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The first interactions among the embryo, endometrium, and corpus luteum (CL) are essential for pregnancy success. Small extracellular vesicles (sEVs) are part of these interactions. We previously demonstrated that sEVs from in vivo- or in vitro-produced bovine embryos contain different miRNA cargos. Herein we show: 1) the presence and origin (in vivo or in vitro) of the blastocyst differentially reprograms endometrial transcriptional profiles; 2) the endometrial explant (EE) cultured with in vivo or in vitro embryos release sEVs with different miRNA contents, and; 3) the luteal explant (CLE) exposed to these sEVs have distinct mRNA and miRNA profiles. To elucidate this, the EE were cultured in the presence or absence of a single Day-7 in vivo (EE-AI) or in vitro (EE-IVF) embryo. After of culture we found, in the EE, 45 and 211 differentially expressed genes (DEGs) associated with embryo presence and origin, respectively. SEVs were recovered from the conditioned media (CM) in which EE and embryos were co-cultured. Four miRNAs were differentially expressed between sEVs from CM-EE-AI and CM-EE-IVF. Luteal explants exposed in culture to these sEVs showed 1360 transcripts, and fifteen miRNAs differentially expressed. The DEGs associated with embryo presence and origin, modulating cells' proliferation, and survival. These results demonstrate that in vivo- or in vitro-produced bovine embryos induce molecular alterations in the endometrium; and that the embryo and endometrium release sEVs capable of modifying the mRNA and miRNA profile in the CL. Therefore, the sEVs-mediated embryo-endometrium-CL interactions possibly regulate the CL viability to ensure pregnancy success.

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This study explored the migration of follicular fluid (FF)-derived extracellular vesicles (EVs) of the uterine environment to the bloodstream and their interaction with neutrophils in vivo and in vitro. For the in vivo experiment, six Nellore heifers (Bos indicus) received an intrauterine infusion seven days after ovulation with 1X PBS only (sham group; n=1), 1X PBS stained with lipophilic dye PKH26 (control group; n=2), or FF-derived EVs stained with PKH26 (treated group; n=3). Plasma was collected at 0, 10, 30, 60-, 180-, 360-, 720-, and 1440-min post-infusion to obtained EVs for analysis by nano flow cytometry. Labeled EVs were present in the bloodstream at 30- and 60-min post-infusion in the treatment group. Additionally, plasma derived-EVs from all groups were positive for Calcein-AM, Alix, Syntenin, and Calnexin, which confirm the presence of EVs. The second experiment utilized the plasma-derived EVs from the heifers from 30 and 60 min timepoints to evaluate if neutrophils can uptake EVs in vitro. As results, it was possible to observe the presence of labeled EVs in neutrophils treated with plasma derived-EVs from the treatment group. In summary, our results suggest that labeled EVs can migrate from the uterine environment rapidly and interact with circulating immune cells in bovine.

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Progesterone (P4) is predicted to act as a negative regulatory hormone for oocyte maturation events; however, its local effects during follicular development remain poorly understood in bovine. The complex process of oocyte meiosis progression is dependent on cellular communication among follicular cells. Besides, the breakdown of this communication, mainly between cumulus cells (CC) and oocyte, through the retraction of cumulus projections connecting these cells can impact oocyte maturation. In our study, we observed that follicles from the ovary ipsilateral to the corpus luteum (CL) containing high intrafollicular P4 concentrations enhance the abundance of proteins detected in follicular-derived small extracellular vesicles (sEVs) predicted to be involved in the retraction of membrane projections based on actin filaments, such as transzonal projections (TZPs). Conversely, we found that follicles from the ovary contralateral to the CL, which contained low intrafollicular P4 concentrations, had a high detection of proteins predicted to regulate the maintenance of TZPs. We also performed RNAseq analysis which demonstrated that 177 genes were differentially expressed in CC under the different P4 environments. Bioinformatic analysis points to changes associated to cell metabolism in cells from follicles ipsilateral to the CL in comparison to genes involved in cell communication in CC from follicles contralateral to the CL. Our functional analysis experiment confirmed that supplementation of cumulus-oocyte complexes during in vitro maturation with P4 at concentration similar to ipsilateral follicles reduces the number of TZPs. In summary, our study underscores a direct association between P4 concentration and cumulus-oocyte interaction, with potential consequences for the acquisition of oocyte competence.

