Experimental approach: The current study aims to develop biodegradable gelatine-based edible films incorporated with microcapsules of Clitoria ternatea-derived anthocyanins as a natural antimicrobial agent. The impact of incorporation of microcapsules with anthocyanins on the morphology, thermal, mechanical, water vapour barrier and physicochemical properties of the gelatine films was evaluated in this study. The effectiveness of the developed films against foodborne pathogens and their application for perishable food protection were also investigated.
Results and conclusions: The results show that incorporating anthocyanin microcapsules enhances the gelatine film physical and mechanical properties by increasing the thickness, tensile strength, Young's modulus and elongation at break of the films. Scanning electronic microscopy analysis revealed that the film surface morphology with anthocyanin microcapsules had a homogeneous and smooth surface texture compared to the control. The thermogravimetric analysis also showed a slight improvement in the thermal properties of the developed films. Agar well diffusion assay revealed that the developed films exhibit significant inhibition against a broad-spectrum of bacteria. Furthermore, the films composed of gelatine with anthocyanin microcapsules significantly reduced the total viable count of microorganisms in the bean curd during storage for 12 days compared with the control films.
Novelty and scientific contribution: Increasing global awareness of healthy and safe food with minimal synthetic ingredients as preservatives has sparked the search for the use of antimicrobial agents of natural origins in active food packaging material. In this study, a safe and effective active packaging film was developed using an environmentally friendly biopolymer, gelatine film incorporated with microcapsules of Clitoria ternatea-derived anthocyanins as a natural antimicrobial agent. This study demonstrated that such a method is not only able to improve the film physical properties but can also significantly prolong the shelf life of food products by protecting them from microbial spoilage.
OBJECTIVES: This survey aimed to clarify the current status of palliative care in the Asia-Pacific region.
METHODS: Questionnaires were sent to a representative physician of each member country/region of the Asia Pacific Hospice Palliative Care Network (APHN). The questionnaire examined palliative care service provision, information regarding physician certification in palliative care, the availability of essential drugs for palliative care listed by the International Association for Hospice and Palliative Care (IAHPC) and the regulation of opioid-prescribing practice.
RESULTS: Of the 14 member countries/regions of the APHN, 12 (86%) responded. Some form of specialist palliative care services had developed in all the responding countries/regions. Eight member countries/regions had physician certifications for palliative care. Most essential drugs for palliative care listed by the IAHPC were available, whereas hydromorphone, oxycodone and transmucosal fentanyl were unavailable in most countries/regions. Six member countries/regions required permission to prescribe and receive opioids.
CONCLUSIONS: The development of palliative care is in different stages across the surveyed countries/regions in the Asia-Pacific region. Data from this survey can be used as baseline data for monitoring the development of palliative care in this region.
METHOD: We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and > 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and > 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality.
RESULTS: 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age > 50 years [(OR = 1.7, 95% CI 1.4-2), (OR = 4.7, 95% CI 3.1-7.6)], female gender [(OR = 1.8, 95% CI 1.4-2.3), (OR = 1.9, 95% CI 1.3-2.9)], shock on admission [(OR = 2.1, 95% CI 1.7-2.7), (OR = 4.8, 95% CI 3.2-7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9-3.2), (OR = 3.9), 95% CI 2.7-5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1-1.6], but not mortality.
CONCLUSIONS: This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality.