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Background There is general agreement that sexuality is a central aspect of human development; it is key in sexual health and reproductive education during adolescence. However, in spite of the existing interventions on this topic and the evidence generated, the inclusion of a gender focus in sexuality is relatively recent and there is little evidence available, thus structured and corroborated interventions with a gender-transforming perspective in sexuality are required. Methods We will use a mixed method experimental design with a parallel cluster-randomized trial (GRTs) that will evaluate the effectiveness of a comprehensive gender-transformative intervention of sexual education (ENFOCATE -Focus-on-), which will be complemented with qualitative studies to understand the implementation process. The participants will be 609 10 th and 11 th -grade students. The randomization will be by grade, and the data will be collected at three moments (pre-intervention, post-intervention, and a 3-month follow-up). Discussion Comprehensive, gender-focused, and culturally pertinent interventions in sexuality are needed for adolescents of countries with high, middle, and low incomes. These produce better results in terms of sexual health, and including a gender-transformative focus contributes to equity in health. Focus-on is unique since it uses a comprehensive gender-transformative intervention in sexual education that will allow putting into practice a program based both on international evidence and that which arises from the object population. It also uses a culturally-sensitive focus, since it is designed based on the characteristics of the object population; it will allow adapting some activities to the needs of the context in which it is developed. Trial registration The study was prospectively registered on June 6, 2023, at ClinicalTrials.gov ID: NCT05896540. Protocol version number 1.0. May 22, 2023.

This study analyzed the relation between Subjective Well-Being, Adverse Childhood Experiences and Mental Health in Chilean children and adolescents. It evaluated the cumulative effect of adverse experienses and subjective well-being. The sample included 2699 children and adolescents from 11 municipal educational establishments of the Antofagasta Region, Chile. All were in the 6 th to 12 th grades; 52.1% (n = 1405) identified as female; ages ranged from 11 to 17 years (Mean = 14.35 years, SD = 1.82). We evaluated Well-Being, Adversities and Mental Health with the Kidscreen-27, Inventary of Adversities and PSC-17, respectively. We used Student t-tests for independent samples and one-way ANOVA for comparisons. Pearson product-moment coefficients were used to estimate the level of association between two or more variables. The results showed significant differences in all dimensions of subjective well-being between those who presented some adversity and those who did not. The cumulative effect of adversities was associated with poor well-being, and mental health was favored when the subjective well-being was higher. We discuss the relation between well-being, adversities and mental health in Chilean children and adolescents.

This study focused on (1) establishing whether levels of mental health measured through behavioral dimensions varied according to the presence or absence of adverse childhood experiences, (2) distinguish which adverse experiences identified and evaluated in a school context predicted risks to mental health in children, and (3) assessing the cumulative effect of adverse experiences on children’s mental health. The design was a cross-sectional survey. It used a sample of 14,957 students in the 1st and 3rd year of elementary school participating in a national mental health program, who were measured on variables related to mental health and adverse experiences. The data were analyzed using Student’s t test, one-way ANOVA, and multiple linear regression models. The results showed that mental health levels are less favorable in those students who had been exposed to more psychosocial adversities and that teacher assessments regarding the child’s behavior and academic progress were the strongest predictor of mental health difficulties. The importance of detecting adversities in the school context and how this should guide school mental health interventions implemented by a public program nationwide are discussed.

Frame-based stereotactic localization generally assumes that all required fiducials are present in a single-slice image which can then be used to form targeting coordinates. Previously, we have published the use of novel localizers and mathematics that can improve stereotactic localization. As stereotactic procedures include numerous imaging slices, we sought to investigate, develop, and test techniques that utilize multiple slices for stereotactic localization and provide a solution for a parallel bipanel N-localizer.  Several multi-slice equations were tested. Specifically, multi-slice stereotactic matrices (ms-SM) and multi-slice normal to parallel planes (ms-nPP) were of particular interest. Bipanel (2N) and tripanel (3N) localizer images were explored to test approaches for stereotactic localization. In addition, combination approaches using single-slice stereotactic matrices (ss-SM) and multi-slice methods were tested. Modification of ss-SM to form ms-SM was feasible. Likewise, a method to determine ms-nPP was developed. For the special case of the parallel bipanel N-localizer, single-slice and multi-slice methods fail, but a novel non-linear solution is a robust solution for ms-nPP. Several methods for single-slice and multi-slice stereotactic localization are described and can be adapted for nearly any stereotactic system. It is feasible to determine ms-SM and ms-nPP. In particular, these methods provide an overdetermined means to calculate the vertical z, which is determined for a tripanel system using single-slice methods. In addition, the multi-slice methods can be used for extrapolation outside of the localizer space. Importantly, a novel non-linear solution can be used for parallel bipanel N-localizer systems, where other methods fail. Finally, multi-slice stereotactic localization assumes strict patient and imaging system stability, which should be carefully assessed for each case.