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BACKGROUND AND AIMS: Ovum pick-up (OPU) is an intrinsic step of in vitro fertilization procedures. Nevertheless, it can cause ovarian lesions and compromise female fertility in bovines. Recently, we have shown that intraovarian injection of adipose-derived mesenchymal stromal cells (AD-MSCs) effectively preserves ovarian function in bovines. Given that MSC-derived extracellular vesicles (MSC-EVs) have been shown to recapitulate several therapeutic effects attributed to AD-MSCs and that they present logistic and regulatory advantages compared to AD-MSCs, we tested whether MSC-EVs would also be useful to treat OPU-induced lesions. METHODS: MSC-EVs were isolated from the secretome of bovine AD-MSCs, using ultrafiltration (UF) and ultracentrifugation methods. The MSC-EVs were characterized according to concentration and mean particle size, morphology, protein concentration and EV markers, miRNA, mRNA, long noncoding RNA profile, total RNA yield and potential for induction of the proliferation and migration of bovine ovarian stromal cells. We then investigated whether intraovarian injection of MSC-EVs obtained by UF would reduce the negative effects of acute OPU-induced ovarian lesions in bovines. To do so, 20 animals were divided into 4 experimental groups (n = 5), submitted to 4 OPU cycles and different experimental treatments including vehicle only (G1), MSC-EVs produced by 7.5 × 106 AD-MSCs (G2), MSC-EVs produced by 2.5 × 106 AD-MSCs (G3) or 3 doses of MSC-EVs produced by 2.5 × 106 AD-MSCs, injected after OPU sessions 1, 2 and 3 (G4). RESULTS: Characterization of the MSC-EVs revealed that the size of the particles was similar in the different isolation methods; however, the UF method generated a greater MSC-EV yield. MSC-EVs processed by both methods demonstrated a similar ability to promote cell migration and proliferation in ovarian stromal cells. Considering the higher yield and lower complexity of the UF method, UF-MSC-EVs were used in the in vivo experiment. We evaluated three therapeutic regimens for cows subjected to OPU, noting that the group treated with three MSC-EV injections (G4) maintained oocyte production and increased in vitro embryo production, compared to G1, which presented compromised embryo production following the OPU-induced lesions. CONCLUSIONS: MSC-EVs have beneficial effects both on the migration and proliferation of ovarian stromal cells and on the fertility of bovines with follicular puncture injury in vivo.

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While cryopreservation of cauda epididymal sperm (SpCau) allows the preservation of post-mortem bulls' gametes, the process triggers sperm damage. Although improving post-thaw sperm quality, using egg yolk extenders (EY) raises biosafety concerns which forces the use of EY-free extenders (EYFE). Since EYFE are less efficient in preserving post-thaw sperm quality, a strategy for ejaculated sperm (SpEj) frozen with EYFE is to add an Equilibrium Time (ET) step period to the cryopreservation process. However, the ET effect on the quality of SpCau cryopreserved in EYFE remains unknown. Distinct from SpEJ, SpCau physiologically displays cytoplasmic droplets (CDs) in the flagellum that may benefit cell exchange during ET. We hypothesized that using ET in SpCau cryopreserved with EYFE impacts sperm morphofunctional features, CD area, and in vitro fertility ability. Extender nanoparticles were also assessed. Following collection from the cauda epididymis of six Nellore bulls by retrograde flow, SpCau were cryopreserved in EYFE BoviFree® (Minitube, Germany) using three ET protocols: ET0 (no-ET); ET2.5 (2.5 h-ET); and ET5 (5 h-ET). SpCau from ET2.5 and ET5 showed a higher (P ≤ 0.05) percentage of motility and integrity of plasma and acrosome membranes and a smaller (P ≤ 0.05) distal CD area. There are no differences in sperm abnormalities, oxidative stress, capacitation-like events, and in vitro fertility ability. However, a better sperm recovery was found after Percoll® selection for ET2.5 and ET5. Interestingly, the number of nanoparticles in the extender decreased in post-thawed samples. In conclusion, an ET of 2.5 or 5 h is required for an efficient SpCau cryopreservation using an EYFE.

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BACKGROUND: It is well described that circulating progesterone (P4) plays a key role in several reproductive events such as oocyte maturation. However, during diestrus, when circulating P4 is at the highest concentrations, little is known about its local impact on the follicular cells such as intrafollicular P4 concentration due to corpus luteum (CL) presence within the same ovary. Based on that, our hypothesis is that the CL presence in the ovary during diestrus alters intrafollicular P4 concentrations, oocyte competence acquisition, follicular cells gene expression, and small extracellular vesicles (sEVs) miRNAs contents. RESULTS: P4 hormonal analysis revealed that ipsilateral to the CL follicular fluid (iFF) presented higher P4 concentration compared to contralateral follicular fluid (cFF). Furthermore, oocyte maturation and miRNA biogenesis pathways transcripts (ADAMTS-1 and AGO2, respectively) were increased in cumulus and granulosa cells of iFF, respectively. Nevertheless, a RT-PCR screening of 382 miRNAs showed that three miRNAs were upregulated and two exclusively expressed in sEVs from iFF and are predicted to regulate cell communication pathways. Similarly, seven miRNAs were higher and two exclusively expressed from cFF sEVs and are predicted to modulate proliferation signaling pathways. CONCLUSION: In conclusion, intrafollicular P4 concentration is influenced by the presence of the CL and modulates biological processes related to follicular cell development and oocyte competence, which may influence the oocyte quality. Altogether, these results are crucial to improve our knowledge about the follicular microenvironment involved in oocyte competence acquisition.

