bluuebunny/crossref_metadata_2025 huggingface dataset:
412 Cortisol cut off point to diagnose adrenal insufficiency (AI) using a monoclonal antibody immunoassay
Authors: Cortez Samuel , McNerney Kyle , Arbelaez Ana Maria
Published: April 2022

OBJECTIVES/GOALS: AI is diagnosed when peak cortisol level after a cosyntropin stimulation test is <18 mg/dL using polyclonal antibody (pAb) immunoassay. However, the polyclonal assay is being replaced by a specific monoclonal antibody (mAb) immunoassay which yields lower cortisol levels, leading to the over diagnosis of AI and use of unnecessary steroid use. METHODS/STUDY POPULATION: We obtained 36 samples from patients undergoing 1 mcg cosyntropin stimulation tests for diagnosis of AI. Samples were analyzed using pAb immunoassay (Abbott Architect
Cortisol), mAb immunoassay (Roche Elecsys Cortisol II), and mass spectrometry (MS). AI was diagnosed if serum cortisol level was <18 using the pAb immunoassay. Measurements by MS and mAb immunoassay were individually used in simple logistic regression models to predict AI. For each model, we calculated a cortisol level corresponding to a 50% probability (median) of AI and used the delta method to determine the standard error and 95% confidence interval of the median. We used receiver operator characteristic (ROC) curve, area under the curve, sensitivity, and specificity to evaluate the potential of the median values as thresholds for each predictor. RESULTS/ANTICIPATED RESULTS: Data showed a mean cortisol level of 17 mcg/dL using the pAb immunoassay, 12 mcg/dL using the mAb immunoassay, and 12.96 mcg/dL using MS. The mean difference in cortisol level between the mAb immunoassay and the pAb immunoassay was 5.12 mcg/dL (p-value <0.01). The ROC curve model indicated an area under the curve of 0.997 with a median value of 11.2 mcg/dL for the mAb immunoassay. This provides a sensitivity of 95%, specificity of 95%, positive predictive value of 95%, and negative predictive value of 94%. This new threshold has a Kappa coefficient of 0.89 when compared to the pAb immunoassay. DISCUSSION/SIGNIFICANCE: New and highly specific mAb immunoassays are being used more widely but yield lower cortisol results. This reflects the need for further studies to determine new cut off points for highly specific cortisol immunoassays. A cut off level of 11.2 mcg/dL would provide a sensitivity of 95% and specificity of 95%.
431 Galectin-3 as a Biomarker and Potential Therapeutic Target in Biliary Atresia
Authors: Yoeli Dor , Luo Yuhuan , Chaidez Alexander , Wang Zhaohui , Adams Megan A. , Huang Christene A. , Mack Cara L. , Navarro-Alvarez Nalu
Published: April 2022

OBJECTIVES/GOALS: Biliary atresia (BA) is a progressive congenital disease that is characterized by periductular inflammation and fibrosis that leads to bile duct destruction and cholestasis in neonates. Galectin-3 (Gal3) plays a key role in inflammation and fibrosis. The aim of this study was to evaluate plasma Gal3 levels in early and late BA. METHODS/STUDY POPULATION: Samples from our institutional Pediatric Liver Biobank were used for this study. Patients were categorized as early BA (at diagnosis), late BA (at liver transplant), early other cholestatic liver disease (CLD), late other CLD, or controls without cholestasis or structural liver disease. Plasma Gal3 levels were measured by standard ELISA. Inflammatory cytokines were measured in a subset of samples using MSD Proinflammatory Panel 1 multiplex ELISA. Liver fibrosis was categorized as none (Ishak or METAVIR 0), mild (Ishak 1-2 or METAVIR 1), moderate (Ishak 3-4 or METAVIR 2-3), and severe (Ishak 5-6 or METAVIR 4) based on histology. Data are presented as median (IQR) and compared using Kruskal-Wallis test. Spearmans correlation was used to assess the relationship between Gal3 and clinical and inflammatory markers. RESULTS/ANTICIPATED RESULTS: Samples from 10 controls, 26 early BA, 24 late BA, 13 early other CLD, and 8 late other CLD patients were used for this study. Gal3 levels in late BA (20.8 [12.4-30.5] ng/mL) and late other CLD (21.8 [16.9 – 27.2] ng/mL) were significantly higher than in controls (10.2 [7.6 – 14.5] ng/mL, p < 0.02) and early BA (11.3 [8.7 – 16.8] ng/mL, p < 0.01), but not significantly different from early other CLD (15.7 [11.9 – 21.4] ng/mL, p > 0.05). Gal3 positively correlated with fibrosis score (rho 0.3, p = 0.01), total bilirubin (rho 0.3, p = 0.002), ALT (rho 0.3, p = 0.01), AST (rho 0.3, p = 0.005), and APRI score (rho 0.3, p = 0.009), and negatively correlated with albumin (rho -0.3, p = 0.01). Out of the 10 cytokine proinflammatory panel, Gal3 was significantly correlated with IL-6 (rho 0.3, p = 0.006). DISCUSSION/SIGNIFICANCE: Gal3 is elevated in late BA and other CLD at time of transplant and correlated with degree of fibrosis, suggesting it may play a role in disease progression to cirrhosis. If targeted in the early disease stage, blocking Gal3 in pediatric cholestatic liver diseases may help delay the progression to cirrhosis and need for transplant.
434 In silico ADMET optimization and preliminary biologic activity of novel spermine oxidase inhibitors as neuroprotective agents
Authors: Furbish Amelia B , Burger Pieter , Peterson Yuri K , Woster Patrick M
Published: April 2022

