OBJECTIVES/SPECIFIC AIMS: To assess the effect of cannabis on impaired judgment and health outcomes among heart failure patients in the emergency room. METHODS/STUDY POPULATION: Patients with heart failure presenting to the emergency room. Cannabis with confounders such as income level, insurance type, tobacco use, and age. Discharged against medical advice to assess impaired judgment. Hospitalization rates, length of stay, and death rate to assess health outcomes. Multivariate logistic regression to access the odds of each of these outcomes from cannabis RESULTS/ANTICIPATED RESULTS: Cannabis is associated with impaired outcome (increase in discharge against medical advice). Cannabis have poorer health outcome in terms of more hospitalizations from the emergency department. Cannabis also have better health outcome in terms of shorter length of stay and death rate among cannabis users Versus nonusers. DISCUSSION/SIGNIFICANCE OF IMPACT: This is crucial to inform health care providers to ensure better counseling of cannabis users. This result should also be considered to interpret other publications that shows better outcomes in patients taking cannabis. Cannabis users might only seem to have a better outcome because they tend to discharge against medical advice and thereby die outside the hospital, etc.

OBJECTIVES/SPECIFIC AIMS: Exosomes are living nanoscale vesicles that can shuttle large amounts of bioactive cargo for intercellular communication. The potential of these nanovesicles to serve as both biomarkers for disease diagnosis and vehicles for delivery of therapeutics has only begun to be explored. To realize these potentials, molecular tools for effective exosome tracking and capturing must be invented in order to advance basic research and clinical translation. METHODS/STUDY POPULATION: We utilize a surface display strategy that enables exosome modification in living mammalian systems. By reconfiguring the surface protein CD63 or viral envelope glycoprotein VSV-G, we generate 3 topologically distinctive protein chimeras for exosome imaging and capture in mammalian systems. RESULTS/ANTICIPATED RESULTS: We have shown that these genetically encoded protein chimeras have the ability to correctly target and integrate into exosomes in cultured human cells. Furthermore, we have demonstrated that the secreted exosomes could be successfully captured by an affinity peptide intentionally displayed on the outer surface of exosomes. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study highlights the potential of these fusion proteins for exosome tracking and provides novel genetic tools for exosome research and translation, one of which is loading protein therapeutics for targeted delivery.

ABSTRACT IMPACT: Antibiotic stewardship guidelines should consider the barriers clinicians in low- and middle-income countries face due to limited biomarkers for determining the etiologic pathogen for viral infections like respiratory syncytial virus (RSV) that have a similar presentation to bacterial infections. OBJECTIVES/GOALS: We aimed to evaluate antibiotic administration practices in children who were hospitalized at a government-run hospital in Amman, Jordan, where point-of-care testing is limited. We hypothesized those with RSV are more likely to be administered antibiotics during their hospitalization than children without RSV. METHODS/STUDY POPULATION: We conducted a cross-sectional cohort study in Jordanian children hospitalized with history of acute respiratory symptoms and/or fever from 2010 to 2013. Admitting diagnoses were dichotomized into suspected viral- (e.g., bronchiolitis) and bacterial-like infection (e.g., sepsis, pneumonia). Stratifying by sex, we performed a polytomous logistic regression adjusting for age, underlying medical condition, maternal education, and region of residence to estimate prevalence odds ratios (PORs) and 95% confidence intervals for macrolides, broad-, and narrow-spectrum antibiotics during hospitalization. Sensitivity and specificity of admission diagnoses and laboratory results were compared. RESULTS/ANTICIPATED RESULTS: Children with a suspected viral-like admission diagnosis, compared to those with suspected bacterial-like, were 89% less likely to be administered a narrow-spectrum antibiotic (POR: 0.11; p<0.001). There were slight differences by sex with males having a lower prevalence than females of narrow-spectrum or broad-spectrum antibiotic administration; but they had a higher prevalence of macrolide administration. Overall, children with RSV had a 30% probability (sensitivity) of being assigned to a suspected viral infection; whereas RSV-negative children had an 85% probability (specificity) of being assigned to a suspected bacterial infection. DISCUSSION/SIGNIFICANCE OF FINDINGS: Children with a suspected viral-like infection were less likely to receive an antibiotic; however, when evaluating the accuracy of admission diagnosis to RSV-laboratory results there were considerable misclassifications. These results highlight the need for developing antibiotic interventions for Jordan and the rest of the Middle East.

