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Background: Mechanical thrombectomy is a time-sensitive treatment, with rapid initiation and reduced delays being associated with better patient outcomes. Several systematic reviews reported on various interventions to address delays. Hence, we performed an umbrella review of systematic reviews to summarise the current evidence. Methods: Medline, Embase, Cochrane Library and JBI were searched for published systematic reviews. Systematic Reviews that detailed outcomes related to time-to-thrombectomy or functional independence were included. Methodological quality was assessed using the JBI critical appraisal tool by two independent reviewers. Results: A total of 17 systematic reviews were included in the review. These were all assessed as high-quality reviews. A total of 13 reviews reported on functional outcomes, and 12 reviews reported on time-to-thrombectomy outcomes. Various interventions were identified as beneficial. The most frequently reported beneficial interventions that improved functional and time-related outcomes included: direct-to-angio-suite and using a mothership model (compared to drip-and-ship). Only a few studies investigated other strategies including other pre-hospital and teamwork strategies. Conclusion: Overall, there were various strategies that can be used to reduce delays in the delivery of mechanical thrombectomy with different effectiveness. The mothership model appears to be superior to the drip-and-ship model in reducing delays and improving functional outcomes. Additionally, the direct-to-angiosuite approach appears to be beneficial, but further research is required for broader implementation of this approach and to determine which groups of patients would benefit the most.
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This study investigates the potential of utilizing green chemically treated spent coffee grounds (SCGs) as micro biofiller reinforcement in Poly-3-hydroxybutyrate-co-3-hydroxyvalerate (PHBV) biopolymer composites. The aim is to assess the impact of varying SCG concentrations (1 %, 3 %, 5 %, and 7 %) on the functional, thermal, mechanical properties and biodegradability of the resulting composites with a PHBV matrix. The samples were produced through melt compounding using a twin-screw extruder and compression molding. The findings indicate successful dispersion and distribution of SCGs microfiller into PHBV. Chemical treatment of SCG microfiller enhanced the interfacial bonding between the SCG and PHBV, evidenced by higher water contact angles of the biopolymer composites. Field Emission Scanning Electron Microscopy (FE-SEM) confirmed the successful interaction of treated SCG microfiller, contributing to enhanced mechanical characteristics. A two-way ANOVA was conducted for statistical analysis. Mass losses observed after burying the materials in natural soil indicated that the composites degraded faster than the pure PHBV polymer suggesting that both composites are biodegradable, particularly at high levels of spent coffee grounds (SCG). Despite the possibility of agglomeration at higher concentrations, SCG incorporation resulted in improved functional properties, positioning the green biopolymer composite as a promising material for sustainable packaging and diverse applications.
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Café , Poliésteres , Poli-Hidroxibutiratos , Café/química , Poliésteres/química , Química Verde , Plásticos Biodegradáveis/químicaRESUMO
Due to growing environmental concerns for better waste management, this study proposes developing a composite aerogel using cellulose nanofibers (CNF) and spent coffee grounds (SCG) through an eco-friendly method for efficient methylene blue (MB) adsorption. Adding SCG to the CNF aerogel altered the physical properties: it increases the volume (4.14 cm3 to 5.25 cm3) and density (0.018 to 0.022 g/cm3) but decrease the water adsorption capacity (2064 % to 1635 %). FTIR spectrum showed distinct functional groups in both all aerogels, showing hydroxyl, glyosidic bonds, and aromatic compounds. Additionally, SCG improved thermal stability of the aerogels. In term of adsorption efficacy, CNF-SCG40% aerogel as exceptionally well. According to Langmuir isotherm models, the adsorption of MB happened in a monolayer, with CNF-SCG40% showing a maximum adsorption capacity of 113.64 mg/g, surpassing CNF aerogel (58.82 mg/g). The study identified that the pseudo-second-order model effectively depicted the adsorption process, indicating a chemical-like interaction. This investigation successfully produced a single-use composite aerogel composed of CNF and SCG using an eco-friendly approach, efficiently adsorbing MB. By utilizing cost-effective materials and eco-friendly methods, this approach offers a sustainable solution for waste management, contributes to an eco-friendly industrial environment, and reduces production expenses and management costs.
