OBJECTIVES/GOALS: The effect of the Direct-Acting Antiviral (DAA) on hepatic histopathological features from patients treated for HCV has not been thoroughly evaluated. The goals of this retrospective study were to determines differences between the liver biopsies collected before and after DAA treatment and correlated the histopathology with clinical outcome. METHODS/STUDY POPULATION: Spectral imaging was used to evaluate differences in intrahepatic macrophage (CD68, CD14, CD16, MAC 387, and CD163) and T cell (CD3, CD4, CD8, CD45, and FoxP3) phenotypes in paired liver biopsies collected from the same patient before (n=10) and after (n=10) achieving SVR (Figure 1). Imaging analysis and machine learning algorithms were used to evaluate changes in these key immune cells. We also compared differential gene expression of over 700 genes using RNA isolated from liver biopsies with NanoString. RESULTS/ANTICIPATED RESULTS: Multispectral imaging analysis showed a significant increase of proinflammatory/M1-like (e.g., CD14+) and anti-inflammatory/M2-like macrophage (e.g., CD163+) phenotypes in pre-treatment versus post-treatment biopsies, respectively. Gene expression analysis revealed enrichment of inflammatory (HLA-B, STAT1, CXCL10) and interferon induced-antiviral (ISG15, OAS3, MX1 and IFIT1) genes in the pre-treatment vs the post-treatment group. Cell deconvolution analysis also showed a significant increase of M1-like macrophages in the pre-treatment group when compared to the post-treatment group or controls. Upregulation of genes associated with cell proliferation and differentiation (c-KIT and Fos) was observed in the post-treatment biopsies of patients with persistent inflammatory infiltrates. DISCUSSION/SIGNIFICANCE: Protein and gene expression profiles observed in patients before DAA therapy showed a strong macrophage-mediated inflammatory response against HCV infection in the liver that shifted significantly to a tissue remodeling microenvironment after treatment.

OBJECTIVES/SPECIFIC AIMS: Our overall goals are: 1. To engage, inform and educate children and families on clinical research and increase their understanding of the goals and process of participation in research studies/clinical trials; 2. To Increase participation of children, especially those who are disproportionately underrepresented, in clinical research in the Western New York region and beyond. METHODS/STUDY POPULATION: The University at Buffalo Clinical Translational Science Institute conducted meetings in schools, community coalitions while holding focus groups with children with chronic conditions and their families and community health workers to identify the general perceptions of research. These conversations then informed the development of a children’s activity book about research. Completed in 2017, our “Sofia Learns about Research” activity book presents research in a non-threatening way by presenting a child with asthma who walks through the process of learning about research, being recruited and participating in research. The book explains basic concepts about research coupled with fun games and the possibility to color. Over 1,000 copies of the activity book have been disseminated to second to fourth graders via afterschool programs, community events, and medical practice waiting rooms. Recipients of the book are directed to short surveys to provide feedback on the book and their perception of research. The parents are also given the option to sign-up for the Buffalo Research Registry in order to be contacted about research opportunities. RESULTS/ANTICIPATED RESULTS: Response has been very positive, with parents and community participants saying “It’s not just a storybook. The activities keep kids entertained while learning new concepts.” In children informally polled via a brief questionnaire pre and post story reading at an afterschool program, there was an increase in those interested in participating in a research study. In a recent event sponsored by the CTSI Community Engagement Core and other UB organizations, a group of fifty children from diverse background colored with enthusiasm several activity pages and obtained stickers for their “Research Passport”. In a recent teacher focus group we learned that the book content may fit the Science Curriculum and plan on reading sessions in inner-city schools after approval from the district. A pilot reading activity in a Montessori program revealed that second grade children were able to understand and complete the activities in the book. We are obtaining further feedback form teachers and parents in order to design simple protocol to be submitted for IRB approval to obtain more formal feed-back and outcomes in future readings. In parents and focus groups several respondents have indicated its relevance to older populations and English-language learners as well. The book has recently been translated into Spanish and Arabic through a partnership with the International Institute of Buffalo, which “welcomes, connects and empowers the foreign born”. Some of the book’s images have been modified in order to be sensitive to the readers’ culture and we are in the process of collaborating with the International Institute to disseminate it to their clients. We are in the initial phase of planning a mobile application which we anticipate will significantly enhance dissemination. DISCUSSION/SIGNIFICANCE OF IMPACT: This presentation will describe the development process, the underpinning concepts and our plans and current progress towards a more formal community and school dissemination and evaluation. This project was made possible by Team Science in that the expertise of a millennial pre-medical student and an anthropologist with high community involvement was coupled with that of a senior clinical translational researcher. Moreover, much research and attention was devoted to the creation of images that are culturally inclusive. To this end, with the exception of the cover page, we have intentionally created the book in black and white so that the child may use his/her imagination and color the way he/she sees the protagonists and the environment. Great attention was devoted to names of the protagonists with the names of the two main characters being among the most common in the world in numerous countries. Also, the book lends itself to a mobile application which will allow the reader to change colors and shapes of the protagonists to fit his/her cultural background. We are in the early planning stages and will share our progress as part of this presentation. We have strived to disseminate the book with a broad approach in our community. This phase is being followed by a more formal dissemination phase via libraries, schools and community events. This part of the project exemplifies the challenge between wanting to disseminate the book broadly while obtaining formal feedback and outcomes in compliance with regulations protecting the anonymity and/or confidentiality of children and families. Therefore for this second phase of dissemination IRB approval is being sought in order to collect more quantitative and qualitative data on the impact of the book. We have already conducted a focus group with teachers to overcome the challenges around informed consent, especially in the public school system. Our initial findings suggest this resource will improve knowledge and perception of research among children and their families. To our knowledge most of the materials explaining research to children are geared to older children and are often sponsored by pharmaceutical companies for a specific trial. If successful, this book can have a profound impact in reaching out to children outside of the research and medical environments, with the ultimate goal of increasing the child’s and family’s willingness to participate in clinical research and clinical trials.

