Mayo Clinic proceedings最新文献

{"title":"Locomotor Brachii Sign in Absence of Severe Aortic Regurgitation.","authors":"Jesse Calestine, Moses Mathur","doi":"10.1016/j.mayocp.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.03.002","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory Fitness and Mortality in Patients With Chronic Kidney Disease: A Prospective Cohort Study.","authors":"Xuemei Sui, Peter Kokkinos, Charles Faselis, Immanuel Babu Henry Samuel, Andreas Pittaras, Jared Gollie, Samir Patel, Carl J Lavie, Jiajia Zhang, Jonathan Myers","doi":"10.1016/j.mayocp.2024.09.023","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.09.023","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between objectively measured cardiorespiratory fitness (CRF) and mortality in patients with chronic kidney disease (CKD).</p><p><strong>Patients and methods: </strong>From a large cohort of US veterans (n=750,302) based on the ETHOS (Exercise Testing and Health Outcomes) study, we identified 45,674 men and women aged 30 to 95 years (mean, 65.1 ± 8.8 years) who completed an exercise treadmill test (ETT) within the Veterans Affairs hospitals across the United States. All were diagnosed with CKD before the ETT by International Classification of Diseases 9^th and 10^th revision codes. Age- and-sex-specific CRF categories (quintiles) were established based on peak metabolic equivalents (METs) achieved during the ETT. We computed HRs and 95% CIs with Cox regression analyses adjusted for comorbidities and medications.</p><p><strong>Results: </strong>During 15.9 years of follow-up, 24,310 individuals (53.2%) died. The adjusted association between CRF and mortality risk was inverse and graded. For each 1-MET increase in CRF, the adjusted HR for mortality was 12% lower (HR, 0.88; 95% CI, 0.875 to 0.885; P<.001). When risk was assessed across CRF categories using the least-fit CRF category as the referent, the adjusted HRs and CIs were 0.76 (95% CI, 0.73 to 0.78), 0.63 (95% CI, 0.61 to 0.66), 0.49 (95% CI, 0.47 to 0.51), and 0.33 (95% CI, 0.30 to 0.35), for low-fit, moderate-fit, fit, and high-fit individuals, respectively. The pattern of the CRF mortality risk association was similar regardless of age, race, or sex.</p><p><strong>Conclusion: </strong>In this large multiethnic study, we found an independent, inverse, and graded association between CRF and mortality in CKD patients. These findings underscore the importance of increasing CRF in CKD patients to lower the risk of mortality.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2023.","authors":"Tait D Shanafelt, Colin P West, Christine Sinsky, Mickey Trockel, Michael Tutty, Hanhan Wang, Lindsey E Carlasare, Liselotte N Dyrbye","doi":"10.1016/j.mayocp.2024.11.031","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.11.031","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prevalence of burnout and satisfaction with work-life integration (WLI) among physicians and US workers in 2023 relative to 2011, 2014, 2017, and 2020, as well as physicians in 2021.</p><p><strong>Participants and methods: </strong>Between October 19, 2023, and March 3rd, 2024, we surveyed US physicians and a probability-based sample of the US working population using methods similar to previous studies. Burnout and WLI were measured using standard tools.</p><p><strong>Results: </strong>Demographic characteristics of the 7643 survey participants were similar to those of practicing US physicians (N=936,074), although participants were more likely to be women (39.6% vs 37.9%). Nonresponder analysis suggested participants were representative of US physicians with regard to burnout and satisfaction with WLI. Overall, 45.2% of physicians reported at least 1 symptom of burnout in 2023 compared with 62.8% in 2021 (P<.001), 38.2% in 2020 (P<.001), 43.9% in 2017 (P=.16), 54.4% in 2014 (P≤.001), and 45.5% in 2011 (P=.49). Overall, 42.2% of physicians (n=2732) were satisfied with WLI in 2023, compared with 30.3% in 2021 (P<.001), 46.1% in 2020 (P<.001), 42.8% in 2017 (P=.02), 40.9% in 2014 (P<.001), and 48.5% in 2011 (P <.001). On multivariable analysis of 2023 participants, physicians were at increased risk for burnout (odds ratio=1.82; 95% CI, 1.63 to 2.05) and were less likely to be satisfied with WLI (odds ratio=0.59; 95% CI, 0.53 to 0.66) than other US workers.