OBJECTIVES/GOALS: The grant writing process provides investigators with critical thinking, problem solving, and communication skills, crucial for personal and professional development. However, opportunities for junior faculty to learn these skills are highly variable. Thus, we developed a grant writing program to assist in the preparation of an NIH R proposal. METHODS/STUDY POPULATION: The R Club Grant Program was implemented in 2021 for junior faculty of the University of Cincinnati’s College of Medicine and Center for Clinical & Translational Science & Training (CCTST). The program consists of a series of workshops (e.g., How to Craft a Specific Aims Page, How to Construct a Competitive R01 Proposal) utilizing examples of successful proposals and grant review criteria to demonstrate how to translate a conceptual framework into a research proposal (level 1). All participants can receive constructive feedback on a Specific Aims page from an experienced grant writer (level 2), and for a select cohort, the program provides comprehensive scientific content edits and iterative feedback on a full research proposal, with a focus on grantsmanship, presentation, and overall competitiveness (level 3). RESULTS/ANTICIPATED RESULTS: Over three NIH grant cycles, the program to date has provided 38 early-career investigators with multi-level grant writing support. All participants attended the workshops and received supporting documents, 21 received feedback on a Specific Aims page, and 6 received one-on-one writing assistance on their full research proposal. Of the 6 investigators who received the greatest level of support, 3 have received NIH scientific review, with a 66.6% funding success rate for either an original (R01, n=1) or subsequent overlapping (R35, n=1) proposal. In a survey sent to workshop attendees, 100% of respondents (n=23) reported ( Strongly Agreed or Agreed ) that the training was a worthwhile investment in their professional development and 96% stated that they will be able to apply the knowledge and skills learned. DISCUSSION/SIGNIFICANCE: Initial evaluation measures suggest that grant writing support programs have great potential to enhance funding success rates. As the program evolves it will be crucial to evaluate both qualitative and quantitative feedback measures to ensure efforts are directed to the appropriate level(s) of service to maximize the funding success of our faculty.

OBJECTIVES/GOALS: The overarching objective is to assess the value of promoting team science practices across a diverse clinical translational science community through the development of learning modules. We aim to share lessons learned to help inform best practices for CTSA hubs interested in promoting team science. METHODS/STUDY POPULATION: We recently created a series of self-paced learning modules focused on the science of team science, which include a variety of text and multimedia content. A preliminary assessment was conducted to determine the perceived value of six video team science Learning Shots and to identify areas for improvement. Significant content revisions are underway based on respondent feedback. In early 2022, a follow up survey will solicit feedback from a larger sample of researchers to reassess the learning modules and to ensure that desired improvements were achieved. We will incorporate continuous improvement cycles to gather future feedback, track improvements, and identify potential future direction for new content. RESULTS/ANTICIPATED RESULTS: The preliminary assessment identified the most effective aspects of the modules to be the variety and knowledge of speakers, diversity of topics, organization of the content, and appropriateness of length. Least effective aspects included a desire for more information in some content areas and not enough focus on the challenges of team science for junior faculty. Suggested areas for improvement include a desire for supplemental descriptive text, links to tools that enable teams to be productive, and additional examples from researchers. The follow up study is expected to yield more detailed information on the impacts of the improvements and the overall effectiveness of the modules. DISCUSSION/SIGNIFICANCE: This project provides insights for CTSA Hubs interested in promoting team science and best practices when developing learning modules. Results contribute to what is known about researchers interest in learning about team science and the effectiveness of using online formats for delivery.

OBJECTIVES/GOALS: While the evolving treatment paradigm for Glioblastoma (GBM) leverages different modalities to improve outcomes, treatment access might be limited by cost and disparities. This study explores the influence of race and social determinants of health (SDoH) on healthcare access and outcomes of GBM patients in a large metropolitan area over a decade. METHODS/STUDY POPULATION: Our institution’s tumor registry (2009-2019) was queried to identify our GBM cohort. Data were supplemented by electronic health records to include demographics, outcome, NCI Comorbidity Index, and the Agency for Healthcare Research and Quality (AHRQ) socioeconomic status (SES) index. RESULTS/ANTICIPATED RESULTS: Of the 559 GBM records, 361 unique patients met the inclusion criteria, and 43% were Non-White. Non-White patients predominantly comprised the lowest AHRQ SES index quartile and had longer hospital stays (LOS; p<0.001). White patients accounted for 61% of privately insured patients (p<0.001). Private insurance (p= 0.02) and age < 65 years (p= 0.039) were associated with a higher rate of home discharge. Patients diagnosed with GBM in the emergency department were more likely to be discharged to acute rehab than home (p<0.001). At 2 years, privately insured patients had longer OS (HR= 1.46; p= 0.04). DISCUSSION/SIGNIFICANCE: In contrast to previous studies, the study demonstrates that GBM affected a higher proportion of Non-White patients. Our data show that SDoH influences multiple outcomes in GBM patients. Efforts to identify and correct these barriers are needed to improve the care of all GBM patients.

