Objectives/Goals: Community-based practices have limited research opportunities for providers. As a rural community-based health system, Mayo Clinic Health System (MCHS) sought to create intramural funding mechanisms to help early-stage researchers conduct pilot research so they are more competitive to compete for more robust extramural funding opportunities. Methods/Study Population: We created a Research Seed Grant Program infrastructure across our four MCHS regions (Southwest and Southeast Minnesota, Northwest and Southwest Wisconsin). This model program featured an initial research funding announcement call based on 6 prioritized programs (AI Validation & Stewardship, Cancer, Health Equity, Population Health, Rural Health, Learning Healthcare System [LHS]), with submissions uploaded to a central electronic repository. Proposal review and ranking was organized on a regional basis, with ranking of all proposals by at least 2 clinical scientist reviewers according to the NIH domain-specific framework (i.e., 1.0 best > 9.0 worst). Awards were competitively selected by conformity to prioritized research areas and through ranking of most competitive overall application scores. Results/Anticipated Results: For our inaugural RFA, we received 55 grant application submissions across the MCHS regions. Fifteen of the most highly ranked applications were selected for awards on a per region basis, providing direct funding as well as protected investigator research time of 10% for up to six months. The selected projects address several research priorities including improving access, reducing health disparities, improving behavioral health in our communities, increasing cancer screening and prevention, and community-based pragmatic trials and interventions. Outcomes from these now completed pilot projects remain pending at this time. Funding for this seed grant program was supported by philanthropy, Mayo Clinic Research Administration, Mayo Clinic Comprehensive Cancer Center, and the Mayo Clinic CCaTS Rural Core. Discussion/Significance of Impact: We present this framework for a LHS-focused Seed Grant program model for consideration of adoption by other national/international LHS. Future plans include tracking of outcome metrics (e.g., published peer review articles, extramural grant applications) of this initial cycle and future expansion of this program to support the goals of our LHS.

Objectives/Goals: Rural disparities in chronic disease burden are well documented. However, the impact of individual socioeconomic status on these rural disparities in prevalence and control status of chronic diseases remains less understood. We aim to assess the association of prevalence and control status of chronic diseases among adults with rurality and socioeconomic status (SES). Methods/Study Population: The Expanded Rochester Epidemiology Project medical records linkage system identified prevalence of asthma, diabetes, hypertension, and mood disorder using ICD codes between 2014 and 2019 among adults in 27 Upper Midwest counties. Uncontrolled status was defined by presence of ED visit or hospitalization with corresponding ICD-9/10 codes. SES was measured by HOUSES index, a validated individual-level SES measure, and rural status was defined by primary Rural Urban Commuting Area codes of 4–10. Hierarchical logistic regression models were used to examine the association of rurality with prevalence and control status of the four chronic diseases, adjusting for age, sex, race/ethnicity, and presence of general medical exam extracted by CPT codes (Model 1) and additionally SES measured by HOUSES (Model 2). Results/Anticipated Results: Among 455,802 adults, 42.8% were rural residents and 87.4% were Non-Hispanic White. Model 1 (without HOUSES) showed higher prevalence and lower control rates of chronic diseases in rural residents, except for asthma. In Model 2, accounting for SES, urban residents were more likely to have an uncontrolled mood disorder, hypertension, and diabetes, and there were no differences in prevalence of chronic diseases that existed between rural and urban residents. Lower SES measured by HOUSES was consistently and significantly associated with higher prevalence and uncontrolled status of chronic diseases (p-value Discussion/Significance of Impact: Patient’s SES explains rural disparities in prevalence (null association with rurality once SES is accounted) and changes the directionality of association for uncontrolled status in Upper Midwest, highlighting the importance of considering SES in rural disparities research.

