OBJECTIVES/GOALS: Development of interventions that improve social functioning (SF) in first episode psychosis (FEP) is hindered by a poor understanding of the neural mechanisms underlying SF deficits. This research aims to identify neural correlates of social functioning in FEP, and to evaluate whether this substrate is malleable in response to cognitive training. METHODS/STUDY POPULATION: This is a secondary data-analysis of participants in an ongoing randomized clinical trial investigating whether 12 weeks of targeted cognitive training is neuroprotective in FEP, versus treatment as usual. Baseline and post-training assessments include a brain MRI, three measures of SF, and a neurocognitive battery. Healthy controls complete MRI only. Differences in cortical thickness (CTh) and gray matter volume (GMV) in regions of interest between FEP and controls will be determined with ANCOVA. Multiple linear regression will be used to determine the relationship between neural substrate and SF in FEP. Linear mixed models will be used to examine the relationship between change in CTh and GMV and change in SF. Data collection is ongoing for this study. RESULTS/ANTICIPATED RESULTS: In preliminary data including 12 FEP and 9 healthy controls, FEP demonstrated cortical loss in the right superior frontal cortex and the right isthmus-posterior cingulate. Greater cortical thickness in the posterior cingulate cortex was associated with better social functioning across multiple measures when controlling for global cognition. Gray matter volume in the parahippocampal gyrus was also associated with better social functioning. Preliminary results evaluating whether targeted cognitive training is neuroprotective in these regions of interest in a manner that is associated with improved social functioning will also be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: Preliminary results link the posterior cingulate and parahippocampal gyrus to SF in FEP. Further research will investigate the contribution of changes in these brain regions to improved SF. The identification of biological treatment targets for SF may lead to development and optimization of novel interventions to alleviate SF deficits in FEP.

OBJECTIVES/SPECIFIC AIMS: Cocaine use is a significant health problem in the United States and associated with increased risk of adverse cardiovascular outcomes. Our goal was to evaluate the effects of rapid cocaine infusions on cardiovascular hemodynamics among patients with cocaine abuse disorder. METHODS/STUDY POPULATION: Patients with a history of cocaine abuse but no overt cardiovascular disease received 4 consecutive intravenous infusions of cocaine (0, 10, 20, 40 mg) given in randomized, double-blinded order. The infusion procedure was repeated on 2 consecutive days (4 infusions each day). Following each dose, patients underwent continuous monitoring via fingertip plethysmography for 30 minutes, followed by an additional 30 minutes washout procedure. Patients were surveyed throughout this timeline to record symptoms of cocaine response. Finger tracings were then used to calculate arterial pressure curves and parameters of heart rate, blood pressure, cardiac output, stroke volume, and systemic vascular resistance according to device-specific algorithms. Mean values were calculated over the entire 30 minutes follow-up and peak values were defined as the maximum value sustained over any 60-second interval during the follow-up period. RESULTS/ANTICIPATED RESULTS: Seven patients were enrolled and received cocaine infusions of 2 consecutive days. Cocaine dose was positively associated with mean cardiac output (R=0.489, p<0.001), peak diastolic blood pressure (R=0.435, p=0.001), mean heart rate (R=0.401, p=0.003), peak systolic blood pressure (R=0.399, p=0.003), peak mean arterial pressure (R=0.362, p=0.008), mean systolic blood pressure (R=0.399, p=0.003), +dP/dt (R=0.346, p=0.012), and peak heart rate (R=0.334, p=0.015). Hemodynamic parameters were also predictive of patient-reported symptoms of cocaine response. DISCUSSION/SIGNIFICANCE OF IMPACT: These data confirm the known pharmacologic effect of cocaine to prevent reuptake of neurotransmitters and demonstrate the feasibility of conducting a noninvasive assessment of cardiovascular hemodynamics as a measure of responsiveness to cocaine infusions. This procedure also provides a benchmark to evaluate the potential impact of pharmacologic treatments on cocaine-induced hemodynamic changes and patient perceptions of cocaine response.

OBJECTIVES/GOALS: Patients who require a hematopoietic cell transplant (HCT) and dont have an HLA-matched related or unrelated donor may rely on a haploidentical donor. The optimal haploidentical donor and guidance for selection is limited. We aim to determine how donor characteristics affect outcomes following haploidentical-HCT for pediatric patients. METHODS/STUDY POPULATION: This is a retrospective cohort study evaluating the effect of donor age and relationship on post-HCT outcomes in children (0-18y) from 2008-2018. Multivariable logistic regression analysis will identify if donor age or donor relationship affect the development of graft-versus-host-disease (GVHD), while adjusting for other patient, donor, and transplant related variables. Two-year overall survival & event-free survival will be determined using Kaplan-Meier curves, stratified by donor age group and donor relationship, and compared by log-rank testing. Sub-analyses will be performed for myeloablative transplants and reduced intensity conditioning, as well as for malignant and non-malignant diseases. RESULTS/ANTICIPATED RESULTS: Our primary aim to is determine the effect of donor age and the effect of donor relationship to patient on the development of GVHD. We hypothesize that utilization of a younger donor will decrease the incidence of GVHD. Further, we hypothesize that utilizing a sibling haploidentical donor will result in less GVHD than a parental donor. Secondary aims include evaluating the effect of donor age and donor relationship on overall survival, event-free survival, non-relapse mortality, relapse, graft failure and time to engraftment. The results of this study will help us to develop criteria for optimal haploidentical donor selection. If donor selection is optimized, this could result in improved outcomes following haploidentical transplants. DISCUSSION/SIGNIFICANCE: Haploidentical donors are increasingly used as many patients, especially ethnic minorities, do not have an HLA-matched donor. This will be the largest study of haploidentical HCT in children. The data gathered will allow us to identify important donor characteristics to help guide physician decision-making when choosing a haploidentical donor.

OBJECTIVES/GOALS: Scholarly activity is a key component of most residency programs. To establish fundamental research skills and fill gaps within training curricula, we developed an online, asynchronous set of modules to introduce trainees to various topics that are germane to the conduct of research and evaluated its effectiveness in resident research education. METHODS/STUDY POPULATION: Research 101 was utilized by residents at the Brookdale Hospital Medical Center in Brooklyn, NY. Resident knowledge, confidence, and satisfaction were assessed using pre- and post-module surveys with 5-point Likert scaled questions, open-ended text responses, and a final quiz. RESULTS/ANTICIPATED RESULTS: Pre-module survey results indicated that residents were most confident with the Aligning expectations, Introduction to research, and Study design and data analysis basics modules and least confident with the Submitting an Institutional Review Board (IRB) protocol at UC and Presenting your summer research modules. Post-module survey responses increased significantly compared to pre-module results for all modules and learning objectives (p<0.0001). “This module met my needs” was endorsed 91.4% of the time. A final quiz of 25 multiple choice questions resulted in a median score of 23. Content analysis of open-ended post-module survey responses identified multiple strengths and opportunities for improvement in course content and instructional methods. DISCUSSION/SIGNIFICANCE: These data demonstratethat residents can benefit from completion of Research 101, as post-module survey scores were significantly higher than pre-module survey scores for all modules and questions, and final quiz scores were high and highlighted opportunities for additional resident learning.