Image-guidance for frame-based stereotaxis is facilitated by incorporating three to four N-localizers or Sturm-Pastyr localizers into a stereotactic frame. An extant frame that incorporates only two N-localizers violates the fundamental principle of the N-localizer, which requires three non-colinear points to define a plane in three-dimensional space. Hence, this two N-localizer configuration is susceptible to error. The present article proposes the V-localizer that comprises multiple diagonal bars to provide four or more non-colinear points to minimize error.Image-guidance for frame-based stereotaxis is facilitated by incorporating three to four N-localizers or Sturm-Pastyr localizers into a stereotactic frame. An extant frame that incorporates only two N-localizers violates the fundamental principle of the N-localizer, which requires three non-colinear points to define a plane in three-dimensional space. Hence, this two N-localizer configuration is susceptible to error. The present article proposes the V-localizer that comprises multiple diagonal bars to provide four or more non-colinear points to minimize error.

Split-type C1 lateral mass fractures have a propensity for progressive fracture displacement. Since almost all cases end up showing progressive fragment diastasis, many authors recommend early surgical treatment. However, placing a C1 lag screw through a C1 split fracture is a challenging task. To overcome this, we designed a patient-custom three-dimensional (3D)-printed guide plate. We present the case of a 57-year-old female patient with a C1 lateral mass split fracture. Considering the amount of fragment translation, primary osteosynthesis was proposed. To purchase both fragments, placement of a lag screw was assisted intraoperatively by a custom 3D-printed composite guide plate, which enabled us to accurately place the screw. After an uneventful procedure, the patient was discharged from hospital after 72 h. Computed tomography scan performed at 12 months showed good fracture consolidation. The use of a patient-specific guide to place a lag screw through a split fracture of the atlas proved to be a safe, accurate, and inexpensive alternative to intraoperative imaging integrated with image-guided surgery.

 Frame-based stereotaxis has been widely utilized for precise neurosurgical procedures throughout the world for nearly 40 years. The N-localizer is an integral component of most of the extant systems. Analysis of targeting errors related to the N-localizer has not been carried out in sufficient detail. We highlight these potential errors and develop methods to reduce them.  Methods: N-localizer systems comprising three and four N-localizers of various geometries were analyzed using Monte Carlo (MC) simulations. The simulations included native and altered geometric dimensions (Width [W] x Height [H]). Errors were computed using the MC simulations that included the x- and y-axes of vertically oriented rods, that altered the W/H ratio, and that added a fourth N-localizer to a three N-localizer system.  Results: The inclusion of an overdetermined system of equations and the geometries of the N-localizer systems had significant effects on target errors. Root Mean Square Errors (RMS-e) computed via millions of MC iterations for each study demonstrated that errors were reduced by (1) inclusion of the x- and y-coordinates of the vertically oriented rods, (2) a greater triangular area enclosed by the diagonal fiducials of the N-localizer system (stereotactic triangle), (3) a larger W/H ratio, and (4) an N-localizer system that comprised four N-localizers. Monte Carlo simulations of Root Mean Square error (RMS-e) is a useful technique to understand targeting while using N-localizer systems in stereotactic neurosurgery. The application of vertical rod positions enhances computational accuracy and can be performed on any N-localizer system. Keeping the target point within the stereotactic triangle enclosed by the diagonal rods can also reduce errors. Additional optimizations of N-localizer geometry may also reduce potential targeting errors. Further analysis is needed to confirm these findings which may have clinical importance.

