CELEBRATING 100 YEARS Mayo Clinic Proceedings
Mission To promote the best interests of patients by advancing the knowledge and professionalism of the physician community. Editor-in-Chief Karl A. Nath, MBChB Mayo Clinic, Rochester, MN Associate Editors Thomas J. Beckman, MD Residents’ Clinics, Concise Reviews, General Internal Medicine Mayo Clinic, Rochester, MN Lori A. Erickson, MD Laboratory Medicine and Pathology, Medical Images Mayo Clinic, Rochester, MN Vesna D. Garovic, MD Women’s Health and Medicine of Sex Differences Mayo Clinic, Rochester, MN Matthew Griffin, MB, ChB Kidney Disease Pathophysiology, Transplantation, Transplant Immunology, Regenerative Medicine, Cell Therapies National University of Ireland, Galway, Ireland Vivekanand Jha, MD, DM, FRCP, FAMS Global Kidney Health The George Institute for Global Health, New Delhi, India Imperial College, London, United Kingdom University of New South Wales, Sydney, Australia Souha S. Kanj, MD Infectious Diseases, Global Health American University of Beirut Medical Center, Beirut Lebanon Carl J. Lavie, MD Cardiovascular Diseases John Ochsner Heart and Vascular Institute, New Orleans, LA S. Vincent Rajkumar, MD Review Articles, Hematology, Website, and Social Media Mayo Clinic, Rochester, MN Priya Sampathkumar, MD Infection Control, Infectious Diseases Mayo Clinic, Rochester, MN Nicholas Talley, MD, PhD Gastroenterology John Hunter Hospital Newcastle, Australia Ayalew Tefferi, MD Hematology Mayo Clinic, Rochester, MN R. Scott Wright, MD Cardiovascular Diseases Mayo Clinic, Rochester, MN Section Editors Samuel J. Asirvatham, MD Cardiovascular Diseases, Innovations in Medicine and Surgery Mayo Clinic, Rochester, MN Sherri A. Braksick, MD Neurology Mayo Clinic, Rochester, MN Timothy B. Curry, MD, PhD Anesthesiology and Perioperative Medicine Mayo Clinic, Rochester, MN John M. Davis, III, MD Rheumatology Mayo Clinic, Rochester, MN Mark Denis P. Davis, MD Dermatology Mayo Clinic, Rochester, MN Matthew T. Drake, MD, PhD Endocrinology HSS (Hospital for Special Surgery), New York, NY Elizabeth B. Habermann, PhD Health Care Policy and Research Mayo Clinic, Rochester, MN W. Michael Hooten, MD Pain Medicine Mayo Clinic, Rochester, MN Paul B. Klaas, JD Legal North Coast Arbitration Chambers, Minneapolis, MN Manish Kohli, MD Medical Oncology University of Utah, Salt Lake City Bhanu Kolla, MD Psychiatry and Addiction Medicine Mayo Clinic, Rochester, MN Jay Mandrekar, PhD Biomedical Statistics and Informatics Mayo Clinic, Rochester, MN M. Hassan Murad, MD Guidelines, Systematic Reviews, and Meta-analysis Mayo Clinic, Rochester, MN Joseph A. Murray, MD Gastroenterology and Hepatology Mayo Clinic, Rochester, MN Shelley S. Noland, MD Humanities in Medicine, The Compass Mayo Clinic, Phoenix, AZ Robert J. Pignolo, MD, PhD Aging and Geriatric Medicine Mayo Clinic, Rochester, MN Andrew D. Rule, MD Nephrology and Hypertension Mayo Clinic, Rochester, MN Tait D. Shanafelt, MD Physician and Health Care Professional Engagement and Fulfillment Stanford Medicine, Stanford, CA Vinaya Simha, MBBS, MD General Diabetes Mayo Clinic, Rochester, MN Robert J. Spinner, MD Neurologic Surgery, Orthopedics Mayo Clinic, Rochester, MN Thomas D. Thacher, MD Family Medicine Mayo Clinic, Rochester, MN Jon C. Tilbert, MD Biomedical Ethics, The Compass Mayo Clinic, Scottsdale, AZ Robert Vassallo, MD Pulmonary Medicine Mayo Clinic, Rochester, MN Rahma Warsame, MD Hematology Mayo Clinic, Rochester, MN www.mayoclinicproceedings.org
Editorial Board Jozef Bartunek, MD, PhD Cardiology Aalst, OLV Hospital Ghent, Oost-Vlaanderen, Belgium Sarah L. Berga, MD Reproductive Endocrinology and Infertility University at Buffalo Jacobs School of Medicine and Biomedical Sciences Buffalo, NY Barry A. Boilson, MD Cardiovascular Medicine Mayo Clinic, Rochester, MN Mohamad Bydon, MD Neurologic Surgery The University of Chicago Medicine, IL Wisit Cheungpasitporn, MD Artificial Intelligence, Nephrology, and Hypertension Mayo Clinic, Rochester, MN Daniel Claassen, MD, MS Neurology Vanderbilt University Medical Center, Nashville, TN Steven P. Cohen, MD Pain Medicine Northwestern University Feinberg School of Medicine Chicago, IL Chyke A. Doubeni, MBBS, MPH Health Care Equity, Community Engagement, Family Medicine The Ohio State University, Wexner Medical Center, Columbus, OH Ghada El-Hajj Fuleihan, MD, MPH Endocrinology (focus on bone) American University of Beirut Beirut, Lebanon Rafael Fonseca, MD Hematology/Oncology Mayo Clinic, Rochester, MN Martha Grogan, MD Cardiovascular Medicine Mayo Clinic, Rochester, MN Christian Hanna, MD, MS Pediatrics, Pediatric Nephrology Mayo Clinic, Rochester, MN Hatim A. Hassan, MD, PhD Nephrology and Hypertension Mayo Clinic, Rochester, MN Aminah Jatoi, MD Medical Oncology Mayo Clinic, Rochester, MN Jari A. Laukkanen, MD, PhD, FESC Cardiovascular Medicine, Healthy Lifestyles University of Eastern Finland, Kuopio, Finland Daniel P. Morin, MD, MPH Cardiology/Electrophysiology University of California San Francisco, San Franciso, CA Suzanne M. Norby, MD Nephrology and Medical Education Mayo Clinic, Rochester, MN Kristine Olson, MD, MS Physician Well-Being and Burnout Yale School of Medicine, New Haven, CT Naveen L. Pereira, MD Cardiovascular Medicine and Heart Failure Mayo Clinic, Rochester, MN Yogesh N. Reddy, MBBS Cardiovascular