An investigation into the simultaneous enzymatic and SERRS properties of silver nanoparticles

Investigation into the use of artificial enzymes has become an increasingly popular area of research due to the numerous advantages offered in comparison to protein enzymes. One particular area of research interest involves the use of metal nanoparticles as artificial enzymes. The peroxidase-like activity of a variety of nanoparticles has recently been shown and their use in a range of assay formats for the detection of various analytes has been explored. Herein the enzyme mimicking activity of silver nanoparticles is investigated using the peroxidase substrate 3,3′,5′,5′-tetramethylbenzidine (TMB). The peroxidase-like nature of these nanoparticles can be used in combination with surface enhanced resonance Raman scattering (SERRS) to provide a novel spectroscopic method of analysis. Negatively charged silver nanoparticles were investigated in combination with TMB using SERRS and it was found that upon formation of the oxidation intermediate of TMB, small clusters of positively charged nanoparticles were formed. The enzyme like behaviour of silver nanoparticles along with their use as a SERRS substrate is combined to demonstrate a simple and rapid method for the direct detection of hydrogen peroxide with a detection limit of 100 nM

Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study.

Background Acute appendicitis is the most common surgical emergency in children. Differentiation of acute appendicitis from conditions that do not require operative management can be challenging in children. This study aimed to identify the optimum risk prediction model to stratify acute appendicitis risk in children. Methods We did a rapid review to identify acute appendicitis risk prediction models. A prospective, multicentre cohort study was then done to evaluate performance of these models. Children (aged 5\u201315 years) presenting with acute right iliac fossa pain in the UK and Ireland were included. For each model, score cutoff thresholds were systematically varied to identify the best achievable specificity while maintaining a failure rate (ie, proportion of patients identified as low risk who had acute appendicitis) less than 5%. The normal appendicectomy rate was the proportion of resected appendixes found to be normal on histopathological examination. Findings 15 risk prediction models were identified that could be assessed. The cohort study enrolled 1827 children from 139 centres, of whom 630 (34\ub75%) underwent appendicectomy. The normal appendicectomy rate was 15\ub79% (100 of 630 patients). The Shera score was the best performing model, with an area under the curve of 0\ub784 (95% CI 0\ub782\u20130\ub786). Applying score cutoffs of 3 points or lower for children aged 5\u201310 years and girls aged 11\u201315 years, and 2 points or lower for boys aged 11\u201315 years, the failure rate was 3\ub73% (95% CI 2\ub70\u20135\ub72; 18 of 539 patients), specificity was 44\ub73% (95% CI 41\ub74\u201347\ub72; 521 of 1176), and positive predictive value was 41\ub74% (38\ub75\u201344\ub74; 463 of 1118). Positive predictive value for the Shera score with a cutoff of 6 points or lower (72\ub76%, 67\ub74\u201377\ub74) was similar to that of ultrasound scan (75\ub70%, 65\ub73\u201383\ub71). Interpretation The Shera score has the potential to identify a large group of children at low risk of acute appendicitis who could be considered for early discharge. Risk scoring does not identify children who should proceed directly to surgery. Medium-risk and high-risk children should undergo routine preoperative ultrasound imaging by operators trained to assess for acute appendicitis, and MRI or low-dose CT if uncertainty remains. Funding None