OBJECTIVES/SPECIFIC AIMS: Although parent involvement is recognized as an integral autism intervention component, and two-thirds of children are currently raised in 2-parent families, the majority of ASD parent research to date has focused on mother-implemented interventions, and fathers have been largely overlooked. However, fathers use interaction styles and language models that are different from mothers and may benefit children with ASD in unique ways. Thus there is a critical need in the field to expand our understanding of the potential contributions of various caregivers to communication outcomes. This investigation aimed to address this void in the research literature and contribute to clinical practice by including fathers in parent-implemented intervention, and adapting parent-implemented autism intervention to fit paternal interaction and communication styles. Specifically, this pilot study investigated the effects of a father-mediated intervention on parent use of responsive verbal and play strategies. Distal effects on child communication and pre-post changes in parental stress levels were also investigated. METHODS/STUDY POPULATION: A single subject, multiple baselines across strategies experiment was conducted with one dyad (i.e., father, child with ASD). In-home father coaching sessions were delivered weekly, targeting 4 responsive strategies (i.e., follow-in comments, follow-in directives, symbolic object play, rough-tumble play). Single subject designs are particularly suitable for autism interventions, as they allow for experimental control with participants who are from heterogeneous populations (McReynolds and Kearn, 1983). Child participant was 3 years, 1 month at the start of intervention and had previously received a received community diagnosis of ASD by a psychologist. Throughout the duration of the study, the child participant attended part-day community-based day care and received 20 hours per week of Applied Behavioral Analysis intervention both in-home and community daycare, as well as occupational therapy and speech-language therapy for 1 hour per week. The participating father was a biological parent who resided with the child continuously since birth. In addition, the father had no other formal parent training in communication intervention before participating. RESULTS/ANTICIPATED RESULTS: The results of the father-implemented intervention program yielded positive results for both father and child participant. The father quickly achieved a high level of competency using 3 of the 4 targeted strategies (i.e., follow-in comments, follow-in directives, and rough-and-tumble/physical play). Follow-in comments were used more frequently than follow-in directives and rough-and-tumble play strategies were used more frequently than symbolic play. Child use of single words increased over baseline and beginning use of multiword utterances was documented. Pre-post changes in parental stress for participating father and his spouse were not significant, however patterns of change across Parental Stress Index subscales scores were noted. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot investigation provided information regarding the treatment efficacy of a clinically relevant instructional program designed to enhance fathers’ ability to use responsive strategies to increase communicative acts or children with ASD. The results of this investigation advance clinical practice in the ASD field by providing intervention data relating to the efficacy of father-implemented instructional programs on child communication goals.

OBJECTIVES/GOALS: Our project aims to assess the composition or characteristics of research papers that score high on alternative metrics. These alternative metrics including the number of newspaper mentions, social media mentions, and the attention score as catalogued on Altmetric, a tool used to document community attention for a given research paper. METHODS/STUDY POPULATION: Our study intends to 1) Utilize topic modeling to identify prevalent themes on Altmetric, and 2) Apply network analysis to elucidate the interconnectedness among universities, funding sources, journals, and publishers associated with high-attention papers. 3) Examine how these patterns vary when attention metrics shift, such as social media mentions, newspaper mentions, or the Altmetric score. We'll first perform this analysis on all types of papers and then limit the networks to Biomedical and Clinical Sciences, and Public and Allied Health Sciences to help inform what health topics garner attention. RESULTS/ANTICIPATED RESULTS: Our initial Altmetric topic models revealed sustained attention for COVID-19 and vaccination-related publications well beyond the pandemic (specifically, papers from January 2023). Health topics like cancer, dementia, and obesity also garnered high attention. Additionally, political papers (elections, democracy), climate change, and battery research had notable attention values. Further analysis needs to be done to explain why these topics gain attention and the type of attention they garner. We will construct networks to see the relationship between attention and entities like universities, funding sources, journals, and publishers. This will identify whether certain clusters of these entities produce papers with high attention or if attention is distributed evenly amoung them. DISCUSSION/SIGNIFICANCE: To gauge the broader impact of scholarly research alternative metrics beyond citations are needed. Altmetric is used widely by CTSA’s to measure the community interest in research. Understanding the types of research that gain traction on Altmetric can help researchers understand how to garner interest from the community.

OBJECTIVES/GOALS: Prostate cancer treatment is associated with significant genitourinary side effects. There is a critical need for treatment with decreased morbidity. We report the development of a novel treatment paradigm combining irreversible electroporation and lower dose radiation to provide prostate cancer patients with a less morbid treatment. METHODS/STUDY POPULATION: Intermediate risk prostate cancer patients will undergo focal irreversible electroporation followed by low dose, whole gland radiation therapy. The primary endpoint is freedom from clinically significant cancer on biopsy at 12-month follow up. Secondary endpoints include safety profile, oncologic efficacy, effectiveness of RT and need for secondary treatment. This trial (NCT05345444) and currently actively recruiting patients after initial feasibility trial. Sample size is calculated to detect an increase in the proportion of patients who are cancer free at 1-year, from 0.80 to 0.95. An exact binomial test with a 10% one-sided significance level will have 94.3% power to detect the difference between the null and alternative hypothesis when the sample size is 42. RESULTS/ANTICIPATED RESULTS: This is a clinical trial in progress. DISCUSSION/SIGNIFICANCE: Combined irreversible electroporation (IRE) and a lower dose radiotherapy (RTIRE) may provide prostate cancer patients a treatment with minimal side effects.