Medicine Mayo Clinic, Rochester, MN Siddharth Singh, MD Gastroenterology, Systematic Reviews, and Meta-analysis University of California San Diego, La Jolla, CA Virend Somers, MD, PhD Cardiovascular Medicine and Sleep Disorders Mayo Clinic, Rochester, MN Jeffrey A. Sparks, MD, MMSc Rheumatology, Inflammation, and Immunity Brigham and Women’s Hospital, Boston, MA Carmen M. Terzic, MD, PhD Physical Medicine and Rehabilitation Mayo Clinic, Rochester, MN Adrian Vella, MD Endocrinology Mayo Clinic, Rochester, MN Hector O. Ventura, MD Cardiovascular Medicine John Ochsner Heart and Vascular Institute, New Orleans, LA Amy W. Williams, MD Clinical Practice and Policy, Nephrology Mayo Clinic, Rochester, MN Statistical Reviewers Yu-Hui H. Chang, PhD, MS, Mayo Clinic, Scottsdale, AZ William S. Harmsen, MS, Mayo Clinic, Rochester, MN Heidi E. Kosiorek, MS, Mayo Clinic, Scottsdale, AZ Katie Kunze, PhD, MA, Mayo Clinic, Scottsdale, AZ Dirk R. Larson, MS, Mayo Clinic, Rochester, MN Benjamin (Ben) D. Pollock, PhD, MSPH, Mayo Clinic, Jacksonville, FL Fazlur Rahman, PhD, University of Alabama at Birmingham, AL Hamid R. Tizhoosh, PhD, Mayo Clinic, Rochester, MN Nan Zhang, MS, Mayo Clinic, Scottsdale, AZ Proceedings Staff Managing Editor: Terry Jopke, BA Assistant Managing Editor: Kimberly D. Sankey Assistant Managing Editor: Margaret R. Wentz, BA Business Manager: Jon T. Nordrum, DPT, DSc Digital Editor: Lisa Muenkel Editorial Offices Mayo Clinic Proceedings, Plummer Building S-10, Rochester, MN 55905 Telephone: (507) 284-2094; E-mail: proceedings@mayo.edu Direct editorial information and inquiries to the above offices. www.mayoclinicproceedings.org
www.mayoclinicproceedings.org Table of Contents Celebrating 100 years of Mayo Clinic Proceedings Foreword 1 Foreword Fredric Meyer Editorials 3 A Century of Hope, Healing, and Innovation: Celebrating the 100th Yearly Volume of Mayo Clinic Proceedings Gianrico Farrugia 6 Mayo Clinic Proceedings: Commemorating a Century of Continuous Communication Karl A. Nath, Morna Conway, and Rafael Fonseca 10 Mayo Clinic Proceedings and Medical Education―Medical Journals as the Partitur of Medical Knowledge Fredric B. Meyer and Rafael Fonseca 13 Cardiorespiratory Fitness and Mayo Clinic Proceedings Carl J. Lavie, Jari A. Laukkanen, and Karl A. Nath 16 Mayo Clinic Proceedings and Progress in Solid Organ Transplantation Matthew D. Griffin 19 Mayo Clinic Proceedings and the Development of Echocardiography Patricia A. Pellikka 22 Mayo Clinic Proceedings and Steatohepatitis: From NASH Recognition to MASH Therapy Hanna L. Erickson, Thomas R. Viggiano, and Harmeet Malhi 26 Mayo Clinic Proceedings’ Centennial Celebration: Advances by Mayo Clinic Department of Laboratory Medicine and Pathology Lori A. Erickson and Eric D. Hsi Continued
29 Mayo Clinic Proceedings’ Central Role in the Clinician Well-being Movement Tait D. Shanafelt 34 Mayo Clinic Proceedings in the Last Century: Seminal Contributions by Mayo Clinic Physicians and Researchers to the Field of Neurogastroenterology Michael Camilleri and Nicholas J. Talley 39 A Century of Neurosurgery at Mayo Clinic and Mayo Clinic Proceedings: A Shared Legacy Robert J. Spinner and Julian S. Rechberger 42 Plasma Cell Disorders and Mayo Clinic Proceedings S. Vincent Rajkumar 45 Cardiac Surgery at Mayo Clinic―A 70th Anniversary Celebration Juan A. Crestanello, Arman Arghami, Elizabeth Stephens, Kimberly A. Holst, Kevin L. Greason, Gabor Bagameri, Mauricio A. Villavicencio, Philip J. Spencer, Alberto Pochettino, Sahar Saddoughi, Paul C. Tang, Phillip G. Rowse, Malakh L. Shrestha, Richard C. Daly, Joseph A. Dearani, Hartzell V. Schaff, and R. Scott Wright 53 Mayo Clinic Proceedings and Evolution of Diabetes Management: A Century of Companionship Vinaya Simha 56 Educating Health Care Professionals About Artificial Intelligence Karl A. Nath 61 Cortisone, Mayo Clinic, and the 1950 Nobel Prize in Medicine: The Seminal Role of Mayo Clinic Proceedings Thom W. Rooke 64 Kendall and Hench: A Critical Collaboration in Cortisone’s Discovery Karl A. Nath 68 The Rochester Epidemiology Project and Mayo Clinic Proceedings: Celebrating 60 Years of Clinical Research Across the Lifespan Jennifer L. St Sauver, Andrew D. Rule, Alanna M. Chamberlain, and Walter A. Rocca 72 Infectious Diseases and Mayo Clinic Proceedings Priya Sampathkumar and Walter R. Wilson Table of Contents Continued
75 The Digital Transformation of Health Care John Halamka and Paul Cerrato 78 From Plummer to Platform Karl A. Nath Icon Key This article has been given “Editor’s Choice” distinction. An author interview accompanies this article. Supplemental material accompanies this article at www.mayoclinicproceedings.org. Indicates articles focusing on health humanities and ethical decision making as applied to medicine and the health sciences. “Mayo Clinic Proceedings,” “Mayo,” “Mayo Clinic,” and the triple-shield Mayo Clinic logo are all registered marks of Mayo Foundation for Medical Education and Research. ª 2026 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. MAYO CLINIC PROCEEDINGS is published monthly by Elsevier on behalf of Mayo Foundation for Medical Education and Research. Table of Contents Supplemental material attached to journal articles has not been edited, and the authors take responsibility for the accuracy of all data.
