OBJECTIVES/GOALS: Team science competencies are not well-defined for nonfaculty staff of Clinical Research Professionals (CRPs) who conduct research. Using an existing framework, our work has determined skills associated with team science competencies as related to CRPs. Our team also outlined examples of those skills on a fundamental, skilled, and advanced level. METHODS/STUDY POPULATION: The team consists of both CRPs and those working in the Team Science space. This team used a modified Delphi approach to determine the skills and leveling examples of each team science competency. The team broke into four groups and was assigned 3-4 competencies each. Each group determined skills needed to support (exhibit, promote) each competency and then described an example of this skill at the fundamental, skilled, and advanced levels. Once each group was finished with their assigned competencies, they were re-assigned to a different group for review and changes. Finally, team science and CRP experts reviewed the skills and levels. RESULTS/ANTICIPATED RESULTS: Our results are a rubric that defines 3-5 practical skills per described competency. These skills are needed to support and promote each competency as a CRP. An additional outcome from this work includes examples of each skill at the fundamental, skilled, and advanced levels in a CRP’s career. Each leveled example is described in a concise, actionable way using Bloom’s taxonomy. This rubric is meant to be easily understood, very useable and able to be used in conjunction with existing CRP competency frameworks. By using Bloom’s taxonomy, we set the stage for future educational programming in Team Science skill-building for clinical research professionals. DISCUSSION/SIGNIFICANCE: Team science concepts and competencies have been increasingly integrated into translational science teams. However, team science competencies related to CRPs have remained largely undefined. Our work helps to define these competencies for CRPs in a practical way. Our rubric fills gaps in, and builds on, existing CRP competency frameworks.

Policies that promote conversion of antibiotics from intravenous to oral route administration are considered “low hanging fruit” for hospital antimicrobial stewardship programs. We developed a simple metric based on digestive days of therapy divided by total days of therapy for targeted agents and a method for hospital comparisons. External comparisons may help identify opportunities for improving prospective implementation.

Women with opioid use disorder (“OUD”) are more likely than other women to experience sexual assault, unintentional pregnancy, transactional sex and coercion regarding reproductive health care choices than women without OUD. Laws described as family friendly may be punitive rather than helpful to women and rarely apply to men. Laws regarding reproductive health and OUD are unevenly enforced and therefore biased against poor, minority women. As part of a larger study oriented toward strengthening systems of care related to the intersection of HIV and OUD, we conducted an analysis of state laws related to pregnant and postpartum women with OUD. Data on disparities in child removals and pregnant women’s use of evidence-based treatment for OUD by income and race were captured for the five states with the most restrictive laws in both categories. Laws that were purportedly designed to improve reproductive health outcomes for women with OUD and/or their children often have the opposite of the expressed intended outcome. There is a relationship between restrictive reproductive choice and coercive OUD treatment policy for women. Restrictive state regulations for pregnant women with OUD persist despite negative outcomes for maternal and child health. Altering coercive and/or criminalizing regulation and redefining ‘family friendly’ may improve outcomes for individuals and families.

Substance use increases throughout adolescence, and earlier substance use may increase risk for poorer health. However, limited research has examined whether stress responses relate to adolescent substance use, especially among adolescents from ethnic minority and high-adversity backgrounds. The present study assessed whether blunted emotional and cortisol responses to stress at age 14 related to substance use by ages 14 and 16, and whether associations varied by poverty status and sex. A sample of 277 Mexican-origin youth (53.19% female; 68.35% below the poverty line) completed a social-evaluative stress task, which was culturally adapted for this population, and provided saliva samples and rated their anger, sadness, and happiness throughout the task. They also reported whether they had ever used alcohol, marijuana, cigarettes, and vaping of nicotine at age 14 and again at age 16. Multilevel models suggested that blunted cortisol reactivity to stress was associated with alcohol use by age 14 and vaping nicotine by age 16 among youth above the poverty line. Also, blunted sadness and happiness reactivity to stress was associated with use of marijuana and alcohol among female adolescents. Blunted stress responses may be a risk factor for substance use among youth above the poverty line and female adolescents.