OBJECTIVES/SPECIFIC AIMS: Afebrile septic patients are twice as likely to die and develop nosocomial infections as compared with those with fever; the reason for these differences is unknown. One hypothesis is that elevated temperatures directly boost immunity and inhibit microorganism growth. However, there is little data examining the clinical effects of warming septic patients. The goal of this study was to determine whether warming afebrile septic patients to fever-range hyperthermia with noninvasive forced air warmers is feasible and safe. METHODS/STUDY POPULATION: This is an ongoing randomized trial on afebrile mechanically ventilated patients with severe sepsis. The intervention consisted of 48 hours of external warming with a forced air warming device to a goal core temperature of 1.5°C higher than the lowest recorded temperature within the 24 hours preceding enrollment. Efficacy of the intervention and adverse event data (i.e., increases in heart rate and vasopressor doses) were collected. Clinical outcomes included 28-day mortality and acquisition of secondary infections. RESULTS/ANTICIPATED RESULTS: In total, 18 patients were randomized to the control and warming groups, respectively. Baseline characteristics (including demographics, comorbidities, and illness severity scores) were similar among the 2 groups, except the control group had more males (61% vs. 28%, p=0.04). Median (IQR) body temperature averaged over the 48-hour intervention period was higher in the warming group [38.2 (37.6, 38.6) vs. 37.1 (36.4, 37.4) °C, p<0.001). Patients in the warming group achieved core temperatures above their goal for a median of 37 (IQR 11, 45) hours during the 48-hour intervention period. There were no differences in heart rate or vasopressor dose changes or acquisition of secondary infections between the groups. Eight (44.4%) control patients and 3 (16.7%) warmed patients died by day 28 (p=0.07). DISCUSSION/SIGNIFICANCE OF IMPACT: Externally warming severe septic patients with forced air warming devices effectively raises core body temperature and is safe. Additional research will focus on cellular and immunological changes seen in warmed Versus control patients.

OBJECTIVES/SPECIFIC AIMS: To diversify the workforce by providing leadership and career coaching training to mentors so that they can be better leaders with their trainees and incorporate career coaching skills into their mentoring style. METHODS/STUDY POPULATION: PROMISED Program helps current and future members of the National Research Mentoring Network (NRMN) develop management, leadership, and career coaching skills so that they may be more effective in guiding their mentees. Studies show that mentees remain engaged in research when they drive their own careers, but mentors rarely help them recognize ways to do this. PROMISED aims to address by providing online leadership training and career coaching training. We developed innovative online leadership training for mentors committed to mentoring people from diverse backgrounds that are focused on management and leadership skills. These modules contain exercises, self-assessments, and discussion boards. We also have reading materials and other supplemental work such as videos to augment the modules. We also created 2-day training on career coaching skills for mentors. Certified career coaches trained participants in career coaching tools so that they could incorporate these skills into their mentoring style. Mentors tend to view themselves as content advisors, and they focus on the next step in the research project rather than the research career. We trained mentors to provide career coaching to their mentees, which will help the mentee establish a successful biomedical research career trajectory. RESULTS/ANTICIPATED RESULTS: In total, 45 mentors attended the Career Coaching Workshop. We assessed 26 mentoring/career coaching traits. Every trait improved on post survey (Likert scale 1–7), for example, “Taking into account the biases and prejudices you bring to the mentor/mentee relationship” (Pre: 4.16, Post: 5.38) and Working with mentees to set clear expectations of the mentoring relationship (Pre: 4.27, Post: 5.32). Some comments from attendees included: “amazing,” “powerful,” “excellent program,” “learned so much.” For the online module, we have a maximum of 20 fellows enrolled in each module. Results show that the fellows rate the module extremely useful. A comment from 1 fellow confirms this: “This session has changed my life and I know that the PROMISED program will transform my abilities as a mentor and as a person.” DISCUSSION/SIGNIFICANCE OF IMPACT: Providing Career Coaching Training and Online leadership skills can significantly improve mentors ability to mentor people, particularly those from diverse backgrounds. In addition, this training can help mentors who are committed to mentoring people from diverse backgrounds promote their own careers as well as their mentees.

