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  1. Fulltext Antimicrobial Use Among Hospitalized Neonates and Children; Findings and Implications from a Comprehensive Point Prevalence Survey Among General Tertiary Hospitals in Pakistan
    Mustafa ZU, Salman M, Khan AH, Harun SN, Meyer JC, Godman B
    Infect Drug Resist, 2024;17:5411-5428.
    PMID: 39664724 DOI: 10.2147/IDR.S491454
    PURPOSE: Antimicrobial resistance is a global health crisis exacerbated by excessive and inappropriate use of antibiotics, especially among low- and middle-income countries including Pakistan. The paediatric population is a key area in view of their vulnerability and excessive prescribing of antibiotics in Pakistan. Consequently, there is an urgent need to robustly assess antimicrobial use among hospitalized neonates and children in tertiary hospitals in Pakistan as they are generally the training centres for new physicians subsequently treating children.

    PATIENTS AND METHODS: A point prevalence survey (PPS) was conducted in the children's wards of 14 tertiary care hospitals in Punjab Province, covering over 50% of the population of Pakistan. This builds on a previous PPS among tertiary care hospitals treating exclusively neonates and children.

    RESULTS: A total of 1811 neonates and children were surveyed with 1744 patients prescribed antibiotics, a prevalence of 96.3%. A total of 2747 antibiotics were prescribed to these 1744 neonates and children, averaging 1.57 antibiotics per patient. Overall, 57.7% of the patients were prescribed one antibiotic and 27.2% two antibiotics, with 85.6% of antibiotics administered parenterally. Over a third (34.4%) of the antibiotics were prescribed prophylactically, with 44.7% of them for surgical procedures. Among those prescribed antibiotics for surgical procedures, 75.2% were prescribed for more than one day. Overall, 92.2% of antibiotics were prescribed empirically, with 86.2% prescribed without mentioning the rationale for their choice in the notes, with 77.6% having no stop date. Respiratory tract infections were the most common indication (43.4%). Staphylococcus species (36.0%) were the most common pathogen with limited Culture and Sensitivity Testing performed. Three quarters (75.2%) of antibiotics were from the Watch list, and 24.4% were Access antibiotics.

    CONCLUSION: A very high prevalence of antibiotic use among neonates and children in tertiary hospitals in Pakistan, including Watch antibiotics, mirroring previous studies. Consequently, initiatives including antimicrobial stewardship programmes are urgently needed to address current inappropriate prescribing.

  2. Development and validation of the renal dosing questionnaire (RDQ-13) for pharmacists
    Zafar R, Rehman IU, Shah Y, Ming LC, Hadi MA, Suleiman AK, et al.
    Medicine (Baltimore), 2024 Dec 20;103(51):e41004.
    PMID: 39705490 DOI: 10.1097/MD.0000000000041004
    Pharmacists, as an integral part of the healthcare team, can play a crucial role in preventing drug-related problems in patients with chronic kidney disease that arise due to inappropriate doses. This study aimed to develop and validate a new tool, the renal dosing questionnaire (RDQ-13), for pharmacists working across hospital, community, and retail pharmacy settings. A cross-sectional study was conducted from January to March 2023 among pharmacists working in different settings. The RDQ-13 scale consists of 3-sections, encompassing demographic details, a knowledge section with 6 domains, each having 4 questions with the choice of "yes/no," an attitude section featuring a Likert scale for 4 items, and a perception section featuring a Likert scale for 3 items. The assessment of construct and discriminative validity was performed along with testing for reliability. The average variance extracted value and the composite reliability value were used for convergent validity. A total of 65 pharmacists completed the RDQ-13, but at retest n = 2 participants were dropped (response rate at retest was 96.9%). Exploratory factor analysis revealed 3-factor loadings with 59.1% of the variance, whereas the Kaiser-Mayer-Olkin value was 0.60. The Cronbach alpha value of 0.700 indicates good internal consistency, whereas the intraclass correlation coefficient (ICC) for the test and retest showed that most domains/scores were statistically significant (P 
  3. Editorial: Drivers of antimicrobial resistance during and after COVID-19 pandemic in low-middle-income countries
    Mustafa ZU, Mallhi TH, Khan YH, Hayat K, Salman M
    Front Public Health, 2024;12:1521798.
