Ultrasound Plane Pose Regression: Assessing Generalized Pose Coordinates in the Fetal Brain.

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 2.97 mm and 6.63° for translation and rotation, respectively.

Probe motion during mid-trimester fetal anomaly scan in the clinical setting: A prospective observational study.

INTRODUCTION: This study aims to investigate probe motion during full mid-trimester anomaly scans. METHODS: We undertook a prospective, observational study of obstetric sonographers at a UK University Teaching Hospital. We collected prospectively full-length video recordings of routine second-trimester anomaly scans synchronized with probe trajectory tracking data during the scan. Videos were reviewed and trajectories analyzed using duration, path metrics (path length, velocity, acceleration, jerk, and volume) and angular metrics (spectral arc, angular area, angular velocity, angular acceleration, and angular jerk). These trajectories were then compared according to the participant level of expertise, fetal presentation, and patient BMI. RESULTS: A total of 17 anomaly scans were recorded. The average velocity of the probe was 12.9 ± 3.4 mm/s for the consultants versus 24.6 ± 5.7 mm/s for the fellows (p = 0.02), the average acceleration 170.4 ± 26.3 mm/s2 versus 328.9 ± 62.7 mm/s2 (p = 0.02), and the average jerk 7491.7 ± 1056.1 mm/s3 versus 14944.1 ± 3146.3 mm/s3 (p = 0.02), the working volume 9.106 ± 4.106 mm3 versus 29.106 ± 11.106 mm3 (p = 0.03), respectively. The angular metrics were not significantly different according to the participant level of expertise, the fetal presentation, or to patients BMI. CONCLUSION: Some differences in the probe path metrics (velocity, acceleration, jerk and working volume) were noticed according to operator's level.

Temporal trend of food consumption markers, breakfast consumption and association with overweight/obesity in schoolchildren aged 7 to 10 years between 2007 and 2019.

Obesity has a multifactorial origin. Among the behavioural risk factors, excessive consumption of unhealthy foods, skipping breakfast and reduced physical activity stand out. The main objective of this article was to identify trends in dietary habits and their association with overweight/obesity over a 12-year period in schoolchildren aged 7 to 10 years in Florianópolis, southern Brazil. A cross-sectional panel analysis study, using anthropometric, sociodemographic, physical activity and food consumption data of schoolchildren aged 7 to 10 years, collected in three waves of the Study of Prevalence of Obesity in Children and Adolescents (EPOCA), carried out during the years 2007, 2012/2013 and 2018/2019, was performed. To analyse the trend in dietary variables over the years, the 95% CIs were compared with the non-overlap of intervals indicating statistical significance. Multiple logistic regression analysis was performed to test the association of weight status with dietary markers. The prevalence of overweight/obesity was 34.4%, 37.2% and 34.2% in 2007, 2012/2013 and 2018/2019, respectively, and there were no statistically significant differences among waves. There was a progressive and significant reduction in the consumption of soft drinks and sweets and in eating breakfast by schoolchildren, from 2007 to 2019. Breakfast consumption was inversely associated with the chance of overweight/obesity (OR 0.74, 95% CI 0.59-0.93), and female students were less likely to have overweight/obesity when compared to boys (OR 0.70, 95% CI 0.61-0.81). The reduction in the consumption of soft drinks and sweets over the years might be caused by efforts in public policies that intended to reduce the consumption of unhealthy foods among schoolchildren. The progressive and significant reduction in having breakfast should be better elucidated in future studies, to minimise the potential impact of this practice on schoolchildren's bodyweight.

Seeking arrangements: cell contact as a cleavage-stage biomarker.

