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Bacterial infection risk in work environments has been extensively reported for healthcare workers, while this risk is rarely researched in other occupations. This study aimed to identify occupational environments in Taiwan’s agricultural and healthcare industries with elevated bacterial infection risks by comparing risks for general bacterial infections and pneumonia. Using labour and health insurance claim data from 3.3 million workers (January 2004–December 2020), a retrospective cohort was constructed to estimate occupational infection risks with Cox regression and the Anderson-Gill extension. Significantly elevated hazard ratios were found for workers in vegetable growing, crop cultivation service, mushroom growing, flower growing, and fruit growing, ranging from 1.13 to 1.39 for general bacterial infections and 1.68 to 3.06 for pneumonia infections. In afforestation and the inland fishing industry, pneumonia risk was significantly elevated with, respectively, 1.87 and 1.21. In the healthcare section, especially workers in residential care services and residential care services for elderly stand out regarding their pneumonia risk, with significant hazard ratios of 3.49 and 1.75. The methods used in this study were proven to be effective in identification of occupation environments at risk and can be used in other settings. These findings call for prioritization of bacterial infection prevention by occupation.
Introduction: Late-life depression (LLD) is associated with cognitive deficit with risk of future dementia. By examining the entropy of the spontaneous brain activity, we aimed to understand the neural mechanism pertaining to cognitive decline in LLD.
Methods: We collected MRI scans in older adults with LLD (n = 32), mild cognitive impairment [MCI (n = 25)] and normal cognitive function [NC, (n = 47)]. Multiscale entropy analysis (MSE) was applied to resting-state fMRI data. Under the scale factor (tau) 1 and 2, reliable separation of fMRI data and noise was achieved. We calculated the brain entropy in 90 brain regions based on automated anatomical atlas (AAL). Due to exploratory nature of this study, we presented data of group-wise comparison in brain entropy between LLD vs. NC, MCI vs. NC, and LLD and MCD with a p-value below 0.001.
Results: The mean Mini-Mental State Examination (MMSE) score of LLD and MCI was 27.9 and 25.6. Under tau 2, we found higher brain entropy of LLD in left globus pallidus than MCI (p = 0.002) and NC (p = 0,009). Higher brain entropy of LLD than NC was also found in left frontal superior gyrus, left middle superior gyrus, left amygdala and left inferior parietal gyrus. The only brain region with higher brain entropy in MCI than control was left posterior cingulum (p-value = 0.015). Under tau 1, higher brain entropy was also found in LLD than in MCI in right orbital part of medial frontal gyrus and left globus pallidus (p-value = 0.007 and 0.005).
Conclusions: Our result is consistent with prior hypothesis where higher brain entropy was found during early aging process as compensation. We found such phenomenon particular in left globus pallidus in LLD, which could be served as a discriminative brain region. Being a key region in reward system, we hypothesis such region may be associated with apathy and with unique pathway of cognitive decline in LLD. We will undertake subsequent analysis longitudinally in this cohort
The aim of this 4-year follow-up study was to examine the predictive effects of demographics, three types of sexual stigma, three types of self-identity confusion, anxiety, depression, family support and problematic Internet use before the coronavirus disease 2019 (COVID-19) pandemic on new-onset suicide risk and persistent suicide risk in young adult lesbian, gay and bisexual individuals who experienced the COVID-19 pandemic in Taiwan.
Methods
Baseline data were collected from 1,000 lesbian, gay and bisexual individuals in 2018 and 2019. Outcome data on suicide risk were collected again in 2023. The suicide module of the Mini International Neuropsychiatric Interview was used to assess suicide risk in terms of thoughts of death, desire to self-harm, thoughts of suicide, plans for suicide and suicide attempts in the preceding month at the initial and follow-up assessments. Baseline three types of sexual stigma, self-identity disturbance, depression, anxiety and problematic Internet use were used to examine their prediction of new-onset suicide risk and persistent suicide risk at follow-up.
Results
In total, 673 individuals participated in the follow-up survey. Notably, 16.5% of the participants who had no suicide risk at baseline had new-onset suicide risk at follow-up; 46.4% of the participants who had suicide risk at baseline also had suicide risk at follow-up. Participants who were transgender (p = .003), who perceived greater levels of microaggression (p < .001), and who had greater levels of problematic Internet use at baseline (p = .024) were more likely to have new-onset suicide risk at follow-up. Participants who had greater levels of self-identity confusion were more likely to have persistent suicide risk at follow-up (p = .023).