OBJECTIVES/GOALS: The goal of this project was to conduct a preliminary assessment of in vivo feasibility early on in the drug-discovery process in an effort to expedite the translation of novel drug scaffolds to potential clinical candidates. The data gathered in this study will be used to direct analog synthesis of our current lead compounds through rational drug design. METHODS/STUDY POPULATION: Based on virtual and physical high-throughput screening efforts and subsequent similarity searching, we identified a set of potent and selective spermine oxidase (SMOX) inhibitors adhering to a common structural scaffold. In order to address potential barriers to in vivo use, we then conducted a robust optimization analysis in an effort to identify analogs with improved drug-like characteristics. Docking simulations to predict binding were performed and visualized using molecular modeling software (MOE and PyMol). ADMET properties were calculated using a variety of software resources including SwissADME and CDD Vault. RESULTS/ANTICIPATED RESULTS: Through these optimization efforts, we were able to successfully identify analogs with improved drug-like characteristics, including increases in predicted CNS penetration, isosteric replacement of metabolically labile functional groups, increased lipophilicity, and elimination of structural attributes suggestive of off-target activity. Analogs were ranked according to predicted binding and properties of in vivo feasibility. Compounds achieving the highest scores were then selected as scaffolds to guide analog synthesis. DISCUSSION/SIGNIFICANCE: Despite evidence implicating induction of SMOX as a mechanism contributing to neuronal pathology, the lack of potent and selective inhibitors with profiles conducive for in vivo use has significantly impeded clinical investigation of this target. In this presentation, rational drug design focusing on translational optimization will be discussed.
450 Gender Differences in the Association of Impulsive Behavior and Susceptibility to E-cigarette Use among Adolescents with Congenital Heart Defects
Authors: Fox Kristen R. , Ferketich Amy K. , Groner Judith A. , Rausch Joseph R. , Garg Vidu , Neville Steven P. , Grant Victoria R. , Jackson Jamie L.
Published: April 2022

OBJECTIVES/GOALS: Adolescents with congenital heart defects (CHD) have an elevated risk for future cardiovascular events, but information about their risk for e-cigarette use (“vaping”) is unknown. This study aims to present preliminary findings on gender differences in the association of impulsive behavior and vaping susceptibility from an ongoing investigation. METHODS/STUDY POPULATION: Adolescents with CHD (12-18 years; N=63) reported their vaping susceptibility and completed subjective (UPPS-P)/objective (Iowa Gambling Task; IGT) assessments of impulsive behavior previously associated with tobacco use. The UPPS-P includes 5 facets: 1) negative urgency (impulsivity under negative emotions), 2) positive urgency (impulsivity under positive emotions), 3) lack of premeditation (acting without thinking), 4) lack of perseverance (inability to focus), and 5) sensation seeking (seeking thrilling experiences). The IGT is a computerized task that creates conflict between immediate reward and delayed punishment via selections from advantageous/disadvantageous card decks. Linear regressions stratified by gender determined associations between vaping susceptibility and impulsivity. RESULTS/ANTICIPATED RESULTS: Nearly 30% (29.7%) of adolescents with CHD were susceptible to vaping. Negative urgency was associated with vaping susceptibility among females (Î² = 0.44, p = .035) but not males (Î² = 0.25, p = .128). Positive urgency was associated with vaping susceptibility among males (Î² = 0.37, p = .021) and trended toward significance among females (Î² = 0.40, p = .058). Lack of premeditation was associated with vaping susceptibility among males (Î² = 0.36, p = .025) but not females (Î² = 0.15, p = .490). The association between lack of perseverance and vaping susceptibility trended toward significance among males (Î² = 0.30, p = .064) but not females (Î² = -0.18, p = .413). IGT performance was not associated with susceptibility to vaping among either gender. UPPS-P facets and IGT performance were not significantly correlated. DISCUSSION/SIGNIFICANCE: The association of impulsivity and vaping susceptibility appears to be characterized by emotion-based rash action (positive/negative urgency) for females and by decreased conscientiousness (lack of premeditation/perseverance) for males. If replicated, the findings have implications for assessment of vaping risk and tailored intervention.
451 Unique Gray Matter Volume Differences in Bilingual Children with Reading Disability
Authors: Schug Alison , Eden Guinevere F.
Published: April 2022