RESEARCH QUESTION: What can three-dimensional cell contact networks tell us about the developmental potential of cleavage-stage human embryos? DESIGN: This pilot study was a retrospective analysis of two Embryoscope imaging datasets from two clinics. An artificial intelligence system was used to reconstruct the three-dimensional structure of embryos from 11-plane focal stacks. Networks of cell contacts were extracted from the resulting embryo three-dimensional models and each embryo's mean contacts per cell was computed. Unpaired t-tests and receiver operating characteristic curve analysis were used to statistically analyse mean cell contact outcomes. Cell contact networks from different embryos were compared with identical embryos with similar cell arrangements. RESULTS: At t4, a higher mean number of contacts per cell was associated with greater rates of blastulation and blastocyst quality. No associations were found with biochemical pregnancy, live birth, miscarriage or ploidy. At t8, a higher mean number of contacts was associated with increased blastocyst quality, biochemical pregnancy and live birth. No associations were found with miscarriage or aneuploidy. Mean contacts at t4 weakly correlated with those at t8. Four-cell embryos fell into nine distinct cell arrangements; the five most common accounted for 97% of embryos. Eight-cell embryos, however, displayed a greater degree of variation with 59 distinct cell arrangements. CONCLUSIONS: Evidence is provided for the clinical relevance of cleavage-stage cell arrangement in the human preimplantation embryo beyond the four-cell stage, which may improve selection techniques for day-3 transfers. This pilot study provides a strong case for further investigation into spatial biomarkers and three-dimensional morphokinetics.

Learning-based keypoint registration for fetoscopic mosaicking.

PURPOSE: In twin-to-twin transfusion syndrome (TTTS), abnormal vascular anastomoses in the monochorionic placenta can produce uneven blood flow between the two fetuses. In the current practice, TTTS is treated surgically by closing abnormal anastomoses using laser ablation. This surgery is minimally invasive and relies on fetoscopy. Limited field of view makes anastomosis identification a challenging task for the surgeon. METHODS: To tackle this challenge, we propose a learning-based framework for in vivo fetoscopy frame registration for field-of-view expansion. The novelties of this framework rely on a learning-based keypoint proposal network and an encoding strategy to filter (i) irrelevant keypoints based on fetoscopic semantic image segmentation and (ii) inconsistent homographies. RESULTS: We validate our framework on a dataset of six intraoperative sequences from six TTTS surgeries from six different women against the most recent state-of-the-art algorithm, which relies on the segmentation of placenta vessels. CONCLUSION: The proposed framework achieves higher performance compared to the state of the art, paving the way for robust mosaicking to provide surgeons with context awareness during TTTS surgery.

Dietary patterns and biochemical markers related to diabetes mellitus: an association analysis based on data from the Study of Cardiovascular Risk in Adolescents (ERICA).

OBJECTIVE: The aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age. METHODS: Dietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations. RESULTS: Three dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (ß = -0.76; P = 0.005) and HbA1c in the second and third tertiles (ß = -0.04; P = 0.002; ß = -0 .06; P < 0.001), and the Western pattern with HbA1c (ß = -0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (ß = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (ß = 0.11; P = 0.012). CONCLUSIONS: This study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.

Trends in the prevalence of obesity, overweight, and thinness among schoolchildren aged 7-14 years from southern Brazil (2002-2019).

OBJECTIVE: To analyze the obesity, overweight, and thinness trends among Brazilian schoolchildren by sex, age group, and type of school according to World Health Organization (WHO) and International Obesity Task Force (IOTF) criteria. METHODS: We conducted four surveys between 2002 and 2018/19 involving schoolchildren aged 7-14 years from a state capital in southern Brazil. Weight status was classified using both WHO and IOTF criteria. RESULTS: In the total sample, obesity prevalence based on the IOTF and the WHO criteria were 72% and 44% higher in 2018/19 compared with 2002, respectively. Over the whole period, the obesity prevalence increased among children (WHO: 10.1% vs. 14.1%; IOTF: 5.0% vs. 8.3%), and those from public schools (WHO: 10.5% vs. 16.4%; IOTF: 5.6% vs. 10.1%). There was no significant reduction in thinness prevalence over the analyzed period. CONCLUSION: Obesity prevalence remains on an upward trend in a state capital in southern Brazil, especially among children from public schools. A higher prevalence of overweight and obesity was observed using the WHO criteria compared with IOTF criteria.