Conclusion
Intervention strategies for reducing suicide risk in lesbian, gay and bisexual individuals should be developed with consideration of the predictors identified in this study.
While the competitive behavior of firms with regard to entry and exit activities serves as a driving force behind the business cycle, little attention has been paid to the issue of industry clusters when discussing belief-driven cyclical fluctuations. Faced with this deficiency, this study analyzes the possibility of the emergence of equilibrium indeterminacy from the perspective of industrial organization. By analyzing the effects of endogenous overhead costs in the market, this paper finds that belief-driven business cycle fluctuations are related to industry clusters. More specifically, a stronger spillover effect or a less pronounced congestion effect tends to increase the likelihood of local indeterminacy.
This experiment aimed to investigate the impacts of tributyrin (TB) dietary supplementation on serum biochemical indices and meat quality characteristics of longissimus thoracis et lumborum (LTL) muscle of lambs after weaning. Thirty healthy Small-Tailed Han female lambs (27.5 ± 4.1 kg; mean ± standard deviation) were randomly assigned to five treatments: basal diet (1) without TB, (2) with 0.5 g/kg TB, (3) with 1.0 g/kg TB, (4) with 2.0 g/kg TB or (5) with 4.0 g/kg TB. Each treatment consisted of six lambs, and the lambs were weaned on d 90 and were raised until d 165. Results showed that supplementing TB significantly promoted serum immunoglobulin concentrations of lambs such as immunoglobulins G, A and M. Besides, TB significantly increased muscle ether extract content, intermuscular fat length, pH value and redness but decreased lightness, drip loss and shear force. In addition, TB significantly elevated inosine-5ʹ-phosphate content and upregulated the relative expressions of genes related to lipid metabolism such as SREBP-1C, SCD, PPARγ, FAS and LPL. The mostly important, TB significantly enhanced essential amino acids (EAAs) and conjugated linoleic acids contents of the LTL muscle, despite it decreased total unsaturated fatty acids level. In conclusion, supplementing TB not only could promote the healthy status of weaned lambs via promoting serum immunity but also may improve nutritional quality of LTL muscle by improving EAA and conjugated linoleic acid contents.
Persistent cognitive deficits and functional impairments are associated with bipolar disorder (BD), even during the euthymic phase. The dysfunction of default mode network (DMN) is critical for self-referential and emotional mental processes and is implicated in BD. The current study aims to explore the balance of excitatory and inhibitory neurotransmitters, i.e. glutamate and γ-aminobutyric acid (GABA), in hubs of the DMN during the euthymic patients with BD (euBD).
Method
Thirty-four euBD and 55 healthy controls (HC) were recruited to the study. Using proton magnetic resonance spectroscopy (1H-MRS), glutamate (with PRESS sequence) and GABA levels (with MEGAPRESS sequence) were measured in the medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC) and the posterior cingulate gyrus (PCC). Measured concentrations of excitatory glutamate/glutamine (Glx) and inhibitory GABA were used to calculate the excitatory/inhibitory (E/I) ratio. Executive and attentional functions were respectively assessed using the Wisconsin card-sorting test and continuous performance test.
Results
euBD performed worse on attentional function than controls (p = 0.001). Compared to controls, euBD had higher E/I ratios in the PCC (p = 0.023), mainly driven by a higher Glx level in the PCC of euBD (p = 0.002). Only in the BD group, a marginally significant negative association between the mPFC E/I ratio (Glx/GABA) and executive function was observed (p = 0.068).
Conclusions
Disturbed E/I balance, particularly elevated Glx/GABA ratio in PCC is observed in euBD. The E/I balance in hubs of DMN may serve as potential biomarkers for euBD, which may also contribute to their poorer executive function.
