In this survey of 41 hospitals, 18 (72%) of 25 respondents reporting utilization of National Healthcare Safety Network resources demonstrated accurate central-line–associated bloodstream infection reporting compared to 6 (38%) of 16 without utilization (adjusted odds ratio, 5.37; 95% confidence interval, 1.16–24.8). Adherence to standard definitions is essential for consistent reporting across healthcare facilities.

Background: Gaze behavior differences between expert and novice surgeons have been established in general surgery literature. Limited information is available about surgeon’s visual attention during microsurgery procedures where surgical microscope is used. Methods: 4 experts and 3 novices performed 37 independent sutures under the surgical microscope. Eye movements of surgeons and scene video of the surgical performance were recorded. Total suturing time and subtask times were compared between level of expertise. We defined three discrete surgical actions and examined eye gaze (fixation) directly related to each of these actions. Fixation duration (total, pre-action,and post-action duration) were compared between expert and novice, over 3 subtasks (piercing, exiting and cutting) and between pre- and post-action phases. Results: Expert surgeons completed the suture with shorter total time and displayed longer fixation time than novices. Experts also maintained their visual engagement constantly over the 3 level of subtask in comparison to novices who required a longer fixation time for the challenging subtask (piercing). Experts use longer pre- than post-action fixation, and this pattern is distributed over all three subtasks. This gaze engagement strategy was not shown in novices. Conclusions: The action-related fixation can be used to evaluate microsurgeons’ level of expertise and in surgical education for gaze training.

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide. Oral medications for control of motor symptoms are the mainstay of treatment however, as the disease progresses, patients with PD may develop dysphagia or other medical illnesses that prohibit them from safely taking oral medications. Currently there are no clinical guidelines for managing distressing motor symptoms in patients with PD and severe dysphagia, which can therefore be quite challenging. Methods: A scoping review using MEDLINE, EMBASE, CENTRAL, CINAHL, AgeLine and Psyc INFO databases (1946-2021) was conducted. Articles examining PD with dysphagia in palliative care or at end-of-life were included. Studies that included patients who were also on oral PD medications or received device-aided therapy were excluded. Results: Of 3836 articles screened for title and abstract, 274 were selected for full text review, and 20 articles were finally selected for data extraction. These included five case reports, one retrospective cohort study, one book chapter and 13 narrative reviews. Conclusions: There are very few articles addressing the issue of treatment of patients with advanced PD who are unable to take oral medications. Although rotigotine patch and apormorphine injections are most frequently recommended, there are no clinical trials in this patient population to support those recommendations.

We describe a large SARS-CoV-2 outbreak involving an acute care hospital emergency department during December 2020 and January 2021, in which 27 healthcare personnel worked while infectious, resulting in multiple opportunities for SARS-CoV-2 transmission to patients and other healthcare personnel. We provide recommendations for improving infection prevention and control.

OBJECTIVES/GOALS: #NAME? METHODS/STUDY POPULATION: Cell culture & protein identification: human T cells were purified from healthy blood, then activated & cultured for 5d. CAR-T cells were collected from infusion bags of cancer patients undergoing CAR-T. Silver staining of naive & activated healthy T-cell lysates was compared; B-II spectrin was upregulated and confirmed by Western blot. Migration assays: naive & activated T-cells were imaged during migration on ICAM-1 and ICAM-1 + CXCL12 coated plates. T-cells were transfected with BII-spectrin cDNA & the chemokine dependence of migration was compared with controls. In-vivo studies: in a melanoma mouse model, BII-spectrin transfected or control T-cells were injected; tumors were followed with serial imaging. Human patient records were examined to correlate endogenous BII-spectrin levels and CAR-T response. RESULTS/ANTICIPATED RESULTS: Activated T-cells downregulate the cytoskeletal protein B-II spectrin compared to naive cells, leading to chemokine-independent migration in in vitro assays and off-target trafficking when CAR-T cells are given in vivo. Restoration of B-II spectrin levels via transfection restores chemokine-dependence of activated T-cells. In a mouse melanoma model, control mice injected with standard activated T-cells showed fewer cells in the tumor site and more cells in the off-target organs (spleen, lungs) when compared to mice injected with B-II spectrin transfected cells. Furthermore, among 3 human patients undergoing CAR-T therapy, those with higher endogenous B-II spectrin levels experienced fewer side-effects, measured by the neurotoxicity and cytokine release syndrome grades. DISCUSSION/SIGNIFICANCE: A major hurdle to widespread CAR-T therapy for cancer is significant, often fatal side-effects. Our work shows that the protein B-II spectrin is downregulated during CAR-T production, and that restoring B-II spectrin levels decreases side-effects while increasing tumor clearance--hopefully translating to better CAR-T regimens for the future.