OBJECTIVES/GOALS: Developmental dyslexia is a common reading disability (RD) which negatively impacts academic success. To address the role of early language experience on RD, we tested if the reported differences in gray matter volume (GMV) in RD also manifests in poor readers with a bilingual language background. METHODS/STUDY POPULATION: We studied 54 Spanish-English Bilingual Typical Readers with Oral Reading Recognition Test (ORRT) scores above 100 (avg. =113 Â± 10), 51 Spanish-English Bilinguals with RD with ORRT scores below 92 (avg. =84 Â± 7), 54 English Monolingual Typical Readers with ORRT scores above 100 (avg. =113 Â± 10) and 51 English Monolinguals with RD with ORRT scores below 92 (avg. =84 Â± 7) from the Adolescent Brain & Cognitive Development Study. All groups had an average age of 12 Â± 0.7 years and were matched for sex and self-ratings of English ability. Structural magnetic resonance images were analyzed using Voxel-Based Morphometry and the bilingual and monolingual groups were separately compared in two-sample t-tests (p < 0.05). RESULTS/ANTICIPATED RESULTS: Monolinguals with RD had less GMV than the Monolingual Typical Readers in the right supramarginal gyrus (Brodmanns Area (BA) 40; MNI Coordinates: 69, -27, 39) (p=0.011) similar to the right superior temporal finding reported in the existing literature. However, a comparison of Bilinguals with RD and Bilingual Typical Readers did not show any GMV differences in superior temporal regions. Instead, our Bilinguals with RD had less GMV compared to the Spanish-English Bilingual Typical Readers in the right superior frontal gyrus (BA 11; MNI Coordinates: 21, 44, -24) extending to the middle frontal gyrus (BA 10) (p = 0.014). DISCUSSION/SIGNIFICANCE: Our findings suggest that the neuroanatomical bases of RD in Spanish-English Bilingual children are not the same as those observed for monolinguals, and biological models developed in monolinguals cannot be generalized. This has implications for diagnoses and treatment of RD in bilinguals.
107 Environmental Exposure to Metals Mixtures and the Outcome of Cognitive Function in Adolescents
Authors: Saxena Roheeni , Gamble Mary , Wasserman Gail A. , Liu Xinhua , Parvez Faruque , Navas-Acien Ana , Factor-Litvak Pam , Kioumourtzoglou Marianthi-Anna , Gibson Elizabeth A. , Graziano Joseph H.
Published: April 2022

OBJECTIVES/GOALS: Exposure to arsenic, cadmium, manganese, and lead have been linked to adverse neurocognitive outcomes in adults/children, but effects in adolescents are not fully characterized. This study aims to examine the association between exposure to a mixture of metals (As, Cd, Mn, Pb, Se) and cognitive function in adolescents. METHODS/STUDY POPULATION: The Metals, Arsenic, & Nutrition in Adolescents Study (MANAS) is a cross-sectional study of 572 Bangladeshi adolescents. Blood levels of As, Cd, Mn, Pb, and Se were measured via ICP-MS. An abbreviated Cambridge Neuropsychological Test Automated Battery (CANTAB) was administered, with subtests assessing cognitive function and executive function tasks. Linear regression and Bayesian kernel machine regression (BKMR) were used to examine associations between individual metals, the overall mixture of metals, and cognitive function as measured by the CANTAB. RESULTS/ANTICIPATED RESULTS: Linear regression showed that As (B=−2.40) and Mn (B=−5.31) were negatively associated with Spatial Working Memory (p<0.05). Negative associations were also observed between Cd and Spatial Recognition Memory (SRM) (B=−2.77, p<0.05), and between Pb and Delayed Match to Sample (DMS), a measure of visual recognition and memory (B=−3.67, p<0.05). Se and Spatial Span Length (B=0.92, p<0.05) were seen to be positively associated. BKMR showed no overall effect of the mixture but indicated that Pb was negatively associated with DMS, and that Cd was negatively associated with SRM. Se was positively associated with Planning, Reaction Time, and Spatial Span. Posterior inclusion probability consistently rated Se as the most influential mixture component. DISCUSSION/SIGNIFICANCE: Se was positively associated with cognition, while Mn and As were linked to poorer working memory, and Cd and Pb were associated with poorer visual recognition and memory. We saw agreement between linear regression and BKMR in analyzing metal mixture exposures. Findings suggest interventions aimed at adolescents might influence lifelong cognition.
460 Adaptive Capacity and Preparedness of CTSAs: The Environmental Scan Approach and Findings
Authors: Volkov Boris B , Hoyo Veronica
Published: April 2022

