OBJECTIVES/GOALS: Launch a case-based learning collaborative on best practices that meet social, emotional and physical health needs of underserved communities as they relate to environmental toxins—specifically those related to the train derailment in OH. Topics discussed could also include disasters and spills, air quality, extreme heat, and water. METHODS/STUDY POPULATION: In response to a call for action delivered by PA’s Acting Secretary of Health, we established a partnership between Penn State CTSI, Project ECHO at Penn State, and Primary Health Network (PHN). PHN is the largest Federally Qualified Health Center in PA, making it uniquely qualified to reach rural providers diagnosing and treating patients impacted by environmental events. Utilizing the ECHO model, we are hosting monthly, 1-hour sessions on environmental determinants of health starting October 2023. Experts in pulmonology, toxicology, atmospheric science, and rural medicine (whom many participants would have limited access to outside of the ECHO platform) and participants have the opportunity to share and learn from their varied experiences exemplifying a culture of ‘all teach, all learn’. RESULTS/ANTICIPATED RESULTS: Project ECHO is an ideal model for upscaling workforce quickly, allowing participants to be responsive in the care of their community, regardless of location and access to specialty clinics. 74 participants across 26 PA counties registered for the series, ranging from PCPs, medical directors, and state officials. Upon registration, nearly half of our direct patient-care participants do not routinely conduct an environmental exposure history and almost 70% report receiving questions from their patients related to how the environment might impact their health. More than half of those providers reported feeling unprepared to answer patients’ questions related to the environment’s impact on their health. Evaluation data will be collected at enrollment, after each session, and post-series. DISCUSSION/SIGNIFICANCE: This series could result in: * Reduction of health disparities caused by environmental events (no cost, virtual learning) * Increased preparedness to quickly address health questions/symptoms related to environmental exposures * Increased awareness of the environmental impacts on health. * Improved testing/treatment for patients

OBJECTIVES/GOALS: Real-world data (RWD) may offer insights into mental health treatment as usual and illuminate targets for implementation and translation. This requires strong research-community partnerships (RCP). In this presentation, we will highlight key components of an ongoing RCP in leveraging RWD to advance translational science. METHODS/STUDY POPULATION: The RCP was formed to develop an infrastructure for NAMI Chicago, a community-based organization that oversees a city-wide social services helpline, to support collection of RWD data to understand whether NAMI helpline support services and referrals meet callers’ emotional and physical needs. This RCP includes three entities: NAMI Chicago, UIC’s Center for Clinical and Translational Science’s Community Engagement and Collaboration (CEC) Core, and UIC’s Institute for Health and Research Policy’s Data Management Core (DMC). From a preliminary review of case notes, this case study details concrete examples that fit into Brookman-Frazee etal. (2012)’s RCP framework to illustrate the trajectory of this partnership through its formation, execution of activities, and sustaining NAMI Chicago’s data capacity. RESULTS/ANTICIPATED RESULTS: In the formation of this RCP, we identified our joint goal of creating a database infrastructure to link NAMI Chicago’s existing helpline data with a database co-created in REDCap through APIs. Based on the identified joint goal, we defined our roles/responsibilities that best aligned with our own individual expertise to execute the necessary operational processes. The RCP is currently executing the activities to create this data infrastructure. Barriers included delays in securing a computing environment and enablers included an established long-standing relationship between NAMI Chicago and CEC. Distal outcomes of this RCP include increasing NAMI Chicago’s capacity to systematically use RWD to better inform their practices and identify barriers in accessing social service resources in Chicago. DISCUSSION/SIGNIFICANCE: The identification of enablers, barriers, and the necessary operational processes and activities will outline a “blueprint” for other institutions and community organizations to successfully utilize RWD to understand mental health practices and advance translational research.