ABSTRACT IMPACT: By outlining telehealth access disparities in the vision-impaired population, this scoping review has identified a set of effective and clinically appropriate implementation strategies and interventions for improving the technical, provider-level, and system-level accessibility of telehealth for vision-impaired patients. OBJECTIVES/GOALS: Evidence-based recommendations that ensure telehealth access for vision-impaired patients are critical to reducing health disparities. This review identifies, evaluates, and proposes strategies for public and private sector stakeholders to increase telehealth access for vision-impaired patients during the pandemic and beyond. METHODS/STUDY POPULATION: This scoping review included five steps: 1) the implementation of an iterative search strategy using relevant keywords to query 4 electronic databases (PubMed, Cochrane, Google Scholar, and Europe PMC) for relevant articles, 2) the application of a set of inclusion criteria to filter database results for article evaluation, 3) a quality assessment of the articles retained, 4) the extraction and summary of data from each assessed article, and 5) a narrative synthesis of the qualitative literature reviewed. RESULTS/ANTICIPATED RESULTS: To date, 21 articles that fit the inclusion criteria, published between 2006 and 2020, have been identified. To ensure the most robust collection of existing literature is aggregated, the iterative search strategy and inclusion criteria sorting process will be underway until December 20. The assessment of articles, and extraction and summary of data contained within said articles, will be finalized on January 20. The narrative synthesis will be complete on February 1. The poster and abstract will be complete by February 20. DISCUSSION/SIGNIFICANCE OF FINDINGS: Future research should examine outcomes associated with the implementation of accessible telehealth programs to identify remaining barriers. To improve outcomes for vision-impaired patients, policymakers, providers, payers, and industry must collaborate to promote accessibility in telehealth design and implementation.

OBJECTIVES/GOALS: Access to biostatistics expertise is essential for a successful clinical and translational research program. However, demand for statistical support at academic research centers can strain the capacity of biostatistics units. Our objective was to efficiently increase access to statistical expertise. METHODS/STUDY POPULATION: In cooperation with the Cancer Center Biostatistics Shared Resource, we replaced an informal 1-hour drop-in consultation program with structured office hours to provide statistical support to clinical and translational researchers at the University of California, Davis Medical Center. We doubled office hours to 2 hours per week and established six 20-minute appointments. Two Ph.D. level statisticians staff office hours. Researchers schedule appointments through Acuity Scheduling, a free on-line resource. Availability of the service is advertised monthly by sending an informational flyer to various university listservs. RESULTS/ANTICIPATED RESULTS: Prior to implementing the program in 2014, we averaged 91 office hour consults per year. Subsequently, consultations jumped to 171 in 2014 and have averaged 150 per year since then. Office hours attract students, residents, staff and faculty from a wide range of disciplines including the Schools of Medicine, Nursing, Veterinary Medicine and basic science departments. Project types span the clinical and translational spectrum covering lab, animal, clinical and population-level studies. Most consults related to data analysis and interpretation (57%) followed by sample size calculations/study design (29%) and response to reviewers (4%), with general statistical advice as the remainder. DISCUSSION/SIGNIFICANCE OF IMPACT: With 6 micro-consults per week, we can meet with many investigators and triage their statistical support needs. This program has proved very popular and was highly rated in a recent user survey, with several investigators noting that the consults facilitated successful publications and proposals.

OBJECTIVES/SPECIFIC AIMS: Little is known about potentially obesogenic endocrine-disruptors’ effects on excessive gestational weight gain (GWG) and postpartum weight retention (PPWR), which increase risk of adverse pregnancy and postnatal outcomes. We explored associations between prenatal organophosphate (OP) pesticide exposure and increased weight both during and after pregnancy. METHODS/STUDY POPULATION: Three dimethyl (DM) and three diethyl (DE) OP metabolites were measured in spot urine samples collected at <18, 18-25, and >25 gestational weeks among 688 participants in the Generation R Study. Metabolite levels were expressed as molar concentration/gram creatinine and log10-transformed. GWG and PPWR were calculated as the difference between weight at each prenatal/postnatal visit or maximum gestational weight and pre-pregnancy weight. In covariate-adjusted regression models we assessed associations of metabolite concentrations at each prenatal visit and, where appropriate, averaged across pregnancy with early-to-mid pregnancy, mid-to-late pregnancy, late pregnancy-to-maximum, and total GWG; insufficient and excessive GWG according to Institute of Medicine guidelines; and long-term PPWR at 6 and 10 years postpartum. Based on OP pesticides’ lipophilicity and association with hypomethylation, we investigated interactions with pre-pregnancy body mass index, periconceptional folic acid supplementation, and breastfeeding duration. RESULTS/ANTICIPATED RESULTS: A 10-fold increase in late pregnancy DE metabolite concentration was associated with 1.34 kg [95% confidence interval: 0.55, 2.12] higher late pregnancy-to-maximum GWG. A 10-fold increase in mean DE metabolite concentration across pregnancy was associated with 2.41 kg [0.62, 4.20] lower PPWR at 6 years. Stratified analysis suggested that the prenatal finding was driven by women with pre-pregnancy BMI ≥25 kg/m2, while the postnatal finding was driven by women with pre-pregnancy BMI <25 kg/m2 and with inadequate folic acid supplementation. We found no associations between OP pesticide metabolites and insufficient or excessive weight gain and no interaction with breastfeeding. DISCUSSION/SIGNIFICANCE OF IMPACT: In this longitudinal analysis, we observed a positive association of OP pesticide metabolites with GWG in late pregnancy among overweight/obese women, potentially reflecting inhibition of OP pesticide detoxification by oxidative stress. Postnatally, under/normal weight women with higher OP pesticide metabolites had lower PPWR, possibly due to better metabolic function and a more healthful diet. These results suggest that there may be a critical period during the late phase of pregnancy when OP pesticide exposure may increase GWG, and this association may be amplified in overweight/obese women. Areas for future research include examination of how the interaction between OP pesticides and polymorphisms of the paraoxonase (PON1) gene, which detoxifies OP pesticides, affect GWG/PPWR; exploration of the interplay among maternal pre-pregnancy BMI, oxidative stress, and PON1 levels; and characterization of the variability of OP pesticides exposure across pregnancy using more frequent repeated urine samples.