Objectives/Goals: Alzheimer’s disease (AD) has limited treatments and an extremely high rate of clinical trial failure. Through a collaborative effort, Agomelatine (AGO) was identified as having repurposing potential for AD. This study sets out to evaluate the preclinical potential of AGO for the treatment of AD. Methods/Study Population: The TgF344-AD rat model (expresses human mutant “Swedish” amyloid-precursor protein and a Δ exon 9 presenilin 1) was used to test AGO’s potential to reduce cognitive deficits and neuropathology. The model was chosen due to its age-dependent progressive AD pathology and cognitive decline. Treatment with AGO at ~10 mg/kg body weight/day began at 5 months of age (pre-pathology) and continued until 11 months of age when cognitive testing (active place avoidance task) and tissue collection occurred. Immunohistochemistry was used to evaluate amyloid beta plaque burden and microglial response in the hippocampus. Results/Anticipated Results: AGO-treated female TgF344-AD rats showed reduced cognitive deficits with an increased latency to first entrance in aPAT testing compared to nontreated transgenic littermates. There were no differences between the cognitive performance of AGO treated and untreated male TgF344-AD rats. Interestingly, this reduced cognitive deficit did not correlate with decreased amyloid beta pathology in female AGO-treated rats yet male transgenic treated rats did have decreased amyloid burden in the dentate gyrus (DG) of the hippocampus. AGO modulated microglial activation in the DG of female transgenic rats. Discussion/Significance of Impact: AGO reduced cognitive deficits in females, but did not change their amyloid burden. This suggests that AGO could increase resilience to amyloid deposition in female rats. With the recent development of amyloid targeting drugs, novel non-amyloidogenic treatments have a large translational potential.

Objectives/Goals: Current popular scoring systems for evaluating facial nerve function are subjective and imprecise. This study aims to quantify speech and facial motor changes in patients suffering from facial palsy after cerebellopontine angle (CPA) tumor resection to lay the foundation for a scoring algorithm that is higher resolution and more objective. Methods/Study Population: We will obtain audio and video recordings from 20 adult patients prior to and after surgical resection of unilateral CPA tumors between October 2024 and February 2025. We will obtain preoperative recordings within two weeks prior to surgery and postoperative recordings following a preset schedule starting from the day after surgery up to one year. Audio recordings entail patient readings of standardized passages and phonations while video recordings entail patient performance of standardized facial expressions. We will analyze video data for key distance measurements, such as eye opening and wrinkle size, using DynaFace. We will process audio data using VoiceLab to extract metrics such as prominence and tonality. We will perform statistical tests such as t-tests and ANOVA to elucidate changes across time. Results/Anticipated Results: I expect to obtain 9 sets of audio and video recordings from each of the 20 participants. In terms of speech, I expect average speech duration to increase postoperatively. Similarly, I expect to find increases in time spent breathing, number of breaths taken, and mean breathing duration. In terms of facial movement, I expect nasolabial fold length to decrease postoperatively, as well as eye opening size and left-right symmetry at rest. For both audio and video, I expect these changes to revert towards their preoperative baseline as time passes. I also expect average House-Brackmann and Sunnybrook facial grading scores to increase postoperatively and then decrease with time, correlating strongly with the video and audio findings. I will use trajectory analysis and time point matching to handle any missing data. Discussion/Significance of Impact: This study will validate our analysis platform’s ability to automatically quantify measurable changes that occur to speech and facial movement which correlate strongly with existing scoring systems. Future work will synthesize these data streams to move towards establishing biomarkers for facial nerve function that aid clinical decision-making.

Objectives/Goals: The neighborhoods children grow up in are critical drivers of social, emotional, and cognitive development. This study utilized factor scores of environment, education, and socioeconomic variables in the Adolescent Brain Cognitive Development Study (ABCD) and its association with cognitive functioning in youth. Methods/Study Population: This study used ABCD (n  =  9,543) linked external data, cognitive performance, and self-reported data from youth (ages 9–10) and their caregivers. We utilized four factor scores of the Child Opportunity Index 2.0 (COI), including socioeconomic attainment, poverty, neighborhood enrichment, and child education. Furthermore, this study investigated the association between the COI factors and youth cognitive functioning via the NIH Toolbox. Covariates included age, sex, county level crime rates, perceptions of neighborhood threat, parent education, and family income; site and family relationship were held as random effects. Results/Anticipated Results: Increased Socioeconomic Attainment and Child Education factor scores were distinctly associated with increased cognitive performance across all subscales and composite scores that include aspects of overall cognitive ability, executive functioning, and learning and memory. Increased poverty factor scores were significantly associated with decreased cognitive performance across all substances and composite scores. Finally, increased neighborhood enrichment factor scores were significantly associated with increased oral reading recognition task scores only and no other cognitive task. Discussion/Significance of Impact: Findings suggest distinct dimensions of neighborhood opportunity associated with aspects of cognition. The present study can help to inform public health efforts and policy on improving modifiable built and natural environmental structures that may aid in supporting cognitive development.