OBJECTIVES/GOALS: Total-body symptom surveys among patients with idiopathic orthostatic intolerance (OI) at our referral center suggest that non-conventional OI symptoms, such as pelvic pain, impact quality of life. We seek to identify additional common yet unconventional symptoms reported during clinic visits to improve targeted symptom management. METHODS/STUDY POPULATION: Pelvic pain symptom surveys were completed by 178 patients age 18 and over with a chief complaint of OI. Pelvic pain prevalence was assessed using the International Pelvic Pain Society (IPPS) and Pelvic Congestion Syndrome (PCS) surveys. Expanding on this work, surveys will be distributed to a population with the same inclusion criteria but with a broader symptom scope, chosen based on patient reports during clinical encounters—including presence of migraines, cold digits (Raynaud’s phenomenon), anxiety and depression. The Migraine Disability Assessment Test (MIDAS), modified Assessment of Systemic Sclerosis–Associated Raynaud’s Phenomenon (ASRAP), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) surveys, respectively, will be used to obtain symptom prevalence. RESULTS/ANTICIPATED RESULTS: Of the pelvic pain survey participants, pelvic pain was endorsed by 144/178 (80.9%) of respondents. Prevalence of the additional surveyed symptoms—migraines, cold digits, anxiety, and depression—will similarly be assessed. Given that in our referral clinic we have observed a trend of patients reporting these additional symptoms, we anticipate that at least some of them will be prevalent in a majority of the patient population formally surveyed, similar to the trend observed with pelvic pain prevalence. In particular, we anticipate many patients will report significant migraines, as migraine pain severity on a scale of 0-10 with 0 being no migraine pain and 10 being the most severe migraine pain imaginable is one of the elements of the IPSS survey, and 106/178 (59.6%) reported migraine pain of 5 or higher. DISCUSSION/SIGNIFICANCE: Novel treatment approaches for OI are needed, as lifestyle management is the current treatment paradigm. Several patients reporting pelvic pain have undergone targeted workup and subsequent symptomatic treatment that has improved their quality of life. Other targeted symptom approaches to prevalent symptoms could have the same effect.

OBJECTIVES/GOALS: To investigate digital behavior patterns before cerebrovascular disease (CeVD), we compared accelerometer-measured physical activity (PA) phenotypes of future CeVD patients versus controls in UK Biobank. METHODS/STUDY POPULATION: Accelerometer data from 76,525 eligible participants monitored for 7-days (Jan. 2013-Dec. 2015) was classified into four categories: sedentary, light PA (LPA), moderate-to-vigorous PA (MVPA), and sleep. Covariables and diagnoses were defined using baseline data and patient records. Daily PA patterns associated with incident CeVD were compared to controls using negative binomial regression models. RESULTS/ANTICIPATED RESULTS: Adult participants with future CeVD (n = 2,163) spent 4.4% less time in MVPA (Incident Rate-Ratio (IRR) 0.956; 95% CI = 0.923-0.992; p = 0.016) compared to controls. During 0:00-5:59h (midnight to 5:59AM), future CeVD patients were less likely to sleep (IRR = 0.985; 95% CI = 0.977-0.992; p <0.001) but more likely to be sedentary (IRR = 1.189; 95% CI = 1.098-1.290; p <0.001) or in LPA (IRR = 1.108; 95% CI = 1.015-1.211; p <0.001). In subgroup analyses, decreased MVPA was observed in current/former smokers (IRR = 0.887; 95% CI = 0.819-0.963), males (IRR = 0.931; 95% CI = 0.870-0.997), and the unemployed/retired (IRR = 0.923; 95% CI = 0.856-0.998), an effect more pronounced in depressed patients (p for interaction = 0.044) and prolonged (> 2 hr/day) screen users (p for interaction = 0.018). DISCUSSION/SIGNIFICANCE: The digital phenotype of PA prior to CeVD is characterized by less sleep during 0:00-5:59h and less daily MVPA, demonstrating the utility of accelerometer data in identifying candidates for preventative intervention.

OBJECTIVES/GOALS: Socioeconomic status (SES) affects risk of disease and access to therapies. The expanded access (EA) pathway allows for the clinical use of investigational products for patients who have serious illness but no Food and Drug Administration (FDA)-approved therapeutic options. The SES of patients who receive EA is unknown. METHODS/STUDY POPULATION: We reviewed the patients who were approved for treatment through a single-patient EA pathway between 2018 and 2023. Using Michigan Medicine (MM) DataDirect software linked to the MM electronic medical record system, we linked the EA pathway patients to neighborhood data from the National Neighborhood Data Archive (NaNDA) to compare neighborhood related markers of affluence among EA patients and others treated at MM. We used descriptive statistics to compare variables between EA pathway patients and residents of the state of Michigan or the local county surrounding MM (Washtenaw County), using US Census tract data to provide context for these findings. RESULTS/ANTICIPATED RESULTS: MM patients who received EA treatments were more likely to come from neighborhoods that showed markers of high SES compared to residents of the state of Michigan but not Washtenaw County. This includes the proportion of persons living in poverty (12.5% EA / 13.4% Michigan / 12.4% Washtenaw) and education in the form of a bachelor’s degree or higher (32.2% / 30.6% / 57.2%). This varied by the disease being treated. Oncology patients were more likely to be from areas with less poverty and more education (12.4% / 76.8%) than the EA average. EA patients being treated for infectious diseases were from areas with more poverty and less education (13.5% / 26.7%). DISCUSSION/SIGNIFICANCE: Patients treated at Michigan Medicine using treatments obtained through the EA pathway came from areas that were, on average, more affluent than residents of the state of Michigan as a whole. This finding warrants more research to ensure equitable access to these therapies for patients in disadvantaged neighborhoods.