OBJECTIVES/SPECIFIC AIMS: To diversify the biomedical research workforce by training postdoctoral scholars and junior faculty from 6 Minority Serving Institutions (MSIs) on practical research skills such as Critical and Creative Thinking, Formulating the Problem, Asking the Right Question, Grant Writing, and Team Science METHODS/STUDY POPULATION: In collaboration with our partners, we identified 11 topics where trainees lack research funding. Next, we identified instructors for these topics. We converted the topics to online module with modules ranging from 2 to 8 weeks. In working with an online education expert, we developed innovative online training using Moodle as the content management system. Scholars complete readings, videos, self-assessments and participate in discussion board each week. In addition, we have weekly synchronous sessions for each module. All scholars are required to take the grant writing module and 8 other modules. After each module, trainees complete a brief survey to evaluate the module. The leaders at the MSI participated in an intensive face-to-face training session on how to be a career coach so that they could be career coaches for the LEADS Scholars at their home institutions. RESULTS/ANTICIPATED RESULTS: In the first year, we selected 13 LEADS Scholars. All but 3 scholars elected to take every module. The 3 scholars did not enroll in the Peer Reviewing module. Results of the brief survey at the end of each module indicate that the scholars value each of the modules and rate them very highly. When 1 scholar wanted to leave the program, we decided to have a conference call with all of the LEADS Scholars to determine what was working and what was not working with the program. All scholars recognized the value of LEADS. Some scholars felt that the weekly synchronous session was too demanding as they have competing demands on their time. We consulted with the leadership at the MSI and decided to modify the requirements of the program such that every synchronous call was not required for successful completion of the module and to earn a badge. Scholars need to have at least 9 badges to earn a certificate. In addition to the training, we decided that scholars would also benefit from mock reviews of their grants. This will help them submit successful grants. We learned that the best way to serve the needs of the scholars is to work iteratively with the scholars and leadership to develop a successful program that most effectively meets their needs of the scholars and helps them launch a successful career. DISCUSSION/SIGNIFICANCE OF IMPACT: Postdoctoral scholars and junior faculty from MSI need practical research training to help launch their research career. We suspect that this is true of many institutions and plan to develop these modules so that they can be widely disseminated to other institutions.

OBJECTIVES/SPECIFIC AIMS: Goal—broaden the academic offer to enhance clinical and translational research productivity and cost effectiveness. Objective—implement a distance learning program on conducting proficient research management. METHODS/STUDY POPULATION: Needs assessment attested students’ interest in enrolling and willingness to recruit graduates by the research industry and academia. A master of science in clinical research management and regulatory compliance (MS-CRMRC) was developed using the Core Competency Domains for Clinical Research Professional. Experts from research academia, pharmaceutical industry, composed a Proposal Development Committee. RESULTS/ANTICIPATED RESULTS: Access of a distance learning MS-CRMRC program for students with time constrains. Competent research professional graduates working side by side with the principal investigator on onsite teamwork management, to streamline research processes in compliance to regulations. DISCUSSION/SIGNIFICANCE OF IMPACT: Improvement of clinical and translational research productivity and efficient use of grants funds prevails as a generalized concern. The MS-CRMRC offers an accessible alternative to empower the research enterprise by developing knowledgeable skilled professionals to tackle this need.