OBJECTIVES/SPECIFIC AIMS: The primary objective of this study is to determine the prevalence of maternal GBS colonization and demographic risk factors associated with maternal GBS colonization in Latin America. Secondary objectives include: To determine if there is an association between maternal colonization with GBS and stillbirth or preterm birth in Latin America. To determine the effect of cesarean section (CS) on the incidence of neonatal sepsis with GBS in mothers colonized with GBS. METHODS/STUDY POPULATION: Study Population: Pregnant women who received prenatal care at sites that utilize the Perinatal Information System (SIP) from 1989 through 2015, and were screened for GBS between 35 and 37 weeks of gestation. Maternal exclusion criteria included spontaneous abortion, stillbirth before 35 weeks, and lack of screening for GBS. Methods: Estimated prevalence (and 95% confidence interval) of maternal GBS colonization for the entire data set, by region, and by country. The prevalence data for each country further stratified by maternal age, ethnicity, education, civil status and habitation. Descriptive statistics calculated for each clinical prenatal and clinical perinatal health indicator as well as for each clinical history variable for GBS colonized and non-GBS colonized women. Odds ratios will be calculated for each demographic and clinical risk factor. Fisher’s exact tests will be used to test hypotheses about the relationship between maternal GBS colonization and specific perinatal outcomes such as stillbirth or preterm birth. We will use multiple logistic regression models to test the hypotheses about the relationships between demographic variables, maternal GBS colonization and perinatal outcomes. RESULTS/ANTICIPATED RESULTS: Preliminary results: 712,061 records included in database. 98,852 records with data for GBS screening. o90.6% White, 7.4% Mixed, 0.6% Black, 0.3% Native Indian, 0.1% Other. GBS prevalence among screened women, 17.5% There was a significant association between maternal GBS colonization and ethnicity (X2 (4, N=97006)=569.901, p<0.01) o Prevalence rates by ethnicity: 20.5% Black, 18.4% White, 15.2% Native Indian, 8.8% Mixed, 3.3% Other. There was a significant association between maternal GBS colonization and age (X2 (4, N=98655)=119.901, p<0.01) o Prevalence rates by age group:. Age ≤ 20 - 15.2%. Age 21-34 – 17.8%. Age ≥ 35 – 19.6% Anticipated results:. GBS positive mothers will have an increased burden of stillbirth and preterm birth compared to GBS negative mothers. Neonates born to GBS colonized mothers who deliver via cesarean section will have a decreased incidence of sepsis compared to neonates born to GBS colonized mothers who deliver vaginally DISCUSSION/SIGNIFICANCE OF IMPACT: There have been no comprehensive studies to date that use the CLAP data to characterize the epidemiology of maternal GBS colonization and GBS disease and the burden of neonatal GBS disease in Latin America. Taking advantage of this unique database, this is the first region-wide study using systematically collected data. Our preliminary analysis indicates that GBS colonization status among pregnant women in Latin America is 17.5%, which is greater than previously reported. While there is evidence that maternal carriage of GBS is associated with stillbirth, this will be the first study to quantify the burden of GBS-associated stillbirth in Latin America. Additionally, previous work has been inconclusive in regards to maternal colonization with GBS and its association with preterm birth. This will be the largest study to evaluate the association of maternal GBS carriage with preterm birth. Findings from this study have the potential to inform public health policy and interventions by identifying the prevalence and risk factors.