OBJECTIVES/GOALS: Perioperative surgical care is team-based with close partnership between surgeons, residents, advanced practice professionals (APPs), and others. The objective is to develop an understanding of the current state and implementation needs required for APPs to engage surgical patients in advanced care planning (ACP) to promote goal concordant care. METHODS/STUDY POPULATION: We will conduct a mixed methods evaluation of ACP knowledge, attitudes, and beliefs amongst surgical APPs to identify barriers and facilitators of APPs engaging in a team-based approach to engaging surgical patients in ACP. We will conduct an online survey and qualitative interviews in the following 4 domains: 1) knowledge, skills, and attitudes about engaging in ACP with a patient or their surrogate decision maker during their perioperative care; 2) prior ACP-specific education; 3) experiences conducting ACP discussions with patients; and 4) perceived training needs to increase ACP uptake and documentation. The findings will provide the foundations to design team-based interventions focused on addressing the barriers and inform training and coaching needs to develop expertise and comfort in the ACP process. RESULTS/ANTICIPATED RESULTS: We expect variability in the knowledge, skills, attitudes, and experiences with the ACP process. We anticipate gaining a better understanding of the educational materials best suited to support APPs as they begin engaging patients in ACP. Possible barriers to APP-led ACP discussions include inconsistent role delineation, uncertainty about the value of pre-operative vs. post-operative ACP discussions, lack of experience engaging in ACP discussion, and lack of familiarity with electronic health records ACP tools. Possible facilitators of APP-led ACP discussions may be related to past work experience settings, exposure to ACP in educational preparation, hands-on observation of value of ACP in surgical patients and influences from attending and residents. DISCUSSION/SIGNIFICANCE: While current ACP research in surgery focuses on physician-led patient engagement in ACP discussions, there is a paucity of research focusing on how to develop a team-based approach to ACP discussions in surgery. This study will provide information necessary for the development of interventions that increase team-based ACP for surgical patients.

Increased frequency and occurrence of herbicide-resistant biotypes heightens the need for alternative wild oat management strategies. This study aimed to exploit the height differential between wild oat and crops by targeting wild oat between panicle emergence and seed shed timing. Two field studies were conducted either in Lacombe, AB, or Lacombe, AB and Saskatoon, SK, from 2015 to 2017. In the first study, we compared panicle removal methods: hand clipping, use of a hedge trimmer, and a selective herbicide crop topping application to a weedy check and an industry standard in-crop herbicide application in wheat. These treatments were tested early (at panicle emergence), late (at initiation of seed shed), or in combination at one location over 3 yr. In the second study, we investigated optimal timing of panicle removal via a hedge trimmer with weekly removals in comparison to a weedy check in wheat and lentil. This study was conducted at two locations, Lacombe, AB, and Saskatoon, SK, over 3 yr. Among all the tested methods, the early crop topping treatment consistently had the largest impact on wild oat density, dockage, seedbank, and subsequent year crop yield. The early (at panicle emergence) or combination of early and late (at initiation of seed shed) treatments tended to reduce wild oat populations the following season the most compared to the late treatments. Subsequent wild oat populations were not influenced by panicle removal timing, but only by crop and location interactions. Panicle removal timing did significantly affect wild oat dockage in the year of treatment, but no consistent optimal timing could be identified. However, the two studies together highlight additional questions to be investigated, as well as the opportunity to manage wild oat seedbank inputs at the panicle emergence stage of the wild oat lifecycle.

Identifying developmental endophenotypes on the pathway between genetics and behavior is critical to uncovering the mechanisms underlying neurodevelopmental conditions. In this proof-of-principle study, we explored whether early disruptions in visual attention are a unique or shared candidate endophenotype of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). We calculated the duration of the longest look (i.e., peak look) to faces in an array-based eye-tracking task for 335 14-month-old infants with and without first-degree relatives with ASD and/or ADHD. We leveraged parent-report and genotype data available for a proportion of these infants to evaluate the relation of looking behavior to familial (n = 285) and genetic liability (using polygenic scores, n = 185) as well as ASD and ADHD-relevant temperament traits at 2 years of age (shyness and inhibitory control, respectively, n = 272) and ASD and ADHD clinical traits at 6 years of age (n = 94).

Results showed that longer peak looks at the face were associated with elevated polygenic scores for ADHD (β = 0.078, p = .023), but not ASD (β = 0.002, p = .944), and with elevated ADHD traits in mid-childhood (F(1,88) = 6.401, p = .013, $\eta _p^2$=0.068; ASD: F (1,88) = 3.218, p = .076), but not in toddlerhood (ps > 0.2). This pattern of results did not emerge when considering mean peak look duration across face and nonface stimuli. Thus, alterations in attention to faces during spontaneous visual exploration may be more consistent with a developmental endophenotype of ADHD than ASD. Our work shows that dissecting paths to neurodevelopmental conditions requires longitudinal data incorporating polygenic contribution, early neurocognitive function, and clinical phenotypic variation.