OBJECTIVES/GOALS: The modified Atkins diet (MAD) is used in the management of drug-resistant epilepsy in adults. Some patients on MAD show an increase in serum levels of total cholesterol and low-density lipoprotein (LDL) cholesterol. We explored whether dietary fat composition predicts short-term elevations in serum lipid levels in diet-naïve adults who begin MAD. METHODS/STUDY POPULATION: Participants self-reported their diet intake with 3-day food records at baseline, 1 month and 2 months. Food records were analyzed using Nutrition Data System for Research software. Fasting serum levels of total cholesterol (TC), high-density lipoprotein (HDL) cholesterol, and triglycerides were also collected and LDL level calculated at baseline, 1 month, and 2 months. RESULTS/ANTICIPATED RESULTS: 38 patients submitted complete food records at each study visit (baseline, 1 month, and 2 month). Compared to baseline diet intake, there was a significant reduction in daily carbohydrate intake at 1 and 2 months months (p<0.001). There was also a significant increase in daily saturated fatty acid (SFA) intake at 1 and 2 months (p<0.001), daily mono-unsaturated fatty acid (MUFA) intake at 1 and 2 months (p<0.001), and daily cholesterol intake at 1 month (p<0.05) and 2 months (p<0.001), but no change in daily poly-unsaturated fatty acid (PUFA) intake over time. Compared to baseline, there was a significant increase in serum LDL at 1 month (p<0.001) and 2 months (p<0.01) and an increase in serum TC at 1 month (p<0.01) but not 2 months. DISCUSSION/SIGNIFICANCE OF IMPACT : Despite a significant increase in total fat, saturated fat and mono-unsaturated fat intake as well as an increase in total cholesterol and LDL levels following MAD initiation, dietary fat composition appears to minimally predict serum lipid values in the short term. CONFLICT OF INTEREST DESCRIPTION: Tanya McDonald has received speaking honoraria from Nutricia North America. Bobbie Henry-Barron receives grants from Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research, Nutricia and Vitaflo. Diane Vizthum receives grants from the Johns Hopkins Institute for Clinical and Translational Research (ICTR) which is funded in part by Grant Number UL1 TR 001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Mackenzie C. Cervenka has received grant support from Nutricia North America, Vitaflo, Army Research Laboratory, The William and Ella Owens Medical Research Foundation and BrightFocus Foundation. She receives speaking honoraria from LivaNova, Epigenix, Nutricia North America and the Glut1 Deficiency Foundation and performs consulting with Nutricia North America and Sage Therapeutics and receives Royalties from Demos Health.

OBJECTIVES/GOALS: Many older sepsis survivors develop chronic critical illness (CCI) with poor outcomes. Sepsis is caused by a dysregulated immune response and biomarkers reflecting PICS. The purpose was to compare serial PICS biomarkers in a) older (versus young) adults and b) older CCI (versus older RAP) patients to gain insight into underlying pathobiology of CCI. METHODS/STUDY POPULATION: Prospective longitudinal study with young (≤ 45 years) and older (≥ 65 years) septic adults who were characterized by a) baseline predisposition, b) hospital outcomes, c) serial SOFA organ dysfunction scores over 14 days, d) Zubrod Performance status at three, six and 12-month follow-up and e) mortality over 12 months. Serial blood samples over 14 days were analyzed for selected biomarkers reflecting PICS. RESULTS/ANTICIPATED RESULTS: Compared to the young, more older adults developed CCI (20% vs 42%) and had markedly worse serial SOFA scores, performance status and mortality over 12 months. Additionally, older (versus young) and older CCI (versus older RAP) patients had more persistent aberrations in biomarkers reflecting inflammation, immunosuppression, stress metabolism, lack of anabolism and anti-angiogenesis over 14 days after sepsis. DISCUSSION/SIGNIFICANCE: Older (versus young) and older CCI (versus older RAP) patient subgroups demonstrate early biomarker evidence of the underlying pathobiology of PICS. The population of older sepsis survivors is need of interventions to lower systemic inflammation and stimulate anabolism to prevent skeletal muscle wasting and disability.

OBJECTIVES/SPECIFIC AIMS: Depression is one of the leading causes of diseases and disability among women of all ages in the United States. Lack of resources to meet one’s daily needs, access to health care, job opportunities, and drug use significantly contribute to depression among women. This paper aimed to explore the determinants of depression among women from a large community-based sample. METHODS/STUDY POPULATION: HealthStreet is a community engagement research initiative at the University of Florida that utilizes the community health worker (CHW) model to assess health concerns and conditions of community members and link them to available social and medical services and health research. From October 2011 through December 2016, CHWs assessed 8469 community members from various locations in the community such as grocery stores, bus stops, health fairs, laundromats, and others. Among these 8469 participants contacted and assessed by the CHWs, 4952 (58.5%) were women. RESULTS/ANTICIPATED RESULTS: Of the total 8469 participants, 4952 were women and 1839 (37.1%) reported ever having depression. Mean age of women who reported depression was 44.1 years (SD±14.4). Women who were current users of 3 or more drugs were 10 times more likely (95% CI: 5.73, 18.40; OR 10.27) to report depression compared with those who did not currently use any drugs. Those who were food insecure in the past 12 months (95% CI: 1.970, 2.576; OR 2.253) were twice more likely to report depression, while never married (95% CI: 0.576, 0.771; OR 0.666), and currently unemployed (95% CI: 0.535, 0.715; OR 0.619) women were less likely to report depression. Chronic health conditions such as hypertension (41.6% vs. 33.7%), diabetes (14% vs. 10.5%), and cancer (12.1% vs. 8.3%), and comorbid psychiatric symptoms such as anxiety (54.2% vs. 10.8%) and bipolar disorder (23.8% vs. 2.8%) were significantly higher (p<0.001) among women with depression compared with their counterparts. Significantly more women without a history of depression had medical insurance (68.8% vs. 64.3%) as compared with women with depression. DISCUSSION/SIGNIFICANCE OF IMPACT: Depression was associated with food insecurity and drug use. The impact of drug use continues to be a major mental health concern among community-based women. Further, these findings emphasize the importance of community engagement programs such as HealthStreet, which utilizes the CHWs’ model to link community members to social and medical services within the community, in improving the mental health of women.