OBJECTIVES/GOALS: We developed a state-wide program to support early career faculty in preparing mentored career development awards, and connect them to resources, mentorship, and career development opportunities. We aimed to build self-efficacy along multiple axes, including research design and grantsmanship, and to facilitate networking with mentors and peers. METHODS/STUDY POPULATION: The program recruited four cohorts of faculty over the course of four years, for a total of 32 faculty participants (63% physician scientists). Participants were selected by a Steering Committee, and represented a variety of specialties from 19 departments across Brown University, University of Rhode Island, and affiliated hospitals. Participation required an institutional commitment of 20% minimum protected time to engage in research and a year-long curriculum that included biweekly didactic sessions, project development support, individual consultations, feedback on drafts, and internal study section review. Participants completed pre-, interim-, and final-assessments, which collected measures of self-efficacy, professional development needs, program satisfaction, and formative feedback. RESULTS/ANTICIPATED RESULTS: Over the first 3 years, 21 participants completed the program, 43% have received NIH or VA K/CDA awards so far, and 48% received other federal or non-federal awards. Over 25 faculty from across institutions participated in leadership and didactics, with even greater participation on mentorship teams, panels, and grant review. All cohorts showed improvements in measures of self-efficacy in grantsmanship and research and reported high satisfaction with program activities. Participants found individualized proposal feedback and internal study sections to be most valuable, and frequently cited the value of peer-learning opportunities. Challenges for scholars include mentorship challenges, competing priorities/protected time, and various external factors that impacted individual research progress. DISCUSSION/SIGNIFICANCE: The program has successfully supported cohorts of junior clinical and translational faculty from across the state in launching their independent research careers. The program may serve as a model for IDeA state inter-institutional collaboration in developing diverse faculty cohorts in the early stages of preparing their career development award.

OBJECTIVES/GOALS: To describe an Honest Broker (HB) tool and workflow integrated with the Institutional Review Board (IRB) to automate requests, approvals and delivery of both de-identified and identified data extractions from a clinical research data warehouse (CRDW). METHODS/STUDY POPULATION: The HB tool has predefined domain tables and is closely integrated IRB for quick and easy review and approval. Investigators can access patient data using query tools, barcodes from biospecimens or build a query in TriNetX and provide the patient list as an input for the HB tool. For de-identified data extraction, the required data domain tables and date ranges can be selected and submitted in the HB tool. For identified data extractions, investigators with an approved IRB protocol can enter the protocol number and the approved date range in the HB tool. This request is automatically forwarded to the IRB for review. RESULTS/ANTICIPATED RESULTS: For de-identified data extraction, an email alert is automatically sent to the investigator once the data extract is completed. For identified data extraction, if IRB approves the request, an HB is immediately notified to release the data. Data release triggers two emails to the investigator: (1) a link to an encrypted zipped file with the requested data, and (2) a password to unlock the encrypted file. If the request is denied, the IRB sends an email to the investigator with the reason for denial and options for remediation. The entire HB workflow is accomplished in a secure environment with an audit trail from the initial data request to data download by the investigator. Since the launch of the HB tool, the time from data request to delivery is approximately an hour for deidentified data and 24 hrs for identified data. DISCUSSION/SIGNIFICANCE: The HB tool has increased successful data delivery in support of publications, grant submissions, and clinical trial recruitment. Optimization of data extraction from the CRDW through automation and integration with the IRB can minimize interaction with data analysts and IRB staff, thus accelerating the conduct of clinical research.

OBJECTIVES/GOALS: This integrated knowledgetranslationproject aims to increase youth engagement in mental health services through enhancing shared decision-making processes. To do this, a knowledge product to support greater involvement in measurement-based care practices will be evaluated and co-developed with youth study participants. METHODS/STUDY POPULATION: This study population includes youth (aged 12-25) with lived/living experience of accessing mental health services through an integrated service delivery model in Ontario. Study methods focus on co-designing a knowledge product with youth partners guided by the Knowledge-to-Action (KTA) Framework. The prototype knowledge product addressing identified barriers to MBC understanding, will be quantitatively evaluated by study participants. Through semi-structured focus groups, qualitative perspectives of the intervention’s impact on shared decision-making and overall engagement in treatment will be collected. The study’s design ensures active collaboration with the study population and aims to enhance MBC understanding and engagement in mental health care among youth. RESULTS/ANTICIPATED RESULTS: We anticipate increased youth involvement within MBC practices, and overall increased engagement in shared-decision making in treatment. We anticipate the developed knowledge product will enhance youth’s understanding of MBC, foster dialogue between youth and clinicians, and promote active involvement and informed decision-making in their mental health treatment. By involving youth in the co-design process, our project is poised to foster a sense of ownership and relevance, ultimately improving youth engagement, decision-making, and mental health outcomes within integrated mental health services. DISCUSSION/SIGNIFICANCE: Youth deserve to have an active role in shaping treatment decisions. This tool may bridge a gap by equipping youth with the knowledge needed to engage in decisions that are often practitioner-led. This study will discuss the impact and strategies for increasing involvement in MBC practices on youth engagement within treatment.

