Browse publications by year: 2023

  1. Al-Japairai K, Hamed Almurisi S, Mahmood S, Madheswaran T, Chatterjee B, Sri P, et al.
    Int J Pharm, 2023 Nov 25;647:123536.
    PMID: 37865133 DOI: 10.1016/j.ijpharm.2023.123536
    Oral administration of drugs is preferred over other routes for several reasons: it is non-invasive, easy to administer, and easy to store. However, drug formulation for oral administration is often hindered by the drug's poor solubility, which limits its bioavailability and reduces its commercial value. As a solution, amorphous solid dispersion (ASD) was introduced as a drug formulation method that improves drug solubility by changing the molecular structure of the drugs from crystalline to amorphous. The hot melt extrusion (HME) method is emerging in the pharmaceutical industry as an alternative to manufacture ASD. However, despite solving solubility issues, ASD also exposes the drug to a high risk of crystallisation, either during processing or storage. Formulating a successful oral administration drug using ASD requires optimisation of the formulation, polymers, and HME manufacturing processes applied. This review presents some important considerations in ASD formulation, including strategies to improve the stability of the final product using HME to allow more new drugs to be formulated using this method.
  2. Khairunnisa-Atiqah MK, Salleh KM, Hair AHA, Mazlan NSN, Mostapha M, Zakaria S
    Int J Biol Macromol, 2023 Dec 31;253(Pt 8):127518.
    PMID: 37865379 DOI: 10.1016/j.ijbiomac.2023.127518
    Cotton thread therapeutic properties as a wound dressing can be enhanced by utilising carboxymethyl cellulose-nanoparticles (CMC/NPs) colloidal solution as a coating solution. Nanoparticles such as graphene oxide (GO), graphene quantum dots (GQD), and silver nanoparticles (AgNP) stability in CMC was investigated through the rheological analysis and UV-Vis spectroscopy of the colloidal solutions. Citric acid (CA) acted as a crosslinker and was utilised to crosslink the colloidal solution with cotton thread. These CMC/NPs coated threads were subjected to mechanical properties and antibacterial activity analysis. Results obtained indicate less nanoparticle agglomeration and were stable in the CMC-based nanofluid. CMC/NPs rheological study suggested that colloidal solutions exhibited shear thinning behaviour and behaved as non-Newtonian fluids with n 
  3. Thomas AR, Soe HHK, Silva CS, Kaur H, Ganendrah LD, Gomez LM
    Am J Dent, 2023 Oct;36(5):246-250.
    PMID: 37865812
    PURPOSE: To compare the accuracy and reliability of cone-beam computed tomography (CBCT) and laser scanner in measuring minor volume changes such as the root canal space.

    METHODS: 35 maxillary incisors were endodontically prepared. A dimensionally stable silicone material was injected into the root canal space and scanned with CBCT. The root canal volume was measured using Romexis 3.0.1 R software. Replicas were carefully removed from the teeth and scanned using an extraoral laser scanner. These images were exported to the Rhinoceros software for volume measurement. The volume of each replica was also assessed using the gravimetric method. To determine the accuracy, the volume obtained from both devices was compared with the gravimetric method. Statistical analysis was done using a paired t-test. The reliability was assessed using the intraclass correlation coefficient.

    RESULTS: There was no statistically significant difference between the mean volume of CBCT 27.04 ± 7.25 mm³ and the mean volume of the gravimetric method 27.87 ± 7.17 mm³ (P< 0.05). A statistically significant difference was seen with the laser scanner at 25.31 ± 6.89 mm³ and the gravimetric method at 27.87 ± 7.17 mm³ (P< 0.05). CBCT showed a good degree of agreement (ICC 0.899), while the laser scanner showed a moderate degree of agreement (ICC 0.644) with the gravimetric method. CBCT proved accurate and reliable in measuring minor volumes like the root canal space, ideally in the range of 20-25 mm³. The laser scanner presented acceptable reliability.