OBJECTIVES/GOALS: This study examined patterns in helpline call data as the COVID-19 pandemic evolved including the impact of stay-at-home orders, relaxing of restrictive orders, and stages of vaccine uptake, as well as differences in call volume by Chicago neighborhood health indicators. METHODS/STUDY POPULATION: From November 1, 2018 to June 30, 2021, 56 NAMI-Chicago workers accepted 26,173 helpline calls from 9,374 individuals from 438 zip codes across northeastern Illinois with the majority of calls from high poverty Chicago communities. Descriptive and time series analyses examined patterns in call volume related to the onset of the COVID-19 pandemic, Illinois Stay-at-Home Order, and Illinois reopening and vaccine uptake plan relative to comparable times the prior year. Health indicators from the Chicago Health Atlas (https://chicagohealthatlas.org/) were examined to determine patterns related to NAMI call volume and various health indicators at the zip code level. RESULTS/ANTICIPATED RESULTS: Time series analysis indicated the greatest number of calls occurred in 2020; specifically, there was a 212% increase in call volume and 331% increase in repeat callers (three or more calls per caller) during the first and second phase (March 20th to May 28th) of Illinois Stay-at-Home Order from 2019 to 2020. Analysis of the callers primary need indicated NAMI provided resources and referrals to people with unmet basic needs such as housing, food, and access to healthcare during the height of COVID-19 Pandemic in 2020. A series of ANOVAs indicated that individuals from Chicago zip codes with high levels of uninsured rates, poverty rates, households using SNAP benefits, and economic diversity called NAMI significantly more than those with low levels of these health indicators. DISCUSSION/SIGNIFICANCE: Helplines are a much-needed model to assess needs and implement services during public health crises, particularly in communities experiencing economic hardship and stress. Implications for behavioral health service needs both during and following the pandemic will be discussed.

OBJECTIVES/GOALS: Diabetes mellitus and COVID-19 have converged to form a syndemic. Our team sought to identify and respond to the evolving needs of patients and communities affected by diabetes amid the COVID-19 pandemic and to engage community partners and student leaders in the advancement of health equity research and practice in the state of Iowa. METHODS/STUDY POPULATION: A team of faculty, staff, students, and community partners was assembled to facilitate, design, and implement mixed methods research related to diabetes care in collaboration with more than five sites in Eastern and Western Iowa during the pandemic, with a focus on potentially preventable complications such as diabetes-related foot ulcers and amputations in adult patients. Attention was directed towards the experiences of rural residents, persons working in frontline occupations during the pandemic, persons from minoritized racial or ethnic groups, and persons who speak Spanish. RESULTS/ANTICIPATED RESULTS: A semi-structured interview study about diabetes care revealed themes in the experiences of persons with diabetes during the pandemic. A pilot study of an educational tool called the Foot Book among patients and providers demonstrated the potential for use of this tool in health care and community settings to reduce gaps in diabetes foot care. All study materials and activities were offered in English and Spanish. Study results were combined with input from community partners to develop ongoing interventions to improve care in Iowa communities. DISCUSSION/SIGNIFICANCE: Amid the syndemic of COVID-19 and diabetes, urgent action is needed to mitigate health inequities and prevent further acceleration of these inequities. Our team developed a community-engaged, patient-centered, and student-led research program that can respond to the needs of patients and communities in the pandemic era.

OBJECTIVES/GOALS: COVID-19 vaccines were met with both public excitement and concern. Our goal was to understand individual’s attitudes about COVID-19 vaccines within Black and Latino communities deeply impacted by COVID-19, in an effort to highlight their potential similarities and differences. METHODS/STUDY POPULATION: Using a community-based participatory approach, we partnered with 16 leaders from community-based organizations to conduct a mixed-methods study examining the perspectives of Black and Latino communities regarding their vaccine acceptance or hesitancy. We focused on Michigan counties highly impacted by COVID-19 infection and deaths. In 2021, we interviewed 24 Black and 16 Latino residents in English or Spanish. We combined this with survey data on vaccine attitudes and behavior from the Detroit Metro Area Communities Study (n=1,800). This research is part of the NIH Community Engagement Alliance Against COVID-19. RESULTS/ANTICIPATED RESULTS: Qualitative and quantitative analysis highlight that Black participants expressed greater mistrust and hesitance around vaccines and less willingness to get vaccinated, often citing historical mistreatment as a contributing factor. The desire to keep themselves, their families and community safe was cited as the most important factor shaping vaccine decisions among both groups. Trust in information and in science was rated as a stronger reason for vaccination among Latinx participants; however, they also appeared to highlight the issue of vaccine access more often than Black participants. Fear of side effects and risks were equally cited as factors that influenced their vaccine hesitancy. DISCUSSION/SIGNIFICANCE: Despite being labeled as minority communities, these two groups have important differences regarding their perspective of COVID-19 vaccines. Our results suggest that public health interventions must be tailored to address the concerns, differences in attitudes, and beliefs among Blacks and Latinos.

