Isolated Ulnar Neuropathy After Acute Angioedema.

Ulnar neuropathy commonly causes hand paresthesia, often associated with mechanical compression or repetitive movements across the elbow or wrist. There are a few cases that document ulnar nerve injury from rapid compression in the absence of trauma. We present a 30-year-old previously healthy male who developed bilateral hand and forearm swelling, numbness, and pain after an allergic reaction initially treated with epinephrine and steroids. Following treatment, swelling improved; however, paresthesia and weakness persisted. Electrodiagnostic studies performed two months later showed severe ulnar neuropathy prominent at the left proximal wrist, confirmed by ulnar motor inching studies. Signs of acute or subacute denervation and active reinnervation were noted in the left flexor digitorum profundus and abductor digiti minimi. Right-sided studies were unrevealing, although magnetic resonance imaging (MRI) showed an acute flexor pollicis longus tear. Given the timing of events, it was felt that the ulnar neuropathy and acute muscle tear were related to the rapid onset of angioedema. Further research should be conducted on how acute episodes of angioedema (allergy) can cause nerve compression in different extremities. There are very scant reports of different types of angioedema (such as vibratory or hereditary) associated with neuropathy; however, there are no reports of acute allergic angioedema associated with neuropathy. A more comprehensive understanding of the pathophysiology of neuropathy following acute angioedema will help guide treatment approaches both acutely and after symptom presentation.

Synthesis and Structural and Optical Properties of Ga(As1-xPx)Ge3 and (GaP)yGe5-2y Semiconductors Using Interface-Engineered Group IV Platforms.

Epitaxial synthesis of Ga(As1-xPx)Ge3 alloys on Si(100) substrates is demonstrated using chemical vapor deposition reactions of [D2GaN(CH3)2]2 with P(GeH3)3 and As(GeH3)3 precursors. These compounds are chosen to promote the formation of GaAsGe3 and GaPGe3 building blocks which interlink to produce the desired crystalline product. Ge-rich (GaP)yGe5-2y analogues have also been grown with tunable Ge contents up to 90% by reactions of P(GeH3)3 with [D2GaN(CH3)2]2 under similar deposition protocols. In both cases, the crystal growth utilized Ge1-xSix buffer layers whose lattice constants were specifically tuned as a function of composition to allow perfect lattice matching with the target epilayers. This approach yielded single-phase materials with excellent crystallinity devoid of mismatch-induced dislocations. The lattice parameters of Ga(As1-xPx)Ge3 interpolated among the Ge, GaAs, and GaP end members, corroborating the Rutherford backscattering measurements of the P/As ratio. A small deviation from the Vegard's law that depends on the As/P ratio was observed and corroborated by ab initio calculations. Raman scattering shows evidence for the existence of Ga-As and Ga-P bonds in the Ge matrix. The As-rich samples exhibited photoluminescence with wavelengths similar to those observed for pure GaAsGe3, indicating that the emission profile does not change in any measurable manner by replacing As by P over a broad range up to x = 0.2. Furthermore, the photoluminescence (PL) data suggested a large negative bowing of the band gap as expected on account of a strong valence band localization on the As atoms. Spectroscopic ellipsometry measurements of the dielectric function revealed a distinct direct gap transition that closely matches the PL emission energy. These measurements also showed that the absorption coefficients can be systematically tuned as a function of composition, indicating possible applications of the new materials in optoelectronics, including photovoltaics.

Controlled Frequency Breathing Reduces Inspiratory Muscle Fatigue.

