It’s possible that I shall make an ass of myself. But in that case one can always get out of it with a little dialectic. I have, of course, so worded my proposition as to be right either way (K.Marx, Letter to F.Engels on the Indian Mutiny)
Monday, September 15, 2025
New U.S. Public Health Service guidelines on occupational HIV exposure and postexposure prophylaxis published in Infection Control & Hospital Epidemiology
Arlington, VA –The Centers for Disease Control and Prevention (CDC), on behalf of the U.S. Public Health Service (PHS), has released the 2025 Guidelines for the Management of Occupational Exposure to Human Immunodeficiency Virus (HIV) and Recommendations for Postexposure Prophylaxis (PEP). The guidelines are published in Infection Control & Hospital Epidemiology (ICHE), the journal of the Society for Healthcare Epidemiology of America (SHEA).
The 2025 guidelines reaffirm many of the practices recommended in the 2013 PHS Guidelines while incorporating major updates that reflect the latest evidence and therapeutic advances. The recommendations provide practical, evidence-based guidance for healthcare personnel (HCP) following occupational exposures to HIV.
Key updates include:
New antiretroviral regimens for PEP based on low rates of side effects and convenient dosing schedules.
Shortened duration of follow-up HIV testing after occupational exposure.
Elimination of routine follow-up laboratory testing for antiretroviral drug toxicity when baseline testing is normal and no signs or symptoms of toxicity develop during PEP.
Considerations for PEP in cases where the source patient has an undetectable viral load.
Guidance for healthcare personnel already on pre-exposure prophylaxis (PrEP) at the time of occupational exposure.
“These updated guidelines reflect the latest evidence and therapeutic advances, helping ensure that healthcare personnel receive timely, safe, and effective care after potential HIV exposure,” said Dr. David J. Weber, President SHEA Board of Trustees and Associate Editor, ICHE. “They also recognize the changing landscape of HIV prevention, including the increasing use of PrEP among healthcare providers.”
The 2025 PHS Guidelines continue to emphasize the importance of prompt evaluation and initiation of PEP following occupational exposures, while streamlining follow-up protocols to reduce unnecessary testing and burden on healthcare personnel.
The full guideline, “2025 U.S. Public Health Service Guidelines for the Management of Occupational Exposure to Human Immunodeficiency Virus and Recommendations for Postexposure Prophylaxis in Healthcare Settings,” is available here: https://doi.org/10.1017/ice.2025.10254.
About Infection Control & Hospital Epidemiology Infection Control & Hospital Epidemiology (ICHE) is the official journal of the Society for Healthcare Epidemiology of America (SHEA), publishing peer-reviewed research on infection prevention, antimicrobial stewardship, and healthcare epidemiology.
2025 US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Post-exposure Prophylaxis in Healthcare Settings
Mayo Clinic study reveals hidden causes of heart attacks in younger adults, especially women
ROCHESTER, Minn. — A new Mayo Clinic study finds that many heart attacks in people under 65 — especially women — are caused by factors other than clogged arteries, challenging long-standing assumptions about how heart attacks occur in younger populations.
Study findings published in the Journal of the American College of Cardiology examined over 15 years of data from the Rochester Epidemiology Project, providing the most comprehensive population evaluation of heart attack causes in people aged 65 and younger.
More than half of heart attacks in women under age 65 were caused by nontraditional factors, such as spontaneous coronary artery dissection (SCAD), embolism and other conditions unrelated to artery-clogging plaque. Heart attack incidence was significantly lower in women than in men — but when women did have heart attacks, the underlying causes were often misdiagnosed.
SCAD, which typically affects younger, otherwise healthy women, was frequently missed and misclassified as a typical heart attack due to plaque buildup. The most common cause of heart attack in both sexes was atherosclerosis, or artery-clogging plaque, but this accounted for only 47% of heart attacks in women, compared to 75% in men. Five-year mortality rates were highest in people who had heart attacks triggered by stressors such as anemia or infection, even though these patients had lower heart injury levels.