ABSTRACT IMPACT: This work provides context from the patient perspective on the impact of hospital policies on their birthing experiencing during the first peak of the pandemic. OBJECTIVES/GOALS: The goal of this study was to report the intrapartum care experiences from people giving birth during the COVID-19 pandemic in the United States. Place of birth included hospital, birth center and home births. METHODS/STUDY POPULATION: Studies that involved patient-related data collection are hindered by pandemic-related changes in clinical practices and research policies. Our aim was to assess patient experience during a pandemic, we explored data collection via a large online community of pregnant women. We asked if women who birthed during COVID-19 changed their birth setting and if they experienced less respectful care, more pressure to undergo induction and/or cesarean birth and newborn separation. We also wanted to explore whether there were differences in the care experience depending on the race of the woman. Open ended questions on care experiences were included and content analysis conducted. Bivariate analysis was conducted comparing those from high versus less COVID-19 impacted areas and by race (White/Black self-identifying). RESULTS/ANTICIPATED RESULTS: The mean age was 31.5 years (SD = 5.0), 80.7% identified as White, 85.0% married, and 85.3% privately insured (N=388). Bivariate unadjusted analyses comparing high vs. low impact COVID-19 states, 22.3% considered changing their place of birth versus 12.7% in less impacted areas (p<.05): no difference pressure for induction/cesarean based on region. In bivariate unadjusted analysis comparing White and Black people, Black people had higher odds of pressure for cesarean or induction compared to White (OR 10.3, 95% CI 2.2 to 48.6, p=.0003). Black people had lower respect scores vs. White (68.7 vs. 72.3 p<.01) and higher odds of preterm birth 3.7 (1.1 to 12.4, p=0.04). Content analysis themes were institutional policies, changes in care, hospital staff interactions, sub-par care, support during birth and mental health. DISCUSSION/SIGNIFICANCE OF FINDINGS: The analysis demonstrated differences among participants from highly versus less impacted COVID-19 states. Disparities persisted with Black women reporting lower respect, pressure for interventions and more preterm birth when compared to White participants. Limitations include use of a convenience sample and self-reported data.

OBJECTIVES/SPECIFIC AIMS: We will use a structured evaluation framework, the payback framework, to document the outcomes of 15 case studies of pilot projects supported by Georgia CTSA from 2007 to 2014. METHODS/STUDY POPULATION: We will use a case study approach including bibliometric analyses of publications associated with the selected projects, document review (e.g., investigator curriculum vitae, biannual project reports) and investigator interviews. RESULTS/ANTICIPATED RESULTS: We will document outcomes in 5 “payback categories”: (1) knowledge, (2) research targeting, capacity building, and absorption, (3) policy and product development, (4) health benefits, and (5) broader economic benefits. DISCUSSION/SIGNIFICANCE OF IMPACT: This study will aid in characterizing the returns resulting from this research funding and identify its strengths and weaknesses. This study will inform our understanding of the diversity and breadth of outcomes resulting from Georgia CTSA-supported research, and the value pilot projects provide to clinical and translational science and the broader community.