Burtch, AR, Ogle, BT, Sims, PA, Harms, CA, Symons, TB, Folz, RJ, and Zavorsky, GS. Controlled frequency breathing reduces inspiratory muscle fatigue. J Strength Cond Res 31(5): 1273-1281, 2017-Controlled frequency breathing (CFB) is a common swim training modality involving holding one's breath for approximately 7-10 strokes before taking another breath. We sought to examine the effects of CFB training on reducing respiratory muscle fatigue. Competitive college swimmers were randomly divided into either the CFB group that breathed every 7-10 strokes or a control group that breathed every 3-4 strokes. Twenty swimmers completed the study. The training intervention included 5-6 weeks (16 sessions) of 12 × 50-m repetitions with breathing 8-10 breaths per 50-m (control group) or 2-3 breaths per 50-m (CFB group). Inspiratory muscle fatigue was defined as the decrease in maximal inspiratory pressure (MIP) between rest and 46 seconds after a 200-yard freestyle swimming race (115 seconds [SD 7]). Aerobic capacity, pulmonary diffusing capacity, and running economy were also measured pre- and posttraining. Pooled results demonstrated a 12% decrease in MIP at 46 seconds post-race (-15 [SD 14] cm H2O, effect size = -0.48, p < 0.01). After 4 weeks of training, only the CFB group prevented a decline in MIP values before to 46 seconds after race (-2 [13] cm H2O, p > 0.05). However, swimming performance, aerobic capacity, pulmonary diffusing capacity, and running economy did not improve (p > 0.05) posttraining in either group. In conclusion, CFB training appears to prevent inspiratory muscle fatigue; yet, no difference was found in performance outcomes.

Ultralow Resistivity Ge:Sb heterostructures on Si Using Hydride Epitaxy of Deuterated Stibine and Trigermane.

The nonconventional deuterated stibine (SbD3) compound has been used for the first time in combination with trigermane (Ge3H8) to produce hyper-doped Ge-on-Si films with carrier concentrations n > 10(20) cm(-3) and record-low resistivities ρ = 1.8 × 10(-4) Ω cm. The growth takes place on Ge and Ge1-xSix buffered Si(100) wafers at ultralow temperatures (∼330 °C) at which Sb diffusion is negligible, leading to extremely flat atomic profiles of the constituents. The Sb substitution in the Ge lattice is determined by RBS channeling and corroborated by high-resolution XRD, which also reveal a systematic increase in lattice constant vs concentration, as expected due to the incorporation of the larger Sb. High-resolution TEM illustrates defect-free monocrystalline structures with device-quality morphologies. The electrical characteristics of the samples are measured using Hall effect and resistivity measurements combined with contactless infrared ellipsometry and are found to be consistent with an extrapolation of the bulk Ge:Sb properties to the high carrier concentrations achieved in our films. The Sb/Ge ratio in the doped layers is approximately the same as that in the precursor reaction mixture, indicating a highly efficient Sb incorporation afforded by the compatible reactivity of the molecules employed in this study. The resultant films are attractive for next generation germanium technologies that require low-resistance n+ junctions or a Fermi level that approaches the direct gap minimum in the conduction band, which drastically enhances the optical emission efficiency of n-type Ge.

Single Molecule Bioelectronics and Their Application to Amplification-Free Measurement of DNA Lengths.

As biosensing devices shrink smaller and smaller, they approach a scale in which single molecule electronic sensing becomes possible. Here, we review the operation of single-enzyme transistors made using single-walled carbon nanotubes. These novel hybrid devices transduce the motions and catalytic activity of a single protein into an electronic signal for real-time monitoring of the protein's activity. Analysis of these electronic signals reveals new insights into enzyme function and proves the electronic technique to be complementary to other single-molecule methods based on fluorescence. As one example of the nanocircuit technique, we have studied the Klenow Fragment (KF) of DNA polymerase I as it catalytically processes single-stranded DNA templates. The fidelity of DNA polymerases makes them a key component in many DNA sequencing techniques, and here we demonstrate that KF nanocircuits readily resolve DNA polymerization with single-base sensitivity. Consequently, template lengths can be directly counted from electronic recordings of KF's base-by-base activity. After measuring as few as 20 copies, the template length can be determined with <1 base pair resolution, and different template lengths can be identified and enumerated in solutions containing template mixtures.

Processive Incorporation of Deoxynucleoside Triphosphate Analogs by Single-Molecule DNA Polymerase I (Klenow Fragment) Nanocircuits.