    CLINICAL SIGNIFICANCE: The laboratory data showed satisfactory outcomes, providing an evidence-based approach and potentially motivating clinicians to integrate cone-beam computed tomography for volume analysis into clinical practice. The accuracy and reliability of laser scanners for small-volume analysis have not previously been evaluated. Consequently, the findings from this study warrant further clinical investigations.

    MeSH terms: Lasers; Root Canal Therapy/methods; Reproducibility of Results; Spiral Cone-Beam Computed Tomography*
  4. Li J, Fong DYT, Lok KYW, Wong JYH, Ho MM, Choi EPH, et al.
    J Glob Health, 2023 Oct 20;13:04125.
    PMID: 37861130 DOI: 10.7189/jogh.13.04125
    BACKGROUND: The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences.

    METHODS: An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic.

    RESULTS: Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction).

    CONCLUSIONS: Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation.

    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Life Style*; Male; Quality of Life*; Exercise; Outcome Assessment (Health Care)
  5. Cahyanto A, Rath P, Teo TX, Tong SS, Malhotra R, Cavalcanti BN, et al.
    J Dent Res, 2023 Dec;102(13):1425-1433.
    PMID: 37861249 DOI: 10.1177/00220345231198185
    Calcium silicate (C3S) cements are available in kits that do not account for patients' specific needs or clinicians' preferences regarding setting time, radiopacity, mechanical, and handling properties. Moreover, slight variations in powder components and liquid content affect cement's properties and bioactivity. Unfortunately, it is virtually impossible to optimize several cement properties simultaneously via the traditional "one variable at a time" strategy, as inputs often induce trade-offs in properties (e.g., a higher water-to-powder ratio [W/P] increases flowability but decreases mechanical properties). Herein, we used Taguchi's methods and genetic algorithms (GAs) to simultaneously analyze the effect of multiple inputs (e.g., powder composition, radiopacifier concentration, and W/P) on setting time, pH, flowability, diametral tensile strength, and radiopacity, as well as prescribe recipes to produce cements with predicted properties. The properties of cements designed with GAs were experimentally tested, and the results matched the predictions. Finally, we show that the cements increased the genetic expression of odonto/osteogenic genes, alkaline phosphatase activity, and mineralization potential of dental pulp stem cells. Hence, GAs can produce cements with tailor-made properties and differentiation potential for personalized endodontic treatment.
    MeSH terms: Calcium; Drug Combinations; Glass Ionomer Cements; Humans; Materials Testing; Oxides/chemistry; Powders; Aluminum Compounds/chemistry; Silicates/pharmacology; Silicates/chemistry
  6. Chin H, Song H, Baek G, Shin M, Jung C, Cha M, et al.
    J Med Internet Res, 2023 Oct 20;25:e51712.
    PMID: 37862063 DOI: 10.2196/51712
    BACKGROUND: Artificial intelligence chatbot research has focused on technical advances in natural language processing and validating the effectiveness of human-machine conversations in specific settings. However, real-world chat data remain proprietary and unexplored despite their growing popularity, and new analyses of chatbot uses and their effects on mitigating negative moods are urgently needed.

    OBJECTIVE: In this study, we investigated whether and how artificial intelligence chatbots facilitate the expression of user emotions, specifically sadness and depression. We also examined cultural differences in the expression of depressive moods among users in Western and Eastern countries.

    METHODS: This study used SimSimi, a global open-domain social chatbot, to analyze 152,783 conversation utterances containing the terms "depress" and "sad" in 3 Western countries (Canada, the United Kingdom, and the United States) and 5 Eastern countries (Indonesia, India, Malaysia, the Philippines, and Thailand). Study 1 reports new findings on the cultural differences in how people talk about depression and sadness to chatbots based on Linguistic Inquiry and Word Count and n-gram analyses. In study 2, we classified chat conversations into predefined topics using semisupervised classification techniques to better understand the types of depressive moods prevalent in chats. We then identified the distinguishing features of chat-based depressive discourse data and the disparity between Eastern and Western users.

