OBJECTIVES/SPECIFIC AIMS: Intestinal stem cells (ISC) primarily act in the repair of ulcerated epithelium, and their proliferative capacity relies on Wnt/β-catenin signaling. However, the role of GCs on basal epithelial cell signaling has not been fully characterized. The objective of this study was to interrogate a mechanism by which steroids may limit ISC activation. GCs inhibit NFκB signaling, which has been shown to play a role in nuclear β-catenin activation in epithelial cells. We hypothesized that GCs limit Wnt/β-catenin signaling required for ISC activation and epithelial restitution by inhibiting NFκB activation in epithelial cells. METHODS/STUDY POPULATION: To examine the effects of GCs on intestinal epithelial cells, we treated a nontransformed human colonic epithelial cell line (NCM460) with dexamethasone and observed the effects on NFκB and Wnt/β-catenin signaling events. We isolated mouse epithelial cells from the distal colon for stem cell culture as 3D “organoids.” We obtained pure epithelial cell preparations from mucosal biopsies isolated from patients treated at GI clinics at the University of Kentucky Chandler Hospital and VA Medical Center, Lexington. Steroid treated patients with equivalent levels of inflammation, but no mucosal ulceration were used as controls. RESULTS/ANTICIPATED RESULTS: In steroid-treated NCM460 cells, we saw an increase in steroid-responsive genes GILZ and SGK1. We saw a significant decrease in transcripts for Wnt target genes, including Axin2 and cmyc; NFκB target genes, including IFNG and IL6; and the shared NFκB and Wnt pathway co-activator CREBBP, despite unchanged transcript levels for β-catenin (CTNNB1). This data was corroborated in 3D stem cell cultures from cells isolated from mouse colon tissue, which had significant decreases in transcripts for stem cell markers Lgr5 and Ascl2, proliferative markers KI67 and PCNA, and Wnt target Axin2. NCM460s transfected with a lentivirus carrying a TCF/LEF luciferase construct showed a 2.5-fold decrease in TNF-stimulated luciferase activity with dexamethasone treatment. Interestingly, this effect can be rescued by glucocorticoid receptor (GR) blockade with RU-486. Intestinal epithelial cells from patient biopsies showed significant decreases in colitis-induced Axin2, p-LRP6 (a positive marker of Wnt Signaling) and nuclear β-catenin, which correlated with decreased p-p65 protein levels. DISCUSSION/SIGNIFICANCE OF IMPACT: Together, these data suggest that steroid therapy inhibits Wnt/β-catenin signaling at multiple levels, and effects stem cell proliferation in pure stem cell cultures. Decreases in TCF/LEF transcriptional activation (nuclear β-catenin’s DNA binding target) can be reversed with steroid receptor blockade with RU-486, suggesting that a receptor level interaction may be occurring. Interestingly, the required co-activator CBP, shared between NFκB and Wnt pathways, has decreased transcription following steroid treatment, which may provide a mechanism for limited Wnt activation following steroid therapy. Although steroids play a significant role in regulating the amount of inflammatory damage that occurs during IBD treatment, our data suggest that they may be limiting pathways required for effective healing as well.

Objectives/Goals: We developed an educational online module to equip researchers with knowledge, skills, and resources for conducting community-engaged research, aiming to foster meaningful collaboration between academia and communities. Methods/Study Population: A working group was formed, including three research faculty, four staff members, and four community partners who have partnered with researchers on community engaged projects. The working group first identified three objectives for the module and outlined what should be covered for each objective. The working group identified existing resources, texts, and videos that would address the objectives and worked in small groups to create additional content for the module. A smaller subgroup then took this content, organized it, and worked with the Office of Online Education to put the content into an interactive online format. Results/Anticipated Results: The three objectives identified for the online module are 1) Describe community engaged research, the purpose it serves, and why researchers do it; 2) Identify how to seek and collaboratively engage with a community partner; and 3) Identify and connect with resources for conducting community engaged research in Indiana. Each objective contains text, interactive figures and images, links to external resources or further reading, and videos of researchers and community partners talking about their own experiences and lessons learned. Each objective also includes activities and prompts for the learner to complete to apply the module content to the work they want to do. Discussion/Significance of Impact: Community engagement ensures research addresses real-world needs, builds trust, and includes diverse perspectives. Many researchers lack best practices to do this ethically. This module teaches skills needed to foster trust through transparency, respect, and by incorporating community voices.