OBJECTIVES/GOALS: It is hypothesized that the global secular trend toward earlier puberty onset, with implications for many future health outcomes, is related to the obesity epidemic. This study aims to examine prospective associations between weight during specific developmental windows and timing of puberty onset. METHODS/STUDY POPULATION: This study includes 1,296 mother-infant dyads from the Boston Birth Cohort, a predominantly minority (>80% black/Hispanic), low-income, and urban prospective birth cohort recruited and followed between 1998 and 2019. Age at peak height velocity (APHV), a well-defined and standardized proxy for puberty onset, is derived by fitting height measurements recorded during clinical visits using a mixed effects growth curve model. Multiple linear regression is performed to examine the relationships between early childhood (ages 2-5y) and prepubertal (ages 6-9y) overweight and obesity, weight trajectories between these two periods, and APHV, while controlling for known contributors to early puberty. RESULTS/ANTICIPATED RESULTS: Compared to counterparts with normal BMIs, kids who were obese during ages 2-5y (boys: −0.21y, CI[−0.39, −0.04]; girls: −0.22y, CI[−0.39, −0.05]) or ages 6-9y (boys: −0.27y, CI[−0.43, −0.11]; girls: −0.37y, CI[−0.52, −0.23]) had an earlier APHV. Being overweight during ages 6-9y was also associated an earlier APHV (boys: −0.26y, CI[−0.46, −0.07]; girls: −0.26y, CI[−0.42, −0.10]). Looking at weight trajectories, kids who were persistently overweight or obese from ages 2-5y to ages 6-9y had an earlier APHV (boys: −0.28y, CI[−0.45, −0.12]; girls: −0.31y, CI[−0.46, −0.16]), as did girls with normal BMIs during ages 2-5y and who were overweight or obese during ages 6-9y (−0.45y CI[−0.64, −0.26]). DISCUSSION/SIGNIFICANCE OF IMPACT: The temporal and dose-response relationships seen in this historically understudied population suggests that childhood obesity is etiologically important in the development, and even programming, of early puberty. This has implications for prediction, prevention, and mitigation of health disparities.

OBJECTIVES/GOALS: Racial and ethnic minority populations have been historically underrepresented in clinical trials, which limits the external validity of study findings. We analyze data from the ACTIV-6 trial to assess whether inclusion efforts were effective in increasing participation from minority groups. METHODS/STUDY POPULATION: ACTIV-6 is a decentralized randomized placebo-controlled platform trial investigating repurposed drugs for the treatment of mild to moderate COVID-19. Study participants could either self-refer online or be recruited through a study site. Two inclusion efforts were introduced to increase participation from racial or ethnic minority populations: targeted advertising and outreach, and strategic selection of study sites that serve diverse populations. We assessed the effectiveness of these interventions by analyzing enrollment trends over time. We also assessed whether participants from racial or ethnic minority populations experienced higher loss to follow-up. RESULTS/ANTICIPATED RESULTS: At the start of the trial, enrollment of non-Hispanic White participants outpaced enrollment from racial or ethnic minority populations. At 4 months, only 108 participants (20.5%) were from racial or ethnic minority populations, but greatly increased by 28 months to 3,544 participants (46.4%), nearly half of all participants. This increase was predominantly due to recruitment through study sites rather than self-referral. In particular, certain sites recruited large numbers of minority participants. We also observed that participants from racial or ethnic minority populations were more likely to drop out of the study before receiving the study drug (3% vs 1%). DISCUSSION/SIGNIFICANCE: Our results suggest that strategic site selection is an effective strategy for recruiting a study population that represents racial and ethnic populations. The benefits of targeted advertising and outreach were less clear. Retention efforts remain important to reduce loss to follow-up.

