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An accurate conceptual site model (CSM) and plume‐delineation at contamination sites are pre‐requisites for successful remediation and for satisfying regulators and stakeholders. PlumeSeeker™ is well‐suited for assessing data gaps in CSMs by using available site data and for identifying the optimal number and locations of sampling locations to delineate contaminant plumes. It is an enhancement of a university research code for plume delineation using geostatistical and stochastic modeling integrated with the groundwater modeling software MODFLOW‐SURFACT™. PlumeSeeker™ increases the overall confidence in the location of the plume boundary through a variance‐reduction approach that selects existing‐ or new monitoring wells for sampling based on minimizing the uncertainty in plume boundary and on new field information. Applicable at sites with or without existing monitoring wells, PlumeSeeker™ is particularly powerful for optimally allocating project resources (labor, well installation, and laboratory costs) between existing wells and sampling at new locations. An application of PlumeSeeker™ at Lakehurst, the naval component of Joint Base McGuire‐Dix‐Lakehurst in New Jersey, demonstrates how the cost of delineating the migration pathway of a perfluorooctanoic acid (PFOA) plume can be minimized by requiring only 9 new sampling locations in addition to samples from 2 existing wells for achieving a 70% reduction in plume uncertainty. In addition, the use of available site data in three different scenarios identified CSM data‐gaps in the source area and in the interaction between Manapaqua Branch and groundwater, where the observed high concentration in this area could have resulted from a combination of groundwater migration and induced infiltration. [ABSTRACT FROM AUTHOR]

Prescribed burning is a cost-effective method for reducing hazardous fuels in pine- and oak-dominated forests, but smoke emissions contribute to atmospheric pollutant loads, and the potential exists for exceeding federal air quality standards designed to protect human health. Fire behavior during prescribed burns influences above-canopy sensible heat flux and turbulent kinetic energy (TKE) in buoyant plumes, affecting the lofting and dispersion of smoke. A more comprehensive understanding of how enhanced energy fluxes and turbulence are related during the passage of flame fronts could improve efforts to mitigate the impacts of smoke emissions. Pre- and post-fire fuel loading measurements taken during 48 operational prescribed burns were used to estimate the combustion completeness factors (CC) and emissions of fine particulates (PM2.5), carbon dioxide (CO2), and carbon monoxide (CO) in pine- and oak-dominated stands in the Pinelands National Reserve of southern New Jersey. During 11 of the prescribed burns, sensible heat flux and turbulence statistics were measured by tower networks above the forest canopy. Fire behavior when fire fronts passed the towers ranged from low-intensity backing fires to high-intensity head fires with some crown torching. Consumption of forest-floor and understory vegetation was a near-linear function of pre-burn loading, and combustion of fine litter on the forest floor was the predominant source of emissions, even during head fires with some crowning activity. Tower measurements indicated that above-canopy sensible heat flux and TKE calculated at 1 min intervals during the passage of fire fronts were strongly influenced by fire behavior. Low-intensity backing fires, regardless of forest type, had weaker enhancement of above-canopy air temperature, vertical and horizontal wind velocities, sensible heat fluxes, and TKE compared to higher-intensity head and flanking fires. Sensible heat flux and TKE in buoyant plumes were unrelated during low-intensity burns but more tightly coupled during higher-intensity burns. The weak coupling during low-intensity backing fires resulted in reduced rates of smoke transport and dispersion, and likely in more prolonged periods of elevated surface concentrations. This research facilitates more accurate estimates of PM2.5, CO, and CO2 emissions from prescribed burns in the Pinelands, and it provides a better understanding of the relationships among fire behavior, sensible heat fluxes and turbulence, and smoke dispersion in pine- and oak-dominated forests. [ABSTRACT FROM AUTHOR]

In the early 20th century, urban centers in New Jersey, especially locations such as Newark, Hoboken, and Camden, were home to many immigrants from Europe. Hoboken stands out amongst these as it was the major port of embarkation for American troops en route to the World War I. The city saw American immigrants supporting the war effort in varying ways. Irish immigrants, for example, may well have looked at American support for Great Britain in a different light than native-born American citizens. Similarly, German-Americans, especially between 1914 and 1917, were ambivalent as American "neutrality" towards Germany shifted towards outright hostility. What can local newspapers, some of which catered to ethnic interests, tell us about the tensions between ethnic loyalties and the call for patriotic support for the Allies as the United States went to war? This paper focuses in part on editorial comments on the need for "loyalty," and/or "patriotism" once war was declared in April, 1917. It was originally presented as a paper at the NJ Historical Commission's 2017 conference, "New Jersey and The Great War," held November 3-4, 2017 at Rowan College at Burlington County and Joint Base McGuire-Dix-Lakehurst. [ABSTRACT FROM AUTHOR]