Findings of evaluative research on the Brazilian Food and Nutritional Security System: A scoping review from 2006 to 2022 / Resultados de pesquisas avaliativas sobre o Sistema Nacional de Segurança Alimentar e Nutricional: uma revisão de escopo de 2006 a 2022

ABSTRACT Objective This study analyzes the results of evaluative research on the Brazilian Food and Nutritional Security System. Method Was conducted a scoping review by collecting information from four bibliographic databases: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), and Web of Science. Three researchers systematically selected the studies and extracted data. The researchers categorized the studies included according to an evaluative approach to the topics of financing, social participation, decentralization and government management, and monitoring and evaluation. Results Were found 1,987 references, 17 of which were selected for analysis. It is presented the evaluation of the System and of its public policy as a developing field permeated by different types of research and methods and which needs to be better qualified in relation to its theoretical and methodological approaches. The results and recommendations of the studies analyzed point out important elements to guide decision-making in relation to the System and its public policy. Conclusion In view of the recent weakening of the governance structure of this public policy at a national level, this study contributes to the debate on food and nutritional security and its reintegration into the Brazilian governmental agenda.

RESUMO Objetivo Este estudo analisou os resultados de pesquisas avaliativas sobre o Sistema Nacional de Segurança Alimentar e Nutricional no Brasil. Método Foi realizado uma revisão a partir da coleta de informações em quatro bancos de dados bibliográficos: Scientific Electronic Library Online (SciELO), Latin American and Caribbean Literature in Health Sciences (LILACS), National Library of Medicine (MEDLINE/PubMed), e Web of Science. Três pesquisadores selecionaram sistematicamente os estudos e extraíram os dados. Os pesquisadores categorizaram os estudos incluídos de acordo com uma abordagem avaliativa sobre os temas de financiamento, participação social e controle, descentralização e gestão governamental, e monitoramento e avaliação. Resultado Foram encontradas 1.987 referências, das quais 17 foram selecionadas para análise. Apresenta-se a avaliação do Sistema e de sua política pública como um campo em desenvolvimento permeado por diferentes tipos de pesquisa e métodos, e que precisa ser mais bem qualificado em relação às suas abordagens teóricas e metodológicas. Os resultados e recomendações dos estudos analisados apontam elementos importantes para orientar a tomada de decisão em relação ao Sistema e sua política pública. Conclusão Diante da recente fragilização da estrutura de governança dessa política pública em nível nacional, este estudo contribui para o debate sobre segurança alimentar e nutricional e sua reinserção na agenda governamental brasileira.

Placental vessel segmentation and registration in fetoscopy: Literature review and MICCAI FetReg2021 challenge findings.

Fetoscopy laser photocoagulation is a widely adopted procedure for treating Twin-to-Twin Transfusion Syndrome (TTTS). The procedure involves photocoagulation pathological anastomoses to restore a physiological blood exchange among twins. The procedure is particularly challenging, from the surgeon's side, due to the limited field of view, poor manoeuvrability of the fetoscope, poor visibility due to amniotic fluid turbidity, and variability in illumination. These challenges may lead to increased surgery time and incomplete ablation of pathological anastomoses, resulting in persistent TTTS. Computer-assisted intervention (CAI) can provide TTTS surgeons with decision support and context awareness by identifying key structures in the scene and expanding the fetoscopic field of view through video mosaicking. Research in this domain has been hampered by the lack of high-quality data to design, develop and test CAI algorithms. Through the Fetoscopic Placental Vessel Segmentation and Registration (FetReg2021) challenge, which was organized as part of the MICCAI2021 Endoscopic Vision (EndoVis) challenge, we released the first large-scale multi-center TTTS dataset for the development of generalized and robust semantic segmentation and video mosaicking algorithms with a focus on creating drift-free mosaics from long duration fetoscopy videos. For this challenge, we released a dataset of 2060 images, pixel-annotated for vessels, tool, fetus and background classes, from 18 in-vivo TTTS fetoscopy procedures and 18 short video clips of an average length of 411 frames for developing placental scene segmentation and frame registration for mosaicking techniques. Seven teams participated in this challenge and their model performance was assessed on an unseen test dataset of 658 pixel-annotated images from 6 fetoscopic procedures and 6 short clips. For the segmentation task, overall baseline performed was the top performing (aggregated mIoU of 0.6763) and was the best on the vessel class (mIoU of 0.5817) while team RREB was the best on the tool (mIoU of 0.6335) and fetus (mIoU of 0.5178) classes. For the registration task, overall the baseline performed better than team SANO with an overall mean 5-frame SSIM of 0.9348. Qualitatively, it was observed that team SANO performed better in planar scenarios, while baseline was better in non-planner scenarios. The detailed analysis showed that no single team outperformed on all 6 test fetoscopic videos. The challenge provided an opportunity to create generalized solutions for fetoscopic scene understanding and mosaicking. In this paper, we present the findings of the FetReg2021 challenge, alongside reporting a detailed literature review for CAI in TTTS fetoscopy. Through this challenge, its analysis and the release of multi-center fetoscopic data, we provide a benchmark for future research in this field.