OBJECTIVES/SPECIFIC AIMS: The objective of this study is to identify and categorize non-invasive measurement methods for autonomic nervous system (ANS) symptoms that develop in hypoglycemic episodes. METHODS/STUDY POPULATION: We first reviewed literature for hypoglycemia symptomology. We then performed a selective literature review of Google Scholar, PubMed and Scopus for an ANS symptom and/or synonyms and the words ‘sensor’ or ‘detection’, e.g. ‘sweat sensor’ and ‘tremor detection’, studies utilizing non-invasive measurements in DM, and datasets of non-invasive measurements in DM. Measurement methods were then organized based on the ANS symptoms and existing metadata models for harmonizing sensors and surveys. RESULTS/ANTICIPATED RESULTS: We identified several measurement methods to for ANS symptoms during hypoglycemic events: thermometer, accelerometer, electrocardiogram (ECG), galvanic skin response (GSR), image processing, infrared imaging, thermal actuator, and ecological momentary assessment (EMA). The stage of implementation varied across the measurement methods from under development, to use in research and clinical settings, and even commercially available consumer products. Measurement methods that could be worn as wrist-band wearables or as film-based epidermal sensors would be capable of automatically gathering data with little to no effort required of the person wearing the device. Image-based methods would require the individual to actively engage in generating a photograph for analysis. In the case of EMA’s, a message containing a question is sent to the individual, often via text message, soliciting short and immediate responses. It is anticipated that one sensor alone would not be sufficient to measure ANS responses to hypoglycemia, but rather several data points would be required. For example, if the GSR was the only signal, sweat in response to vigorous exercise or a warm environment would inject noise into the signal. Including the accelerometer data would allow for the identification of body movement which would indicate exercise, while an ECG signal could confirm the exercise. DISCUSSION/SIGNIFICANCE OF IMPACT: Impaired awareness of hypoglycemia (IAH) is a complication that develops in about 30% of type 1 DM and 10% type 2 DM populations. In individuals with intact awareness of hypoglycemia, the ANS leads to symptoms which includes: shaking, trembling, anxiety, nervousness, palpitation (i.e. change in heart rate and/or function), clamminess, sweating, dry mouth, hunger, pallor (i.e. drop in blood flow and/or skin-surface temperature), and pupil dilation. IAH is defined as the onset of hypoglycemia before the appearance of autonomic warning symptoms. IAH is caused by repeated exposures to low blood glucose levels, which reduces the body’s ability to sense hypoglycemia, and therefore it is difficult for patients to recognize and self-treat. Individuals with IAH are six times more likely to experience severe hypoglycemia, an emergent condition which can lead to unconsciousness, seizure, coma, and death. Clinical investigators are developing interventions that aim to improve awareness of hypoglycemia. Surveys, observations by clinicians, and laboratory tests, often carried out in highly controlled in-patient settings, are currently used to assess the severity of IAH and the ANS’s ability to respond to hypoglycemia. In other disease states, for example heart disease and Parkinson’s disease, electrocardiograms and accelerometers have been used to assess heart function and tremor, respectively. However, there is currently a barrier to examining the efficacy of IAH interventions in real world settings as there are no established objective and non-invasive means to measure ANS symptoms due to hypoglycemia. This work encompasses the first important step necessary to direct translational researchers interested in testing the efficacy of IAH interventions and developing diagnostic tools for IAH in real-world studies outside the clinic. Next steps include evaluating these sensors and specifying EMA surveys, designing studies, and integration and assimilation of these data streams to identify true events of IAH by leveraging informatics platform such as the Utah PRISMS Informatics Ecosystem. Investigators would then be able to conduct studies that aim to develop and validate models that take sensor and EMA data as the input to detect and assess the severity of IAH.

OBJECTIVES/GOALS: To conceptualize, implement and evaluate a three-pronged social media plan with goals to: 1) disseminate information about the Southern California CTSI and its activities on multiple platforms; 2) educate the public about clinical research participation; 3) use storytelling methods to spread awareness about research careers. METHODS/STUDY POPULATION: We will start by creating a logic model to identify activities, outputs, short, medium and long-term outcomes of this social media innovation project, using CTSI and community stakeholder input (focus groups). This model will guide the creation of a comprehensive strategic social media plan that includes an editorial calendar for each platform, storyboarding and an operationalized narrative strategy, as well as KPIs relating to areas like reach, engagement, conversion, and sentiment. Collecting/analyzing these metrics will yield information about how the public feels about clinical research and will assist us in refining our content strategy. After completing formative research, we will create accounts on Instagram, TikTok, LinkedIn and Meta to complement our existing Twitter presence. RESULTS/ANTICIPATED RESULTS: We hope to identify which types of content lead to greater engagement and more positive sentiment on each platform, which will help us iteratively refine our content strategy. Examples of content type can include: imparting research-related information, debunking myths, providing career information, etc. Through this process we will also gain knowledge about what methods are more appealing to our users, such as narrative storytelling. Visually, we anticipate learning about what types of multimedia content works best as a mechanism to disseminate information about clinical research (e.g. video, photo, audio, or a combination). DISCUSSION/SIGNIFICANCE: In a post-pandemic world of dis- and misinformation, it is more important than ever to disseminate trusted, vetted information about clinical research in novel and engaging ways. Through this initiative we will gather information, metrics and key lessons learned to present back to CTSA hubs to inform their short and long-term social media strategies.