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The Positive Mental Health Questionnaire (PMHQ) has been validated across various populations but has displayed diverse psychometric structures depending on the procedures used. The original version of the PMHQ includes 39 items organized into 6 factors, although there are reports that indicate a reduced structure of between 1 and 4 factors. The aim of this study was to assess the psychometric properties of the PMHQ with 1, 4 and 6 factors. A total of 360 healthcare workers aged 23 to 77 (M = 37.06; SD = 10.79) participated. Construct validity was assessed through confirmatory factor analysis using weighted root mean square residual. The original 6-factor (χ2/df: 3.40; RMSEA: 0.085; CFI: 0.913; TLI: 0.906) and a reduced 4-factor (χ2/df: 2.90; RMSEA: 0.072; CFI: 0.931; TLI: 0.926) structure showed acceptable fit. The fit of the 1-factor model was unacceptable. The internal consistency was evaluated through McDonald's ω, and it was acceptable for 4 of 6 factors of the original structure and for 3 of 4 factors of the reduced structure. In conclusion, these findings suggest that the 6-factor and 4-factor models are valid for measuring positive mental health. However, issues with internal consistency must be investigated.

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The aim of this study was to use latent profile analysis to identify specific profiles of burnout syndrome in combination with work engagement and to identify whether job satisfaction, psychological well-being, and other sociodemographic and work variables affect the probability of presenting a profile of burnout syndrome and low work enthusiasm. A total of 355 healthcare professionals completed the Spanish Burnout Inventory, the Utrecht Work Engagement Scale, the Job Satisfaction Scale, and the Psychological Well-Being Scale for Adults. Latent profile analysis identified four profiles: (1) burnout with high indolence (BwHIn); (2) burnout with low indolence (BwLIn); (3) high engagement, low burnout (HeLb); and (4) in the process of burning out (IPB). Multivariate logistic regression showed that a second job in a government healthcare institution; a shift other than the morning shift; being divorced, separated or widowed; and workload are predictors of burnout profiles with respect to the HeLb profile. These data are useful for designing intervention strategies according to the needs and characteristics of each type of burnout profile.

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The oocyte donor plays a pivotal role in bovine in vitro embryo production (IVP) success. The individual factor affects blastocyst/oocyte ratio and determine the existence of outstanding performing animals. The aim of this study was to assess the extent of individual factor effect to IVP efficiency, in a population of Gir oocyte donors. Extreme (high or low IVP efficiency based on blastocyst/oocyte ratio) animals were selected out of a population of 250 oocyte donors (1,734 observations) to form high (>0.48, n = 40), average (0.17-0.48, n = 168), and low (<0.17, n = 42) efficiency donor groups. Cumulus-oocyte complex indicators (total number, IVF-grade number, and IVF-grade/total ratio) were lower (p < 0.05) in high efficiency donors. The number of blastocysts per OPU was analyzed for highest performing bull, and an increase (p < 0.05) in high efficiency donors and a decrease (p < 0.05) in low efficiency donors were noticed, compared to average efficiency donors. The number of pregnancies obtained per OPU was affected (p = 0.017) by donor's efficiency (low: 0.60 ± 0.09 $$ 0.60\pm 0.09 $$ , average: 1.17 ± 0.07 $$ 1.17\pm 0.07 $$ , high: 2.57 ± 0.26 $$ 2.57\pm 0.26 $$ ), being 4.3-fold higher in high than in low efficiency donors. We conclude that producing embryos from high efficiency blastocyst/oocyte ratio donors increases blastocyst and pregnancy numbers by OPU, being an important indicator for donor selection in IVP programs.