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Foreword In addition to its 5 schools, the Mayo Clinic Education Shield governs a number of important programs, initiatives, and entities, prominent among which is Mayo Clinic Proceedings―notably, this journal will celebrate a century of uninterrupted publication on April 21, 2026. Mayo Clinic Proceedings traces its origins to The Bulletin of the Mayo Clinic and Mayo Foundation, which was first published on April 21, 1926, with the intent of providing the staff of Mayo Clinic with a vehicle for communicating and a forum for discussing medical knowledge. Mayo Clinic Proceedings evolved in tandem with Mayo Clinic, and like its sponsoring institution, the vision and purpose of the Proceedings are patient centered, providing content that specifically advances these goals. In its 100-year career, Mayo Clinic Proceedings has progressed from a publication for Mayo Clinic staff into a nationally and internationally recognized journal with a worldwide readership. Its diversity of articles and features is unique for general medical journals in that there is content that appeals to the specialist, the clinical investigator, the surgeon and interventionalist, the practitioner, the educator, the epidemiologist, and the medical student, among other types of readership and niches; its diversity of content is also dynamic with new features continually added. In 2024, the number of article total views and downloads exceeded 8.2 million, with the journal receiving submissions from more than 60 countries worldwide; its most recent Impact Factor is 6.7. The journal has been sufficiently successful to support 2 expansion journals, Mayo Clinic Proceedings: Innovations, Quality & Outcomes, introduced in 2017, and Mayo Clinic Proceedings: Digital Health, introduced in 2023. I applaud the vision of Dr Karl A. Nath, Editor-in-Chief, Mayo Clinic Proceedings, to commemorate this centennial of Mayo Clinic Proceedings by showcasing some of the seminal papers published in the journal during its venerable career. Beginning in Volume 100, Issue 1 of Mayo Clinic Proceedings (January 2025 issue), Dr Nath invited, edited, and compiled a series of monthly editorials that highlight these previously published papers. Dr Gianrico Farrugia, President and CEO, Mayo Clinic, provided the inaugural contribution to this series with his editorial that summarizes the origins, accomplishments, and salient contributions of Mayo Clinic Proceedings. This is sequentially followed by editorials that recognize notable contributions in Mayo Clinic Proceedings that center on the following topics: medical education, cardiorespiratory fitness, transplantation, diabetes, infectious diseases, blood banking and other achievements in laboratory medicine and pathology, plasma cell disorders and other hematologic disease, the development of the echocardiogram, the introduction of cardiopulmonary bypass, nonalcoholic steatohepatitis, developments in neurosurgery, physician well-being and burnout, the Rochester Epidemiology Project, educating health care professionals about artificial intelligence, and the award of the Nobel prize to Kendall and Hench in 1950 for the discovery of cortisone. This largely retrospective series concludes in the April 2026 issue of Mayo Clinic Proceedings with a perspective that looks to the present and future―Mayo Clinic Platform―and is contributed by the President of Mayo Clinic Platform, Dr John Halamka. This editorial is showcased and linked back to the history of Mayo Clinic and Mayo Clinic Proceedings by an accompanying piece entitled “From Plummer to Platform.” These articles are now all brought together into this commemorative publication, thereby distilling high points of the illustrious 100- year career of an illustrious journal. In concluding, I wish to thank Mr John Poe for his administrative expertise and Mayo Clin Proc. n XXX 2026;nn(n):1-2 n https://doi.org/10.1016/j.mayocp.2026.01.005 www.mayoclinicproceedings.org n ª 2026 Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research 1
collaboration and Dr Rafael Fonseca for his wisdom and for his leadership of the Business Advisory Board, Mayo Clinic Proceedings. Finally, it is my true privilege to acknowledge our outstanding partnership with Elsevier in publishing this commemorative issue and, indeed, Elsevier’s outstanding and productive partnering with the Education Shield since 2012. FB Meyer, M.D. Uihlein Professor of Neurosurgery Chair Neurological Surgery Executive Dean of Education (2016-2025) Dean Mayo Clinic Alix School of Medicine (2016-2025) MAYO CLINIC PROCEEDINGS 2 Mayo Clin Proc. n XXX 2026;nn(n):1-2 n https://doi.org/10.1016/j.mayocp.2026.01.005 www.mayoclinicproceedings.org
A Century of Hope, Healing, and Innovation: Celebrating the 100th Yearly Volume of Mayo Clinic Proceedings As many physicians and scientists would readily attest, health care is a field justifiably focused on present outcomes and future advances such that it can be easy to overlook the value and insights from our past. A review of the last century of health care progress, innovation, and setbacks reveals lessons on abiding truths, including that health care works best when we work together to focus on the best interests and needs of the patient,1 and also lessons from the consequential choices that have resulted in enduring significant differences in quality and outcomes across the world. For this reason, Mayo Clinic Proceedings’ 100th volume and upcoming centennial anniversary in April 2026 represent a fitting moment to reflect on the contributions and trajectory of one of health care’s influential clinical journals and one that has documented many of the innovations that have defined the course of modern medicine. Despite its eventual prominence, the publication that would become Mayo Clinic Proceedings began with the simple purpose of sharing “reports of the [Mayo Clinic] Staff Meeting, and to such other reports or lectures as may be considered to merit a place in the special publication.” 