OBJECTIVES/GOALS: We are using ethnographic methods and Dissemination and Implementation (D&I) frameworks to study barriers and facilitators to implementing ‘TeamMAPPS: Team Methods to Advance Processes and Performance in Science.’ TeamMAPPS is an evidence-based Team Science curriculum deployed as five online modules and being implemented across CTSA hubs. METHODS/STUDY POPULATION: For this pre-implementation study, we used the Implementation Mapping framework to understand likely barriers and facilitators, with the aim of designing implementation strategies and long-term outcome measures. Data included field notes from a two-day train-the-trainer, one visit to a key implementing site, and 27 interviews. Participants were four TeamMAPPS conceptualizers, four module designers, and 15 implementers from seven implementing sites, each with a CTSA hub (four were interviewed twice). We coded transcripts using the Consolidated Framework for Implementation Research (CFIR) to identify contextual barriers and facilitators to D&I, the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) D&I outcomes framework, and target competencies of TeamMAPPS. RESULTS/ANTICIPATED RESULTS: Priority D&I outcomes that emerged were adoption, reach, and effectiveness. Potential barriers/facilitators to “adoption” included institutional willingness to incentivize scientists to utilize TeamMAPPS, support for Team Science at CTSAs, and systems of rewards for scientists to undergo trainings. Anticipated barriers/facilitators for “reach” were closely tied to adoption, such as institutions’ ability to persuade or require scientists to take trainings. Other issues relevant to reach included the time it takes to time to complete TeamMAPPS and potentially fraught intra-team dynamics arising if modules are implemented as a whole-team intervention. Anticipated barriers/facilitators for “effectiveness” included having adequate tools to assess actual impact. DISCUSSION/SIGNIFICANCE: TeamMAPPS has the potential to accelerate advances in translational sciences across the CTSA consortium. As this D&I study proceeds we will continue Implementation Mapping and use the Expert Recommendations for Implementing Change (ERIC) to develop bundles of implementer-informed strategies to the effectively deliver TeamMAPPS among CTSAs.

OBJECTIVES/GOALS: An academic medical library evaluated an EHR data abstraction service by assessing uptake and publication metrics, including use by department, purpose of data abstraction requests and publication counts. METHODS/STUDY POPULATION: The evaluation included 167 requests for EHR data processed by the institution’s clinical research data management unit (CRDMU) and recorded in an intake form hosted on REDCap. These requests originated from various departments. The intake forms collected investigator and study information, as well as request completion dates. Information in the intake forms were matched with publications and meeting abstracts that were indexed in a database of faculty publications. Investigators who submitted EHR data requests that could not be readily matched to publications were contacted to verify the status of their studies and any associated publications. RESULTS/ANTICIPATED RESULTS: The evaluation included 167 data requests submitted to the CRDMU between 2016 and 2018. These requests were categorized into the following use cases: retrospective studies (n=93); patient recruitment (n=50); and 'other' (i.e., education, training, or process improvement; feasibility assessments; machine learning (n=14)). By the end of the evaluation period, an average of four years after the data requests were submitted to the CRDMU, 60 of all 167 EHR datasets (35.9%) led to publications as articles or meeting abstracts. 64.5% of the EHR datasets requested for retrospective studies, 56% of the datasets requested for recruitment, and 79.1% of datasets requested for other uses did not lead to publications. DISCUSSION/SIGNIFICANCE: These findings offer evidence that bibliometrics alone provide limited insight into the value of services and data utilized for secondary research. Data ecosystem stakeholders are encouraged to consider—and develop—scalable, reproducible, and more holistic assessments of the impact of their services.