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Celulose , Café , Adsorção , Meio Ambiente , Radical Hidroxila , Azul de MetilenoRESUMO
Multifunctional and sustainable packaging biofilms felicitous to changeable conditions are in large demand as substitutes to petroleum-derived synthetic films. Macroalgae with noticeable film-formation, abundant, low-cost, and edible properties is a promising bioresource for sustainable and eco-friendly packaging materials. However, the poor hydrophobicity and mechanical properties of sustainable macroalgae biofilms seriously impede their practical applications. Herein, lignin nanoparticles (LNPs) produced by a sustainable approach from black liquor of coconut fiber waste were incorporated in the macroalgae matrix to improve the water tolerance and mechanical characteristics of the biofilms. The effect of different LNPs loadings on the performance of biofilms, such as physical, morphological, surface roughness, structural, water resistance, mechanical, and thermal behaviors, were systematically evaluated and found to be considerably improved. Biofilm with 6 % LNPs presented the optimum enhancement in most ultimate performances. The optimized biofilm exhibited great hydrophobic features with a water contact angle of over 100° and high enhancement in the tensile strength of >60 %. This study proposes a facile and sustainable approach for designing and developing LNPs-macroalgae biofilms with excellent and multifunctional properties for sustainable high-performance packaging materials.
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Nanopartículas , Alga Marinha , Lignina , Cocos , Biofilmes , ÁguaRESUMO
The Pseudomonas aeruginosa OG1 strain was used in the bacterial synthesis of MgSe compound nanoparticles. The obtained samples were subsequently shaped into nanocrystalline MgSe films, and their optical, structural, morphological, and electrical properties were assessed on glass and p-Si substrates. Structural and morphological characterizations showed that the fabricated thin film samples have a polycrystalline structure with high quality and uniform grain sizes. The MgSe films produced on glass substrates exhibit a direct spectral band gap of 2.53 eV, according to optical measurements. The Ag/MgSe/p-Si layered diode structure was fabricated using the produced MgSe nanoparticles and then characterized by electrical properties. Electrical measurements were carried out under these two conditions to assess the effects of dark and illumination conditions on the band dynamics of the heterostructure devices. Under illumination, the barrier height decreased while the interface density states distribution increased. These measurements showed that using bacterial-assisted grown MgSe nanocrystalline films, the developed Ag/MgSe/p-Si device structure exhibited a remarkable photoresponse and stable rectifying property. Green synthesis methods for the production of these nanocrystalline materials have the potential to offer low-cost alternatives for photosensitive applications.
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Soil fertilizers have the potential to significantly increase crop yields and improve plant health by providing essential nutrients to the soil. The use of fertilizers can also help to improve soil structure and fertility, leading to more resilient and sustainable agricultural systems. However, overuse or improper use of fertilizers can lead to soil degradation, which can reduce soil fertility, decrease crop yields, and damage ecosystems. Thus, several attempts have been made to overcome the issues related to the drawbacks of fertilizers, including the development of an advanced fertilizer delivery system. Biopolymer aerogels show promise as an innovative solution to improve the efficiency and effectiveness of soil-fertilizer delivery systems. Further research and development in this area could lead to the widespread adoption of biopolymer aerogels in agriculture, promoting sustainable farming practices and helping to address global food-security challenges. This review discusses for the first time the potential of biopolymer-based aerogels in soil-fertilizer delivery, going through the types of soil fertilizer and the advert health and environmental effects of overuse or misuse of soil fertilizers. Different types of biopolymer-based aerogels were discussed in terms of their potential in fertilizer delivery and, finally, the review addresses the challenges and future directions of biopolymer aerogels in soil-fertilizer delivery.
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BACKGROUND: Prostate cancer is the second most common cancer in males worldwide, with αVß5 in-tegrin, a coactivator receptor, being highly expressed in advanced prostate cancer. Irisin, a hormone secreted from skeletal muscles, can reduce cell viability and migration and potentially inhibit αVß5. OBJECTIVE: This study investigates the potential impact of irisin on prostate cancer cells and its underlying mechanism. METHODS: In vitro evaluation of the antiproliferative action of irisin on metastatic prostate cancer (PC-3) cells was tested through MTT assay, flow cytometry, and Western blot. An in vivo evaluation of the antiproliferative effect on prostate cancer xenograft was evaluated in nude mice. RESULTS: In vitro evaluations showed that irisin reduced PC-3 cell viability to 70% and increased the Annexin-V/7AAD positive cell population. Irisin altered the expression of apoptotic proteins, αVß5, and proteins involved in the P13k-Akt pathway. In vivo, irisin inhibited tumor growth and progression, positively affecting animal well-being. In conclusion, irisin has an apoptotic effect on PC-3, possibly through altering αVß5 and the Bcl2/BAX and P13k-Akt signaling pathway, inhibiting tumor growth in vivo. CONCLUSION: Our findings can serve as a foundation for further evaluation of irisin's role in prostate cancer.