Objectives/Goals: The standard care for malignant gliomas includes maximal tumor resection, but challenges arise near functional (speech) areas. Direct cortical stimulation (DCS) identifies functional (nonresectable) cortex. We aim to identify electrophysiologic (via subdural electrode recordings [ECOG]) biomarkers of DCS-positive (functional) areas. Methods/Study Population: Our lab maintains one of the largest datasets of electrophysiology analysis of glioma infiltrated brain cortex in the USA. Recordings of intraoperative brain mapping were analyzed to identify cortical sites that were found to be positive (functional) during DCS. DCS positive and negative (nonfunctional) sites were aligned to corresponding subdural electrodes. Future analysis: We plan to compare the temporal and spectral electrophysiologic variations associated with cortical sites found to be DCS positive versus negative during brain mapping. We plan to train machine learning classifiers that utilize these electrophysiologic biomarkers to discriminate between DCS positive and negative sites. Results/Anticipated Results: In total, our database comprised of 110 resections with brain mapping (DCS) and ECOG, including 4 patients who underwent a second procedure for resection. Eight patients were excluded as their resections were for brain metastases, not glioma. Our final cohort was comprised of 98 glioma resections, including 4 patients who underwent surgery twice for recurrence. During these resections, a total of 1393 sites were mapped via DCS for language function (including picture naming, word reading, and sentence syntax tasks). Of these 1393 sites, 100 sites were found to be DCS positive (7.1% positivity rate). (Currently in the process of conducting analysis comparing electrophysiologic features and biomarkers of DCS positive versus negative sites.) Discussion/Significance of Impact: This research is ongoing. Identifying electrophysiologic biomarkers of critical DCS-positive regions may provide a durable alternative to stimulation mapping. Due to its resource intensity, DCS has access barriers. Future neurosurgeons may use biomarkers from subdural electrode recordings to plan safer cortical resections.

Objectives/Goals: This project (1) assesses provider behavior at the Galveston Secure Against the Fentanyl Epidemic (G-SAFE) Clinic in providing evidence-based care for underserved patients in our community and (2) implements evidence-based anti-stigma intervention in local health care. Methods/Study Population: The efficacy and impact of G-SAFE on healthcare utilization, health outcomes, and patient satisfaction will be determined. Evaluations assessing provider behavior will be made across at least 25 clinic patient visits, taking note of medical students, clinicians, and health providers’ interactions with patients related to decision-making, care plan creation, and communication. Health provider discussion groups will provide essential data in understanding the successful management of SUDs, management of safety and risk, and how best to pilot and assess interventions that promote greater trust-building and a harm-reduction approach to clinical care for patient empowerment and positive outcomes. Results/Anticipated Results: Observations in the clinic will be turned into interventions to improve diagnostics and therapeutics for SUD medical care and behavioral change. We will recruit 40 medical students (with/without exposure to UTMB’s free clinics) as well as 20 clinicians in the G-SAFE Clinic, Emergency Medicine, and Primary Care. Baseline stigma will be measured with the Medical Condition Regard Scale and the Drug and Drug Problems Questionnaire alongside measures of care approaches. The data collected and the educational intervention for medical students and clinicians will make a positive impact on the lives of those affected by SUDs and serve as a model for future interventions on a larger scale. Discussion/Significance of Impact: Health provider’s SUDs stigma undermines both care quality, patient empowerment, and recovery success. Addressing provider stigma is crucial for necessitating a shift toward collaborative, responsive, and creative clinical decision-making to tackle the ethical challenges posed by the opioid crisis.

