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"Cunha, Carla"
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The inflammatory response in the regression of lumbar disc herniation
2018
Lumbar disc herniation (LDH) is highly associated with inflammation in the context of low back pain. Currently, inflammation is associated with adverse symptoms related to the stimulation of nerve fibers that may lead to pain. However, inflammation has also been indicated as the main factor responsible for LDH regression. This apparent controversy places inflammation as a good prognostic indicator of spontaneous regression of LDH. This review addresses the molecular and cellular mechanisms involved in LDH regression, including matrix remodeling and neovascularization, in the scope of the clinical decision on conservative versus surgical intervention. Based on the evidence, a special focus on the inflammatory response in the LDH context is given, particularly in the monocyte/macrophage role. The phenomenon of spontaneous regression of LDH, extensively reported in the literature, is therefore analyzed here under the perspective of the modulatory role of inflammation.
Journal Article
Emotion-focused therapy and forgiveness in the older population: Protocol for a feasibility randomized controlled trial
2026
Over recent decades, Emotion-Focused Therapy, aging, and forgiveness have garnered significant attention in the field of psychology. However, there is a lack of studies on Emotion-Focused Therapy and forgiveness specifically tailored for older adults. This article presents a protocol designed to assess the feasibility and acceptability of a randomized controlled trial of Emotion-Focused Therapy aimed at resolving emotional injuries in individuals aged 65 and older, within the context of interpersonal offenses. Feasibility will be evaluated through recruitment and retention rates, as well as adherence to the intervention protocol. Acceptability will be assessed based on perceived treatment credibility, participants’ expectations regarding outcomes, levels of engagement, and overall satisfaction with the intervention. The study is structured as a two-arm, parallel-group randomized trial with a waiting list control. We propose recruiting a sample of 70 participants, randomly assigned to either an immediate intervention group, which will receive Emotion-Focused Therapy over twelve weekly sessions, or a control group that will receive the same therapy after a twelve-week waiting period. Data will be collected in the beginning, middle, and at the end of therapy, and in two planned follow-ups (three and six months after therapy). Once this protocol is implemented, if the therapy proves to be feasible, acceptable, and shows promising results, the findings will inform a large-scale randomized clinical trial to advance the understanding of this treatment for individuals aged 65 + .
Journal Article
Quality of life assessment instruments for adults: a systematic review of population-based studies
by
Pequeno, Nila Patrícia Freire
,
Cabral, Natália Louise de Araújo
,
Lima, Severina Carla Vieira Cunha
in
Adults
,
Aging
,
Analysis
2020
Background
Against a backdrop of population aging and improving survival rates for chronic noncommunicable diseases (CNCD), researchers are placing growing emphasis on health-related quality of life (HRQoL). The aim of this study was to identify the QoL assessment instruments used in population-based studies with adults conducted around the world.
Methods
A systematic review of original research published in all languages between 2008 and 2018 was conducted. Systematic reviews and meta-analyses were excluded.
Results
Sixty-three articles (38.1% conducted in the Americas) fitted the eligibility criteria. Based on the AHRQ checklist for cross-sectional studies and the Newcastle-Ottawa scale for cohort studies, methodological quality was shown to be fair in the majority of studies (55.6%) and good in 44.4%. The country with the highest number of publications was Brazil (20.6%). Twelve types of generic instruments and 11 specific instruments were identified. The generic instrument SF-36 was the most frequently used measure (33.3% of studies). In-home interviewing was exclusively used by 47.6% of the studies, while 39 studies (61.9%) reported the use of self-administered questionnaires. Over two-thirds of the studies (34.9%) used questionnaires to investigate the association between chronic diseases and/or associated factors.
Conclusions
It was concluded that the wide range of instruments and modes of questionnaire administration used by the studies may hinder comparisons between population groups with the same characteristics or needs. There is a lack of research on QoL and the factors affecting productive capacity. Studies of QoL in older persons should focus not only on the effects of disease and treatment, but also on the determinants of active aging and actions designed to promote it. Further research is recommended to determine which QoL instruments are best suited for population-based studies.
Journal Article
A simple role for BDNF in learning and memory?