</p><p><strong>Conclusion: </strong>Burnout among US physicians improved between 2021 and 2023 and is currently at levels similar to 2017. However, US physicians remain at higher risk for burnout relative to other US workers.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of a Consensus Conference on the Management of Highly Sensitized Multiorgan Transplant Candidates","authors":"Timucin Taner MD, PhD ,&nbsp;Scott W. Biggins MD ,&nbsp;Nathan Cummins MD ,&nbsp;Richard C. Daly MD ,&nbsp;Allan B. Dietz PhD ,&nbsp;Juliet Emamaullee MD, PhD ,&nbsp;Manish J. Gandhi MD ,&nbsp;Julie K. Heimbach MD ,&nbsp;Jignesh K. Patel MD ,&nbsp;Naveen L. Pereira MD ,&nbsp;Andrew Rosenbaum MD ,&nbsp;Alberto Sanchez-Fueyo MD, PhD ,&nbsp;Alexandra Shingina MD ,&nbsp;Mark D. Stegall MD ,&nbsp;Mauricio A. Villavicencio Theoduloz MD ,&nbsp;Joyce W. Wald DO ,&nbsp;Sudhir S. Kushwaha MD","doi":"10.1016/j.mayocp.2025.01.012","DOIUrl":"10.1016/j.mayocp.2025.01.012","url":null,"abstract":"<div><div>The number of highly sensitized patients in need of a multiorgan transplant is increasing. Criteria informing their transplant candidacy, approaches to management on the waitlist, and protocols related to alloantibody monitoring vary widely. We convened a consensus conference to discuss these different practices in the United States and the United Kingdom and to review the contemporary outcomes of these challenging cases. A detailed analysis of the data regarding the liver allografts’ immunoprotective effect on simultaneously transplanted other organs was also completed, and the prospect of the use of liver allografts primarily to facilitate transplantation of highly sensitized patients in need of other organs was discussed. The ethical and allocation-related issues about such prospect were debated with a goal to standardize the approach and provide an evidence-based pathway for pre-, peri-, and post-transplantation management for the highly sensitized multiorgan transplantation candidate.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 700-711"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large Arteriovenous Fistula Aneurysms","authors":"Armin Tabiei MD,&nbsp;Bernardo C. Mendes MD","doi":"10.1016/j.mayocp.2025.01.011","DOIUrl":"10.1016/j.mayocp.2025.01.011","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 754-756"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing Patterns of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Patients With Type 2 Diabetes at Cardiology, Endocrinology, and Primary Care Visits","authors":"Dave L. Dixon PharmD ,&nbsp;Teresa M. Salgado MPharm, PhD ,&nbsp;Amanda Robinson MS ,&nbsp;Salvatore Carbone PhD ,&nbsp;Tyler D. Wagner PharmD, PhD ,&nbsp;Haroon Hyder MD ,&nbsp;Bryan Kirschner PharmD ,&nbsp;Kerri T. Musselman PharmD ,&nbsp;Tonya M. Buffington PharmD ,&nbsp;Roy T. Sabo PhD","doi":"10.1016/j.mayocp.2024.08.026","DOIUrl":"10.1016/j.mayocp.2024.08.026","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prescribing rates of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) at cardiology, endocrinology, and primary care visits in a community health system.</div></div><div><h3>Patients and Methods</h3><div>A cross-sectional study using electronic health record data from Bon Secours Mercy Health outpatient clinics across Virginia (2019, 2020, 2021) included patients 18 years and older with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD), and one or more outpatient visits. Adults with type 1 diabetes, stage 4/5 CKD, end-stage kidney disease, dialysis treatment, pregnancy, or hospice or palliative care were excluded. Prescribing rates were compared overall and for each subgroup among cardiology, endocrinology, and primary care visits using generalized linear mixed modeling with a random practice-level effect.</div></div><div><h3>Results</h3><div>The 22,060 included patients had a mean age of 68 years, 50% were female (n=11,030), 41.3% were Black race (n=9,100), and 74.8% were Medicare beneficiaries (n=16,498). In addition, 17,724 patients (80.3%) had ASCVD, 5276 (23.9%) CKD, and 5,965 (27.0%) HF. Overall, prescriptions for either drug class occurred in 17.4% of eligible patients (n=3,849). Cardiology visits had the lowest prescribing rates overall and for each diagnosis subgroup compared with endocrinology and primary care visits in the raw, unadjusted, and adjusted models.