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Starch nanocrystals (SNCs) are tiny particles that possess unique qualities due to their small size, such as increased crystallinity, thin sheet structure, low permeability, and strong resistance to digestion. Although sago starch nanocrystals (SNCs) are naturally hydrophilic, their properties can be modified through chemical modifications to make them more versatile for various applications. In this study, the esterification process was used to modify SNCs using lauroyl chloride (LC) to enhance their surface properties. Three different ratios of LC to SNC were tested to determine the impact on the modified SNC (mSNC). The chemical changes in the mSNC were analyzed using FTIR and 1H NMR spectroscopy. ##The results showed that as the amount of LC increased, the degree of substitution (DS) also increased, which reduced the crystallinity of the mSNC and its thermal stability. However, the esterification process also improved the hydrophobicity of the SNC, making it more amphiphilic. The emulsification capabilities of the mSNC were investigated using a Pickering emulsion, and the results showed that the emulsion made from mSNC-1.0 had better stability than the one made from pristine SNC. This study highlights the potential of SNC as a particle emulsifier and demonstrates how esterification can improve its emulsification capabilities.
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Nanopartículas , Amido , Amido/química , Emulsões/química , Lauratos , Tamanho da Partícula , Emulsificantes/química , Nanopartículas/química , CloretosRESUMO
In addition to environmental concerns, the presence of microorganisms in plastic food packaging can be hazardous to human health. In this work, cinnamon nanoparticles incorporated with red seaweed (Kappaphycus alvarezii) biopolymer films were fabricated using a solvent casting method. Cinnamon was used as a filler to enhance the properties of the films at different concentrations (1, 3, 5, and 7% w/w) by incorporating it into the matrix network. The physico-chemical, thermal, mechanical, and antimicrobial properties of the cinnamon biopolymer films were obtained using dynamic light scattering (DLS), scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transmission infrared spectroscopy (FT-IR), water contact angle (WCA) measurement, thermogravimetric analysis (TGA), mechanical testing, and antimicrobial testing, respectively. The results showed that the addition of cinnamon nanoparticles to the film improved the morphological, mechanical, thermal, wettability, and antibacterial properties of the nanocomposite films. The cinnamon particles were successfully reduced to nano-sized particles with an average diameter between 1 nm and 100 nm. The hydrophobicity of the film increased as the concentration of cinnamon nanoparticles incorporated into the seaweed matrix increased. The tensile and thermal properties of the cinnamon seaweed biopolymer film were significantly improved with the presence of cinnamon nanoparticles. The biopolymer films exhibited good inhibitory activity at 7% cinnamon nanoparticles against Escherichia coli (E. coli), Staphylococcus aureus (S. aureus), and Salmonella bacteria with inhibition zone diameters of 11.39, 10.27, and 12.46 mm, indicating the effective antimicrobial activity of the biopolymer film. The functional properties of the fabricated biopolymer film were enhanced with the addition of cinnamon nanoparticles.
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Plastic pollution has raised interest in biodegradable and sustainable plastic alternatives. For edible food packaging, seaweed biopolymers have been studied for their film-forming properties. In this study, packaging films were developed using the solvent casting technique from natural red seaweed (Kappaphycus alvarezii) and coffee waste product. The physico-chemical and thermal properties of seaweed/coffee biopolymer films was obtained using dynamic light scattering (DLS), scanning electron microscopy (SEM), Fourier transmission irradiation (FT-IR), water contact angle measurement (WCA) and thermogravimetric analysis (TGA). The characterization study was carried out to improve the film's morphological, thermal, and mechanical properties. The average particle size of coffee waste was found to be between 1.106 and 1.281 µm, with a zeta potential value of -27.0 mV indicating the compound's strong negative charge. The SEM analysis revealed that the coffee filler was evenly dispersed in the polymer matrix, improving the film's structural properties. The FT-IR result shows that coffee waste was successfully incorporated over the film matrix with the presence of a N-H bond. The hydrophobic property of the film was enhanced with the incorporation of coffee filler, indicating increased water contact angle compared to the neat film. The tensile properties of the biopolymer film were significantly improved at 4 wt% coffee powder with optimum tensile strength (35.47 MPa) with the addition of coffee waste powder. The incorporation of coffee waste into the seaweed matrix increased the functional properties of the fabricated biopolymer film. Thus, seaweed/coffee biopolymer film has the potential to be used in food packaging and other applications.
