An elephant in the glasshouse? Trade-offs between acceleration and transformation in COVID-19 vaccine innovation policies.

Against the backdrop of a failing vaccine innovation system, innovation policy aimed at creating a COVID-19 vaccine was surprisingly fast and effective. This paper analyzes the influence of the COVID-19 landscape shock and corresponding innovation policy responses on the existing vaccine innovation system. We use document analysis and expert interviews, performed during vaccine development. We find that the sharing of responsibility between public and private actors on various geographical levels, and the focus on accelerating changes in the innovation system were instrumental in achieving fast results. Simultaneously, the acceleration exacerbated existing societal innovation barriers, such as vaccine hesitancy, health inequity, and contested privatization of earnings. Going forward, these innovation barriers may limit the legitimacy of the vaccine innovation system and reduce pandemic preparedness. Next to a focus on acceleration, transformative innovation policies for achieving sustainable pandemic preparedness are still urgently needed. Implications for mission-oriented innovation policy are discussed.

Zoonotic urbanisation: multispecies urbanism and the rescaling of urban epidemiology

A focus on zoonotic urbanisation challenges existing conceptions of global urbanism. In this article I consider how a modified urban political ecology framework might help to illuminate emerging landscapes of epidemiological risk. I show how a multi-scalar perspective on urban epidemiology, including the impact of colonialism, global capitalism, and changing relations with non-human others, unsettles existing analytical approaches. I contrast resilience-oriented public health paradigms, focused on the malleability of nature, with a historically grounded set of insights into global environmental change. I suggest that the conceptual field of zoonotic urbanisation provides an analytical entry point for understanding an emergent 'triple crisis' spanning climate change, biodiversity loss, and global health threats.

AxeLatoon - Let's Build an Accelerator at School !

High Energy Accelerator Research Organization (KEK) launched an education project for the fabrication of an accelerator named "AxeLatoon" in 2020 together with the National Institute of Technology (KOSEN). This project aims to improve engineering skills of students and foster the next generation of accelerator researchers by providing hands-on training in the field of accelerator science. In the first year, we collaborated with the NIT (KOSEN), Ibaraki College to build an accelerator. Students took the initiative in this extracurricular activity and challenged building an accelerator. From 2021, we expanded this project to other prefectures and four schools are now participating. The design and fabrication of a small cyclotron accelerator is currently underway. Despite the restrictions on activities and the limited mobility of people due to the novel coronavirus pandemic, the project continues to educate students about basic technologies and accelerators. We are holding seminars a few times a month utilizing online communication tools. In this report, we would like to share the status of AxeLatoon's activities based on the actual production of students at KOSEN and deepen the discussion on accelerator outreach programs. © Copyright owned by the author(s) under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0)

MACHINA, the Movable Accelerator for Cultural Heritage In-situ Non-destructive Analysis: project overview

Over the years, transportable instrumentation for cultural heritage (CH) in situ measurements has noticeably widespread, due to logistic, economical and safety reasons. Ion beam analysis, a powerful set of analytical techniques, of great importance for CH, is instead carried out by using fixed instrumentation. To overcome this limit, the Italian national Institute of Nuclear Physics (INFN), CERN (European Centre for Nuclear Research) and the Opificio delle Pietre Dure (OPD), started MACHINA, the "Movable Accelerator for CH In-situ Non-destructive Analysis: the new generation of accelerators for art” to build a transportable accelerator, compact, with strongly reduced weight, absorbed power and cost. MACHINA will be installed at the OPD and dedicated to CH. It will be moved to major conservation centres and museums, when needed. The INFN-CERN proposal, approved in December 2017, became operative in February 2018. 2018 was dedicated to the acquisition of material/instrumentations, to set up both a dummy accelerator (to test the vacuum system) and a vacuum chamber (to test the source). Due to COVID, in 2020 and 2021 the experimental work was slowed down, but we kept developing the control electronics/software and built the second-generation supporting structure. The HF-RFQ power supplies were integrated in October 2021. At the rise of 2022, after conditioning the cavities, we tested the system and in March 2022 we got the first extracted 2-MeV proton beam. In this paper, we present the structure of the MACHINA system, the approach followed and the main solutions adopted, with a special focus on the control system, and finally the first experimental results. © 2023, The Author(s).