DNA polymerases exhibit a surprising tolerance for analogs of deoxyribonucleoside triphosphates (dNTPs), despite the enzymes' highly evolved mechanisms for the specific recognition and discrimination of native dNTPs. Here, individual DNA polymerase I Klenow fragment (KF) molecules were tethered to a single-walled carbon nanotube field-effect transistor (SWCNT-FET) to investigate accommodation of dNTP analogs with single-molecule resolution. Each base incorporation accompanied a change in current with its duration defined by τclosed. Under Vmax conditions, the average time of τclosed was similar for all analog and native dNTPs (0.2 to 0.4 ms), indicating no kinetic impact on this step due to analog structure. Accordingly, the average rates of dNTP analog incorporation were largely determined by durations with no change in current defined by τopen, which includes molecular recognition of the incoming dNTP. All α-thio-dNTPs were incorporated more slowly, at 40 to 65% of the rate for the corresponding native dNTPs. During polymerization with 6-Cl-2APTP, 2-thio-dTTP, or 2-thio-dCTP, the nanocircuit uncovered an alternative conformation represented by positive current excursions that does not occur with native dNTPs. A model consistent with these results invokes rotations by the enzyme's O-helix; this motion can test the stability of nascent base pairs using nonhydrophilic interactions and is allosterically coupled to charged residues near the site of SWCNT attachment. This model with two opposing O-helix motions differs from the previous report in which all current excursions were solely attributed to global enzyme closure and covalent-bond formation. The results suggest the enzyme applies a dynamic stability-checking mechanism for each nascent base pair.

Observing lysozyme's closing and opening motions by high-resolution single-molecule enzymology.

Single-molecule techniques can monitor the kinetics of transitions between enzyme open and closed conformations, but such methods usually lack the resolution to observe the underlying transition pathway or intermediate conformational dynamics. We have used a 1 MHz bandwidth carbon nanotube transistor to electronically monitor single molecules of the enzyme T4 lysozyme as it processes substrate. An experimental resolution of 2 µs allowed the direct recording of lysozyme's opening and closing transitions. Unexpectedly, both motions required 37 µs, on average. The distribution of transition durations was also independent of the enzyme's state: either catalytic or nonproductive. The observation of smooth, continuous transitions suggests a concerted mechanism for glycoside hydrolysis with lysozyme's two domains closing upon the polysaccharide substrate in its active site. We distinguish these smooth motions from a nonconcerted mechanism, observed in approximately 10% of lysozyme openings and closings, in which the enzyme pauses for an additional 40-140 µs in an intermediate, partially closed conformation. During intermediate forming events, the number of rate-limiting steps observed increases to four, consistent with four steps required in the stepwise, arrow-pushing mechanism. The formation of such intermediate conformations was again independent of the enzyme's state. Taken together, the results suggest lysozyme operates as a Brownian motor. In this model, the enzyme traces a single pathway for closing and the reverse pathway for enzyme opening, regardless of its instantaneous catalytic productivity. The observed symmetry in enzyme opening and closing thus suggests that substrate translocation occurs while the enzyme is closed.

Electrochemical charge-transfer resistance in carbon nanotube composites.

Using a model system of single, isolated carbon nanotubes loaded with high-capacitance metal-oxide films, we have quantitatively investigated electrochemical composites on the single-nanotube scale. Electrochemical charging and discharging of a model MnO2 storage material was used to probe interfacial charge transfer and surface impedances at the nanotube interface. We found that one single-walled carbon nanotube has an apparent surface resistivity of 30 mΩ cm(2), approximately 4 times smaller than for a multiwalled carbon nanotube and 50 times smaller than the 1.5 Ω cm(2) resistivity of Pt or graphite films. The improvement originates in the electrochemical-transport properties of microelectrodes shrunk to a nanotube's dimensions rather than any unique nanotube property like curvature, bandstructure, or surface chemistry. In explaining the enhanced performance of certain nanotube-containing composites, the results overturn widely held assumptions about nanotubes' roles while also providing guidelines for optimizing effective composites.

