1068-P: Diabetes and Comorbidities Risk Assessment in Hospitalization and Fatalities from the Mexican COVID-19 Surveillance System

The SARS-CoV-2 outbreak poses a challenge to the Mexican health care system due to its high complication and lethality rates in patients with diabetes and comorbidities. Here, we evaluate the association among diabetes and main comorbidities [obesity, hypertension and chronic kidney disease (CKD)] on COVID-19 outcomes (prevalence, hospitalization, lethality and hospital fatality) in Mexican population. We used available public data released by the Mexican COVID-19 surveillance system (MC-19SS) from January 1st to December 31st of 2020. All 3,401,172 records of SARS-CoV-2 suspected population over or equal to 20 years old were included, out of whom 1,384,470 tested positive. Multiple logistic regression models were fitted to assess the risk over several outcomes (hospitalization and fatality), with self-reported diabetes and comorbidities in confirmed cases, adjusting for age, sex, smoking status and marginalization of the place of residence. Overall population tested, 399,953 (11.8%) subjects had diabetes. Of them, 47.8% also had hypertension, 9.0% obesity and 7.0% CKD. Patients who tested positive to COVID-19 had a higher proportion of diabetes (14.7%). From the 203,310 COVID-19 positive patients with diabetes, 95,225(46.8%) were hospitalized and of those 45,128(47.4%) died; also 4,701 died without had been hospitalized. People with diabetes had significant (p<.005) higher odds of hospitalization OR:2.2, hospital 1.27 and non-hospital 1.98 fatality. Nevertheless, subjects with diabetes and other chronic disease experience higher rates of several outcomes. Diabetes and CKD had the highest odds of hospitalization 7.3 died in hospital (2.14) or out of hospital (6.5) compared with cases without diabetes. This analysis points out that diabetes contributes to the risk of infection and worse outcomes for those infected by SARS-CoV-2. More must be done to combat and prevent diabetes and comorbidities to reduce the burden of COVID-19. Disclosure H. Gallardo-rincón: None. A. Montoya: None. L. Martinez-juarez: Research Support; Self; Lilly Global Health Partnership. J. Lomelin-gascon: None. E. R. Saucedo-martinez: None. R. Mujica-rosales: None. R. Tapia-conyer: None

EFECTO DE LOS FERTILIZANTES INORGÁNICOS Y LA INOCULACIÓN RIZOBIAL SOBRE CRECIMIENTO, NODULACIÓN Y CONTENIDO DE TANINOS EN ACACIELLA ANGUSTISSIMA (MILL.) BRITTON & ROSE

The effects of different inorganic fertilizers and rhizobial inoculation on shoot height, total shoot and root dry weight, nodule number, total shoot nitrogen, nitrogenase activity and tannic acid content of Acaciella angustissima (Mill.) Britton & Rose were investigated in the laboratory. Seedlings were grown in a climate chamber in glass tubes containing sterilized mixture of vermiculite and peat moss, and treated with combinations of nitrogen (N) at 45 mg plant1, phosphorus (P) at 30 mg plant1, potassium (K) at 20 mg plant1 and inoculated with the bacterium Sinorhizobium mexicanum. The combined applications of N, P or K to uninoculated plants increased shoot height and dry weight as compared to the unamended plantlets. The tannin content in uninoculated plants was highest when amended with P+K. Treatment had a significant effect on plant growth, nodulation and tannin content varied. The plants treated with P + K + S. mexicanum had significantly longer shoot height, total shoot and root dry weight, nodule number, total shoot nitrogen, nitrogenase activity and tannic acid content in comparison with unamended plants. It was found that N reduced number of nodules, tannin content and nitrogenase activity of A. angustisisma. As such, farmers should refrain from applying N fertilizer, but could apply P and K to maximize tannin production in A. angustissima.Se investigaron en el laboratorio los efectos de diferentes fertilizantes inorgánicos y la inoculación rizobial sobre la altura de planta, peso seco total de planta, peso seco de raíz, el número de nodulos, el nitrógeno total de la planta, la actividad de la nitrogenasa y el contenido de ácido tánico de Acaciella angustissima (Mili.) Britton & Rose. Las plántulas fueron crecidas en una cámara climática en tubos de vidrio conteniendo una mezcla de vermiculita y turba, y tratadas con las combinaciones de nitrógeno (N) en 45 mg planta"1, fósforo (P) en 30 mg planta"1, potasio (K) en 20 mg planta"1 e inoculado con la bacteria Sinorhizobium mexicanum. La combinación de las aplicaciones de N, P o K en plantas sin inocular incrementa la altura y el peso seco de planta en comparación con las plantas sin tratamiento. El contenido de taninos en plantas no inoculadas fue el más alto cuando suplementamos con P+K. El tratamiento tuvo un efecto significativo sobre el crecimiento de planta, modulación y el contenido de tanino variado. Las plantas tratadas con P + K + S. mexicanum tuvieron significativamente mayor altura de planta, peso seco total de planta, peso seco de raíz, el número de nodulos, nitrógeno total de planta, actividad de la nitrogenasa y contenido de taninos en comparación con las plantas sin suplementar. Fue encontrado que el N reduce el número de nodulos, el contenido de taninos y la actividad de la nitrogenasa de A. angustisisma. Como tal, los agricultores deberían abstenerse de aplicar el fertilizante de N, pero podrían aplicar P y K para maximizar la producción de tanino en A. angustissima

Frecuencia del alelo Q204X del gen miostatina, en hatos de ganado Charolais de la región noreste de México