Objectives/Goals: Community gardening can foster healthy behaviors among low-income communities. This project aimed to develop a community garden. The primary objectives of this project are (1) assessing the need for and perspective on a community garden at the childcare center, (2) installing the garden, and (3) engaging children in gardening education. Methods/Study Population: This project took place at a childcare center in Harrisburg, PA. Most (74.6%) residents identified as Black or Hispanic/Latino. Every child at the center was eligible for free or reduced lunch. A listening session was held with directly impacted community members to discuss the need for a community garden. Four caregivers, 1 early childhood educator and a master gardener (n = 6) attended the listening session, in which they shared their personal strengths and challenges in growing food. Attendees provided suggestions on what foods they wanted to grow. Children enrolled in the center’s summer program (n = 50) were then invited to participate in weekly gardening activities for 9 weeks. Activities were targeted to preschoolers (3- to 5-year-olds). Older children enrolled in the summer program were welcome to participate. Results/Anticipated Results: Feedback from the listening session was positive. Attendees provided ideas on what to grow and shared interest in expanding the garden to the broader community. Project staff installed four garden beds and planted a variety of herbs (basil, mint, and lavender), fruits (strawberry and melon), and vegetables (tomato, squash, pepper, and onion). Roughly 20–50 children were engaged in the garden each week. Eight weeks into the project, one member from the broader community noticed the garden’s growth and expressed gratitude to the staff, stating “I saw you when you first started planting. This is great what you are doing for the kids.” Children and the center’s staff responded positively to the activities. The staff expressed verbal gratitude for the project and were enthusiastic about maintaining the garden. Discussion/Significance of Impact: Developing a community garden was feasible in this sample and shows potential to (1) increase children’s food literacy and vegetable acceptance and (2) bridge the gap from farm to early childcare education. The project’s success paves way for future gardening initiatives that address food access issues within other diverse low-income populations.

Objectives/Goals: To fully understand the scientific objectives, overall financial commitment, and outcome of the pilot projects. Methods/Study Population: We evaluated pilots reported in the in the annual, interim, and final Research Performance Progress Reports (RPPRs) for Clinical and Translational Science Awards (CTSA) Program UM1 and UL1 grants from FYs 2021–2023 to assess research categories across the translational science spectrum. We analyzed the number of pilots involving human subjects, vertebrate animals, both, or neither; financial allocations; publication outputs; and other characteristics. Pilots reported across multiple years were deduplicated and assigned to the latest reporting year. Each pilot was classified into broad (Category 1) and specific (Category 2) areas. Descriptive statistics, including means and frequency distributions, were generated. Multi-year pilots with NA or 0 values used the most recent prior value. Results/Anticipated Results: In the period from FY 2021 to 2023, 61 hubs reported 1,811 unique pilot projects in their RPPRs, receiving a total of approximately $62 million, of which two-thirds were expended. On average, each hub conducted 30 pilots with an award size of about $35K. Just over half of the pilots involved human subjects research (HSR), while about one-third were neither HSR nor vertebrate animal studies (VAS), with the remaining focused primarily on VAS. Notably, only 13% of pilots resulted in peer-reviewed publications. Collaborative efforts were observed in one-third of the projects. The majority of pilots fell into Preclinical Research (46%), followed by Clinical Research (33%) and Public Health (20%). Limitations in data quality were identified, and ten pilots reported $0 awarded funds, which may be captured in future RPPRs. Discussion/Significance of Impact: Analysis of pilots reported in RPPRs from FYs 2021–2023 across 61 hubs shows a strong focus on HSR, highlighting collaborative efforts that enhance translational science and align with CTSA goals. Future analysis will help assess the pilots’ impact and their alignment with NCATS’ mission to expedite research translation into health solutions.

Objectives/Goals: Evaluate the impact of intrauterine growth restriction (IUGR) on neonatal brain development using magnetoencephalography (MEG) and correlate findings with NICU Network Neurobehavioral scale (NNNS) scores at 1 month Methods/Study Population: In this prospective cohort study, we will enroll 30 participants, consisting of 15 neonates diagnosed with IUGR and 15 healthy controls, matched by gestational age, from the University of Arkansas for Medical Sciences. We will perform MEG scans at three key developmental stages: during fetal life, at 1 month, and at 3 months of age and a Bayley IV exam at 12 months of age. The NNNS assessments will be conducted at the 1-month visit to evaluate neurobehavioral outcomes. All MEG data will be synchronized with clinical evaluations and maternal health records to ensure comprehensive analysis. Results/Anticipated Results: We anticipate that the study will reveal significant differences in brain maturation and neural activity patterns between IUGR-affected infants and healthy controls. Specifically, we expect to find altered neural connectivity and delayed maturation in the delta and theta frequency bands during the early neonatal period in the IUGR group. These anticipated neuroimaging findings will be correlated with NNNS scores to assess functional implications of the observed brain activity differences. If our hypotheses are confirmed, the study will provide robust biomarkers for early identification of neurodevelopmental delays in IUGR-affected infants, paving the way for targeted early interventions. Discussion/Significance of Impact: This study could significantly enhance early detection and intervention strategies for IUGR, potentially reducing long-term neurodevelopmental challenges and improving clinical outcomes

