Introduction Psychotherapies, such as mindfulness-based interventions (MBIs), are currently needed to tackle mental health problems. Online MBIs have become promising since face-to-face interventions are limited during the COVID-19 pandemic due to lockdown and social distancing. This systematic review and meta-analysis aimed to investigate the effect of online MBIs in improving mental health, mainly depression, anxiety, and stress. Materials and methods A systematic literature search was conducted according to the PRISMA 2020 guidelines on several databases for eligible studies up to October 17, 2021. Study quality was assessed using the Cochrane’s Risk of Bias 2 tool. Effect sizes were presented as standardized mean difference (Hedges’ g) between the online MBIs and control groups at post-test and follow-up using a random-effects model. Results Eight randomized controlled trials involving 868 participants were included in this meta-analysis. The pooled adherence rate to online MBIs was 94% (95% CI = 91% to 98%). The findings revealed that online MBIs had a statistically significant small to moderate effect in reducing depression (g = -0.32; 95% CI = -0.49 to -0.14; I2 = 0%), a small effect on anxiety (g = -0.25; 95% CI = -0.43 to -0.06; I2 = 27%), and a moderate effect on stress (g = -0.62; 95% CI = -1.09 to -0.16; I2 = 83%). In addition, significant small effects at follow-up were observed for depression (g = -0.26; 95% CI = -0.48 to -0.04; I2 = 0%) and anxiety (g = -0.28; 95% CI = -0.48 to -0.08; I2 = 0%), but not for stress. Conclusion Online MBIs have beneficial effects on mental health, particularly depression, anxiety, and stress, during the COVID-19 pandemic. Given the limitations of the current study, future trials that specifically consider potential effect influencing factors, longer follow-up evaluation, and methodological quality are warranted.

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Background: Neonatal hyperbilirubinemia is one of the most common conditions for neonate inpatients. Indonesia faces a major challenge in which different guidelines regarding the management of this condition were present. This study aimed to compare the existing guidelines regarding prevention, diagnosis, treatment and monitoring in order to create the best recommendation for a new hyperbilirubinemia guideline in Indonesia. Methods:  Through an earlier survey regarding adherence to the neonatal hyperbilirubinemia guideline, we identified that three main guidelines are being used in Indonesia. These were developed by the Indonesian Pediatric Society (IPS), the Ministry of Health (MoH), and  World Health Organization (WHO). In this study, we compared factors such as prevention, monitoring, methods for identifying, risk factors in the development of neonatal jaundice, risk factors that increase brain damage, and intervention treatment threshold in the existing guidelines to determine the best recommendations for a new guideline. Results: The MoH and WHO guidelines allow screening and treatment of hyperbilirubinemia based on visual examination (VE) only. Compared with the MoH and WHO guidelines, risk assessment is comprehensively discussed in the IPS guideline. The MoH guideline recommends further examination of an icteric baby to ensure that the mother has enough milk without measuring the bilirubin level. The MoH guideline recommends referring the baby when it looks yellow on the soles and palms. The WHO and IPS guidelines recommend combining VE with an objective measurement of transcutaneous or serum bilirubin. The threshold to begin phototherapy in the WHO guideline is lower than the IPS guideline while the exchange transfusion threshold in both guidelines are comparably equal. Conclusions: The MoH guideline is outdated. MoH and IPS guidelines are causing differences in approaches to the management hyperbilirubinemia. A new, uniform guideline is required.

Objective: To determine the risk factors associated the incidence of NPC, particularly in Indonesia. Methods: This systematic review and meta-analysis was conducted according to PRISMA statement. Database including PubMed, Scopus, Science Direct, Web of Science, and GARUDA were retrieved. Newcastle-Ottawa scale was used to assess the quality of published study and analyse the risk of bias of included study. Random-effect model and reported pooled Odds Ratio (OR) with 95%CI was carried out in our meta-analysis. Results: A pooled of 7 studies were included in our study which included 764 participants. We found that female gender was not associated with the incidences of NPC (OR 1.45, 95% CI: 0.61-3.45, p=0.40), and smoking was highly increased the incidence of NPC (OR 4.39 95% CI (0.79-24.40), but not statistically significant (p=0.09). Furthermore, salted fish consumption and some HLA alleles were associated with increased risk. Conclusion: The incidence of NPC is not associated with female gender nor smoking habits. However, the risk of NPC is higher for those who consume salted fish and have some susceptible HLA alleles. Further investigations in larger studies are needed to confirm these findings.