2 At the time, physical weekly meetings of the Mayo Clinic physician staff and fellows functioned as an integral way for clinicians to collaborate, share best practices, and engage in Mayo Clinic’s culture of continuous learning. To emphasize the importance of this meeting, Mayo Clinic’s founding physicians, Drs Will and Charles Mayo, always sat in the front row. Recognizing that colleagues unable to attend the gathering could also benefit from the information shared, the Mayo brothers turned to Maude Mellish Wilson, Mayo Clinic’s first institutional librarian and Mayo Clinic Proceedings’ first editor, to summarize the discussion.3 In the last 100 years, what started as an internal newsletter has since grown to become one of the most influential medical journals in the world with an impact factor of 7.2, putting it in the top 10th percentile for general and internal medicine journals. Today, Mayo Clinic Proceedings reaches across the globe, with more than 7 million downloads in 2024 and 80% of manuscripts being submitted by noneMayo Clinic authors.4 In 1926, when the journal first began, few could have predicted this eventual impact. At the time, Mayo Clinicdand much of health caredwas undergoing profound change. What had started as a small family practice in Rochester, Minnesota, had grown to 100 members, with Saint Marys Hospitaldthe practice’s main hospitaldperforming more operations than any hospital in the United States. At the same time, Mayo Clinic physicians and researchersdalongside colleagues across the sectordwere pursuing groundbreaking advances and integrating them into an innovative integrated care delivery model that produced better outcomes for many more patients. In the 1920s alone, Mayo Clinic created a system for grading cancers on a numerical basis,5 standardized insulin therapy for diabetic patients,6 and introduced balanced anesthesia into clinical practice.7 Meanwhile, work was underway on even more profound breakthroughs: the discovery of cortisone, which would later be awarded a Nobel Prize in Medicine,8 and the creation of intravenous anesthesia,7 among others. Many of these innovative treatments, approaches, and theories would first appear in Mayo Clinic Proceedings as part of an emerging model of discovery, translation, and delivery EDITORIAL 8 Mayo Clin Proc. n January 2025;100(1):8-10 n https://doi.org/10.1016/j.mayocp.2024.11.012 www.mayoclinicproceedings.org n ª2024 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
of high-quality, compassionate, and cuttingedge health care that has, for more than 160 years, defined health care at Mayo Clinic. Since its founding, Mayo Clinic Proceedings has been at the forefront of the diligent, rigorous, and difficult work of assessing whether a new treatment is safe, effective, and capable of delivering better outcomes for patients and making that determination available for others to read. For instance, while penicillin was first discovered in 1928 by Alexander Fleming, it would not have a significant impact on patient care until the mid-1940s, thanks in large part to pioneering studies published in Mayo Clinic Proceedings over time by a team of Mayo Clinic physicians led by Dr Wallace Herrell.9 Today, health care faces a moment that is as consequential as any other in the last 100 years. As our predecessors experienced in the early 20th century, transformative new technologies and breakthroughs are now rapidly changing long-held assumptions and creating approaches that only a few years ago were impossible to imagine. This is why, in 2019, Mayo Clinic launched its Bold. Forward. plan to lead the transformation of the entire health care system from a pipeline model to a platform model of care for the benefit of patients everywhere. Already, in 5 short years, Mayo Clinic and its partners have discovered new cures, connected people with data to create new knowledge, and led the transformation for all of health care to a highly dynamic and innovative platform model of care.10 Just as important, we are seeing unparalleled interest in collaborating to solve intractable problems within the sector, resulting in new, innovative partnershipsdsuch as a distributed data network11 for health caredthat are leading to real, lasting solutions. However, as in the 1920s, none of these innovations, treatments, or solutions is without its drawbacks or pitfalls, and we will continue to rely on the rigor and diligence of journals like Mayo Clinic Proceedingsdand its companion journals Mayo Clinic Proceedings: Digital Health and Mayo Clinic Proceedings: Innovations, Quality, & Outcomesdto document the trajectory of patient-centered, scientific discovery in a transformed health care system. In the last years alone, Mayo Clinic Proceedings has published cutting-edge work on how artificial intelligence can transform cardiology care,12 the impacts of electronic health record usability on physician well-being,13 and the potential of voice biomarkers as a novel method of remote patient diagnosis.14 If we are to succeed in seizing the potential of our current moment to transform health care to a platform model of care, we would do well to look to our