Objectives/Goals: Trainees in clinical and translational science (CTS) take courses in biostatistics, epidemiology, and other quantitative areas. To be most successful, trainees require competency in algebra. We developed a quantitative assessment and study guide to assess trainee’s quantitative skills and provide review material to address weaknesses. Methods/Study Population: The Tufts CTS Graduate Program is the training core of the Tufts CTSI and its associated pre- and post-doctoral T32 awards. Approximately 10 trainees with a range of backgrounds (e.g., physicians, medical students, master’s-level researchers, and basic science PhDs) and varying math education experiences matriculate each year. We wanted to address the resulting range of quantitative skills to help students succeed in our program. In Spring 2023, we met with faculty teaching quantitative courses to identify core algebra concepts needed to succeed in their classes. A graduate student in computational mathematics with extensive tutoring experience then drafted assessment questions, a comprehensive study guide, and brief cheat sheet. The material was reviewed and revised with input from quantitative faculty. Results/Anticipated Results: We developed a 20-item quantitative assessment covering properties of operators; identity elements and inverses; simplification of arithmetic and algebraic expressions; solving algebraic equations; functions; equations of a line; and exponents/logarithms. A cheat sheet provided trainees with a brief refresher for these topics. A study guide provided more detailed instruction, example exercises and solutions, and referenced publicly available, online resources (e.g., Khan Academy). During the introductory summer course for the Tufts CTS Program, trainees were allowed to use the cheat sheet and were given 1 hour to complete the assessment. Trainees who got questions incorrect were directed to relevant sections in the study guide. We anticipate collecting formal feedback to evaluate the material. Discussion/Significance of Impact: Trainees must have adequate foundational algebra skills to succeed in CTS graduate programs and as future researchers. Developing a quantitative assessment allowed us to identify areas of weakness resulting from educational disparities or reflecting other aspects of their backgrounds and to provide material to reinforce their preparation.

Objectives/Goals: Posttraumatic stress disorder (PTSD) is common during pregnancy and postpartum, leading to adverse birth outcomes. Despite effective interventions like narrative exposure therapy, PTSD often goes untreated due limited training opportunities and lack of community support. Expanding training for PTSD is crucial to improving access to care. Methods/Study Population: Six 3-day PNET trainings were delivered to 57 participants over a 23-month period. Workshop attendees represented a variety of professions (19% Social Workers, 19% Mental Health Graduate Trainees, 18% Psychologists, 18% Counselors, 12% Doulas, 11% Physicians, and 5% Home Visitor/Parent Educators) with varying levels of specialty experience from diverse locations (2 countries and 13 states). Key workshop outcomes included participant one-week post-workshop satisfaction, perceptions of acceptability, appropriateness, and feasibility of the intervention, and pre- to one-week post-workshop perceptions of connectedness to trauma treatment and perinatal healthcare communities. Data will be explored at 6 months post-workshop to evaluate longer-term effects on connectedness. Results/Anticipated Results: The majority of workshop attendees (84%, M =  4.76, range 1–5) reported being “extremely satisfied” with the training and 98% indicated they would “recommend it to others.” Most attendees found NET to be acceptable (M  =  4.64, range  =  1–5), appropriate (M  =  4.37, range  =  1–5), and feasible (M  =  4.49, range  =  1–5) to use within their practice. Paired t-tests revealed a significant increase in a sense of connectedness to both the trauma treatment and perinatal healthcare communities from pre- to post-workshop. Discussion/Significance of Impact: Findings indicate that the PNET workshop is feasible and effective in training interdisciplinary providers on perinatal PTSD evidence-based interventions. By training a range of professionals and fostering a sense of connectedness, the PNET workshop has the potential to make effective trauma treatments accessible to underserved populations.