"This research shines a spotlight on heart attack causes that have historically been under-recognized, particularly in women," says Claire Raphael, M.B.B.S., Ph.D., an interventional cardiologist at Mayo Clinic and first author of the study. "When the root cause of a heart attack is misunderstood, it can lead to treatments that are less effective — or even harmful."
This new understanding could save lives. A misdiagnosed SCAD, for example, may be treated with a stent unnecessarily, increasing the risk of complications. Recognizing and correctly diagnosing these nontraditional heart attacks allows for more appropriate care and better long-term outcomes.
Key findings from the study:
Out of 1,474 heart attacks, 68% were from typical plaque buildup (traditional heart disease), but nontraditional causes made up a majority of heart attacks in women.
SCAD was nearly 6 times more common in women than men.
Heart attacks caused by stressors such as anemia or an infection were the second-most common cause overall, and the deadliest, with a five-year mortality rate of 33%.
Truly unexplained heart attacks were rare, making up less than 3% of cases after expert review.
Overall, the study provides insights that could reshape how heart attacks are diagnosed and managed in younger adults.
"Our research highlights the larger need to rethink how we approach heart attacks in this patient population, and for younger adult women, in particular. Clinicians must sharpen their awareness of conditions like SCAD, embolism and stress-related triggers, and patients should advocate for answers when something doesn't feel right," says Rajiv Gulati, M.D., Ph.D., chair of the Division of Interventional Cardiology and Ischemic Heart Disease at Mayo Clinic. Dr. Gulati is senior author of the study.
"Understanding why a heart attack happened is just as important as treating it," says Dr. Raphael. "It can mean the difference between recovery and recurrence."
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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.
Journal
Journal of the American College of Cardiology
Article Publication Date
15-Sep-2025
Behind the numbers: The shift in US psychiatric beds – large for-profit chains expand as public hospitals retreat
Columbia University's Mailman School of Public Health
September 15, 2025--Inpatient psychiatric care has dramatically shifted to large for-profit chains, according to new research from Columbia University Mailman School of Public Health and Johns Hopkins Bloomberg School of Public Health. The researchers found that the total number of inpatient psychiatric beds barely changed from 2011 to 2023. But behind the stable headline figure lies a dramatic shift: a decline in beds at general hospitals offset by a rise in beds at standalone psychiatric facilities—particularly those owned by large for-profit chains.
Until now there was limited research on recent developments in the psychiatric bed supply. The findings were published in JAMA Psychiatry.
Over the 12-year period, the share of psychiatric beds in standalone facilities that provide only psychiatric care rose from 65 percent to 74 percent. A shift also occurred in the ownership of those standalone facilities. In 2011, just 11% of standalone psychiatric facility beds were owned by large for-profit chains. By 2023, the share had grown to 27%. Meanwhile, government-owned beds declined from 64 percent in 2011 to 48 percent in 2023.
“Psychiatric beds are increasingly located in hospitals that only provide psychiatric care, and those hospitals are more likely than ever to be owned by large for-profit chains,” said Adam Sacarny, PhD, Associate Professor of Health Policy and Management at Columbia Mailman School and last author.
“There may be benefits to patients of more care being delivered at specialized hospitals, but there have also been reports of safety and quality-of-care concerns at some large chains. These developments therefore merit careful study to ensure patients receive high-quality psychiatric care,” noted Karen Shen, PhD, the study’s corresponding author and Assistant Professor of Health Policy and Management at Johns Hopkins Bloomberg School.
To assess these trends, researchers analyzed 2011–2023 data from the Healthcare Cost Report Information System (HCRIS), identifying freestanding psychiatric hospitals and categorizing them by ownership type, including large for-profit chains—defined as groups operating at least 15 hospitals. The analysis also used data from the American Hospital Association’s Annual Survey.