OBJECTIVES/GOALS: Illuminate processes and findings of the Environmental Scan of Adaptive Capacity and Preparedness of CTSAs done by the CTSA Working Group. Share challenges, strategies, and lessons learned for CTSAs to build Capacity to address clinical and translational barriers while responding to emergencies. METHODS/STUDY POPULATION: An Environmental Scan approach for searching, collecting, analyzing and using information from diverse sources regarding CTSA hubs experiences during emergency as related to research implementation, translation, support, adaptation, and preparedness: - Triangulating multiple data sources and mixed methods (e.g., literature review, document/RPPR analysis, and expert review); - Secondary analysis of the JCTS COVID-19 Survey of the CTSAs: challenges, lessons learned, and practices that work in various program components/areas; - Using feedback of CTSA professionals from multiple disciplines to enhance our knowledge of emergency preparedness and efficient adaptation to public health and other crises. RESULTS/ANTICIPATED RESULTS: The E-scan approach helped identify challenges, successful practices, and evidence-based strategies for building adaptive capacity and preparedness of CTSAs across various scientific sectors of the translational science spectrum. Some of the findings include: - Roadmaps for the creation of new collaborative research resources (biobanks; data repositories, etc.); - Rapid clinical and research decision making during public health crises; - New community-based research strategies to facilitate communication, research dissemination, and participant recruitment based on existing trust-based networks; - Innovative resource allocation to guarantee continuity of training and research opportunities for trainees. DISCUSSION/SIGNIFICANCE: The Environmental Scan of the Adaptive Capacity of CTSA hubs provides useful knowledge and tools to diverse clinical research stakeholders for mitigating the impact of a disaster via adjusting programs, practices, and processes, and building capacity for effective, emergency-ready and responsive research, training, and community engagement.
471 Empowering the Participant Voice (EPV): Participant Feedback to Improve the Clinical Research Enterprise
Authors: Kost Rhonda G. , Andrews Joseph , Chatterjee Ranee , Cheng Alex , Dozier Ann , Ford Daniel , Harris Paul A.
Published: April 2022

OBJECTIVES/GOALS: Six CTSA sites formed a collaboration to DEVELOP, DEMONSTRATE, AND DISSEMINATE new infrastructure to streamline collection and analysis of research participant feedback, using the Research Participant Perception Survey (RPPS), common standards, and customized REDCap-based tools, to improve the clinical research enterprise. METHODS/STUDY POPULATION: DEVELOP charter, consensus approach, core survey, deployment standards, data-use agreements; define meta-data, system requirements for the infrastructure, use-cases. Engage stakeholders for broad institutional and community input. Build RPPS/REDCap project, visual analytics Dashboard External Module, and Program Dashboard module for evaluation. Configure to use with Multilingual Module. DEMONSTRATE by implementing site-based use cases that reflect local priorities and span diverse populations, testing different methods of survey deployment (REDCap, patient portal, SMS) to showcase utility and flexibility. Generate data for local and inter-institutional benchmarking. Refine, then DISSEMINATE new infrastructure across the Consortium and REDCap community for broader testing and uptake. RESULTS/ANTICIPATED RESULTS: The project team refined the RPPS survey for inclusivity and mode of informed consent; defined standards for survey timing, sampling, and study metadata; configured the data dictionary in English and Spanishfor use with the multi-lingual module ; developed tools for project evaluation. Stakeholder engagement identified themes of anticipated value and fears about feedback. We designed an At-a-Glance Dashboard to display survey results with detailed analytics and filters. A REDCap application programming interface will send de-identified site data to the EPV Consortium Database to support benchmarking. Full implementation began November 2021 and will scale in 2022. Dissemination to Consortium and REDCap users is ongoing through presentations and a project website (www.Rockefeller.edu/research/epv). DISCUSSION/SIGNIFICANCE: Direct feedback from representative populations about their experiences in research is essential to understand and resolve barriers to broad participation in research. Streamlined RPPS/REDCap infrastructure provides a platform for local and national benchmarking, and collection of actionable data to improve clinical research.
488 Translational Science Competencies in a Virtual CTSA Internship Program
Authors: Aleksunes Lauren , Ebanks Yasheca , Tafuto Barbara , Lechner Doreen , Gladson Barbara
Published: April 2022

