the Taiwan Stroke Registry InvestigatorsBackground-Stroke is a leading cause of death around the world. Improving the quality of stroke care is a global priority, despite the diverse healthcare economies across nations. The American Heart Association/American Stroke Association Get With the Guidelines-Stroke program (GWTG-Stroke) has improved the quality of stroke care in 790 US academic and community hospitals, with broad implications for the rest of the country. The generalizability of GWTG-Stroke across national and economic boundaries remains to be tested. 2,3 This was followed by the implementation of the American Heart Association/American Stroke Association Get With the Guidelines-Stroke program (GWTG-Stroke). 4 GWTG-Stroke was the first large-scale nationwide assessment of the quality of stroke care based on a set of predefined performance measures. The 790 participating hospitals showed substantial and sustained improve- Clinical Perspective on p 1123Stroke is the second leading cause of death globally, 5 with nations with diverse health care systems facing a similar medical and economic burden. 6 Whether the successful GWTG-Stroke is applicable beyond the United States remains to be tested. A key determinant that may hamper broad application of GWTG-Stroke around the world is the diversity of healthcare economies. It could be difficult for nations spending substantially less in healthcare dollars to apply GWTG-Stroke standards. To examine whether GWTGStroke is workable across nations with substantial disparities in health expenditures, we applied GWTG-Stroke to assess the quality of stroke care in Taiwan. Like the United States, stroke is the third leading cause of death in Taiwan. In 2008, the total cost of stroke in the United States, with 780 000 new or recurrent stroke cases, was estimated to be $65.5 billion, with direct (medical) costs constituting two thirds or $43.6 billion. 5 Taiwan, with a population of 23 million (1/13 of that of the United States), with Ϸ80 000 new or recurrent strokes a year, spent a total of US $375 million in medical costs for stroke in 2007. 7 The total medical costs per new or recurrent stroke patient were Ϸ1/10 of those spent in the United States. 5 The Taiwan Stroke Registry (TSR) is an appropriate program to assess the generalizability of GWTG-Stroke across national as well as economic boundaries. TSR, sponsored by the Department of Health (DOH), was launched in 2006. With the exception of anticoagulation for deep vein thrombosis (DVT) and measures for smoking cessation, all the parameters adapted by GWTG-Stroke for assessing quality of stroke care have been included in TSR. Methods TSR Design and the Criteria for Hospital SelectionTSR is the first nationwide effort in Taiwan to establish a reliable national stroke database for assessing the quality of stroke care and identifying areas that require improvement. TSR was designed and a TSR operation manual developed after a series of consensus conferences attended by an expert panel (16 stroke neurologists and 2 epi...

Aim:To evaluate the association of cognitive impairment, depressive mood and sarcopenia among older men living in the veterans retirement community in southern Taiwan Methods: This cross-sectional study recruited 353 men aged 65 years and older. In addition to demographic characteristics, all participants were measured for gait speed, handgrip strength and muscle mass by using bioelectrical impedance analysis (BIA). The diagnosis of sarcopenia was made according to the European Working Group on Sarcopenia in Older People criteria. Slow walking speed was defined as ≤0.8 meter/second. Low muscle strength was defined as the handgrip strength less than 22.5 kg which was adjusted according to Taiwanese norms. A heightadjusted muscle mass of 8.87 kg/m2 from a previous Taiwanese study was defined as low muscle mass. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE), and the Geriatric Depression Scale-15 (GDS-15) was used for screening of depressive symptoms.Results: Among the 353 participants (mean age 82.7 ± 5.3 years), 30.9% (109/353) were classified as sarcopenic. Multivariate logistic regression showed that sarcopenia was independently associated with cognitive impairment (adjusted OR 3.03, 95% CI 1.63-5.65, P < 0.001) and depressive symptoms (adjusted OR 2.25, 95% CI 1.03-4.89, P = 0.04). Conclusions:Sarcopenia was significantly associated with cognitive impairment and depressive symptoms among otherwise healthy older men living in the veterans retirement community. Further outcome study is required to explore the interrelationship of cognition, depressive symptoms and sarcopenia in older adults. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 102-108.

