no competing interests exist.

There are many studies that have sought to find drug therapies to prevent harm arising from sepsis. Such studies have represented a progress in the support to septic patients and also in the development of new pharmacological alternatives. Our interest was to investigate the caffeine effect on sepsis behavioural and memory impairments. Male rats were anaesthetized and the surgery was made to allow exposure of the caecum, which was then squeezed to extrude a small amount of faeces from the perforation site, which was later placed back into the peritoneal cavity. This procedure, which served to generate experimental sepsis, is herein referred to as ceccum ligation and perforation (CLP). The caffeine (10 mg/kg) was administered by gavage route, once daily, during 7 or 14 consecutive days to investigate the effects of acute or subchronic caffeine treatment on long-term behavioural and cognitive deficits induced by CLP. On the last day, 1 hr after caffeine administration, the animals were submitted to open-field, elevated plus maze (EPM), forced swimming and step-down inhibitory avoidance tests. The results showed that caffeine increased the percentage of open arm entries and open arm time in the EPM test, and reduced the immobility time when compared to the sham-operated group. The caffeine also increased the latency in the inhibitory avoidance test platform. Our results demonstrated that the caffeine improved behavioural changes and improved the neurocognitive deficits of sepsis-surviving animals. It is possible that blockage of the adenosine receptors may be responsible for the results here observed., (© 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)

This paper addresses the popular health movement in Nova Iguaçu-RJ in the 1970s and 1980s. Amidst political repression, residents organized themselves to find solutions to various problems, including health problems. Health demands are enhanced both by the dengue epidemic and linkages with the Brazilian health reform and a struggle for democracy. Using documental historical sources from newspapers, health dissemination papers and documents from the House of Oswaldo Cruz-Fiocruz collection, this paper concludes that the example of Nova Iguaçu reveals both the complexity of the process of political opening at the local level and efforts of conducting a health reform where it was needed the most. Resistance on the part of the medical corporation, private interests in health and the existence of a still incipient popular political organization and culture are some of the elements that account for the hardships in advancing the manifest wishes of policies. The specificities of local arenas also point to possible institutional arrangements, sometimes very peculiar and not reproducible in other settings.

Two journeys have had an important bearing on social thought regarding the Amazon: Carlos Chagas', from 1912 to 1913, and Mário de Andrade's, in 1927. The article examines how their travel experiences influenced these two men's views and interpretations of the relation between malaria and the project to bring civilization to the tropics. In Chagas' texts, wonderment is the category that organizes his perception of the Amazon region, evinced in the idea that the pathology of the tropics challenges established knowledge of the disease. Empathy, on the other hand, is the explanatory key to understanding Mário de Andrade's critical outlook, which entails the valorization of forms of sociability, beliefs, and popular manifestations in the region, including those related to malaria.

The article transcribes and comments on three papers published by sociologist José Arthur Rios in the Boletim do Serviço Especial de Saúde Pública in the early 1950s. These texts stand as valuable references in understanding a period in which projects for cultural change guided health programs and especially health education initiatives. The article begins by portraying the backdrop against which the Special Public Health Service conducted its activities following its 1942 creation as the result of a cooperation agreement between the Brazilian and U.S. governments. Aspects of José Arthur Rios' professional trajectory and intellectual influences are also examined, and the role of the social scientist in non-academic areas and in the shaping of public agencies and policies in Brazil is discussed.

This Introduction presents the Forum on the 20 years of experience with the Unified National Health System (SUS), consisting of 3 articles and a postscript. The first article provides a historical overview of the implementation of the SUS, in light of the Constitutional provisions pertaining to health. It discusses the context and main issues underlying the creation of the SUS in Brazil and proposes a renewed linkage between health sector policies and an expanded project for Brazilian society. The second article analyzes the SUS' dynamics; strides in access to and comprehensiveness of care; and challenges for the achievement of its objectives, in light of factors that are external to the system, involving the need for greater politicization of analyses on the issue. The third article approaches social and political processes that developed from 1988 to 2008. It mainly analyzes the history of two collegiate bodies under the SUS at the Federal level: the National Health Council and the Tripartite Inter-Managers' Commission. Despite the complexity identified by the authors and the important obstacles they identify, the reflections indicate that the SUS has been a successful social policy, besides contributing to the consolidation of democracy in Brazil.