    PMID: 39744378 DOI: 10.3389/fpubh.2024.1521798
  4. Fulltext Distributed Denial of Services (DDoS) attack detection in SDN using Optimizer-equipped CNN-MLP
    Mehmood S, Amin R, Mustafa J, Hussain M, Alsubaei FS, Zakaria MD
    PLoS One, 2025;20(1):e0312425.
    PMID: 39869573 DOI: 10.1371/journal.pone.0312425
    Software-Defined Networks (SDN) provides more control and network operation over a network infrastructure as an emerging and revolutionary paradigm in networking. Operating the many network applications and preserving the network services and functions, the SDN controller is regarded as the operating system of the SDN-based network architecture. The SDN has several security problems because of its intricate design, even with all its amazing features. Denial-of-service (DoS) attacks continuously impact users and Internet service providers (ISPs). Because of its centralized design, distributed denial of service (DDoS) attacks on SDN are frequent and may have a widespread effect on the network, particularly at the control layer. We propose to implement both MLP (Multilayer Perceptron) and CNN (Convolutional Neural Networks) based on conventional methods to detect the Denial of Services (DDoS) attack. These models have got a complex optimizer installed on them to decrease the false positive or DDoS case detection efficiency. We use the SHAP feature selection technique to improve the detection procedure. By assisting in the identification of which features are most essential to spot the incidents, the approach aids in the process of enhancing precision and flammability. Fine-tuning the hyperparameters with the help of Bayesian optimization to obtain the best model performance is another important thing that we do in our model. Two datasets, InSDN and CICDDoS-2019, are utilized to assess the effectiveness of the proposed method, 99.95% for the true positive (TP) of the CICDDoS-2019 dataset and 99.98% for the InSDN dataset, the results show that the model is highly accurate.
  5. Fulltext Exploring the Therapeutic Potential of Podophyllum hexandrum Root Extract: Chemical Composition, Antimicrobial Efficacy, and Antioxidant and Anticancer Activities
    Sofi MA, Sofi MA, Nanda A, Nayak BK, Othman Z, Sadikan MZ
    Scientifica (Cairo), 2025;2025:5100547.
    PMID: 40134767 DOI: 10.1155/sci5/5100547
    Medicinal plants have been used for centuries as therapeutic compounds to address various health issues. Their rich phytochemical composition offers diverse bioactive substances with potential health benefits. This study aimed to explore the therapeutic potential of Podophyllum hexandrum root extract by investigating its chemical composition and antimicrobial, antioxidant, and anticancer properties. The phytochemical profiling of P. hexandrum root was conducted using GC-MS analysis, which identified 26 compounds in the extract. The ethanolic root extract displayed strong inhibitory effects in the well diffusion assay against all tested microbes, with minimum inhibitory concentration (MIC) values ranging from 64 to 256 μg/mL. Candida albicans exhibited the lowest MIC value of 64 μg/mL. The antioxidant activity of the extracts was compared to standard antioxidant, revealing a dose-dependent response with a notable radical scavenging activity of 59.23% at 100 μg/mL. Furthermore, the extract demonstrated strong cytotoxic effects against the human cancer cell line HT-29, with IC50 values of 38.20 and 32.5 μg/mL for 24 and 48 h. Overall, this study emphasizes the remarkable antibacterial, antioxidant, and anticancer properties of P. hexandrum root extract.
  6. A Study of Skin Cancer Knowledge, Attitudes, and Preventive Practices Among Healthcare Professionals and the General Population in Pakistan: Insights for Healthcare Interventions and Policy Development
    Aslam A, Jamshed S, Mustafa AG, Shanmugham S, Wazir A, Ali Hussnain, et al.
    J Skin Cancer, 2025;2025:3035274.