A nanoparticle-conjugated cancer drug provides a novel strategy for cancer therapy. In this study, we manipulated nanodiamond (ND), a carbon nanomaterial, to covalently link paclitaxel for cancer drug delivery and therapy. Paclitaxel was bound to the surface of 3-5 nm sized ND through a succession of chemical modifications. The ND-paclitaxel conjugation was measured by atomic force microscope and nuclear magnetic resonance spectroscopy, and confirmed with infrared spectroscopy by the detection of deuterated paclitaxel. Treatment with 0.1-50 microg ml(-1) ND-paclitaxel for 48 h significantly reduced the cell viability in the A549 human lung carcinoma cells. ND-paclitaxel induced both mitotic arrest and apoptosis in A549 cells. However, ND alone or denatured ND-paclitaxel (after treatment with strong alkaline solution, 1 M NaOH) did not induce the damage effects on A549 cells. ND-paclitaxel was taken into lung cancer cells in a concentration-dependent manner using flow cytometer analysis. The ND-paclitaxel particles were located in the microtubules and cytoplasm of A549 cells observed by confocal microscopy. Furthermore, ND-paclitaxel markedly blocked the tumor growth and formation of lung cancer cells in xenograft SCID mice. Together, we provide a functional covalent conjugation of ND-paclitaxel, which can be delivered into lung carcinoma cells and preserves the anticancer activities on the induction of mitotic blockage, apoptosis and anti-tumorigenesis.

It is known that bond strength is a dynamic property that is dependent upon the force loading rate applied during the rupturing of a bond. For biotin−avidin and biotin−streptavidin systems, dynamic force spectra, which are plots of bond strength vs loge(loading rate), have been acquired in a recent biomembrane force probe (BFP) study1 at force loading rates in the range 0.05−60 000 pN/s. In the present study, the dynamic force spectrum of the biotin−streptavidin bond strength in solution was extended from loading rates of ∼104 to ∼107 pN/s with the atomic force microscope (AFM). A Poisson statistical analysis method was applied to extract the magnitude of individual bond-rupture forces and nonspecific interactions from the AFM force−distance curve measurements. The bond strengths were found to scale linearly with the logarithm of the loading rate. The nonspecific interactions also exhibited a linear dependence on the logarithm of loading rate, although not increasing as rapidly as the specific interactions. The dynamic force spectra acquired here with the AFM combined well with BFP measurements by Merkel et al. The combined spectrum exhibited two linear regimes, consistent with the view that multiple energy barriers are present along the unbinding coordinate of the biotin−streptavidin complex. This study demonstrated that unbinding forces measured by different techniques are in agreement and can be used together to obtain a dynamic force spectrum covering 9 orders of magnitude in loading rate.

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It has been found that a common shipping and packaging material for commercial AFM cantilever tips, poly(dimethylsiloxane) (PDMS), causes a thin layer of silicone oil contamination on AFM cantilever tips. Due to the similarity of elemental compositions between silicone oils and AFM cantilevers (both contain silicon and oxygen), it is difficult to detect such contaminants with the widely used surface characterization technique, X-ray photoelectron spectroscopy (XPS), since XPS provides mainly elemental and short-range chemical information. However, by using static time-of-flight secondary-ion mass spectrometry (TOF-SIMS), a technique that is extremely surface-sensitive, silicone oils on AFM cantilevers can easily be identified by their molecular fragments. A simple dip cleaning procedure using a mixture of concentrated sulfuric acid and hydrogen peroxide (piranha solution) was found to be an easy and effective way to remove organic contamination, including silicone oils, from AFM cantilever tips. It has also been shown, in both XPS and TOF-SIMS spectra, that a small amount of Au is present on the tip side of AFM cantilevers. This is most likely due to thermal diffusion of Au during the deposition of Au on the back side of the cantilevers, placed there to enhance laser reflectivity in the detection system of AFM instruments. No simple dipping approach was found to remove Au contamination on the tip side without also damaging the required Au coating on the back side of the cantilevers.

The benefits of increasing the number of surface hydroxyls on TiO2 nanoparticles (NPs) are known for environmental and energy applications; however, the roles of the hydroxyl groups have not been characterized and distinguished. Herein, TiO2 NPs with abundant surface hydroxyl groups were prepared using commercial titanium dioxide (ST-01) powder pretreated with alkaline hydrogen peroxide. Through this simple treatment, the pure anatase phase was retained with an average crystallite size of 5 nm and the surface hydroxyl group density was enhanced to 12.0 OH/nm2, estimated by thermogravimetric analysis, Fourier transform infrared spectroscopy, and X-ray photoelectron spectroscopy. Especially, this treatment increased the amounts of terminal hydroxyls five- to six-fold, which could raise the isoelectric point and the positive charges on the TiO2 surface in water. The photocatalytic efficiency of the obtained TiO2 NPs was investigated by the photodegradation of sulforhodamine B under visible light irradiation as a function of TiO2 content, pH of solution, and initial dye concentration. The high surface hydroxyl group density of TiO2 NPs can not only enhance water-dispersibility but also promote dye sensitization by generating more hydroxyl radicals.

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