SurgT challenge: Benchmark of soft-tissue trackers for robotic surgery.

This paper introduces the "SurgT: Surgical Tracking" challenge which was organized in conjunction with the 25th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2022). There were two purposes for the creation of this challenge: (1) the establishment of the first standardized benchmark for the research community to assess soft-tissue trackers; and (2) to encourage the development of unsupervised deep learning methods, given the lack of annotated data in surgery. A dataset of 157 stereo endoscopic videos from 20 clinical cases, along with stereo camera calibration parameters, have been provided. Participants were assigned the task of developing algorithms to track the movement of soft tissues, represented by bounding boxes, in stereo endoscopic videos. At the end of the challenge, the developed methods were assessed on a previously hidden test subset. This assessment uses benchmarking metrics that were purposely developed for this challenge, to verify the efficacy of unsupervised deep learning algorithms in tracking soft-tissue. The metric used for ranking the methods was the Expected Average Overlap (EAO) score, which measures the average overlap between a tracker's and the ground truth bounding boxes. Coming first in the challenge was the deep learning submission by ICVS-2Ai with a superior EAO score of 0.617. This method employs ARFlow to estimate unsupervised dense optical flow from cropped images, using photometric and regularization losses. Second, Jmees with an EAO of 0.583, uses deep learning for surgical tool segmentation on top of a non-deep learning baseline method: CSRT. CSRT by itself scores a similar EAO of 0.563. The results from this challenge show that currently, non-deep learning methods are still competitive. The dataset and benchmarking tool created for this challenge have been made publicly available at https://surgt.grand-challenge.org/. This challenge is expected to contribute to the development of autonomous robotic surgery and other digital surgical technologies.

Omega-3 and omega-6 fatty acids food intake and metabolic syndrome in adolescents 12 to 17 years old: A school-based cross-sectional study.

BACKGROUND & AIMS: Fatty acids (FAs) of the omega-3 and omega-6 family are considered essential, and adequate intake seems to be associated with lower risk of developing chronic non-communicable diseases. The objective was to evaluate the association of omega-3 and omega-6 FAs dietary intake with the prevalence of MS and its components waist circumference (WC), blood pressure (BP), fasting blood glucose, triglycerides and High Density Lipoprotein - cholesterol (HDL-c) in Brazilian adolescents aged 12-17 years. METHODS: This is a school-based cross-sectional investigation, using data from the Study of Cardiovascular Risks in Adolescents (ERICA), carried out between 2013 and 2014. The following variables were collected and assessed: 1) sociodemographic (sex, age, type of school, school location whether urban or rural and region of the country); 2) food consumption was measured through a 24-h Food Recall (24 hR), and a second 24 hR was applied to 7% of the total sample; 3) anthropometrics (weight, height, WC), BP and biochemical (glycemia, triglycerides and HDL-c) were also assessed. Logistic regression analysis was performed according to gender and age group. RESULTS: A total of 36,751 adolescents participated in the study. The intake of omega-3 FAs in the total population was 1.71 g/day and of omega-6 FAs, 13.56 g/day, with an omega-6/omega-3 ratio of 7.93:1. It was found that higher intake of omega-3 FAs was associated with an 53% lower chance of low HDL-c. For omega-6 FAs, no significant results were found. CONCLUSIONS: The findings indicated an association between omega-3 FAs and HDL-c. More studies are needed to elucidate the effects of omega-6 FAs.

A Temporal Learning Approach to Inpainting Endoscopic Specularities and Its Effect on Image Correspondence.