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Despite the advances in in vitro embryo production (IVP) over the years, the technique still has limitations that need to be overcome. In cell cultures, it is already well established that three-dimensional culture techniques are more physiological and similar to the in vivo development. Liquid marble (LM) is a three-dimensional system based on the use of a hydrophobic substance to create in vitro microbioreactors. Thus, we hypothesized that the LM system improves bovine in vitro oocyte maturation and embryo culture. In experiment I, bovine cumulus-oocyte complexes (COCs) were placed for in vitro maturation for 22h in two different groups: control (conventional 2D culture) and LM (three-dimensional culture). We found that oocyte nuclear maturation was not altered by the LM system, however it was observed a decrease in expression of genes important in the oocyte maturation process in cumulus cells of LM group (BCL2, EIF4E, and GAPDH). In experiment II, the COCs were conventionally matured and fertilized, and for culture, they were divided into LM or control groups. There was a decrease in blastocyst rate and cell counting, a down-regulation of miR-615 expression, and an increase in the DNA global methylation and hydroxymethylation in embryos of LM group. Therefore, for the bovine in vitro embryo production, this specific three-dimensional system did not present the advantages that we expected, but demonstrated that the embryos changed their development and epigenetics according to the culture system.

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The stem cell-based research for reproductive biotechnology has been widely studied and shows promise for repairing defective tissue or degenerated cells to treat different diseases. The adipose tissue and amniotic membrane have awakened great interest in regenerative medicine and arises as a promising source of mesenchymal stem cells. Both types, adipose and amniotic derived mesenchymal stem cells (AMSCs) are multipotent cells with an enhanced ability to differentiate into multiple lineages.. We aimed to evaluate the effect of basal supplementation of exosomes in cell cultures with canine amniotic mesenchymal stem cells (MSCs). Mesenchymal stem cells derived from canine amniotic and adipose tissue were isolated and cultured performing cell passages until 80-90% confluence was reached. The growth curve was determined and peak cell growth was observed in the second passage. The cells were then characterized and differentiated into adipogenic, chondrogenic and osteogenic lineages. Extracellular vesicles from amnion were isolated using an ultracentrifugation protocol and characterized by nanosight analysis. To evaluate their ability to improve cellular viability in naturally inefficient passages, exosomes were co-cultures to the MSC cells. The results showed a 15-20% increase in the expansion rate of cultures supplemented with vesicles extracted in the first and second passages when compared to the control group. Statistical analysis using the Dunnett test (p ≤ 0.05) corroborated this result, showing a positive correlation between supplementation and expansion rate. These results indicate not only the importance of exosomes in the cell communication process but also the feasibility of the culture supplementation protocol for therapeutic purposes. The potential of the AMSCs for reproductive biotechnology is undoubted, however, their application to repair reproductive disorders and the involved mechanisms remain elusive. The strategies to enable the Adipose Stem Cells and AMSCs application in reproductive biotechnology and optimize their use for tissue regeneration open new venues using exosomes interactions.

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Aiming to evaluate the effects of increased body energy reserve (BER) in Nellore cows' reproductive efficiency, cows were fed with different nutritional plans to obtain animals with high BER (HBER; Ad libitum diet) and moderate BER (MBER: cows fed 70% of HBER group ingestion). To evaluate the BER, cows were weekly weighted and evaluated for subcutaneous fat thickness and insulin serum concentration along the experimental period. At the end of the experimental period, animals were submitted to estrous synchronization and artificial insemination. Animals were slaughtered approximately 120 h after ovulation induction and the reproductive tracts were collected for embryo recovery and samples collection. Cumulus-oocyte-complexes (COC) and follicular fluid were collected from 3-6 mm in diameter ovarian follicles to perform miRNA analysis of cumulus cells (CC) and extracellular vesicles from follicular fluid (EV FF). As expected, differences were observed among MBER and HBER groups for body weight, fat thickness, and insulin serum concentration. HBER animals showed lower ovulation and embryo recovery rates compared to MBER animals. Different miRNAs were found among CC and EV FF within groups, suggesting that the BER may influence follicular communication. This suggests that small follicles (3-6 mm diameter) are already under BER effects, which may be greater on later stages of follicular development.

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MicroRNAs (miRNAs) are small non-coding RNA molecules involved in the post-transcriptional regulation of specific mRNA targets, thus possibly controlling many biological processes. The miRNA profiling analysis can contribute to understanding several signaling pathways, as biomarkers for molecular diagnostic, as well as potential to be used as therapeutic targets. The miRNAs expression can be analyzed by quantitative reverse transcription PCR (RT-qPCR), microarrays, and RNA sequencing. The RT-qPCR method is sensitive and specific and has a lower cost when compared to other techniques as microarrays and RNA sequencing. Therefore, the protocol presented in this chapter describes step by step all the details to perform miRNA analysis using primer-based RT-qPCR.

