Objectives/Goals: Unsafe sleep practices contribute to sleep-related infant mortality, a leading cause of preventable sudden unexplained infant death (SUID). Infant illness represents a risk for SUID. However, the mechanism behind this increased risk is unknown. The objective of this study was to measure changes to safe sleep practices during infant illness. Methods/Study Population: We performed a prospective cohort survey study of infants aged 0–12 months presenting to the pediatric emergency department. We assessed sleep practices prior to illness, during illness, and 2 weeks and 1 month following illness. We assessed adherence to American Academy of Pediatrics safe sleep recommendations at each point in time. Wilcoxon sign rank test was used to examine changes between time points. Regression models compared caregivers who reported a change to unsafe sleep practices with those who did not. Results/Anticipated Results: Of enrolled participants (n = 142), 110 (77%) completed all three follow-up surveys. For those with complete follow-up, 62.4% were female, 60.3% were Black, non-Hispanic, 25.7% were White, non-Hispanic. The most common chief complaint was respiratory illness (35.7%), followed by fever (22.7%), and 70.3% of patients were discharged home. Across all sleep behaviors surveyed, caregivers reported, on average, a 12% change to unsafe sleep practices during illness. These changes were sustained at the 2-week and 1-month follow-ups. Factors associated with a change to unsafe sleep practice were parental age. Discussion/Significance of Impact: Over 10% of infants experienced a change to unsafe sleep practices during illness, sustained at 2-week and 1-month follow-ups. This may explain the association of infant illness with SUID. Interventions promoting safe sleep adherence during illness are key to decreasing sleep-related infant mortality.

Psychosocial factors play an important role in the manifestation of attention-deficit/hyperactivity disorder (ADHD) symptoms and accompanying impairment levels in children. In a community sample of 796 children evaluated at 4, 5, and 6 years of age, bidirectional effects were examined for each of three components of parenting (parental support, hostility, scaffolding skills) and ADHD-specific symptoms that are not associated with symptoms of oppositional defiant disorder. Results indicated that (a) age 4 parenting factors were not associated with changes in ADHD-I (inattention) or ADHD-H (hyperactive-impulsive) symptoms in the subsequent year, (b) ADHD-I and ADHD-H symptoms at age 4 were not associated with changes in parenting factors at age 5, (c) age 5 ADHD-I and ADHD-H symptoms were associated with decreases in parental scaffolding skills and increases in parental hostility from ages 5 to 6 years, and (d) parental support at age 5 was associated with a decrease in ADHD-H symptoms at age 6. Findings suggest that ADHD symptoms can lead to poorer parenting attitudes and behavior, while parental support during kindergarten has a small effect on decreasing ADHD-H symptoms over time.

Background: The 2022 WHO global survey on infection prevention and control (IPC) exposes significant gaps in IPC in the WHO Southeast Asia region. A better understanding of IPC vulnerabilities will inform improvement initiatives. We describe an evaluation of IPC practices known to prevent and contain carbapenem-resistant organisms (CROs) at hospitals participating in the United States Centers for Disease Control Global Action in Healthcare Network –Antimicrobial Resistance in India. Prior hospital evaluations suggest resistance to carbapenems among gram-negative isolates is up to 45%. Methods: We conducted a mixed methods evaluation including cross-sectional surveys, semi-structured interviews, and site observations at five hospitals (one government, two private tertiary care, and two private teaching) located in three cities. The number of hospital beds ranged from 362 to 2,011. Hospital and IPC program characteristics, and CRO prevention and containment activities were examined virtually. Site observations focused on hand hygiene, environmental cleaning, personal protective equipment (PPE), CRO containment practices and use of water for patient care. Results: All sites had IPC programs with established policies and qualified IPC staff. The IPC nurse-to-bed ratio ranged from 1:73 to 1:432 (mean, 1:209). Due to the integral role of microbiology staff in IPC at these hospitals, the two departments had strong communication channels associated with CRO identification. Screening for CRO colonization, if done, targeted patients from outside hospitals. Three of the five hospitals routinely implemented contact precautions for patients with identified CROs, displayed isolation signage at the bedside, and provided adequate PPE at point-of-use; however, all sites reported barriers to effective isolation and/or cohorting patients with CROs. Timely communication of CROs to clinical staff varied and no sites effectively relayed CRO status upon patient discharge to another facility. IPC teams identified gaps in environmental cleaning procedures and practices related to medical devices and equipment. All sites used alternatives to tap water for clinical care and sink etiquette was evident. Each IPC team performed audits of patient isolation and hand hygiene practices. Despite the considerable proportion of IPC resources dedicated to daily education and feedback in clinical areas, the IPC teams reported that improvement was often difficult to achieve. Conclusion: Given the high burden of CROs and limited IPC resources, detailed knowledge of IPC opportunities for improvement will help hospitals target novel interventions for CRO prevention and containment. Further investigation of colonization rates and effective performance improvement methods in these settings is needed.