OBJECTIVES/GOALS: Early HIV detection and treatment are key to reducing patient morbidity and mortality, yet 40% of people living with HIV do not know their status. “OPT-OUT” approaches to hiv testing, in which patients #_MSOCOM_1 are informed that an HIV test will be conducted unless they decline, are being increasingly recognized as a means to increase HIV testing. METHODS/STUDY POPULATION: the ed at Uhealth tower (UHT) implemented #_MSOCOM_1 the focus program that integrates routine “opt-out” HIV screening into the existing electronic medical record workflow to increase the number of individuals who know their HIV status, optimize linkage to care, and reduce stigma associated with HIV. the emr facilitates the opt-out screening model and maximizes the use of information systems to seamlessly integrate screening as a routine practice in a high-volume ed. our partnership with the florida department of health in miami dade (FDOH) allows uht to verify whether cases are new or known /out-of-care, link individuals immediately to care, and increase efficiencies with real-time data reconciliation. RESULTS/ANTICIPATED RESULTS: since implementation#_MSOCOM_1, from October 2019 - Dec 2022, the UHT ED screened 34, 314 eligible patients for HIV, of which, 17, 850 were tested. 228 people with hiv were identified; 37 were newly diagnosed. of HIV+ Diagnoses, 54.67% of HIV+ individuals were black and 36.89% HISPANIC. HIV+ individuals were referred to the doh with linkage to care at 81%. comparatively, before the onset of focus, the ED ordered 38 HIV tests, with one positive from Oct 2018 TO Sept. 2019. DISCUSSION/SIGNIFICANCE: UHT ED’s focus “OPT-OUT” HIV testing is a valuable conduit for HIV detection, prevention, and care. OPT-OUT screening removes the stigma associated with hiv testing, fosters earlier diagnoses and treatment, reduces health disparities, and decreases the risk of transmission.

OBJECTIVES/GOALS: Kidney transplant is superior to dialysis for the treatment of end-stage kidney disease, but accessing transplant requires high patient engagement. We sought to develop a group counseling intervention with patients and their social support members using an evidence-based, stakeholder-engaged approach. METHODS/STUDY POPULATION: We employed an Intervention Mapping approach to incorporate qualitative data from stakeholders on barriers to accessing kidney transplant. Data were collected from 13 focus groups of African American (AA) and white adult kidney transplant candidates and their social support networks in Minnesota and Georgia. We completed this process through (1) qualitative data collection, (2) utilizing data and intervention mapping methods to develop a conceptual framework to describe associations between behavioral determinants and desired outcomes, and (3) using these products to identify evidence-based approaches to modify behavioral determinants through a theory based intervention. RESULTS/ANTICIPATED RESULTS: Participants describe experiences of overwhelm, isolation, helplessness, and difficulty communicating. In addition, AA participants expressed distrust in the medical system. We systematically incorporated these themes into a conceptual model of behavior change that identifies determinants of necessary actions to obtain transplant, including knowledge, self-efficacy, reduced decisional conflict, and perception of social support. Evidence-based methods to modify these determinants, such as modeling, goal-setting, and mobilizing social support, were incorporated into the design of a group education and counseling intervention with an individualized risk calculator. DISCUSSION/SIGNIFICANCE OF IMPACT: Intervention mapping allows for behavior change theories to be incorporated into counseling sessions with patients and their social support networks. This approach translates qualitative data into an evidence-based intervention which will be piloted in a randomized controlled trial (RCT) to determine feasibility for a larger RCT.

In recent years, there have been concerted efforts to better recruit, support, and retain diverse faculty, staff, and trainees in academic medicine. However, many institutions lack comprehensive and strategic plans to provide support to retain and recruit individuals from historically underrepresented groups. In this article, we itemize specific mechanisms through which institutions can support diverse individuals with the goal of improving inclusion and belonging in the workforce to better reflect the diversity of the intended patient and research participant population.

The Community Research Liaison Model (CRLM) is a novel model to facilitate community-engaged research (CEnR) and community–academic research partnerships focused on health priorities identified by the community. This model, informed by the Principles of Community Engagement, builds trust among rural communities and expands capacity for community and investigator-initiated research. We describe the CRLM development process and how it is operationalized today. We followed a multi-phase process to design and implement a community engagement model that could be replicated. The resulting CRLM moves community–academic research collaborations from objectives to outputs using a conceptual framework that specifies our guiding principles, objectives, and actions to facilitate the objectives (i.e., capacity, motivations, and partners), and outputs. The CRLM has been fully implemented across Oregon. Six Community Research Liaisons collectively support 18 predominantly rural Oregon counties. Since 2017, the liaison team has engaged with communities on nearly 300 community projects. The CRLM has been successful in facilitating CEnR and community–academic research partnerships. The model has always existed on a dynamic foundation and continues to be responsive to the lessons learned by the community and researchers. The model is expanding across Oregon as an equitable approach to addressing health disparities across the state.