Objectives/Goals: The extracellular matrix (ECM) of the sinoatrial node (SAN) is critical for maintaining automaticity in hiPSC-derived pacemaking cardiomyocytes (PCMs) under cyclic strain. We aim to determine the ECM ligands responsible for cell-ECM mediated mechanotransduction and the resulting phenotype in PCMs. Methods/Study Population: HiPSCs are differentiated to PCM and replated on substrate with 5 or 15 kPa PDMS that are coated with 5 or 25 ug/cm of either collagen I or fibronectin at sub-confluent density to restrict junction engagement to only costameres. Then, PCM are subjected to 10% cyclic mechanical strain at 1 Hz for 48 hours, with static culture as control. PCMs from all conditions are subsequently fixed and stained for cardiomyocyte-specific troponin T (TnT), pacemaking HCN4 channel, and pro-pacemaking transcription factors (Shox2, Isl1, Tbx3, Tbx18). Additionally, PCM cell size will also be assessed. Results/Anticipated Results: Considering the amount of hypertrophy and myofilament in CMs correlates with mechanical strain, we expect a reduced degree of mechanotransduction in hiPSC-PCM on collagen I with a stiffness 15 kPa to induce smaller cell size with fewer myofilament and an upregulation of HCN4 and pro-pacemaking transcription factors than those on 5 kPa and those on fibronectin of either 5 or 15 kPa after cyclic strain. This is because COL1 is reported to have a lower signaling threshold but a limited sensitivity to force which contributes to the diminished mechanotransduction signaling. Discussion/Significance of Impact: Effects of the microenvironment on hiPSC-PCMs via costamere mechanotransduction may provide insights for engineering biopacemakers with a suitable ECM, to potentially preserve automaticity in hiPSC-PCMs and sustain long-term pacemaking function, making biopacemakers a step closer to reality.

Objectives/Goals: Effective research relies on a well-trained study coordinator workforce, but mentorship programs are lacking. Retaining and empowering career development for skilled research staff is challenging. To address this, the Michigan Institute for Clinical and Health Research launched the STEP.up program. Methods/Study Population: The Staff Enrichment Program for Research Professionals (STEP.up) was created in 2018. To increase knowledge and awareness of our program, we developed an implementation guide to share best practices and open access to our program structure and content. We identified seven critical elements integral to program success. The implementation guide provides a description and rationale for these elements. We partnered with an instructional designer to build a descriptive and easy-to-use guide that describes insights into the successful implementation of the program, practical strategies for program management, and adaptable resources for institutions to use and tailor to their unique needs. Results/Anticipated Results: In the STEP.up program, early career, new-to-role, or new-to-organization research staff members are paired with senior research professionals in a 9-month structured mentorship and career development experience to promote professional development, job satisfaction, and retention for individuals currently working as research professionals. Of the 82 participants from 2018 to 2024, 76 (93%) have remained in their roles as study coordinators. The STEP.up program implementation guide provides the tools, resources, and insights senior research professionals need to implement this program successfully at their sites. Discussion/Significance of Impact: STEP.up program materials are available as an open-source resource on the DIAMOND portal. This resource can encourage others to invest in structured mentorship for research professionals to help establish a culture of growth and cultivate a resilient, skilled, and committed research workforce.

Objectives/goals: This project will focus on identifying the barriers that result in low adherence to quality care indicators that establish effective and efficient pediatric emergency care. The overall objective is to understand motivations behind adherence (or lack thereof) and find solutions to facilitate compliance. Methods/Study Population: This study will use a mixed-methods design to investigate the barriers. Quantitative data will be collected through a survey provided to healthcare providers involved in pediatric emergency care, including physicians, nurses, and administrative staff in both pediatric and general hospitals. Qualitative data will be collected through semi-structured interviews with a group of respondents to gain insight on their experience regarding compliance. Quantitative data will be analyzed using statistical analyses while qualitative data will undergo a thorough thematic analysis. Both sets of data will be reviewed to identify themes and differences in barriers across hospital types and healthcare roles. Results/Anticipated Results: We will have gathered insights and perspectives from key stakeholders that are relevant to our study to ensure a comprehensive understanding of any potential implications that may arise from our study. We anticipate that the specific results will highlight key differences in adherence between pediatric and general hospitals. The study is expected to identify specific barriers hindering compliance with established guidelines in both settings. The results may be used to increase adherence to critical quality indicators and improve patient care. Discussion/Significance of Impact: Pediatric injury care prioritizes the immediacy of care for children with acute illness and injury. With certain hospital protocols not being adhered to, there is a risk of wasting crucial time and resources that can affect patient care outcomes. The results would provide recommendations to improve and increase efficiency in pediatric injury care.