The findings indicate that the growth of for-profit chains is ongoing, and thus likely not merely a response to policies like the Affordable Care Act or federal mental health parity legislation which were passed in the early 2010s. Instead, it represents a broader shift in how psychiatric care is delivered.
In addition to Shen and Sacarny, the study’s co-authors include Mark Olfson, MD, MPH of Columbia University Mailman School of Public Health and Columbia Psychiatry.
Columbia University Mailman School of Public Health
Founded in 1922, the Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Columbia Mailman School is the third largest recipient of NIH grants among schools of public health. Its nearly 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change and health, and public health preparedness. It is a leader in public health education with more than 1,300 graduate students from 55 nations pursuing a variety of master’s and doctoral degree programs. The Columbia Mailman School is also home to numerous world-renowned research centers, including ICAP and the Center for Infection and Immunity. For more information, please visit www.mailman.columbia.edu.
Military spouses reported that they relied more often on people in their social networks for emotional support and assistance than formal sources such as chaplains or counselors, according to a new study led by communication professor Leanne Knobloch.
CHAMPAIGN, Ill. — Cycles of deployment and reintegration can be stressful, disruptive times for military spouses and their families. Although the Department of Defense and its military communities offer a number of formal resources to help military spouses cope during these challenging periods, very few of those who participated in a recent study said they actually used them. Only 16.5% of those in the study had participated in a formal reintegration program after their partners returned from deployment.
The findings are concerning and contribute to a growing body of research indicating that thousands of military spouses may not be receiving the support they need when attempting to establish a new normal during their partners’ deployment and return, said communication professor Leanne Knobloch of the University of Illinois Urbana-Champaign. Knobloch led the project, which evaluated data from 1,325 military spouses whose partners had returned from deployment within the previous six months.
Naval Health Research Center research psychologists Hope S. McMaster, Karen Tannenbaum and Travis N. Ray co-wrote the paper, published in the journal Military Psychology. The team analyzed data from the Millennium Cohort Family Study, a nationwide study of military families that began in 2011. McMaster is the principal investigator for that project.
“Military spouses who have unmet needs for support are vulnerable to stress during cycles of deployment and reintegration,” Knobloch said. “Most of the literature looks at perceptions of support by asking people, ‘If you needed something, would you have someone in your life who could provide it for you?’ We wanted to take a different route and ask military spouses about the support that they actually received and used to manage stressors during deployment and reintegration.”
The researchers documented the availability and outcomes of different types of support, including formal sources — such as chaplains, support groups, health care practitioners and community services — and informal sources — such as family, friends, neighbors and co-workers — to determine whether any of these predicted spouses’ mental health, social functioning and marital quality during reintegration.
The participants’ ages ranged from 18 to 63. The majority were female, 86% of them were civilians and more than half of them had at least one child. More than 67% were married to enlisted service members. Approximately 84% of the service members were on active-duty status. Their military branch affiliations included the Air Force (about 41%), Army (38%), Navy (12%) and the Marine Corps (about 9%), according to the study.
A striking finding of the study was how little actual support military spouses reported receiving across the deployment cycle, the researchers said. Slightly more than 21% of the spouses said they received formal services. However, the majority (52%) said they relied on informal sources, such as the individuals in their social network.
“Military spouses who received informal support from friends and family members had better outcomes upon reintegration. They reported better marital quality, mental health and social functioning upon reintegration, which underscores the importance of the social circle surrounding them,” Knobloch said.
“Our findings point to extended family and friends as the unsung heroes who are rallying to support military spouses. Those unsung heroes may not be as visible for military command, policy or programming, but they are carrying much of the load,” Knobloch said. “Recognizing their contributions is really important.”
Because informal sources of support were so potent, they may supersede the value of formal services and provide the most return on investment, the team said.
