Autumn olive (Elaeagnus umbellata Thunb.) berry reduces fasting and postprandial glucose levels in mice

BACKGROUND/OBJECTIVES: Fasting and postprandial hyperglycemia should be controlled to avoid complications of diabetes mellitus. This study investigated the effects of autumn olive (Elaeagnus umbellata Thunb.) berry (AOB) on fasting and postprandial hyperglycemia in mice. MATERIALS/METHODS: In vitro α-glucosidase inhibitory effect of AOB was determined. Maltose solution (2 g/kg) with and without AOB extract at 500 mg/kg or acarbose at 50 mg/kg was orally administered to normal mice after overnight fasting and glucose levels were measured. To study the effects of chronic consumption of AOB, db/db mice received the basal diet or a diet containing AOB extract at 0.4% or 0.8%, or acarbose at 0.04% for 7 weeks. Blood glycated hemoglobin and serum glucose and insulin levels were measured. Expression of adiponectin protein in epididymal white adipose tissue was determined by Western blotting. RESULTS: In vitro inhibitory effect of AOB extract on α-glucosidase was 92% as strong as that of acarbose. The AOB extract (500 mg/kg) or acarbose (50 mg/kg) significantly suppressed the postprandial rise of blood glucose after maltose challenge and the area under the glycemic response curve in normal mice. The AOB extract at 0.4% or 0.8% of diet or acarbose at 0.04% of diet significantly lowered levels of serum glucose and blood glycated hemoglobin and homeostasis model assessment for insulin resistance values in db/db mice. The expression of adiponectin protein in adipose tissue was significantly elevated by the consumption of AOB at 0.8% of diet. CONCLUSIONS: Autumn olive (E. umbellata Thunb.) berry may reduce postprandial hyperglycemia by inhibiting α-glucosidase in normal mice. Chronic consumption of AOB may alleviate fasting hyperglycemia in db/db mice partly by inhibiting α-glucosidase and upregulating adiponectin expression.

Chest compression quality, exercise intensity, and energy expenditure during cardiopulmonary resuscitation using compression-to-ventilation ratios of 15:1 or 30:2 or chest compression only: a randomized, crossover manikin study

OBJECTIVE: Our aim was to compare the compression quality, exercise intensity, and energy expenditure in 5-minute single-rescuer cardiopulmonary resuscitation (CPR) using 15:1 or 30:2 compression-to-ventilation (C:V) ratios or chest compression only (CCO). METHODS: This was a randomized, crossover manikin study. Medical students were randomized to perform either type of CPR and do the others with intervals of at least 1 day. We measured compression quality, ratings of perceived exertion (RPE) score, heart rate, maximal oxygen uptake, and energy expenditure during CPR. RESULTS: Forty-seven students were recruited. Mean compression rates did not differ between the 3 groups. However, the mean percentage of adequate compressions in the CCO group was significantly lower than that of the 15:1 or 30:2 group (31.2±30.3% vs. 55.1±37.5% vs. 54.0±36.9%, respectively; P<0.001) and the difference occurred within the first minute. The RPE score in each minute and heart rate change in the CCO group was significantly higher than those of the C:V ratio groups. There was no significant difference in maximal oxygen uptake between the 3 groups. Energy expenditure in the CCO group was relatively lower than that of the 2 C:V ratio groups. CONCLUSION: CPR using a 15:1 C:V ratio may provide a compression quality and exercise intensity comparable to those obtained using a 30:2 C:V ratio. An earlier decrease in compression quality and increase in RPE and heart rate could be produced by CCO CPR compared with 15:1 or 30:2 C:V ratios with relatively lower oxygen uptake and energy expenditure.

Development and Pilot Applications of Simulation-Based Emergency Department Crisis Management Team Training Program

PURPOSE: Emergency departments (EDs) are complex and dynamic working environments in which crises can easily develop. ED members must be trained to recognize and prevent impending crises or resolve active ones. Patient simulation (PS) is emerging as an effective tool in team training. We investigate the participants' responses to a simulation-based ED Crisis Management Team Training (CMTT) program we developed and applied. METHODS: We developed a pilot 2-hour simulation-based ED-CMTT program and applied to ED members who worked in three different types of EDs. The program was consisted of a lecture for principles of crisis resource management (CRM) and team dynamics, orientation to simulator and simulation environment, PS session with videoassisted debriefing and survey. After finishing the program, participants completed a survey and were solicited comments. RESULTS: Fifty-two trainee participated in more than one of total seven pilot programs. The responses for the program are as follow: enjoyable and satisfied, 4.00+/-0.74; helpful for their teamwork, 3.98+/-0.73; understanding of CRM principles, 4.00+/-0.63; attainment of learning objectives, 3.80+/-0.83; quality of faculty, 3.90+/-0.63; time allocation, 3.40+/-0.70. The responses for PS session are as follow: realism of scenario, 3.98+/-0.63; realism of simulator, 3.10+/-1.05; realism of simulation environment, 3.44+/-0.98; quality of audio-visual system, 3.81+/-0.74. Overall comments were positive and commonest request was to have more experiences in variable scenarios. However, some problems like time shortage and lack of realism were also pointed. CONCLUSION: The participants' reaction show that the simulation-based ED-CMTT program was well accepted by ED members. Creating more variable crisis scenarios and realistic simulation setting will be necessary for improving the program.