Disclosure: Patricia Simner: Research Contracts: BD Diagnostics, OpGen Inc., Qiagen Sciences Inc, T2 Diagnostics, Accelerate Diagnostics; Research Collaborators:Ares Genetics, CosmosID, IDbyDNA, Illumina; Consulting: OpGen Inc., BD Diagnostics, Shionogi Inc., GeneCapture, Qiagen Sciences Inc, Entasis, Day Zero Diagnostics, Next Gen Diagnostics

OBJECTIVES/GOALS: Adoption of the Observational Medical Outcomes Partnership (OMOP) common data model promises to transform large-scale observational health research. However, there are diverse challenges for operationalizing OMOP in terms of interoperability and technical skills among coordinating centers throughout the US. METHODS/STUDY POPULATION: A team from the Critical Path Institute (C-Path) collaborated with the informatics team members at Johns Hopkins to provide technical support to participating sites as part of the Extract, Transform, and Load (ETL) process linking existing concepts to OMOP concepts. Health systems met regularly via teleconference to review challenges and progress in ETL process. Sites were responsible for performing the local ETL process with assistance and securely provisioning de-identified data as part of the CURE ID program. RESULTS/ANTICIPATED RESULTS: More than twenty health systems participated in the CURE ID effort.Laboratory measures, basic demographics, disease diagnoses and problem list were more easily mapped to OMOP concepts by CURE ID partner institutions. Outcomes, social determinants of health, medical devices, and specific treatments were less easily characterized as part of the project. Concepts within the medical record presented very different technical challenges in terms of representation. There is a lack of standardization in OMOP implementation even among centers using the same electronic medical health record. Readiness to adopt OMOP varied across the institutions who participated. Health systems achieved variable level of coverage using OMOP medical concepts as part of the initiative. DISCUSSION/SIGNIFICANCE: Adoption of OMOP involves local stakeholder knowledge and implementation. Variable complexity of health concepts contributed to variable coverage. Documentation and support require extensive time and effort. Open-source software can be technically challenging. Interoperability of secure data systems presents unique problems.

OBJECTIVES/GOALS: The purpose of this study is to compare the mental health of African Americans to Whites during 2019 and 2020 using the a National Survey on Drug Use and Mental Health (NSDUMH). METHODS/STUDY POPULATION: Secondary data analysis from the National Survey on Drug Use and Health. The data consisted of 55,772 observations, 3,090 variables. This study will consist of the United State adult data population from 2019 and 2020 using the National Survey on Drug Use and Mental Health (NSDUMH). RESULTS/ANTICIPATED RESULTS: The results of this research will be produced from the following analysis. The analysis will consist of a secondary data analysis from the National Survey on Drug Use and Mental Health (NSDUMH). The primary independent variable of interest is race. All the indicator (race, sex, insurance, etc). Dependent variable is the mental health of African Americans and Whites. This is the variable in the NSDUMH labeled as the Major Depressive Episodes (MDE). The data analysis will be conducted using univariate analysis describing the study population. Bivariate analysis will be performed using chi-square. Since our dependent variable will be dichotomous we will be using several logistic regressions. DISCUSSION/SIGNIFICANCE: Strengthen mental health and psychosocial support services as part of strengthening preparedness, response and resilience to COVID-19 and future public health emergencies. Also adopt the updated Comprehensive Mental Health Action Plan for the future.

