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Neurocognitive consequences of occupational heavy metal exposure among electronic waste sorting workers in Thailand Harasarn, Kornwika; Keawkaen, Practhaya; Thetkathuek, Anamai
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2994

Electronic waste sorting workers in Thailand are chronically exposed to heavy metals, including lead (Pb), cadmium (Cd), and nickel (Ni), in informal work settings characterized by limited use of personal protective equipment and suboptimal hygiene practices. This study aimed to evaluate the associations between heavy metal exposure, individual risk factors, and neuropsychological performance among workers. A cross-sectional study was conducted involving 76 exposed workers and 49 non-exposed controls. Data were collected using structured interviews, surface wipe sampling of workplace dust for Pb, Cd, and Ni, and blood metal measurements. Neuropsychological function was assessed using the Digit Span Forward Test (DSFT) and Digit Span Backward Test (DSBT). The mean ages of the exposed and non-exposed groups were 47.39±12.64 and 49.92±8.46 years, respectively. Surface dust concentrations of Pb, Cd, and Ni were significantly higher in the exposed group than in controls (all p<0.001). In contrast, blood metal concentrations did not differ between groups (Pb: 6.41±1.49 vs 6.41±1.62µg/dL, p=0.885; Cd: 0.97±0.39 vs 0.91±0.28µg/L, p=0.501; Ni: 2.60±0.48 vs 2.52±0.45µg/L, p=0.689). No significant difference was observed in DSFT scores between groups (p=0.912). However, DSBT scores differed significantly (p<0.001), with the exposed group scoring higher (2.23±0.55) than the non-exposed group (1.72±0.39). Among exposed workers, simple linear regression identified education (β=0.353, p=0.002), income (β=0.257, p=0.025), age (β=-0.236, p=0.041), and alcohol consumption (β=-0.231, p=0.044) as significant predictors of DSFT performance. However, DSBT scores differed significantly (p<0.001). Drinking alcohol, smoking, Pb in dust, and working area size were significant predictors of DSBT performance (p=0.020, 0.022, 0.013, and <0.001, respectively). These findings indicate that cognitive performance among Thai informal e-waste workers is more strongly influenced by socioeconomic factors and surface lead contamination than by blood metal levels. Interventions focusing on education, income support, and routine workplace surface cleaning, supported by surface-based environmental monitoring and community health volunteers, are critical for protecting cognitive health in this vulnerable population.

Delayed percentage attenuation ratio (DPAR) on multiphase CT as a quantitative predictor of early response in hepatocellular carcinoma Supriatna, Yana; Bachtiar, Rifki; Makkaraeng, Muhammad Y.; Budiman, Arif
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2996

Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality, and transarterial chemoembolization (TACE) is the standard therapy for intermediate-stage disease. However, response to TACE is variable, and reliable quantitative imaging biomarkers are needed to support early treatment decision-making. This study aimed to evaluate the predictive value of the delayed percentage attenuation ratio (DPAR) measured from pre-TACE multiphasic computed tomography (CT) in forecasting early therapeutic response. A retrospective cross-sectional study was conducted involving patients with a definitive diagnosis of HCC who underwent their first TACE session and had complete multiphasic CT imaging before and after treatment. Quantitative washout parameters, delayed percentage attenuation ratio (DPAR), absolute washout (WOAbs), and relative washout (WORel) were measured using standardized region of interest (ROI) placement by three radiologists. Treatment response was assessed four to six weeks post-TACE based on modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria and classified into responders and non-responders. Diagnostic performance was evaluated using receiver operating characteristic (ROC) analysis, and interobserver reliability was assessed using intraclass correlation coefficient (ICC) and Cohen’s κ. A total of 49 HCC patients were included and analyzed. Responders demonstrated significantly higher DPAR values compared with non-responders (median 134.5 vs 113.0; p<0.001). DPAR showed the strongest discriminative performance with an area under the curve (AUC) of 0.898, outperforming WOAbs (AUC 0.689) and WORel (AUC 0.704). The optimal DPAR threshold of ≥120.5 provided 84.4% sensitivity and 88.2% specificity to predict early post-TACE treatment response. Interobserver reliability was excellent for all washout parameters (ICC 0.98–0.99), and agreement for mRECIST classification was also excellent (κ=0.867). In conclusion, pre-TACE DPAR is a robust and reproducible quantitative imaging biomarker that accurately predicts early response to TACE in HCC. A threshold value of ≥120.5 may assist in treatment planning and patient selection in routine clinical practice.