    PMID: 40151506 DOI: 10.1155/jskc/3035274
    Background: Skin cancer is a major global health issue that can be life-threatening. The current study explores the knowledge, attitudes, and practices of healthcare professionals and the general population regarding skin cancer. Method: A cross-sectional study was conducted between January and June 2023 in Lahore, the second-largest city in Pakistan. A total of 407 respondents from the general population and 230 healthcare professionals were recruited using a convenient and snowball sampling technique, respectively. Data were collected using questionnaires and statistical analysis, including chi-square tests, and bivariate logistic regression was performed using SPSS Version 20. Result: In the overall population, 46.4% identified as male, 45.0% as female, and 8.6% chose not to disclose their gender. Significantly differing levels of skin cancer knowledge were observed between genders, with males reporting a higher knowledge (36.4%, crude odds ratio = 1.413, p 
  7. Bridging the gap: Evaluating communication effectiveness and satisfaction towards telepsychiatry services at a teaching hospital from the providers' and patients' perspectives
    Shaharudin MA, Mohd Daud TI, Sy-Cherng LW, Abdul Manaf MR
    Australas Psychiatry, 2026 Oct 28.
    PMID: 42949258 DOI: 10.1177/10398562261501495
    BackgroundThe COVID-19 pandemic accelerated telepsychiatry adoption, proving its flexibility despite ongoing challenges.AimThis study investigated whether perceived communication effectiveness, satisfaction, and technology self-efficacy are associated with frequency of recent telepsychiatry use among mental health service providers (MHSPs) and patients at a Malaysian teaching hospital.MethodsA cross-sectional study was conducted between February and May 2024. Participants included MHSPs and patients with at least one telepsychiatry session. Independent variables-perceived communication effectiveness, satisfaction, and technology self-efficacy-were assessed using the Telehealth Usability Questionnaire (TUQ) and the Modified Technology Self-Efficacy Scale (MTSES). The dependent variable was frequency of recent telepsychiatry use within the past 2 months. Associated factors were identified via comparative analyses and ordinal logistic regression.ResultsAmong 92 MHSP respondents (median age 36; 65.7% female), perceived communication effectiveness significantly associated with frequency of recent use (adjusted OR: 2.05, p = 0.008); satisfaction and self-efficacy were not significant. For patients, only younger age significantly associated with recent telepsychiatry use (adjusted OR: 0.90, 95% CI: 0.82-0.98; p = 0.016).ConclusionPerceived communication effectiveness is associated with more frequent recent telepsychiatry use among providers, while satisfaction and technology self-efficacy are not. These findings suggest that enhancing the perceived utility is essential for broader adoption.
  8. Screening of medicinal phytocompounds with structure-based approaches to target key hotspot residues in tyrosyl-DNA phosphodiesterase 1: augmenting sensitivity of cancer cells to topoisomerase I inhibitors
    Suleman M, Khan A, Khan SU, Alissa M, Alghamdi SA, Alghamdi A, et al.
    J Biomol Struct Dyn, 2025 Apr 15.
    PMID: 40231415 DOI: 10.1080/07391102.2025.2490061
    One of cancer's well-known hallmarks is DNA damage, yet it's intriguing that DNA damage has been explored as a therapeutic strategy against cancer. Tyrosyl-DNA phosphodiesterase 1, involved in DNA repair from topoisomerase I inhibitors, a chemotherapy class for cancer treatment. Inhibiting TDP1 can increase unresolved Top1 cleavage complexes in cancer cells, inducing DNA damage and cell death. TDP1's catalytic activity depends on His263 and His493 residues. Using molecular simulation, structure-based drug design, and free energy calculation, we identified potential drugs against TDP1. A multi-step screening of medicinal plant compound databases (North Africa, East Africa, Northeast Africa, and South Africa) identified the top four candidates. Docking scores for top hits 1-4 were -7.76, -7.37, -7.35, and -7.24 kcal/mol. Top hit 3 exhibited the highest potency, forming a strong bonding network with both His263 and His493 residues. All-atoms simulations showed consistent dynamics for top hits 1-4, indicating stability and potential for efficient interaction with interface residues. Minimal fluctuations in residue flexibility suggest these compounds can stabilize internal flexibility upon binding. The binding free energies of -35.11, -36.70, -31.38, and -23.85 kcal/mol were calculated for the top hit 1-4 complexes. Furthermore, the chosen compounds demonstrate outstanding ADMET characteristics, such as excellent water solubility, effective gastrointestinal absorption, and the absence of hepatotoxicity. Cytotoxicity analysis revealed top hit 2 higher probability of activity against 24 cancer cell lines. Our findings suggest that these compounds (top hits 1-4) hold promise for innovative drug therapies, suitable for both in vivo and in vitro experiments.