OBJECTIVES/GOALS: We modeled risk of reintubation within 48 hours of cardiac surgery using variables available in the electronic health record (EHR). This model will guide recruitment for a prospective, pragmatic clinical trial entirely embedded within the EHR among those at high risk of reintubation. METHODS/STUDY POPULATION: All adult patients admitted to the cardiac intensive care unit following cardiac surgery involving thoracotomy or sternotomy were eligible for inclusion. Data were obtained from operational and analytical databases integrated into the Epic EHR, as well as institutional and departmental-derived data warehouses, using structured query language. Variables were screened for inclusion in the model based on clinical relevance, availability in the EHR as structured data, and likelihood of timely documentation during routine clinical care, in the hopes of obtaining a maximally-pragmatic model. RESULTS/ANTICIPATED RESULTS: A total of 2325 patients met inclusion criteria between November 2, 2017 and November 2, 2019. Of these patients, 68.4% were male. Median age was 63.0. The primary outcome of reintubation occurred in 112/2325 (4.8%) of patients within 48 hours and 177/2325 (7.6%) at any point in the subsequent hospital encounter. Univariate screening and iterative model development revealed numerous strong candidate predictors (ANOVA plot, figure 1), resulting in a model with acceptable calibration (calibration plot, figure 2), c = 0.666. DISCUSSION/SIGNIFICANCE OF IMPACT: Reintubation is common after cardiac surgery. Risk factors are available in the EHR. We are integrating this model into the EHR to support real-time risk estimation and to recruit and randomize high-risk patients into a clinical trial comparing post-extubation high flow nasal cannula with usual care. CONFLICT OF INTEREST DESCRIPTION: REF has received grant funding and consulting fees from Medtronic for research on inpatient monitoring.

ABSTRACT IMPACT: This project will aid in the optimization of treatment for those with heart failure with a reduced ejection fraction in order to both maximize health benefits and minimize financial burdens. OBJECTIVES/GOALS: To evaluate the accuracy and clinical applicability of a novel web-based application programming interface in the optimization of care for patients being treated for heart failure with reduced ejection fraction (HFrEF). The purpose of this validation is to ensure the translatability of this algorithm to a clinical setting using real-world data. METHODS/STUDY POPULATION: This study is a retrospective analysis of a previously created algorithm designed to optimize therapy for patients currently diagnosed with HFrEF. Patients that are seen for HFrEF treatment at Michigan Medicine are enrolled in a heart failure registry and were included in this study. Exceptions include those with heart transplants, LVAD, and those undergoing treatment with chronic inotropes (milrinone/dobutamine). Clinically relevant information (demographics, vital statistics, labs, and medications including dose and frequency) was taken from their respective electronic health record (EHR) and this data was used as the input for the algorithm. The therapy recommendations were collected and manually compared to the 2017 ACC/AHA/HFSA guidelines to verify the accuracy of the algorithm outputs. RESULTS/ANTICIPATED RESULTS: Data is currently being collected and analyzed. At first glance, our algorithm has been successful at detecting patients that are good candidates for therapy optimization. Based on inputs given, the treatment recommendations have been appropriate when compared to the most up-to-date HF treatment guidelines. The algorithm has also correctly identified levels of urgency for therapeutic recommendations. Finally, we have also shown the algorithm to have effectiveness for identifying areas of inappropriately adjusted therapy. Preliminary results have led to changes to the functionality of the algorithm, including how medications are retrieved from the EHR’s and how medication doses are identified. Previous iterations created discrepancies in dosing and the algorithm has since been adjusted. DISCUSSION/SIGNIFICANCE OF FINDINGS: By verifying its validity, our algorithm can accurately flag patients with HFrEF that are eligible for therapy optimization and give providers the opportunity to make appropriate changes. Given the high health and financial burdens of HFrEF, our algorithm has the ability to provide significant morbidity, mortality, and financial benefits.

OBJECTIVES/GOALS: To describe principles, best practices, and techniques recommended to instill deep understanding of the application and interpretation of statistical techniques and statistical inference among translational scientists and trainees, that best support the concepts of scientific Rigor, Reproducibility and Reporting. METHODS/STUDY POPULATION: Each of the six New York City Area Biostatistics, Epidemiology and Research Design (BERD) resources have strong educational programs, novel curricular components, and creative strategies, implemented by award winning educators. To capitalize on shared knowledge, innovation, and resources, the six teams formed the New York City Area BERD Collaborative (NYC-ABC) comprised of BERD resources from Mt. Sinai, Cornell, Einstein, Columbia, Rockefeller, and NYU. The collaborative suggests principles, concepts, tools and approaches to support the concepts of scientific Rigor, Reproducibility and Reporting in translational science. RESULTS/ANTICIPATED RESULTS: Principles:

• Value of team science approach and including biostatisticians early and often.

• Carefully designing experiments to reduce bias and increase precision.

• Trainees’ focus is often on “statistical significance” and the p-value. Consequences of data dredging/p-hacking, and the impact of sample size and other factors on statistical significance.

• Emphasizing the effect size and answering the scientific hypothesis when reporting results.

• Statistical code used to produce results should be well annotated and raw data posted online to enhance reproducibility.

• Incorporate effective multiple modalities (i.e. didactic, demonstrative, hands on workshops, applications, and tools).

• Approach from “the drivers’ seat” perspective, rather than strictly mathematical.