Development and evaluation of a synthetic Cu-Zn-reinforced biphasic calcium phosphate scaffold for periodontal bone repair Novelia, Devina; Cahyadi, Theophani O.; Sidharta, Natasya MP.; Octavia, Mora; Situmorang, Evi UM.; Edbert , Daniel
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3001

Periodontal bone defects require bone grafting materials that provide structural stability, biocompatibility, and reliable biological performance. Synthetic alloplastic scaffolds composed of biphasic calcium phosphate, integrating hydroxyapatite (HAp) and β-tricalcium phosphate (β-TCP), offer a promising alternative to other graft materials. Polycaprolactone provides flexibility and support for pore formation, while copper (Cu) and zinc (Zn) ions contribute to their antimicrobial and osteogenic benefits. This study aimed to investigate the physicochemical, morphological, mechanical, and biological properties of a synthetic HAp40/β-TCP60 alloplastic scaffold reinforced with polycaprolactone and to compare them with those of a commercial xenograft. The scaffold was fabricated using a freeze-drying method with dimethylformamide, and characterization included Fourier-transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) for chemical and crystalline confirmation, Archimedes principle for porosity, light microscopy, and scanning electron microscopy (SEM) for morphological assessment, compressive testing, blood adhesion, as well as water and blood absorption analysis. FTIR and XRD verified the successful incorporation of polycaprolactone and the formation of a well-ordered biphasic calcium phosphate structure. Light microscopy showed that the synthetic scaffold had smaller macropore dimensions (324±49 µm) than the control (1410±541 µm), while SEM demonstrated markedly higher microporosity (8.184±2.581 µm) compared to the control (0.287±0.091 µm). Water absorption was lower in the synthetic scaffold (174.7%) than in the control (1172.5%), whereas blood absorption was comparable (300% vs 316.6%). The synthesized scaffold also exhibited superior blood adhesion, as evidenced by the absence of turbidity after agitation. Mechanical testing revealed that the control had superior compressive and yield strengths (0.980 MPa and 0.537 MPa, respectively) compared to the synthesized scaffold (0.287 MPa and 0.126 MPa, respectively). In conclusion, the synthetic HAp40/β-TCP60 scaffold exhibited properties within optimal ranges, highlighting its potential as a promising synthetic alloplastic material for clinical bone regeneration.

Comparison of interleukin-6 and serum creatinine levels in preeclampsia and normal pregnancy patients: A cross-sectional study in Indonesia Dewi, Syerli R.; Yeni, Cut M.; Munizar, Munizar; Dewi, Tgk. Puspa; Utami, Niken A.; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3016

Preeclampsia (PE) is a complication of pregnancy with high morbidity and mortality, characterized by endothelial dysfunction, systemic inflammation, and impaired renal function. Interleukin-6 (IL-6) and serum creatinine have potential as biomarkers for early detection of PE; however, data from Indonesia are limited. The aim of this study was to compare IL-6 and serum creatinine levels between pregnant women with PE and normotensive controls, as well as their diagnostic performance in identifying PE. A cross-sectional study involving pregnant women with PE and normotensive controls was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. Serum IL-6 and creatinine levels were measured using the ECLIA method. Levels were compared using the Mann–Whitney test; diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis, and multivariable logistic regression was used to evaluate combined diagnostic contribution. A total of 68 pregnant women were included, comprising 34 patients with PE and 34 normotensive controls. Median IL-6 levels were significantly higher in the PE group (16.05 pg/mL) than in the control group (3.71 pg/mL). Receiver operating characteristic analysis demonstrated excellent diagnostic performance of IL-6, with an are under the curve (AUC) of 0.831 (95%CI: 0.734–0.929). At an optimal cutoff value of 5.52 pg/mL, IL-6 achieved a sensitivity of 73.53%, specificity of 76.47%, and diagnostic accuracy of 86.76%. Median serum creatinine levels were also significantly elevated in the PE group (0.56 mg/dL) compared with controls (0.44 mg/dL; p<0.001). The AUC for serum creatinine was 0.806 (95%CI: 0.700–0.912), indicating good diagnostic performance. At a cutoff value of 0.475 mg/dL, serum creatinine demonstrated a sensitivity of 70.59%, specificity of 73.53%, and accuracy of 72.06%. Multivariable logistic regression confirmed that IL-6 (B=0.123; p=0.005) and serum creatinine (B=9.306; p=0.023) were independently associated with PE, explaining 57.5% of PE variability (Nagelkerke R²=0.575). These findings indicate that serum IL-6 and creatinine are significantly associated with PE, and their combined assessment shows potential as a predictive biomarker with good diagnostic performance.

