Health advocacy, as defined by the widely used CanMEDS framework of medical competencies, involves far more than treating the patient in front of you. It requires physicians to recognize health needs that patients themselves may never voice, to mobilize resources on their behalf, and to promote changes that advance health equity in collaboration with individuals and communities. In a country like Brazil, where the constitutionally guaranteed Unified Health System (SUS) was built on the principle of universal, comprehensive care, this competency carries particular weight. The country’s National Curriculum Guidelines for medical education explicitly emphasize comprehensive care across all levels of the health system, and they call for the development of ethical, critical, and socially engaged professionals. Still, the study’s authors note that translating these aspirations into actual teaching practice remains a persistent challenge for medical educators everywhere.

To understand how advocacy is actually taught — or not taught — the research team, led by Mariana Eri Sato of FMUSP’s Primary Health Care Supervision unit together with Márcia Oliveira Mayo Soares and Milton Arruda Martins, turned to a qualitative, hermeneutic approach. Rather than surveying a large sample with fixed questions, the researchers convened a focus group with eleven professors drawn from six different specialties: Gynecology and Obstetrics, Pediatrics, Psychiatry, Preventive Medicine, Internal Medicine, and Family and Community Medicine. Crucially, every participant was actively engaged in teaching primary health care to undergraduates, meaning the discussion captured the perspectives of the very faculty members tasked with delivering this content. The session was audio-recorded, fully transcribed, and then analyzed through comprehensive interpretive reading, a technique in which researchers immerse themselves in the material to identify recurring analytical categories. Those categories were subsequently interpreted in light of established theoretical frameworks in medical education, and the study received ethics approval from the Research Ethics Committee of FMUSP’s Hospital das Clínicas, with informed consent obtained from all participants.

The single most consistent theme to emerge from the discussion was the difficulty of teaching students to identify health needs that go beyond the explicit demands patients bring into the consultation room. A patient may present with back pain, for example, while the underlying issue is unsafe housing, unemployment, food insecurity, or untreated depression that the patient never mentions. Learning to see these hidden dimensions — and to connect the care of one individual patient to the collective health of the community they belong to — is, in the professors’ view, the central educational challenge of advocacy. It demands a fundamental shift in clinical reasoning, from the classic biomedical model that asks ‘what disease explains this symptom?’ to a broader question: ‘what social and structural forces are shaping this person’s health, and what can I do about them?’

For all these difficulties, the participants were remarkably unified on one point: primary health care is a privileged setting for learning advocacy. Unlike a hospital ward, where patients appear as isolated cases stripped of context, primary care embeds future doctors in communities over time. Students working in primary care settings witness firsthand how social determinants of health — income, education, sanitation, access to transport — translate into disease and suffering. They see families across generations, follow patients through the consequences of policy decisions, and encounter the gap between what the health system promises and what it delivers. In the Brazilian context, where SUS organizes care around territorial responsibility and community engagement, primary care offers an almost laboratory-like environment for observing the interplay between medicine and society.

Yet the professors also identified a sobering institutional reality: the contribution of primary health care to the curriculum is often undervalued. Within the culture of academic medicine, where high-technology hospital specialties traditionally command prestige, the intellectual and social richness of community-based teaching can be dismissed as secondary. This devaluation is not merely symbolic. It shapes how resources are allocated, how teaching time is protected, and how seriously students take their primary care rotations. When the institutional signal suggests that advocacy and community health are peripheral concerns, students absorb that message regardless of what the official curriculum says.

Indeed, the study’s most consequential finding concerns the nature of the obstacles themselves. The professors did not point primarily to pedagogical problems — a lack of teaching techniques, materials, or know-how. Instead, the barriers they identified were institutional: curricular fragmentation that slices learning into disconnected blocks, assessment systems that fail to measure advocacy competencies at all, and the hidden curriculum, the unwritten norms and values that students absorb by watching what is rewarded and what is ignored. Curricular fragmentation is particularly corrosive for advocacy, because advocacy is inherently integrative; it requires students to bridge clinical care, public health, ethics, and social analysis, precisely the connections that fragmented curricula tend to sever. And assessment gaps matter enormously in competency-based education, because what is not tested is, in practice, not taught. If students are never evaluated on their ability to recognize unvoiced health needs or mobilize community resources, they quickly learn that these skills are optional.

