Mayo Clinic proceedings最新文献

{"title":"Aortic Arch Morphology Is Associated With Long-term Mortality After Transcatheter Aortic Valve Replacement","authors":"Gerardo V. Lo Russo MD , Hasan Alarouri MBBS , Ke-Wei Chen MD , Ju-Hsin Chang MD , Chia-Hao Liu MD , Ghasaq Saleh MD , Shih-Sheng Chang MD , Hoda Hatoum PhD , Mohamad Alkhouli MD, MBA","doi":"10.1016/j.mayocp.2025.01.001","DOIUrl":"10.1016/j.mayocp.2025.01.001","url":null,"abstract":"","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 4","pages":"Pages 749-750"},"PeriodicalIF":6.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739712","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":"Proteomic Profile of Ischemic Heart Disease in Heart Failure: A Community Study.","authors":"Kayode O Kuku, Maryam Hashemian, Jungnam Joo, Joseph J Shearer, Carolina G Downie, Mohit Aggarwal, Suzette J Bielinski, Véronique L Roger","doi":"10.1016/j.mayocp.2024.12.016","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.12.016","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics, outcomes, and proteomic profiles of prevalent ischemic heart disease (IHD) in heart failure (HF) in a clinically phenotyped cohort.</p><p><strong>Methods: </strong>We studied an HF community cohort (N=1351) enrolled between September 10, 2003, and September 18, 2012, with linked medical records and measured 7289 plasma protein targets using an aptamer-based assay. Ischemic heart disease was defined by prior myocardial infarction, angiographic coronary disease, or revascularization. Cause-specific hazards model was used to test the association between IHD status and cardiovascular (CV) mortality while considering the interaction by ejection fraction (EF) group. Linear regression adjusting for age, sex, and estimated glomerular filtration rate with multiple testing correction was used to evaluate the cross-sectional association of proteins with IHD status and with CV risk factors.</p><p><strong>Results: </strong>There were 678 patients with IHD (median age, 78 years [interquartile range, 69 to 84 years]; 271 [40%] female). The association between IHD status and CV mortality was markedly influenced by EF (P_interaction=.002). Ischemic heart disease was associated with excess 5-year CV mortality in the reduced EF group (hazard ratio, 2.14; 95% CI, 1.42 to 3.21) but not in the preserved EF group (hazard ratio, 1.04; 95% CI, 0.80 to 1.36). Fifty-two proteins (31 up-regulated, 21 down-regulated) were associated with IHD compared with non-IHD, including 42 proteins associated with risk factors and 10 with no association with risk factors.</p><p><strong>Conclusion: </strong>These data suggest that unique proteomic profiles reveal biologic signatures of IHD in HF, emphasizing the importance of molecular data in classifying HF phenotypes. In addition, our findings underscore the prognostic significance of IHD in HF with reduced EF.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753343","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":"Causal Associations of Insomnia With Chronic Kidney Diseases and Underlying Blood Proteins: An Observational and Mendelian Randomization Study.","authors":"Kunying Wang, Shuo Ye, Hongliang Feng, Yannis Yan Liang, Sheng Guo, Rui Zheng, Yujing Zhou, Guangbo Jia, Lu Qi, Guoan Zhao, Jihui Zhang, Sizhi Ai","doi":"10.1016/j.mayocp.2024.12.020","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.12.020","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the causal association between insomnia and chronic kidney disease (CKD) and to explore the underlying protein pathways.</p><p><strong>Methods: </strong>In primary analyses, multivariate regression and 1-sample mendelian randomization (1SMR) analyses were performed to estimate the associations between insomnia and CKD in the UK Biobank cohort. The study was conducted from March 13, 2006, to November 12, 2021. Thereafter, a 2-sample MR (2SMR) analysis was used to validate the findings from primary analyses. Finally, proteome-wide MR analysis was conducted to pinpoint CKD-associated blood proteins, supplemented by the colocalization analysis. In addition, the potential mediation effects of blood proteins on the pathway of insomnia giving rise to CKD were explored through a 2-step MR design.</p><p><strong>Results: </strong>Across the multivariate regression, 1SMR, and their sensitivity analyses, we found consistent evidence suggesting that more frequent insomnia was associated with a higher risk of CKD (multivariate regression: hazard ratio, 1.21 [95% CI, 1.17 to 1.25; P<.001]; 1SMR: odds ratio, 1.35 [95% CI, 1.02 to 1.79; P=.04]). Consistent evidence was obtained by using 2SMR (odds ratio,1.06; 95% CI, 1.02 to 1.11; P=.009). Genetically predicted 124 circulating proteins were associated with CKD in proteome-wide MR analysis. ENPP5 is a promising novel target that mediates the association between insomnia and CKD.</p><p><strong>Conclusion: </strong>More frequent insomnia is causally associated with increased risk of CKD, and ENPP5 as a potential blood protein mediates the association between insomnia and CKD. These findings indicate that addressing insomnia could serve as a viable and valid intervention to mitigate CKD risk.