OBJECTIVES/SPECIFIC AIMS: Missing data is a common problem in research studies that may lead to inconclusive or inaccurate results. It may even lead to harm secondary to wrong research conclusions. The purpose of this ancillary study is to measure the differences in missing data following implementation of a variety of mechanisms to improve data quality and documentation in a global quality improvement study. Many of the sites involved in the study were in low-income or middle-income countries with minimal research infrastructure. Missing data is defined as “values that are not available that would be meaningful for analysis if they were observed” (The prevention and treatment of missing data, New Engl J Med 367; 14, nejm.org, October 4, 2012). METHODS/STUDY POPULATION: All study sites used REDCap software to enter various data points including hospital and ICU admission and discharge dates as well as whether items on a Checklist relevant to processes of care in the ICU were reviewed. After initial general data collection phase, we categorized data as “must have” and “good to have.” “Must have” variables were defined as data variables that were essential for the study outcomes. “Good to have” variables would not affect the main outcomes of the study if missing. We measured completeness of data using the in-built REDCap data quality check feature. We used several strategies to encourage reduction of missing data. We initially did random data checks but noted that the amount of missing data was substantial and could not be adequately addressed this way. Second, we created excel sheets highlighting missing data for each site and notified sites. This proved onerous to create and made it burdensome for sites to identify easily where data was missing. Third, we built a custom report form in REDCap specifically able to identify which “must have” data points were missing. This could be easily accessed by the principal investigator at each site and made completing the data forms more straightforward. We encouraged all sites to complete their data collection by sending weekly data reports to each site highlighting the patients with missing data. An instructional YouTube tutorial was also created and the link was shared with all sites to demonstrate how to use the custom built report form in REDCap and how to appropriately fill in the missing data. Since this was a global study, we communicated with sites using a variety of locally favored mechanisms including Zoom, FaceTime, WeChat, WhatsApp as well as email. By harnessing the buy-in of local champions our approach was successful. RESULTS/ANTICIPATED RESULTS: The total number of patients recruited for the CERTAIN study is 4843. The rate of all missing variables improved with the efforts described above. Hospital admission dates were missing in 8.4% pre efforts and 4.2% post efforts (p<0.01). ICU admission dates were missing in 5.5% pre and 2.0% post (p<0.01). Documentation of completion of processes of care (including central line review, urinary catheter review, consideration for blood transfusion) improved significantly from pre to post (p<0.01). DISCUSSION/SIGNIFICANCE OF IMPACT: Missing data can be a problem in all types of research studies. This study provides some preliminary evidence for effective approaches that can reduce the problem of missing data when conducting a global study at sites with limited research infrastructure in place. By addressing the concern about missing data, we can be more confident that our results can be accurately analyzed and interpreted, improving the quality of the research.

ABSTRACT IMPACT: This work will impact participants of clinical trials by better informing them of their trial’s results and their important role within the clinical research process. OBJECTIVES/GOALS: This project aims to equip researchers with an online tool for the development, dissemination, and collection of participant feedback for plain language clinical trial (CT) result summaries (PLCTRS). PLCTRS ensure that participants fully understand their trial’s results and their role in the CT process. METHODS/STUDY POPULATION: This online development platform is a web application made with CSS, HTML, and JavaScript. First, general trial identification information including study aims and eligibility will be input by researchers. Then, they will be prompted with tips and suggestions for composing in plain language and to ensure inclusion of all essential trial information. Next, the platform will disseminate this writing electronically to participants. Participants then provide meaningful feedback on the platform about their comprehension for the researcher, which the platform will aggregate and summarize for revisions. This process of drafting and feedback is repeated until a satisfactory PLCTRS is finalized. RESULTS/ANTICIPATED RESULTS: The anticipated results of this project are overall improved comprehension of clinical trial results by participants. This comprehension will be measured by participants ability to answer certain questions not only regarding trial outcomes, but also about the trial in general. For instance, before and after interacting with the PLCTRS, trial participants will be asked if they can identify which investigational drug was being studied and its possible side effects. This project could anticipate identification of trial elements and results deemed difficult to comprehend by participants; thus they would be better informed after interacting with the platform. DISCUSSION/SIGNIFICANCE OF FINDINGS: This project will ensure that participants better comprehend the trials they participated in beyond the required informed consent process - which only covers their comprehension prospectively. This project seeks to address the gap of ensuring participant comprehension retrospectively.

Mini-sabbaticals are formal short-term training and educational experiences away from an investigator’s home research unit. These may include rotations with other research units and externships at government research or regulatory agencies, industry and non-profit programs, and training and/or intensive educational programs. The National Institutes of Health have been encouraging training institutions to consider offering mini-sabbaticals, but given the newness of the concept, limited data are available to guide the implementation of mini-sabbatical programs. In this paper, we review the history of sabbaticals and mini-sabbaticals, report the results of surveys we performed to ascertain the use of mini-sabbaticals at Clinical and Translational Science Award hubs, and consider best practice recommendations for institutions seeking to establish formal mini-sabbatical programs.