Frequency of the myostatin Q204X allele in Charolais cattle herds in northeast Mexico was determined by sampling 289 animals from four herds. Each herd had allele carriers, with a total of 15 carriers identified, and overall genotypicfrequency of 5.2 % and allelic frequency of 2.6 %. The number of carriers per herd was not significantly different (P>0.05) between herds, although two herds had more than 8 % carriers. The allele was in Hardy-Weinberg equilibrium within the studied herds. Evaluation of genes that affect quantitative traits, such as the myostatin Q204X allele, is vital to determining their role and potential applications in breeding strategies.En el presente trabajo se determinó la frecuencia del alelo Q204X del gen miostatina (MSTN) en individuos de cuatro hatos de la raza Charolais del noreste de México. En el total de la población (n=289) se encontraron 15 portadores del alelo Q204X, mostrando frecuencias genotípicas y alélicas de 5.2 y 2.6 %, respectivamente. No se encontró ninguna diferencia (P>0.05) entre el número de individuos portadores en los hatos estudiados. Sin embargo, al menos dos de los hatos presentaron un porcentaje de portadores arriba del 8 %. Se determinó que el alelo está en equilibrio Hardy-Weinberg en los hatos estudiados. El establecimiento de la presencia del alelo Q204X en el gen MSTN del ganado Charolais, abre la posibilidad de implementar estrategias experimentales enfocadas a determinar su papel y uso potencial en la selección de animales con mayor mérito genético

Online continuing medical education as a key link for successful noncommunicable disease self-management: the CASALUD™ Model

Héctor Gallardo-Rincón,1 Rodrigo Saucedo-Martínez,1 Ricardo Mujica-Rosales,1 Evan M Lee,2 Amy Israel,2 Braulio Torres-Beltran,3 Úrsula Quijano-González,3 Elena Rose Atkinson,3 Pablo Kuri-Morales,4 Roberto Tapia-Conyer1 1Fundación Carlos Slim, Mexico City, Mexico; 2Lilly Global Health, Eli Lilly and Company, Vernier, Switzerland; 3C230 Consultores, Mexico City, Mexico; 4Mexican Ministry of Health, Mexico City, Mexico Purpose: The purpose of this study is to evaluate how the benefits of online continuing medical education (CME) provided to health care professionals traveled along a patient “educational chain”. In this study, the educational chain begins with the influence that CME can have on the quality of health care, with subsequent influence on patient knowledge, disease self-management, and disease biomarkers. Methods: A total of 422 patients with at least one noncommunicable disease (NCD) treated in eight different Mexican public health clinics were followed over 3 years. All clinics were participants in the CASALUD Model, an NCD care model for primary care, where all clinic staff were offered CME. Data were collected through a questionnaire on health care, patient disease knowledge, and self-management behaviors; blood samples and anthropometric measurements were collected to measure patient disease biomarkers. Results: Between 2013 and 2015, the indexes measuring quality of health care, patient health knowledge, and diabetes self-management activities rose moderately but significantly (from 0.54 to 0.64, 0.80 to 0.84, and 0.62 to 0.67, respectively). Performing self-care activities – including owning and using a glucometer and belonging to a disease support group – saw the highest increase (from 0.65 to 0.75). A1C levels increased between 2013 and 2015 from 7.95 to 8.41% (63–68 mmol/mol) (P<0.001), and blood pressure decreased between 2014 and 2015 from 143.7/76.8 to 137.5/74.4 (systolic/diastolic reported in mmHg) (P<0.001). The mean levels of other disease biomarkers remained statistically unchanged, despite the improvements seen in the previous “links” of the educational chain. Conclusion: Online CME can effect certain changes in the educational chain linking quality of health care, patient knowledge, and self-management behaviors. However, in order to assure adequate NCD control, the entire health care system must be improved in tandem. Online CME programs, such as CASALUD’s, are feasible strategies for impacting changes in disease self-management at a clinic level throughout a country. Keywords: chronic disease, health education, type 2 diabetes mellitus, Mexico, continuing medical education, primary care&nbsp

Effect of pest-controlling neem and mata-raton on bean growth, soil N and soil CO2_{2} emissions

Extracts of plants such as neem (Azadirachta indica A. Juss.) and mata-raton (Gliricidia sepium (Jacquin)) are used to control pests. However, certain components of neem, such as azadirachtin, can exert a negative effect on fungi and nitrifying bacteria, and, in turn, can impact the C and N cycles in soil. Nutrient cycling might thus be inhibited and affect the sustainability of an agricultural system in which plant extracts are used to control pests. Here, we investigated the effect of neem extract on microbial activity and N mineralization in soil. We studied the effect of neem and mata-raton leaf extracts on bean growth (Phaseolus vulgaris L$.)$, nodule formation by Rhizobium, soil CO$_{2}$ emissions and soil N dynamics. Four treatments were applied: (1) "neem treatment": extracts of neem leaves, (2) "mata-raton treatment": extracts of mata-raton, (3) "chemical treatment": a chemical insecticide, lambda cyalothrin, and (4) "control": untreated plants. Our results show that in non-amended soil the number of nodules in the neem treatment was 18 for beans cultivated. This nodule number was 2.1 times lower compared with the soil treated with lambda cyalothrin (chemical treatment). In manure-amended soil, the number of nodules was 28 in the neem treatment. This nodule number was 1.6 times lower than in the mata-raton treatment. This indicated that neem extracts inhibited Rhizobium in soil and nodule formation in bean. In the manure-amended soil, the emission of CO$_{2}$ was 1.9 times lower in the neem-treated soil than in the other treatments. The increase in the concentration of NO$_{3}^{-}$ was 1.03 mg N kg$^{-1}$ soil day$^{-1}$ in the neem treatment and 4.1 times lower compared with the other treatments. As such, microbial activity was inhibited by the neem extracts when added to the manure-amended soil. It was found that application of neem leaf extract inhibited microbial activity and reduced nodule formation in bean, but lambda cyalothrin or leaf extracts of Gliricidia sepium did not