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753342","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":"Safety of Acamprosate in Patients With Alcohol-Associated Liver Disease: A Single-Arm Phase 2 Trial.","authors":"Tiffany Wu, Omar Y Mousa, Tasha Kulai, Cori Larson, Amy Olofson, Patrick S Kamath, Vijay H Shah, Timucin Taner, William Sanchez, Douglas A Simonetto","doi":"10.1016/j.mayocp.2024.12.013","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.12.013","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the safety of acamprosate, a Food and Drug Administration-approved medication for alcohol use disorder, in patients with alcohol-associated liver disease.</p><p><strong>Methods: </strong>In this phase 2 open-label study, 12 patients with alcohol use disorder and alcohol-associated liver disease were enrolled between September 2020 and May 2022. Participants received acamprosate for 12 weeks and were followed up to 24 weeks. The primary end point was drug safety profile; secondary end points included alcohol craving, measured by the Penn Alcohol Craving Scale, and relapse. All safety data were reviewed by the Data and Safety Monitoring Board.</p><p><strong>Results: </strong>Patients were enrolled sequentially with Model for End-Stage Liver Disease-Sodium score below 20 (n=6) and 20 and above (n=6). Median age was 50 years, and 7 (58.3%) were female. Seven patients confirmed initiation of acamprosate, whereas 5 were lost to follow-up. There were no significant adverse events; only 1 patient reported pruritus, and no patients demonstrated worsening of liver disease. All patients experienced a decrease in or unchanged craving score from baseline to end of study.</p><p><strong>Conclusion: </strong>Acamprosate may be safe for and well tolerated by patients with alcohol-associated liver disease. Further studies are needed to assess the long-term efficacy of acamprosate.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04287920.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710611","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":"Impact of Lipid-Lowering Combination Therapy With Statins and Ezetimibe vs Statin Monotherapy on the Reduction of Cardiovascular Outcomes: A Meta-analysis.","authors":"Maciej Banach, Vikash Jaiswal, Song Peng Ang, Aanchal Sawhney, Novonil Deb, Pierre Amarenco, Dan Gaita, Zeljko Reiner, Ivan Pećin, Carl J Lavie, Peter E Penson, Peter P Toth","doi":"10.1016/j.mayocp.2025.01.018","DOIUrl":"https://doi.org/10.1016/j.mayocp.2025.01.018","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of combination lipid-lowering therapy (LLT) compared with statin monotherapy for low-density lipoprotein cholesterol (LDL-C) reduction, associated adverse events, and outcomes.</p><p><strong>Methods: </strong>A systematic literature search was conducted using PubMed, Embase, and ClinicalTrials.gov to identify relevant articles published from inception until the end of June 2024. The outcomes were assessed using pooled odds ratios (ORs) for categorical data and mean difference for continuous data, with corresponding 95% CIs.</p><p><strong>Results: </strong>A total of 14 studies (11 randomized controlled trials and 3 cohort studies) with 108,373 very high-risk patients were included in the final analysis. The mean age of the patients in the combination LLT group and the statin monotherapy group was 67.31 and 67.89 years, respectively. Pooled analysis revealed that combination LLT significantly more effectively reduced the LDL-C level from baseline (mean difference, -12.96 mg/dL; 95% CI, -17.27 to -8.65; P<.001) and significantly reduced all-cause mortality (OR, 0.81; 95% CI, 0.67 to 0.97; P=.02), major adverse cardiovascular events (OR, 0.82; 95% CI, 0.69 to 0.97; P=.02), and stroke incidence (OR, 0.83; 95% CI, 0.75 to 0.91; P<.001), with an insignificant effect on cardiovascular mortality (OR, 0.86; 95% CI, 0.65 to 1.12; P=.26) when compared with statin monotherapy. The risk of adverse events and the therapy discontinuation rate were comparable between groups.</p><p><strong>Conclusion: </strong>Combination LLT was associated with an overall greater reduction in LDL-C, the same risk of adverse effects, and significantly lower risk of all-cause mortality, major adverse cardiovascular events, and stroke compared with statin monotherapy. Forthcoming guidelines should consider the lipid-lowering combination therapy as early as possible, preferably up-front, for more effective LDL-C goal achievement and significant reduction of cardiovascular disease outcomes and mortality in high- and very high-risk patients.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691750","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":"Population-Based Incidence of Infectious Mononucleosis and Related Hospitalizations: 2010 Through 2021.","authors":"Jennifer L St Sauver, Robert M Jacobson, Susan A Weston, Chun Fan, Philip O Buck, Susan A Hall","doi":"10.1016/j.mayocp.2024.09.017","DOIUrl":"10.1016/j.mayocp.2024.09.017","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the risks of infectious mononucleosis (IM) and serious IM outcomes are changing over time.