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Introduction: The development of new biomaterials with improved properties is a trend in regenerative medicine. The successful healing of implants is related to their osseointegration and the topographic geometry of their surface. Treatment with argon plasma acts on the surface of the implants, bringing several benefits to their osseointegration in the body. Material and Methods: Previously the in vivo study, the topography implants were observed by scanning electron microscopy (SEM). Following the implants were inserted in 14 male rats, and one perforation was made in the right and left tibias for implant placement without the surface treatment (control group), and with the argon plasma surface treatment (experimental group), respectively. The rats were euthanized at 4 weeks, a time in which tibia fragments were submitted for histological and histomorphometric examination, and torque removal test for comparison and analysis of osseointegration. Results: The SEM images showed the argon plasma surface treatment altered the topography. At the end of the study, both greater bone formation and better osseointegration were verified in the experimental group, and a statistically significant difference between the groups was observed. Conclusion: It was concluded that implants with this surface treatment can bring more practicality in the rehabilitation treatment, and more comfort in the patients' postoperative time (AU)

Introdução: O desenvolvimento de novos biomateriais com propriedades aprimoradas é uma tendência na medicina regenerativa. A cicatrização bem-sucedida dos implantes está relacionada à sua osseointegração e à geometria topográfica de sua superfície. O tratamento com plasma de argônio atua na superfície dos implantes, trazendo diversos benefícios para sua osseointegração no corpo. Materiais e Métodos: Antes do estudo in vivo, a topografia dos implantes foi observada por microscopia eletrônica de varredura (MEV). Em seguida, os implantes foram inseridos em 14 ratos machos, e uma perfuração foi feita nas tíbias direita e esquerda para a colocação do implante sem o tratamento de superfície (grupo controle) e com o tratamento de superfície de plasma de argônio (grupo experimental), respectivamente. Os ratos foram sacrificados após 4 semanas, momento em que fragmentos das tíbias foram submetidos a exame histológico e histomorfométrico, além do teste de remoção de torque para comparação e análise da osseointegração. Resultados: As imagens de MEV mostraram que o tratamento de superfície com plasma de argônio alterou a topografia. Ao final do estudo, foi verificada maior formação óssea e melhor osseointegração no grupo experimental, e foi observada diferença estatisticamente significativa entre os grupos. Conclusão: Concluiu-se que os implantes com esse tratamento de superfície podem trazer mais praticidade no tratamento de reabilitação e maior conforto no pós-operatório dos pacientes (AU)

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Resumen Introducción: El bienestar psicológico favorece el funcionamiento de la vida personal y social. Para su evaluación, es necesario contar con instrumentos válidos y confiables que permitan decidir y valorar las acciones necesarias para promoverlo. Objetivo: Evaluar las propiedades psicométricas de la Escala de Bienestar Psicológico para Adultos (BIEPS-A) en una muestra mexicana. Método: Se aplicó la escala BIEPS-A y la Escala de Autoestima de Rosenberg (EAR) a 188 estudiantes universitarios y 94 participantes de población general. Resultados: Un análisis paralelo detectó un factor único en la escala BIEPS-A, estructurado mediante análisis factorial exploratorio (componentes principales, rotación oblicua) que retuvo 9 reactivos y explicó el 54% de la varianza. La consistencia interna fue de aceptable (α de Cronbach = .78) a elevada (alfa ordinal = .90). El análisis de curva ROC identificó un punto de corte equivalente a la mediana (ABC = .72, p < .01) y otro al percentil 75 (ABC = .80, p < .01), y ser mujer, tener entre 18 y 25 años y bajo o leve nivel de autoestima como predictores de bajo nivel de bienestar psicológico. La escala BIEPS-A mostró validez concurrente (r = .57) y predictiva con la EAR (β = .63). Discusión y conclusiones: La escala BIEPS-A es un instrumento válido y confiable para evaluar el bienestar psicológico en población mexicana; sin embargo, las diferencias respecto a su estructura original indican la necesidad de una escala de bienestar psicológico diseñada específicamente para población mexicana.