2010
Since its discovery almost three decades ago, the secreted neurotrophin brain-derived neurotrophic factor (BDNF) has been firmly implicated in the differentiation and survival of neurons of the CNS. More recently, BDNF has also emerged as an important regulator of synaptogenesis and synaptic plasticity mechanisms underlying learning and memory in the adult CNS. In this review we will discuss our knowledge about the multiple intracellular signalling pathways activated by BDNF, and the role of this neurotrophin in long-term synaptic plasticity and memory formation as well as in synaptogenesis. We will show that maturation of BDNF, its cellular localization and its ability to regulate both excitatory and inhibitory synapses in the CNS may result in conflicting alterations in synaptic plasticity and memory formation. Lack of a precise knowledge about the mechanisms by which BDNF influences higher cognitive functions and complex behaviours may constitute a severe limitation in the possibility to devise BDNF-based therapeutics for human disorders of the CNS.
Journal Article
A new approach to reduce the carbon footprint in resistance spot welding by energy efficiency evaluation
by
Cunha, Carla Ferreira Andrade
,
de Carvalho, Hugo Marcelo Bezerra
,
de Oliveira Gomes, Jefferson
in
Automobile industry
,
CAE) and Design
,
Carbon
2022
Actions aiming to reduce energy consumption directly contribute to the reduction of manufacturing costs and carbon footprint while supporting manufacturing processes’ productivity. Resistance spot welding is relevant in the automotive sector. Due to its operational characteristics, this process has high energy consumption. Despite this fact, few studies have found to guide solutions for its reduction. In this sense, this study proposes a method to improve the resistance spot welding process’s energy performance without compromising its quality. This study applies statistical analysis (ANOVA) to support predictive models that characterise energy and quality performance. The statistical analyses confirmed and quantified the influence of the control factors in energy and quality performance indicators. The predictive models made it possible to anticipate energy consumption and quality behaviour from adjustments in the welding line process parameters studied in this paper. To fit the best compromise between energy consumption and quality, energy labels to classify the process’s energy performance were proposed. The best compromise solution for the studied process parameter ranges in this work was as follows:
C
wel
= 8 kA,
T
wel
= 8 cycles, and
F
ele
= 3.3 kN. This parameter combination results in a consumption of approximately 2 Wh per spot weld. Approximately 33% less than the average estimated consumption per spot weld in the automotive industry.
Journal Article
Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis
by
Oliveira, Ana Marlúcia
,
Queiroz, Valterlinda A. de O.
,
Cunha, Carla de Magalhães
in
Adolescents
,
Anthropometry
,
blood glucose
2018
This study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (−0·41 kg/m²; 95 % CI −0·46,−0·36) and WC (−0·43 cm; 95 % CI −0·52,−0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.
Journal Article
Processed and ultra-processed foods are associated with high prevalence of inadequate selenium intake and low prevalence of vitamin B1 and zinc inadequacy in adolescents from public schools in an urban area of northeastern Brazil
by
Lima, Severina Carla Vieira Cunha
,
Falcão, Raphaela Cecília Thé Maia de Arruda
,
Sena-Evangelista, Karine Cavalcanti Maurício
in
Adolescent
,
Adolescent Nutritional Physiological Phenomena
,
Adolescents
2019
Changes in eating behavior of adolescents are associated with high consumption of processed and ultra-processed foods. This study evaluated the association between these foods and the prevalence of inadequate micronutrient intake in adolescents. A cross-sectional study was conducted with 444 adolescents from public schools in the city of Natal, northeastern Brazil. The adolescents' habitual food consumption was evaluated using two 24-hour dietary recalls. Foods were categorized according to the degree of processing (processed and ultra-processed) and distributed into energy quartiles, using the NOVA classification system. Inadequacies in micronutrient intake were assessed using the estimated average requirement (EAR) as the cutoff point. Multivariate logistic regression models were used to estimate the relationship between energy percentage from processed and ultra-processed foods and prevalence of inadequate micronutrient intake. The mean (Standard Deviation (SD)) consumption of total energy from processed foods ranged from 5.8% (1.7%) in Q1 to 20.6% (2.9%) in Q4, while the mean consumption of total energy from ultra-processed foods ranged from 21.4% (4.9%) in Q1 to 61.5% (11.7%) in Q4. The rates of inadequate intake of vitamin D, vitamin E, folate, calcium, and selenium were above 80% for both sexes across all age groups. Energy consumption from processed foods was associated with higher prevalence of inadequate selenium intake (p < 0.01) and lower prevalence of inadequate vitamin B1 intake (p = 0.04). Energy consumption from ultra-processed foods was associated with lower prevalence of inadequate zinc and vitamin B1 intake (p < 0.01 and p = 0.03, respectively). An increase in the proportion of energy obtained from processed and ultra-processed foods may reflect higher prevalence of inadequate selenium intake and lower prevalence of vitamin B1 and zinc inadequacy.