The article focuses on the initiative of the U.S. Air Force to train air advisors through the Air Advisory Academy (AAA). It mentions that the initiative is aimed to establish an Air Force directed Air Education and Training Command (AETC)-led schoolhouse thereby assuring their capacity in the warfare arena. It adds that AAA was able to educate and train 4,300 students who have been operational at Joint Base McGuire-Dix-Lakehurst in New Jersey.

The article focuses on the services offered by the U.S. Air Force Expeditionary Center (USAF EC) located at Joint Base McGuire-Dix-Lakehurst in New Jersey. It recalls the history of the USAF EC, which was created in 1917, and outlines its services which focused on providing advance training for expeditionary operations. It explores the design of USAF EC and discusses the functions of its two schools such as the mobility operations schools (MOS) and expeditionary operations school (EOS).

On August 29, 2021, the United States government oversaw the emergent establishment of Operation Allies Welcome (OAW), led by the U.S. Department of Homeland Security (DHS) and implemented by the U.S. Department of Defense (DoD) and U.S. Department of State (DoS), to safely resettle U.S. citizens and Afghan nationals from Afghanistan to the United States. Evacuees were temporarily housed at several overseas locations in Europe and Asia* before being transported via military and charter flights through two U.S. international airports, and onward to eight U.S. military bases,† with hotel A used for isolation and quarantine of persons with or exposed to certain infectious diseases.§ On August 30, CDC issued an Epi-X notice encouraging public health officials to maintain vigilance for measles among Afghan evacuees because of an ongoing measles outbreak in Afghanistan (25,988 clinical cases reported nationwide during January-November 2021) (1) and low routine measles vaccination coverage (66% and 43% for the first and second doses, respectively, in 2020) (2). [ABSTRACT FROM AUTHOR]

Hypertensive disorders in pregnancy (HDPs), defined as prepregnancy (chronic) or pregnancy-associated hypertension, are common pregnancy complications in the United States.* HDPs are strongly associated with severe maternal complications, such as heart attack and stroke (1), and are a leading cause of pregnancy-related death in the United States.† CDC analyzed nationally representative data from the National Inpatient Sample to calculate the annual prevalence of HDP among delivery hospitalizations and by maternal characteristics, and the percentage of in-hospital deaths with an HDP diagnosis code documented. During 2017-2019, the prevalence of HDP among delivery hospitalizations increased from 13.3% to 15.9%. The prevalence of pregnancy-associated hypertension increased from 10.8% in 2017 to 13.0% in 2019, while the prevalence of chronic hypertension increased from 2.0% to 2.3%. Prevalence of HDP was highest among delivery hospitalizations of non-Hispanic Black or African American (Black) women, non-Hispanic American Indian and Alaska Native (AI/AN) women, and women aged ≥35 years, residing in zip codes in the lowest median household income quartile, or delivering in hospitals in the South or the Midwest Census regions. Among deaths that occurred during delivery hospitalization, 31.6% had any HDP documented. Clinical guidance for reducing complications from HDP focuses on prompt identification and preventing progression to severe maternal complications through timely treatment (1). Recommendations for identifying and monitoring pregnant persons with hypertension include measuring blood pressure throughout pregnancy,§ including self-monitoring. Severe complications and mortality from HDP are preventable with equitable implementation of strategies to identify and monitor persons with HDP (1) and quality improvement initiatives to improve prompt treatment and increase awareness of urgent maternal warning signs (2). [ABSTRACT FROM AUTHOR]

The article discusses the legal issues concerning the use of other transactions (OT) for protopypes by the U.S. Department of Defense (DoD) with the support of Congress. Other topics include the need for DoD lawyers to learn the risks and benefits related to OT use to better advise military commanders and acquisition professionals, and how OTs can help address the barriers faced by nontraditional defense contractors (NDC) from working with the government.

The article discusses legal issues involving the Randolph-Sheppard Act, particularly its implementation in military cafeterias in U.S. bases. Also cited are the Act's aim to provide more economic and employment opportunities to blind persons to make them more self-sufficient, and the issues over the solicitation or award of contract under the Act.