ABSTRACT IMPACT: By understanding Junior investigator characteristics and CTSA support services which strongly influence scientific productivity and impact, we will inform and improve research training and enhance the career development of future generations of clinical and translational science researchers. OBJECTIVES/GOALS: In the field of clinical and translational science, the career trajectory and definition of Junior Investigators (JIs) vary greatly. This study aims to investigate JI characteristics, training, and support that contribute to career development at the University of California Los Angeles (UCLA) Clinical and Translation Science Institute (CTSI). METHODS/STUDY POPULATION: Every 18 months, the UCLA CTSI administers the Longitudinal Scientific Achievement Survey, which collects information on the predictors of scientific productivity and impact. In 2018, a special supplement was added to survey JIs who received CTSA support between 2011 and 2017 (n=305), including questions on knowledge, use, and effectiveness of CTSA specific support, barriers and facilitators of research, scientific productivity, and perceived scientific impact. A literary analysis was conducted to explore previous categorizations of JIs. The JIs in our sample conducted bench to bedside, population and policy research at our four partner sites. Bivariate and logistic regression analysis were conducted to examine the significant predictors of a new grant award attributed to the CTSA support/services. RESULTS/ANTICIPATED RESULTS: The survey response rate was 82% (n=250). Respondents include core voucher co-investigators, enrollees in the Training Program in Translational Science, and K- and K-to-R workshop participants. Bivariate results showed new grant awardees significantly more likely to have the following characteristics: physician scientist with an MD and PhD (47%), pilot grant awardee (42%), core voucher awardee (49%), four or more types of CTSI support (48%), prior affiliation with an NIH institute/center other than NCATS (42%), and reported at least one impact in science, health, and/or the community (72%). Multivariate results showed that investigators with a prior core voucher award, a prior NIH affiliation, or reported one or more impacts were the strongest predictors of obtaining a new grant (each with OR>=4.0). DISCUSSION/SIGNIFICANCE OF FINDINGS: The most successful investigators consulted with NIH program officers and received feedback on their research plans and methods. Sufficient funding is crucially important to research progression. In our CTSA hub, vouchers and grants to initiate new studies or offset costs of existing research are consistent predictors of new extramural funding.

OBJECTIVES/SPECIFIC AIMS: Our aim was to assess the feasibility and acceptability of a VW-based cardiac rehabilitation (CR) program (Destination Rehab) as an extension of a face-to-face conventional CR program. We hypothesized that a VW-based CR program could be successfully implemented as an extension of conventional CR and would have high acceptability among cardiac patients. METHODS/STUDY POPULATION: We recruited 30 adult cardiac patients (10/site) hospitalized at Mayo Clinic Hospitals in Rochester, MN, Jacksonville, FL or Scottsdale, AZ with a diagnosis for CR (eg, acute coronary syndrome (ACS), heart failure, elective percutaneous coronary intervention (PCI)). Other inclusion criteria included at least 1 modifiable, lifestyle risk factor target: sedentary lifestyle (< 3 hours physical activity (PA)/week), unhealthy diet (< 5 servings fruits and vegetables/day) or current smoking (>1 year). Patients participated in an 8-week, health education program using a VW platform from a prior proof-of-concept study and provided intervention usability, usefulness and satisfaction feedback. We assessed cardiovascular (CV) health behaviors (diet, PA) and risk factors (eg, blood pressure (BP), lipids) at baseline and immediate post-intervention. RESULTS/ANTICIPATED RESULTS: Among 30 patients enrolled (mean age; 59 years; 50% women; 65% <college graduate; 32% annual household income <$50,000), 28 (98%) completed the study. The majority (64%) were enrolled in conventional CR with a high session completion rate (median 36 sessions, interquartile range 8-36). The most common CR indication was PCI (68%). There were statistically significant improvements in PA from baseline to post-intervention: vigorous PA, +10.7 (SD 11.7) minutes/day (p = 0.05) and flexibility exercises +0.9 (SD 0.9) days/week for men (p=0.05). There were favorable trends in risk factors: systolic BP (−6.8 mmHg, SD 29.8), total cholesterol (−31.6 mg/dL, SD 46.2) and LDL (−26 mg/dL, SD 44.8) from baseline to post-intervention, although not statistically significant. The majority reported that they would continue to use VW as a resource (76%) and agreed/strongly agreed that the program improved their heart health knowledge (86%) and assisted with adapting healthier lifestyle (100%). Overall, the VW CR program received a rating of 8 (scale 0-10). DISCUSSION/SIGNIFICANCE OF IMPACT: VW-based CR program is a feasible, highly acceptable and innovative platform to influence health behaviors and CV risk and can increase accessibility to disadvantaged populations with higher CVD burdens.