  9. PVTE system performance improvement via numerical optimization of heat sink design and fluid working conditions
    Azirul A, Ibrahim A, Nazri NS, Jarimi H, Mohd Zainuri MAA, Syafiq U
    Sci Rep, 2025 Apr 19;15(1):13586.
    PMID: 40253444 DOI: 10.1038/s41598-025-97461-x
    In recent times, there has been increasing interest to address climate change by implementing renewable energy to enhance the energy sector as soon as possible. However, solar radiation turns into heat reducing the photovoltaic (PV) panel efficiency. The waste heat from PV panels can be utilized by thermoelectric (TE) to convert into electricity and enhance PV panel efficiency. In this study, the 3D CFD and thermal-electric numerical model was developed for thermal and electrical analysis of different heat sink designs and materials for a thermoelectric generator (TEG) to be used in a (PV) system. Heat sink was installed on the cold side of the Photovoltaic-Thermoelectric (PVTE) system to dissipate the heat from the PV panels, where varying flow inlets and convection coefficient parameters for dissipating the heat on the cold side of the PVTE system were investigated. The simulated TEG power generation with different heat sink designs, heat sink materials, convection coefficients (h) and flow inlets (v) were compared. The results showed that the TEG with pin fin heat sink design (H3) made from aluminium (Al) generated the highest power generations than the other designs. The results also showed the power generation significantly increases until saturation point around 2.01 m s- 1 for the flow inlet and also increases when the convection coefficient increases above 20 (W/m2) °C.
  10. Fulltext Publisher Correction: Sensitivity analysis and dynamics of brucellosis infection disease in cattle with control incident rate by using fractional derivative
    Farman M, Hincal E, Jamil S, Gokbulut N, Nisar KS, Sambas A
    Sci Rep, 2025 Apr 09;15(1):12094.
    PMID: 40204737 DOI: 10.1038/s41598-025-91927-8
  11. Exploring the impact of particle stability, size, and morphology on nanofluid thermal conductivity: A comprehensive review for energy applications
    Farooq S, Habib M, Cardozo O, Ullah K, Pandey AK, Said Z
    Adv Colloid Interface Sci, 2025 Mar 28;341:103495.
    PMID: 40203562 DOI: 10.1016/j.cis.2025.103495
    Recent advancements enhance the efficiency of energy conversion processes and leverage nanofluids-novel thermal fluids with nanoparticles (under 100 nm) suspended in conventional fluids. These nanofluids significantly alter thermophysical properties, notably thermal conductivity, which is crucial for evaluating their thermal performance. Despite three decades of intensive research, disagreements persist due to a lack of comprehensive data on how particle size, shape, stability, and others influence thermal conductivity. This review tries to fill this literature gap by critically reviewing how the characteristics that distinguish nanofluids from their micrometer-sized counterparts affect the stability and convective heat transfer. The study compares experimental results in a systemic way that addresses the reported inconsistencies and provides a general summary of the thermal behavior of nanofluids in energy systems. It has also pointed out the lack of reliable hybrid models considering all parameters affecting thermal conductivity. The current study assembles data from different analyses showing that a particle size within the 10-50 nm range may enhance thermal conductivity, depending on the base-fluid used. Likewise, the morphological options available, namely, spherical, ellipsoid, platelet, and blade-like, all have given promise for enhancing thermal conductivity, hence considering morphological issues. Finally, stability, defined by the zeta potential analyses, forms a vital criterion for the long-term sustainability of these enhancements. By consolidating experimental results across different research groups, this review highlights the variability and sometimes contradictory findings in thermal conductivity enhancements, ranging from negligible increases to over 50% improvement in specific nanofluids systems. The absence of reliable hybrid models encapsulating all influencing parameters for predicting thermal conductivity is critically addressed. It is concluded by identifying the main challenges in the field and offering recommendations for standardizing measurement techniques, which include the need for a unified model capable of predicting thermal conductivity enhancements with an accuracy of ±5%.