Well-designed, accessible short-term research training programs are needed to recruit and retain underrepresented persons into clinical and translational research training programs and diversify the workforce. The Michigan Institute for Clinical and Health Research developed a summer research program, training over 270 students in 15 years. In response to the 2020 COVID-19 pandemic, we pivoted swiftly from an in-person format to a fully remote format. We describe this process, focusing on factors of diversity, equity, and inclusion including enabling student participation in remote research activities. We collected data about students’ learning experiences since the program’s inception; therefore, we could evaluate the impact of remote vs. in-person formats. We examined data from five cohorts: three in-person (2017–2019; n = 57) and two remote (2020–2021; n = 45). While there was some concern about the value of participating in a remote format, overall students in both formats viewed the program favorably, with students in the remote cohorts rating some aspects of the program significantly more favorably. In addition, more students who identified as Black or African American participated in the remote format than in the in-person format. We describe lessons learned from this unprecedented challenge and future program directions.

OBJECTIVES/GOALS: Nearly half of mothers who report electronic (e)-cigarette use during pregnancy believe e-cigarettes are less harmful than traditional cigarettes. We aim to determine the association of quitting e-cigarette use in pregnancy with the risk of preterm birth and low birth weight. METHODS/STUDY POPULATION: We conducted a cross-sectional study of women participating in the Pregnancy Risk Assessment Monitoring System and with live singleton birth during 2016-2019. Women were classified based on their e-cigarette use: before pregnancy only (quitters), last three months of pregnancy only (initiators), at both times (sustained users), and neither time (non-users). We used a modified Poisson regression to determine the association between quitting e-cigarette use and preterm birth (<37 weeks) and low birth weight (<2,500 grams) adjusting for demographic, social-economic, and behavior-related risk factors. Analyses were weighted to account for the survey design and non-response. RESULTS/ANTICIPATED RESULTS: Based on 150,950 women who responded to the survey, there were estimated 2.9% quitters, 0.2% initiators, 1.0% sustained users, and 95.9% non-users in the U.S. Compared to sustained e-cigarette users, quitters had a similar risk in preterm birth (adjusted risk ratio [ARR]: 0.84, 95% confidence interval [CI]: 0.65, 1.08) and a significantly reduced risk in low birth weight (ARR: 0.77, 95%CI: 0.61, 0.97) adjusting for traditional cigarette use, age, race/ethnicity, education, marital status, family income, prior preterm birth, prior live births, BMI prior to pregnancy, pregnancy weight gain, kotelchuck index, multivitamin use, drinking prior to pregnancy, year of birth, and residential state. DISCUSSION/SIGNIFICANCE: As FDA authorizes the sales of certain e-cigarettes, women smokers may switch to e-cigarettes, believing they are reducing harm. Our study shows that quitting e-cigarette use is associated with a reduction of low birth weight. Clear messaging is needed to help women cease e-cigarette use in pregnancy.

ABSTRACT IMPACT: The importance of this study is to evaluate the responses following the exposure of opioid drugs in young adults to address the current opioid epidemics OBJECTIVES/GOALS: To compare the proportion of patients between 18 and 25 years of age, who develop an opioid abuse disorder following dental surgery, to those following other surgical procedures, when an opioid drug is used for acute postoperative pain control. METHODS/STUDY POPULATION: We fashioned an IRB-sponsored retrospective cohort study of patients, ages 18 to 25 years old, who presented for dental surgery or other medical surgical procedures, at Strong Memorial Hospital Medical Center, at the University of Rochester and received opioid drug treatments, for acute surgical pain management. Patients with the diagnosis of acute surgical pain were included in the study. However, those with chronic pain or other related abnormalities were excluded, even if a diagnosis of acute surgical pain was present in the electronic chart. The clinical data were retrieved from electronic medical records and NYS-iStop records. All statistics were significant at the level of <0.1 RESULTS/ANTICIPATED RESULTS: We identified 167 subjects, of whom, only 150 subjects met inclusion criteria (n=100) in dentistry and (n=50) in other medical specialties. Patients were followed up in a 7-year period. Most of the subjects were females (n=91), Caucasian (n=80), and lived in a suburban location (n=78). The most frequently prescribed opioid included hydrocodone (n=119). A significantly higher proportion (8.7%) of patients developed opioid abuse disorders in the control group, compared to 1% of subjects in the experimental group (p 0.02). Those in the control group received marginally significant higher doses of MMEs 447.2 +/-644.8 mg vs 306.2 +/-354.7mg in the experimental group (p 0.086). Those in the control group had significantly longer periods of opioid treatment 10 (+/-12) compared to 6(+/-6) days in the experimental group DISCUSSION/SIGNIFICANCE OF FINDINGS: It is paramount to evaluate the morphine milligram equivalents, and duration of opioid treatment given to the young population with acute surgical pain, to prevent opioid abuse disorders in this vulnerable cohort.