The hidden curriculum deserves particular attention because it operates beneath the level of formal instruction. Students learn from what their teachers model, from the jokes told in the corridor, from which rotations are described as ‘real medicine’ and which are treated as boxes to tick. If hospital-based, procedure-oriented faculty implicitly convey that advocacy is soft or political work unworthy of a serious physician, no amount of lecture content on social determinants will counteract that message. Conversely, the study suggests, the same mechanism can work in favor of advocacy when it is made deliberate: faculty who visibly advocate for their patients, who name the social forces behind a clinical problem, and who treat community engagement as core medical work transmit a powerful counter-message.

That is precisely where the study’s conclusions offer grounds for optimism. The participants identified a set of strategies already embedded in primary health care teaching at FMUSP that could serve as underrecognized vehicles for developing advocacy: role modeling by engaged faculty, the Person Centered Clinical Method (PCCM), small-group learning, and reflective portfolios. Each of these tools, the researchers argue, already pushes students beyond the biomedical gaze. The Person Centered Clinical Method explicitly trains students to explore the patient’s illness experience, context, and goals, creating natural openings for identifying unvoiced needs. Small-group learning allows students to discuss difficult cases collectively and to practice articulating the collective dimensions of health. Reflective portfolios ask students to make their values and observations explicit, turning tacit experience into conscious learning. The problem is not that these methods fail to teach advocacy; it is that nobody has named them as advocacy teaching, and so their contribution goes unrecognized, unsupported, and unassessed.

The study’s practical implication is therefore deceptively simple: make the invisible visible. By explicitly framing existing primary care teaching practices as health advocacy education, aligning assessment systems with that framing, and securing institutional support for community-based teaching, medical schools could embed advocacy across the curriculum without inventing new courses from scratch. For a world grappling with widening health inequities, aging populations, and the mounting burden of diseases rooted in social conditions, the stakes extend well beyond one Brazilian institution. The FMUSP professors’ experience suggests that the future of advocacy in medicine may depend less on adding content than on recognizing, rewarding, and protecting the teaching that is already happening — often in the least glamorous corners of the medical school, where students first learn what it truly means to stand up for a patient.

Subject of Research: Teaching health advocacy competency in primary health care medical education

Article Title: Teaching health advocacy in primary health care: a qualitative study with professors from the University of São Paulo medical school

Article References: Sato, M. E., Soares, M. O. M., & Martins, M. A. (2026). Teaching health advocacy in primary health care: a qualitative study with professors from the University of São Paulo medical school. BMC Medical Education. https://doi.org/10.1186/s12909-026-10587-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10587-y

Keywords: medical education, health advocacy, primary health care, qualitative research, social determinants of health, competency-based education, CanMEDS framework, hidden curriculum, Brazilian Unified Health System, University of São Paulo, curriculum reform, faculty perspectives

The scale of the problem the researchers are targeting is enormous. According to estimates by the World Health Organization, malaria was responsible for approximately 600,000 deaths in 2024, and Célia Regina da Silva Garcia, a professor in the Department of Clinical and Toxicological Analysis at FCF-USP, notes that an estimated 90 percent of those deaths are caused by P. falciparum. Effective treatments for malaria do exist, but the parasite has progressively developed resistance to frontline drugs such as chloroquine and artemisinin, the backbone of current therapy in most endemic regions. That erosion of drug efficacy has made the search for new chemical classes of antimalarials a global priority, and it is precisely the gap that the São Paulo team’s work is designed to fill.

The strategy the researchers pursued is known as drug repurposing, an approach that has gained traction across infectious disease research because it exploits compounds whose pharmacology, safety profiles, and synthetic routes are already partly understood. Rather than screening millions of novel chemicals, repurposing starts with molecules validated for another indication and asks whether they also act against a new target organism. In this case, the team synthesized and tested fourteen derivatives of an antineoplastic, or cancer-treating, drug against P. falciparum parasites cultured in the laboratory. The in vitro experiments were funded by the São Paulo Research Foundation (FAPESP) through a series of research grants and fellowships supporting the laboratory’s long-running program on parasite cell biology and chemotherapy.