Supporting Tech Founders—A Needs-Must Approach to the Delivery of Acceleration Programmes for a Post-Pandemic World

Along with most economic sectors, the COVID-19 crisis has had a strong impact on start-up accelerators, forcing them to seek urgent and imaginative solutions to quickly adapt to a new environment. The enforced change brought challenges that have been exacerbated by the sudden slowdown in economic activity. Despite these difficulties, it has become clear that the accelerated digital transformation that emerged through a needs-must approach to engage with start-ups through remote means has also presented new opportunities for accelerators to improve their programmes. This article analyses the impact of the COVID crisis on the organisation and results obtained by a European accelerator, which delivers programmes for growth stage technology start-ups. For this purpose, two very similar programmes have been analysed and compared: one focused on industrial technologies (delivered in 2019–2020) and another one focused on products and services built on space technologies (2020–2021). The research has been undertaken using observational techniques, reinforced through the collection of primary and secondary data throughout the study duration. The result of the analysis point to a possible post-COVID accelerator model that blends online and remote delivery as a new way of improving the experience of start-ups and optimising the use of scarce resources. © 2023 by the authors.

Promotion of entrepreneurship through business incubators: Regional analysis in Spain

This study focuses on business incubators in Spain, which helps compare regions within Spain. This study has four goals: to shape taxonomy of the Spanish business incubator system, to compare between regions, to identify the factors affecting incubators' success, and to analyse during the COVID pandemic. Of the 478 business incubators registered in Spain, 89 were selected as the sample for study. Business incubators provide office space, equipment and mentoring services, as well as financial, legal and administrative support for entrepreneurs and start-up companies. Non-parametric statistical techniques are used to compare between regions, considering each regional business incubator as an ecosystem. The study focuses on six Spanish regions: Madrid, Catalonia, Castile-Leon, Aragon, Basque Country and Galicia. © 2023 Elsevier Inc.

Rapid determination of SARS-CoV-2 nucleocapsid proteins based on 2D/2D MXene/P-BiOCl/Ru(bpy)32+ heterojunction composites to enhance electrochemiluminescence performance.

At the end of 2019, the novel coronavirus disease 2019 (COVID-19), a cluster of atypical pneumonia caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been known as a highly contagious disease. Herein, we report the MXene/P-BiOCl/Ru(bpy)32+ heterojunction composite to construct an electrochemiluminescence (ECL) immunosensor for SARS-CoV-2 nucleocapsid protein (CoVNP) determination. Two-dimensional (2D) material ultrathin phosphorus-doped bismuth oxychloride (P-BiOCl) is exploited and first applied in ECL. 2D architectures MXene not only act as "soft substrate" to improve the properties of P-BiOCl, but also synergistically work with P-BiOCl. Owing to the inimitable set of bulk and interfacial properties, intrinsic high electrochemical conductivity, hydrophilicity and good biocompatible of 2D/2D MXene/P-BiOCl/Ru(bpy)32+, this as-exploited heterojunction composite is an efficient signal amplifier and co-reaction accelerator in the presence of tri-n-propylamine (TPA) as a coreactant. The proposed MXene/P-BiOCl/Ru(bpy)32+-TPA system exhibits a high and stable ECL signal and achieves ECL emission quenching for "signal on-off" recognition of CoVNP. Fascinatingly, the constructed ECL biosensor towards CoVNP allows a wide linear concentration range from 1 fg/mL to 10 ng/mL and a low limit of detection (LOD) of 0.49 fg/mL (S/N = 3). Furthermore, this presented strategy sheds light on designing a highly efficient ECL nanostructure through the combination of 2D MXene architectures with 2D semiconductor materials in the field of nanomedicine. This ECL biosensor can successfully detect CoVNP in human serum, which can promote the prosperity and development of diagnostic methods of SARS-CoV-2.

Optimization Design of X-ray Flattening Filter and Shielding of 25 MeV Electron Accelerator Used for Blood Irradiator

According to the epidemic prevention requirements of the coronavirus disease 2019 and technical requirements of blood irradiators, a new type of blood irradiator based on X band 2.5 MeV electron linear accelerator has been developed at Xihua University. In this paper, MCNP5 was used to optimize the design of flattening filter and shielding of X ray beam of the blood irradiator, and relevant experimental verification was carried out. After optimization design, the X ray beam flatness of the blood irradiator is improved from 59.8% to 92.4%, the weight of the shielding structure is reduced, and the maximum dose rate at 50 mm around the shielding body is 1 μSv/h, which is much better than the Chinese national standard of blood irradiator. © 2022, Editorial Board of Nuclear Electronics & Detection Tech. All right reserved.