past to inform our future. As we approach its 100th anniversary, Mayo Clinic Proceedings’ retrospective during the next 16 monthsdhighlighting the evolution of modern health care at Mayo Clinic and, by extension, the entire health care sectordwill provide critical insight into how true innovation happens, the hard work necessary to translate discoveries into highimpact medicine, and the steps required to consistently deliver excellent care to every patient with fidelity and compassion. As we look to the future of health care and Mayo Clinic Proceedings, the clinicians, researchers, educators, innovators, and others interested in and committed to creating a better future for health care and to meeting the needs of patients across the world should continue to read and follow this publication with close attention. Entering its second century, Mayo Clinic Proceedings will continue to lead the frontier of what is possible within health care while serving out its mission to promote the best interest of patients everywhere by advancing health care knowledge across the world, thereby ensuring that more people lead longer, more thriving lives. POTENTIAL COMPETING INTERESTS The author reports no competing interests. Gianrico Farrugia, MD President and Chief Executive Officer, Mayo Clinic, Rochester, MN Correspondence: Address to Gianrico Farrugia, MD, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Twitter: @GFarrugiaMD). ORCID Gianrico Farrugia: https://orcid.org/0000-0003-34735235 EDITORIAL Mayo Clin Proc. n January 2025;100(1):8-10 n https://doi.org/10.1016/j.mayocp.2024.11.012 www.mayoclinicproceedings.org 9
REFERENCES 1. Olsen KD, Dacy MD. Mayo Clinicd150 years of serving humanity through hope and healing. Mayo Clin Proc. 2014;89(1):8-15. 2. Our new bulletin. The Clinical Bulletin. 1926;71926:1-1. 3. Lanier WL. Celebrating Mayo Clinic Proceedings’ 90th anniversary: a story of longevity and progression of mission. Mayo Clin Proc. 2016;91(1):3-9. 4. Aim and scope. Mayo Clinic Proceedings. Accessed September 5, 2024. https://www.mayoclinicproceedings.org/content/aims 5. Wright JR Jr. Albert C. Broders, tumor grading, and the origin of the long road to personalized cancer care. Cancer Med. 2020; 9(13):4490-4494. 6. Nelson CW. Early treatment of Mayo patients with diabetes. Mayo Clin Proc. 1992;67(2):108. 7. Ellis TA 2nd, Narr BJ, Bacon DR. Developing a specialty: J.S. Lundy’s three major contributions to anesthesiology. J Clin Anesth. 2004;16(3):226-229. 8. Burns CM. The history of cortisone discovery and development. Rheum Dis Clin North Am. 2016;42(1):1-14. vii. 9. Henry NK, Steckelberg JM, Wilson WR. The clinical use of penicillindrevisited. Mayo Clin Proc. 1992;67(12):1128. 10. Farrugia G, Lee TH. Cure, connect, transform: three Mayo Clinic strategy components for servant leaders. NEJM Catalyst. July 9, 2020. 11. Cerrato PL, Halamka JD. How AI drives innovation in cardiovascular medicine. Front Cardiovasc Med. 2024;11:1397921. 12. Lopez-Jimenez F, Attia Z, Arruda-Olson AM, et al. Artificial intelligence in cardiology: present and future. Mayo Clin Proc. 2020;95(5):1015-1039. 13. Melnick ER, Dyrbye LN, Sinsky CA, et al. The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clin Proc. 2020;95(3):476-487. 14. Sara JD, Orbelo D, Maor E, Lerman LO, Lerman A. Guess what we can heardnovel voice biomarkers for the remote detection of disease. Mayo Clin Proc. 2023;98(9):1353-1375. MAYO CLINIC PROCEEDINGS 10 Mayo Clin Proc. n January 2025;100(1):8-10 n https://doi.org/10.1016/j.mayocp.2024.11.012 www.mayoclinicproceedings.org
Mayo Clinic Proceedings: Commemorating a Century of Continuous Communication This issue of Mayo Clinic Proceedings is the first in Volume 100 of a medical journal that has been continuously published since April 21, 1926. This date marks the provenance of Mayo Clinic Proceedings, which was then titledThe Bulletin of the Mayo Clinic and the Mayo Foundation.1 To build up to, to recognize, and to commemorate the centenary of publication of Mayo Clinic Proceedings that will occur next year, we plan the monthly publication of editorials, beginning with this issue and continued all the way through to April 2026. These editorials will highlight notable contributions published in Mayo Clinic Proceedings during the course of its venerable existence. Medical journals have diverse roles, many of which continue to evolve, especially in this age of digitalization, the internet, open access, artificial intelligence, preprint servers, and social media.2,3 The rationale for and the function of most if not all of these roles, however, still coalesce around the communication and/or the discussion of medical knowledge. It was with this intention in mind that the Bulletin of the Mayo Clinic and the Mayo Foundation was first introduced in 1926dto provide a forum for communicating and discussing medical knowledge, in this case, institutionally and, specifically, by and among the medical staff of Mayo Clinic.1 As the content of this Mayo Clinicesupported publication evolved, the Bulletin underwent several name changes, with the adoption of thenameMayo Clinic Proceedingsin1964.1,4-6 The first Editor-in-Chief and Editorial Board of Mayo Clinic Proceedings were appointed in 1964; external peer review was initiated in the 1970s; external editorialists were invited in the 1980s; submissions were broadened to non-Mayo authors in 1992; in 1996, Mayo Clinic Proceedings refreshed its purview and focus from a multidiscipline journal to a general and internal medicine journal, and in the same year, Mayo Clinic Proceedings engaged its first