The results were striking in two respects. First, the molecules proved effective at killing the parasite during its asexual stage, the phase in which Plasmodium invades and reproduces inside human red blood cells and produces the cyclical fevers that define clinical malaria. A drug that clears asexual parasites is, by definition, a treatment: it addresses the disease in the symptomatic patient. Second, and arguably more important from a public health perspective, the compounds also acted against gametocytes, the specialized sexual-stage parasites that are taken up by Anopheles mosquitoes during a blood meal and that make onward transmission possible. A therapy that eliminates gametocytes would not only cure the individual patient but could also block the passage of the parasite from humans back into the mosquito vector, interrupting transmission chains at the community level.

This dual-stage activity is rare among antimalarial candidates. Most existing drugs are optimized for the blood-stage parasites and have little or no effect on mature gametocytes, which is one reason malaria transmission can persist even in treated populations. A single molecule class capable of both curing the patient and reducing infectivity to mosquitoes would be a valuable addition to the therapeutic arsenal, particularly in regions pursuing malaria elimination rather than mere control. The São Paulo findings, while still confined to laboratory cultures, indicate that the 6-anilinopurine scaffold underlying these compounds deserves serious attention as a platform for exactly that kind of transmission-blocking chemotherapy.

Underlying the antiparasitic effect, the researchers believe, is a specific molecular target inside the parasite’s cell: histone deacetylase enzymes, and in particular an enzyme known as PfHDAC1. Histone deacetylases regulate gene expression by modifying the proteins around which DNA is wound, and they have long been recognized as important drug targets in cancer chemotherapy, which helps explain why compounds designed as anticancer agents would show activity against a parasite. By inhibiting the parasite’s version of the enzyme, the derivatives appear to disrupt essential developmental programs in Plasmodium. Garcia explains that the team’s experiments have strengthened the hypothesis that histone deacetylase enzymes are an important therapeutic target for malaria, and that this understanding has allowed the group to design new molecules that are increasingly potent and selective against the parasite.

That structure-activity analysis is the second major contribution of the study. The fourteen tested derivatives varied in their chemical structure, and by comparing how those structural differences changed antiparasitic potency, selectivity, and target engagement, the team gathered the information needed for rational drug design. As Garcia describes it, rational design allows chemists to refine a molecule’s structure in a targeted manner rather than relying on trial and error. In practical terms, the researchers can now adjust side chains and functional groups to maximize inhibition of the parasite enzyme while minimizing interaction with human cells, a balancing act that determines whether a laboratory hit can ever become a safe medicine.

Safety, in fact, remains the central caveat. Because the work so far has been conducted entirely in vitro, the potential side effects of the compounds in patients have not yet been assessed. Some of the tested derivatives showed reduced efficacy against human cells while retaining their effect on the parasites, an encouraging sign of selectivity that suggests a lower risk of serious adverse effects. Nevertheless, Garcia is candid about the concerns: molecules in that class can cause fatigue, nausea, vomiting, and hematological changes such as a decrease in platelets, and she acknowledges that it is natural for such concerns to exist. Only in vivo tests, in animal models and eventually in clinical trials, can confirm whether the therapeutic window observed in culture dishes holds up in a living body.

There is also a pharmacological hurdle specific to this chemical class that the team must overcome. Drugs of this type tend to degrade rapidly inside the body, which can undermine their effectiveness regardless of how potent they are in a test tube. In vivo studies will therefore serve a second purpose beyond safety: verifying whether the candidate molecules remain chemically stable long enough in a patient’s circulation to reach and clear the parasite. Stability, selectivity, and potency together form the triad of criteria that any successor compound emerging from the group’s rational design program will need to satisfy before it can advance toward preclinical and clinical development.

Looking further ahead, Garcia’s team intends to extend its testing to other malaria-causing parasite species, most notably Plasmodium vivax, which is the predominant malaria parasite in Brazil and across much of the equatorial world. P. vivax poses distinct challenges: it can cause relapses even after treatment because it produces latent liver-stage forms called hypnozoites that can reactivate months later, and it is more widespread in equatorial countries than P. falciparum. Garcia emphasizes that evaluating antimalarial drug candidates against different parasite species is essential to ensure they are effective in the various regions of the world where malaria burden is concentrated. If the 6-anilinopurine derivatives, or the optimized molecules designed from them, prove active against multiple Plasmodium species and safe enough for human use, the cancer research toolbox may yet deliver one of the most sought-after prizes in tropical medicine: a single therapy that treats the sick and stops the spread.