BEACON: Scalable Near-Data-Processing Accelerators for Genome Analysis near Memory Pool with the CXL Support

Genome analysis benefits precise medical care, wildlife conservation, pandemic treatment (e.g., COVID-19), and so on. Unfortunately, in genome analysis, the speed of data processing lags far behind the speed of data generation. Thus, hardware acceleration turns out to be necessary. As many applications in genome analysis are memory-bound, Processing-In-Memory (PIM) and Near-Data-Processing (NDP) solutions have been explored to tackle this problem. In particular, the Dual-Inline-Memory-Module (DIMM) based designs are very promising due to their non-invasive feature to the cost-sensitive DRAM dies. However, they have two critical limitations, i.e., performance bottle-necked by communication and the limited potential for memory expansion. In this paper, we address these two limitations by designing novel DIMM based accelerators located near the dis-aggregated memory pool with the support from the Compute Express Link (CXL), aiming to leverage the abundant memory within the memory pool and the high communication bandwidth provided by CXL. We propose BEACON, Scalable Near-Data-Processing Accelerators for Genome Analysis near Memory Pool with the CXL Support. BEAC-ON ad-opts a software-hardware co-design approach to tackle the above two limitations. The BEACON architecture builds the foundation for efficient communication and memory expansion by reducing data movement and leveraging the high communication bandwidth provided by CXL. Based on the BEACON architecture, we propose a memory management framework to enable memory expansion with unmodified CXL-DIMMs and further optimize communication by improving data locality. We also propose algorithm-specific optimizations to further boost the performance of BEACON. In addition, BEACON provides two design choices, i.e., BEACON- D and BEACON-S. BEACON-D and BEACON-S perform the computation within the enhanced CXL-DIMMs and enhanced CXL-Switches, respectively. Experimental results show that compared with state-of-the-art DIMM based NDP accelerators, on average, BEACON-D and BEACON-S improve the performance by 4. 70x and 4. 13x, respectively. © 2022 IEEE.

Northern Perspectives: Commissioning and Clinical Operation of the Northernmost Linear Accelerators in Canada

Purpose: Offering radiation therapy services closer to northern communities is an exciting step forward in improving patient quality of care in Canada. Thanks to close collaboration between Alberta cancer centers, expert and high quality treatment is now possible closer to home for more Canadians. Methods: The development of an excellent program in a short time frame was possible thanks to strong collaborations within Alberta as well as with the wider Medical Physics community. Virtualization of training and day-to-day communication allows a center, 500 km away from the next nearest radiation therapy program, to still draw on expertise of dozens of medical physicists, radiation therapists, and radiation oncologists. Results: A collaborative and competent local team has come together around a patient centric program that treats patients close to home. The team is treating 14 patients daily. With staffing to fully utilizing one unit at a time, the team has treated over 60 patients since opening. The response from the community is overwhelmingly positive and there is high demand for treatments. Conclusion: A new radiation therapy treatment center was opened in a northern community during a global pandemic. Lessons learned have application to the opening of radiation therapy centers across Canada especially as Covid continues to be an ebbing and flowing global threat. The response from the community and the benefits to patient quality of life is also motivation for other jurisdictions to bring radiation therapy closer to all Canadians.

Accelerated LD-based selective sweep detection using GPUs and FPGAs

Selective sweep detection carries theoretical significance and has several practical implications, from explaining the adaptive evolution of a species in an environment to understanding the emergence of viruses from animals, such as SARS-CoV-2, and their transmission from human to human. The plethora of available genomic data for population genetic analyses, however, poses various computational challenges to existing methods and tools, leading to prohibitively long analysis times. In this work, we accelerate LD (Linkage Disequilibrium) - based selective sweep detection using GPUs and FPGAs on personal computers and datacenter infrastructures. LD has been previously efficiently accelerated with both GPUs and FPGAs. However, LD alone cannot serve as an indicator of selective sweeps. Here, we complement previous research with dedicated accelerators for the ω statistic, which is a direct indicator of a selective sweep. We evaluate performance of our accelerator solutions for computing the w statistic and for a complete sweep detection method, as implemented by the open-source software OmegaPlus. In comparison with a single CPU core, the FPGA accelerator delivers up to 57.1× and 61.7× faster computation of the ω statistic and the complete sweep detection analysis, respectively. The respective attained speedups by the GPU-accelerated version of OmegaPlus are 2.9× and 12.9×. The GPU-accelerated implementation is available for download here: https://github.com/MrKzn/omegaplus.git. © 2022 IEEE.