    RESULTS: Our data revealed intriguing cultural differences. Chatbot users in Eastern countries indicated stronger emotions about depression than users in Western countries (positive: P

    MeSH terms: Affect; Artificial Intelligence*; Counseling; Humans; Mental Health*
  7. Mansor N, Ahmad N, Md Said S, Tan KA, Sutan R
    J Med Internet Res, 2023 Oct 20;25:e48968.
    PMID: 37862090 DOI: 10.2196/48968
    BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults.

    OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting.

    METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention.

    RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (β=-.12; P=.002; Cohen d=0.23), willingness to sext (β=-.16; P

    MeSH terms: Attitude; Female; Humans; Male; Sexual Behavior/psychology; Students; Intention*; Young Adult; Text Messaging*
  8. Paudel S, Shankar PR, Subedi N, Palaian S
    PLoS One, 2023;18(10):e0291265.
    PMID: 37862336 DOI: 10.1371/journal.pone.0291265
    INTRODUCTION: Bronchial asthma continues to be a problem in the Himalayan country of Nepal. This study explored the impact of bronchial asthma on patients' lives in a hill village in Syangja district, Nepal, and obtained information about the perceived impact of the illness, knowledge of the disease, self-care behaviors and treatment among patients.

    MATERIAL AND METHODS: The study site is the village of Jyamire (located at an elevation between 900 to 1200 m) Syangja district. Individuals suffering from asthma residing in the village aged 18 years or above were included. Semi-structured interviews were conducted face-to-face with the respondents at their homes using an interview guide. The interviews were audio recorded, transcribed in the Nepali language, and then translated into English for further analysis.

    RESULTS: Most participants were female, between 18 to 60 years of age, and housewives. Most houses were built of mud and poorly ventilated. Gas was used for cooking though firewood was also used. Most used to get an average of three serious attacks a year both during winter and summer. The themes that emerged were the number and seasonal variation in attacks, the perceived effect of asthma on their lives and social interactions, the knowledge of the interviewee about the disease, the impact of asthma on their socioeconomic status, and treatment and self-care behaviors. Residing in a hill village required them to walk up and down several times a day and the disease seriously impacted their lives. The smoke produced during different ceremonies and during cooking also worsened their asthma.

    CONCLUSION: Findings suggest, the existence of multiple factors, a few unique to Nepal contributing to poor asthma control. Though the recent socioeconomic improvement has led to improved prevention and treatment options, asthma seriously affected the patients.