OBJECTIVES/GOALS: Early diagnosis of congenital sensorineural hearing loss (SNHL) is of paramount importance in preventing speech and language impairment.Diffusion tensor imaging (DTI) MRI can identify brain microstructural changes that may potentially contribute towards prognosticating rehabilitation. METHODS/STUDY POPULATION: We retrospectively reviewed pediatric patients with SNHL who obtained DTI MRI between 2011 and 2019, identifying 16 pediatric patients (age <18 years) with at least moderate asymmetric/bilateral SNHL., and gender-matched controlswithout neurological, developmental, or MRI-based brain macrostructural abnormalities. The following brainstem regions and tracts of the auditory pathway were assessed: superior olivary nucleus (SON), inferior colliculus (IC), ipsilateral tracts between the inferior colliculus and superior olivary nucleus (IC-SON). Diffusion values for bilateral regions and tracts were generated, then averaged to calculate a mean value for fractional anisotropy (FA) and mean diffusivity (MD) for each subject. RESULTS/ANTICIPATED RESULTS: Significant differences were identified in FA values of the SON between the SNHL cohort and controls (0.377±0.056 vs 0.422±0.052; p=0.009). No other FA or MD values were significantly different. In children £5 years, MD was significantly decreased in the SNHL cohort compared to controls in the IC (0.918±0.051 vs 1.120±0.142; p<0.001). In children >5 years, there were no significant differences in MD (1.124±0.198 vs 0.997±0.103; p = 0.119). There were no significant differences in MD or FA in the white matter fibers of the IC-SON tract [applewebdata%3A//720AAF0C-C4CF-459C-A42A-6BAA56C4E4CA#_msocom_2]. DISCUSSION/SIGNIFICANCE: This is the first study to assess microstructural changes in brainstem auditory pathway regions among children with SNHL. Longitudinal studies are warranted to assess the predictive value of DTI imaging for long-term outcomes and prognosticating intervention.

OBJECTIVES/GOALS: Identify causes for clinical research professional turnover Define data collection methods for exit interviews Provide institutions with resources to collect and analyze exit interviews Employ strategies to maximize the impact of exit interviews on retention METHODS/STUDY POPULATION: The Clinical Research Professional Taskforce (CRPT) exit interview Subgroup has met monthly since January 2023. Action items were agreed to and minutes were kept and reviewed at subsequent virtual working meetings. All members were given opportunity to speak and contribute. After a landscape analysis, conducted via survey, five institutions agreed to provide examples of their exit interview questions. Members spoke at length about goals, methods, collection techniques, institutional involvement, lessons learned and practical applications that could become best practices. RESULTS/ANTICIPATED RESULTS: The Subgroup aggregated all questions into categories and developed sample questions incorporating all data without using any word for word. In order to allow for quantitative assessment and standardized reporting the Subgroup formulated questions to be responded to utilizing a Likert scale with free text fields for select questions where further information is needed. The Subgroup developed best practices describing decision-making metrics, understanding reasons for turnover and reporting data back to leadership. Practical aspects such as method and time of survey collection, anonymity, and training staff are also included. DISCUSSION/SIGNIFICANCE: We are hopeful that sample questions and best practices will be helpful and widely utilized. Understanding the causes and impacts of CRP turnover are critical to meeting the current needs of clinical research. Further work is being done to calculate the cost of turnover to make the business case.

OBJECTIVES/GOALS: Contrary to current dogma, prior work has suggested that in humans, SNP-determined endothelial cell reduction in CD39 expression associates with a diminished risk for venous thromboembolism. Our objective was to examine the impact of endothelial cell (EC) CD39 expression on arterial thrombosis that replicates human data. METHODS/STUDY POPULATION: We generated a novel CD39 cell-specific conditional knockout mouse line for endothelial cells (EC-cKO: Tie2-Cre+; cd39flox/flox versus WT: Tie2-Cre-; cd39flox/flox). We validated the knockout of expression of CD39 on EC using FACS analysis and measured EC CD39 activity using the Kinase Glo ATP hydrolysis assay on magnetically sorted EC. We then used a standard FeCl3 carotid injury model to evaluate time to arterial thrombosis in vivo by measuring time to occlusion tracked via a Doppler flow probe on the exposed vessel. RESULTS/ANTICIPATED RESULTS: FACS analysis revealed a specific 97% knockout of CD39 expression on EC (p<0.001) but not on other cells within the vasculature. There was also significant reduction in ATP hydrolysis (81%; p=0.019) in EC-cKO mouse EC versus WT. We next examined the time to arterial thrombosis. EC-specific conditional knockout of CD39 exhibited a significant prolongation in time to thrombosis compared to WT (WT: 8.28 minutes +/- 0.82; EC-cKO: 11.92 minutes +/- 1.34; p=0.024). Analysis of carotid blood-flow revealed that EC-cKO and WT mice had similar baseline blood flow velocity (p=0.51), but after vessel injury with FeCl3, EC-cKO mice exhibited a 16% increase maximal flow velocity relative to baseline compared to WT (p<0.001), as well as a 19% increase at 2-minutes post-injury in comparison to EC-WT mice (p<0.001). DISCUSSION/SIGNIFICANCE: Our findings demonstrate that CD39 activity plays a role in modulating arterial thrombosis and blood-flow regulation within the vasculature. These findings exemplify the therapeutic potential of modulating endothelial CD39 activity, as well as the potential for using SNPs within the gene coding for CD39 as a cardiovascular disease marker.