  12. Fulltext Larvicidal Activity of Chisocheton erythrocarpus Nano-emulsion Formulation against Aedes aegypti
    Ngadni MA, Chong SL, Awang K, Azirun MS, Omar D, Ishak IH, et al.
    J Oleo Sci, 2025;74(4):385-395.
    PMID: 40175119 DOI: 10.5650/jos.ess24118
    This study aims to improve the larvicidal activity of crude Chisocheton erythrocarpus extract (CCEE) against Aedes aegypti larvae via nano-emulsion formulation method. The fruits of C. erythrocarpus possesses limonoids with good larvicidal activity against Aedes mosquitoes. Using ternary phase diagrams, four selected formulations were prepared using non-ionic surfactants, methylester and water. The optimized nano-emulsion (S5) was discovered to possess submicron particle size (36.32 nm), low polydispersity index (0.348) and higher zeta potential value (-18.2 mV). After 48-hours, the CCEE and S5 demonstrated respective LC50 values of 139.44 ppm and 75.83 ppm against Ae. aegypti larvae. Higher larvicidal activity of S5 signified improved cuticular penetration of the active ingredient. Moreover, morphological deformities of treated larvae indicated possible interference with the larvae's breathing mechanism, contributing to their death. Thus, the nano-emulsion formulation of C. erythrocarpus extract has the potential to be used as a vector control agent to prevent the spread of dengue infections.
  13. Fulltext Quetiapine-induced hypokalemic periodic paralysis in a pregnant woman: a case report
    Pauzi MHM, Kadir AA, Dinsuhaimi SI, Yudin ZM, Yusuf WNW
    Korean J Fam Med, 2025 Mar;46(2):115-119.
    PMID: 40139925 DOI: 10.4082/kjfm.24.0301
    Quetiapine-induced hypokalemic periodic paralysis (QIHPP) is a rare condition. Herein, we present the case of a 31-year-old pregnant Malay woman diagnosed with bipolar II disorder and QIHPP. She presented to the casualty department with a 2-day history of bilateral lower limb weakness and numbness. Her renal function tests showed moderate hypokalemia (2.5 mmol/L), whereas other investigations were normal. Quetiapine was suspected to be the cause, prompting a psychiatric referral to manage her acute condition. Balancing the risks of untreated QIHPP against the potential relapse of bipolar symptoms from quetiapine discontinuation or dosage reduction poses a significant treatment challenge for pregnant women with QIHPP. Finally, we reduced the quetiapine dosage after careful consideration, leading to the normalization of potassium levels and symptom resolution. Therefore, clinicians should be aware of this side effect when initiating or continuing quetiapine treatment in women of childbearing age or pregnant women with psychiatric disorders. It is crucial to monitor serum electrolytes, especially potassium, following quetiapine administration and warn patients about its potential side effects.
  14. Retraction notice to "The nexus between Islamic social finance, quality of human resource, governance, and poverty" [Heliyon 8 (2022) e11885]
    Widiastuti T, Mawardi I, Zulaikha S, Herianingrum S, Robani A, Al Mustofa MU, et al.
    Heliyon, 2025 Feb 28;11(4):e42820.
    PMID: 40201260 DOI: 10.1016/j.heliyon.2025.e42820
    [This retracts the article DOI: 10.1016/j.heliyon.2022.e11885.].
  15. Rehabilitation playthings design to promote positive emotions among people living with Alzheimer's Disease: a conceptual synthesis
    You D, Ramli SH, Ibrahim R, Romli MH, Chu Q, Yu X, et al.
    Disabil Rehabil Assist Technol, 2025 Apr 07.