publisher4-6; by 1999, Mayo Clinic Proceedings’ controlled circulation reached 120,000,4 and it was this controlled circulation, in large part, that enabled so many international physicians (including K.A.N. and R.F.) and institutions to become acquainted with and value the Proceedings.7 With such expansion and accomplishments, Mayo Clinic Proceedingsthus established itself as a prominent general medical journal with a national and international intent, reach, and readership. During these years, Mayo Clinic was on its own trajectory in becoming the largest, integrated, not-for-profit, multidiscipline medical practice worldwide, with the most number of #1 rankings, as well as on its own trajectory in supporting the largest number of ACGME accredited programs worldwide. The evolution of Mayo Clinic Proceedings and its forebears, from their provincial beginnings to an international medical journal, thus proceeded alongside the growth of Mayo Clinic itself. Such growth and success of Mayo Clinic Proceedings reflect the leadership and the multitudinous and unique contributions of its prior Editors-in-Chief: Drs Edwin D. Bayrd, Alvin B. Hayles, John L. Juergens, Robert G. Siekert, Pasquale J. Palumbo, Udaya B.S. Prakash, and William L. Lanier.8 The current editorial team was privileged to assume the leadership of Mayo Clinic Proceedings fromDr Lanier and his team. Dr Lanier innovatively and brilliantly led the expansion of the Proceedings in becoming a successful journal with a global compass and reach.4-6 UnderDr Lanier’s leadership, Elsevier was successfully engaged in 2012 as the publisher of Mayo Clinic Proceedings, an engagement and collaboration that continue to markedly promote the success and growth of the journal. The appeal of Mayo Clinic Proceedings has long resided in its diversity of content that is EDITORIAL 4 Mayo Clin Proc. n January 2025;100(1):4-7 n https://doi.org/10.1016/j.mayocp.2024.11.014 www.mayoclinicproceedings.org n ª2024 Published by Elsevier Inc on behalf of Mayo Foundation for Medical Education and Research
intended to reach a broad readershipdacademic as well as practicing physicians and other providers, generalists as well as specialists; internists as well as surgeons and interventionalists; educators as well as trainees; regional as well as national health care students and savants. Such content has historically included, among other types of articles, Editorials, Commentaries, Original Articles, Reviews, Special Articles, Residents’ Clinics, Letters to the Editor, Medical Images, and Path to Patient quiz presentations. The current leadership team added new sections that include Women’s Health; the Medicine of Sex Differences; Aging and Geriatrics; Metaanalysis and New Methodologies; Physician and Health Care Professional Engagement and Fulfillment; Diversity, Equity, and Inclusion; Community Engagement; Medical Ethics; and a team of international Associate Editors. New types of articles include Perspectives and Controversies, Research Letters, Innovations in Medicine and Surgery, Thematic Reviews, and Understanding Disease, the last providing an in-depth exposition of the pathogenesis of diseases and their treatment, written by an expert but geared for the generalist. At the beginning of the Table of Contents for every issue and started in May 2019, there is now the “In the Limelight” article that provides synopses, of approximately 400 words, of 3 articles that are not highlighted by an editorial in that issue; this feature is intended to attract the attention of the reader to these articles, and by drawing readers into the journal, to engage their perusal of other journal content. With the expertise and support of Elsevier, our website has been entirely refreshed with expanded content and newsworthy items and displayed in a more arresting, easy-to-navigate fashion and format (www. mayoclinicproceedings.org). To provide a sense of the type of literature published in the Proceedings, the following original articles were published in the year before the time of this writing (September to October 2024): dietary sodium intake as a risk factor for type 2 diabetes9; cognitive decline as a risk factor for chronic kidney disease, a study that was based on the UK Biobank data and Mendelian randomization10; the adverse effects of proton pump inhibitors on bone health in patients with rheumatic disease11; the presence of decreased white matter in the brain in older adults using prescription opioids12; chronic lymphedema as a risk for nonmelanoma skin cancer13; a clinical trial demonstrating the beneficial effects of social behavioral intervention on metabolic risk factors in resourcelimited communities14; calf muscle pump dysfunction and all-cause mortality15; and the efficacy of inclisiran in reducing low-density lipoprotein cholesterol.16 Articles published that emphasize innovation in medicine and surgery include the use of machine learning in the diagnosis of pulmonary hypertension by echocardiography,17the use of human acellular vessels for arterial bypass in chronic limbthreatening ischemia,18 and exosome therapy as a novel strategy to promote the healing of chronic nonhealing wounds.19 Reviews are regularly published as, for example, present and evolving therapies for migraine,20 pathophysiology and classification of obesity,21 management of vasomotor symptoms of menopause,22 diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome,23 and management of Clostridioides difficile infection.24 We promote the publication of clinical practice guidelines, such as the management of type 2 diabetes mellitus based on