Service attachment: the relative contributions of ward climate perceptions and attachment anxiety and avoidance in male inpatients with psychosis.

BACKGROUND: It has been suggested that mental health services can help meet the attachment needs of inpatients and improve patient outcomes through the provision of a 'secure base'; however, what defines the latter is unclear. Perception of ward climate might be a useful indicator. AIM: The aim of this study was to examine whether inpatient perceptions of the ward climate, which is partly under the control of the service, or inpatients' own personal levels of attachment anxiety and avoidance are more associated with their attachment to their service. METHOD: Seventy-six men diagnosed with a psychotic illness, who were residents in one of four regional medium-security units in England, completed questionnaire measures of service attachment, personal attachment style and ward climate. RESULTS: Ward climate was more strongly associated with service attachment than personal levels of attachment anxiety and avoidance. The most important aspect of ward climate for service attachment was the depth and influence of staff support for the inpatients. CONCLUSIONS: Although patient characteristics are important influences on development of service attachment, ward climate is also important. The latter may be easily and reliably monitored with a brief questionnaire. Strategies to enhance and maintain its positive components are likely to be important for progress with forensic hospital inpatients who have a psychotic illness.

Rational design of monocrystalline (InP)(y)Ge(5-2y)/Ge/Si(100) semiconductors: synthesis and optical properties.

In this work, we extend our strategy previously developed to synthesize functional, crystalline Si(5-2y)(AlX)y {X = N,P,As} semiconductors to a new class of Ge-III-V hybrid compounds, leading to the creation of (InP)(y)Ge(5-2y) analogues. The compounds are grown directly on Ge-buffered Si(100) substrates using gas source MBE by tuning the interaction between Ge-based P(GeH3)3 precursors and In atoms to yield nanoscale "In-P-Ge3" building blocks, which then confer their molecular structure and composition to form the target solids via complete elimination of H2. The collateral production of reactive germylene (GeH2), via partial decomposition of P(GeH3)3, is achieved by simple adjustment of the deposition conditions, leading to controlled Ge enrichment of the solid product relative to the stoichiometric InPGe3 composition. High resolution XRD, XTEM, EDX, and RBS indicate that the resultant monocrystalline (InP)(y)Ge(5-2y) alloys with y = 0.3-0.7 are tetragonally strained and fully coherent with the substrate and possess a cubic diamond-like structure. Molecular and solid-state ab initio density functional theory (DFT) simulations support the viability of "In-P-Ge3" building-block assembly of the proposed crystal structures, which consist of a Ge parent crystal in which the P atoms form a third-nearest-neighbor sublattice and "In-P" dimers are oriented to exclude energetically unfavorable In-In bonding. The observed InP concentration dependence of the lattice constant is closely reproduced by DFT simulation of these model structures. Raman spectroscopy and ellipsometry are also consistent with the "In-P-Ge3" building-block interpretation of the crystal structure, while the observation of photoluminescence suggests that (InP)(y)Ge(5-2y) may have important optoelectronic applications.

Electronic measurements of single-molecule catalysis by cAMP-dependent protein kinase A.

Single-molecule studies of enzymes open a window into their dynamics and kinetics. A single molecule of the catalytic domain of cAMP-dependent protein kinase A (PKA) was attached to a single-walled carbon nanotube device for long-duration monitoring. The electronic recording clearly resolves substrate binding, ATP binding, and cooperative formation of PKA's catalytically functional, ternary complex. Using recordings of a single PKA molecule extending over 10 min and tens of thousands of binding events, we determine the full transition probability matrix and conversion rates governing formation of the apo, intermediate, and closed enzyme configurations. We also observe kinetic rates varying over 2 orders of magnitude from one second to another. Anti-correlation of the on and off rates for PKA binding to the peptide substrate, but not ATP, demonstrates that regulation of enzyme activity results from altering the stability of the PKA-substrate complex, not its binding to ATP. The results depict a highly dynamic enzyme offering dramatic possibilities for regulated activity, an attribute useful for an enzyme with crucial roles in cell signaling.