Malnutrition is a key factor in metabolic syndrome (MS) and sarcopenia, assessing the nutritional status of these patients is a pressing issue. The purpose of this study was to clarify sarcopenia and sarcopenic obesity in patients with MS based on nutritional status. This was a case–control study between MS/non-MS. Body composition was measured by dual-energy X-ray absorptiometry. Muscle function was assessed by handgrip strength, five times sit-to-stand test, gait speed test and short physical performance battery (SPPB). The Mini Nutritional Assessment (MNA) was performed to assess the nutritional status in the participants in this study. Overall, a total of 56 % and 13 % of participants suffered from possible sarcopenia and sarcopenia, respectively. There was a higher rate of possible sarcopenic obesity in the MS group than in the non-MS group (48·9 % v. 24·7 %, P < 0·01), and all the sarcopenia participants in the MS group had sarcopenic obesity. MNA score was significantly associated with sarcopenia status (P < 0·01). The MNA combined with body fat score showed better acceptable discrimination for detecting sarcopenic obesity and sarcopenia in MS (AUC = 0·70, 95 % CI 0·53, 0·86). In summary, there was a higher prevalence of possible sarcopenic obesity in MS, and all the MS patients with sarcopenia had sarcopenic obesity in the present study. We suggest that the MNA should be combined with body fat percentage to assess the nutritional status of MS participants, and it also serves as a good indicator for sarcopenia and sarcopenic obesity in MS.
Comparative lawyers are interested in similarities between legal systems. Artificial intelligence offers a new approach to understanding legal families. This chapter introduces machine-learning methods useful in empirical comparative law, a nascent field. This chapter provides a step-by-step guide to evaluating and developing legal family theories using machine-learning algorithms. We briefly survey existing empirical comparative law data sets, and then demonstrate how to visually explore these using a data set one of us compiled. We introduce popular and powerful algorithms of service to comparative law scholars, including dissimilarity coefficients, dimension reduction, clustering, and classification. The unsupervised machine-learning method enables researchers to develop a legal family scheme without the interference from existing schemes developed by human intelligence, thus providing a powerful tool to test comparative law theories. The supervised machine-learning method enables researchers to start with a baseline scheme (developed by human or artificial intelligence) and then extend it to previously unstudied jurisdictions.
Electro-osmotic chemical treatment is an innovative method to improve the strength of soft clays for geotechnical engineering purposes; the effectiveness of the treatment may be related to treatment time, the concentration of the solutions injected, and to variation of pH in the clay. The objective of this study was to investigate the relationship between the above-mentioned factors and the improvement in strength when calcium chloride solution was used as an injection material. A series of tests was carried out by injecting different concentrations of calcium chloride solution into a kaolin suspension, for different treatment times, during electro-osmosis. After the tests, the pH, cone resistance, water content, and concentration of Ca2+ in the kaolin at different locations were measured and analyzed. The results show that the concentration of Ca2+ in the kaolin, the pH, and the strength were increased near the cathode with increases in concentration of CaCl2 and treatment time. An insignificant increase in strength, due to ion exchange over the entire specimen, for short treatment times of 2 to 24 h, was observed because of a small increase in concentration of Ca2+ and in pH. During long-term treatment (120 h), a considerable increase in concentration of Ca2+ (137.0 mg/g) and pH (pH = 10) was observed near the cathode. This led to a pozzolanic reaction, which in turn caused a significant increase in the mechanical strength of the kaolin.
The Tuluanshan Formation of the eastern Coastal Range of Taiwan overlies an andesitic core complex presumed to be the source of hydrothermal fluids responsible for the Si- and Mg-rich mineralization of sepiolite and palygorskite (attapulgite) which are found in veins within fissures and in fracture zones of the volcanic rocks of the region. This study was undertaken in order to understand these relationships better by characterizing sepiolite and palygorskite in this Formation and by examining their occurrence and distribution in the Tungho (TH) and Chunjih (CJ) areas. Samples were analyzed using X-ray diffraction (XRD), thermal analysis, Fourier-transform infrared (FTIR) spectroscopy, and petrographic, scanning (SEM), and transmission (TEM) electron microscopic methods. Sepiolite and palygorskite are blocky and earthy-type materials that display fibrous characteristics when viewed using TEM and SEM and occurred alone or with chalcedony in veins. The fibers of blocky sepiolite are commonly intercalated with smectite but the earthy type of sepiolite and palygorskite observed in this study displayed precipitation from fluid enriched in Si, Al, Mg, and minor Fe and depleted in other ions at an earlier stage of offset of the andesitic veins. Continuation of reverse faulting and high shearing stress caused the precipitation of a significant quantity of interlaminated sepiolite. Sepiolite and palygorskite were formed at an earlier stage of fluid interaction relative to smectite in the Tuluanshan Formation.