In the 5th c. BCE, Rome is understood to have experienced a moment of transition. Scholars highlight evidence for warfare absent widespread triumph, social conflict within Rome, and regional disruption in established power dynamics, trade networks, and material cultures. Despite a revised understanding of the period, wherein narratives of decline were superseded by those of transformation, the long century after the purported fall of monarchy, especially in its middle and later portions, remains segregated in scholarship from the Archaic period and Middle Republic. This article seeks to reframe the moment as integral to events both before and after it. By way of an examination of material remains of architectural projects, I argue that disciplinary preferences for periodization, a Rome-centered historical telos, and hierarchical material taxonomies have manufactured an absence of remains and activity, and I suggest that the field categorically moves away from these practices.

OBJECTIVES/GOALS: To determine the impact of fertility preserving treatment (FPT) on likelihood of live birth in a cohort of reproductive-age women (18-45 y) after diagnosis of gynecologic malignancy or pre-malignancy METHODS/STUDY POPULATION: We performed a retrospective cohort study of women ages 18-45 seen by gynecologic oncologists for newly diagnosed cervical cancer (CC), endometrial intraepithelial neoplasia (EIN) or endometrial cancer (EC), and borderline ovarian tumor (BOT) or invasive ovarian cancer (OC) at an academic center from 2015-2019, excluding women who completed childbearing. Our primary outcome was live birth after diagnosis and our exposure was FPT defined as services received by reproductive endocrinology and infertility specialists. We performed Pearsons Chi-squared and log binomial regression to assess association between live birth and FPT with adjustment for patient demographic and disease factors. RESULTS/ANTICIPATED RESULTS: Out of 220 women (median age 36 y), most were White (54% vs. 25% Black) and 37% percent were diagnosed with BOT/OC (vs. 35% EIN/EC; 28% CC). After diagnosis of disease, 19% of women (n=41) had documented FPT and 8% of women (n= 17) had a live birth. By the end of follow-up, 6% of women who did not receive FPT had a live birth (n=11/178) compared to 15% of those who did (n=6/40, p=0.12). In univariate regression, women who received FPT were 2.4 times more likely to have a live birth after disease diagnosis that those who did not receive FPT (p-value = 0.06). However, after adjusting for age at diagnosis, relationship status, disease stage and disease type, the association between FPT and live birth was less robust (RR = 1.4, p-value = 0.6). DISCUSSION/SIGNIFICANCE: In this study, a minority of women had FPT or live births. Our data suggest that FPT benefit should be considered in context of age, relationship status, and disease characteristics for reproductive-age women diagnosed with gynecologic malignancies. Given the complexity, women should be offered referral for consultation with a fertility specialist.

This secondary analysis examined the influence of changes in physical activity (PA), sedentary time and energy expenditure (EE) during dietary energy restriction on the rate of weight loss (WL) and 1-year follow-up weight change in women with overweight/obesity. Measurements of body weight and composition (air displacement plethysmography), RMR (indirect calorimetry), total daily EE (TDEE) and activity EE (AEE), minutes of PA and sedentary time (PA monitor) were taken at baseline, after 2 weeks, after ≥5 % WL or 12 weeks of continuous (25 % daily energy deficit) or intermittent (75 % daily energy deficit alternated with ad libitum day) energy restriction, and at 1-year post-WL. The rate of WL was calculated as total %WL/number of dieting weeks. Data from both groups were combined for analyses. Thirty-seven participants (aged 35 (sd 10) years; BMI = 29·1 (sd 2·3) kg/m2) completed the intervention (WL = –5·9 (sd 1·6) %) and 18 returned at 1-year post-WL (weight change=+4·5 (sd 5·2) %). Changes in sedentary time at 2 weeks were associated with the rate of WL during energy restriction (r = –0·38; P = 0·03). Changes in total (r = 0·54; P < 0·01), light (r = 0·43; P = 0·01) and moderate-to-vigorous PA (r = 0·55; P < 0·01), sedentary time (r = –0·52; P < 0·01), steps per d (r = 0·39; P = 0·02), TDEE (r = 0·46; P < 0·01) and AEE (r = 0·51; P < 0·01) during energy restriction were associated with the rate of WL. Changes in total (r = –0·50; P = 0·04) and moderate-to-vigorous PA (r = –0·61; P = 0·01) between post-WL and follow-up were associated with 1-year weight change (r = –0·51; P = 0·04). These findings highlight that PA and sedentary time could act as modifiable behavioural targets to promote better weight outcomes during dietary energy restriction and/or weight maintenance.