</p><p><strong>Patients and methods: </strong>Individuals with a diagnosis of IM and hospitalizations due to IM were identified among persons residing in an Upper Midwest region between January 1, 2010, and December 31, 2021, using the Rochester Epidemiology Project. Infectious mononucleosis rates were calculated assuming the entire population between 2010 and 2021 was at risk, and IM-associated hospitalization rates were calculated among everyone with a diagnosis of IM. Poisson regression was used to test trends and estimate incidence and hospitalization rate ratios.</p><p><strong>Results: </strong>We identified 5334 individuals with IM; the overall IM rate was 60.60 per 100,000 person-years (95% CI, 58.98 to 62.25). Rates were highest in females, individuals of White race, those with non-Hispanic ethnicity, and individuals 15 to 19 years old (all P<.05). Infectious mononucleosis rates decreased significantly over time among all age groups (all tests for trend, P<.05). Overall, 234 individuals (4.3%) were hospitalized with IM (43.87 per 1000 persons with IM; 95% CI, 38.43 to 49.87), and hospitalization rates among those with IM increased over time (test for trend, P<.05). Individuals younger than 10 years, those 20 years or older, and individuals of Hispanic ethnicity had increased risk for IM-associated hospitalization (all adjusted P<.05).</p><p><strong>Conclusion: </strong>Although rates of IM diagnosis have decreased over time, risk of hospitalization in individuals with IM has increased. Age and ethnicity increase the risk of hospitalization due to IM.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586266","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":"Association Between Vacation Characteristics and Career Intentions of US Physicians-A Cross-Sectional Analysis.","authors":"Christine A Sinsky, Purva Shah, Lindsey E Carlasare, Tait D Shanafelt","doi":"10.1016/j.mayocp.2024.09.020","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.09.020","url":null,"abstract":"<p><strong>Objective: </strong>To assess the association between physicians' vacation characteristics and career intentions.</p><p><strong>Participants and methods: </strong>This is a cross-sectional survey of a sample of US physicians between November 2022 and September 2023. Vacation days in the last year, inbox coverage, performance of patient-related work on vacation (WOV), intent to reduce clinical hours in the next 12 months, and intent to leave current practice in the next 24 months were assessed.</p><p><strong>Results: </strong>Of 5059 respondents, 2163 of 4537 (47.7%) reported fewer than 15 days of vacation in the last year, with 443 of 4537 (9.8%) taking 5 or fewer days. Nearly half (48.6%) reported not having full electronic health record inbox coverage on vacation. Most (72.0%) reported WOV, with 33.6% performing more than 30 minutes per day. On multivariable analyses adjusting for personal and professional characteristics, taking 15 or fewer days of vacation per year (odds ratio [OR], 1.37 [95% CI, 1.14 to 1.64]), absence of full inbox coverage (OR, 1.36 [95% CI, 1.13 to 1.63]), and more than 30 minutes per day of WOV (OR, 1.50 [95% CI, 1.24 to 1.81]) were each associated with higher odds of intent to reduce clinical hours. Similarly, taking 15 or fewer days of vacation per year (OR, 1.19 [95% CI, 1.00 to 1.41]), not having full inbox coverage (OR, 1.33 [95% CI, 1.12 to 1.57]), and more than 30 minutes per day of WOV (OR, 1.44 [95% CI, 1.21 to 1.72]) were each associated with higher odds of intent to leave current practice.</p><p><strong>Conclusion: </strong>In this large, cross-sectional study, the number of vacation days taken, inbox coverage, and time spent on patient-related work while on vacation were each independently associated with career intentions. Organizational efforts to optimize these vacation characteristics may foster retention of physicians.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586245","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":"Self-Monitoring of Blood Pressure and Feedback via Mobile App in Treatment of Uncontrolled Hypertension: the SMART-BP Randomized Clinical Trial.","authors":"Minjae Yoon, Taeho Hur, Sung-Ji Park, Sang-Ho Jo, Eung Ju Kim, Soo-Joong Kim, Musarrat Hussain, Cam-Hao Hua, Sungyoung Lee, Dong-Ju Choi","doi":"10.1016/j.mayocp.2024.09.018","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.09.018","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of mobile apps with tailored recommendations on changes in blood pressure (BP) and drug adherence.</p><p><strong>Patients and methods: </strong>This study is a randomized, open-label, multicenter trial to evaluate the efficacy of self-monitoring of BP (SMBP) with a mobile application-based feedback algorithm (SMBP app with feedback) compared with SMBP alone. Patients with uncontrolled hypertension aged 19 years or older were randomly assigned. In the control group, the patients only measured their BP at home using the mobile app combined with a Bluetooth BP monitor and received standard care, whereas in the intervention group, the patients could also receive alerts for BP measurement and additional recommendations from the app using a feedback algorithm in response to the obtained BP value. The primary end point was the change in mean home systolic BP at 24 weeks.