“When we asked military spouses why they didn't participate in a formal reintegration program, a little less than half said they weren’t aware of these programs. Another 40% said that there was no program available to them. These barriers tell us why people are not taking advantage of these resources,” Knobloch said.
Other reasons for nonparticipation were time constraints (29%), doubts about whether the training would be helpful (26%), a lack of child care (26%) and work conflicts (11%). Another 9% of those surveyed said they had participated in such training previously and did not need to repeat it, while 5% said that their partner had discouraged it, according to the study.
Skepticism about the usefulness of the services was a barrier particularly among women and spouses who were in the military themselves, while a lack of child care was a barrier for parents of multiple children and those affiliated with the Air Force or the Marine Corps, according to the study.
Spouses were more likely to participate in a formal reintegration program if they were employed outside the home or if their partner had been in combat, the team found. Certain groups were underserved across various sources of support, including spouses of enlisted personnel, those who were Hispanic and those who were unemployed.
Overall, the findings indicated that one-size-fits-all solutions to formal reintegration programs may not adequately address the various barriers to accessing these programs that spouses face, the teams said. Tailored outreach strategies might be helpful such as providing on-demand virtual training or promotional materials about the programs’ efficacy or providing child care for parents.
Their other recommendations included making support programs for military spouses a command-level priority, in part to bolster retention of service members, as studies indicate they are more likely to leave the armed forces if their spouses’ needs are not being met. The team further suggested educating civilians about military life and engaging them in efforts to assist military spouses.
The Millennium Cohort Family Study is one of three studies within the broader Millennium Cohort Program, which includes the Millennium Cohort Study of service members and the Study of Adolescent Resilience. McMaster is the principal investigator for SOAR as well.
The Millennium Cohort Program is funded by the Defense Health Agency, the Department of Veteran Affairs and the Office of Military Community and Family Policy.
Availability, predictors, and outcomes of actual support for military spouses during deployment and reunion: Findings from the Millennium Cohort Family Study
Mizzou researchers enhancing soybean taste to win over more consumers
Scientists are developing innovative ways to improve flavor of soy-based foods, deliver more health benefits and appeal to a wider audience
In Missouri, soybeans aren’t just a crop; they’re the state’s top commodity. At the University of Missouri, researchers are developing innovative ways to improve the flavor of soy-based foods, deliver more health benefits and appeal to a wider audience.
In a recent study, Bongkosh “Jeab" Vardhanabhuti, an associate professor of food science, and her team at the College of Agriculture, Food and Natural Resources compared the taste and aroma of four soybean varieties — three specially bred by plant scientists at Mizzou. All the varieties were grown under identical conditions and processed into a raw soy slurry, similar to uncooked soymilk. They found that a variety called “Super” yielded the best results, delivering the most pleasant flavor and aroma, making it more appealing to Western consumers.
“The typical soy foods are soy milk, tofu, soy sauce, tempeh and miso,” Vardhanabhuti, who works in the Division of Food, Nutrition and Exercise Sciences, said. “People in Asian culture have been using soybean products for centuries. Now, more and more Western consumers are interested in soy products, and we are looking to offer options for everyone.”
“The biggest challenge with soy is flavor,” she said. “Our research zeroes in on this issue. While the beany flavor might be acceptable in foods like tofu or soy milk, it’s less welcome in products such as plant-based burgers or protein shakes, where you don’t want the taste of soy dominating.”
Specially bred soybeans
The specially bred Super soybean used by Mizzou researchers was designed with a healthier fat profile. Plant scientists also reduced certain sugars that don’t offer nutritional value and removed an enzyme called lipoxygenase, a key culprit in creating off-flavor compounds.
“Overall, this research shows that smart plant breeding can make soy-based foods taste better, which could help more people accept and enjoy them,” Vardhanabhuti said.