OBJECTIVES/SPECIFIC AIMS: Computed tomography (CT) enables 3-dimensional (3D) visualization of cortical bone structures with high spatial resolution, and thus has been the gold-standard method for evaluation and diagnosis of craniofacial skeletal pathologies. However, ionizing radiation and, in particular, repeated scanning for presurgery and postsurgery assessments, is of concern when applied to infants and young children. Recent advances in solid-state MRI allow the capture of the short-T2 signals in cortical bone while suppressing the signal from soft-tissue protons having T2 relaxation time 1–2 orders of magnitude longer (50–100 ms). One approach, a dual-radiofrequency (RF) pulse and ultrashort echo time (UTE) imaging based method, exploits different sensitivities of bone and soft tissue to different RF pulse widths and TEs. This study aims to demonstrate the feasibility of producing 3D renderings of the human skull and visualization of cranial sutures using the bone-selective MRI technique in comparison to CT. METHODS/STUDY POPULATION: Imaging technique: Two RF pulses differing in duration and amplitude are alternately applied in successive repetition time (TR) along the pulse train. Within each TR, 2 echoes are acquired. Acquisition of the first echo starts at the ramp-up of the encoding gradient (TE1), allowing for capture of signals with very short lifetimes (bone), while that of the second starts after a longer delay (TE2). In total, 4 echoes are obtained: ECHO11 (RF1TE1), ECHO12 (RF1TE2), ECHO21 (RF2TE1), and ECHO22 (RF2TE2). During reconstruction, ECHO11 is combined with ECHO21 and ECHO12 is combined with ECHO22, resulting in 2 images. The subtraction of these 2 images yields an enhanced bone contrast. Data acquisition/processing: The pulse sequence described above was applied for MR imaging of a human cadaveric skull and 2 adult human subjects in vivo, at 3T field strength (Siemens Prisma, Erlangen, Germany). Imaging parameters: TR/TE1/TE2=7/0.06/2.46 ms, RF1/RF2 durations=40/520 μs, flip angle=12°, matrix size=2563, field of view=2803 mm3, voxel size=1.1 mm isotropic, number of radial spokes=25,000, and scan time=6 minutes. Segmentation of bone voxels was performed using ITK-SNAP in a semi-automatic fashion, leading to 3D renderings of the skull. For comparison, a CT scan was also performed in the human cadaveric skull with 1 mm isotropic resolution. Validation: The biometric accuracy was assessed by measuring eight anatomic distances: (1) Maximum craniocaudal aperture of the right orbit. (2) Maximum craniocaudal aperture of the left orbit. (3) Maximum height of the mandible from chin point in the midline. (4) Maximum cranial length (5) Maximum cranial width. (6) Maximum height of piriform aperture. (7) Distance between lateral most aspect of mandibular condyles. (8) Distance between lateral most aspect of posterior hard palate in both CT- and MRI-based 3D renderings of the human cadaveric skull using Mimics software (Materialise®, Ghent, Belgium). These distances were compared with those directly measured on the cadaveric skull. RESULTS/ANTICIPATED RESULTS: Compares CT with the proposed MRI method on cadaveric human skull images, along with corresponding 3D renderings. Compared with CT, the 3D rendered images maintain most features over the entire head (e.g., zygomatic arch), except for appearance of some artifacts in the mandibular region. In vivo head images in 2 adult subjects: axial magnitude images and 3D rendering. In the axial images, bone voxels as well as the inner table of the cranium are clearly visualized, and cranial and spinal bone structures are well depicted in the 3D renderings. Some voxels were erroneously included or excluded in the renderings. The mean difference in measurements of the 8 anatomic distances was 6, 4, and 2 mm when comparing MRI Versus CT, MRI Versus in situ, and CT Versus in situ, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Bone proton magnetization exhibits a substantial level of signal decay during the relatively long duration of RF2 due to its very short T2 relaxation time. In contrast, soft-tissue retains nearly the same level of signal intensities over all echoes. Thus, subtraction of ECHO22 from ECHO11, when compared with the difference between ECHO11 and ECHO12, enhances bone contrast from soft tissue. The proposed, dual-RF dual-echo 3D UTE imaging technique produces isotropic high-resolution bone-specified images in the whole head within a clinically feasible imaging time (6 min), leading to clear visualization of craniofacial skeletal structures. These are key components necessary for translation to the clinical setting. Optimization of postprocessing for more realistic 3D renderings and thus accurate anatomic measurements is currently being implemented. The proposed method’s potential as a nonradiative alternative to CT will then be thoroughly evaluated in pediatric patients.