</p><p><strong>Results: </strong>From September 1, 2019, through July 8, 2020, 184 patients were randomized into 2 groups: SMBP app with feedback (n=97) and SMBP alone (n=87). At 24 weeks, the mean ± SD home systolic BP reduction from baseline was significantly greater in the SMBP app with feedback group than in the SMBP alone group (-22.4±13.5 vs -17.2±13.3 mm Hg; P=.02). The SMBP app with feedback group had higher drug adherence and proportion of adherence of 95% or greater than the SMBP alone group.</p><p><strong>Conclusion: </strong>The SMBP app with feedback is superior to SMBP alone in terms of systolic BP reduction and improved drug adherence in patients with hypertension. Given the high cost of traditional interventions between patients and health care professionals, feedback through mobile apps could potentially be a useful tool in the management of hypertension.</p><p><strong>Trial registration: </strong>clinicaltrials.gov Identifier: NCT04470284.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567418","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":"A Contemporary Assessment of the Prevalence of Chronic Diseases That Contribute to Health Care Utilization.","authors":"Harold I Salmons, Dirk R Larson, Rachel E Gullerud, Hilal Maradit Kremers, Jennifer L St Sauver, Arjun S Sebastian, Daniel J Berry, Jennifer J Westendorf, Matthew P Abdel","doi":"10.1016/j.mayocp.2024.10.023","DOIUrl":"https://doi.org/10.1016/j.mayocp.2024.10.023","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the most prevalent diagnosed conditions contributing to health care visitations in a defined US population by age and racial group, educational level, and socioeconomic deprivation.</p><p><strong>Patients and methods: </strong>The Rochester Epidemiology Project is a medical records-linkage system that captures medical care provided to residents of Olmsted County, Minnesota. The Rochester Epidemiology Project was queried for all Olmsted County residents. International Classification of Diseases codes were obtained for individuals included in the project between January 1, 2014, and December 31, 2019, and they were categorized into 46 broad disease groups. Age- and sex-specific prevalences were estimated by dividing the number of individuals within each group by the corresponding population.</p><p><strong>Results: </strong>In total, 154,254 individuals were included, and 122,627 (65,782 [53.6%] female) had at least one diagnosis of interest. Arthritis/joint disorders and back problems (ie, musculoskeletal disorders) were the most prevalent across all ages (42%), followed by skin (40%) and anxiety/depression/bipolar disorders (24%). Lower education and a higher area deprivation index score were associated with certain modifiable chronic diseases.</p><p><strong>Conclusion: </strong>Musculoskeletal diseases were the most prevalent diagnosed conditions contributing to health care visitations within a defined US population. Individual level of education and socioeconomic deprivation were associated with modifiable diseases. An emphasis on effective diagnosis and management of musculoskeletal conditions in health care delivery models and more focused preventative efforts in disadvantaged communities are imperative.</p>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":" ","pages":""},"PeriodicalIF":6.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567299","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":"Charting a New Path Forward in Addressing Employee Well-being in Health Care","authors":"Kaisa C. Wieneke MPH ,&nbsp;Bridget E. Berkland MA, NBC-HWC ,&nbsp;Gretl C. Kruse MS, MHA ,&nbsp;Melissa R. Priestley MPA ,&nbsp;Danielle M. Teal MAOL, PMP ,&nbsp;Colin P. West MD, PhD","doi":"10.1016/j.mayocp.2024.11.018","DOIUrl":"10.1016/j.mayocp.2024.11.018","url":null,"abstract":"<div><div>Health care worker well-being is critical to delivering optimal care to our patients. With greater understanding of these issues, evidence-informed models of employee well-being have been developed to guide efforts to improve well-being in the workplace. To ensure that organizational approaches resonate with staff needs, these models can be improved for local application by engaging employees in a co-creation process in which they actively participate in developing and refining the institutional framework for employee well-being. This article describes how the Mayo Clinic Employee Well-Being team, led by Mayo Clinic’s first organization-level medical director and administrator of Employee Well-Being, integrated employee input with existing well-being models through a comprehensive process to define a program structure reflecting the most important staff needs. The novel features of this approach are intended to serve as a guide for health care organizations as we work together to promote learning and working environments in medicine in which every member of the health care team can thrive.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"100 3","pages":"Pages 501-513"},"PeriodicalIF":6.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529420","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}