Health systems currently underutilize systematic reviews. Here, we describe a proof of concept project designed to augment the standard systematic review process by presenting qualitative information as a companion to a review on deprescribing interventions. We conducted a thematic analysis of semi-structured interviews with Veterans Health Administration clinicians and Veterans to describe first-hand experiences of engaging in the deprescribing process. Qualitative findings were incorporated into an interactive, web-based product designed to supplement the systematic review report. Preliminary evaluation suggests that integration of narratives as a companion to systematic reviews is of interest to frontline clinicians, researchers, and health system administrators.

OBJECTIVES/GOALS: Maternal undernutrition, a form of malnutrition, can alter neonatal leptin signaling and result in metabolic dysfunction in adulthood. We developed a mild undernutrition model to relate more to societys nutritional challenges and to test the hypothesis that a shift in the neonatal leptin surge would result in sex-specific metabolic changes. METHODS/STUDY POPULATION: We studied pups from undernourished dams which were calorically restricted by 20% (CR20) from embryonic day 15 until postnatal day (PND) 21. We tested 216 offspring from 11 Fed dams and 13 undernourished dams (CR20), detecting a leptin surge in control fed progeny at PND11. At 3 months of age, offspring from 3 dams per maternal nutrient status were either exposed to a 45% high fat diet (HFD) or control diet (10% fat) for 16 weeks. Anterior pituitary hormones were analyzed in the pituitary and serum of neonates and adults. To determine the mechanism of the phenotype observed in male adult offspring on the HFD, single cell RNA sequencing was used to analyze the pituitary, fat and liver. RESULTS/ANTICIPATED RESULTS: Offspring of CR20 dams had an early leptin surge peaking at PND8 and GH levels at PND1 were higher in CR20 progeny. Weights of both male and female CR20 offspring were lower and body lengths were shorter than controls. As adults, Fed mice from both sexes had increased weight gain with HFD. However, although CR20 females gained weight on the HFD, male progeny from CR20 dams did not gain weight on the HFD and appeared protected from impact. We found sex-specific changes in pituitary Gh, Ghrhr, and Ghsr mRNA levels. Single cell RNA sequencing of pituitary, fat and liver of male offspring showed significant regulation of transcripts in fat of male offspring from Fed dams that was not found in CR20 males when compared to control fed mice. DISCUSSION/SIGNIFICANCE: Mild undernutrition causes a prematurely high leptin surge and sex-specific growth responses to a HFD, including resistance to a HFD in underfed males. Transcript analysis in fat of males resistant to HFD induced obesity may reveal mechanisms that provide protection against HFD induced weight gain.

OBJECTIVES/GOALS: Disparities persist among minority and marginalized populations in immunizations and research. The Clinical Research Vehicle Team aimed to bring research to our community’s doorstep, building generalizability of research outcomes. Our mission adapted due to the pandemic to include increasing COVID-19 vaccinations and health education. METHODS/STUDY POPULATION: Community Engagement Events are planned when event organizers submit a request, then the proposal is discussed by the Clinical Research Vehicle (CRV) Team and UF HealthStreet. We go to underserved communities throughout Florida, food distributions, churches, community centers, rural areas, etc. At these events we offer services at no cost, including: COVID-19 and flu vaccines, as well as health screenings. We provide health education to individuals and refer them to UF HealthStreet for community resources, as appropriate. Research events are planned when researchers submit a request for the CRV, then the request is discussed by the CRV Team. The studies covered topics from COVID-19 research to the development of a diverse health database. Our fleet consists of two Community Health Vehicles and the CRV. RESULTS/ANTICIPATED RESULTS: As Community Engagement Events are ongoing, the presented numbers are reflective of the data available at the time of submission. Our impact includes administering 1,606+ COVID vaccines, conducting 1,081+ health screenings, collecting data from 944 screenings, providing 265 Flu vaccines, supporting 267+ community health events, and serving 25+ communities. The Clinical Research Vehicle facilitated 6 IRB-approved studies, administration of monoclonal antibody infusions, extended the capabilities of the Clinical Research Center, and enabled clinical trials aimed for novel treatments for COVID-19 positive participants. DISCUSSION/SIGNIFICANCE: Championing this initiative has shown an impact on vaccination rates and health education in communities. Experience and knowledge gained by our team throughout the pandemic while engaging with community members provided a platform from which to build generalizability of research outcomes and support translational science.