OBJECTIVES/GOALS: A barrier to the proliferation of team science is that academicians are often trained in disciplinary silos where “independent” research contributions are lauded. To tackle some of the most pressing scientific challenges, dismantling silos and increasing team science training efforts that focus on early career investigators is a must. METHODS/STUDY POPULATION: A team science training workshop for early career investigators from varied disciplinary backgrounds was informed by a 20-item needs assessment that addressed essential team science competencies and was completed by early career investigators participating in federally funded professional development programs on our campus. During the workshop, the benefits of cross-disciplinary teaming was discussed. Strategies including team formation, team effectiveness and/or dysfunction, diagnosing team strengths and weaknesses, and teaming in community settings were discussed. Instructional methods included short presentations, video clips, case studies, group discussions, pair and share activities, and panel discussions with expert role models encouraged active learning. RESULTS/ANTICIPATED RESULTS: The impact and value of the workshop series to participant’s professional development and knowledge of team science concepts will be evaluated before and after the workshop. Multiple Likert-scale items focused on team science competencies (e.g., confidence in your ability to carry out responsibilities specific to your role on a team, recognize when the team is not functioning well; engage team science practices in on-going research), and open-ended questions (e.g., importance of engaging community partners in academic research teams, vision of what factors contribute to an effective team science collaboration) will be completed by program participants before and after completing the workshop. DISCUSSION/SIGNIFICANCE: Effective collaboration among scientists with expertise in different disciplines is needed to address and solve complex scientific problems. We believe our interactive approach to team competency training sessions would work in a variety of settings and improve team skills.

OBJECTIVES/GOALS: To demonstrate the value of the Competency Index for Clinical Research Professional (CICRP) as a tool in program evaluation using a pre- and post- design to evaluate student perceived self-efficacy in clinical trial competencies at program entry and at program completion. METHODS/STUDY POPULATION: Using a separate-sample pre-post study design, we administered the CICRP questionnaire to students in the entry and exit courses of the Master of Clinical Research (MCR) Program during the 2021-2022 academic year, using QualtricsTM (Provo, Utah) survey instrument for use on desktop or mobile device. We included the 20 CICRP competency items asking students to rate their self-efficacy in performing each item using a Likert Scale (from 0-10) (0=not at all confident; 10= extremely confident). Links to the survey were included in the courses for the foundational entry course and for the final culminating project course. RESULTS/ANTICIPATED RESULTS: Overall, 54 students took the CICRP during the entry course and 56 during the exit. Cronbach’s alpha for each assessment ranged from 0.93 to 0.98. Both the Welch’s two-sample t-test and Wilcoxon rank-sum test show very significant differences between the group of students entering the program and leaving the program (p value < 0.001). A significant increase in mean CICRP total score is seen at each experience level between program entry and program exit (p<0.001) A linear regression, adjusting for available covariates, individuals taking the exit course have a mean CICRP total score 92.690 (p value < 0.001) higher than individuals taking the entry course. DISCUSSION/SIGNIFICANCE: Competency indices have been used to measure self-efficacy in translational research scientists, thus the use of CICRP to measure self-efficacy can be useful in assessing whether our competency-based program is meeting the JTF Competency needs of students.

OBJECTIVES/GOALS: To establish the root causes of vaccine hesitancy in populations who have less equitable access to health and healthcare services, and experience healthcare inequities, related to the environmental and social determinants of health, through community engagement and conversations, collaboration, circulation, and communication. METHODS/STUDY POPULATION: Existing data from a cross-sectional survey, vaccine hesitancy (VH) parent study, entitled 'Western New York (WNY) COVID-19 Collaborative to Promote Vaccine Acceptance,' conducted July to November 2022, after IRB approval, will be qualitatively analyzed. In the parent study, surveys were administered in WNY community congregations and community centers to individuals that historically have less equitable access to healthcare resources and may encounter health and healthcare disparities. Minorities, in urban and rural areas, age eighteen and older were identified through the NYS Department of Health’s Immunization Information System for daily vaccination rates. A qualitative analysis, promoting fact base HL, and building an inferential statical machine learning tool are the next steps. RESULTS/ANTICIPATED RESULTS: We anticipate the results to show an interplay of multiple factors, including personal, cultural, historical, social, and political, and varies depending on circumstances of time, place, and the type of vaccine being offered. Additionally, a lack of awareness or understanding of vulnerabilities and seriousness of vaccine-preventable diseases, lack of trust in health care providers, social norms, distrust of the healthcare system, biomedical research, and government policy, limited knowledge and understanding of vaccine safety and efficacy, and fear/uncomfortable with needles, as well as the less addressed environmental and social determinants of health associated with racial/ethnic minorities in communities with limited resources may also contribute to VH and less favorable health outcomes. DISCUSSION/SIGNIFICANCE: Identifying people who historically have less equitable access to healthcare resources and may be more likely to resist healthcare services, due to distrust in the system is important. Creating and evaluating an innovative tool to predict refusal of public health interventions is essential to avoid spreading preventable diseases.