Electronic measurements of single-molecule processing by DNA polymerase I (Klenow fragment).

Bioconjugating single molecules of the Klenow fragment of DNA polymerase I into electronic nanocircuits allowed electrical recordings of enzymatic function and dynamic variability with the resolution of individual nucleotide incorporation events. Continuous recordings of DNA polymerase processing multiple homopolymeric DNA templates extended over 600 s and through >10,000 bond-forming events. An enzymatic processivity of 42 nucleotides for a template of the same length was directly observed. Statistical analysis determined key kinetic parameters for the enzyme's open and closed conformations. Consistent with these nanocircuit-based observations, the enzyme's closed complex forms a phosphodiester bond in a highly efficient process >99.8% of the time, with a mean duration of only 0.3 ms for all four dNTPs. The rate-limiting step for catalysis occurs during the enzyme's open state, but with a nearly 2-fold longer duration for dATP or dTTP incorporation than for dCTP or dGTP into complementary, homopolymeric DNA templates. Taken together, the results provide a wealth of new information complementing prior work on the mechanism and dynamics of DNA polymerase I.

Dissecting single-molecule signal transduction in carbon nanotube circuits with protein engineering.

Single-molecule experimental methods have provided new insights into biomolecular function, dynamic disorder, and transient states that are all invisible to conventional measurements. A novel, nonfluorescent single-molecule technique involves attaching single molecules to single-walled carbon nanotube field-effective transistors (SWNT FETs). These ultrasensitive electronic devices provide long-duration, label-free monitoring of biomolecules and their dynamic motions. However, generalization of the SWNT FET technique first requires design rules that can predict the success and applicability of these devices. Here, we report on the transduction mechanism linking enzymatic processivity to electrical signal generation by a SWNT FET. The interaction between SWNT FETs and the enzyme lysozyme was systematically dissected using eight different lysozyme variants synthesized by protein engineering. The data prove that effective signal generation can be accomplished using a single charged amino acid, when appropriately located, providing a foundation to widely apply SWNT FET sensitivity to other biomolecular systems.

Single-molecule lysozyme dynamics monitored by an electronic circuit.

Tethering a single lysozyme molecule to a carbon nanotube field-effect transistor produced a stable, high-bandwidth transducer for protein motion. Electronic monitoring during 10-minute periods extended well beyond the limitations of fluorescence techniques to uncover dynamic disorder within a single molecule and establish lysozyme as a processive enzyme. On average, 100 chemical bonds are processively hydrolyzed, at 15-hertz rates, before lysozyme returns to its nonproductive, 330-hertz hinge motion. Statistical analysis differentiated single-step hinge closure from enzyme opening, which requires two steps. Seven independent time scales governing lysozyme's activity were observed. The pH dependence of lysozyme activity arises not from changes to its processive kinetics but rather from increasing time spent in either nonproductive rapid motions or an inactive, closed conformation.

Single-molecule dynamics of lysozyme processing distinguishes linear and cross-linked peptidoglycan substrates.

The dynamic processivity of individual T4 lysozyme molecules was monitored in the presence of either linear or cross-linked peptidoglycan substrates. Single-molecule monitoring was accomplished using a novel electronic technique in which lysozyme molecules were tethered to single-walled carbon nanotube field-effect transistors through pyrene linker molecules. The substrate-driven hinge-bending motions of lysozyme induced dynamic electronic signals in the underlying transistor, allowing long-term monitoring of the same molecule without the limitations of optical quenching or bleaching. For both substrates, lysozyme exhibited processive low turnover rates of 20-50 s(-1) and rapid (200-400 s(-1)) nonproductive motions. The latter nonproductive binding events occupied 43% of the enzyme's time in the presence of the cross-linked peptidoglycan but only 7% with the linear substrate. Furthermore, lysozyme catalyzed the hydrolysis of glycosidic bonds to the end of the linear substrate but appeared to sidestep the peptide cross-links to zigzag through the wild-type substrate.