Objectives/Goals: Baseline lung allograft dysfunction (BLAD) is defined as the failure to attain normal lung function after transplant and has been associated with impaired survival. BLAD has no consensus definition and assessment of varying thresholds of abnormality may identify an impact on survival or development of chronic lung allograft dysfunction (CLAD). Methods/Study Population: This is a retrospective cohort analysis of bilateral lung transplant recipients who were transplanted between 1/1/2012 and 12/31/2022 who have complete pulmonary function data posttransplant. Thresholds of BLAD including percent predicted levels of FEV1 and FVC at 80%, 75%, 70%, 65%, and 60% were assessed. Outcomes evaluated include survival, development of CLAD, and association of key risk factors with the development of BLAD including donor, recipient, operative, and postoperative characteristics. Results/Anticipated Results: Totally, 680 bilateral lung transplant recipients were identified. Prevalence of BLAD ranged from 41.9% to 9.7% at specified thresholds. We anticipate performing survival analyses and evaluating development of CLAD in patients with BLAD at varying thresholds. We are assessing key donor, recipient, operative, and postoperative variables for association with BLAD. Preliminary analyses demonstrate significant associations of BLAD with recipient-donor height mismatch, prolonged mechanical ventilation time posttransplant, increased length of hospitalization posttransplant, the use of cardiopulmonary bypass intraoperatively and surgical allograft downsizing. Discussion/Significance of Impact: A threshold of BLAD at 70% predicted FEV1 and FVC or lower suggests importance for developing CLAD. Key characteristics associated with BLAD suggest importance of height mismatch, operative complexity, frailty, and severity of disease at time of transplant and immediately postoperatively.

Objectives/Goals: Physical therapy (PT) is a recognized and evidence-based component of oncology care that has been shown to benefit people with various cancers, such as breast, lung, head and neck, thyroid, or prostate cancer. The goal of this evaluation was to determine the level of PT service utilization by World Trade Center (WTC) Health Program members with cancer. Methods/Study Population: The Program is a limited benefits federal program that serves responders and survivors of the September 11th attacks in New York City, the Pentagon, and Shanksville PA. Our analyses include enrolled Program members with a cancer certification. Cancer types were divided into two categories, Category A (breast, lung, head and neck, thyroid, or prostate cancer) and Non-Category A (all other cancer types). Data included medical claims, certification, and enrollment data from July 2011 to December 2023. The 2023 Current Procedural Terminology (CPT) code list from the Centers for Medicare and Medicaid Services were used to identify claims associated with PT interventions. Our analyses describe trends in PT claims, CPT codes, cancer certifications by subtype, and number of members with Category A cancers and PT claims. Results/Anticipated Results: Since the Program’s inception in 2011, PT claims had gradually increased except for in 2020 when there was a sudden decrease, most likely due to the interruption of in-person services due to the COVID-19 pandemic. From 2021 to 2023, PT claims began to increase again. The most common types of PT interventions were therapeutic exercises, manual therapy, and neuromuscular reeducation. In 2023, the most recent year of full data available, Category A cancers made up 38% of all cancer certifications, with prostate and breast cancer being the most common. Category A cancers were evaluated together due to prior existing evidence outlining significant benefit from PT intervention. In total, Category A cancers represent over 14,000 Program members. Less than 1% of members with a Category A cancer had a PT related claim in 2023. Discussion/Significance of Impact: The mission of the Program is to provide quality and compassionate medical care and treatment to our members. Better understanding the utilization of PT services provided by the Program will allow us to increase awareness and support of interventions for members of our Program who could benefit from PT services.