OBJECTIVES/GOALS: Diabetes is related to risk for heart disease, stroke, high blood pressure, and COVID-19. It is exacerbated by built/social environment issues, e.g., food insecurity, access to healthy foods and health care, and other poverty-related factors. Our goal is to assess the efficacy of an integrated care model for patients with poorly controlled diabetes. METHODS/STUDY POPULATION: We utilize an integrated, team-based approach to diabetes treatment. In a traditional care model, too little focus is on social determinants and their impacts on health and well-being. Our project involves enrollment of patients with diabetes in an intervention whereby their medical care is integrated with intensive diabetes education and provision of social and other health services, including diet and nutrition, exercise, provision of foods and nutritional supplements, and other support services as needed to achieve optimal health and to reduce morbidity and unnecessary hospitalization and emergency room visits. Subjects are underserved patients treated through our non-profit community clinic partners. We track metrics including individual outcomes, organizational outcomes, and collective impact. RESULTS/ANTICIPATED RESULTS: We anticipate that patients enrolled in this study will demonstrate significant improvements in diabetes control and management. Clinical improvements will include better glycemic control, improved hypertension and dyslipidemia management, reduced complications, and increased preventive measures including foot, eye and oral health exams and monitoring of microalbuminuria. Overall, we anticipate decreased frequency of hospitalizations and readmissions as well as decreased frequency of emergency care visits for treatment of diabetes-related issues. We expect patients to experience enhanced self-efficacy, increased physical activity, and improved quality of life. Their outcomes will be compared to controls receiving the standard medical regimen, matched on age, race, gender, and time of onset. DISCUSSION/SIGNIFICANCE: These activities will improve understanding of factors influencing diabetes outcomes at individual and upstream levels. It will inform food distribution and models of care for improved patient outcomes, including social determinants of health and will establish new protocols for community-based provision of health care to our most vulnerable.

OBJECTIVES/GOALS:

1. 1. Determine test characteristics of Neuro ICU nurse interpretation of real-time bedside qEEG for seizure detection

2. 2. Determine difference in time to detection of seizures between qEEG interpretation and raw cEEG reads

3. 3. Determine how seizure characteristics affect accuracy of qEEG reads

METHODS/STUDY POPULATION:

• Subjects: Nurses caring for patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG.

• Nurses evaluate qEEG display at the bedside on an hourly basis after undergoing a standardized qEEG training session. The standard practice of independent review of cEEG and treatment by the Neuro ICU team remains unchanged.

• Post-hoc review of cEEG data by two blinded, board-certified neurophysiologists will be performed for each patient. The raw cEEG data will be scored for the number of seizures present per hour, background, seizure duration, and seizure spatial extent.

• The time from first seizure occurrence to clinical recognition will be recorded.

RESULTS/ANTICIPATED RESULTS:

• Thus far, 91 patients with 583 1-hour blocks of nurse interpretations have been studied, with 6 patients experiencing seizures while on study. Enrollment will be completed on 1/17/20

• Preliminary data show a sensitivity of 95.8% (79.9%, 99.9%), specificity of 95.2 (93.1%, 96.8%), positive predictive value of 46.0% (36.9%, 55.4%), negative predictive value of 99.8% (98.7%, 99.9%), positive likelihood ratio of 19.8 (13.6, 28.9), negative likelihood ratio (0.04 (0.01, 0.3). All confidence intervals are 95%. False alarm rate is 0.05/hour.

• Further analyses are pending completion of enrollment in January 2020.

DISCUSSION/SIGNIFICANCE OF IMPACT: Nurse interpretation of real-time bedside qEEG for seizure detection is feasible in the Duke Neuro ICU. QEEG functions well as a screening tool with good specificity and low false alarm rate. Use of qEEG by nurses could lead to shorter time to seizure detection, which may improve patient outcomes. CONFLICT OF INTEREST DESCRIPTION: Safa Kaleem, BS: Research reported in this publication was supported by a Pfizer Foundation grant and the Duke Clinical Translational Science Institute (CTSI). The content is solely the responsibility of the authors and does not necessarily represent the official views of the Pfizer Foundation or the Duke CTSI. Jennifer H. Kang, MD: None to declare. Alok Sahgal, MD: None to declare. Christa B. Swisher, MD: Received speaker’s honorarium from EISAI and UCB.