    MeSH terms: Female; Humans; Male; Nepal/epidemiology; Smoke; Qualitative Research
  9. Hassan NA, Hashim JH, Wan Puteh SE, Wan Mahiyuddin WR, Mohd MSF, Shaharudin SM, et al.
    PLoS One, 2023;18(10):e0283133.
    PMID: 37862373 DOI: 10.1371/journal.pone.0283133
    This study is an attempt to investigate climate-induced increases in morbidity rates of food poisoning cases. Monthly food poisoning cases, average monthly meteorological data, and population data from 2004 to 2014 were obtained from the Malaysian Ministry of Health, Malaysian Meteorological Department, and Department of Statistics Malaysia, respectively. Poisson generalised linear models were developed to assess the association between climatic parameters and the number of reported food poisoning cases. The findings revealed that the food poisoning incidence in Malaysia during the 11 years study period was 561 cases per 100 000 population for the whole country. Among the cases, females and the ethnic Malays most frequently experienced food poisoning with incidence rates of 313 cases per 100,000 and 438 cases per 100,000 population over the period of 11 years, respectively. Most of the cases occurred within the active age of 13 to 35 years old. Temperature gave a significant impact on the incidence of food poisoning cases in Selangor (95% CI: 1.033-1.479; p = 0.020), Melaka (95% CI: 1.046-2.080; p = 0.027), Kelantan (95% CI: 1.129-1.958; p = 0.005), and Sabah (95% CI: 1.127-2.690; p = 0.012) while rainfall was a protective factor in Terengganu (95% CI: 0.996-0.999; p = 0.034) at lag 0 month. For a 1.0°C increase in temperature, the excess risk of food poisoning in each state can increase up to 74.1%, whereas for every 50 mm increase in rainfall, the risk of getting food poisoning decreased by almost 10%. The study concludes that climate does affect the distribution of food poisoning cases in Selangor, Melaka, Kelantan, Sabah, and Terengganu. Food poisoning cases in other states are not directly associated with temperature but related to monthly trends and seasonality.
    MeSH terms: Adolescent; Adult; Female; Foodborne Diseases*; Humans; Malaysia/epidemiology; Temperature; Incidence; Young Adult; Climate Change*
  10. Amaral AFS, Potts J, Knox-Brown B, Bagkeris E, Harrabi I, Cherkaski HH, et al.
    Int J Epidemiol, 2023 Dec 25;52(6):e364-e373.
    PMID: 37862437 DOI: 10.1093/ije/dyad146
    MeSH terms: Humans; Lung*
  11. Ismanto A, Hadibarata T, Sugianto DN, Zainuri M, Kristanti RA, Wisha UJ, et al.
    Mar Pollut Bull, 2023 Nov;196:115677.
    PMID: 37862842 DOI: 10.1016/j.marpolbul.2023.115677
    The main aim of this study was to assess the presence of microplastics in the water and sediments of the Surakarta city river basin in Indonesia. In order to accurately reflect the river basin, a deliberate selection process was employed to choose three separate sampling locations and twelve sampling points. The results of the study revealed that fragments and fibers were the primary types of microplastics seen in both water and sediment samples. Furthermore, a considerable percentage of microplastics, comprising 53.8 % of the total, had dimensions below 1 mm. Moreover, the prevailing hues identified in the water samples were blue and black, comprising 45.1 % of the overall composition. In contrast, same color categories accounted for 23.3 % of the microplastics found in the soil samples. The analysis of microplastic polymers was carried out utilizing ATR-FTIR spectroscopy, which yielded the identification of various types including polystyrene, silicone polymer, polyester, and polyamide.
    MeSH terms: Environmental Monitoring; Indonesia; Plastics/analysis; Water/analysis; Geologic Sediments; Rivers
  12. Pang WQ, Lai CS, Mad' Atari MF, Pandian BR, Mohamad Ibrahim MN, Tan ST, et al.