OBJECTIVES/SPECIFIC AIMS: To establish a conceptual framework todevelop a CTS-IDP with data analytics, and an e-Learning Faculty DevelopmentGuide on best practices and use of the IDP over the CTS academic life-course.METHODS/STUDY POPULATION: To accomplish our goal, we propose thefollowing methods: (1) an online survey, using a convenience sample of the 24KL2 CTSA IDP Collaborative members (conducted in 2017), to assess perceivedneeds for a universal CTS-IDP, current IDP practices, barriers to IDP use, andto discern and align each CTSA Hub’s interests, expertise andcommitment to specific areas of the study; (2) A scoping narrative literaturereview, utilizing the Arksey and O’Malley framework covering the timeperiod corresponding to the initiation of funding (1999) of the original K30Clinical Research Curriculum Awards through to the present CTSA funding period,incorporating Medical Subject Heading (MeSH) keywords (career development;career development plan; employee plan; mentoring plans; compacts; researchcontracts; career planning; mentor guide), initially delineated by USC referencelibrarian and to be expanded by reference librarian services from the IcahnSchool of Medicine at Mount Sinai and University of Rochester, and performed onNIH searchable databases including NCBI PubMed, Central and Medline &Worldwide Science; Web of Science, ProQuest, ProQuest Abi/Inform,Google Scholar, Cochrane, Ovid MEDLINE databases, as well as Google forpublished papers in English and Spanish. For this portion of the work, we willdescribe and characterize (1) research career development or progressionconstructs, domains, and milestones; (2) establish the presence or absence ofdefined and/or pre-specified timed milestone objectives and inclusionof SWOT analytics (strengths, weaknesses, opportunities, and threats)and/or Gantt chart approaches; (3) delineate IDPs structure, toolkitsand their key features (competencies, skills acquisition and processesutilized); (4) and identify specific gaps to best address the need forpersonalized career development education. Based on this review, we willsynthesize CTS milestones, develop a time frame for meeting RCD expectations,and establish RCD benchmarks for achieving these milestones, all in consensuswith the IDP Collaborative Workgroup. RESULTS/ANTICIPATED RESULTS:Seventy-seven percent of the IDP CTSA’s responded to the onlinesurvey, led by University of Rochester, and the results can be summarized asfollows: (1) 100% agreed that the IDP process is important and shouldbe considerably improved to optimize effectiveness; (2) a range of diverse IDPformats are utilized, making comparisons across programs difficult; (3)50% of CTSA hubs report only fair to good compliance with the IDPprocess; (4) a major barrier to the IDP process is lack of instruction regardinghow best to utilize; (5) poor alignment of currently available IDPs designed forbasic science PhDs with CTS investigators; (6) an absence of a CTS specific IDPto best foster RCD for this specific career trajectory. When asked: What are thebarriers to writing a detailed and thoughtful IDP, responses in order ofagreement from greatest to least were: No verification of acquired competencies,beyond self-report (56%), Static platform (38%), Notconstructed for clinical and translational researcher (31%), Noanalytical or documentation on use (31%), No instruction given toscholars on how to use it effectively and efficiently (31%), The IDPwe are using is more constructed for PhD students and postdoctoral fellows(25%), No instruction given to the scholars on why it is important asadult learners (19%), and Not constructed for early careerphysicians/scientist (13%). Additional progress has beenmade on our Scoping review: An initial ABI/Inform and PubMed USCresearch librarian conducted search using Author names yielded 72 articles, ofwhich only 2 were relevant to the topic at hand. A ProQuest™ searchyielded 19 potentially relevant articles, 11 of which were of relevance to thetopic of IDPs; and a Google Scholar search yielded 18 and 25 on careerdevelopment and self-management, respectively. This has enabled us to put forthan initial model of factors that impact the purpose and design of IDPs thatincludes? DISCUSSION/SIGNIFICANCE OF IMPACT: Discussion: Our initialdata suggests that many CTSA institutions see the need to further enhance thementoring process with a more informed and personalized IDP template andprocess. Furthermore, our initial scoping review suggests a framework upon whichto build specific components of a more ideal and useful IDP to best guidementored research career development of CTS trainees. Significance: Developingand evaluating collaborative evidence-based CTS IDP and corresponding e-LearningGuide could potentially prevent or reduce important delays in RCD, a commonroadblock for the translation of clinical interventions. Ultimately, the CTS-IDPserves not only to support and frame a scholar’s RCD“habits of mind” during training and early careerdevelopment but to also to achieve a sustainable long-term career at a CTSresearcher equipped to meet the ever challenging and dynamic researchlandscape.

Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.

Pragmatic trials aim to generate timely evidence while ensuring feasibility, minimizing practice burden, and maintaining real-world conditions. We conducted rapid-cycle qualitative research in the preimplementation period of a trial evaluating a community paramedic program to shorten and prevent hospitalizations. Between December 2021 and March 2022, interviews (n = 30) and presentations/discussions (n = 17) were conducted with clinical and administrative stakeholders. Two investigators analyzed interview and presentation data to identify potential trial challenges, and team reflections were used to develop responsive strategies. Solutions were implemented prior to the commencement of trial enrollment and were aimed at bolstering feasibility and building ongoing practice feedback loops.

OBJECTIVES/SPECIFIC AIMS: Responding to the need and interest of students and faculty of the UHSP in learning about CTR, the Title V Cooperative Project between UPR-MSC and UCC, developed and offered a training cycle (TC) in CTR. METHODS/STUDY POPULATION: Undergraduate students (US), undergraduate faculty (UF), and graduate students (GS) were invited to register in: Research Education Towards Opportunities (RETO) and Mentorship Offering Training Opportunities for Research (MOTOR), which consisted of 20 hours of training in CTR, with interdisciplinary sessions in: Introduction and preparation of a presentation in CTR; Identify, interview and share a presentation of a CT researcher; participation in conferences and a summer camp in CTR. At the end of the TC, surveys—satisfaction and needs assessment—for training in CTR were administered. RESULTS/ANTICIPATED RESULTS: Thirty-three (33) registered in the TC, distributed: 13 (39.39%) US in RETO, 12 (36.36%) GS and 8 (24.24%) UF in MOTOR. Of these, 25 (75.75%) answered and submitted the on-line surveys and received a completion certificate. All (100%) were satisfied with the TC, and for 96% of the respondents, their expectations were fulfilled, and will continue in the TC. They selected critical review, scientific communication, and cultural diversity as thematic areas of interest. In addition, 60% of them selected neuroscience, cancer and medical imaging as main research areas of interest. DISCUSSION/SIGNIFICANCE OF IMPACT: The TC demonstrated to be an effective strategy to provide new knowledge, experiences, and interest in CTR. It also established a pathway for future engagement in CTR.

OBJECTIVES/GOALS: The Mayo Clinic Clinical and Translational Science (CTS) Predoctoral program aims to develop independent researchers capable of leading multi-disciplinary teams to accelerate the translation of discovery to application. Here, we detail the outcomes of our graduates over the past ten years (2010-2019). METHODS/STUDY POPULATION:): A survey was fielded with all CTS graduates whose degrees were conferred since the program’s inception to 2019. Items addressed their current position, whether they were still involved in research, what type of research they were involved in, and whether they stayed involved with education. They also submitted a recent CV, from which data were collected about publications and grants. A subset were then contacted for a semi-structured interview. Items included questions addressing motivation for pursuing a PhD in CTS, whether the program prepared them for their current work, gaps they felt they had in training, and whether they felt they were making a difference in the lives of patients. RESULTS/ANTICIPATED RESULTS: Of the 41 alumni, 34 responded (83% response rate). Of these, 19 (56%) are at Mayo Clinic, 9 (26%) work for other academic institutions, and 6 (21%) do not work for an academic institution. Most have remained in research (33/34, 97%). The majority (22/33, 67%) are involved in clinical research, 30% (10/33) in basic science, and 24% (8/33) in healthcare delivery research. Most (23/34, 68%) are engaged in educational activities. When asked about changes they have led, 67% (18/27) led quality improvement projects and 44% (12/27) designed a new research method. Several hold leadership positions either in their organization (12/16, 75%) or in a professional organization (10/16, 63%). DISCUSSION/SIGNIFICANCE OF IMPACT: The CTS Predoctoral program successfully prepares scholars for careers involving clinical and translational research; furthermore, alumni remain in research-oriented careers after graduation. We will continue to gather longitudinal data alumni move forward in their careers.

