The "open letter": radiologists' reports in the era of patient web portals.

Historically, radiologists' official written reports have functionally been proprietary communications between radiologists and referring providers. Although never secret, these reports have traditionally been archived in the medical record, with tightly controlled access. Patients rarely viewed reports directly. As patient-centered care, transparent communication, and electronic archiving have converged, however, radiologists' reports, like many other medical record components, are increasingly accessible to patients via web-based "portals." Many radiologists harbor justified anxiety about whether and how radiology reports should change in response to these portals. Direct patient access to radiology reports raises several questions, including: who are reports really for, what is their essential purpose, what content should they include or omit, what limits should be placed on their accessibility, and what ethical and legal ramifications arise from the reports' unfettered accessibility. In this paper, we outline the challenges and opportunities that arise from direct patient access to radiology reports via web-based portals, and propose an approach to optimizing radiologists' reports in an era of enhanced transparency. We conclude that, in effect, the health information web portal is a "train which has left the station"; patient portals are a nationwide reality, and transparency is now a public and professional expectation. Radiologists urgently need to consider quality implications for their report writing in order to address the challenges these developments pose, and to best harness the potential benefits for patients and providers.

Swine manure-based pilot-scale algal biomass production system for fuel production and wastewater treatment--a case study.

Integration of wastewater treatment with algae cultivation is one of the promising ways to achieve an economically viable and environmentally sustainable algal biofuel production on a commercial scale. This study focused on pilot-scale algal biomass production system development, cultivation process optimization, and integration with swine manure wastewater treatment. The areal algal biomass productivity for the cultivation system that we developed ranged from 8.08 to 14.59 and 19.15-23.19 g/m(2) × day, based on ash-free dry weight and total suspended solid (TSS), respectively, which were higher than or comparable with those in literature. The harvested algal biomass had lipid content about 1.77-3.55%, which was relatively low, but could be converted to bio-oil via fast microwave-assisted pyrolysis system developed in our lab. The lipids in the harvested algal biomass had a significantly higher percentage of total unsaturated fatty acids than those grown in lab conditions, which may be attributed to the observed temperature and light fluctuations. The nutrient removal rate was highly correlated to the biomass productivity. The NH3-N, TN, COD, and PO4-P reduction rates for the north-located photo-bioreactor (PBR-N) in July were 2.65, 3.19, 7.21, and 0.067 g/m(2) × day, respectively, which were higher than those in other studies. The cultivation system had advantages of high mixotrophic growth rate, low operating cost, as well as reduced land footprint due to the stacked-tray bioreactor design used in the study.

Constraints on carbon monoxide emissions based on tall tower measurements in the US Upper Midwest.

We interpret a full year of high-frequency CO measurements from a tall tower in the U.S. Upper Midwest with a time-reversed Lagrangian Particle Dispersion Model (STILT LPDM) and an Eulerian chemical transport model (GEOS-Chem CTM) to develop top-down constraints on U.S. CO sources in 2009. Our best estimate is that anthropogenic CO emissions in the U.S. Upper Midwest in 2009 were 2.9 Tg, 61% lower (a posteriori scale factor of 0.39) than our a priori prediction based on the U.S. EPA's National Emission Inventory for 2005 (NEI 2005). If the same bias applies across the contiguous U.S., the inferred CO emissions are 26 Tg/y, compared to the a priori estimate of 66 Tg/y. This discrepancy is significantly greater than would be expected based solely on emission decreases between 2005 and 2009 (EPA estimate: 23% decrease). Model transport error is an important source of uncertainty in the analysis, and we employ an ensemble of sensitivity runs using multiple meteorological data sets and model configurations to assess its impact on our results. A posteriori scale factors for the U.S. anthropogenic CO source from these sensitivity runs range from 0.22 to 0.64, corresponding to emissions of 1.6-4.8 Tg/y for the U.S. Upper Midwest and 15-42 Tg/y for the contiguous U.S. The data have limited sensitivity for constraining biomass + biofuel burning emissions and photochemical CO production from precursor organic compounds. Our finding of a NEI 2005 overestimate of CO emissions is consistent with recent assessments for individual cities and with earlier analyses based on the NEI 1999, implying the need for a better mechanism for refining such bottom-up emission estimates in response to top-down constraints.

Cultivating Chlorella sp. in a pilot-scale photobioreactor using centrate wastewater for microalgae biomass production and wastewater nutrient removal.

This study is concerned with a novel mass microalgae production system which, for the first time, uses "centrate", a concentrated wastewater stream, to produce microalgal biomass for energy production. Centrate contains a high level of nutrients that support algal growth. The objective of this study was to investigate the growth characteristics of a locally isolated microalgae strain Chlorella sp. in centrate and its ability to remove nutrients from centrate. A pilot-scale photobioreactor (PBR) was constructed at a local wastewater treatment plant. The system was tested under different harvesting rates and exogenous CO(2) levels with the local strain of Chlorella sp. Under low light conditions (25 µmol·m(-2)s(-1)) the system can produce 34.6 and 17.7 g·m(-2)day(-1) biomass in terms of total suspended solids and volatile suspended solids, respectively. At a one fourth harvesting rate, reduction of chemical oxygen demand, total Kjeldahl nitrogen, and soluble total phosphorus were 70%, 61%, and 61%, respectively. The addition of CO(2) to the system did not exhibit a positive effect on biomass productivity or nutrient removal in centrate which is an organic carbon rich medium. The unique PBR system is highly scalable and provides a great opportunity for biomass production coupled with wastewater treatment.