• Endorse flipped classroom approach

DISCUSSION/SIGNIFICANCE OF IMPACT: Like any complex discipline, biostatistical education can be approached from several dimensions, but it remains essential to focus on fundamental goals of science. We remind our trainees that the goal of science is to create knowledge, not to “find significance”. Deep understanding of inferential methods and proper interpretation of results are key. CONFLICT OF INTEREST DESCRIPTION: None.

ABSTRACT IMPACT: Mobile app may help improve the depression symptoms among underserved patients OBJECTIVES/GOALS: Depression is one of most common mental health conditions and the leading cause of disability worldwide, affecting about one in 10 adults in the US. The aim of this study was to explore the factors that affect feasibility of incorporating mobile app self-management tools for depression in integrated primary care settings. METHODS/STUDY POPULATION: This was a cross-sectional questionnaire study of depressed patients at two primary care clinics in a Midwest academic medical center. Adult patients (≥19 years) who had an active or previous diagnosis of depression were included in the study. A self-administered survey collected information pertaining to demographics, smartphone ownership, data plan type, smartphone application usage, mobile app self-management interest, health literacy, and patient activation. Chi-square analysis was conducted to compare the patient demographic characteristics, the smartphone ownership, phone plan, smartphone use for health information between two clinics. Multinominal logistic regression analysis was conducted to examine the association between the patient activation and patient characteristics. RESULTS/ANTICIPATED RESULTS: Over 80% of patients owned a smartphone, 80.5% were willing to use data for depression management, and 68.9% believe an app can help in depression management. A higher literacy level was significantly associated with higher level of patient activation (Chi-square=8.5453; p=0.0360). These results suggest that planning interventions that use mobile apps within this patient population is likely feasible and the intended underserved patients at these clinics have an interest in using depression related apps which is similar to findings found by other studies exploring app interest. DISCUSSION/SIGNIFICANCE OF FINDINGS: Understanding patient activation levels within a given population can help to shape corresponding needs. The use of depression related self-management mobile apps will likely require the development of educational materials to facilitate patient use and engagement which means understanding the literacy needs of this population as well.

OBJECTIVES/GOALS: Specialty care for asthmatic children should prevent adverse asthma outcomes. This study of children receiving care in the Arkansas Medicaid program used a comparative effectiveness research design to test whether allergy specialty care was associated with reduced adverse asthma outcomes. METHODS/STUDY POPULATION: Using the Arkansas All Payer Claims Database we studied Medicaid-enrolled children with asthma using a propensity score greedy nearest neighbor one-to-one matching algorithm. We matched children with (treatment) and without (comparison) an allergy specialist visit in 2018. The propensity score model included 26 covariates (demographic, clinical, and social determinants of health). Multivariable adjusted logistic regression was used to estimate adverse asthma events (AAE: emergency department visit or inpatient hospitalization with a primary or secondary diagnosis of asthma in 2019). RESULTS/ANTICIPATED RESULTS: We identified 3,031 children with an allergy specialist visit in 2018, and successfully propensity-score matched 2,910 of the treatment group with a non-allergy specialist visit comparison group. The rate of AAEs in 2019 was 9.5% for individuals with an allergy specialist visit versus 10.1% among those without a specialist visit (p=0.450). The adjusted regression analysis showed 20.3% lower rates of AAEs (aOR: 0.797; 95% Confidence Interval: 0.650, 0.977; p=0.029) in 2019 for children with an allergy specialist visit in 2018 compared to those that did not. DISCUSSION/SIGNIFICANCE: Utilizing allergy specialist care was associated with better asthma outcomes in our statewide study of Arkansas Medicaid-enrolled children with asthma. Asthma quality metrics based on guideline-based recommendations for allergy specialist care should be considered in population health management programs.