FLASH in the Clinic Track (Oral Presentations) RAPID CONVALESCENT PLASMA STERILIZATION USING HIGH DOSE RATE ELECTRON RADIATION

Background and Aims: Passive antibody administration through convalescent plasma has shown benefit in treating COVID-19 in the early stages of the disease in patients >65 years old, and in other viral outbreaks. A practical, rapid method to sterilize convalescent plasma while also maintaining antibody function would be valuable for safe treatment in future viral pandemics. Plasma sterilization by irradiation requires kGy of dose to deactivate bacteria and viruses of concern. Conventional lab-based irradiators would require days to reach such doses, while ultra-high dose rate irradiation (FLASH) would require minutes. We present a proof-of-concept on sterilizing plasma with 25 kGy in approximately 3 minutes without damaging the antibodies in the plasma. Methods: A Varian Trilogy LINAC was configured for 16 MeV FLASH electron irradiation. Frozen aliquots of convalescent plasma from patients with COVID-19 were placed in a 3D printed holder submerged in liquid aiming to preserve sample temperature (RT, 4°C or –20°C). The number of pulses was estimated with EBT-XD film. Samples were irradiated with a dose of 25 kGy in ~33,330 pulses over 185 seconds. Antibody binding against the receptor-binding domain (RBD) of the S1 region of SARS-CoV-2 was measured by ELISA pre- and post-irradiation. Results: Frozen plasma aliquots from 10 COVID-19 convalescent plasma donors were irradiated in frozen state to 25 kGy dose. IgG antibody binding against SARS-CoV-2 RBD after irradiation remained at 90.8% of non-irradiated samples (Fig. 1;OD 1.25 vs. 1.36, p<0.0003). (Figure Presented) Fig. 1 ( O034). Plasma aliquots from 10 convalescent plasma samples were irradiated at sterilizing 25-kGy doses. IgG binding to SARS-CoV-2 RBD antigen by ELISA is 90.8% compared to unirradiated. Conclusions: FLASH irradiation allows for rapid sterilization of blood plasma from potential pathogens while largely preserving antibody binding function and specificity.

Implementation of marker less Surface Guided Radiotherapy in a complex multi-stakeholder environment

Purpose or Objective Surface guided Radiotherapy (SGRT) is more and more used in radiation therapy. With SGRT a marker less patient’s workflow can be implemented in a radiotherapy center and will give patients more comfort during their treatments, skin marks should no longer be placed. The implementation of SGRT in a Radiotherapy Network Centre with 4 radiotherapy sites and 9 linear accelerators can be quite challenging. This work demonstrates the steps adopted in our Network for the implementation of a SGRT system and the progressive transition to a marker less Radiotherapy with the use of a “Superusers” Team. Materials and Methods In October 2020 we have started the implementation of C-Rad Surface Guided Radiotherapy system in our Radiotherapy Network Center. We began with a “Superusers” Team - a selected group of 5 RTTS and 3 physicists with previous extended experience on SGRT/ tattoo less. The implementation of SGRT was progressive and included: I) Superusertraining by cRAD II) Training of the “Superusers” team at one linear accelerator in order to evaluate current used methods, identify bottlenecks and troubleshooting and create a new uniformized workflow III) Introduction of table parameters, since the Surface scanning system can only give accurate measurements with object within 5 cm of targeted position IV) Going Marker less meaning new patients had no tattoos workflow V) Create support materials, such as the positioning and procedure manuals. VI) Train the RTT’s. A SWOT analyze (see fig 1) was done by the superuserteam, our management and cRAD. (Figure Presented) Results From SWOT analyze, we see that the use of a Superuser team concept has helped with the fast implementation of marker less SGRT based positioning workflow and especially in a period of Covid-19. In one year, we have implemented SGRT in 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs. The more RTTs were trained and used to the new workflow, time of implementing in a new machine became shorter. At the time of writing, more than 75% of the treated population is in a tattoo less workflow. (See fig 2) (Figure Presented) Conclusion The use of the Superusers principe has allowed the implementation of marker less SGRT based positioning workflow in a one-year period at 3 radiotherapy sites totaling 7 linear accelerators and 25 trained RTTs.