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Cue-based associative learning (i.e., Pavlovian conditioning) is a foundational component of behavior in almost all forms of animal life and may provide insight into individual differences in addiction liability. Cues can take on incentive-motivational properties (i.e., incentive salience) through Pavlovian learning. Extensive testing with non-human animals (primarily rats) has demonstrated significant variation among individuals in the behaviors this type of learning evokes. So-named "sign-trackers" and "goal-trackers" have been examined in many studies of non-human animals, but this work in humans is still a nascent area of research. In the present proof-of-concept study, we used a Pavlovian conditioned approach task to investigate human sign- and goal-tracking in emerging adults. Conditioned behaviors that developed over the course of the task were directed toward the reward-cue and toward the reward location. Participants' eye-gaze and behavior during the task were submitted to a latent profile analysis, which revealed three groups defined as sign-trackers (n = 10), goal-trackers (n = 4), and intermediate responders (n = 36). Impulsivity was a significant predictor of the sign-tracking group relative to the goal-tracking group. The present study provides preliminary evidence that a simple procedure can produce learned Pavlovian conditioned approach behavior in humans. Though further investigation is required, findings provide a promising step toward the long-term goal of translating important insights gleaned from basic research into treatment strategies that can be applied to clinical populations.
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Objetivos , Motivação , Animais , Condicionamento Clássico , Sinais (Psicologia) , Humanos , Ratos , Ratos Sprague-Dawley , RecompensaRESUMO
The development of bioplastic materials that are biobased and/or degradable is commonly presented as an alleviating alternative, offering sustainable and eco-friendly properties over conventional petroleum-derived plastics. However, the hydrophobicity, water barrier, and antimicrobial properties of bioplastics have hindered their utilization in packaging applications. In this study, lignin nanoparticles (LNPs) with a purification process were used in different loadings as enhancements in a Kappaphycus alvarezii matrix to reduce the hydrophilic nature and improve antibacterial properties of the matrix and compared with unpurified LNPs. The influence of the incorporation of LNPs on functional properties of bioplastic films, such as morphology, surface roughness, structure, hydrophobicity, water barrier, antimicrobial, and biodegradability, was studied and found to be remarkably enhanced. Bioplastic film containing 5% purified LNPs showed the optimum enhancement in almost all of the ultimate performances. The enhancement is related to strong interfacial interaction between the LNPs and matrix, resulting in high compatibility of films. Bioplastic films could have additional advantages and provide breakthroughs in packaging materials for a wide range of applications.
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The interaction of electromagnetic (EM) waves with the COVID-19 virus is studied to define the frequencies that cause maximum energy absorption by the virus and the power level needed to cause a lethal temperature rise. The full-wave EM simulator is used to model the virus and study the effects of its size and dielectric properties on the absorbed power across a wide range of frequencies. The results confirm potential resonance conditions, where specific frequencies produce maximum absorption and subsequent temperature rise that can destroy the virus. Furthermore, the study confirms that maximum power deposition in the virus occurs at specific wavelengths depending on its size. Also, the simulation is used to find the power required to destroy the virus and determine the total power required to destroy it in an oral activity, such as coughing, made by infected individuals. Furthermore, the study explained why irradiation by UV-C band is effective to decrease virus activity or even eradicate it.
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The growing concern about pollution produced by plastic waste and the consequent environmental dangers has led to increased interest in replacing plastics with sustainable and biodegradable alternatives. Biopolymers such as seaweed have been examined for their film-forming characteristics to make edible films for packaging applications. This study aimed to prepare biopolymeric packaging films through a solvent-casting process using natural red seaweed (Kappaphycus alvarezii) and kenaf cellulose nanofiber (CNF), followed by film surface treatment using silane. The hydrophobic properties of the seaweed/CNF biopolymer were examined through water solubility (WS), moisture absorption capacity (MAC), water vapor permeability (WVP), and contact angle (CA) measurements. Fourier transform infra-red (FT-IR) film spectra clearly showed successful modification of the seaweed film (SF) by silane and the incorporation of kenaf CNF over the surface of the seaweed film. The wettability-related analysis showed positive results in determining the modified film's hydrophobicity properties. Film degradation analysis using the soil burial method showed a lower degradation rate for films with a higher CNF loading. Overall, the characterization results of the seaweed/CNF biopolymer film predicted hydrophobicity properties. The slow degradation rate was improved with surface modification using silane treatment and the incorporation of kenaf CNF filler with the seaweed matrix. As a result, we found that the seaweed/CNF biopolymer film could be used as high-grade packaging material in many potential applications.