OBJECTIVES/SPECIFIC AIMS: This study seeks to understand the relationship between opioid prescribing and patient satisfaction among non-surgical, hospitalized patients. As part of this study, we qualitatively examined challenges in delivering safe and patient-centered care through voices of physicians’, and nurses.’ METHODS/STUDY POPULATION: We collected data through in-person interviews using semi-structured guides tailored to the informant roles. Study participants came from 1 healthcare system located in a mid-Western state. Each interview lasted 30–45 minutes, was audio-recorded with consent, and transcribed for analysis. Two researchers each coded 17 transcripts for discussions around patient-centeredness (including patient satisfaction, patient experiences), and patient safety for hospitalized patients experiencing pain. Analysis followed a general inductive approach, where researchers identified themes related to the research questions using an open coding technique. They discussed and reached consensus on all codes, and extracted several preliminary themes. The analysis was supported by NVivo software. RESULTS/ANTICIPATED RESULTS: The following themes emerged: (1) complex decision-making process to prescribe opioids for hospitalized patients; (2) the role of objective findings in prescribing decisions; (3) bargaining process in prescribing opioids; (4) balancing patient-centeredness and patient safety for selected populations; (5) opioids are the predominant medications for pain care. DISCUSSION/SIGNIFICANCE OF IMPACT: Clinicians’ decision to prescribe opioids for nonsurgical hospitalized patients is based on multiple factors, including patient’s condition, patient’s preference for pain medications, or standard hospital’s pain care regimen. Interventions that improve clinicians’ ability to prescribe opioids may be needed to improve delivery of patient-centered and safe pain care.

OBJECTIVES/SPECIFIC AIMS: Objectives: Decreasing costs and increasing evidence for clinical utility have contributed to whole genome sequencing (WGS) becoming a clinical reality. While previous studies have surveyed the attitudes of patients and community members towards specific gene tests, an emerging literature has begun to describe the preferences of diverse recipients for WGS results. In this study, we sought to identify and synthesize the quantitative evidence on preferences for results from WGS using a systematic review of the literature. METHODS/STUDY POPULATION: We conducted a search of articles on PubMed including subject index terms WGS, whole exome sequencing, genome sequencing, secondary findings, incidental findings, attitudes, preferences, choices, utilities, stated-preferences, discrete choice experiment, and willingness-to-pay. We conducted 11 formal searches to refine the strategy and conducted a final search in December 2017. Duplicates were eliminated and a title and abstract review was conducted to select articles meeting inclusion criteria. RESULTS/ANTICIPATED RESULTS: Our search strategy identified 79 publications meeting initial search criteria with 30 manuscripts meeting inclusion criteria. Of these, most studies were conducted with patient-participants enrolled in existing sequencing studies, while few engaged members of the general public. Of the studies conducted on patients, most were on the medical setting of cancer and related syndromes. The earliest publication date of a manuscript meeting our inclusion criteria was in 2012, yet the majority were published in 2015 or later. DISCUSSION/SIGNIFICANCE OF IMPACT: Between 2012 and 2015, we saw an increasing focus in the medical literature on understanding public and patient preferences for return of results from WGS and WES. Both public and patient populations participating in surveys expressed preferences for receiving results from next-generation sequencing, even if the results are secondary or incidental findings unrelated to the primary indication for sequencing. A primary factor related to patient interest in incidental or secondary findings is the extent to which these results can inform medical intervention. Few studies surveyed representative population-based samples, and this may be an area for future investigation.

OBJECTIVES/SPECIFIC AIMS: Ivor-Lewis esophagectomy (ILE) is an invasive surgical procedure with a high incidence of postoperative pneumonia. Antibiotic prophylaxis could reduce respiratory infections but increase Clostridium difficile and antibiotic resistance. Our institution reduced the duration of piperacillin-tazobactam prophylaxis following ILE from 4 to 1 day or less in January 2015. We evaluated short-term outcomes in ILE patients before and after this institutional change. METHODS/STUDY POPULATION: Retrospective cohort study of all ILE patients from 2012 to 2016. We confirmed antibiotic duration directly from nursing medication administration records. The primary outcomes of this study were rates of C. difficile and postoperative pneumonia. Secondary outcomes include other infection, length of hospital stay, and readmission within 30 days. We used logistic regression to analyze impact of days of antibiotics and χ2 or Fischer exact tests for categorical variables. RESULTS/ANTICIPATED RESULTS: Of 104 ILE patients, 40.4% (n=42) were after January 2015, 11.5% developed pneumonia and 5.8% developed C. difficile colitis. ILE patients received more days of antibiotics before the institutional change compared with after (6.1 vs. 2.9 d, p<0.01). For a 1-day increase in antibiotic duration, the odds of acquiring C. difficile increased significantly by 1.2 (p=0.03). Before compared with after the institutional change, rates of C. difficile were 8.1% Versus 2.4% (p>0.2), rates of pneumonia were 11.3% Versus 11.9% (p>0.2), and length of stay was 10.9 Versus 10.5 days (p>0.2), respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Institutional policy can have an impact on patient outcomes. Antibiotic stewardship is associated with reduced rates of inpatient C. difficile. Our study suggests reduced antibiotics are not associated with pneumonia, although larger studies are necessary to confirm this finding. Surgeons should consider the benefit of decreased rates of C. difficile before administering prolonged antibiotic prophylaxis following esophagectomies.