Fast neutron absorption spectroscopy is widely used in the study of nuclear structure and element analysis. However, due to the traditional neutron source pulse duration being of the order of nanoseconds, it is difficult to obtain a high-resolution absorption spectrum. Thus, we present a method of ultrahigh energy-resolution absorption spectroscopy via a high repetition rate, picosecond duration pulsed neutron source driven by a terawatt laser. The technology of single neutron count is used, which results in easily distinguishing the width of approximately 20 keV at 2 MeV and an asymmetric shape of the neutron absorption peak. The absorption spectroscopy based on a laser neutron source has one order of magnitude higher energy-resolution power than the state-of-the-art traditional neutron sources, which could be of benefit for precisely measuring nuclear structure data.
An online pattern recognition method of lower limb movements is proposed based on the personalized surface electromyography (sEMG) signals, and the corresponding experimental researches are performed in the rehabilitation training. Further, a wireless wearable acquisition instrument is used. Based on this instrument, a host computer for the personal online recognition and real-time control of rehabilitation training is developed. Three time-domain features and two features in the nonlinear dynamics are selected as the joint set of the characteristic values for the sEMG signals. Then a particle swarm optimization (PSO) algorithm is used to optimize the feature channels, and a k-nearest neighbor (KNN) algorithm and the extreme learning machine (ELM) algorithm are combined to classify and recognize individual sample data. Based on the multi-pose lower limb rehabilitation robot, the real-time motion recognition and the corresponding rehabilitation training are carried out by using the online personalized classifier. The experimental results of eight subjects indicate that it takes only 6 min to build an online personalized classifier for the four types of the lower limb movements. The recognition between switches of different rehabilitation training movements is timely and accurate, with an average recognition accuracy of more than 95%. These results demonstrate that this system has a strong practicability.
This paper systematically examines the theoretical and quantitative interrelations between government spending and disposable income inequality in a tractable monopolistically competitive Ramsey macroeconomy. Upon an increase in government size, we analytically show that whether the long-run after-tax Gini coefficient rises or falls depends on the sign and magnitude of the wealth/capital inequality effect versus those of the adjusted-labor effect. Under (i) a mild level of productive public expenditure externalities and (ii) a sufficiently high intertemporal elasticity of consumption substitution, our calibrated model is able to generate qualitatively as well as quantitatively consistent income inequality effects of government spending vis-à-vis recent estimation results.
To identify the optimal weight gain at the end of the second trimester.
Design:
This was a population-based cohort study from the antenatal care system in Tianjin, China. We calculated gestational weight gain (GWG) based on the weight measured in the first trimester and the end of the second trimester. Restricted cubic spline analysis was performed to model the possible non-linear relationships between GWG and adverse outcomes. The optimal GWG was defined as the value of the lowest risk. Non-inferiority margins and the shape of the spline curves identified the recommended ranges in Chinese-specific BMI categories.
Setting:
Tianjin Maternal and Child Health Cohort.
Participants:
Singleton pregnant women aged 18–45 years.
Results:
In total, 69 859 pregnant women were included. Adverse outcome (including stillbirth, preterm birth, hypertensive disorders of pregnancy, gestational diabetes mellitus, small and large for gestational age) was significantly associated with GWG at the end of the second trimester. The risk score was non-linearly correlated with GWG in the underweight, normal weight and overweight groups. GWG at the end of the second trimester should not be < 7 kg in underweight group. For most normal-weight women, a GWG of about 8 kg is optimal. Pregnant women who are overweight should not have a GWG of more than 9 kg. We advised women with overweight and obesity to keep positive growth of GWG (> 0 kg) in the first and second trimesters.
Conclusions:
According to the comprehensive adverse maternal and infant outcomes, we recommend the optimal GWG at the end of the second trimester. This study may provide a considerable reference for weight management.