Background: Ellipsoptera lepida, the ghost tiger beetle, is in decline throughout much of its range, especially in the northeastern United States. In New Jersey, the species was known from 18 historic coastal dune and interior upland sites, although modern collection records for the species are rare. Aims/Methods: Because of the decline of E. lepida, the authors performed extensive surveys of historic sites, as well as potential undocumented sites based on satellite imagery during 2014–2015. One of the previously undocumented sites was an anthropogenic dune on a developed barrier island that had only been constructed 3–4 years prior. Because of its novelty, we conducted more intensive surveys at this site to document abundance and characterize adult and larval habitat. Results: Many historic sites were apparently extirpated or contained small numbers of beetles, although several new populations were located at coastal and inland sites. Abundance of adults and larvae in constructed dunes greatly exceeded densities recorded at other coastal sites. An analysis of vegetation density based on satellite imagery indicates that E. lepida larvae and adults depend on early and mid-successional dunes for optimal habitat. Discussion: Nearly all inland sites appear to be suitable only because of incidental anthropogenic habitat disturbance while natural disturbance processes play a greater role in maintaining habitat at coastal sites. The high densities we observed in constructed dunes are likely because the constructed dune system is at a single, highly suitable successional stage. This species is unlike another rare coastal tiger beetle native to New Jersey, Habroscelimorpha dorsalis, in that it can persist in the presence of beach vehicle and pedestrian disturbance if suitable dunes are available. Implications for insect conservation: Our findings indicate the potential for creating and maintaining additional habitat for Ellipsoptera lepida in parts of its range where it may be declining. [ABSTRACT FROM AUTHOR]

Per‐ and polyfluoroalkyl substances (PFAS) have emerged as contaminants of environmental concern following release from industrial practices and use of aqueous film–forming foam (AFFF). Of the identified PFAS in surface water samples from known AFFF release sites, perfluorooctanesulfonate (PFOS) and perfluorohexanesulfonic acid (PFHxS) are frequently detected. The focus of the present study was to determine the effects of PFOS and PFHxS to the native (and common) fathead minnow, Pimephales promelas, over critical life stages of reproduction and development. Two separate, 42‐d experiments were carried out using sexually mature fish, exposed to either PFOS or PFHxS. Measured exposure concentrations for PFOS and PFHxS were 0, 44, 88, 140, and 231 µg/L and 0, 150, 300, 600, and 1200 µg/L, respectively. At day 21 of the adult exposure, eggs were collected and reared for 21 d to determine the effects of PFOS or PFHxS on development, growth, and survival of larvae. The no‐observable‐effect concentration (NOEC) for PFOS was 44 µg/L, and the lowest‐observable‐effect concentration was 88 µg/L based on reduced growth in juvenile (F1) fish. Effects from PFOS exposures that did not follow a standard dose–response curve were reduced gonadosomatic index in adult males (at 44 µg/L) and reduced fecundity in females (at 140 µg/L). There was no toxicity on apical endpoints to report on adult or juvenile fish exposed to PFHxS up to 1200 µg/L. Importantly, we note that both PFOS and PFHxS accumulated in gonads and liver of adult fish following the respective exposures. The present study supports previous literature on PFOS toxicity and accumulation in fathead minnows but resulted in a lower NOEC than previously established for this species. Environ Toxicol Chem 2021;40:811–819. © 2020 SETAC [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to investigate two famous disasters at sea, the Titanic and the Concordia, separated by 100 years, based on a comparison and analysis of those historical events, demonstrating how lessons learned and training methods used in the hazardous marine environments of aircraft carrier operations, as well as the near-solo conditions of technical scuba diving, can be better implemented in managing a large ship at sea. Design/methodology/approach: This study starts with a historical analysis of these two ship-wrecks, both large, technically advanced ships that sank due to poor leadership, a breakdown in command and panic. Next, the study compares and contrasts scuba with operations aboard an aircraft carrier, two different maritime scenarios, yet similar in that there are many hazards that may require split-second decisions with limited or no communication with others. Both these mind-sets and training approaches have direct application to leadership and disaster planning on a large ship by being focused on minimizing decisions under stress in order to reduce panic. Findings: This study demonstrates the value and impact of training that minimizes decisions under stress and enable people to make decisions independently in the face of a loss of communications. Focusing on two famous naval accidents, our analysis shows how such training can prevent panic and disaster, and can have direct application to leadership and disaster planning on a large ship. Originality/value: This study uniquely compares and contrasts many of the planning and decision-making strategies used for both aircraft carrier operations and technical scuba diving, and the need to be able to make split-second decisions without communicating to others, and how these approaches can be used to better train a commercial ship to respond to an unforeseen disaster at sea. [ABSTRACT FROM AUTHOR]

The article announces the Louis H. Bauer Founders Award is given to Michael A. Berry.