    PMID: 40193318 DOI: 10.1080/17483107.2025.2484624
    Purpose: Cognitive decline and social isolation pose significant challenges to the well-being of people with Alzheimer's disease (AD). While recreational activities and rehabilitation playthings (RPTs) have demonstrated benefits in fostering positive emotions among this population, there remains a scarcity of playthings specifically designed to address their unique needs. This study aims to develop a conceptual framework for RPTs design to enhance emotional well-being in people living with AD. Materials and Methods: Guided by research question construct classification, this study identified three key research questions. A systematic literature review was conducted using Scopus, Web of Science, and PubMed to address these questions. Selected articles were evaluated based on their relevance to RPTs and their focus on improving social engagement and positive emotions in individuals with AD. Results: Through meticulous review and analysis, fifty-seven articles were selected and systematically categorized into sub-themes include: types of RPTs, meaningful activities associated with RPTs, design characteristics, and design principles and strategies. The results are further synthesized to formulate a potential theoretical proposition for future investigation. Conclusion: The proposed conceptual framework recommends that by integrating positive emotion design, compassionate design, co-creation, and suitable play experiences in RPTs design could preserve personhood and elicit positive emotions among people living with AD.
  16. Germline mutation and protein expression analysis of mismatch repair genes MSH6 and PMS2 in Malaysian Lynch syndrome patients
    Zahary MN, Kaur G, Hassan MR, Sidek AS, Singh H, Yeh LY, et al.
    Int J Colorectal Dis, 2014 Feb;29(2):261-2.
    PMID: 24072394 DOI: 10.1007/s00384-013-1770-1
  17. Synergism: biocontrol agents and biostimulants in reducing abiotic and biotic stresses in crop
    Anuar MSK, Hashim AM, Ho CL, Wong MY, Sundram S, Saidi NB, et al.
    World J Microbiol Biotechnol, 2023 Mar 19;39(5):123.
    PMID: 36934342 DOI: 10.1007/s11274-023-03579-3
    In today's fast-shifting climate change scenario, crops are exposed to environmental pressures, abiotic and biotic stress. Hence, these will affect the production of agricultural products and give rise to a worldwide economic crisis. The increase in world population has exacerbated the situation with increasing food demand. The use of chemical agents is no longer recommended due to adverse effects towards the environment and health. Biocontrol agents (BCAs) and biostimulants, are feasible options for dealing with yield losses induced by plant stresses, which are becoming more intense due to climate change. BCAs and biostimulants have been recommended due to their dual action in reducing both stresses simultaneously. Although protection against biotic stresses falls outside the generally accepted definition of biostimulant, some microbial and non-microbial biostimulants possess the biocontrol function, which helps reduce biotic pressure on crops. The application of synergisms using BCAs and biostimulants to control crop stresses is rarely explored. Currently, a combined application using both agents offer a great alternative to increase the yield and growth of crops while managing stresses. This article provides an overview of crop stresses and plant stress responses, a general knowledge on synergism, mathematical modelling used for synergy evaluation and type of in vitro and in vivo synergy testing, as well as the application of synergism using BCAs and biostimulants in reducing crop stresses. This review will facilitate an understanding of the combined effect of both agents on improving crop yield and growth and reducing stress while also providing an eco-friendly alternative to agroecosystems.
  18. Agroforestry orchards support greater butterfly diversity than monoculture plantations in the tropics
    Wan Zaki WM, Yahya MS, Norhisham AR, Sanusi R, van der Meer PJ, Azhar B
    Oecologia, 2023 Mar;201(3):863-875.
    PMID: 36914820 DOI: 10.1007/s00442-023-05348-3
    Large-scale deforestation in the tropics, triggered by logging and subsequent agricultural monoculture has a significant adverse impact on biodiversity due to habitat degradation. Here, we measured the diversity of butterfly species in three agricultural landscapes, agroforestry orchards, oil palm, and rubber tree plantations. Butterfly species were counted at 127 sampling points over the course of a year using the point count method. We found that agroforestry orchards supported a greater number of butterfly species (74 species) compared to rubber tree (61 species) and oil palm plantations (54 species) which were dominated by generalist (73%) followed by forest specialists (27%). We found no significant difference of butterfly species composition between agroforestry orchards and rubber tree plantation, with both habitats associated with more butterfly species compared to oil palm plantations. This indicates butterflies were able to persist better in certain agricultural landscapes. GLMMs suggested that tree height, undergrowth coverage and height, and elevation determined butterfly diversity. Butterfly species richness was also influenced by season and landscape-level variables such as proximity to forest, mean NDVI, and habitat. Understanding the factors that contributed to butterfly species richness in an agroecosystem, stakeholders should consider management practices to improve biodiversity conservation such as ground vegetation management and retaining adjacent forest areas to enhance butterfly species richness. Furthermore, our findings suggest that agroforestry system should be considered to enhance biodiversity in agricultural landscapes.