Biomarkers for diagnosis, disease progression, and therapeutic response in psoriasis vulgaris: A mini-review Edwar, Sarah Q.; Irawan, Yudo; Budianti, Windy K.; Novianto, Endi; Fitri, Eyleny M.
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3017

Psoriasis vulgaris is a chronic immune-mediated inflammatory disease with substantial clinical, psychosocial, and public health impact. Despite advances in therapeutic options, disease management continues to rely predominantly on clinical assessment, which remains limited in its ability to detect early disease, quantify subclinical inflammation, monitor disease progression, and anticipate long-term outcomes. These limitations are further compounded by marked interindividual heterogeneity in disease course, systemic inflammatory burden, comorbidity risk, and treatment response. Although a growing body of research has identified numerous candidate biomarkers related to genetic susceptibility, epidermal pathology, immune activation, and systemic inflammation, their clinical relevance and integration into routine practice remain unclear. A comprehensive synthesis that bridges molecular biomarkers with clinically meaningful applications is therefore needed. This review critically examines the current landscape of biomarkers in psoriasis vulgaris and explores their potential roles in diagnosis, assessment of disease progression, and prediction of therapeutic response. This review discusses genetic biomarkers associated with disease susceptibility and immune pathway regulation, tissue-associated biomarkers reflecting epidermal dysfunction and local inflammatory activity, and soluble biomarkers indicative of systemic inflammation and metabolic dysregulation. By organizing existing evidence across these biomarker domains, this review seeks to highlight conceptual frameworks, unresolved challenges, and future directions for biomarker-informed psoriasis management.

Enhancing neuromuscular recovery after sciatic nerve injury using stem cell therapy: Evidence from a preliminary preclinical study Firlana, Cut R.; Emril, Dessy R.; Dedy Syahrizal; Sartika, Cynthia R.; Lestari, Nova D.; Habibie, Yopie A.
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3018

Sciatic nerve injury results in motor dysfunction and muscle atrophy, with limited effective therapies. Umbilical cord–derived mesenchymal stem cells (UC-MSCs) may promote neuromuscular recovery, but their effects on functional and muscle recovery remain unclear. This study aimed to evaluate the effects of UC-MSC therapy on functional and muscle recovery in an animal model of sciatic nerve injury. An animal experimental study with a post-test-only control group was conducted using adult male Wistar rats. Rats were randomly allocated into three groups: sham operation, saline control with sciatic nerve injury, and UC-MSC treatment after sciatic nerve injury. UC-MSCs were administered at a dose of 1×10⁶ cells/kg body weight immediately after nerve injury. Functional recovery was assessed using the extensor postural thrust (EPT) test, and muscle recovery was evaluated using the gastrocnemius muscle index (GMI) post 35 days of observation. Data were analyzed using one-way ANOVA for EPT percentage recovery and Kruskal–Wallis tests for GMI values, followed by post-hoc analysis. Our data indicated there was no significant EPT percentage recovery among the study groups. In contrast, relative gastrocnemius muscle mass was significantly different across groups (p=0.012), with post-hoc analysis demonstrating a significantly higher GMI in the UC-MSC group compared to the saline control group (109.75% vs 81.68%, p=0.003), indicating improved preservation of gastrocnemius muscle mass following UC-MSC therapy. This study highlights that UC-MSC therapy significantly improved gastrocnemius muscle preservation after sciatic nerve injury but did not result in detectable functional motor recovery at the observation time point. These findings suggest that UC-MSCs might exert early structural benefits that may precede functional recovery.