For this study, researchers prepared the raw soy slurry by washing the soybeans, soaking them in water overnight and then grinding them with fresh water. The mixture was strained and refrigerated. They measured protein, fat, moisture, fiber and ash content using standard laboratory methods. Additionally, gas chromatography was used to analyze the types of fats in the soy oil, while ion chromatography and enzyme tests measured sugars such as sucrose. Finally, several tests were conducted to assess aroma compounds.
Nine trained panelists — all experienced in sensory testing — evaluated the slurries based on 12 traits: color, five aroma characteristics and six flavor characteristics.
Soy options for everyone
With an annual on-farm value exceeding $2.5 billion, soybeans are Missouri’s most profitable crop. Making soybean products more appealing to a broader audience could provide an even greater boost to the state’s economy.
“There’s a clear need for soybeans with a milder or even neutral flavor profile — beans that can be added to a variety of products without announcing themselves on the palate,” Vardhanabhuti said.
This research is the first in a series of studies that Vardhanabhuti’s research team is conducting to improve the taste of soybeans. Next, the team will examine improving the taste in products such as tofu, soy milk and soy protein.
Vardhanabhuti and her team reported their findings in the study, “Novel soybean type with improved volatile and sensory characteristics of raw soy slurries,” published in Food Chemistry.
Co-authors are Memphis Bancroft, Jhongyan Huang, Stephan Sommer and Connie Liu at Mizzou; Kristin Bilyeu at the United States Department of Agriculture.
A new experiment called QROCODILE, led by the University of Zurich and the Hebrew University of Jerusalem, has achieved record sensitivity in the hunt for light dark matter. Using superconducting detectors cooled to near absolute zero, the team set world-leading limits on how dark matter interacts with ordinary matter — opening the door to future breakthroughs in one of physics’ greatest mysteries.
[Hebrew University of Jerusalem]– Dark matter, the elusive substance that makes up about 85% of the universe’s mass, remains one of the greatest mysteries in physics. Invisible and undetectable by ordinary means, it neither emits nor absorbs light, leaving scientists with only indirect evidence of its existence. For decades, researchers have tried in vain to catch a glimpse of these elusive particles.
Now, an international collaboration of scientists has unveiled promising first results with a novel experiment called QROCODILE (Quantum Resolution-Optimized Cryogenic Observatory for Dark matter Incident at Low Energy). The project, led jointly by the University of Zurich and the Hebrew University of Jerusalem, involving also Cornell University, Karlsruhe Institute of Technology (KIT), and MIT, has demonstrated a new path in the search for “light” dark matter particles.
At the heart of QROCODILE is a cutting-edge superconducting detector capable of measuring incredibly faint energy deposits — down to just 0.11 electron-volts, millions of times smaller than the energies usually detected in particle physics experiments. This sensitivity opens an entirely new frontier: testing the existence of extremely light dark matter particles, with masses thousands of times smaller than those probed by previous experiments.
In a science run lasting more than 400 hours at temperatures near absolute zero, the team recorded a small number of unexplained signals. While these events cannot yet be confirmed as dark matter — they may stem from cosmic rays or natural background radiation — they already allow researchers to set new world-leading limits on how light dark matter particles interact with electrons and atomic nuclei
An additional strength of the experiment is its potential to detect the directionality of incoming signals. Since the Earth moves through the galactic halo, dark matter particles are expected to arrive from a preferred direction. Future upgrades could allow scientists to distinguish between true dark matter signals and random background noise, a crucial step toward a definitive discovery.
Prof. Yonit Hochberg of the Racah Institute of Physics at the Hebrew University, one of the project’s lead scientists, explains: “For the first time, we’ve placed new constraints on the existence of especially light dark matter. This is an important first step toward larger experiments that could ultimately achieve the long-sought direct detection.”
The next stage of the project, NILE QROCODILE, will further enhance the detector’s sensitivity and move the experiment underground to shield it from cosmic rays. With improved shielding, larger detector arrays, and even lower energy thresholds, the researchers aim to push the boundaries of our understanding of the dark universe.