    Plant Physiol Biochem, 2023 Nov;204:108104.
    PMID: 37862933 DOI: 10.1016/j.plaphy.2023.108104
    Graphene oxide (GO) is a novel nanomaterial with distinct physical properties and significant biological applications. The use of GO in plant tissue culture offers several new properties and potential applications. This research is vital due to the growing need for innovative techniques to promote plant growth, improve plant productivity and mitigate challenges posed by environmental stressors. This study focused on the rare Cameron Highlands white strawberry plants (Fragaria x ananassa) and addressed issues such as callus production during direct shoot induction and hyperhydricity. The research aimed to investigate the effects of GO on the regeneration process and genetic stability of white strawberry plants and to use molecular markers to ensure that plants propagated in vitro are true to type. For this purpose, shoot tip explants were used and different concentrations of GO (0, 2.5, 5.0, 7.5, 10 mg/L) were added to the Murashige and Skoog (MS) medium for six weeks. The results showed that the optimum concentration for promoting the development of white strawberry seedlings was 7.5 mg/L of GO. The study also revealed that the addition of 7.5 mg/L GO in combination with 8 μM TDZ to the MS medium facilitated the induction of multiple shoots. Moreover, the clonal fidelity of the in vitro plants treated with GO showed a genetic similarity of over 97%. These results confirm that lower GO concentrations improve plant development and stability. Consequently, this nanomaterial has a positive effect on the growth of strawberry plants and is therefore well suited for strawberry tissue culture.
    MeSH terms: Nanoparticles*
  13. Zaman R, Cai X, Shubhra QTH
    Trends Mol Med, 2023 Dec;29(12):976-978.
    PMID: 37863716 DOI: 10.1016/j.molmed.2023.10.003
    Yang et al. recently demonstrated the high potential of liquid metal microspheres (LM MSs) in cancer therapy. By amplifying the effects of magnetic hyperthermia and embolization, LM MSs not only target primary tumors, but also potentiate immune defenses. This dual-action approach effectively curtails distant tumor growth, marking a pivotal advancement in cancer immunotherapy.
    MeSH terms: Combined Modality Therapy; Embolization, Therapeutic*; Humans; Hyperthermia, Induced*; Immunotherapy
  14. Kher U, Nimbalkar S, Patil PG, Mehta N
    J Prosthet Dent, 2023 Oct 18.
    PMID: 37863756 DOI: 10.1016/j.prosdent.2023.09.024
    Bony defects in the esthetic zone, especially in the maxillary anterior region, increase the complexity of surgical and prosthetic procedures. Moving teeth with preprosthetic osseous distraction techniques can be an alternative nonsurgical option to traditional regenerative or reparative surgical therapies to increase bone volume. Healthy peri-implant bone, periodontium, and adjacent teeth provide a favorable environment for implant restorations. The esthetic rehabilitation of the maxillary region after the removal of 2 ankylosed central incisors is presented. The lateral incisors were moved mesially to the central incisor positions, and implants placed in the lateral incisor positions after new healthy bone had been induced.
  15. Kaisbain N, Khoo KKL, Lim WJ
    Am J Emerg Med, 2023 Dec;74:196.e1-196.e4.
    PMID: 37863804 DOI: 10.1016/j.ajem.2023.10.009
    BACKGROUND/AIMS: Electrocardiogram (ECG) is an inexpensive, fundamental screening tool used in daily clinical practice. It is essential in the diagnosis of life-threatening conditions, such as acute myocardial infarctions, ventricular arrhythmias etc. However, ECG lead misplacement is a common technical error, which may translate into wrong interpretations, unnecessary investigations, and improper treatments.