Subject of Research: Repurposing anticancer 6-anilinopurine derivatives as dual-stage antimalarial compounds targeting Plasmodium falciparum histone deacetylase

Article Title: Anti-cancer molecules show promise in the fight against malaria

Article References: Anti-cancer molecules show promise in the fight against malaria. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: malaria, Plasmodium falciparum, drug repurposing, anticancer compounds, histone deacetylase, gametocytes, University of São Paulo, FAPESP, ACS Omega, drug resistance, Plasmodium vivax, rational drug design

The motivation behind the project is refreshingly practical. The São Paulo group had long relied on publicly available web applications to visualize the meteorological datasets that underpin much of their research, from railway maintenance studies to climate analytics. But those third-party tools kept falling short: missing weather variables, inadequate spatial coverage, and rigid interfaces that could not be tailored to the regions the scientists actually cared about. Rather than continue patching together imperfect solutions, the team decided to build its own application, one that would let them define custom areas of interest, add any climate variable their studies required, span wide date ranges, and produce graphics that clearly communicate atmospheric conditions.

What began as an in-house utility in the early 2020s has matured into something with far broader significance. In many parts of the world, establishing and maintaining a dense network of physical weather stations remains financially and logistically out of reach. For academic labs, educational institutions, and small non-governmental organizations, open-access numerical weather prediction datasets from global modeling centers are often the only continuous source of environmental information. Yet a stubborn gap separates the raw, high-volume data archives that agencies publish from the lightweight, real-time visual assets that non-specialists can actually use. DatavizAmz was designed to close that gap, offering spatial visualizations without heavy local server overhead or a dedicated geographic information systems engineering team.

Under the hood, the system is a study in elegant frugality. The backend is a Python script that taps into the National Oceanic and Atmospheric Administration’s open data dissemination program, pulling output from the Global Forecast System, the flagship American weather model. NOAA runs GFS in four daily cycles, initiated at 00:00, 06:00, 12:00, and 18:00 UTC, and each cycle generates forecasts stretching up to sixteen days into the future. The data arrive as GRIB2 files, a binary format standardized by the World Meteorological Organization that efficiently packs enormous volumes of georeferenced atmospheric grids but is notoriously difficult for ordinary software to handle. DatavizAmz decodes these files using the Herbie library together with the Xarray package, extracting only the two-dimensional surface slices the dashboard needs.

Herbie brings a clever trick to the table: instead of downloading an entire GRIB2 file, the library reads a remote index file that maps the exact byte offsets of every variable and atmospheric layer inside the binary container. It then issues targeted HTTP range requests to fetch only the specific fragments required, discarding the rest before transmission. If NOAA’s primary NOMADS servers are slow or down, Herbie automatically falls back to high-speed cloud mirrors hosted on Amazon Web Services or Google Cloud. This byte-level surgery keeps bandwidth costs low and storage footprints tiny. A complete forty-eight-hour visualization cycle for the team’s Amazon monitoring region produces a payload of roughly sixteen megabytes, small enough that no persistent database system is needed at all.

The raw GFS grid arrives at a resolution of 0.25 degrees, which translates to a spacing of about twenty-eight kilometers near the equator. For the Amazon bounding box the team monitors, stretching from 4.125 degrees north to 12.125 degrees south and covering roughly twenty-eight degrees of longitude, that means an input matrix of just 66 by 114 grid points. To make the visuals seamless, the pipeline upsamples the grid by a factor of four, yielding an effective resolution of about seven kilometers and an output matrix of 264 by 456 pixels. Before resampling, a Gaussian filter with a standard deviation of 1.0 across a five-by-five kernel window strips out high-frequency noise. The choice of interpolation method is deliberately physics-aware: bicubic interpolation smooths continuous thermodynamic variables like temperature and relative humidity, while bilinear resampling is reserved for fluxes and vector quantities such as wind and precipitation, precisely to prevent non-artifacts like negative rainfall or phantom wind spikes near sharp gradients.