Drillholes on shells provide a useful way to investigate prey and predator relationships. The current study documents predator–prey interactions exemplified by a faunal assemblage of the fossil gastropod Turritella cingulifera from the Pleistocene Szekou Formation in Hengchun Peninsula, Taiwan. All recognisable skeletal and shell fragments that are larger than 3 mm in size were collected and recorded. Processed bulk sediments (5.24 kg) contained 1462 molluscan shells, including 824 specimens of T. cingulifera, and 27 non-molluscan invertebrates. In the current study, approximately 41.6% (609/1462) of molluscs are drilled with at least one hole. Drilling intensities (DIs) regardless of shell completeness in all gastropods, bivalves and the turritelline gastropod T. cingulifera are 0.546, 0.060 and 0.413, respectively. DI on turritellids is significantly lower than that on other gastropods (χ2= 21.039, P < 0.001). Furthermore, the percentage of drillholes that occur in multiply drilled specimens is 34.7% (95/275) for turritelline gastropods based on complete to nearly complete specimens (n = 588). Our study shows no significant preference of drillhole position either on the suture or on the whorl (χ2= 0.055, P = 0.814). Most drillholes are located in whorls two to four proximal to the aperture. Drillhole diameters of the shells with one drillhole and ones with multiple drillholes are 1.0 and 0.5 mm on average, and the results of Mann–Whitney tests indicate that they are significantly different (P < 0.001). The first turritelline gastropod shell with an incomplete drillhole from Taiwan is documented here. The dominant drilling predators were naticids based on the drillhole morphology and the presence of naticids in the same assemblage. No apparent prey size selectivity is observed, so a ‘size refugium’ does not exist for the turritellids in the current study.
We explored long-term employment status and income before and after depression diagnosis among men and women and at different working ages in Taiwan.
Methods
Data from 2006 to 2019 were obtained from the National Health Insurance Research Database (NHIRD). Individuals with newly diagnosed depressive disorder aged 15 to 64 years during the study period were identified. An equal number of individuals without depression were matched for their demographic and clinical characteristics. Employment outcomes included employment status, which was categorized into employed or unemployed, and annual income. Based on the occupation categories and monthly insurance salary recorded in the Registry for Beneficiaries of the NHIRD, a subject was defined as unemployed if he or she differed from the income earner or the occupation category was unemployed. Monthly income was defined as zero for unemployed subjects and proxied as monthly insurance salary for others. Annual income was the sum of monthly income in each observation year.
Results
A total of 420,935 individuals with depressive disorder were included in the study, and an equal number of individuals with not diagnosed depression served as controls. Employment rate and income were lower in the depression group than in the control group before the year of diagnosis, with a difference of 5.7% in employment rate and USD 1,173 in annual income. This gap increased considerably after the year of diagnosis (7.3% in employment rate and USD 1,573 in annual incomes) and further widened in the subsequent years (8.1% in employment rate and USD 2,006 in annual incomes in the 5th following year). The drops in the employment rate and income caused by depression were more evident in men and older age groups than in women and younger age groups, respectively. However, the reduction in employment rate and income in the following years after the diagnosis was more considerable among younger age groups.
Conclusions
The effect of depression on employment status and income was significant during the year of diagnosis and continued afterwards. The effect on employment outcomes varied between genders and across all age groups.
Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear.
Aims
To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders.
Method
Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders.
Results
A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02–5.29) or accident (RR = 1.62, 95% CI 1.43–1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40–1.66), bipolar disorder (RR = 1.99, 95% CI 1.83–2.16), MDD (RR = 1.98, 95% CI 1.89–2.08) or ADHD (RR = 1.34, 95% CI 1.24–1.44).
Conclusions
Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.