OBJECTIVES/SPECIFIC AIMS: The iobio project enables anyone (eg, diagnosticians, MDs, genetic counselors, citizen scientists) to perform useful analysis of genomic data, without a need to rely on bioinformaticians. iobio uses a novel real-time analysis framework, coupled with powerful visualizations delivered in a standard web browser. The project successfully supports free academic/nonprofit users, but occasions exist where it is more applicable for the project to be delivered commercially. Frameshift Genomics is developing commercial applications and functionality, which will exist alongside and in coordination with the academic project. These products will be marketed to large institutions including genome institutes, hospitals, diagnostic labs etc., but also to individual users who do not have access to large compute resources, or bioinformatic analysts, and everything in between. METHODS/STUDY POPULATION: The commercial iobio project under Frameshift Genomics aims to develop applications and features that cannot be successfully supported by an academic model. For example, when analyses are scaled up to processing of extremely large data sets, a commercial product with access to compute resources makes more sense than an academic tool. Bam.iobio is an application that samples data from sequencing alignment files, taking seconds to generate and visualize statistics representative of the entire file. This app is offered for free academically. When analysis involves thousands of such files, however, the commercial application, multibam.iobio, is more suitable. Other examples, including support for licensed third-party software and permitting extensive computation via cloud platforms, can also only be reasonably be supported via commercial software. Finally, development of commercial applications is driving adoption of more rigorous testing platforms, delivering more robust products. A particular strength of the iobio platform is allowing non-bioinformaticians to understand their data, for example providing quality control functionality providing confidence in data sets and the conclusions drawn from them. Such analyses are critical to all users of genomic data, and the iobio platform is ideally suited to provide an intuitive, integrated framework for performing them. RESULTS/ANTICIPATED RESULTS: The iobio project has been readily adopted by many in the community and shows significant promise for democratizing genomic analysis. Work is ongoing, supported by NIH small business grants, to develop commercial applications that will be marketed to analysts and medical professionals from large genome institutes and universities, to individual project users and citizen scientists. DISCUSSION/SIGNIFICANCE OF IMPACT: There are currently a number of iobio tools available academically, and they have been embraced by many in the genomics community. In fact, a number of popular platforms (eg, Galaxy, the International Cancer Genome Consortium (ICGC) data portal, mygene2 at the University of Washington) have incorporated iobio tools into their own platforms. To date, the gene.iobio variant interrogation tool has been used in a number of diagnostic projects, aiding identification of putative causative variants, and the pre-release version of the commercial multibam.iobio tool has been critical in unearthing data quality problems in project level data.