Journal Article
Influence of sugar consumption from foods with different degrees of processing on anthropometric indicators of children and adolescents after 18 months of follow-up
by
de Santana, Mônica Leila Portela
,
Barreto, Jamile Rafaela Pereira da Silva
,
Cunha, Carla de Magalhães
in
Abdomen
,
Adolescent
,
Adolescents
2022
Excessive consumption of ultra-processed foods is associated with the development of metabolic changes in children and adolescents. However, the consumption of total sugars, monosaccharides and disaccharides present in these ultra-processed foods and other food groups and its association with anthropometric indicators must be evaluated. Therefore, this study aimed at analysing the influence of sugar consumption from foods with different degrees of processing on anthropometric indicators of children and adolescents after 18 months of follow-up. This cohort study was conducted among 492 children and adolescents aged 7–15 years. Information on food consumption and anthropometry was collected during three follow-up stages. NOVA classification was used for food categorisation. The influence of sugar consumption on the variation of anthropometric measurements over time was evaluated using generalised estimation equation models. During the analysis period, for each increase of 1 g/d in the consumption of total sugars and monosaccharides from ultra-processed foods, there was an increase of 0·002 kg/m2 (P = 0·030) and 0·001 kg/m2 (P = 0·019) in BMI/Age; increase of 0·073 (P < 0·001), 0·032 (P < 0·001) and 0·100 (P < 0·001) in the BMI/Age z-score; and increase of 0·001 cm (P = 0·001), 0·001 cm (P = 0·003) and 0·003 cm (P < 0·001) in waist circumference, with the consumption of total sugars, monosaccharides and disaccharides, respectively. Our study findings support the evidence that the consumption of total sugars, monosaccharides and disaccharides from ultra-processed foods is associated with weight gain and abdominal fat in children and adolescents, which may represent an important risk factor for excess weight in this age group.
Journal Article
Restrained eating behaviour, anorexia nervosa and food consumption between children and adolescents: a scoping review
by
de Santana, Mônica Leila Portela
,
Costa, Priscila Ribas de Farias
,
Santos Belfort, Érika
in
Adolescent
,
Adolescents
,
Anorexia
2022
Anorexia nervosa (AN) and restrained eating behaviour (REB) are characterised by reduced food intake to achieve body weight loss. This scope review aimed to describe the existing evidence on the association between AN, restrictive eating behaviour and food consumption. Studies with children and adolescents of both sexes of all races and ethnicities were included. Experimental and observational studies, systematic reviews, meta-analysis, case reports or series, conference abstracts, dissertations and theses were also included. The search was conducted in ten electronic databases and grey literature without language restriction on 14 November 2020. Twenty-four studies met the inclusion criteria. Most studies included girls and identified lower intake of energy content, fat and certain micronutrients. There was also a higher intake of caffeine, fibre, vegetables, legumes and fruits and a lower intake of low-quality snack, fast food, sweets and foods with high carbohydrate and fat contents. The need to improve the quality of the diet among study participants was also identified. Thus, it is recommended that the evaluation of food consumption be careful to develop effective prevention strategies for the development of AN/REB and minimise nutritional deficiencies in these individuals.
Journal Article
Energy Performance of the Iron Ore Mining Sector in Brazil in the Period from 2011 to 2020
by
Santos, Yolacir Carlos de Souza
,
Cunha, Carla César Martins
in
Engineering
,
Materials Engineering
,
Metallic Materials
2025
Mining is an important Brazilian industrial sector and, like many others, requires large amounts of energy for its operation. However, the disclosure of information within this sector, specifically related to energy, is often combined with pelletizing data, which hinders the analysis of the sector in a disaggregated manner. In this context, this study aimed to analyze the energy performance of the Brazilian iron ore mining sector from 2011 to 2020. Due to the lack of disaggregated data disclosure, primary information from the National Mining Agency was used, obtained from the regulated sector based on the submission of Annual Mining Reports. By collecting and processing individual data from each mining complex regarding the use of diesel and electrical energy, it was possible to analyze the energy consumption of the iron ore mining sector and estimate it in a disaggregated manner between the mining and beneficiation sectors. The study concluded that there was an increase in energy consumption (51%) over the period studied and identified that the majority of energy expenditure was due to the use of diesel oil. Using consolidated energy performance indicators in the mineral sector, this study found a trend of increasing energy requirements for iron ore production over the study period (33% increase in mining, 39% increase in beneficiation, and 41% overall). This trend was explained by the decline in ore grades, increased stripping ratio, and longer mean transportation distances, all of which contribute to higher energy consumption in mining and beneficiation processes.
Journal Article