The N-localizer is generally utilized in a 3-panel or, more rarely, a 4-panel system for computing stereotactic positions. However, a stereotactic frame that incorporates a 2-panel (bipanel) N-localizer system with panels affixed to only the left and right sides of the frame offers several advantages: improved ergonomics to attach the panels, reduced claustrophobia for the patient, mitigation of posterior panel contact with imaging systems, and reduced complexity. A bipanel system that comprises two standard N-localizer panels yields only two three-dimensional (3D) coordinates, which are insufficient to solve for the stereotactic matrix without further information. While additional information to determine the stereotactic positions could include scalar distances from Digital Imaging and Communications in Medicine (DICOM) metadata or 3D regression across the imaging volume, both have risks related to noise and error propagation. Therefore, we sought to develop new stereotactic localizers that comprise only lateral fiducials (bipanel) that leave the front and back regions of the patient accessible but that contain enough information to solve for the stereotactic matrix using each image independently. Methods: To solve the stereotactic matrix, we assumed the need to compute three or more 3D points from a single image. Several localizer options were studied using Monte Carlo simulations to understand the effect of errors on the computed target location. The simulations included millions of possible combinations for computing the stereotactic matrix in the presence of random errors of 1mm magnitude. The matrix then transformed coordinates for a target that was placed 50mm anterior, 50mm posterior, 50mm lateral, or 50mm anterior and 50mm lateral to the centre of the image. Simulated cross-sectional axial images of the novel localizer systems were created and converted into DICOM images representing computed tomography (CT) images. Results: Three novel models include the M-localizer, F-localizer, and Z-localizer. For each of these localizer systems, optimized results were obtained using an overdetermined system of equations made possible by more than three diagonal bars. In each case, the diagonal bar position was computed using standard N-localizer mathematics. Additionally, the M-localizer allowed adding a computation using the Sturm-Pastyr method. Monte Carlo simulation demonstrated that the Z-localizer provided optimal results.INTRODUCTIONThe N-localizer is generally utilized in a 3-panel or, more rarely, a 4-panel system for computing stereotactic positions. However, a stereotactic frame that incorporates a 2-panel (bipanel) N-localizer system with panels affixed to only the left and right sides of the frame offers several advantages: improved ergonomics to attach the panels, reduced claustrophobia for the patient, mitigation of posterior panel contact with imaging systems, and reduced complexity. A bipanel system that comprises two standard N-localizer panels yields only two three-dimensional (3D) coordinates, which are insufficient to solve for the stereotactic matrix without further information. While additional information to determine the stereotactic positions could include scalar distances from Digital Imaging and Communications in Medicine (DICOM) metadata or 3D regression across the imaging volume, both have risks related to noise and error propagation. Therefore, we sought to develop new stereotactic localizers that comprise only lateral fiducials (bipanel) that leave the front and back regions of the patient accessible but that contain enough information to solve for the stereotactic matrix using each image independently. Methods: To solve the stereotactic matrix, we assumed the need to compute three or more 3D points from a single image. Several localizer options were studied using Monte Carlo simulations to understand the effect of errors on the computed target location. The simulations included millions of possible combinations for computing the stereotactic matrix in the presence of random errors of 1mm magnitude. The matrix then transformed coordinates for a target that was placed 50mm anterior, 50mm posterior, 50mm lateral, or 50mm anterior and 50mm lateral to the centre of the image. Simulated cross-sectional axial images of the novel localizer systems were created and converted into DICOM images representing computed tomography (CT) images. Results: Three novel models include the M-localizer, F-localizer, and Z-localizer. For each of these localizer systems, optimized results were obtained using an overdetermined system of equations made possible by more than three diagonal bars. In each case, the diagonal bar position was computed using standard N-localizer mathematics. Additionally, the M-localizer allowed adding a computation using the Sturm-Pastyr method. Monte Carlo simulation demonstrated that the Z-localizer provided optimal results.The three proposed novel models meet our design objectives. Of the three, the Z-localizer produced the least propagation of error. The M-localizer was simpler and had slightly more error than the Z-localizer. The F-localizer produced more error than either the Z-localizer or M-localizer. Further study is needed to determine optimizations using these novel models.CONCLUSIONThe three proposed novel models meet our design objectives. Of the three, the Z-localizer produced the least propagation of error. The M-localizer was simpler and had slightly more error than the Z-localizer. The F-localizer produced more error than either the Z-localizer or M-localizer. Further study is needed to determine optimizations using these novel models.

La finalidad del presente estudio fue indagar acerca del nivel de sentido de comunidad percibido en los contextos escolares y su relación con el bienestar y la salud mental de adolescentes escolarizados; considerando además el género como categoría relevante. Participaron 2839 estudiantes provenientes de 11 establecimientos educacionales municipales de Calama (Chile), quienes cursaban entre 6o. básico y 4o. medio, y cuyas edades fluctuaban entre 11 y 18 años. Se evaluó el sentido de comunidad, el nivel de bienestar y las dificultades en salud mental a través de los instrumentos SCI-2, Kidscreen-27 y PSC-17, respectivamente. Para el análisis de datos se efectuaron pruebas t de student, ANOVA de un factor y regresiones lineales múltiples. los resultados muestran que el sentido de comunidad, el bienestar y la salud mental son mejores en estudiantes que cursan enseñanza básica y en aquellos de género masculino. También se encontró que el sentido de comunidad predice el bienestar como la salud mental en adolescentes. Para concluir se reflexiona acerca de la relevancia del sentido de comunidad en el bienestar y la salud mental de adolescentes escolarizados.

Categorical data analysis offers valuable tools for evaluating school-based prevention programs, yet these methods remain rarely applied in cyberbullying research. This literature review examined how categorical approaches, including contingency tables and related techniques, have been used in studies evaluating school-based cyberbullying prevention. A comprehensive search was conducted in Web of Science covering publications from 2020 to 2025, yielding 100 articles. After applying predefined inclusion and exclusion criteria, 24 studies were reviewed in full, of which 8 met all requirements for final analysis. The results revealed a predominant reliance on linear statistical techniques, such as t-tests, ANOVA, and regression models, applied mainly to continuous variables. By contrast, categorical analyses were seldom employed. The chi-square test appeared as the most frequent approach, but its use was generally restricted to descriptive purposes, with little application of complementary methods such as standardized residuals, effect size measures, or logistic models. This restricted application reduced the ability to capture response patterns, subgroup differences, and categorical associations essential for evaluating program outcomes. The findings highlight a methodological gap in cyberbullying prevention research and emphasize the potential of categorical data analysis to enrich interpretation. Incorporating these methods could increase methodological rigor, reveal nuanced behavioral patterns, and provide actionable evidence for educators, policymakers, and program designers seeking to strengthen school-based prevention strategies.