OBJECTIVES/SPECIFIC AIMS: Smoking during pregnancy (SDP) is associated with negative health outcomes, both proximal (e.g., preterm labor, cardiovascular changes, low birth weight) and distal (e.g., increased child externalizing behaviors and attention deficit/hyperactivity disorder (ADHD) symptoms, increased risk of child smoking). As pregnancy provides a unique, strong incentive to quit smoking, investigating SDP allows analysis of individual predictive factors of recalcitrant smoking behaviors. Utilizing a female twin-pair cohort provides a model system for characterizing genotype×environment interactions using statistical approaches. METHODS/STUDY POPULATION: Using women from the Missouri Adolescent Female Twin Study, parental report of twin ADHD inattentive and hyperactive symptoms at twin median age 15, and twin report of DSM-IV lifetime diagnosis of major depressive disorder, trauma exposure (physical assault and childhood sexual abuse), collected at median age 22, were merged with Missouri birth record data for enrolled twins, leading to 1553 individuals of European ancestry and 163 individuals of African-American ancestry included in final analyses. A SDP propensity score was calculated from sociodemographic variables (maternal age, marital status, educational attainment, first born child) and used as a 6-level ordinal covariate in subsequent logistic regressions. RESULTS/ANTICIPATED RESULTS: For European ancestry individuals, parental report of hyperactive ADHD symptoms and exposure to childhood sexual abuse were predictive of SDP, while a lifetime diagnosis of major depressive disorder, parental report of inattentive ADHD symptoms, and exposure to assaultive trauma were all not significantly predictive of future SDP. For African-American individuals, none of these variables were significant in predicting future SDP. DISCUSSION/SIGNIFICANCE OF IMPACT: Understanding this relationship of risk-mechanisms is important for clinical understanding of early predictors of SDP and tailoring interventions to at risk individuals. Ultimately, the focus of this research is to mitigate risk to pregnant smokers and their children. Additionally, the cohort-ecological approach informs how well research and administrative (vital record) data agree. This allows for evaluation of whether administrative data improve prediction in research cohorts, and conversely if research data improve prediction over standard sociodemographic variables available in administrative data.

OBJECTIVES/SPECIFIC AIMS: 1. Determine positive predictive value, negative predictive value, sensitivity, and specificity of Neuro ICU nurse interpretation of real-time bedside qEEG. 2. Determine difference in time to detection of first seizure between Neuro ICU nurse qEEG interpretation and EEG fellow reads of cEEG. 3. Determine what qualities of seizures make detection by neuro ICU nurses more or less likely – e.g. duration of seizures, type of seizures, spatial extent of seizures. METHODS/STUDY POPULATION: Recruit neuro ICU nurses taking care of 150 patients admitted to the Neuro ICU at Duke University Hospital who are initiated on cEEG monitoring. Nurses will be consented for their participation in the study. Neuro ICU nurses will evaluate the qEE RESULTS/ANTICIPATED RESULTS: From literature estimates of a 20% seizure prevalence in critical care settings, we hope to have 30 patients with seizures and 120 without. Based on prior study in the Duke Neuro ICU, we hypothesize that Neuro ICU nurses will have sensitivity and DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first prospective study of neuro ICU nurse interpretation of real-time bedside qEEG in patients with unknown NCSE/NCS presence. If nurse sensitivity, specificity, and positive predictive value are clinically useful, which we deem would be so at a sensitivity of 70% or greater, with acceptable false alarm rate, nurse readings of qEEG could significantly decrease the time to treatment of seizures in the Neuro ICU patient population, and perhaps could improve patient outcomes.

OBJECTIVES/GOALS: Low statistical power is a problem is many fields. We performed a systematic review to determine the median statistical power of studies of epilepsy surgery outcomes. METHODS/STUDY POPULATION: We performed a PubMed search for studies reporting epilepsy surgery outcomes for the years 1980-2000, focusing on studies using stereo-electroencephalography (SEEG). We extracted patient count data for comparisons of surgical outcome between groups, based on a prognostic factor. We defined a clinically meaningful difference the surgical outcome for MRI positive (66.9%) compared to MRI negative (45.5%) in the largest study in the series. The statistical power of a Chi-square test was computed as the percentage of simulated runs (10,000 repetitions) assuming this difference with a p-value less than 0.05. RESULTS/ANTICIPATED RESULTS: Based on 69 studies, the median sample size was 38 patients, and the median statistical power was 24%. This implies at least a 17% (0.5/[0.24+0.05)) chance a study with a significant result in false, assuming 1:1 pre-test odds. A 'typical’ SEEG study with 33 patients and 2:1 allocation had a median significant odds ratio of 6.5, which over-estimates the true odds ratio of 2.4. DISCUSSION/SIGNIFICANCE: Studies of epilepsy surgery outcomes using SEEG are statistically underpowered. This means true effects will be missed, the chance a study with a significant result is false will be inflated, and significant effects found will be over-estimated. Studies of surgery outcome need better statistical rigor if they are to reliably guide treatment.