Abstract Introduction: Psychological well-being favors the functioning of personal and social life. Valid and reliable instruments are necessary for its evaluation that allow deciding and assessing the actions necessary to promote it. Objective: To evaluate the psychometric properties of the Scale of Psychological Well-being for Adults (BIEPS-A) in a Mexican sample. Methods: The BIEPS-A scale and the Rosenberg Self-Esteem Scale (RSES) were administered to 188 university students and 94 participants from the general population. Results: A parallel analysis detected a single factor in the BIEPS-A scale, structured by exploratory factor analysis (main components, oblique rotation) that retained 9 items and explained 54% of the variance. Internal consistency ranged from acceptable (Cronbach's α = .78) to high (ordinal alpha = .90). ROC curve analysis identified a cut-off point equivalent to the median (AUC = .72, p <.01) and another to the 75th percentile (AUC = .80, p <.01). The latter identified as a woman, between 18 and 25 years old with a low or slight level of self-esteem as predictors of a low level of psychological well-being. The BIEPS-A scale showed concurrent (r = .57) and predictive (β = .63) validity with the EAR. Discussion and conclusions: The BIEPS-A scale is a valid and reliable instrument to assess psychological well-being in the Mexican population. However, the differences with respect to its original structure indicate the need for a psychological well-being scale designed specifically for the Mexican population.

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The aim of this study is to provide preliminary data about the occurrence of Neospora caninum- and Toxoplasma gondii-related abortions and perinatal deaths in sheep from Argentina. Thirty ovine aborted foetuses and 33 perinatal deaths were submitted to the Veterinary Diagnostic Service at INTA EEA Balcarce (Argentina) during 2017-2019. A complete necropsy was performed on all specimens submitted, and foetal and placental tissues were examined. Foetal cavity fluids were collected for assessment of antibodies to N. caninum and T. gondii by indirect fluorescent antibody technique (IFAT). Placental and foetal tissue samples were collected for DNA extraction and histopathological analysis. The differential diagnosis with other causes of abortion was carried out. Of the sampled specimens, 20.63% (13/63) displayed evidence for N. caninum infection by IFAT and PCR, and in 61.5% (8/13) of the positive specimens the parasite was confirmed as the cause of abortion/perinatal death based on the presence of compatible histological lesions and/or positive immunohistochemistry test, positive PCR and/or positive IFAT, and no other infectious agents diagnosed. In contrast, T. gondii infection was confirmed in 9.52% (6/63) of the analysed specimens, but only in 2 lambs T. gondii was determined as the death cause. Neospora caninum and T. gondii co-infections were confirmed in 4 analysed specimens (2 aborted foetuses and 2 perinatal deaths). These results demonstrated that N. caninum is efficiently transmitted and a frequent cause of ovine reproductive failure in the commercial analysed flocks compared with T. gondii. Despite T. gondii congenital infection was detected in some specimens (6/63), it was confirmed as the cause of death in only two of them. Thus, and considering the limited availability of confirmed samples, we could not determine whether toxoplasmosis is a major problem in Argentinian sheep flocks or not. More studies on a greater number of specimens from different ovine production systems under different management conditions are necessary to assess the real impact of neosporosis and toxoplasmosis in Argentina.

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Abstract Introduction Anxiety and depression in pregnant women are a public health problem. Their adequate detection requires valid and reliable instruments that are also useful for prevention and treatment. Objective To identify the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) in a sample of Mexican pregnant women. Method The HADS was applied to 716 pregnant women between 13 and 46 years old (M = 26.55; SD = 6.56) attended in a public hospital in Mexico City. Results With a sample of 358 participants, a parallel analysis indicated a bifactorial structure for HADS, identified by exploratory factor analysis (Factor 1: anxiety, Factor 2: depression). The factors explained 53% of the variance and correlated positively (r = .36). The global internal consistency (Cronbach's α = .81; ordinal α = .93) and by factor (anxiety: Cronbach's α = .79; ordinal α = .88; depression: Cronbach's α = .79; ordinal α = .87) was acceptable. With data from the remaining 358 participants, a confirmatory factor analysis showed an acceptable fit for the structure detected (χ2/gl = 2.72; RMSEA = .06 [IC .05, .08]; GFI = .93; AGFI = .90; TLI = .90; CFI = .92). Discussion and conclusions The Hospital Anxiety and Depression Scale has adequate psychometric properties to be used in pregnant Mexican women. Its use in routine pregnancy controls would be useful to prevent, detect, and timely treat these conditions.