Background Social restrictions due to the COVID-19 pandemic have shifted most learning methods into online courses, especially for medical skills education. However, the effects of online courses on medical skill education amongst medical students are still arguable. The study aims to analyse medical students’ knowledge, attitude, practice and satisfaction towards medical skills between online and offline courses. Method We performed a case–control study conducted among 533 medical students with online (as a case group, n = 288) and offline courses (as a control group, n = 245). We evaluated three fundamental medical skills, including history taking [HT], lung physical examination [LPE], and heart physical examination [HPE]. We tested the knowledge and skills among students through theory and practical examinations. Students’ attitudes and satisfaction were assessed using a validated questionnaire. Results The scores for knowledge and practical skills among the online group were significantly higher ( p = 0.016, p = 0.004, respectively). In comparison, the scores for the students’ attitudes and satisfaction were substantially lower ( p = 0.000, p = 0.003, respectively) compared to the control group. Most of the students in both groups passed the exam (case vs. control = 81.94%; 83.27%, respectively). Males were the only factor associated with a higher rate of passing the examination (OR 0.42, 95% CI [0.27–0.67], p = 0.000). Conclusions Online learning could be an alternative approach on improving student’s knowledge and practice towards medical skill especially amidst COVID-19 pandemic, however further consideration on student’s attitude and satisfaction are mandatory to achieve appropriate competence as future general practitioner.

Background: The impact of COVID-19 may be more severe in developing countries. Our study aims to analyze the accuracy of several inflammatory biomarkers in predicting COVID-19 mortality, providing information about the most suitable markers for developing countries. Methods: A retrospective cohort study was conducted at Dr. Soetomo General Hospital, Indonesia, from March to June 2020. White Blood Cells (WBC) count, Neutrophil-Lymphocyte Ratio (NLR), Procalcitonin (PCT), D-Dimer, and C-Reactive Protein (CRP) have been collected from the electronic medical records. We performed survival analysis to provide the hazard ratio and Receiver Operating Characteristic (ROC) curve analysis to test for accuracy for each parameter. Results: A total of 423 patients who met the criteria for participating had a median age of 54 (IQR 45-61) years. Patients in the death group are characterized by older age and shorter length of hospitalization. The WBC, NLR, PCT, D-Dimer, and CRP are found significantly higher in the death group (P=0.000). The WBC, NLR, PCT, D-Dimer, and CRP have an Area Under the Curve (AUC) of 0.709, 0.773, 0.738, 0.721, and 0.769, respectively moderate accuracy in predicting COVID-19 patient mortality. We found that NLR is significantly more accurate than the age parameter (Z=3.527; P=0.000) but has equal accuracy with other laboratory parameters.  Conclusions: Since NLR obtained the highest accuracy, we still recommend routine complete blood count tests as prognostic biomarkers with the highest feasibility to be performed in developing countries.

Universities participate in realizing Indonesia's vision 2045 “The Indonesians who are excellent, civilized, and mastering science technology, to bring Indonesia as the center of science technology development in the Asia and the world”. It would need intense effort and synergy, considering the science literacy of Indonesian students was ranked the 10th lowest out of 79 countries in 2018. The innovation capacity is ranked 74 out of 141 countries.  Research is an essential activity, encouraging the development of science technology. Research competency should be honed by high school students as part of scientific inquiry. Therefore, this community service was carried out in collaboration with FORISMA FK UNAIR, aimed to increase students’ understanding of the urgency, stages, and procedures of research as well as increase interest in research activities. It was also intended to develop their skills to compile and present research proposals. The partner was Raudlatul Jannah High School Sidoarjo. It was implemented through workshops, coaching, and presentations followed by the teachers and 11th-grade students.  The whole activity successfully improved students' knowledge. Increased knowledge score was obtained in 83% of participants. The pre-test evaluation showed 88% of participants had poor knowledge, whilst post-test evaluations were predominantly good. This community service increased students’ interest in research and changed their perceptions of research’s importance. This improved students' capability to identify research problems, search and compile scientific references as a basis for building hypotheses and conceptual frameworks, and determine research methods. The four groups of students were able to produce research proposals of sufficient quality and were able to present and discuss them in the forum. This community service was perceived to help the school in the implementation of curriculum, especially in science literacy. The school was committed to deepening students' knowledge and skills in the field of scientific research by providing research project modules. This community service is part of the contribution of higher education to the achievement of the vision of Indonesia 2045. This can be a model of scientific inquiry learning in secondary education, thus it is necessary to be implemented in other high schools.

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