Multi-stakeholder perspectives on cervical cancer screening implementation in Indonesia: A qualitative study of cervical screening barriers in Banda Aceh Yolanda, Febrina; Dewi, Tgk. Puspa; Nainggolan, Sarah I.; Munawar, Munawar; Munizar, Munizar; Bulqini, Rijal; Suhanda, Rachmad; Rusnaidi, Rusnaidi
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3022

Indonesia is committed to the WHO's cervical cancer elimination strategy through the National Action Plan (RAN) 2023–2030, targeting 75% screening coverage by 2030. However, current rates remain critically low at 7.02%. This study explores multi-stakeholder perspectives to identify implementation barriers and facilitators for policy enhancement. A qualitative descriptive case study was conducted in Banda Aceh (July-August 2025) involving 25 stakeholders: City Health Office Head, 11 puskesmas heads, 11 VIA coordinators and 2 community organization representatives. Thematic analysis using NVivo v.16 identified key implementation factors. Five major themes emerged: (1) Knowledge gaps—screening perceived necessary only when symptomatic despite available information; (2) Access paradox—excellent geographic access and flexibility undermined by limited examination rooms, insufficient midwives, and psychosocial barriers (shame, fear, lack of spousal support); (3) Financial sustainability—free services threatened by complex BPJS claims and low reimbursement affecting logistics; (4) Service quality variation—dependent on cross-sector collaboration and staff competency, with uneven training and limited cryotherapy (only 2 centers); and (5) Communication challenges—inconsistent digital media use necessitates face-to-face counseling and cadres, though reach remains limited. Implementation faces psychological barriers, capacity limitations, and uneven digital adoption despite strong infrastructure. Priority policy recommendations include: (1) HPV DNA self-sampling to overcome privacy barriers; (2) simplified BPJS claims with adequate reimbursement; (3) systematic competency-building and cryotherapy expansion; and (4) culturally-adapted education integrating local language and religious leaders. These evidence-based enhancements could accelerate Indonesia's RAN 2030 elimination targets.

Development of decellularized mouse auricular scaffolds using sodium dodecyl sulfate immersion-agitation for microtia tissue engineering Jaya, Putu KD.; Dewi, Anak AAAP.; Lestarini, Asri; Witari, Ni PD.; Evayanti, Luh G.
Narra J Vol. 5 No. 3 (2025): December 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i3.1610

Effective treatment strategies for microtia remain limited due to the side effects and shortcomings associated with current therapeutic approaches. Tissue engineering, particularly the development of biological scaffolds, has emerged as a promising alternative. However, research on auricular scaffold fabrication in murine models using sodium dodecyl sulfate (SDS) and the immersion–agitation decellularization technique remains scarce. The aim of this study was to evaluate the effects of varying SDS concentrations on the decellularization efficiency and extracellular matrix (ECM) preservation of murine auricular tissue for scaffold development. Auricular tissues from mice (n=4) were immersed in Erlenmeyer flasks containing 0.1%, 0.5%, or 1% SDS and subjected to continuous agitation until the tissues became macroscopically translucent. Qualitative assessments included macroscopic appearance and microscopic evaluation using hematoxylin–eosin and Masson's trichrome staining. Quantitative analysis involved counting residual nuclei, while semiquantitative analysis of ECM area fractions was performed using ImageJ software. Statistical comparisons were conducted using one-way analysis of variance (ANOVA), with significance defined as p<0.05. The results demonstrated that the decellularized scaffolds exhibited macroscopic translucency, significantly reduced nuclear content (p=0.001), and preserved ECM integrity (p=0.012). Among the tested concentrations, 0.5% SDS provided the optimal balance between effective decellularization and ECM preservation. These findings support the potential application of murine auricular scaffolds decellularized with 0.5% SDS via the immersion–agitation method for future microtia tissue engineering.

Neurocognitive consequences of occupational heavy metal exposure among electronic waste sorting workers in Thailand Harasarn, Kornwika; Keawkaen, Practhaya; Thetkathuek, Anamai
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.2994