the Department of Veterans Affairs and Department of Defense clinical practice guidelines,25 the Princeton IV Consensus recommendations for the management of erectile dysfunction and cardiovascular disease,26 and the diagnosis and evaluation of osteoporotic fractures based on the International Working Group on DXA Best Practices.27 Our Perspectives and Commentaries include such discussions as the controversial role of large language models in medical manuscript writing,28 the pros and cons of traditional Medicare or Medicare Advantage from a leukemia and cancer perspective,29 the recent increase in maternal mortality in the United States,30 the current challenges and hurdles in the career of the clinical investigator,31 measuring and monitoring health equity in health care organizations,32 hypertension care in the digital age,33 and the pressing issue of medical supply shortages.34 A recent Understanding Disease article discussed oxalate metabolism and its EDITORIAL Mayo Clin Proc. n January 2025;100(1):4-7 n https://doi.org/10.1016/j.mayocp.2024.11.014 www.mayoclinicproceedings.org 5
involvement in kidney and cardiovascular diseases.35 Mayo Clinic Proceedings jointly published with Kidney International the Mayo Clinic consensus report on membranous nephropathy.36During the past year, we have also published a thematic review series on forward thinking on clinical trials in clinical practice and another series on physician health. The success and stature of Mayo Clinic Proceedings are underscored by the following metrics and accomplishments: in 2023, the journal received submissions from some 60 countries; most articles published are from authors outside Mayo Clinic; the number of its downloads in 2024 is expected to exceed 7 million, which is the highest for the journal; its current impact factor issued by Clarivate is 7.2, placing it at 23 of 239 general medical journals; its 5-year impact factor is 8.1; the 2023 CiteScore is 16.8, placing the Proceedings at 21 of 636 general medical journals; its time to first decision is 13 days and to acceptance 83 days; and the diversity and depth of submissions to Mayo Clinic Proceedings enabled the publication of 2 expansion journals, Mayo Clinic Proceedings: Innovations, Quality, & Outcomes in 2017, currently led by Dr Taimur Sher, and Mayo Clinic Proceedings: Digital Health in 2023, currently led by Dr Francisco Lopez-Jimenez. We are delighted to introduce in this issue the inaugural and foundational contribution to the series of editorials commemorating this century of publications: Dr Gianrico Farrugia, President and CEO of Mayo Clinic, highlights the growth, success, and some of the seminal contributions of the Proceedings and underscores why journals such as Mayo Clinic Proceedings and its expansion journals are critical bellwethers and forums in uncovering and discussing the challenges, opportunities, and innovation in the current landscape of health care.37This will be followed next month by an editorial by Drs Fonseca and Meyer focused on salient contributions in medical education published in the Proceedings. Finally, we deeply thank all the authors, reviewers, readers, and other contributors who have enabled the raison d’être and longevity of Mayo Clinic Proceedings andwho have made this century-long journey ever so fruitful, fulfilling, and, indeed, feasible. POTENTIAL COMPETING INTERESTS Dr Karl A. Nath is supported by NIH R01 DK133401 and serves as Editor-in-Chief, Mayo Clinic Proceedings. Dr Nath has no disclosures. Dr Morna Conway is a scholarly publishing consultant who works as an external consultant to Mayo Clinic Proceedings. Dr Conway has no disclosures. Dr Rafael Fonseca is the Chief Innovation Officer, Mayo Clinic, Arizona, and Chair, Business Advisory Board, Mayo Clinic Proceedings. He is supported by NCI grants CA186781-07CAA and CA271410-01 and the Riney Foundation. Consulting: AbbVie, Adaptive Biotechnologies, Amgen, AstraZeneca, Bayer, Binding Site, BMS (Celgene), Millenium Takeda, Jansen, Juno, Kite, Merck, Pfizer, Pharmacyclics, Regeneron, Sanofi. Scientific Advisory Boards: Adaptive Biotechnologies, Caris Life Sciences, ONCOtracker. Board of Directors: Antegene (for profit), AZBio (not for profit). Patent for FISH inMM, w$2000/year grants. ACKNOWLEDGMENTS It is both a privilege and pleasure to recognize the decades-long, outstanding dedication and expertise of our editorial office staff, Ms Terry Jopke, Ms Kimberly Sankey, and Ms Peg Wentz. They have contributed indispensably to the growth and success of Mayo Clinic Proceedings. Karl A. Nath, MB.ChB Editor-in-Chief Morna Conway, PhD Morna Conway, Inc, Murfreesboro, TN Rafael Fonseca, MD Division of Hematology, Department of Medicine Mayo Clinic, Scottsdale, AZ Correspondence: Address to Karl A. Nath, MB.ChB, Mayo Clinic, Plummer 10, 200 First St SW, Rochester, MN 55905 (nath.karl@mayo.edu). MAYO CLINIC PROCEEDINGS 6 Mayo Clin Proc. n January 2025;100(1):4-7 n https://doi.org/10.1016/j.mayocp.2024.11.014 www.mayoclinicproceedings.org