  19. The impact of environmental knowledge and green supply chain practices in improving sustainable energy production: the moderating role of green behavior and green leadership
    Chen SL, Su YS, Diep GL, Sivanandan P, Sadiq M, Phan TTH
    Environ Sci Pollut Res Int, 2023 Apr;30(19):57017-57031.
    PMID: 36930320 DOI: 10.1007/s11356-023-26340-7
    Global warming and the dreadful climate condition in China demands the sustainable energy transition and production that must be far away from coal-based energy production. The present article, thereby, intends to assess the effectiveness of environmental knowledge and green supply chain practices on sustainable energy production. The study also introduces green behavior and green leadership as a moderator to evaluate the proposed relationship. Primary data has been collected and assessed by PLS-SEM. The findings reveal that environmental knowledge, green purchases, and internal environmental management (IEM) have a positive association with sustainable energy production (SEP) in China. The outcomes also indicate that green behavior significantly moderates among environmental knowledge, green purchases, and SEP, and green leadership significantly moderates among IEM and SEP in China. The research guides the policymakers in establishing policies related to SEP using green behavior, GSC practices, and environmental knowledge.
  20. Fulltext Inhibition of CT26 Colon Cancer Cell Growth by Green-Synthesised Silver Nanoparticles-Mediated Strobilanthes crispus Extract
    Abd Ghafar SA, Hairil Anuar AH, Salihuddin MAH, Mohamad Hanafiah R
    Malays J Med Sci, 2026 Aug;33(4):51-62.
    PMID: 42936851 DOI: 10.21315/mjms-11-2025-798
    BACKGROUND: This study evaluated the antiproliferative and pro-apoptotic activities of green-synthesised silver nanoparticles using Strobilanthes crispus extract (AgNP-SC) against CT26 colon carcinoma cells. Strobilanthes crispus (S. crispus), rich in phytochemicals, was utilised as a natural reducing and stabilising agent during AgNP synthesis, potentially enhancing their cytotoxic potential.

    METHODS: AgNP-SC was synthesised by reducing silver nitrate with an aqueous extract of S. crispus, with nanoparticle formation indicated by the appearance of a dark brown colour. Cytotoxicity was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Apoptotic changes were examined through acridine orange/propidium iodide (AO/PI) staining, while cell cycle distribution was analysed using flow cytometry. Gene expression of apoptotic markers was analysed using reverse transcription polymerase chain reaction (RT-PCR).

    RESULTS: MTT analysis demonstrated a significant, concentration-dependent decrease in CT26 cell viability following AgNP-SC treatment, with cell viability reduced to below 50% at concentrations ≥ 25 μg/mL (P < 0.05). AO/PI staining revealed classical apoptotic features, including chromatin condensation, membrane blebbing, and nuclear fragmentation. Flow cytometric analysis showed a significant accumulation of cells in the G1 phase accompanied by a marked reduction in the S-phase population in treated groups compared to untreated controls (P < 0.05), indicating G1 cell cycle arrest and inhibition of DNA synthesis. RT-PCR analysis further demonstrated significant upregulation of pro-apoptotic genes (CED-3 and CED-4) and downregulation of the anti-apoptotic gene CED-9 (P < 0.05), confirming activation of the intrinsic mitochondrial apoptotic pathway.

    CONCLUSION: Green-synthesised AgNP-SC exhibits potent anticancer properties, suggesting its potential as a natural-based nanotherapeutic agent for colon cancer. Further in vivo and mechanistic studies are warranted to validate its therapeutic efficacy.

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