OBJECTIVES/GOALS: Data were collected or abstracted from a wide variety of sources related to health and health care needs to determine the current health status of the Galveston community including:

• Demographics

• Social Determinants of Health

• Health Care Access and Insurance Status

• Poverty and Socio-Economic Indicators Impacting Health

• Health Behaviors

• Chronic Disease

• Communicable Disease

• Birth Outcomes

• Mortality

• Cancer

• Data on Services Provided at UTMB

• Data on Services Provided through the Galveston County Health District

• Data on Services Provided through the St. Vincent’s House Clinics, student-led clinics operated at a local non-profit organization

• Previous Galveston County Community Health Needs Assessment

• Identifying Gaps in Services

• Prevention Quality Indicator Data

METHODS/STUDY POPULATION: In addition to collection and analysis of secondary data, we also interviewed key stakeholders to solicit their input and recommendations. We met with leadership from St. Vincent’s House regarding current services provided, perceived issues and concerns, and needs for improvements. We met with leaders from UTMB’s academic enterprise to discuss the operation of our current student-led clinics as well as ways in which clinical practice experiences might be expanded and included more formally in the student curricula should the clinical capacity of St. Vincent’s House also be significantly expanded. This would increase the number of services that could be offered at St. Vincent’s and greatly increase the capacity for enrolling patients without relying on faculty volunteers to staff the clinics. We also met with UTMB leaders in a position to provide insight to issues that bridge the UTMB practice arena and public health and with Community Health leaders from the Galveston County Health District and Teen Health Clinics. Information Services leadership and Institute for Translational Science informatics faculty and staff were instrumental in determining what data could be abstracted from the Electronic Medical Record (without patient identifiers) to determine the specific need for services at St. Vincent’s. RESULTS/ANTICIPATED RESULTS: The City of Galveston has a population just under 50,000. Since 2010, the proportion of elderly has increased, and the proportion of families with younger children has decreased. Poverty is high at 22.3% for all people, and especially high for children at 32.1%. Poverty disproportionately affects racial and ethnic minorities, with 36.5% of the Black population living below the poverty level, compared to 25.5% Hispanic, 30.5% Asian, and 14.7% White. Home ownership is decreasing, and median rent costs have sharply increased. The percentage without health insurance is considerable, driven by educational attainment, age, and race. In 2017, >40% of renters spent more than 35% of their income on housing. Upwards of 2,650 reported not having access to a vehicle for transportation. While residents of Galveston County as a whole are less impoverished, those that are impoverished share marked similarities. Lower educational attainment, in particular failure to complete high school or obtain a college degree, are correlated with race. Lower educational attainment then is highly predictive of poverty and low income. The income inequality ratio, i.e., the greater division between the top and bottom ends of the income spectrum in Galveston County is higher than in Texas or the nation and has increased every year but one since 2010. Issues of concern for Galveston County include obesity, Type II diabetes, and disability. These are exacerbated by built and social environment issues such as food insecurity, limited access to healthy foods, and food deserts in some neighborhoods. Pre-term birth rates are higher in Galveston than in the state or nation, and approximately 40% of women do not receive prenatal care until the 2nd or 3rd trimester or receive no prenatal care at all. 8.4% of births are low-birth weight. Marked disparities by race and ethnicity exist for each of these indicators. Age-adjusted death rates for all-cause mortality are higher in Galveston County than they are in Texas or the United States. Perhaps of most concern are the rates of death from septicemia, which are nearly triple that of the U.S. and nearly double that of the state, and cancer. Cancer incidence is not particularly remarkable, however, cancer age-adjusted mortality rates for many specific cancers well exceed state rates. DISCUSSION/SIGNIFICANCE OF IMPACT: With a clearer picture of the medical and other needs impacting health or health care access for our community, all stakeholders and experts can provide more detailed recommendations about prioritizing care and especially, preventive care—much of which could conceivably be provided in St. Vincent’s House clinics. Opportunities exist for enhanced practice and education opportunities for UTMB students from all schools. Preventive Care and Population Health practices can be brought to bear in novel practice settings that could serve as models for provision of integrated services. Social and other services provided by non-profit organizations can be coordinated and streamlined. It is our hope that the considerable data presented herein will enable stakeholders to begin to prioritize issues and to make some evidence-based decisions about the next steps in this process. Throughout the interview and data collection process, all stakeholders have expressed both enthusiasm and hope at the prospect of re-visioning how they can contribute to a process that will improve how we as a community care for our most vulnerable members. CONFLICT OF INTEREST DESCRIPTION: The authors have no conflicts of interest to disclose.