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Starch hydrogels are highly available, biocompatible and biodegradable materials that have promising applications in medical and pharmaceutical industries. However, their applications are very limited due to their poor mechanical properties and fragility. Here, we investigated, for the first time, conventional corn and waxy corn starch-based hydrogels for loading patchouli essential oil. The essential oil extracted by supercritical carbon dioxide with a yield reached 8.37 ± 1.2 wt.% (wet sample) at 80 °C temperature and 10 MPa pressure. Patchouli essential oil exhibited a 23 to 28 mm zone of inhibition against gram-positive and gram-negative bacteria. Waxy starch hydrogels had better properties in term of viscosity, water evaporation stability and the delivery of essential oil than conventional starch hydrogels. The viscosity and spreadability of a 6% waxy starch sample were 15,016 ± 59 cP and 4.02 ± 0.34 g·cm/s, respectively, compared with those of conventional starch hydrogel (13,008 ± 29 cP and 4.59 ± 0.88 g·cm/s). Waxy starch-based hydrogels also provided slower in vitro biodegradation behavior and sustained release of essential oil compared with conventional starch hydrogels. All the samples were biocompatible and non-cytotoxic to fibroblast cells; the addition of patchouli essential oil enhances the proliferation of the cells. The enhanced viscosity, good antibacterial and improved biocompatibility results of prepared hydrogels confirm their suitability for wound healing applications.
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Xerogels are advanced, functional, porous materials consisting of ambient, dried, cross-linked polymeric networks. They possess characteristics such as high porosity, great surface area, and an affordable preparation route; they can be prepared from several organic and inorganic precursors for numerous applications. Owing to their desired properties, these materials were found to be suitable for several medical and biomedical applications; the high drug-loading capacity of xerogels and their ability to maintain sustained drug release make them highly desirable for drug delivery applications. As biopolymers and chemical-free materials, they have been also utilized in tissue engineering and regenerative medicine due to their high biocompatibility, non-immunogenicity, and non-cytotoxicity. Biopolymers have the ability to interact, cross-link, and/or trap several active agents, such as antibiotic or natural antimicrobial substances, which is useful in wound dressing and healing applications, and they can also be used to trap antibodies, enzymes, and cells for biosensing and monitoring applications. This review presents, for the first time, an introduction to biopolymeric xerogels, their fabrication approach, and their properties. We present the biological properties that make these materials suitable for many biomedical applications and discuss the most recent works regarding their applications, including drug delivery, wound healing and dressing, tissue scaffolding, and biosensing.
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HYPOTHESIS: As compared to common aliphatic surfactants, increasing the number of pendant or incorporated aromatic groups in a surfactant is expected to offer significant enhancement in the affinity for graphene surfaces. The basis for enhanced graphene-philicity of aromatic surfactants is that they can develop appreciable π - π interactions with graphene. Furthermore, charged (anionic) surfactants are expected to confer electrostatic stabilization on surfactant-graphene composites. Hence, it is expected that anionic aromatic surfactants combine these two properties for effective stabilization of graphene dispersions in water. EXPERIMENTAL: The properties of two custom made graphene-compatible surfactants carrying two and three aromatic moieties in the hydrophobic tails, namely DC3Ph2 (sodium 1,4-dioxo-1,4-bis(3-phenylpropoxy)butane-2-sulfonate) and TC3Ph3 (sodium 1,5-dioxo-1,5-bis(3-phenylpropoxy)-3-((3-phenylpropoxy)carbonyl) pentane-2-sulfonate) were compared with other common ionic commercial surfactants. Air-water (a/w) surface tension measurements were used to assess the surfactant adsorption and interfacial packing in the absence and presence of graphene. The surfactant coverage index for graphene (Ф) was calculated using surfactant headgroup areas derived from a/w surface tension data, chain volumes, and molecular fragment volumes from literature. FINDINGS: Increasing the number of aromatic groups and tails per surfactant was shown to increase the ability of surfactants to pack and fill space, as expressed by Ф. Comparison between the values of Ф for surfactants of different chain structure and architecture showed that the affinity for graphene increased with Ф. Hence, there is an implicit link between surfactant-graphene compatibility and the identity, chemical composition and architecture of the surfactant chains.