Resumen Introducción La ansiedad y la depresión en gestantes representan un problema de salud pública. Su adecuada detección requiere de instrumentos válidos y confiables que también sirvan para su prevención y tratamiento. Objetivo Identificar las propiedades psicométricas de la Escala Hospitalaria de Ansiedad y Depresión (HADS) en una muestra de mujeres embarazadas mexicanas. Método Se aplicó la HADS a 716 gestantes de entre 13 y 46 años (M = 26.55; DE = 6.56), atendidas en un hospital público en la Ciudad de México. Resultados Con una muestra de 358 participantes, un análisis paralelo indicó una estructura bifactorial para la HADS, identificada mediante análisis factorial exploratorio (Factor 1: ansiedad, Factor 2: depresión). Los factores explicaron el 53% de la varianza y correlacionaron positivamente (r = .36). La consistencia interna global (α de Cronbach = .81, α ordinal = .93) y por factor (ansiedad: αde Cronbach = .79, α ordinal = .88; depresión: α de Cronbach = .79, α ordinal = .87) fue aceptable. Con los datos de las 358 participantes restantes, un análisis factorial confirmatorio mostró un ajuste aceptable para la estructura detectada (χ2/gl = 2.72; RMSEA = .06 [IC .05, .08]; GFI = .93; AGFI = .90; TLI = .90; CFI = .92). Discusión y conclusión La Escala Hospitalaria de Ansiedad y Depresión posee adecuadas propiedades psicométricas para su empleo en mujeres embarazadas mexicanas. Su uso en controles rutinarios del embarazo sería útil para prevenir, detectar y atender oportunamente estos padecimientos.

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INTRODUCTION: Medical students report higher levels of anxiety than students from other majors. Knowledge about their psychological well-being is scarce. OBJECTIVE: To identify sociodemographic and academic factors that predict the level of anxiety and psychological well-being in Mexican medical students. METHOD: Cross-sectional study of Mexican medical students of first (n = 59), third (n = 43) and fifth semester (n = 59), who answered a sociodemographic questionnaire, Beck Anxiety Inventory, the Psychological Well-being Scale for adults and the Family Adaptability and Cohesion Evaluation Scale. RESULTS: Females showed higher levels of anxiety (p < 0.01). Anxiety in males was similar in the different semesters (p > 0.05); women of third and fifth semesters were more anxious than those at first semester (p < 0.01). Anxiety and psychological well-being were negatively correlated (p < 0.001). The "Less anxiety, higher level of well-being" and "More anxiety, lower level of well-being" subgroups were characterized, and a logistic regression identified that being a woman (OR = 4.70) and not practicing any religion (OR = 2.49) are predictive factors of higher levels of anxiety. CONCLUSIONS: Female medical students constitute a population at risk for higher levels of anxiety and less psychological well-being, which compromises their learning, quality of life and future professional practice.

INTRODUCCIÓN: Estudiantes de medicina reportan mayor ansiedad que estudiantes de otras carreras. El conocimiento sobre su bienestar psicológico es escaso. OBJETIVO: Identificar factores sociodemográficos y académicos predictores del nivel de ansiedad y bienestar psicológico en estudiantes mexicanos de medicina. MÉTODO: Estudio transversal de estudiantes mexicanos de medicina de primer (n = 59), tercer (n = 43) y quinto semestre (n = 59), que contestaron un cuestionario sociodemográfico, la Escala de Ansiedad de Beck, la Escala de Bienestar Psicológico para Adultos y la Escala de Evaluación de la Cohesión y la Adaptabilidad Familiar. RESULTADOS: Las mujeres presentaron mayor ansiedad (p < 0.01). La ansiedad en hombres fue similar en los distintos semestres (p > 0.05); las mujeres de tercer y quinto semestre fueron más ansiosas que las del primero (p < 0.01). Ansiedad y bienestar psicológico correlacionaron negativamente (p < 0.001). Se identificaron los subgrupos "Menor ansiedad, mayor bienestar" y "Mayor ansiedad, menor bienestar", y una regresión logística identificó que ser mujer (OR = 4.70) y no profesar alguna religión (OR = 2.49) son factores predictores de mayor ansiedad. CONCLUSIONES: Las estudiantes de medicina constituyen una población de riesgo para mayor ansiedad y menor bienestar psicológico, lo que compromete su aprendizaje, calidad de vida y futuro ejercicio profesional.

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Resumen Introducción: Estudiantes de medicina reportan mayor ansiedad que estudiantes de otras carreras. El conocimiento sobre su bienestar psicológico es escaso. Objetivo: Identificar factores sociodemográficos y académicos predictores del nivel de ansiedad y bienestar psicológico en estudiantes mexicanos de medicina. Método: Estudio transversal de estudiantes mexicanos de medicina de primer (n = 59), tercer (n = 43) y quinto semestre (n = 59), que contestaron un cuestionario sociodemográfico, la Escala de Ansiedad de Beck, la Escala de Bienestar Psicológico para Adultos y la Escala de Evaluación de la Cohesión y la Adaptabilidad Familiar. Resultados: Las mujeres presentaron mayor ansiedad (p < 0.01). La ansiedad en hombres fue similar en los distintos semestres (p > 0.05); las mujeres de tercer y quinto semestre fueron más ansiosas que las del primero (p < 0.01). Ansiedad y bienestar psicológico correlacionaron negativamente (p < 0.001). Se identificaron los subgrupos “Menor ansiedad, mayor bienestar” y “Mayor ansiedad, menor bienestar”, y una regresión logística identificó que ser mujer (OR = 4.70) y no profesar alguna religión (OR = 2.49) son factores predictores de mayor ansiedad. Conclusiones: Las estudiantes de medicina constituyen una población de riesgo para mayor ansiedad y menor bienestar psicológico, lo que compromete su aprendizaje, calidad de vida y futuro ejercicio profesional.