REFERENCES 1. Lantz JC, Beck CS. Mayo Clinic Proceedings: from internal newsletter to international journal. Mayo Clin Proc. 2000;75(4): 329-330. 2. Podolsky SH, Greene JA, Jones DS. The evolving roles of the medical journal. N Engl J Med. 2012;366(16):1457-1461. 3. Andres E, Lavigne T. Medical journals: role, place, issues, and future challenges. J Clin Med. 2024;13(7):2059. 4. Lanier WL. The evolution of Mayo Clinic Proceedings. Mayo Clin Proc. 2000;75(1):8-9. 5. Lanier WL. The end of an era in Mayo Clinic Proceedings’ publishing practices. Mayo Clin Proc. 2011;86(12):1138-1140. 6. Lanier WL. Celebrating Mayo Clinic Proceedings’ 90th anniversary: a story of longevity and progression of mission. Mayo Clin Proc. 2016;91(1):3-9. 7. Nath KA. Affirming the mission of Mayo Clinic Proceedings. Mayo Clin Proc. 2017;92(7):1015-1018. 8. Reflections from past editors. Mayo Clin Proc. 2000;75(4):340343. 9. Wang X, Ma H, Kou M, et al. Dietary sodium intake and risk of incident type 2 diabetes. Mayo Clin Proc. 2023;98(11):1641-1652. 10. Yang S, Zhou C, Ye Z, et al. Association between cognitive function and risk of chronic kidney disease: a longitudinal cohort and mendelian randomization study. Mayo Clin Proc. 2024;99(9):1399-1410. 11. Palmowski A, Schmajuk G, Yazdany J, et al. Proton pump inhibitor use and bone health in patients with rheumatic diseases: a cross-sectional study. Mayo Clin Proc. 2024;99(7):1046-1057. 12. Warner NS, Hanson AC, Schulte PJ, et al. Prescription opioids and brain structure in community-dwelling older adults. Mayo Clin Proc. 2024;99(5):716-726. 13. Anand NC, Campbell EH, Baum CL, et al. Association of lower extremity lymphedema and nonmelanoma skin cancer. Mayo Clin Proc. 2023;98(11):1653-1659. 14. Ding EL, Watson KT, Makarechi L, et al. Social induction via a social behavioral intervention on changes in metabolic risk factors: a randomized controlled trial in rural Appalachia, United States. Mayo Clin Proc. 2024;99(7):1058-1077. 15. McBane RD, Liedl D, Wysokinski W, et al. Calf rEF: impact of calf muscle pump dysfunction with reduced ejection fraction on all-cause mortality. Mayo Clin Proc. 2024;99(6):902912. 16. Wright RS, Kausik K, Landmesser U, et al. Effects of inclisiran in patients with atherosclerotic cardiovascular disease: a pooled analysis of the ORION-10 and ORION-11 randomized trials. Mayo Clin Proc. 2024;99(8):1222-1235. 17. Anand V, Weston AD, Scott CG, Kane GC, Pellikka PA, Carter RE. Machine learning for diagnosis of pulmonary hypertension by echocardiography. Mayo Clin Proc. 2024;99(2):260-270. 18. Sen I, Clouse WD, Lauria AL, et al. Outcomes of arterial bypass with the human acellular vessel for chronic limb-threatening ischemia performed under the FDA expanded access program. Mayo Clin Proc. 2024;99(1):57-68. 19. Pumford AD, Staricha KL, Kunkel ET, Armstrong MF, Behfar A, Van Abel KM. Exosome therapy for a nonhealing scalp wound following chemoradiation and surgical therapy. Mayo Clin Proc. 2024;99(6):1006-1012. 20. Ashina M, Hoffmann J, Ashina H, et al. Pharmacotherapies for migraine and translating evidence from bench to bedside. Mayo Clin Proc. 2024;99(2):285-299. 21. Busebee B, Ghusn W, Cifuentes L, Acosta A. Obesity: a review of pathophysiology and classification. Mayo Clin Proc. 2023; 98(12):1842-1857. 22. Kling JM, Stuenkel CA, Faubion SS. Management of the vasomotor symptoms of menopause: twofers in your clinical toolbox. Mayo Clin Proc. 2024;99(7):1142-1148. 23. Grach SL, Seltzer J, Chon TY, Ganesh R. Diagnosis and management of myalgic encephalomyelitis/chronic fatigue syndrome. Mayo Clin Proc. 2023;98(10):1544-1551. 24. Voth E, Khanna S. Rise to the challenge: master the management of Clostridioides difficile infection. Mayo Clin Proc. 2024;99(6):971979. 25. Conlin PR, Burke BV, Hobbs C, et al. Management of type 2 diabetes mellitus: synopsis of the Department of Veterans Affairs and Department of Defense Clinical Practice Guideline. Mayo Clin Proc. 2024;99(8):1323-1336. 26. Köhler TS, Kloner RA, Rosen RC, et al. The Princeton IV Consensus recommendations for the management of erectile dysfunction and cardiovascular disease. Mayo Clin Proc. 2024; 99(9):1500-1517. 27. Khan AA, Slart RH, Ali DS, et al. Osteoporotic fractures: diagnosis, evaluation, and significance from the International Working Group on DXA Best Practices. Mayo Clin Proc. 2024;99(7):1127-1141. 28. Diaz Milian R, Moreno Franco P, Freeman WD, Halamka JD. Revolution of peril? The controversial role of large language models in medical manuscript writing. Mayo Clin Proc. 2023; 98(10):1444-1448. 29. Kantarjian H, Zeidan AM, Fathi AT, Stein E, Rajkumar V, Tefferi A. Traditional Medicare or Medicare Advantage: the leukemia and cancer perspective. Mayo Clin Proc. 2024;99(1):15-21. 30. Dilmaghani D, Nath KA, Garovic VD. Increasing maternal mortality in the United States: looking beneath and beyond the numbers. Mayo Clin Proc. 2024;99(6):873-877. 31. Nath KA, Garovic VD. The career of the clinical investigator: quo vadis? Mayo Clin Proc. 2023;98(4):509-512. 32. Evenson SE, Hafferty FW, Sharp RR, Tilburt JC. Measuring and monitoring health equity in health care organizations: why it’s important and how to move forward. Mayo Clin Proc. 2024; 99(8):1212-1218. 33. Zoghby Z. Hypertension care in the digital age. Mayo Clin Proc. 2024;99(8):1219-1221. 34. Tosh PK, Schafer JM, Harvieux TP, Hall BL. Medical supply shortagesdwe are part of the problem . and solution. Mayo Clin Proc. 2023;98(12):1763-1766. 35. Hawkinsevan der Cingel G, Walsh SB, Eckardt KU, Knauf F. Oxalate metabolism: from kidney stones to cardiovascular disease. Mayo Clin Proc. 2024;99(7):1149-1161. 36. Nath KA, Erickson LA, Garovic VD. Primary and secondary diagnoses in medicine: insights from Mayo Clinic Consensus Report on Membranous NephropathydExecutive Summary. Mayo Clin Proc. 2023;98(11):1599-1601. 37. Farrugia G. A century of hope, healing, and innovation: celebrating the 100th yearly volume of Mayo Clinic Proceedings. Mayo Clin Proc. 2025;100(1):8-10. EDITORIAL Mayo Clin Proc. n January 2025;100(1):4-7 n https://doi.org/10.1016/j.mayocp.2024.11.014 www.mayoclinicproceedings.org 7
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