The aim of this study was to assess which machine, Radixact or CyberKnife, can deliver better treatment for lung and prostate stereotactic body radiation therapy (SBRT) with the use of Synchrony® real-time motion tracking system. Ten and eight patients treated with lung and prostate SBRT, respectively, using the CyberKnife system were selected for the assessment. For each patient, a retrospective Radixact plan was created and compared with the original CyberKnife plan. There was no statistically significant difference in the new conformity index of the Radixact plans and that of the Cyberknife plans in both lung and prostate SBRT. The average homogeneity index in the Radixact plans was better in both lung and prostate SBRT with statistical significance (p = 0·04 for lung and p = 0·02 for prostate). In lung SBRT, the dose to lungs was lower in Cyberknife plans (p = 0·002). In prostate SBRT, there was no statistically significant difference in organs at risk sparing between Cyberknife plans and Radixact plans. In conclusion, CyberKnife was better in lung SBRT while Radixact was better in prostate SBRT.

To investigate the downstream rim seal gas ingestion characteristics of a 1.5-stage turbine, the URANS equations were solved numerically using the SST turbulence model. The effects of different purge flow rates and the second vane on the ingestion characteristics of the aft cavity and the nonuniform fluctuations of the main gas path pressure are analysed. The results showed that the aft cavity is affected by the combined effects of the blade and the second vane, and the potential field at the leading edge of the second vane greatly influence the airflow variation in the aft cavity, which enhances the ingress of the mainstream into the wheel-space. The front purge flow weakens the egress between the suction side of the blade and the suction side of the second vane. The potential field at the leading edge of the second vane suppresses the nonuniform distribution of airflow in the aft cavity caused by the rotational effect of the blade.

The epidemic of tuberculosis has posed a serious burden in Qinghai province, it is necessary to clarify the epidemiological characteristics and spatial-temporal distribution of TB for future prevention and control measures. We used descriptive epidemiological methods and spatial statistical analysis including spatial correlation and spatial-temporal analysis in this study. Furthermore, we applied an exponential smoothing model for TB epidemiological trend forecasting. Of 43 859 TB cases, the sex ratio was 1.27:1 (M:F), and the average annual TB registered incidence was 70.00/100 000 of 2009–2019. More cases were reported in March and April, and the worst TB stricken regions were the prefectures of Golog and Yushu. High TB registered incidences were seen in males, farmers and herdsmen, Tibetans, or elderly people. 7132 cases were intractable, which were recurrent, drug resistant, or co-infected with other infections. Three likely cases clusters with significant high risk were found by spatial-temporal scan on data of 2009–2019. The exponential smoothing winters' additive model was selected as the best-fitting model to forecast monthly TB cases in the future. This research indicated that TB in Qinghai is still a serious threaten to the local residents' health. Multi-departmental collaboration and funds special for TB treatments and control are still needed, and the exponential smoothing model is promising which could be applied for forecasting of TB epidemic trend in this high-altitude province.

During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders’ familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions.

These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.

We conducted the first detailed mineral magnetic investigation of more than nine loess–paleosol couplets of the composite Titel-Stari Slankamen loess section in Serbia, which provides one of the longest and most complete terrestrial record of paleoclimatic changes in Europe since ~1.0 Ma. The results show that the ferrimagnetic mineral assemblage of the loess units is dominated by partially oxidized multidomain (MD) and pseudo-single domain (PSD) magnetite; however, with an increasing degree of pedogenesis, the eolian contribution is gradually masked by pedogenic superparamagnetic(SP) and single-domain (SD) ferrimagnets (mainly maghemite). The overall consistency of ferrimagnetic grain-size parameters indicates an absence of dissolution of the fine-grained ferrimagnetic fraction despite changes in climate regime over the past 1.0 Ma. The variations of normalized dJ/dT@120K and normalized χheating@530°C reflect a long-term stepwise increase in aridity during glacials with a major step at ~0.6–0.5 Ma, over the last 1.0 Ma. Overall, the results provide an improved basis for the future use of the magnetic properties of Serbian loess deposits for paleoclimatic reconstruction.

This work is the first in situ U–Pb geochronological study of perovskite and calcic garnet (andradite) from the Guli complex in the Maimecha–Kotuy alkaline province (Polar Siberia, Russia). The U–Pb isotopic compositions of perovskite from contact zones of the two carbonatite stocks (Southern and Northern) and from jacupirangite separating the stocks were determined by laser-ablation inductively-coupled-plasma mass-spectrometry (LA-ICPMS) and isotope-dilution thermal-ionisation mass-spectrometry (ID-TIMS). The LA-ICPMS and ID-TIMS data for perovskite from the Northern carbonatite stock are in good agreement, yielding 206Pb/238U ages of 250.4 ± 1.1 Ma and 249 ± 2 Ma, respectively. These ages are also within the analytical uncertainty from the ID-TIMS results for perovskite from jacupirangites (250 ± 1 Ma). The LA-ICPMS results for perovskite from the Southern carbonatite stock indicate its somewhat older age (255.3 ± 2.4 Ma), implying the possibility of small-volume mantle magmatism predating the eruption of the Siberian flood basalts at ca. 252–251 Ma. This interpretation is supported by reports of pre-flood magmatism elsewhere in eastern Siberia. Andradite crystals from the contact between the Southern stock and metasomatised melilitolite were analysed by ID-TIMS. These measurements are inconclusive (247 ± 6 Ma) and could not be used to constrain further the timing of carbonatitic magmatism in the southern part of the complex. The present contribution also presents a refined methodology for LA-ICPMS geochronological studies of perovskite with elevated levels of common lead, and addresses some of the problems with previously proposed calibration standards.