Background: A prolonged outbreak of carbapenemase-producing Serratia marcescens (CPSM) was identified in our quaternary healthcare center over a 2-year period from 2015 through 2017. A reservoir of IMP-4–producing S. marcescens in sink drains of clinical hand basins (CHB) was implicated in propagating transmission, supported by evidence from whole-genome sequencing (WGS). We assessed the impact of manual bioburden reduction intervention on further transmission of CPSM. Methods: Environmental sampling of frequently touched wet and dry areas around CPSM clinical cases was undertaken to identify potential reservoirs and transmission pathways. After identifying CHB as a source of CPSM, a widespread annual CHB cleaning intervention involving manual scrubbing of sink drains and the proximal pipes was implemented. Pre- and postintervention point prevalence surveys (PPS) of CHB drains performed to assess for CPSM colonization. Surveillance for subsequent transmission was conducted through weekly screening of patients and annual screening of CHB in transmission areas, and 6-monthly whole-hospital PPS of patients. All CPSM isolates were assessed by WGS. Results: In total, 6 patients were newly identified with CPSM from 2015 to 2017 (4.3 transmission events per 100,000 surveillance bed days [SBD]; 95% CI, 1.6–9.4). All clinical CPSM isolates were linked to CHB isolates by WGS. The CHB cleaning intervention resulted in a reduction in CHB colonization with CPSM in transmission areas from 72% colonization to 28% (ARR, 0.44; 95% CI, 0.25–0.63). A single further clinical case of CPSM linked to the CHB isolates was detected over 2 years of surveillance from 2017 to 2019 following the implementation of the annual CHB cleaning program (0.7 transmissions per 100,000 SBD; 95% CI, 0.0–3.9). No transmissions were linked to undertaking the cleaning intervention. Conclusions: A simple intervention targeted at reducing the biological burden of CPSM in CHB drains at regular intervals was effective in preventing transmission of carbapenemase-producing Enterobacterales from the hospital environment to patients over a prolonged period of intensive surveillance. These findings highlight the importance of detailed cleaning for controlling the spread of multidrug-resistant organisms from healthcare environments.

Funding: None

Disclosures: Jason Kwong, Austin Health

Infants struggle to understand familiar words spoken in unfamiliar accents. Here, we examine whether accent exposure facilitates accent-specific adaptation. Two types of pre-exposure were examined: video-based (i.e., listening to pre-recorded stories; Experiment 1) and live interaction (reading books with an experimenter; Experiments 2 and 3). After video-based exposure, Canadian English-learning 15- to 18-month-olds failed to recognize familiar words spoken in an unfamiliar accent. However, after face-to-face interaction with a Mandarin-accented talker, infants showed enhanced recognition for words produced in Mandarin English compared to Australian English. Infants with live exposure to an Australian talker were not similarly facilitated, perhaps due to the lower vocabulary scores of the infants assigned to the Australian exposure condition. Thus, live exposure can facilitate accent adaptation, but this ability is fragile in young infants and is likely influenced by vocabulary size and the specific mapping between the speaker and the listener's phonological system.

There is increasing evidence that both black and green tea are beneficial for prevention of cardiovascular disease (CVD). We conducted a systematic review and meta-analysis evaluating the effects of tea flavonoids on cardiovascular (CVD) and all-cause mortality outcomes.Searches across five databases including PubMed and Embase were conducted through November 2018 to identify randomized controlled trials (RCTs) and prospective cohort studies reporting cardiovascular and all-cause mortality outcomes. Two investigators independently conducted abstract and full-text screenings, data extractions, and risk of bias (ROB) assessments using the Nutrition Evidence Library Bias Assessment Tool (NEL BAT). Mixed-effects dose-response meta-regression and standard random-effects meta-analyses for outcomes with ≥ 4 studies were performed. 0 RCTs and 38 prospective cohort studies were included in the systematic review. NEL BAT scores ranged from 0–15 (0 being the lowest risk). Our linear meta-regression model showed that each cup increase in daily tea consumption (about 280 mg and 338 mg of total flavonoids for black and green tea, respectively) was associated with 3–4% lower risk of CVD mortality (predicted adjusted RR = 0.96; CI 0.93–0.99 for green tea and RR = 0.97; CI 0.94–0.99 for black tea). Furthermore, eachcup increase in daily tea consumption was associated a 2% lower risk of all-cause mortality (predicted adjusted relative risk (RR) = 0.98; 95% CI 0.97–0.99 for black tea and RR = 0.98; CI 0.96–0.99 for green tea, respectively). Two studies reported multivariable Cox regression analysis results for the relationship between black tea intake and risks of all-cause mortality outcomes. The results from these two studies were combined with our linear meta-regression result in a random-effects model meta-analysis and showed that each cup increase in daily black tea consumption was associated with an average of 3% lower risk of all-cause mortality (pooled adjusted RR = 0.97; 95% CI 0.87- 1.00) with large heterogeneity (I2 = 81.4%; p = 0.005). Current evidence indicates that increased tea consumption may reduce cardiovascular and all-cause mortality in a dose-response manner. This systematic review was registered on PROSPERO.