Academic Moral Entrepreneurship and Knowledge Translation to Turn Crises Into Opportunities: The Case of VeniSIA

Crises generate disruptions, but they can also foster the development of academic moral entrepreneurship when the stakeholders'engagement is obtained. In this article, we present how knowledge translation (KT) was used to create stakeholder engagement in the academic moral entrepreneurship case of the Venice sustainability innovation accelerator (VeniSIA), an accelerator for sustainable business ventures developed by Ca'Foscari University of Venice, Italy. The extraordinary floods of 2019 and the early waves of the COVID-19 pandemic challenged the survival of the unique city of Venice, which was experiencing a decay crisis that seemed endless. However, the university functioned as a moral entrepreneur, rule enforcer, and catalyst to promote a greater common good. In a three-phase process, dedicated KT tools were adopted to commit various stakeholders from different ecosystems (academics, innovators, partners, and institutions) to align their goals to save the heritage of the city and ensure its sustainable future. This article sheds new light on the university's third mission and the potential yet decisive role of universities and researchers to foster conversations among meaningful stakeholders on topical issues that can shape the future of local and global communities. IEEE

Technological Improvements in Low- and Middle-Income Countries (LMICs): A Review of the Literature and the "Sociedad de Lucha Contra el Cáncer" (SOLCA) Institutional Experience in Neuro-Radiosurgery During the Coronavirus Disease 2019 (COVID-19) Pandemic.

OBJECTIVE: Neurosurgery is a medical field that requires specialized professionals and equipment, 2 important but scarce resources in low- and middle-income countries. Our goal was to report our experience with the replacement and implementation of linear accelerators with radiosurgery capabilities at "Sociedad de Lucha Contra el Cáncer" (SOLCA) Hospital in Quito, Ecuador, and give some recommendations for future technological replacements (TRs). METHODS: Two surveys were performed in SOLCA's radiosurgery department, one before the TR was finalized and one after, consisting of an open and multiple-choice questionnaire. Questions focused on the performance of the new equipment, perceptions regarding the training, and the influence of the pandemic on the whole process. In addition, we share our experience regarding the difficulties and benefits of TR at SOLCA. RESULTS: The most-reported limitation was lack of training (48%). By the time of the second survey, 95.2% of the staff had already treated patients or planned a radiosurgical procedure; 42.9% considered training to have been adequate, and 76.2% felt that the pandemic hindered the training process. Currently, 33 radiosurgeries have been done (26 for the central nervous system and 7 stereotactic radiation body therapies). CONCLUSIONS: The TR in SOLCA had similarities with other experiences in low- and middle-income countries, but the pandemic brought additional limitations, mainly complicating the staff training. Nevertheless, those limitations can be resolved with a structured training program and international collaboration. Overall, the benefits obtained from a TR result in exponentially better medical care and accessibility to novel treatments.

Applying the Investment Multiplier to Identify Key Points of Economic Growth

The crisis phenomena irregularity due to the COVID-19 pandemic requires new, to a certain extent, non-routine tools for their settlement, namely the action effect enhancers of the state and private investors to develop the economy in conditions of shrinking volumes of available financial resources. The paper proposes the Investment Multiplier (IM) as such a tool. The author's model was generated based on a detailed description of developing multiplier processes to analyze its action. The study aims to estimate the IM values of the economies of Kurgan, Sverdlovsk, and Chelyabinsk, the most industrially developed Russian regions, and identify the main points of their economic growth. The key research method was regression analysis. The present study establishes interconnectivity between marginal propensity and savings, marginal propensity and imports, marginal tax rate, and investment accelerator, and their influence on the regional multiplier. From a position of investment multiplier, the authors try to narrow the research gap in how investment policies influence the economic growth of the Russian regions. The study results determine IM values for the analyzed regions, identifying their differences and reasons. The key points of economic growth in these regions were identified. The scientific novelty involves applying changes in regional multiplier processes' dynamics to determine the key development points. The practical significance is that the IM value is an analytical tool that will identify existing key points of regional economic development and, by managing the IM value, create new points for investments with a large-scale multiplier effect, thus developing the regional economy. © 2022 by the authors. Licensee ESJ, Italy. Commons Attribution (CC-BY) license (https:.