ABSTRACT IMPACT: Understanding gene expression changes after viral vaccination and booster may help predict vaccine efficacy. OBJECTIVES/GOALS: Utilize a systems biology approach to identify gene expression changes after administration of Zaire Ebola virus glycoprotein expressed in a Chimp Adeno3 vector (ChAd3-EBOZ) and either boosted ˜7 weeks later with modified vaccinia Ankara MVA expressing Zaire and Marburg GPs plus Tai forest NP (MVA-BN ®Filo) or given saline (placebo). METHODS/STUDY POPULATION: As part of the phase 1b, open-label vaccination trial of ChAd3-EBO-Z in Mali, West Africa, peripheral blood mononuclear cells were isolated from eight volunteers for whole genome transcriptomics analysis. Four subjects received the MVA-BN ®-Filo booster and four received saline. Samples were taken prior to receipt of the booster or placebo, as well as 1, 7, and 14 days afterwards. Significant differentially expressed genes were identified using RNA-seq between baseline and post-MVA-BN ®Filo. Functional enrichment analysis against the GO Ontology Database and the Immune Signatures C7 collection of MSigDB (ImmuneSigDB) was performed. These differentially expressed genes were also examined for associations with Ebola antibody titers and cell-mediated immune responses. RESULTS/ANTICIPATED RESULTS: The majority of gene expression changes occurred on day 1 post-MVA-BN ®-Filo administration. 870 genes had significantly different expression when day 1 samples were compared to pre-booster baseline (791 upregulated/79 downregulated). Those upregulated genes are mainly involved type I interferon and regulation of viral life cycle pathways. The downregulated genes are involved in regulation of cellular defense response, lymphocyte mediated immunity. Comparing to the C7 Immune Signatures collection datasets, we identified more than 100 upregulated genes from 6 studies of yellow fever vaccination that were also significantly upregulated in our study. The top enriched ontological pathway of those genes is cellular response to type I Interferon. DISCUSSION/SIGNIFICANCE OF FINDINGS: The use of a systems biology approach to compare gene expression changes among vaccine studies utilizing whole genome transcriptomics data allows the identification of genes involved in the immune response to vaccination and might aid in predicting vaccine efficacy.

This study aimed to investigate the clinical characteristics and to analyse the epidemiological features of coronavirus disease 2019 (COVID-19) patients during convalescence. In this study, we enrolled 71 confirmed cases of COVID-19 who were discharged from hospital and transferred to isolation wards from 6 February to 26 March 2020. They were all employees of Zhongnan Hospital of Wuhan University or their family members of which three cases were <18 years of age. Clinical data were collected and analysed statistically. Forty-one cases (41/71, 57.7%) comprised medical faculty, young and middle-aged patients (aged ⩽60 years) accounted for 81.7% (58/71). The average isolation time period for all adult patients was 13.8 ± 6.1 days. During convalescence, RNA detection results of 35.2% patients (25/71) turned from negative to positive. The longest RNA reversed phase time was 7 days. In all, 52.9% of adult patients (36/68) had no obvious clinical symptoms, and the remaining ones had mild and non-specific clinical symptoms (e.g. cough, sputum, sore throat, disorders of the gastrointestinal tract etc.). Chest CT signs in 89.7% of adult patients (61/68) gradually improved, and in the others, the lesions were eventually absorbed and improved after short-term repeated progression. The main chest CT manifestations of adult patients were normal, GGO or fibre streak shadow, and six patients (8.8%) had extrapulmonary manifestations, but there was no significant correlation with RNA detection results (r = −0.008, P > 0.05). The drug treatment was mainly symptomatic support therapy, and antibiotics and antiviral drugs were ineffective. It is necessary to re-evaluate the isolation time and standard to terminate isolation for discharged COVID-19 patients.

In this paper, the generation of relativistic electron mirrors (REM) and the reflection of an ultra-short laser off the mirrors are discussed, applying two-dimension particle-in-cell simulations. REMs with ultra-high acceleration and expanding velocity can be produced from a solid nanofoil illuminated normally by an ultra-intense femtosecond laser pulse with a sharp rising edge. Chirped attosecond pulse can be produced through the reflection of a counter-propagating probe laser off the accelerating REM. In the electron moving frame, the plasma frequency of the REM keeps decreasing due to its rapid expansion. The laser frequency, on the contrary, keeps increasing due to the acceleration of REM and the relativistic Doppler shift from the lab frame to the electron moving frame. Within an ultra-short time interval, the two frequencies will be equal in the electron moving frame, which leads to the resonance between laser and REM. The reflected radiation near this interval and corresponding spectra will be amplified due to the resonance. Through adjusting the arriving time of the probe laser, a certain part of the reflected field could be selectively amplified or depressed, leading to the selective adjustment of the corresponding spectra.

Many family characteristics were reported to increase the risk of bipolar disorder (BPD). The development of BPD may be mediated through different pathways, involving diverse risk factor profiles. We evaluated the associations of family characteristics to build influential causal-pie models to estimate their contributions on the risk of developing BPD at the population level. We recruited 329 clinically diagnosed BPD patients and 202 healthy controls to collect information in parental psychopathology, parent-child relationship, and conflict within family. Other than logistic regression models, we applied causal-pie models to identify pathways involved with different family factors for BPD. The risk of BPD was significantly increased with parental depression, neurosis, anxiety, paternal substance use problems, and poor relationship with parents. Having a depressed mother further predicted early onset of BPD. Additionally, a greater risk for BPD was observed with higher numbers of paternal/maternal psychopathologies. Three significant risk profiles were identified for BPD, including paternal substance use problems (73.0%), maternal depression (17.6%), and through poor relationship with parents and conflict within the family (6.3%). Our findings demonstrate that different aspects of family characteristics elicit negative impacts on bipolar illness, which can be utilized to target specific factors to design and employ efficient intervention programs.