OBJECTIVES/GOALS: We adapted the Serious Illness Care Program (SICP), an evidence-based intervention designed to promote early serious illness conversation, to be delivered via telehealth for older patients with acute myeloid leukemia and myelodysplastic syndromes. The purpose of this study is to assess the feasibility and usability of the adapted intervention. METHODS/STUDY POPULATION: We are conducting a single-arm pilot study of an adapted SICP that is delivered via telehealth for older patients with AML or MDS (>=60 years) and their caregivers (if available). The adapted SICP includes: 1) Patient preparation pamphlet: sent to patient prior the visit with their clinician, 2) Geriatric assessment: completed by study team and provided to clinician prior to their visit with the patient, 3) A 30-60 minute telehealth visit with their primary oncologist or oncology advance practitioner, 4) Serious Illness Conversation Guide (SICG): used by the clinician during the visit to elicit patient values, 5) Family guide: provided to patient following their visit to help patient’s share their values with their family, 6) Electronic medical record note template for clinicians to document their visit the patient. RESULTS/ANTICIPATED RESULTS: We hypothesize that the adapted SICP intervention will be feasible and usable. We will assess feasibility based on retention rate (percent of patients who consent and complete the visit); >80% is considered feasible. Usability will be assessed using the telehealth usability questionnaire; an average score of >5 is considered usable. Other measures include psychological health, advance care planning engagement, quality of life, and disease understanding. We plan to enroll 20 patients in this study. To date, 11 patients have consented to participate, 10 patients have scheduled SICP visits, 9 patients have completed their visits, 7 patients have completed post-intervention qualitative interviews, and 4 patients have completed post-intervention surveys. DISCUSSION/SIGNIFICANCE: The adapted telehealth-based SICP may promote early serious illness conversation, patient-reported outcomes, and end-of-life experience for older patients with AML and MDS. Results from this study will be used to inform development of clinical trials testing the impact of the adapted SICP on patient- and caregiver-reported outcomes.

OBJECTIVES/GOALS: Nurses are leaving the profession at an alarming rate due to increased workload and burnout.#_msocom_1 Computational models that are reliable and reproducible are needed to quantitatively examine nursing workload and estimate potential effect of interventions. This project developed a logical data model to represent nursing EHR interactions. METHODS/STUDY POPULATION: With nursing EHR interactions as a starting point, we expand upon literature that examined the EHR workload of physicians. We conducted an exploratory analysis of nursing EHR audit log data at a large academic medical center, and explored components of nursing workload that can be extracted from other health system data. Using concepts derived from the studying temporal biomedical data patterns, we formulated a data structure that describes nurse EHR interactions, nurse intrinsic and situational characteristics, and nurse outcomes of interest in a scalable and extensible manner. RESULTS/ANTICIPATED RESULTS: Temporal machine learning models are grounded in the concept of vectors. We developed a logical data model that describes tasks performed by nurses (NTask), nurse types (NType), and nursing outcomes (NOutcome). For each nurse (k), we define a function <NTask (k, i)>, i=1 to N as a vector of dimension N, where N is the number of time periods in the study. The i component corresponds to the activity that the nurse is doing. The model will allow the quantitative classification of activity patterns for any finite number of nurses for an arbitrary set of tasks and for time at any specified resolution. The expected outcome is a set of vectors that can then be utilized to quantitatively model nurse activity trajectories and other patterns of nurse EHR interactions. DISCUSSION/SIGNIFICANCE: By instantiating the logical data model, we will demonstrate how nurse EHR interactions can be studied using temporal unsupervised learning and state-of-the-art artificial intelligence methods. We plan to simulate the potential impact of workload interventions and predict risk for nurse burnout.