OBJECTIVES/GOALS: The University of Michigan Frankel Cardiovascular Center (FCVC) Innovation Challenge is an annual competition offering funding for innovative ideas to improve cardiovascular care. Due to the COVID-19 pandemic, administrators converted the recruitment process and pitch event to fully virtual. METHODS/STUDY POPULATION: We detail the process of converting the event from a hybrid process (virtual and in-person recruiting and in-person event) to a fully virtual one. Changes to the event included implementing a virtual recruiting process utilizing short video recordings as submission format; a new tool for storing and displaying submissions; fully virtual finalist selection and coaching; and a fully virtual pitch and judging event. The submission process tracked information about submissions that include the type of idea (process or product), role of team lead, and department of team lead. RESULTS/ANTICIPATED RESULTS: The FCVC Innovation Challenge was successfully converted to a fully virtual event. Methods and tools will be shared to allow similar institutions to replicate a successful virtual pitch event. These include methods and tools utilized to allow participants to describe their ideas, strategies to select and coach finalists, and to host a virtual pitch event. Data will be shared on the number of ideas and category (product/process) of projects submitted, and number and category of finalists selected. DISCUSSION/SIGNIFICANCE: This case review can demonstrate how institutions can use a similar virtual idea submission and pitch process to (1) catalyze innovative ideas that can impact patient care by accessing its communitys ideas and (2) fund innovative ideas that do not fit traditional mechanisms.

OBJECTIVES/GOALS: The COVID-19 pandemic may have affected the relationship/experience of the mother-child dyad (Provenzi et al., 2021). Our objective is to identify the association of pandemic related maternal stress with child development. We will further evaluate the role of bonding, attachment, and trauma on this association. METHODS/STUDY POPULATION: We aim to recall a prospective cohort (n=200) of Latinx/Hispanic mothers from an ongoing study, power analysis will estimate minimum sample size (power=0.80 and alpha =0.05). Assessments of pandemic related maternal stress (PRMS) will be done with the COVID-19 and Perinatal Experiences Interview, perceived stress scale, and Parental Stress Index. Bonding, attachment, and trauma history will be assessed with psychological questionnaires and Childs behaviors with the Ackerman-CBCL questionnaire. Descriptive statistical analysis will be done. Correlations will identify associations and multivariate models will assess the role of parental bonding and effects of maternal attachment/trauma on associations to PRMS and child behavioral outcomes (controlling for confounding effects). RESULTS/ANTICIPATED RESULTS: First, we expect to find that mothers will report higher levels of stress (pandemic related, perceived, and parental) which will be associated with less bonding behaviors towards her child. Second, we expect that mothers levels of PRMS will be mediated by poorer bonding characteristics thus leading to negative child behavioral outcomes (i.e., poor regulation, crying spells, alterations in physiological patterns, and social-emotional developmental outcomes). Further mothers insecure attachment traits and trauma history will moderate perception of stress and negative child behavioral outcomes. DISCUSSION/SIGNIFICANCE: Results will describe stress in Latinx/Hispanics mothers during the pandemic and effects on child development. Identifying the role of maternal bonding/attachment will point to how this formative relationship has transformed during the pandemic, providing knowledge of mother-child resiliency.