We focus on the importance and necessity of post-competency-based training in medical education alongside its current challenges and opportunities. Integrating post competency training into standardized educational frameworks is increasingly recognized as a critical component of preparing residents and postgraduates for real-world clinical practice. Post competency training represents a commitment to excellence in medical education, striving to produce competent, skilled practitioners to meet the challenges of modern healthcare.

The risk of emerging infectious diseases (EID) is increasing globally. More than 60% of EIDs worldwide are caused by animal-borne pathogens. This study aimed to characterize the virome, analyze the phylogenetic evolution, and determine the diversity of rodent-borne viruses in Hainan Province, China. We collected 682 anal and throat samples from rodents, combined them into 28 pools according to their species and location, and processed them for next-generation sequencing and bioinformatics analysis. The diverse viral contigs closely related to mammals were assigned to 22 viral families. Molecular clues of the important rodent-borne viruses were further identified by polymerase chain reaction for phylogenetic analysis and annotation of genetic characteristics such as arenavirus, coronavirus, astrovirus, pestivirus, parvovirus, and papillomavirus. We identified pestivirus and bocavirus in Leopoldoms edwardsi from Huangjinjiaoling, and bocavirus in Rattus andamanensis from the national nature reserves of Bangxi with low amino acid identity to known pathogens are proposed as the novel species, and their rodent hosts have not been previously reported to carry these viruses. These results expand our knowledge of viral classification and host range and suggest that there are highly diverse, undiscovered viruses that have evolved independently in their unique wildlife hosts in inaccessible areas.

Background and Objectives: The Hot AXIOS system, which features a cautery-enhanced lumen-apposing metal stent, facilitates EUS-guided transmural drainage of pancreatic fluid collection (PFC). We aimed to evaluate the safety and efficacy of stents in a multicenter Chinese cohort. Patients and Methods: Thirty patients from nine centers with a single pancreatic pseudocyst (PP) or walled-off necrosis (WON) who underwent EUS-guided transgastric or transduodenal drainage with the novel stent were prospectively enrolled. Results: We included 15 (50%) patients with PPs and 15 (50%) with WONs. The mean diameter of the PFCs was 11.06 ± 3.56 cm. Stent placement was technically successful in all patients (100%), whereas clinical success was achieved in 93.3% of patients (28/30). Clinical success was defined as the alleviation of clinical symptoms combined with at least a 50% reduction in PFC diameter within 60 days after surgery. 73.3% (22/30) of AXIOS stents were removed after reaching clinical success in the 1^st month of follow-up. A total of 14 (46.7%) PFC-associated infections occurred (4 pre- and 10 postoperation), which recovered within 1 week after treatment. Other complications included three (10%) partially or fully blocked stents and two (6.7%) stent migrations. Regarding the fully opened stent without blocking, complete remission of PFCs within 1 month was independently predicted by a previous pancreatitis attack > 6 months prior (adjusted odds ratio: 11.143; 95% confidence interval: 1.108–112.012; P = 0.041). Conclusion: EUS-guided drainage of PFCs using the Hot AXIOS system is safe and efficient. Regarding completely patent stents, a previous pancreatitis attack > 6 months prior predicts a greater chance of achieving 100% remission of PFCs within 1 month of AXIOS treatment.

Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery. Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples. To investigate the correlations among mindfulness, marital quality, anxiety, and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas. A cross-sectional study was conducted. The self-administered questionnaire was submitted online through smartphones. The levels of mindfulness, anxiety, depression, and marital quality were respectively investigated by the mindful attention awareness scale (MAAS), the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), and the marriage perception scale (MPS) in these enrolled Han and Tujia primiparas. No statistical significance was observed in the prevalence of postpartum anxiety and depression, nor scores of MAAS and MPS-Total in different regions or ethnicities (P > 0.05). However, MPS-Marital interaction (P < 0.05), MPS-Family relationship (MPS-FR) (P < 0.01), and MPS-Marital conflict (MPS-MC) (P < 0.01) scores of urban primiparas were higher than those of rural primiparas. The MPS-MC score of Han primiparas was higher than that of Tujia primiparas (P < 0.05). Negative correlations were observed between MAAS and SAS (r = -0.457, P < 0.01), and MAAS and SDS (r = -0.439, P < 0.01). SAS has revealed a highly positive correlation with SDS (r = 0.720, P < 0.01) and a weak negative correlation with MPS (r = -0.200, P < 0.05). Besides, a weak negative correlation was observed between MAAS and MPS-MC (r = -0.184, P < 0.05), and a weak positive correlation was noticed between SAS and MPS-MC (r = -0.225, P < 0.01). Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety (P < 0.05, 95%CI: -0.384 to 0.033), MPS-MC and postpartum anxiety (P < 0.01, 95%CI: 0.027-0.193), MPS-FR and postpartum depression (P < 0.05, 95%CI: -0.365 to 0.031), and MPS-MC and postpartum depression (P < 0.01, 95%CI: 0.022-0.206). Mindfulness demonstrates negative correlations with marital conflict, postpartum anxiety and depression, and it may have cross-ethnic and trans-regional characteristics. Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study, it demonstrates a full mediation effect on the relationships between family relationships, marital conflict, and postpartum anxiety and depression.

This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology , focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving “early detection”. The five-year age-standardized net survival for esophageal cancer patients falls short of expectations. Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer. While advancements in endoscopic technology have been significant, there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques. Therefore, it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer, investigate the most cost-effective screening methods suitable for different regions, and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.