The article addresses the role played within the social imaginary of Brazil by the scientific voyages of physicians in the first half of the twentieth century. Two texts are analyzed: a report by Arthur Neiva and Belisário Penna published in Memórias do Instituto Oswaldo Cruz and another by Julio Paternostro, released in 1945 in Viagem ao Tocantins. The former contributed to singling out pathology as defining mark of national identity during the First Republic (1899-1930), a fact that had repercussions in the following decades, as apparent in Paternostro's book, which at the time of its publication was presented as an indictment of national problems. These portraits of Brazil highlight as attributes of the country not only disease but also the geographic and, primarily, cultural distance separating the coast from the sertão.

The article analyzes reports from two scientific journeys into the Amazon conducted by the Instituto Oswaldo Cruz, in 1910 and 1913, under the leadership of Oswaldo Cruz and Carlos Chagas, respectively. These reports contributed to the construction of representations and images of the region. Field observations not only provided data for the study and control of tropical diseases but also had a hand in the movement to denounce the serious sanitation conditions under which rubber workers labored. Journeys through the Amazon valley put the scientists in direct contact with the environment and with sick populations; these travels also made them face the huge challenges of learning about malaria and trying to control it. Analyses of these reports are part of studies on 'portraits of Brazil', which raise issues within the history of public health policies. In this endeavor to reveal the process by which scientific records are constructed, we worked with primary sources,from manuscripts to official texts.

Studies on the normal pattern of development and post-natal maturation of the recurrent laryngeal nerve in rats are scanty. The aim of the present study was to investigate the normal microscopic aspects of the recurrent laryngeal nerve myelinated fibers in the post-natal developing rat, with special attention to longitudinal morphology and lateral symmetry. Fifteen male rats were divided into experimental groups according to age 20, 55, 76, 150 and 250 days. A female group aged between 76 and 150 days was also used. Right and left RLN were studied by light microscopy at proximal, medium and distal segments and morphometric data comparisons were made between sides, segments, ages and gender. Our results showed that the left recurrent laryngeal nerves were significantly longer than the right in all ages studied and this difference increased with ageing. There was a slight decrease in the myelinated fiber number, according to proximal to distal gradient, but a significant decrease was observed only on older animals (ages 55 (both sides), 76 (left side), and 150 (left side) days). This difference was also observed for female rats (left side). No differences between ages were observed. There was an age-dependent difference on ranges and histograms form (younger animals showed a unimodal histogram while older animals showed a bimodal one), with no significant differences between segments or sides, in all groups studied. Also, no differences between males and females of the same age were observed. In conclusion, the RLN alters its morphology due to development and ageing and the present study describe normal patterns of the recurrent laryngeal nerve development in rats that can be useful for a better understanding of pathological alterations on experimental neuropathies involving the laryngeal nerves.

Public health in Brazil achieved remarkable development at the turn of the 20th century thanks in part to physicians and social thinkers who made it central to their proposals for "modernizing" the country. Public health was more than a set of medical and technical measures; it was fundamental to the project of nation building. I trace the interplay between public health and social ideas in the late 19th and early 20th centuries. Physicians and social thinkers challenged the traditional belief that Brazil's sociocultural and ethnic diversity was an obstacle to modernization, and they promoted public health as the best prescription for national unity. Public health ideas in developing countries such as Brazil may have a greater impact when they are intertwined with social thought and with the processes of nation building and construction of a modern society.

While Robert Merton approached the issue form the perspective of "scientific ethos" and Thomas Kuhn, from the perspective of "paradigm/normal science," this comparative analysis of these two author's conceptions of the social nature of science suggests that their views merged particularly when they argued that taking values into account was essential to understanding scientific activities. Placing prime importance on the notion of scientific community, these authors both analyze science as a practice which is defined and developed out of a set of beliefs, principles, and norms shared by a given collectivity. While there were some substantive differences between Merton's and Kuhn's outlooks - each had his own unique way of defining 'social' in the context of science - a comparison of their work underlines the importance of seeing institutionalized beliefs and values as essential in guiding the concrete actions of scientists.