OBJECTIVES/GOALS: Despite food pantries’ efforts to improve nutritional quality and encourage healthy cooking, limited evidence exists regarding pantry shoppers’ culinary preferences and kitchen equipment access. This project utilized pantry food demonstrations and samples to collect recipe and kitchen tool feedback. METHODS/STUDY POPULATION: For 4 months, a Culinary Medicine team delivered food demonstrations at Crossroads Community Services food market in Dallas, Texas, which serves primarily Hispanic and Black residents. Each demo provided a food sample, corresponding printed recipe in English or Spanish, and a survey. Part 1 of the survey measured shoppers’ hedonic liking of the sampled food and their likelihood of recreating it. Part 2 used the same scale for non-sampled recipes adapted from Health meets Food Community Culinary Medicine programming. Averages of appeal and likelihood to cook between sampled and unsampled groups were compared with a student’s T test. Part 3 contained a visual graphic of 24 kitchen appliances, and shoppers circled each item they owned. Investigators collected surveys from 207 shoppers across 12 demos. RESULTS/ANTICIPATED RESULTS: Preliminary analyses showed a positive response to the food demonstrations with a mean rating on a 5-point Likert scale of 4.58 for recipe appeal and 4.46 for likelihood of cooking the recipe at home. The Health meets Food recipes not demonstrated were also positively reviewed (4.40 for appeal and 4.32 for likelihood to cook). There was a statistically significant difference in appeal between sampled and non-sampled recipes (p = 0.03) while no significant difference was found for likelihood to cook (p = 0.08). On average, clients owned 75% of kitchen appliances with most clients owning a sauté pan (94%) but few having access to a food processor (27%). DISCUSSION/SIGNIFICANCE: An effective nutrition program for food pantry clients must be accessible, culturally relevant, nourishing, and enjoyable. Providing samples alongside recipes may increase appeal and engagement. Consideration of kitchen equipment access is essential to promote recipe recreation at home.

OBJECTIVES/GOALS: Missed appointments (MAs) negatively impact the health outcomes of adults living with type 2 diabetes mellitus (T2DM), causing disruptions in clinic operation and added financial cost to healthcare providers and systems. This study aimed to identify risk factors for MAs in both in-person and telehealth settings among adults living with T2DM. METHODS/STUDY POPULATION: Using a sequential multi-method design guided by the modified Quality-Caring Model, the quantitative phase of this study used electronic health records (EHR) data in Calendar Years 2019 and 2020 with 7,276 encounters made by 2,235 patients with T2DM from four diabetes clinics within a tertiary academic medical center in Baltimore, MD. Multivariable random effect logistic regression were used to examine the association between MAs and included predictors (i.e., patient characteristics [e.g., age, race, health status], health provider factors [e.g., types of provider], and health system factors [e.g., scheduling lag]). Based on the results of the quantitative phase, a purposive sample of 23 adults with T2DM and 10 providers were then interviewed individually via phone or zoom. RESULTS/ANTICIPATED RESULTS: The EHR data found that the following variables decreased the odds of MAs: having an activated patient portal account, patients with age over 46 or with white race. Telehealth was associated with 50% decreased odds of MAs during COVID (after 3/23/2020). On the other hand, longer scheduling lag increased the odds of MAs. Qualitative interviews revealed that MAs were often related to social needs, such as lack of/limited health-related transportation and its associated financial burden. Telehealth helped break these barriers for some adults with T2DM, but technical challenges in telehealth persisted for those with low digital health literacy and people who did not have a digital device and/or with unstable internet connection. Providers worried that these challenges might undermine the quality of diabetes care. DISCUSSION/SIGNIFICANCE: Disparities in MAs by age and race were noted, which might reflect the impact of unmeasured social needs in EHR. Perceived convenient telehealth may reduce MAs in T2DM care. However, the persistent technical challenges of telehealth should be addressed to optimize the quality of diabetes care and to promote care continuity for underserved populations.

