Aberrant energy metabolism is one characteristic of diabetes mellitus (DM). Two types of DM have been identified, type 1 and type 2. Most of type 2 DM patients eventually become insulin dependent because insulin secretion by the islets of Langerhans becomes exhausted. In the present study, we show that resveratrol (3,5,4'-trihydroxylstilbene) possesses hypoglycemic and hypolipidemic effects in streptozotocin-induced DM (STZ-DM) rats. In resveratrol-treated STZ-DM rats, the plasma glucose concentration on day 14 was reduced by 25.3 +/- 4.2%, and the triglyceride concentration was reduced by 50.2 +/- 3.2% compared with the vehicle-treated rats. In STZ-nicotinamide DM rats, the plasma glucose concentration on day 14 was reduced by 20.3 +/- 4.2%, and the triglyceride concentration was reduced by 33.3 +/- 2.2% compared with the vehicle-treated rats. Resveratrol administration ameliorates common DM symptoms, such as body weight loss, polyphagia, and polydipsia. In STZ-nicotinamide DM rats, resveratrol administration significantly decreased insulin secretion and delayed the onset of insulin resistance. Further studies showed that glucose uptake by hepatocytes, adipocytes, and skeletal muscle and hepatic glycogen synthesis were all stimulated by resveratrol treatment. Because the stimulation of glucose uptake was not attenuated in the presence of an optimal amount of insulin in insulin-responsive cells, the antihyperglycemic effect of resveratrol appeared to act through a mechanism(s) different from that of insulin.

The antihyperglycemic action of puerarin, purified from the roots of Pueraria lobata, was investigated in streptozotocin-induced diabetic rats (STZ-diabetic rats). Bolus intravenous injection of puerarin decreased the plasma glucose concentrations in a dose-dependent manner in STZ-diabetic rats. Similar treatment with puerarin also decreased the plasma glucose in normal rats, although the effect was not as great as that in STZ-diabetic rats. Puerarin at the effective dose (15.0 mg/kg) significantly attenuated the increase of plasma glucose induced by an intravenous glucose challenge test in normal rats. In the isolated soleus muscle of STZ-diabetic rats, puerarin enhanced the uptake of radioactive glucose in a concentration-dependent manner. Moreover, the mRNA and protein levels of the subtype 4 form of glucose transporter (GLUT4) in soleus muscle were increased after repeated intravenous administration of puerarin in STZ-diabetic rats for 3 days. These results suggest that puerarin can increase the glucose utilization to lower plasma glucose in diabetic rats lacking insulin.

OBJECTIVES Whether early medication reconciliation and integration can reduce polypharmacy and potentially inappropriate medication (PIM) in the emergency department (ED) remains unclear. Polypharmacy and PIM have been recognized as significant causes of adverse drug events in older adults. Therefore, this pilot study was conducted to delineate this issue. DESIGN An interventional study. SETTING A medical center in Taiwan. PARTICIPANTS Older ED patients (aged ≥65 years) awaiting hospitalization between December 1, 2017, and October 31, 2018 were recruited in this study. A multidisciplinary team and a computer‐based and pharmacist‐assisted medication reconciliation and integration system were implemented. MEASUREMENTS The reduced proportions of major polypharmacy (≥10 medications) and PIM at hospital discharge were compared with those on admission to the ED between pre‐ and post‐intervention periods. RESULTS A total of 911 patients (pre‐intervention = 243 vs post‐intervention = 668) were recruited. The proportions of major polypharmacy and PIM were lower in the post‐intervention than in the pre‐intervention period (−79.4% vs −65.3%; P < .001, and − 67.5% vs −49.1%; P < .001, respectively). The number of medications was reduced from 12.5 ± 2.7 to 6.9 ± 3.0 in the post‐intervention period in patients with major polypharmacy (P < .001). CONCLUSION Early initiation of computer‐based and pharmacist‐assisted intervention in the ED for reducing major polypharmacy and PIM is a promising method for improving geriatric care and reducing medical expenditures. J Am Geriatr Soc 67:2298–2304, 2019

SUMMARYIn order to systematically investigate the mechanical characteristic of a multiple friction pendulum system with numerous concave sliding interfaces and one articulated slider located between these concave sliding interfaces, general mathematical formulations have been derived from the proposed concept of subsystems. In addition, based on the plasticity theory, an analytical model called the multiple yield and bounding surfaces model has been proposed in this study. On the basis of the subsystem concept, the mathematical formulations and the plasticity model for the entire system can be obtained via the general formulations for each subsystem. The first subsystem includes the concave sliding interfaces above the articulated slider and the second subsystem consists of the concave sliding interfaces below the articulated slider. The proposed plasticity model has two separate groups of multiple yield and bounding surfaces. The first and second groups are adopted to model the mechanical behavior of the sliding motions of the first and second subsystems, respectively. The connection of these two subsystems in series forms the mechanical characteristic of the entire MFPS isolation system. By virtue of the derived mathematical formulations and the proposed plasticity model, the phenomena of the sliding motions of the MFPS isolator with numerous concave sliding interfaces under uni-and bi-directional cyclical loadings can be clearly understood. Numerical analyses are in good agreement with the experimental results and infer that the natural frequency and damping effect of the MFPS isolator with multiple concave sliding interfaces change continually during earthquakes and are controllable through appropriate designs.