Objectives/Goals: Identify risks in the regulatory reliance ecosystem, specifically for generic reliance pathways, using system theoretic process analysis (STPA), a proactive hazard analysis method, and create sustainable solutions to ensure global accessibility to the highest attainable standard of health. Methods/Study Population: A systematic literature review will assess the regulatory reliance ecosystem and interactions among National Regulatory Agencies (NRAs). This will involve using a hierarchical control structure (HCS) to identify operational loop failures, decision-making, and information flow. The HCS will inform an STPA to prevent adverse outcomes like patient harm or regulatory non-compliance. With IRB approval, 10 regulatory experts will also be interviewed to gather insights on risk scenarios. Their input will be used to integrate regulatory pathways into the HCS for adaptability, and a second round of interviews will be conducted to validate the scenarios and assess the effectiveness of recommendations. Results/Anticipated Results: A preliminary literature review on regulatory reliance pathways from PubMed, WHO guidelines, and the DIA global forum, revealed potential risks in NRA interactions, such as overly redacted reports obscuring critical details and discrepancies in product versions or incomplete reviews affecting evaluations. Diverging guidelines and failure to adapt to country-specific needs are potential risks that also impact patient access to essential medicines. The STPA framework, along with expert feedback, will uncover unknown risks like “secondary-reliance” and soft risks, leading to sustainable recommendations to improve and optimize the safety of regulatory reliance. Discussion/Significance of Impact: Safe regulatory reliance is crucial for global health equity and patient access to essential and innovative medicines. STPA will identify and address different layers of risk in the system, improving safety, efficiency, and innovation for timely patient access to therapeutics.

Objectives/Goals: To determine the role of carcinoembryonic antigen cell adhesion molecule 6 (CEACAM6) in signaling cascade and interaction with other cell surface proteins in human epithelial solid tumors such pancreatic adenocarcinoma and colon cancer Methods/Study Population: In this study, we employed three-dimensional (3D) tumor models to replicate the in vivo tumor microenvironment better, allowing for a more accurate assessment of cellular responses compared to traditional two-dimensional (2D) cultures. We used immunoprecipitate to pull down the CEACAM6 protein and investigate the integrins expression level. Results/Anticipated Results: The expression and functional activity of CEACAM6 are susceptible to modulation by various surface proteins, leading to notable alterations in cellular behavior. Integrins, particularly Integrin B4, are one such protein whose expression is influenced by CEACAM6-mediated intracellular signaling cascades, suggesting a complex interplay that enhances CEACAM6 activation.The 3D models facilitate cell–cell interactions, enabling tumor cells to proliferate and undergo metabolic changes that reflect actual tumor biology. Thereby enhancing the relevance of crosstalk between CEACAM6 and integrins. These findings underscore the potential of CEACAM6 as a promising therapeutic target. They reveal a molecular mechanism that could inform the development of innovative therapeutic strategies in cancer. Discussion/Significance of Impact: These findings underscore the potential of CEACAM6 as a promising therapeutic target, revealing a novel molecular mechanism that could inform the development of innovative therapeutic strategies for pancreatic and colon cancer and potentially other malignancies.

Objectives/Goals: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that affects 2 million people worldwide causing severe disability. This study uses the Gamt-GFP transgenic mouse line as a novel approach to track oligodendrocyte lineage cell regeneration in inflammatory demyelination for identifying potential therapies. Methods/Study Population: We previously showed that Gamt, an enzyme required for creatine synthesis, is essential for oligodendrocyte (OL) maturation and survival using the Gamt-Green Fluorescent Protein (Gamt-GFP) reporter line. In this study, we capitalize on this finding and track OL lineage cells in an experimental autoimmune encephalomyelitis (EAE) mouse model by inducing immune-mediated demyelination in the Gamt-GFP reporter line. At 7 days postimmunization (dpi), both control and EAE mice receive 4 mg/kg tamoxifen for 4 consecutive days to induce GFP expression. GFP+ cells and those also expressing OL lineage markers [Olig2 (pan-OL lineage cell marker), NG2 (OL precursor cells; OPCs), and CC1 (mature OL)] are quantitated by immunofluorescent staining of spinal cord sections collected at 28 dpi. Results/Anticipated Results: Preliminary data using immunofluorescent staining demonstrated GFP was expressed in Olig2+ cells in the inflammatory ventral white matter lesions of mice with EAE, whereas no GFP labeling was present in the control mice. Moreover, GFP+ cells also expressed NG2+. In contrast, few CC1+ cells were detected in the inflammatory lesions. The low number of dual labeled GFP+CC1+ cells in these lesions suggests OPCs under the EAE environment are unable to efficiently differentiate into mature OL. Therefore, the Gamt-GFP reporter mouse can be used to identify and track activated OL lineage cell populations (i.e., GFP+CC1) in inflammatory lesions in the EAE mouse model. Discussion/Significance of Impact: The Gamt-GFP reporter line identifies activated OL lineage cells responding to inflammatory demyelination, making it a valuable tool for testing potential therapeutics aimed at enhancing remyelination. This model helps bridge the gap between preclinical and clinical research to guide MS therapy development.