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Grafite , Tensoativos , Sódio , Tensão Superficial , Tensoativos/química , Água/químicaRESUMO
Oil spills and oily wastewater have become a major environmental problem in recent years, directly impacting the environment and biodiversity. Several techniques have been developed to solve this problem, including biological degradation, chemicals, controlled burning, physical absorption and membrane separation. Recently, biopolymeric aerogels have been proposed as a green solution for this problem, and they possess superior selective oil absorption capacity compared with other approaches. Several modification strategies have been applied to nanocellulose-based aerogel to enhance its poor hydrophobicity, increase its oil absorption capacity, improve its selectivity of oils and make it a compressible and elastic magnetically responsive aerogel, which will ease its recovery after use. This review presents an introduction to nanocellulose-based aerogel and its fabrication approaches. Different applications of nanocellulose aerogel in environmental, medical and industrial fields are presented. Different strategies for the modification of nanocellulose-based aerogel are critically discussed in this review, presenting the most recent works in terms of enhancing the aerogel performance in oil absorption in addition to the potential of these materials in near future.
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Cellulose nanofibers (CNFs) are the most advanced bio-nanomaterial utilized in various applications due to their unique physical and structural properties, renewability, biodegradability, and biocompatibility. It has been isolated from diverse sources including plants as well as textile wastes using different isolation techniques, such as acid hydrolysis, high-intensity ultrasonication, and steam explosion process. Here, we planned to extract and isolate CNFs from carpet wastes using a supercritical carbon dioxide (Sc.CO2) treatment approach. The mechanism of defibrillation and defragmentation caused by Sc.CO2 treatment was also explained. The morphological analysis of bleached fibers showed that Sc.CO2 treatment induced several longitudinal fractions along with each fiber due to the supercritical condition of temperature and pressure. Such conditions removed th fiber's impurities and produced more fragile fibers compared to untreated samples. The particle size analysis and Transmission Electron Microscopes (TEM) confirm the effect of Sc.CO2 treatment. The average fiber length and diameter of Sc.CO2 treated CNFs were 53.72 and 7.14 nm, respectively. In comparison, untreated samples had longer fiber length and diameter (302.87 and 97.93 nm). The Sc.CO2-treated CNFs also had significantly higher thermal stability by more than 27% and zeta potential value of -38.9± 5.1 mV, compared to untreated CNFs (-33.1 ± 3.0 mV). The vibrational band frequency and chemical composition analysis data confirm the presence of cellulose function groups without any contamination with lignin and hemicellulose. The Sc.CO2 treatment method is a green approach for enhancing the isolation yield of CNFs from carpet wastes and produce better quality nanocellulose for advanced applications.
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OBJECTIVE: End-of-life and anticipatory medications (AMs) have been widely used in various health care settings for people approaching end-of-life. Lack of access to medications at times of need may result in unnecessary hospital admissions and increased patient and family distress in managing palliative care at home. The study aimed to map the use of end-of-life and AM in a cohort of palliative care patients through the use of the Population Level Analysis and Reporting Data Space and to discuss the results through stakeholder consultation of the relevant organizations. METHODS: A retrospective observational cohort study of 799 palliative care patients in 25 Australian general practice health records with a palliative care referral was undertaken over a period of 10 years. This was followed by stakeholders' consultation with palliative care nurse practitioners and general practitioners who have palliative care patients. RESULTS: End-of-life and AM prescribing have been increasing over the recent years. Only a small percentage (13.5%) of palliative care patients received medications through general practice. Stakeholders' consultation on AM prescribing showed that there is confusion about identifying patients needing medications for end-of-life and mixed knowledge about palliative care referral pathways. SIGNIFICANCE OF RESULTS: Improved knowledge and information around referral pathways enabling access to palliative care services for general practice patients and their caregivers are needed. Similarly, the increased utility of screening tools to identify patients with palliative care needs may be useful for health care practitioners to ensure timely care is provided.