While bioremediation technologies for trichloroethene (TCE), a suspected carcinogen, have been successfully demonstrated in neutral pH aquifers, these technologies are often ineffective for remediating TCE contamination in acidic aquifers (i.e., pH < 5.5). Acidophilic methanotrophs have been detected in several low pH environments, but their presence and potential role in TCE degradation in acidic aquifers is unknown. This study applied a stable isotope probing-based technique to identify active methanotrophs that are capable of degrading TCE in microcosms prepared from two low pH aquifers. A total of thirty-five clones of methanotrophs were derived from low pH microcosms in which methane and TCE degradation had been observed, with 29 clustered in γ-Proteobacteria and 6 clustered in α-Proteobacteria. None of the clones has a high similarity to known acidophilic methanotrophs from other environments. The presence and diversity of particulate MMO and soluble MMO were also investigated. The pmoA gene was detected predominantly at one site, and the presence of a specific form of mmoX in numerous samples suggested that Methylocella spp. may be common in acidic aquifers. Finally, a methane-grown culture at pH 4 was enriched from an acidic aquifer and its ability to biodegrade various chlorinated ethenes was tested. Interestingly, the mixed culture rapidly degraded TCE and vinyl chloride, but not cis-dichloroethene after growth on methane. The data suggest that aerobic biodegradation of TCE and other chlorinated solvents in low pH groundwater may be facilitated by methanotrophic bacteria, and that there are potentially a wide variety of different strains that inhabit acidic aquifers. [ABSTRACT FROM AUTHOR]

This article provides insights into the current state of developmental testing (DT) and requirements management in Department of Defense information systems employing Agile development. The authors describe the study methodology and provide an overview of Agile development and testing. Insights are described for requirements, detailed planning, test execution, and reporting. This work articulates best practices related to DT and requirements management strategies for programs employing modernized Software Development Life Cycle practices. [ABSTRACT FROM AUTHOR]

Despite multiple base closing rounds, the United States Department of Defense still has excess base capacity, and thus President Trump and high-level Defense Department officials are calling for more base closure through the Base Realignment and Closure (BRAC) process. However, another BRAC may not be the optimal solution, because simple base closure is not an efficient way to reduce surplus base capacity. Thus, Defense Department officials should consider other methods to reduce surplus capacity, including reduction in base size, leasing excess base property, or transferring it to another government agency for a variety of alternative uses. The surplus capacity issue also offers an opportunity to DOD to reassess base utilization, to update base requirements with current and future force structure. While BRAC focuses on American military bases, the process and alternatives also have international applications. [ABSTRACT FROM AUTHOR]

This article is a modified version of the exhibit text used in "Tracking Sandy: Monmouth County Remembers." Guest curated for the Monmouth County Historical Association (MCHA) by the author of this piece, this crowdsourced exhibit was installed in MCHA's headquarters in October 2017. The text is being published in this format to allow distribution to a wider audience/in perpetuity after the exhibit has come down, and to ensure the stories shared for the creation of the exhibit can continue to be told. This is not intended to be a comprehensive history of Sandy's impact globally, in the US, or even on the entire state of New Jersey (NJ) specifically, nor is it a thorough case study on the effectiveness of crowdsourcing community history (though that may be an interesting subject for another discussion). [ABSTRACT FROM AUTHOR]

The Command and Control (C2) Agility theory developed by experts from the Command and Control Research Program based upon analysis of military operations, posits that a C2 approach is characterized by three dimensions: (1) allocation of decision rights, among entities, (2) patterns of interaction, and (3) distribution of information. An entity's C2 approach is agile when these three dimensions can be changed as required due to a change in circumstances. The Institute for Defense Analyses has produced a handbook C2 by Design to guide operationalization of the C2 Agility theory. C2 agility becomes salient as complexity increases; and the complex, dynamic nature of disaster response environments suggests the applicability of C2 Agility theory to emergency management. This article builds on early NATO study panel findings that used disaster response case studies to validate C2A theory, and draws on existing case literature to identify what factors influenced C2A during Hurricane Katrina and explore how lessons learned from that response impacted C2A during the subsequent US response to Hurricane Sandy. The analysis uses C2A assessment factors from C2 by Design to examine these cases and recommends how the US government can achieve improved C2A during future responses to complex disasters. [ABSTRACT FROM AUTHOR]

The article discusses how use of energy savings performance contracts can be used to improve utility security and resilience at department of defense installations that experience frequent utility disruptions. Topics discussed include role of energy savings performance contracts (ESPCs) currently play in government procurement; and U.S. Department of Defense (DoD) installations and bases operate worldwide.