ABSTRACT IMPACT: The Summer Foundation on Research gave undergraduate students the opportunity to do research despite the new normal - COVID-19 pandemic. OBJECTIVES/GOALS: The COVID-19 pandemic prevented domestic and international undergraduate students from attending in-person Mayo Clinic Summer Undergraduate Research Programs. Mayo decided to redesign this program as a virtual, 4-week Summer Foundations in Research (SFIR) program. The goal of this program was to give students a scientific research experience. METHODS/STUDY POPULATION: The SFIR included an Introduction to Experimental Design, Dialogue methodology for communicating science, scientific mentoring, asynchronous online modules and a Resiliency component. Evaluations of the program were undertaken to gather feedback for program improvement and to assess the educational and mental health impact on participants. These evaluations asked student to rate each section of the program. Additionally, students were encouraged to provide their own comments and feedback. Statistical analysis of quantitative data was performed using excel. The qualitative data was studied using the identification, analysis and interpretation of patterns method per the student’s comments on each of the questions addressed in the survey. RESULTS/ANTICIPATED RESULTS: These evaluations revealed positive outcomes across program components: 66% of the participants found the Resiliency component extremely worthwhile, 80% of participants liked the experimental design and 70% liked the educational courses. Qualitative data showed that mentor/mentee interactions were highly valued, and both participants and faculty suggested increasing the amount of time devoted to these interactions. Small group discussions gave students the opportunity to get to know other peers and encouraged further discussions about science and the community. Participants suggested minor improvements to the program, such as re-creating the online modules specific for undergraduate students, increasing 1-to-1 and small group’s discussion, and increasing the length of the program. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite the quick pivot of the SFIR program, the re-design and new format supported the development of participants’ resilience skills and training as future scientists during a particularly challenging time. Mayo is committed to continuing this program as an early step in a pathway to careers in research.

OBJECTIVES/GOALS: During the COVID-19 pandemic, translational scientists sought to provide scientific and data expertise to school districts serving diverse and disadvantaged students to enable equitable access to in-person learning. METHODS/STUDY POPULATION: We showcase two CTSA examples. One is a partnership with the second largest U.S. school district; the second is a national network of scientists and urban and rural school districts. In each example, CTSAs assembled expert science teams to support data-driven decision-making. The teams provided honest brokering of COVID-19 science, scientific interpretation that is sensitive to local context, and responses to community-driven questions. The teams collaborated with school district partners to design actionable data displays on key metrics including primary COVID-19 cases, school-acquired cases, quarantines, and missed school. The national ABC Science Collaborative) provided a platform for shared learning and reproducibility and credibility of science using district data. RESULTS/ANTICIPATED RESULTS: The CTSAs developed easily interpretable and actionable data displays. Partnered school districts observed data in real time to identify signals of change. Districts in the national network were able to learn in real time from variation across districts based on policies and procedures that they adopted, such as quarantine, masking, and physical distancing. DISCUSSION/SIGNIFICANCE: This scientific collaboration is a model of rapid CTSA response, informing science and real-time action. The data displays enable school districts to explain decisions regarding student and staff health and safety. These partnerships and data designs are infrastructure that can be quickly mobilized for emergent and for ongoing information needs.

OBJECTIVES/SPECIFIC AIMS: This study will elucidate what percent of unnecessary ED visits for chronic conditions can be reduced by extant telemedicine devices, and which telemedicine devices can yield the greatest reduction in unnecessary ED visits for chronic conditions. METHODS/STUDY POPULATION: We intend to use the Nationwide Emergency Department Sample (NEDS) to estimate the percent of ED visits, with a chronic condition as the principal diagnosis, were only evaluation and management services were rendered. The NEDS is the largest publicly available, all-payer ED database, providing national estimates of ED visits. The NEDS contains information on patient demographics, principal diagnosis (captured by ICD-9-CM codes and defined as the main reason for bringing the patient to the hospital), and procedure codes using Current Procedural Terminology, Fourth Edition (CPT-4). Patients with a chronic condition will be identified using Chronic Condition Indicator developed by the Agency for Healthcare Research and Quality and, from them, patients who only received “evaluation and management” services will be extracted using the CPT-4 codes 99281–99283 and G0380–G0383. Then using our previously developed database, wherein FDA-approved OTC medical devices were allied to chronic conditions by applying the transitive property of equality between telemedicine devices – measurement and measurement – conditions pairs, we will elucidate what percent of unnecessary ED visits for chronic conditions which can be reduced by extant telemedicine devices. RESULTS/ANTICIPATED RESULTS: We anticipate multiple OTC telemedicine devices will be necessary to evaluate and manage common principal conditions. DISCUSSION/SIGNIFICANCE OF IMPACT: Telemedicine is seen as a potentially powerful tool for improving healthcare and reducing cost. UnitedHealthcare, the largest US insurance provider, has partnered with Doctors on Demand, the largest players in the telemedicine app space, and other app-based telemedicine services to provide on-demand access to physicians. However, to reach the full potential of telemedicine, and more specifically towards reducing unnecessary ED visits for chronic conditions, telemedicine services need to include capabilities that will allow for the evaluation and management of chronic conditions. This study is a pragmatic first step towards understanding what telemedicine devices would best augment existing telemedicine services to reduce unnecessary ED utilization.