</div></div><div><h3>Conclusion</h3><div>Overall prescribing rates for SGLT2i and GLP-1 RA were low among adults with type 2 diabetes and ASCVD, HF, or CKD. Additional research is warranted to identify barriers, and potential solutions, to improve prescribing of these therapies.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 647-656"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sedentary During the Week, but Active on the Weekend … Is the “Weekend Warrior” Pattern of Activity a Good Recommendation?","authors":"Clinton A. Brawner PhD,&nbsp;Steven J. Keteyian PhD","doi":"10.1016/j.mayocp.2025.02.010","DOIUrl":"10.1016/j.mayocp.2025.02.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 593-595"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights from the Current Issue – Audiovisual Summary","authors":"Karl A. Nath MBChB","doi":"10.1016/j.mayocp.2025.03.010","DOIUrl":"10.1016/j.mayocp.2025.03.010","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Page e1"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Information","authors":"","doi":"10.1016/S0025-6196(25)00123-5","DOIUrl":"10.1016/S0025-6196(25)00123-5","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Page A7"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human Reviewers' Ability to Differentiate Human-Authored or Artificial Intelligence–Generated Medical Manuscripts","authors":"Scott A. Helgeson MD ,&nbsp;Patrick W. Johnson BS ,&nbsp;Nilaa Gopikrishnan MD ,&nbsp;Tapendra Koirala MD ,&nbsp;Pablo Moreno-Franco MD ,&nbsp;Rickey E. Carter PhD ,&nbsp;Zachary S. Quicksall MS ,&nbsp;Charles D. Burger MD","doi":"10.1016/j.mayocp.2024.08.029","DOIUrl":"10.1016/j.mayocp.2024.08.029","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the ability of humans to differentiate human-authored vs artificial intelligence (AI)–generated medical manuscripts.</div></div><div><h3>Methods</h3><div>This is a prospective randomized survey study from October 1, 2023, to December 1, 2023, from a single academic center. Artificial intelligence–generated medical manuscripts were created using ChatGPT 3.5 and were evaluated alongside randomly selected human-authored manuscripts. Participants, who were blinded from manuscript selection and creation, were randomized to receive three manuscripts that were either human-authored or AI-generated and had to fill out a survey questionnaire after review regarding who authored the manuscript. The primary outcome was accuracy of human reviewers in differentiating manuscript authors. Secondary outcomes were to identify factors that influenced prediction accuracy.</div></div><div><h3>Results</h3><div>Fifty-one physicians were included in the study, including 12 post-doctorates, 19 assistant professors, and 20 associate or full professors. The overall specificity of 55.6% (95% CI, 30.8% to 78.5%), sensitivity of 31.2% (95% CI,11.0% to 58.7%), positive predictive value of 38.5% (95% CI,13.9% to 68.4%) and negative predictive value of 47.6% (95% CI, 25.7% to 70.2%). A stratified analysis of human-authored manuscripts indicated that high-impact factor manuscripts were identified with higher accuracy than low-impact factor ones (<em>P</em>=.037). For individual-level data, neither academic rank nor prior manuscript review experience significantly predicted the accuracy. The frequency of AI interaction was a significant factor, with occasional (odds ratio [OR], 8.20; <em>P</em>=.016), fairly frequent (OR, 7.13; <em>P</em>=.033), and very frequent (OR, 8.36; <em>P</em>=.030) use associated with correct identification. Further analysis revealed no significant predictors among the papers' qualities.</div></div><div><h3>Conclusion</h3><div>Generative AI such as ChatGPT could create medical manuscripts that could not be differentiated from human-authored manuscripts.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 622-633"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}