OBJECTIVES/SPECIFIC AIMS: Patients are increasingly using online materials to learn about gynecologic cancer. Recent studies demonstrate that 85-96% of patients with a gynecologic malignancy utilize the Internet as a health resource. Providers can refer patients to educational materials produced by major medical associations available on their websites. However, patient educational materials (PEMs) published by professional organizations from other surgical specialties have been shown to be difficult to read for the average American. The NIH and AMA recommend that PEMs be written between a sixth and eighth grade reading level. In this study, we assess the readability of online PEMs on gynecologic cancer published by major medical associations. METHODS/STUDY POPULATION: Seven national medical association websites with PEMs on gynecologic malignancy were surveyed: American College of Obstetricians and Gynecologists, Center for Disease Control, Foundation for Women’s Cancer, National Cancer Institute, National Cervical Cancer Coalition, National Ovarian Cancer Coalition, and Society of Gynecologic Oncology. Online PEMs were identified and analyzed using five validated readability indices. One-way ANOVA and Tukey’s test were performed to detect differences in readability between publishers. RESULTS/ANTICIPATED RESULTS: Two hundred and thirty PEMs were included in this analysis. Mean readability grade levels with standard deviation were: 11.3 (2.8) for Coleman-Liau index; 11.8 (3.2) for Flesch-Kincaid; 11.1 (1.2) for FORCAST formula; 12.5 (2.7) for Gunning FOG formula; 12.1 (2.6) for New Dale-Chall formula; and 13.5 (2.5) for SMOG formula. Overall, PEMs were written at a mean 12th grade reading level. Only 4.3% of articles were written at an 8th grade reading level or below. ANOVA demonstrated a significant difference in readability between publishing associations (p<0.01). PEMs from the Center for Disease Control had a mean 10th grade reading level and were significantly lower than all other organizations. PEMs from The Foundation for Women’s Cancer had a mean 13th grade reading level and were significantly higher than most other organizations. DISCUSSION/SIGNIFICANCE OF IMPACT: Gynecologic oncology PEMs available from major medical association are written well above the recommended sixth to eight grade reading level. Simplifying PEMs may improve patient understanding of their disease and facilitate physician-patient communication.

OBJECTIVES/GOALS: Despite a steady rise of graduate degrees in biostatistics earned in the US, the percent from minorities remains low. This poster will describe the Collaborative Undergraduate Biostatistics Experience (CUBE), an 8-week program aimed to diversify and bring awareness to the field of collaborative biostatistics, from recruitment through evaluation. METHODS/STUDY POPULATION: The CUBE program is funded jointly by the NIH’s NIDA/NIAAA (award number: 1R25DA058482-01) and is designed to give underrepresented minority (URM) undergraduate students in STEM the opportunity to engage in a collaborative biostatistics and health data science experience, along with related professional development activities. The program is built on four pillars: 1) training in introductory biostatistics, 2) training in R programming, 3) professional development, and 4) a collaborative research project addressing research questions in various disciplines. The CUBE program was delivered in the summer of 2022 as a pilot to four URM students at Virginia Tech (VT) and the University of Virginia (UVA), with two at each site. In summer 2023, the program was offered to 5 students (3 VT, 2 UVA). RESULTS/ANTICIPATED RESULTS: This poster will provide strategies learned over two summers with respect to recruitment and enrollment, along with details on the program content, timeline, and short- and long-term program evaluation metrics (both quantitative and qualitative). The CUBE program was well-received by students participating in summers 2022 and 2023, where improved attitudes towards statistics were demonstrated, and 7 of the total 9 participants (78%) over the past two summers expressed interest in pursuing a graduate degree in biostatistics or a career in quantitative research. Of these 7 students, 1 is currently enrolled in a biostatistics graduate program in the United States. DISCUSSION/SIGNIFICANCE: Results can be used to offer recommendations to leaders in the field on how to establish similar programs seeking to provide a pipeline for equity and diversity in the practice of collaborative biostatistics and health data science.

ABSTRACT IMPACT: This work seeks to improve the diagnostic accuracy of urinary tract infection among hospitalized older adults and mitigate antibiotic overuse in this population. OBJECTIVES/GOALS: Primary objective: To determine the diagnostic accuracy of serum procalcitonin (PCT) for the diagnosis of symptomatic urinary tract infection (UTI) in hospitalized older adults. Secondary objectives: (1) To develop a predictive model for the diagnosis of UTI; (2) To determine the ability of PCT in discriminating between lower and upper UTI. METHODS/STUDY POPULATION: We performed a prospective observational cohort study of 228 participants from a single institution. The study population included older adults (age 65 or older) who were hospitalized on the general medicine wards with a possible or suspected urinary tract infection (UTI). Upon obtaining informed consent, serum procalcitonin (PCT) was processed on remnant blood samples collected from the emergency department. We performed additional data collection through the electronic health record to obtain demographic information, clinical characteristics, and other laboratory and imaging results. Clinicians were surveyed for the diagnosis of UTI and charts were adjudicated by independent reviews of the medical record by infectious diseases experts to determine the primary endpoint of symptomatic UTI. RESULTS/ANTICIPATED RESULTS: We anticipate that serum procalcitonin predicts the presence of symptomatic urinary tract infection (UTI) by demonstrating an area under the receiver operating characteristic curve of at least 0.85. A predictive model developed in our cohort for the diagnosis of symptomatic UTI will be improved by the addition of serum PCT to the prediction model. Finally, we anticipate the serum PCT will accurately discriminate between upper and lower UTI. DISCUSSION/SIGNIFICANCE OF FINDINGS: Diagnosis of symptomatic UTI in hospitalized older adults is challenging and may lead to overuse of antibiotics and the development of antibiotic resistance in this vulnerable patient population. Serum procalcitonin offers a novel diagnostic strategy in the diagnosis of symptomatic UTI to enable more appropriate antibiotic therapy.