The relationship between magmatism and gold mineralization has been a topic of interest in understanding the formation of ore deposits. The Baizhangzi gold deposit, located in the northern margin of the North China Craton, is hosted by the Baizhangzi granite (BZG) and provides a case to evaluate the relation between granite and gold mineralization in Late Triassic. In this study, we present petrography, bulk geochemistry, zircon U-Pb isotope and trace elements data, as well as major elements of biotite and plagioclase for the BZG to evaluate the petrogenesis and link with gold mineralization. The BZG comprises biotite monzogranite, biotite-bearing monzogranite and monzogranite (BZGs). Zircon U-Pb geochronology shows that all the granitoids of BZGs were coeval with a formation age of 232 Ma. The granitoids, with high SiO2, Al2O3 and Sr, while low Y and Yb, show adakitic affinity. They are enriched in LILFs (e.g., Rb, Ba, Th, U and Sr) and LREEs, while depletion in HFSEs (e.g., Nb, Ta, P and Ti). The geochemical and mineral chemical data suggest that the granitoids have experienced the fractional crystallization of biotite + plagioclase + K- feldspar + apatite. Crystallization temperature is estimated as ca. 700°C, and pressure is between 0.71 kbar and 1.60 kbar. The monzogranite shows higher values of logfO2, △FMQ and △NNO than the biotite-bearing monzogranite, ranging from −19.76 to −11.71, −4.93 to +3.67 and −5.48 to +3.11, respectively. The fractional crystallization, together with high fO2, K-metasomatism and low evolution degree, provided favourable conditions for gold mineralization.
During the COVID-19 outbreak in May 2021, Taipei City has transformed many vacant hotels to augmented quarantine hotels, recruiting retired medical staff to provide medical care, in order to preserve hospitals’ medical capabilities. In an augmented quarantine hotel at Caesar Park Hotel Taipei, the complexity of COVID quarantine, quarantine status of the residents, and hotel staff working with medical staff has made the original emergency response plan inappropriate. Henceforth, a series of modifications were made to ensure the emergency response readiness of Caesar Park Hotel Taipei.
Method:
The enhancements of emergency response capability of the augmented quarantine hotel at the Caesar Park Hotel Taipei, were made in accordance with the following list: 1. Revise evacuation plan, 2. Setup emergency equipment cart, 3. Modify emergency response procedure, 4. Update staff training and resident notice, 5. Routine stock count of medical supplies and emergency equipment.
Results:
The enhanced emergency response plan has ensured the safety of all personnel, plans were made in accordance with the COVID-19 quarantine status, and the staff has a clear perception of their duty with a picture of the overall emergency response plan.
Conclusion:
The enhanced emergency response plan was completed and under implementation in June 2021, and at the end of that month there was a fire that took four lives with 22 injured at a quarantine hotel in Changhua County. A review of the enhanced emergency response plan was made by the staff and corresponding hospital; many problems that happened at the Chunghua County quarantine hotel fire had already been considered or prevented in the enhanced emergency response plan. Such a method for building an enhanced emergency response plan has the potential to be implemented in more locations, and possibly in different scenarios.
OBJECTIVES/GOALS: The goal of this study was to develop a clinically applicable technique to increase the precision of in vivo dose monitoring during radiation therapy by mapping the dose deposition and resolving the temporal dose accumulation while the treatment is being delivered in real time. METHODS/STUDY POPULATION: Ironizing radiation acoustic imaging (iRAI) is a novel imaging concept with the potential to map the delivered radiation dose on anatomic structure in real time during external beam radiation therapy without interrupting the clinical workflow. The iRAI system consisted of a custom-designed two-dimensional (2D) matrix transducer array with integrated preamplifier array, driven by a clinic-ready ultrasound imaging platform. The feasibility of iRAI volumetric imaging in mapping dose delivery and real-time monitoring of temporal dose accumulation in a clinical treatment plan were investigated with a phantom, a rabbit model, and a cancer patient. RESULTS/ANTICIPATED RESULTS: The total dose deposition and temporal dose accumulation in 3D space of a clinical C-shape treatment plan in a targeted region were first imaged and optimized in a phantom. Then, semi-quantitative iRAI measurements were achieved in an in vivo rabbit model. Finally, for the first time, real-time visualization of radiation dose delivered deep in a patient with liver metastases was performed with a clinical linear accelerator. These studies demonstrate the potential of iRAI to monitor and quantify the radiation dose deposition during treatment. DISCUSSION/SIGNIFICANCE: Described here is the pioneering role of an iRAI system in mapping the 3D radiation dose deposition of a complex clinical radiotherapy treatment plan. iRAI offers a cost-effective and practical solution for real-time visualization of 3D radiation dose delivery, potentially leading to personalized radiotherapy with optimal efficacy and safety.