We present the data and initial results from the first pilot survey of the Evolutionary Map of the Universe (EMU), observed at 944 MHz with the Australian Square Kilometre Array Pathfinder (ASKAP) telescope. The survey covers $270 \,\mathrm{deg}^2$ of an area covered by the Dark Energy Survey, reaching a depth of 25–30 $\mu\mathrm{Jy\ beam}^{-1}$ rms at a spatial resolution of $\sim$ 11–18 arcsec, resulting in a catalogue of $\sim$ 220 000 sources, of which $\sim$ 180 000 are single-component sources. Here we present the catalogue of single-component sources, together with (where available) optical and infrared cross-identifications, classifications, and redshifts. This survey explores a new region of parameter space compared to previous surveys. Specifically, the EMU Pilot Survey has a high density of sources, and also a high sensitivity to low surface brightness emission. These properties result in the detection of types of sources that were rarely seen in or absent from previous surveys. We present some of these new results here.

In order to maximize the utility of future studies of trilobite ontogeny, we propose a set of standard practices that relate to the collection, nomenclature, description, depiction, and interpretation of ontogenetic series inferred from articulated specimens belonging to individual species. In some cases, these suggestions may also apply to ontogenetic studies of other fossilized taxa.

This study examined effects of risk factors in multiple domains measured in preschool and kindergarten on age 6 depression symptoms, and on changes in symptom levels between ages 4 and 6. Two models were examined in a large, diverse (N = 796) community sample of children and parents. Risk variables included SES, stress, conflict, parental depression, parental hostility, support, scaffolding, child negative affect (NA), effortful control (EC), sensory regulation (SR), and attachment security. Model 1 included effects of risk factors at ages 4 and 5 on child depression symptoms at age 6. Model 2 also included depression symptoms at all three ages to examine changes in these symptoms. Model 1 revealed that age 4 and 5 parental depression, NA, EC, and SR predicted age 6 child depression levels, Several age 4 variables had indirect pathways to age 6 depression via age 5 EC. Model 2 revealed that preschool depression was the only age 4 variable, and EC and SR were the only age 5 variables that significantly predicted increases in age 6 depression. These findings highlight the role of self-regulation in child depression and suggest that targeting self-regulation may be an effective prevention and intervention strategy.

Complete body fossils of salamanders are relatively rare, but provide critical information on the evolutionary roots of extant urodele clades. We describe new specimens of the fossil salamandrids Taricha oligocenica Van Frank, 1955, and Taricha lindoei Naylor, 1979, from the Oligocene Mehama and John Day formations of Oregon that illustrate aspects of skeletal morphology previously unseen in these taxa, and contribute to our understanding of population-level variation. Morphological analysis of these specimens supports the classification of T. oligocenica and T. lindoei as two different species, distinct from extant Taricha. Parsimony-based, heuristic analysis of phylogeny using 108 morphological characters for 40 taxa yields different results from a phylogenetic analysis that excludes four taxa known only via vertebrae. Our smaller analysis generally agrees with molecular phylogenies of the family Salamandridae, but with poorer resolution for molgin newts, especially between Taricha and Notophthalmus. The analysis including all taxa produced polytomies mostly related to complications from several fossil taxa. The presence or absence of dorsally expanded, sculptured neural spine tables on trunk vertebrae, an important character in past descriptions of fossil salamandrids, appears to be either homoplastic within the Salamandridae, or requires an expansion of characters or character states. Taricha oligocenica and T. lindoei are separate species of an at least 33 million-year-old clade, but their relationships with each other and extant North American salamandrids remain unclear with current levels of morphological data. Salamandrid research requires additional morphological data, particularly for the vertebrae and ribs, to better resolve salamandrid evolutionary history through morphological characters.