The origin story of the 1st Battalion, 114th Infantry has been lost over time. Whether through poor record keeping or due to the turbulence of the Civil War, the unit, formerly known as the Third New Jersey, is unable to trace its lineage before 1860. It is believed, however, that the battalion, currently stationed in Woodbury, New Jersey, has roots in the Revolutionary Warera New Jersey Militia as well as an auxiliary organization formed by the state during the Civil War, the New Jersey Rifle Corps. The purpose of this paper is to document and substantiate the history of the 1st Battalion, 114th Infantry, from the period of 1860 to the start of World War I. It is possible to do this using open source archives and documents. It is the goal of this author, and of the unit's commander, to eventually trace the lineage of the 1st of the 114th even further back, to the colonial militia. [ABSTRACT FROM AUTHOR]

Between 1840 and 1844, three quilts attributed to different women were made in Philadelphia, Pennsylvania, and New Egypt, New Jersey. The quilts are inscribed with many of the same names. The purpose of this study is to understand the connections between these quilts. These quilts would be interesting just as examples of a strong regional style, but more importantly, they serve as primary documents of broad community con-nections that transcend the religious and familial ties frequently associated with Album-style quilts. These quilts show strong connections of family and friends and record business connections in the rapidly evolving industrial world of Philadelphia and New Jersey. Beyond this, the quilts demonstrate a close association among individuals of traditional Christian beliefs with friends exploring the new Mormon faith. Drawing on museum and personal collections, historical documents, archival research, local histories, and extensive genealogical research, this study expands our knowledge of the influence of mercantilism and religion in the creation of Album quilts in the United States during the early 1840s. [ABSTRACT FROM AUTHOR]

The author demonstrates a stable Lagrangian solid modeling method, tracking the interactions of solid mass particles rather than using a meshed grid. This numerical method avoids the problem of tensile instability often seen with smooth particle applied mechanics by having the solid particles apply stresses expected with Hooke's law, as opposed to using a smoothing function for neighboring solid particles. This method has been tested successfully with a bar in tension, compression, and shear, as well as a disk compressed into a flat plate, and the numerical model consistently matched the analytical Hooke's law as well as Hertz contact theory for all examples. The solid modeling numerical method was then built into a 2-D model of a pressure vessel, which was tested with liquid water particles under pressure and simulated with smoothed particle hydrodynamics. This simulation was stable, and demonstrated the feasibility of Lagrangian specification modeling for fluid-solid interactions. [ABSTRACT FROM AUTHOR]

An effort was made to study and characterize the evolution of transient tribological wear in the presence of sliding contact. Sliding contact is often characterized experimentally via the standard ASTM D4172 four-ball test, and these tests were conducted for varying times ranging from 10 seconds to 1 hour, as well as at varying temperatures and loads. A numerical model was developed to simulate the evolution of wear in the elastohydrodynamic regime. This model uses the results of a Monte Carlo study to develop novel empirical equations for wear rate as a function of asperity height and lubricant thickness; these equations closely represented the experimental data and successfully modeled the sliding contact. [ABSTRACT FROM AUTHOR]

A sensorless algorithm was developed to predict rotor speeds in an electric three-phase induction motor. This sensorless model requires a measurement of the stator currents and voltages, and the rotor speed is predicted accurately without any mechanical measurement of the rotor speed. A model of an electric vehicle undergoing acceleration was built, and the sensorless prediction of the simulation rotor speed was determined to be robust even in the presence of fluctuating motor parameters and significant sensor errors. Studies were conducted for varying pulse width modulator resolutions, and the sensorless model was accurate for all resolutions of sinusoidal voltage functions. [ABSTRACT FROM AUTHOR]