OBJECTIVES/GOALS: This project will provide novel insights into mechanism(s) by which differences in inflammation develop & resolve, or fail to resolve, in metabolically different groups of bariatric surgery patients determined by Type 2 Diabetes status. My work may uncover unique differences between cohorts, encouraging development of personalized medicine. METHODS/STUDY POPULATION: I analyzed human blood samples collected before and 3, 6, & 12 months after bariatric surgery at the University of Kentucky through an established tissue bank. Subjects hadnormal glucose tolerance, pre-diabetes, or Type 2 Diabetes, based on HbA1c%. Iisolated peripheral blood mono nuclear cells & will comparecytokine profiles among cohorts across all time points. I will define & perturbmetabolic differencesin immune cells among cohorts & across time via isotope tracing, fuel source limitation, and metabolite inhibition. This will determine causal relationships between cytokine profiles & immune cell metabolism. RESULTS/ANTICIPATED RESULTS: I anticipatecytokine profiles, a functional output of immune cells, will differ among cohorts pre-surgery, and that this difference will diminish post-surgery. Differencesmay be insignificant by the 12 month time point. I also anticipate differences in fuel usage and metabolite productionin immune cells among cohorts pre-surgery, and that these differences only partially resolve post-surgery to poise immune cells for continued chronic inflammatory action. I hypothesize that T2D status has a lasting impact on immune cell function and fuel usage patterns, and will continue to supportchronic inflammation following short term T2D remission and longer-term weight loss. DISCUSSION/SIGNIFICANCE: There has been an alarming increase in obesity and its comorbidities over recent decades, and inflammation is a known supporter of T2D. The anticipated rewiring of immune cell metabolism post-surgery, if incomplete, may poise subjects forweight regain and T2D recurrence.

OBJECTIVES/GOALS: Tobacco use remains a significant public health problem in rural America. Community health centers (CHCs) can help reduce the burden of tobacco use in rural areas, but we know little about their knowledge and implementation of best practices for tobacco control. This study assessed the knowledge and existence of tobacco control practices in rural CHCs. METHODS/STUDY POPULATION: Using a cross-sectional study design, we electronically surveyed health administrators and providers (n=64) in six rural CHCs in Louisiana between March 2021 and June 2023. The assessment measured 1) knowledge of the U.S. Public Health Service Clinical Practice Guideline for Treating Tobacco Use, 2) the priority given to smoking cessation programming, 3) the presence of best practices for tobacco control programming, such as having a tobacco control champion and team, 4) establishment of treatment and smoke-free campus policies, and 5) existence of referral procedure to external cessation services. We used descriptive statistics to characterize survey participants and responses. RESULTS/ANTICIPATED RESULTS: Most of the respondents were female (80%), White (61.8%), between 35 and 49 years of age (48.1%), and non-smokers (72.7%). Only half (51.6%) reported knowledge of the guideline for treating tobacco use among all respondents. Only a third (32.8%) said their health center gave smoking cessation high priority relative to other health priorities. Only a third (35.9%) reported having a tobacco champion; less than a fifth (18.8%) said they had a tobacco control team at their health center. Although all health centers had a smoke-free campus policy, about a quarter (23.4%) were unaware of the policy. Less than a quarter (23.4%) reported having a written policy for smoking cessation treatment at their health center, and less than half (46.7%) knew about cessation services to which they could refer patients. DISCUSSION/SIGNIFICANCE: Rural CHCs had limited knowledge of the guideline for tobacco use treatment. Smoking cessation lacked priority, and the prevalence of tobacco control best practices implementation was low. Rural CHCs must improve their implementation of guideline-recommend policies and clinical strategies to promote treatment and reduce the burden of tobacco use.

