The DRS-R-98, a 16-item clinician-rated scale with 13 severity items and 3 diagnostic items, was validated against the Cognitive Test for Delirium (CTD), Clinical Global Impression scale (CGI), and Delirium Rating Scale (DRS) among five diagnostic groups (N=68): delirium, dementia, depression, schizophrenia, and other. Mean and median DRS-R-98 scores significantly (P<0.001) distinguished delirium from each other group. DRS-R-98 total scores correlated highly with DRS, CTD, and CGI scores. Interrater reliability and internal consistency were very high. Cutoff scores for delirium are recommended based on ROC analyses (sensitivity and specificity ranges: total, 91%-100% and 85%-100%; severity, 86%-100% and 77%-93%, respectively, depending on the cutoffs or comparison groups chosen). The DRS-R-98 is a valid measure of delirium severity over a broad range of symptoms and is a useful diagnostic and assessment tool. The DRS-R-98 is ideal for longitudinal studies.

Per‐ and polyfluoroalkyl substances (PFAS) are a recalcitrant group of chemicals and can be found throughout the environment. They often collect in wastewater systems with virtually no degradation prior to environmental discharge. Some PFAS partitions to solids captured in wastewater treatment which require further processing. Of all the commonly applied solids treatment technologies, incineration offers the only possibility to completely destroy PFAS. Little is known about the fate of PFAS through incineration, in particular, for the systems employed in water resource recovery facilities (WRRF). This review covers available research on the fate of PFAS through incineration systems with a focus on sewage sludge incinerators. This research indicates that at least some PFAS destruction will occur with incineration approaches used at WRRFs. Furthermore, PFAS in flue gas, ash, or water streams used for incinerator pollution control may be undetectable. Future research involving full‐scale fate studies will provide insight on the efficacy of PFAS destruction through incineration and whether other compounds of concern are generated. Practitioner points Thermal processing is the only commercial approach available to destroy PFAS. Thermal degradation conditions required for destruction of PFAS during incineration processes are discussed. Fate of PFAS through water resource recovery facility incineration technologies remains unclear. Other thermal technologies such as smoldering combustion, pyrolysis, gasification, and hydrothermal liquefaction provide promise but are in developmental phases.

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Untreated wastewater samples were collected from the Great Lakes Water Authority (GLWA) Water Resource Recovery Facility (WRRF) located in southeast Michigan between April 8 and May 26, 2020. The WRRF is the largest single-site wastewater treatment facility in the US, and it receives wastewater from its service area via three main interceptors: Detroit River Interceptor (DRI), North Interceptor-East Arm (NI-EA), and Oakwood-Northwest-Wayne County Interceptor (O-NWI). A total of 54 untreated wastewater samples were collected (18 per interceptor) at the point of intake into the WRRF. Viruses were isolated from wastewater using electropositive NanoCeram column filters (Argonide, Sanford, Florida). For each sample, an average of 45 L of wastewater was passed through NanoCeram electropositive cartridge filters at a rate of no more than 11.3 L=m. Viruses were eluted and concentrated and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) concentrations were quantified with reverse transcription quantitative polymerase chain reaction (RT-qPCR). SARS-CoV-2 was detected in 100% of samples, and measured concentrations were in the range of 10 4-10 5 genomic copies/L. Quantification of concentrations of human viruses, such as SARS-CoV-2, in wastewater is a critical first step in the development of wastewater-based epidemiology predictive methods. However, accurate prediction involves the incorporation of multiple other measurements, data, and processes, such as the estimation of fate and detention times of viruses in the sewer collection network, estimation of contributing population, incorporation of disease characteristics based on anthropometric data, and others. A viral disease prediction model (Viral PD) that incorporates all these other inputs is currently being developed for COVID-19 in Detroit, Michigan.

Gabapentin (GBP) has gained wide acceptance in the treatment of pain, migraine, bipolar illness, and epilepsy. It has a relatively benign side effect profile, lacks significant drug interactions, is not liver metabolized, and is renally excreted. Herein three cases are presented that demonstrate withdrawal symptoms after abrupt discontinuation of GBP. Clinicians are encouraged to taper GBP dosage, especially when patients have taken high doses, and to warn patients of possible adverse effects of abruptly discontinuing GBP themselves.