Objectives/Goals: Goals for this work include identifying areas for continuous curricular improvement as well as documenting best practices in multidimensional mentoring in innovation. Programmatic goals include pivoting early career scientists toward translational science solutions that are commercially viable. Methods/Study Population: Using Likert-scaled perception surveys of fellowship participants, preliminary pre- and post-fellowship responses are presented. Preliminary regression analyses are used to identify trends in participants’ ratings across innovation pathways and customer-focused design. Results/Anticipated Results: Focusing on the initial cohort of fellows’ perceptions of their competencies in the areas of technology propositions and industry networking, we observed a near twofold improvement reported competency, suggesting a key strength area for the Fellowship program. Discussion/Significance of Impact: First of its kind at Penn State College of Medicine, the Center for Medical Innovation’s partnership with Clinical and Translational Science Institutesignals enhanced commitment to developing early career fundamental scientists in the areas of intellectual property, customer-focused design, and commercialization. Significance of this work includes capturing best practices.

OBJECTIVES/SPECIFIC AIMS: Upper-extremity (UE) impairment affects 88% of stroke survivors due to dysfunctional shoulder-hand coordination. Patients may be able to grasp with the arm at rest, but unable to grasp in a functional context (eg, from a high shelf) because shoulder use elicits involuntary hand muscle activity. Further, much rehabilitation research is directed at unsuccessful stroke recovery (patients with persistent UE impairment) but very little towards patients who show successful clinical recovery (such as those with mild UE impairment) even though these patients have attained the desired rehabilitation outcome. We examined the neurophysiological trajectory of successful compared to unsuccessful post-stroke recovery in the context of functional UE movements to clearly identify what factors are necessary for successful recovery of functional UE movements after stroke. METHODS/STUDY POPULATION: We studied 3 populations: (1) mildly-impaired patients, early (at <17 d, 30 d, 90 d, and 180 d) after stroke as a model of successful post-stroke recovery, (2) moderately-impaired, chronic patients (>6-months post stroke) with persistent hand function impairment, as a model of incomplete post-stroke recovery (unsuccessful recovery), and (3) Healthy age-range matched controls. We used transcranial magnetic stimulation (TMS) in all 3 groups at the given time points to measure corticomotor excitability (motor evoked potentials, recruitment curve), corticomotor inhibition (short-interval intracortical inhibition, long-interval intracortical inhibition), and intracortical facilitation of hand muscles with the shoulder positioned in different degrees of flexion or abduction (these shoulder positions are known to elicit involuntary, undesired hand muscle activation, which leads to UE dysfunction and impairment in individuals with stroke). RESULTS/ANTICIPATED RESULTS: Data collection are in process and will be presented. Preliminary data from controls shows that corticomotor excitability of selected hand muscles is affected by changes in shoulder position. Preliminary findings in controls are consistent with clinical findings in stroke that certain shoulder positions elicit involuntary and undesired hand muscle activation, leading to UE dysfunction and disability. Findings from the stroke groups will be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: We hypothesize that this centrally-facilitated coupling between shoulder and hand muscles is disrupted after stroke, which may play a central role in the inability of patients to perform functional UE movements. By comparing the TMS metrics in mildly-impaired Versus moderately-impaired chronic patients, we will be able to identify the longitudinal change in neurophysiology underlying shoulder-hand coordination that is associated with successful or unsuccessful clinical recovery of UE function after stroke. Thus, these findings will help us distinguish between the neurophysiology underlying successful from unsuccessful UE recovery leading to more mechanism-based interventions for UE dysfunction post stroke in the future.