OBJECTIVES/GOALS: Hemiplegic cerebral palsy (HCP) limits the functional ability of one side of the body, but motor impairments are very heterogeneous among children with this diagnosis. The purpose of this study was to evaluate the CST using DTI and tractography analyses as it relates to quantitative measures of the severity of weakness and mirror movements in HCP. METHODS/STUDY POPULATION: Preliminary results include five participants with HCP (2M, 16±7.8 years) and six controls (2M, 12±3.5 years). DTI data were collected using a spin-echo echo-planar imaging sequence with diffusion weighting of b=1000 s/mm2 in 60 different directions and 8 scans without diffusion weighting (b=0 s/mm2). Images were processed with steps of brain extraction, denoising, motion and eddy current correction, and fit with tensors to generate maps of diffusivity metrics. Anatomical landmarks were used to guide probabilistic tractography of the CST for analyses in both the lesioned and non-lesioned hemispheres. To quantify grasp weakness and mirroring severity, participants completed a bilateral assessment of grip strength using handheld force measurement devices and custom MATLAB data acquisition software. RESULTS/ANTICIPATED RESULTS: DTI is a feasible method to evaluate CST microstructure in HCP and typically developing pediatric participants. Spearman correlation analyses, using age and sex as covariates, revealed that for the lesioned hemisphere CST, there were significant positive correlations between grasp weakness severity and mean diffusivity (MD) (Ï=0.66, p=0.038) and between grasp weakness severity and axial diffusivity (AD) (Ï =0.68, p=0.030). There was not a significant correlation between grasp weakness severity and fractional anisotropy (FA) (Ï =-0.47, p=0.166). For the non-lesioned hemisphere CST, there was a significant positive correlation between mirroring severity and radial diffusivity (RD) (Ï =0.70, p=0.023). There was not a significant correlation between mirror movement severity and FA (Ï =-0.41, p=0.2361). DISCUSSION/SIGNIFICANCE: The correlations demonstrated here show a potential relationship between CST microstructure and the severity of hand impairments in HCP. While these relationships between CST diffusivity properties and hand function are preliminary, they provide the first steps to better understand underlying neural mechanisms for motor impairments in HCP.

OBJECTIVES/SPECIFIC AIMS: Dissemination of research findings through the published literature is a complex but critical part of the scholarly communication process. Additionally, this time point on the translational spectrum is a key objective of the National Clinical Association for Advancing Translational Sciences (NCATS). Tracking the dissemination of research outputs can be difficult to identify and evaluate. The purpose of this case study was 2-fold: (1) identify tools and resources available freely to the public and through university subscriptions used to assess research output; and (2) compare the effectiveness of these tools oat tracking output at different levels of granularity. METHODS/STUDY POPULATION: The authors, Spectrum staff (D.A.) and School of Medicine librarian (M.B.), attended webinars hosted by other Academic Medical Center libraries conducting work on impact tracking and learned from vendor product managers about available tools and resources during on-site campus visits. Publications from Stanford’s Clinical and Translational Science Award (CTSA) were used to track the diffusion of research outputs (e.g., number of citations, document types, research areas, relative citation ratio, CTSAs collaboration) via library subscription services (e.g., Web of Science and Scopus) and freely available tools (e.g., iCite and PubMed). RESULTS/ANTICIPATED RESULTS: The authors found certain tools were more inclusive in retrieving grant funded research outputs. For example, in the case of UL1 grant (UL1TR001085, UL1TR000093, UL1RR025744), on a grant-level output, there were discrepancies in the number of publications retrieved: (1) PubMed found 644 outputs; (2) Web of Science found 497 outputs; and (3) Scopus found 190 outputs. After de-duplication, the search across Web of Science (WoS), Scopus, and PubMed yielded 899 publications. In total, 389 outputs were unique to PubMed; 165 were unique to WoS; and 90 were unique to Scopus. Future analysis will be conducted to identify the source of unique outputs from each database (e.g., conference proceeding, specific journals). Additional analysis based on other units of research outputs (e.g., author-level outputs and article-level outputs) are expected to yield similar discrepancies. DISCUSSION/SIGNIFICANCE OF IMPACT: Citation analysis is a valuable method of assessing research output and, to a larger extent, research impact in a given field. It can help investigators illustrate qualifications for undertaking new projects, highlight collaborations across schools and departments, justify a grant renewal, and/or highlight accomplishments for promotion. However, systematic and comprehensive evaluations are needed in tandem with citation analysis/bibliometric analysis to assess the translation and uptake of research outputs and activities that result in research impact. Furthermore, both investigators and staff need adequate time and training to process research outputs/activities and to effectively organize them in easily understood visualizations.