OBJECTIVES/GOALS: Antibiograms are used to guide empiric antibiotic selection. However, it is unclear if antibiotic profiles differ between symptomatic urinary tract infections (UTIs) and asymptomatic bacteriuria (ASB). We aimed to compare antibiotic susceptibility profiles of urinary E. coli isolates from patients with a symptomatic UTI to those with ASB. METHODS/STUDY POPULATION: We conducted a cohort study of 1,140 urinary E. coli isolates from unique patients that received care through Vanderbilt University Medical Center (VUMC) from Nov 2020 – Jun 2021. We included any patient that was seen at VUMC as an inpatient, outpatient or at the emergency department with ≥ 105 colony forming units/mL E. coli detected from a clinical urine specimen. Chart abstractions were performed to capture reported UTI symptoms and demographic information. Descriptive statistics were conducted to compare antibiotic susceptibility profiles (i.e., susceptible, intermediate, resistant) between symptomatic and ASB groups. The risk of detection of a multidrug-resistant organism (MDRO) (intermediate, or resistant to at least one antibiotic in three or more classes) was assessed between groups. RESULTS/ANTICIPATED RESULTS: Among 1,140, 1,018 (89%) and 122 (11%) were symptomatic and ASB, respectively. When comparing symptomatic and ASB, the median ages were 50 and 46. Groups had similar proportions of no indwelling catheter (94% v. 95%) and without diabetes (87% v. 88%). The collection setting between inpatient, emergency department, and outpatient were similar with most being outpatient (79% v. 83%). The proportion of patients who were pregnant, immuno compromised, or had a structural/functional urinary tract abnormality were higher in the symptomatic group. The proportion of isolates resistant and susceptible to tested antibiotics were similar between groups, with only ciprofloxacin showing slightly higher resistance among ASB (16% v. 25%). The risk of MDRO detection was similar between groups (RR: 0.858, 95% CI: 0.64, 1.15). DISCUSSION/SIGNIFICANCE: Antibiotic susceptibility comparison demonstrated similar profiles, which suggests antibiogram use as appropriate to guide ASB treatment. Results offer insight on whether traditional methods for assessing antibiotic susceptibility on population-levels could benefit from further refinement by patient-specific clinical parameters.

OBJECTIVES/GOALS: Patients with multiple myeloma (MM) experience significant disease- and treatment-related symptom burden, especially with higher lines of therapy (LOT). We used a remote symptom monitoring app to characterize overall symptom profile, symptom bother, and quality of life (QOL) among patients with MM across LOT and longitudinally. METHODS/STUDY POPULATION: We used Carevive PROmpt, a symptom monitoring app for cancer patients. From 11/10/22 to 9/27/23, we enrolled 84 adult patients with MM of any stage and anywhere in the treatment continuum from Duke Health MM clinics. Participants received weekly symptom surveys while on active treatment. Per prior studies, we defined heavily pretreated patients as those on current LOT ≥4. Our sample had a mean (SD) age of 63.7 (10.8) years and was 56.0% male; 73.8% had a prior bone marrow transplant, 40.5% were on LOT ≥4 (53.6% on LOT <4, 6.0% missing), 58.3% were on triplet therapy or higher. For 14 symptoms, we described the prevalence of moderate to very severe (MOD-VS) symptoms based on LOT overall and over time. We also described responses to “How bothersome are treatment side effects?” and “Overall QOL over the past week” based on LOT. RESULTS/ANTICIPATED RESULTS: Surveys continued for a mean (SD) of 14.9 (9.6) weeks (range: 44). The top 5 MOD-VS symptoms ever experienced were fatigue (66.7% of patients), neuropathy (48.8%), muscle pain (44.0%), insomnia (39.3%), and general pain (38.1%). Patients on LOT ≥4 had most of these symptoms more often than LOT <4 (fatigue: 70.6% of patients vs. 60.0%, neuropathy: 71.8% vs. 40.0%, muscle pain: 47.1% vs. 42.2%, insomnia: 35.3% vs. 40.0%, general pain: 47.1% vs. 33.3%). For those on LOT ≥4, 42.9% of survey responses endorsed “somewhat”, “quite a bit”, or “very much” symptom bother compared to 32.7% for LOT <4. QOL was similar between groups. Over many months, patients on LOT ≥4 had several persistent symptoms (neuropathy, sadness, insomnia), but even those on LOT <4 had unmet symptom needs (fatigue, general pain, constipation). DISCUSSION/SIGNIFICANCE: Evidence shows that treatment selection at higher LOT in MM often underrates the impact of cumulative symptom burden. Our study reveals significant longitudinal unmet needs regarding symptom and distress management in MM; understanding this can help guide treatment decisions and palliative care for MM patients with escalating treatment demands.