    METHODS/RESULTS: We report a case of a multiple ECG lead misplacement made across two different planes of the heart, resulting in a bizarre series of ECG, mimicking an acute high lateral myocardial infarction. Multiple ECGs were done as there were abrupt changes compared to previous ECGS. Patient was pain free and administration of potentially harmful procedures and treatments were prevented.

    CONCLUSION: Our case demonstrated the importance of high clinical suspicion in diagnosing ECG lead misplacement. It is the responsibility of both the healthcare workers who are performing and interpreting the ECG to be alert of a possible lead malposition, to prevent untoward consequences to the patient.

    MeSH terms: Arrhythmias, Cardiac/diagnosis; Electrocardiography/methods; Health Personnel; Humans
  16. Chen L, Kumar S, Wu H
    Arch Microbiol, 2023 Oct 20;205(11):356.
    PMID: 37863957 DOI: 10.1007/s00203-023-03699-2
    The emergence and transmission of antibiotic resistance is a global public health crisis with significant burden on healthcare systems, resulting in high mortality and economic costs. In 2019, almost five million deaths were associated with drug-resistant infections, and if left unchecked, the global economy could lose $100 trillion by 2050. To effectively combat this crisis, it is essential for all countries to understand the current situation of antibiotic resistance. In this review, we examine the current driving factors leading to the crisis, impact of critical superbugs in three regions, and identify novel mechanisms of antibiotic resistance. It is crucial to monitor the phenotypic characteristics of drug-resistant pathogens and describe the mechanisms involved in preventing the emergence of cross-resistance to novel antimicrobials. Additionally, maintaining an active pipeline of new antibiotics is essential for fighting against diverse antibiotic-resistant pathogens. Developing antibacterial agents with novel mechanisms of action is a promising way to combat increasing antibiotic-resistant pathogens.
    MeSH terms: Drug Resistance, Microbial
  17. Koh MY, Lai ST, Lim KS, Lim SYH, Chin J, Chia ZJ, et al.
    Asia Pac J Public Health, 2023 Nov;35(8):524-528.
    PMID: 37864316 DOI: 10.1177/10105395231207238
    We investigated the COVID-19 pandemic's impact on values and religiosity in multi-ethnic Malaysia. Values were measured as changes in values, daily activities, and life priorities using a 5-point Likert scale (-2 to +2). Centrality of Religiosity Scale measured changes in religiosity. Around 176 predominantly female (66.5%), Chinese (68.2%) respondents, aged 35.5 ± 14.1 completed the survey. Most life values changed positively: a sense of security at home (2, interquartile range [IQR]: 1-2), connection with family (1, 1-2), and contribution to society (1, 1-2). Certain life priorities' importance increased: health (2, IQR 2-2), family (2, 2-2), and happiness (2, 1-2); except power and money. These significant positive changes in values and religiosity varied between genders and ethnicities.
    MeSH terms: Ethnic Groups; Female; Humans; Male; Surveys and Questionnaires; Religion; Pandemics*
  18. Yunus RM, Johar H, Katiman D
    J Aging Soc Policy, 2023 Nov 02;35(6):743-755.
    PMID: 35290173 DOI: 10.1080/08959420.2022.2049575
    Like many other countries across the globe, Malaysia is rapidly graying. It is projected that older adults will comprise 10-15% of the country's total population in the next decade. Despite the surge in chronic diseases and a rise in dependency in daily living activities among Malaysian elders, formal support and long-term care services (LTC) have not been adequately developed. The existing tax-funded health care system - currently under huge financial strain - has no systematic or comprehensive LTC provision in place. This paper highlights the need for sustainable and equitable LTC services in Malaysia while drawing insight from existing LTC provision and financing arrangements in neighboring countries. It offers several recommendations to move forward in LTC planning using an approach that is unique to the Malaysian context.
  19. Sakti AD, Anggraini TS, Ihsan KTN, Misra P, Trang NTQ, Pradhan B, et al.
    Sci Total Environ, 2023 Jan 01;854:158825.
    PMID: 36116660 DOI: 10.1016/j.scitotenv.2022.158825
    Air pollution has massive impacts on human life and poor air quality results in three million deaths annually. Air pollution can result from natural causes, including volcanic eruptions and extreme droughts, or human activities, including motor vehicle emissions, industry, and the burning of farmland and forests. Emission sources emit multiple pollutant types with diverse characteristics and impacts. However, there has been little research on the risk of multiple air pollutants; thus, it is difficult to identify multi-pollutant mitigation processes, particularly in Southeast Asia, where air pollution moves dynamically across national borders. In this study, the main objective was to develop a multi-air pollution risk index product for CO, NO2, and SO2 based on Sentinel-5P remote sensing data from 2019 to 2020. The risk index was developed by integrating hazard, vulnerability, and exposure analyses. Hazard analysis considers air pollution data from remote sensing, vulnerability analysis considers the air pollution sources, and exposure analysis considers the population density. The novelty of this study lies in its development of a multi-risk model that considers the weights obtained from the relationship between the hazard and vulnerability parameters. The highest air pollution risk index values were observed in urban areas, with a high exposure index that originates from pollution caused by human activity. Multi-risk analysis of the three air pollutants revealed that Singapore, Vietnam, and the Philippines had the largest percentages of high-risk areas, while Indonesia had the largest total high-risk area (4361 km2). Using the findings of this study, the patterns and characteristics of the risk distribution of multiple air pollutants in Southeast Asia can be identified, which can be used to mitigate multi-pollutant sources, particularly with respect to supporting the clean air targets in the Sustainable Development Goals.
    MeSH terms: Asia, Southeastern; Environmental Pollutants*; Humans; Socioeconomic Factors; Risk Assessment; Particulate Matter/analysis; Remote Sensing Technology
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