OBJECTIVES/SPECIFIC AIMS: Patients with gynecologic cancer are known to have an increased risk of venous thromboembolism (VTE) in the postoperative period secondary to hypercoagulability from both malignancy and pelvic surgery. Recent literature suggests that chemotherapy itself may be thrombogenic and prophylaxis may be beneficial in ambulatory patients receiving chemotherapy. Although extended VTE prophylaxis is commonly given after surgical staging, administration of prophylactic anticoagulation during chemotherapy or radiation treatment is not routinely performed. This study seeks to characterize risk factors and timing of VTE in a cohort of women diagnosed with uterine serous carcinoma (USC). METHODS/STUDY POPULATION: After institutional review board approval, a cross-sectional study was performed of all women diagnosed with USC between January 1999 and January 2016 at Albert Einstein College of Medicine. Data analysis was performed using Stata version 14.2 (Stata Statistical Software: Release 14, 2015. College Station, TX: StataCorp LP). Baseline clinical data was analyzed to calculate descriptive statistics. Normality of continuous variables was visually assessed and if no substantial violations were noted, data was reported as means±standard deviations. Otherwise, they were reported as medians with interquartile ranges. Categorical data was presented as number of patients with percentages. Bivariate analysis was performed to assess the association between clinical variables and diagnosis of VTE. Continuous variables (age, body mass index, number of risk factors for VTE) were visually assessed for normality. Levene’s test was used to assess for equal variance among groups. If no substantial violations were noted, means and standard deviations were calculated using 2 sample t-test for equal variance. Variables violating normality assumptions were analyzed using the Mann-Whitney U-test, calculating medians and interquartile ranges. Categorical and dichotomous variables (VTE risk factors, race, stage) were examined using the χ2 test or Fisher’s exact test (if expected values for more than 20% of cells were less than 5). Odds ratios were reported with 95% confidence intervals. Using a backwards stepwise elimination approach, a multivariable logistic regression model was fit to accurately examine association of risk factors with VTE, adjusting for other covariates. The resulting model was assessed for calibration and discrimination using Hosmer-Lemeshow test for goodness of fit, classification table, and ROC curve. Regression diagnostics were run in order to identify potentially influential covariate patterns in the model. First-order interactions were assessed for using product interaction terms (interaction defined as p-value for the likelihood ratio test <0.05). The resulting model was assessed for calibration and discrimination using Hosmer-Lemeshow test for goodness of fit, classification table, and ROC curve. A Cox proportional hazards model was also fit in order to examine the association between individual covariates and time to clot development. Log-rank testing was performed to compare survivorship experience by groups and survivorship curves were generated using the Kaplan-Meier method. Assumptions of the proportional hazards model was confirmed visually using log-log plots and goodness of fit assessment. RESULTS/ANTICIPATED RESULTS: A total of 413 patients were identified for inclusion in the study. The majority of patients (83%) were of non-White race. Bivariate analysis revealed no significant associations between age, BMI, or race with diagnosis of VTE (p=0.75, 0.49, and 0.28, respectively). Patients who had more than 2 risk factors for VTE had a significantly increased likelihood of VTE diagnosis (p=0.02). There was a highly significant association between stage of USC and diagnosis of VTE (p=0.005). Patients with stage III and stage IV cancer were 2.4 and 3.5 times more likely to develop VTE than patients with stage I cancer (95% CI: 1.09–5.30, 1.74–6.83, respectively). Of the 70 patients who were diagnosed with VTE, most were not postoperative (64.3%) and a large proportion developed clots while receiving chemotherapy (35.7%). Patients who developed VTE while on chemotherapy had a median Khorana score of 1 (IQR: 1, 2). In logistic regression modeling examining association of VTE with potential risk factors, covariates selected as significant for inclusion at the p<0.25 level included cancer stage, composite number of risk factors, diabetes, hypertension, cardiovascular disease (CVD), and COPD. Composite risk score was identified to be a potential confounder of the relationship between individual risk factors and development of clot and was therefore left in the model for adjustment. After adjusting for other covariates, only stage 4 disease (OR: 2.66, 95% CI: 1.53, −4.64) and hypertension (OR: 2.90, 95% CI: 1.14–7.36) were associated with development of VTE and were included in the final model. No concerning violation of assumptions of logistic regression or interaction was identified. The Hosmer-Lemeshow goodness of fit test identified that the model was well-fit using 10 groupings (p=0.35) and receiver operator characteristic testing showed that the model had acceptable discrimination with a ROC value of 0.7. The final model was found to classify 83.1% of participants correctly. Regression diagnostics identified 4 potentially influential covariate patterns. These patterns were eliminated from the model and no meaningful differences were noted. Patients contributed a total of 16,414 person months of analysis time in study follow-up. A negative, linear association was noted between stage of cancer and time to clot development. Long-rank testing revealed a significant difference in failure by stage of disease (p<0.001) and presence of hypertension (p=0.03). Cox proportional hazard modeling revealed that after adjustment for other covariates, only cancer stage and the presence of cardiovascular disease were significantly associated with time to failure. Patients with cardiovascular disease had a 2.02-fold increased risk of CVD compared to those without CVD (95% CI: 1.16–3.47). Those with stage 3 and 4 cancer were 3.19 (95% CI: 1.53-6.64) and 8.05 (95% CI: 4.11–15.78) fold more likely to develop VTE compared to those with stage 1 disease, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study demonstrated that patients with USC are at high risk of developing VTE at all time points after their disease diagnosis, not just those who have undergone recent surgery. This risk is highest for women with hypertension, CVD, and stages III and IV disease. The fact that patients who developed clots on chemotherapy had an average Khorana score of 1, suggesting that they would not have been successfully risk stratified using previously published tools. To the best of our knowledge, this is the first study to report a high hazard for VTE in patients with serious endometrial cancer even several months after surgical staging. Although this is a retrospective study and cannot make inferences about VTE incidence, it generates the hypothesis that extended VTE prophylaxis may be beneficial in this cohort of patients regardless of their latency from surgical staging. Large randomized studies are needed to test this hypothesis.