Video streams are utilised to guide minimally-invasive surgery and diagnosis in a wide range of procedures, and many computer-assisted techniques have been developed to automatically analyse them. These approaches can provide additional information to the surgeon such as lesion detection, instrument navigation, or anatomy 3D shape modelling. However, the necessary image features to recognise these patterns are not always reliably detected due to the presence of irregular light patterns such as specular highlight reflections. In this paper, we aim at removing specular highlights from endoscopic videos using machine learning. We propose using a temporal generative adversarial network (GAN) to inpaint the hidden anatomy under specularities, inferring its appearance spatially and from neighbouring frames, where they are not present in the same location. This is achieved using in-vivo data from gastric endoscopy (Hyper Kvasir) in a fully unsupervised manner that relies on the automatic detection of specular highlights. System evaluations show significant improvements to other methods through direct comparison and ablation studies that depict the importance of the network's temporal and transfer learning components. The generalisability of our system to different surgical setups and procedures was also evaluated qualitatively on in-vivo data of gastric endoscopy and ex-vivo porcine data (SERV-CT, SCARED). We also assess the effect of our method in comparison to other methods on computer vision tasks that underpin 3D reconstruction and camera motion estimation, namely stereo disparity, optical flow, and sparse point feature matching. These are evaluated quantitatively and qualitatively and results show a positive effect of our specular inpainting method on these tasks in a novel comprehensive analysis. Our code and dataset are made available at https://github.com/endomapper/Endo-STTN.

Physical environment of the operating room during cesarean section: A systematic review.

INTRODUCTION: Environmental factors in the operating room during cesarean sections are likely important for both women/birthing people and their babies but there is currently a lack of rigorous literature about their evaluation. The principal aim of this study was to systematically examine studies published on the physical environment in the obstetrical operating room during c-sections and its impact on mother and neonate outcomes. The secondary objective was to identify the sensors used to investigate the operating room environment during cesarean sections. METHODS: In this literature review, we searched MEDLINE a database using the following keywords: Cesarean section AND (operating room environment OR Noise OR Music OR Video recording OR Light level OR Gentle OR Temperature OR Motion Data). Eligible studies had to be published in English or French within the past 10 years and had to investigate the operating room environment during cesarean sections in women. For each study we reported which aspects of the physical environment were investigated in the OR (i.e., noise, music, movement, light or temperature) and the involved sensors. RESULTS: Of a total of 105 studies screened, we selected 8 articles from title and abstract in PubMed. This small number shows that the field is poorly investigated. The most evaluated environment factors to date are operating room noise and temperature, and the presence of music. Few studies used advanced sensors in the operating room to evaluate environmental factors in a more nuanced and complete way. Two studies concern the sound level, four concern music, one concerns temperature and one analyzed the number of entrances/exits into the OR. No study analyzed light level or more fine-grained movement data. CONCLUSIONS: Main findings include increase of noise and motion at specific time-points, for example during delivery or anaesthesia; the positive impact of music on parents and staff alike; and that a warmer theatre is better for babies but more uncomfortable for surgeons.

Association between dietary patterns and biomarkers in connection with diabetes mellitus in adolescents: A systematic review.

AIMS: To perform a systematic review to investigate the association between adolescents' a posteriori dietary patterns with diabetes-related biomarkers (fasting blood glucose, fasting insulinemia, glycated hemoglobin and homeostatic model assessment insulin resistance index (HOMA-IR)). DATA SYNTHESIS: Review registered with PROSPERO under number CRD42020185369. Studies with adolescents aged 10-19 years that identified dietary patterns by a posteriori methods were included. The databases used included: PubMed, SCOPUS, Web of Science, Food Science and Technology Abstracts, CINAHL, SPORTDiscus, Lilacs/BVS, The Cochrane Central Register of Controlled Trials, ProQuest Dissertations&Theses Global and Capes Theses Bank and Brazilian Digital Library of Theses and Dissertations. Risk of bias was assessed via the Agency for Healthcare Research and Quality tool. Eight cross-sectional studies that evaluated 6438 adolescents (55.5% females) were included. For fasting blood glucose, the results were inconsistent and some studies found no association for the dietary patterns called traditional (57%), Western (42%) and healthy (28%). For the fasting insulinemia and HOMA-IR outcomes, the Western dietary pattern showed a positive association or higher means in 60% and 50% of the studies, respectively. No studies that evaluated glycated hemoglobin were found. CONCLUSION: Fasting insulinemia and HOMA-IR outcomes were positively associated with the Western dietary patterns. The studies reviewed did not present consistent evidence of an association with western, healthy and traditional dietary patterns with fasting blood glucose, as the results were conflicting or did not show statistical significance.