Abstract Introduction: Medical students report higher levels of anxiety than students from other majors. Knowledge about their psychological well-being is scarce. Objective: To identify sociodemographic and academic factors that predict the level of anxiety and psychological well-being in Mexican medical students. Method: Cross-sectional study of Mexican medical students of first (n = 59), third (n = 43) and fifth semester (n = 59), who answered a sociodemographic questionnaire, Beck Anxiety Inventory, the Psychological Well-being Scale for adults and the Family Adaptability and Cohesion Evaluation Scale. Results: Females showed higher levels of anxiety (p < 0.01). Anxiety in males was similar in the different semesters (p > 0.05); women of third and fifth semesters were more anxious than those at first semester (p < 0.01). Anxiety and psychological well-being were negatively correlated (p < 0.001). The “Less anxiety, higher level of well-being” and “More anxiety, lower level of well-being” subgroups were characterized, and a logistic regression identified that being a woman (OR = 4.70) and not practicing any religion (OR = 2.49) are predictive factors of higher levels of anxiety. Conclusions: Female medical students constitute a population at risk for higher levels of anxiety and less psychological well-being, which compromises their learning, quality of life and future professional practice.

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RESUMEN Fundamento: la expresión de empatía en la relación médico-paciente presenta múltiples beneficios en la atención a la salud. La evidencia indica menor empatía en fases avanzadas del desarrollo curricular en medicina. Existe escasa información al respecto en población mexicana. Objetivo: identificar el nivel de empatía general y sus factores asociados en tres momentos distintos del desarrollo curricular en estudiantes mexicanos de medicina. Métodos: estudio transversal, realizado en la Escuela de Medicina de una universidad privada en la Ciudad de México, sobre 161 estudiantes de medicina inscritos en primer, tercer y quinto semestre de la carrera de medicina que completaron la escala multidimensional de empatía, versión reducida. Se realizaron análisis por semestre y sexo; se identificaron subgrupos con diferente nivel de empatía y se realizó un análisis con estimadores de riesgo. Resultados: las mujeres fueron más empáticas que los hombres (p = 0,0001) excepto en la detección de emociones ajenas que no mostró diferencias entre sexos (p = 0,99). Las mujeres no mostraron diferencias entre semestres (p > 0,05), los hombres de primer semestre fueron más empáticos que los de tercero y quinto (p = 0,005) particularmente para detectar emociones ajenas (p = 0,002). Ser hombre aumentó la probabilidad de mostrar menor nivel de empatía (OR = 2,36, p = 0,02). Conclusiones: el menor nivel de empatía en estudiantes hombres de semestres avanzados de medicina puede comprometer los beneficios hasta ahora reportados de la expresión de esta habilidad en la relación médico-paciente y en consecuencia disminuir la calidad de la atención. Es necesaria una estrategia de instrucción en empatía para este grupo estudiantil.

ABSTRACT Foundation: the expression of empathy in the doctor-patient relationship has multiple benefits in health care. The evidence indicates lower empathy in advanced stages of curriculum development in medicine. There is little information about it in the Mexican population. Objective: to identify the level of general empathy and its associated factors in three different moments of the curricular development in Mexican medical students. Methods: a cross-sectional study, conducted at the Higher School of Medicine of a private university in Mexico City, on 161 medical students enrolled in the first, third and fifth semesters of the medical degree that completed the multidimensional empathy scale, reduced version. Analyzes were performed by semester and sex; Subgroups with different levels of empathy were identified and an analysis was carried out with risk estimators. Results: women were more empathetic than men (p = 0.0001) except in the detection of other people's emotions that showed no differences between sexes (p = 0.99). Women did not show differences between semesters (p> 0.05), the first semester men were more empathetic than the third and fifth (p = 0.005), particularly to detect other people's emotions (p = 0.002). Being a man increased the probability of showing a lower level of empathy (OR = 2.36, p = 0.02). Conclusions: the lower empathy level in male students of advanced medicine semesters can compromise the benefits so far reported of the ability expression in the doctor-patient relationship and consequently decreases the quality of care. An empathy instructional strategy is necessary for this student group.