The most eye-catching feature of the dashboard is its particle-based wind animation, which renders the atmosphere as thousands of drifting streamlines over a satellite basemap. To achieve this without crushing browser performance, the system encodes wind velocity into the red and green channels of an ordinary PNG image, with the east-west and north-south components normalized across a range spanning minus forty to plus forty meters per second, equivalent to 144 kilometers per hour in each direction. When a frame loads, the JavaScript engine draws the image onto an offscreen canvas, scans the pixel array, decodes the byte values back into velocity vectors, and then sets 2,500 virtual particles loose across the grid. Each particle queries the decoded wind field at its location, advances, and leaves a color-coded streamline behind, while a semi-transparent overlay brush applied each frame creates the trailing fade that makes the flow feel continuous. The particle count is configurable, so users on older hardware can trade animation density for smoother frame rates.

The team did not simply trust the pipeline; they verified it quantitatively. Across 7,524 raw grid nodes, they measured the numerical distortion introduced by upsampling and smoothing. For two-meter temperature, the mean absolute error came out to 0.08 kelvin, with a root-mean-square error of 0.12 kelvin and a maximum local error below 0.45 kelvin along sharp frontal zones. Ten-meter wind velocity showed a mean absolute error of just 0.05 meters per second. Non-negativity constraints on precipitation are strictly enforced after interpolation, and the low-pass filtering damps extreme point peaks by less than 2.8 percent. Georeferencing was cross-validated against high-resolution vector lines of the Amazon mainstem and its major tributaries, confirming sub-pixel spatial registration with no coordinate system misalignment. Automated unit tests covering these checks ship with the repository.

There are honest limitations, and the authors enumerate them. The system is built around the deterministic single-run GFS model at its fixed 0.25-degree resolution, so it cannot capture fine-scale convective dynamics the way regional models can, and it does not visualize forecast uncertainty the way ensemble systems like GEFS would. The smoothing that makes the visuals beautiful also acts as a low-pass filter that slightly softens localized extremes. The pipeline depends on the continued availability of NOAA’s data endpoints and the upstream Herbie framework, and there is an inherent lag of roughly three and a half to four hours between each model cycle and the completion of data publication. The developers are candid that the upscaled, filtered outputs are intended for visual rendering only, not for generating novel high-resolution microclimate datasets or replacing raw model forecasts in quantitative meteorological budgeting.

Still, the implications reach well beyond one research group in São Paulo. Previous versions of DatavizAmz have supported the team’s projects since 2022, and by simply editing a handful of configuration variables, latitude and longitude bounds, zoom level, frame count, the team has already repurposed the system to monitor the state of São Paulo as easily as the Amazon. A live implementation runs on the university’s servers, displaying a rolling forty-eight-hour window of temperature, relative humidity, wind gusts, precipitation, and flowing wind particles. The authors sketch a roadmap for community contributions: archiving historical data with a date selector, an interactive click-and-drag region selector, additional climate variables, alternative forecast models, and an extended visualization horizon reaching the full sixteen days that GFS provides. For resource-constrained institutions watching flood seasons, droughts, or storm systems in data-sparse corners of the planet, an open-source window into the atmosphere may prove to be one of the most quietly consequential tools to emerge from the open weather data movement.

Subject of Research: An open-source meteorological data pipeline and interactive WebGIS dashboard for visualizing NOAA GFS forecast data in the Brazilian Amazon

Article Title: DatavizAmz: Operational pipeline and interactive web dashboard for high-definition meteorological visualization in the Brazilian Amazon

Article References: Gogliano Sobrinho, O., de Queiroz, W. D., Pizzigatti Corrêa, P. L., dos Santos Motta, R., Moraes Pereira, P. A., & Nascimento Maia, C. (2026). DatavizAmz: Operational pipeline and interactive web dashboard for high-definition meteorological visualization in the Brazilian Amazon. SoftwareX, 36, Article 103048. https://doi.org/10.1016/j.softx.2026.103048

Image Credits: AI Generated

DOI: 10.1016/j.softx.2026.103048

Keywords: DatavizAmz, Brazilian Amazon, NOAA, Global Forecast System, GRIB2, weather visualization, WebGIS, open-source software, Herbie, MapLibre, wind particle animation, University of São Paulo