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents.

OBJECTIVE: To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments. METHODS: Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics. RESULTS: Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome. CONCLUSIONS: Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Robust endoscopic image mosaicking via fusion of multimodal estimation.

We propose an endoscopic image mosaicking algorithm that is robust to light conditioning changes, specular reflections, and feature-less scenes. These conditions are especially common in minimally invasive surgery where the light source moves with the camera to dynamically illuminate close range scenes. This makes it difficult for a single image registration method to robustly track camera motion and then generate consistent mosaics of the expanded surgical scene across different and heterogeneous environments. Instead of relying on one specialised feature extractor or image registration method, we propose to fuse different image registration algorithms according to their uncertainties, formulating the problem as affine pose graph optimisation. This allows to combine landmarks, dense intensity registration, and learning-based approaches in a single framework. To demonstrate our application we consider deep learning-based optical flow, hand-crafted features, and intensity-based registration, however, the framework is general and could take as input other sources of motion estimation, including other sensor modalities. We validate the performance of our approach on three datasets with very different characteristics to highlighting its generalisability, demonstrating the advantages of our proposed fusion framework. While each individual registration algorithm eventually fails drastically on certain surgical scenes, the fusion approach flexibly determines which algorithms to use and in which proportion to more robustly obtain consistent mosaics.

Methodological aspects and characteristics of participants in the study on the prevalence of obesity in children and adolescents in Florianópolis, Southern Brazil, 2018-2019: EPOCA study.

PURPOSE: To describe the methodological aspects and characteristics of the participants of the EPOCA survey. METHODS: The study was conducted with schoolchildren aged between seven to 14 years old from 30 schools in Florianópolis, Southern Brazil. Body mass, height, girths, and skinfold thicknesses were measured. Food consumption and physical activity from the previous day were self-reported using the validated Web-CAAFE questionnaire. Adolescents completed a specific questionnaire about physical activity, meal consumption, and weight control behaviors. Parents/guardians responded to a sociodemographic and habits questionnaire. RESULTS: A total of 1671 schoolchildren participated in the study (response rate: 27.2%). About 63% of schoolchildren were enrolled in public schools. Most studied in the morning shift (54.2%), were female (53.1%) and aged between seven and 10 years (58.1%). The prevalence of overweight was 33.7% and obesity was 11.3%. CONCLUSIONS: The data obtained will allow us to assess the trend in the prevalence of overweight and obesity and associated factors when compared to other surveys performed. Descriptions of the logistics and protocols can help in the development and improvement of similar studies. It is hoped that the results of EPOCA 2018/2019 may help in the design of obesity prevention policies and programs for this population.

Presença de desertos alimentares em um distrito sanitário de uma capital brasileira: um estudo descritivo e exploratório sobre a distribuição espacial de estabelecimentos comerciais de alimentos / Food deserts in a health district of a Brazilian capital: a descriptive and exploratory study on the spatial distribution of commercial food establishments

Introdução: O ambiente alimentar que a comunidade está inserida pode influenciar, positiva ou negativamente no acesso à alimentação de qualidade e consequentemente na sua saúde. Objetivo: Identificar a presença de desertos alimentares em um distrito sanitário de uma capital brasileira. Métodos: Estudo descritivo, transversal e exploratório, utilizando dados secundários de diferentes fontes institucionais para mapear a distribuição espacial de estabelecimentos de comercialização de alimentos: restaurantes, padarias, supermercados, minimercados/mercearias, hortifrutigranjeiros, vendedores ambulantes e lanchonetes/fastfood. Os estabelecimentos foram agrupados nas categorias in natura, ultraprocessados e mistos, de acordo com a predominância do tipo de alimentos comercializados. Para a análise, a densidade de estabelecimentos in natura juntamente com os mistos por mil habitantes (usuários cadastrados nos centros de saúde) foram calculadas.  Resultados: Foram investigados 111 estabelecimentos, sendo 20% que comercializavam alimentos in natura (saudáveis), 27% alimentos ultraprocessados (não saudáveis) e 53% considerados mistos. Conclusões: Foram observadas áreas que podem ser consideradas desertos alimentares, locais onde há pouca (ou ausência) de oferta de alimentos in natura, e por consequência dificultando o acesso a alimentos saudáveis.