Electronic waste sorting workers in Thailand are chronically exposed to heavy metals, including lead (Pb), cadmium (Cd), and nickel (Ni), in informal work settings characterized by limited use of personal protective equipment and suboptimal hygiene practices. This study aimed to evaluate the associations between heavy metal exposure, individual risk factors, and neuropsychological performance among workers. A cross-sectional study was conducted involving 76 exposed workers and 49 non-exposed controls. Data were collected using structured interviews, surface wipe sampling of workplace dust for Pb, Cd, and Ni, and blood metal measurements. Neuropsychological function was assessed using the Digit Span Forward Test (DSFT) and Digit Span Backward Test (DSBT). The mean ages of the exposed and non-exposed groups were 47.39±12.64 and 49.92±8.46 years, respectively. Surface dust concentrations of Pb, Cd, and Ni were significantly higher in the exposed group than in controls (all p<0.001). In contrast, blood metal concentrations did not differ between groups (Pb: 6.41±1.49 vs 6.41±1.62µg/dL, p=0.885; Cd: 0.97±0.39 vs 0.91±0.28µg/L, p=0.501; Ni: 2.60±0.48 vs 2.52±0.45µg/L, p=0.689). No significant difference was observed in DSFT scores between groups (p=0.912). However, DSBT scores differed significantly (p<0.001), with the exposed group scoring higher (2.23±0.55) than the non-exposed group (1.72±0.39). Among exposed workers, simple linear regression identified education (β=0.353, p=0.002), income (β=0.257, p=0.025), age (β=-0.236, p=0.041), and alcohol consumption (β=-0.231, p=0.044) as significant predictors of DSFT performance. However, DSBT scores differed significantly (p<0.001). Drinking alcohol, smoking, Pb in dust, and working area size were significant predictors of DSBT performance (p=0.020, 0.022, 0.013, and <0.001, respectively). These findings indicate that cognitive performance among Thai informal e-waste workers is more strongly influenced by socioeconomic factors and surface lead contamination than by blood metal levels. Interventions focusing on education, income support, and routine workplace surface cleaning, supported by surface-based environmental monitoring and community health volunteers, are critical for protecting cognitive health in this vulnerable population.

Enhancing neuromuscular recovery after sciatic nerve injury using stem cell therapy: Evidence from a preliminary preclinical study Firlana, Cut R.; Emril, Dessy R.; Dedy Syahrizal; Sartika, Cynthia R.; Lestari, Nova D.; Habibie, Yopie A.
Narra J Vol. 6 No. 1 (2026): April 2026
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v6i1.3018

Sciatic nerve injury results in motor dysfunction and muscle atrophy, with limited effective therapies. Umbilical cord–derived mesenchymal stem cells (UC-MSCs) may promote neuromuscular recovery, but their effects on functional and muscle recovery remain unclear. This study aimed to evaluate the effects of UC-MSC therapy on functional and muscle recovery in an animal model of sciatic nerve injury. An animal experimental study with a post-test-only control group was conducted using adult male Wistar rats. Rats were randomly allocated into three groups: sham operation, saline control with sciatic nerve injury, and UC-MSC treatment after sciatic nerve injury. UC-MSCs were administered at a dose of 1×10⁶ cells/kg body weight immediately after nerve injury. Functional recovery was assessed using the extensor postural thrust (EPT) test, and muscle recovery was evaluated using the gastrocnemius muscle index (GMI) post 35 days of observation. Data were analyzed using one-way ANOVA for EPT percentage recovery and Kruskal–Wallis tests for GMI values, followed by post-hoc analysis. Our data indicated there was no significant EPT percentage recovery among the study groups. In contrast, relative gastrocnemius muscle mass was significantly different across groups (p=0.012), with post-hoc analysis demonstrating a significantly higher GMI in the UC-MSC group compared to the saline control group (109.75% vs 81.68%, p=0.003), indicating improved preservation of gastrocnemius muscle mass following UC-MSC therapy. This study highlights that UC-MSC therapy significantly improved gastrocnemius muscle preservation after sciatic nerve injury but did not result in detectable functional motor recovery at the observation time point. These findings suggest that UC-MSCs might exert early structural benefits that may precede functional recovery.

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harapan@unsyiah.ac.id

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harapan@unsyiah.ac.id

Editorial Address
School of Medicine Universitas Syiah Kuala Darussalam, Banda Aceh, 23111 Indonesia

Location
Kota banda aceh,

Aceh

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name -

Contact Email harapan@unsyiah.ac.id

Phone +62895600103060052

Journal Mail Official harapan@unsyiah.ac.id

Editorial Address School of Medicine Universitas Syiah Kuala Darussalam, Banda Aceh, 23111 Indonesia

Location Kota banda aceh, Aceh INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
harapan@unsyiah.ac.id

Phone
+62895600103060052

Journal Mail Official
harapan@unsyiah.ac.id

Editorial Address
School of Medicine Universitas Syiah Kuala Darussalam, Banda Aceh, 23111 Indonesia

Location
Kota banda aceh,

Aceh

INDONESIA