The decline in snake populations has been attributed primarily to anthropogenic disturbances, including habitat destruction and fragmentation. We radio-tracked Northern Pinesnakes ( Pituophis m. melanoleucus) in a military Target Zone and in the surrounding undisturbed buffer zone at the Warren Grove Gunnery Range in the New Jersey Pine Barrens, USA, to examine differences in spatial movement patterns and behavior. There were no differences in home range size ( X¯ = 60.0 ± 32.7 ha), core activity area ( X¯ = 10.6 ± 8.2 ha), range length ( X¯ = 1294.8 ± 32.7 m), or mean distance traveled per day ( X¯ = 65.2 ± 30.1 m) across all snakes, or between sexes (male n = 13, female n = 11), or location within ( n = 13) or outside ( n = 11) of the Target Zone. However, there were differences between tracking years. Northern Pinesnakes in 2005 and 2006 ( n = 13) traveled greater total distance and mean distance per day and had larger home ranges compared to snakes radio-tracked in 2003 and 2004 ( n = 11). In 2005 and 2006, snakes in the Target Zone traveled longer distances compared to snakes outside the Target Zone. Pinesnakes used both the Target Zone and undisturbed buffer zone for mating, nesting, foraging, and hibernating. Although the Target Zone was disturbed regularly, the open-canopied landscape, cover availability, and sandy soils maintained habitat for Northern Pinesnakes. Our data indicate that the military disturbance had little impact on the spatial ecology of Northern Pinesnakes; the disturbed area supported enough natural habitat features used by Northern Pinesnakes and was surrounded by a large tract of undisturbed landscape. These data can aid in developing mitigation and conservation strategies where the habitat of Northern Pinesnakes is threatened by development, in particular, across other military installations, which commonly overlap with the occurance of Northern Pinesnakes. [ABSTRACT FROM AUTHOR]

The article focuses on addressing the establishment of religion, or prohibiting the free exercise of religion in military society under the First Amendment of US Constitution's Bill of Rights. Topics discussed include U.S. Supreme Court case Lemon v. Kurtzman which deals with violation of the Establishment Clause of the First Amendment, affirmation of constitutionality of National Day of Prayer in U.S. SUpreme Court case Lynch v. Donnelly, and cultural changes in the U.S. military society.

The article presents information on the Electromagnetic Aircraft Launch System (EMALS). It informs that the U.S. Navy launched an EA-18G Growler successfully on June 25, 2013 in the second phase of manned aircraft launch tests. The benefits of EMALS is also discusses which includes higher launch energy capacity, increased reliability and efficiency, and more accurate end-speed control.

The article discusses no establishment of religion and religious freedom in the U.S. military society. It states that the U. S. Constitution ensures that religion in the public square does not end on military installations. It mentions practice of hostility in shade of the concept neutrality toward religion by the military in the U.S.

The article discusses the collaboration, leadership, and veterans-related nonprofit organizations in the U.S. It states that veterans related organizations related such as the Wounded Warrior Project (WWP), Veterans of Foreign Wars (VFW) and Purple Heart have established presence. Philadelphia Flag Day Association (PFDA) vice president Michael Axelrod testifies collaborations toward common goals. It mentions that nonprofit leaders agree that collaboration will be vital to address new trends.

Rates of primary and secondary syphilis have increased in the past decade, warranting renewed attention to the diagnosis and treatment of this disease. Men who have sex with men are particularly affected; however, increases in infection rates have also been noted in women, as well as in all age groups and ethnicities. Physicians need to vigilantly screen high-risk patients. The concurrent rise in congenital syphilis also requires special attention and reemphasizes the need for continued early prenatal care and syphilis screening for all pregnant women. Syphilis infection in patients coinfected with human immunodeficiency virus has also become more common. New experimental diagnostic approaches, including using the B cell chemoattractant chemokine (CXC motif) ligand 13 as a cerebrospinal fluid marker, may help identify suspected neurosyphilis cases. Additionally, point-of-care immunochromatographic strip testing has been suggested for screening high-risk populations in developing countries. Nontreponemal screening tests followed by treponemal confirmatory tests continue to be standard diagnostics; however, interpreting false-negative and false-positive test results, and identifying serofast reactions, can be challenging. Although doxycycline, tetracycline, ceftriaxone, and azithromycin have been used to successfully treat syphilis, penicillin remains the drug of choice in all stages of infection and is the therapy recommended by the Centers for Disease Control and Prevention. Close follow-up is necessary to ensure treatment success. [ABSTRACT FROM AUTHOR]

Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment. [ABSTRACT FROM AUTHOR]