Introduction: The communities' food environment can positively or negatively influence access to quality food and consequently, people's health. Objective: Identify the presence of food deserts in a health district of a Brazilian capital. Methods: Descriptive, cross-sectional and exploratory study, using secondary data from different institutional sources to map the spatial distribution of food establishments such as restaurants, bakeries, supermarkets, minimarkets/grocery stores, fruit and vegetable stores, street vendors and cafeterias/fast food. The establishments were grouped into fresh, ultra-processed and mixed food categories, according to the predominance of the type of food offered. For the purpose of analysis, the density of fresh food establishments together with mixed food establishments per thousand inhabitants (as registered in the health centers) was calculated.  Results: A total of 111 establishments were investigated, 20% selling fresh foods (healthy), 27% ultra-processed foods (unhealthy) and 53% considered mixed food sellers. Conclusions: Areas that can be considered food deserts were found, i.e. places where there is little (or absence) of fresh food supply, and consequently making access to healthy foods difficult.

I Plano Municipal de Segurança Alimentar e Nutricional de Duque de Caxias (2017-2020): uma avaliação com base no ciclo das políticas públicas / I Duque de Caxias, Brazil, Municipal Plan for Food and Nutrition Security (2017-2020): an assessment based on the public policy cycle

Introdução: O I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN) é uma ferramenta de planejamento, gestão e implementação da Política de Segurança Alimentar e Nutricional. Em Duque de Caxias, RJ, o I PLAMSAN foi sancionado em 2016. Objetivo: Realizar avaliação do I PLAMSAN-DC (2017-2020), utilizando como procedimentos metodológicos uma aproximação do "Ciclo de Políticas Públicas". Métodos: Estudo de avaliação usando elementos da ferramenta "ciclo de políticas públicas" com base nos seguintes procedimentos metodológicos: 1) Análise documental; 2) Revisão de literatura; 3) Avaliação do cumprimento das metas com base nas respostas advindas das Secretarias que compõem a Câmara Intersetorial de Segurança Alimentar e Nutricional. Resultados: Verificou-se que, dentre as 42 metas do Plano, 14,7% foram cumpridas, 34,1% foram parcialmente cumpridas, e 51,2% não foram cumpridas. Conclusões: Observou-se que ainda não há acentuado papel por parte do nível municipal para a concretude de inúmeras ações que necessitam de recursos financeiros. Além disso, verifica-se a necessidade de superação de entraves, sobretudo em relação ao alcance da intersetorialidade e fortalecimento das estruturas componentes do sistema de segurança alimentar e nutricional.

Introduction: The I Plano Municipal de Segurança Alimentar e Nutricional (PLAMSAN, I Municipal Plan for Food and Nutrition Security) is a planning, managing and implementing tool of the Food and Nutrition Security Policy. In Duque de Caxias, RJ, the I PLAMSAN was sanctioned in 2016. Objective: To carry out an evaluation of the I PLAMSAN-DC (2017-2020), using as methodological procedures an approximation of the "Public Policies Cycle". Methods: Evaluation study using elements of the "Public Policies Cycle" tool based on the following methodological procedures: 1) Document analysis; 2) Literature review; 3) Assessment of achievement of goals based on responses from the secretariats that make up the Intersectoral Chamber for Food and Nutrition Security. Results: Among the 42 goals of the Plan, 14.7% were met, 34.1% were partially met, and 51.2% were not met. Conclusions: The municipality still does not play an important role in the implementation of a number of food and nutrition initiatives that require financial resources. In addition, there is a need to overcome barriers, especially in terms of achieving intersectoriality and of strengthening the structures that make up the food and nutrition security system.