Real-time Face Mask Detection System on Edge using Deep Learning and Hardware Accelerators

Real-time face mask detection with the use of Artificial Intelligence is one of the most advanced ways of detecting face masks and their wearing condition in public or private areas. In this work, a system based on Object Detection models is proposed which can detect and classify the type of mask wearing conditions in real-time. The system is implemented with two latest deep convolutional neural networks;YOLOv5s and YOLOv5l. The proposed system can efficiently detect and classify face masks based on their wearing condition as well as count them and store the count into a CSV file format with a timestamp. To perform real-time inference, the deep learning models were deployed on Nvidia Jetson Nano and Jetson Xavier NX which are embedded solutions inspired by Edge AI. The detection algorithms achieved mAP of 86.43 and 92.49 for YOLOv5s and YOLOv5l respectively. Comparing the mAP of both detection models, YOLOv5l achieved higher mAP than YOLOv5s while comparing fps on both hardware, Nvidia Jetson Xavier NX provides more fps than Nvidia Jestion Nano for realtime inference. © 2021 IEEE.

Management of the Russian Interregional Investment Distribution Using the Autonomous Expenditure Multiplier Model

An effective and competitive investment policy requires improvements to the existing tools. The ongoing COVID‐19 crisis requires understanding as to how the recovery processes should be implemented. This study aims to develop a model for determining the autonomous expenditure multiplier (AEM) values, considering the investment accelerator action. The scientific novelty consists of proving that the AEM is not only an effects enhancer of the government and private invest-ment, but also a tool to specify on the regional industrial map of Russia where investment projects will allow significant economic growth. The work’s practical significance consists of determining the possibility of applying the AEM as a tool to improve investment efficiency. The key research method was paired linear regression analysis. Based on the developed model, the AEM values for the economies of the five Central Federal District regions are calculated. Additionally, authors pro-vide an explanation on how AEM values correlate to regional economic specialization. For example, atypically low AEM values for Moscow can be explained by high daily workforce movement among Moscow and the Moscow region. The information support difficulties of the proposed model are defined, and the directions to overcome them are proposed. Empirical results show significant dif-ferences in the AEM values of the researched regions, and that the AEM as a management tool for interregional investment distribution will help to invest the limited resources of both the state and private businesses more effectively. Additionally, authors establish that the achieved results fall in line with real macroeconomic situations within the regions, which proves that the proposed model reflects real world processes. Primary beneficiaries and end users of the study are government agen-cies, state‐owned corporations, and members of broader scientific community. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

Statewide public radiotherapy services in Victoria: Getting out of service provider silos to improve equity of care and access to optimal treatment

Aim: The healthcare technological revolution has seen many treatment innovations become available to optimise cancer treatments. Radiotherapy has benefited from numerous such innovations however some of this unique equipment is expensive and often targeted towards specific anatomy or tumour types. To enable public radiotherapy services to offer these advanced treatments when very high capital cost was involved, the Victorian government-funded particular specialist radiotherapy machines, designating these as statewide services. This approach aimed to ensure Victorian patients that might benefit most could access these services without cost, while still receiving the rest of their care as close to home as possible. Methods : Government funded public MR linear accelerator (MR-linac) and Gamma Knife™ radiotherapy treatment machines. Both are significantly more expensive than a standard linac and only two of each existed in Australia - none in Victoria - prior to their acquisition. The Victorian 'Statewide radiotherapy services framework' was developed and published to underpin these new services and a website created covering indications information to support and facilitate appropriate referrals of suitable patients from within the state. Additionally, patient-reported outcomes were introduced as a routine part of these services. Results : The Victorian Gamma Knife™ service commenced treatments in 2021 and has already delivered over 135 courses of radiotherapy, 25% of these being for new indications. Treatments have been provided to patients from 85 different locations across the state. Although delayed due to the COVID-19 pandemic and limited worldwide installation expertise of this novel technology, the MR-linac service has just commenced clinical treatments. Conclusions : Statewide specialist radiotherapy services have been developed and implemented, providing fee free access to all Victorians irrespective of their place of residence. With more personalised cancer treatments becoming routine, a cost-effective way to have expensive equipment available to treat those who could most benefit has been established.