OBJECTIVES/SPECIFIC AIMS: Stress urinary incontinence (SUI) significantly affects quality of life and occurs in 60% of men after radical prostatectomy, with 5% requiring surgical treatment. The artificial urinary sphincter (AUS) offers these patients excellent control of their post-prostatectomy SUI. The device contains 3 parts: the pump, urethral cuff, and pressure regulating balloon. Despite the effectiveness of AUS, up to 50% of patients require surgical revision after initial placement due to recurring SUI. Thus far, literature is heterogeneous regarding the causes of mechanical AUS failure and appropriate surgical management. Our study aims to characterize the most common reasons of AUS failure requiring surgical revision and the survival of each AUS component. METHODS/STUDY POPULATION: We report a series of 48 patients who received AUS placement and/or revision by 1 surgeon from 2010 to 2013. Upon presenting for revision, intraoperatively, the surgeon systematically evaluated the device for failure of the balloon, cuff and pump as well as urethral erosion and atrophy. In patients not requiring revision all device components were presumed functional. We conducted retrospective chart review to collect baseline characteristics, intraoperative findings, and postoperative outcomes. Using Kaplan-Meier estimates, we calculated incidence rates of component failure for the cuff, pump, and balloon. To identify risk factors for AUS failure, Cox regression was performed for univariate and multivariable testing. Multivariable modeling included those variables considered biologically plausible and significant in univariate testing. RESULTS/ANTICIPATED RESULTS: In total, 48 patients were studied with median follow up of 4.25 years. All patients received an AMS 800 device with a 61–70 mL balloon filled with 27 cc of isotonic contrast. Cuff sizes ranged from 3.5 to 5.5 cm, with 4.5 cm selected in 33/48 cases (68.8%); 19 of the patients required AUS correction (41.7%). Balloon leak constituted 57.9% (11/19) of failures, followed by cuff failure/urethral atrophy (21.1%), urethral erosion (10.5%), and individual cases of infection and pump failure. Median time to mechanical failure due to balloon leak was 3.67 years (IQR 2.17, 5.33); median time to failure for nonballoon causes was 0.54 years (IQR 0.25, 1.83). Survival of the balloon, cuff, and pump was 100%, 95.7%, and 97.9% at 1 year and 76.9%, 91.0%, and 97.9% at 5 years, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study identifies fluid leakage from the balloon as the most common cause of AUS failure, particularly in patients presenting between 1 and 5 years after initial placement. For such patients, interrogating the balloon first can decrease infection risk and surgical morbidity as it can avoid manipulation of the urethral cuff. Furthermore, simply replacing lost fluid saves cost and allows for immediate reactivation of the AUS device.

OBJECTIVES/GOALS: In this study, the ability of a pathologist to detect malignancy on digital pseudo-H&E slides obtained via structured illumination microscopy (SIM) imaging of fresh diagnostic breast biopsies was assessed. The speed of imaging and processing was also assessed for potential clinical implementation. METHODS/STUDY POPULATION: This study was conducted in accordance with an Ochsner Medical Center of New Orleans IRB. 200 patients undergoing either stereotactic or ultrasound-guided diagnostic breast biopsies were consented and an additional core from the suspicious lesion was collected for research use. Research biopsies were transported to the lab and stained with DRAQ5 and Eosin-Y and imaged with SIM before being submitted for histology processing. Imaging and digital processing times were recorded. The resulting SIM images and histology slides were given to a pathologist for blind review to assess accuracy. RESULTS/ANTICIPATED RESULTS: The ex-vivo structured illumination microscopy images and subsequent histology slides from 79 research cores have been assessed to date. Some samples were excluded from the total data set and not included in the final assessment due to technical failures of the imaging protocol. Of the current set, the pathologist has a specificity of 88% and a sensitivity of 65%, as well as an NPV of 88% and a PPV of 65%. Staining time for each biopsy was completed within 3 and a half minutes and imaging at 20x magnification took between 4 and 12 minutes, depending on size and implementation of autofocus to the imaging system. Image processing took approximately 5 minutes per biopsy and is a direct function of biopsy size. DISCUSSION/SIGNIFICANCE: Decreased time between cancer suspicion and treatment will improve the prognosis of breast cancer patients. SIM imaging of fresh breast biopsies could ultimately allow primary and secondary histology to be performed simultaneously and minimize histopathology time, thus allowing clinicians and patients to implement treatment course more quickly.