OBJECTIVES/GOALS: The Workforce Development Core of the New Jersey Alliance for Clinical and Translational Science (NJ ACTS) has developed an internship program for students to engage in virtual research projects across the CTSA Hub. We sought to evaluate how intern projects within NJ ACTS align with the competencies needed for translational science. METHODS/STUDY POPULATION: Core leads and researchers within NJ ACTS developed 34 projects that were completed by individual interns or pairs of interns. Forty-two professional, undergraduate, and graduate students across the 3 Hub institutions have completed semester-long intern projects. Intern mentors mapped their projects to the C-COMEND competency profile for translational scientists which were further aligned with the seven fundamental character traits defined by Translation Together. RESULTS/ANTICIPATED RESULTS: More than 75% of intern projects addressed the C-COMEND competencies in Personal Development, Communication and Dissemination, Project Management and Time Management. Few projects (< 10%) focused on skills related to preclinical or clinical research. The competencies needed for development as a Rigorous Researcher were most consistently addressed in the intern projects. Additionally, intern projects fostered a number of skills needed for becoming a Domain Expert and Skilled Communicator. DISCUSSION/SIGNIFICANCE: Taken together, a virtual internship program can be designed to introduce and/or refine the competency skills needed for translational science.
494 A Flexible and Transformational Approach for Learning Research and Communication Skills: The Center for Research Education and Science Communications Opportunities (CRESCO) of the Title V Cooperative Project between the University of Puerto Rico Medical Sciences Campus and the Universidad Central del Caribe (Title V Coop)
Authors: Flores-Rivera Efrain , Rivera-Vazquez Mildred , De Jesús-Ojeda Lizbelle , Garcia-Garcia Ruben , Moscoso-Alvarez Jose R. , Irizarry-Ramirez Margarita , Santiago-Rodriguez Elvis , Ubieta-Santiago Jose R. , Navarro-Figueroa Rodolfo
Published: April 2022

OBJECTIVES/GOALS: The Title V Coop developed CRESCO, a physical and virtual space in the libraries of the two cooperating institutions. Adopting a flexible and transformational approach, it offers services to support the development of research and information skills of undergraduate students and faculty who receive clinical-translational research (CTR) training. METHODS/STUDY POPULATION: Since 2016, CRESCO has been staffed by a multidisciplinary team composed of three librarians, a statistician, an instructional designer, and an IT specialist. The physical facilities of the two libraries were remodeled and equipped, and a central portal was created to provide services and access to resources on a 7/24 basis. Online tutorials, workshops, and mentoring services have been offered that address topics in statistics, literature search, plagiarism, and the use of several research software. Services statistics are collected, and a questionnaire is administered to evaluate the workshops. RESULTS/ANTICIPATED RESULTS: The main results include 12 online tutorials created in CTR areas and available in the CRESCO hub portal; 14,660 mentoring/consultations offered in statistics, the use of research-related software, and the search for scientific literature search; and 6 online workshops created in CTR areas, with 463 attendees. When evaluating online workshops, participants considered that their acquired learning was high or extremely high on the following topics: use of Intellectus Statistics (88%, n = 96); selection of statistical tests (81%, n = 92); use of Turnitin (85%, n = 76); literature search (91%, n = 58); and citations and references in Mendeley (90%, n = 67). DISCUSSION/SIGNIFICANCE: These results suggest that the flexible, multidisciplinary, and transformational approach of CRESCO has been successful in helping undergraduate students and faculty develop the skills necessary to conduct CTR projects.
500 Building research knowledge base through training and elective courses in Clinical and Translational Research (CTR) as part of the Title V Cooperative Project (Title V Coop) between the University of Puerto Rico Medical Sciences Campus (UPR-MSC) and the Universidad Central del Caribe (UCC)
Authors: Soto-Santiago Juan C , García-García Rubén , Irizarry-Ramírez Margarita , Rosado-Santiago Edgardo L , De Jesús-Ojeda Lizbelle , Flores-Rivera Efraín , Álvarez José R Moscoso , Ruiz-Izcoa Elaine
Published: April 2022

OBJECTIVES/GOALS: Research Education Towards Opportunities (RETO) Mentoring Offering Training Opportunities for Research (MOTOR) 1 – 2 and the elective courses (INTD 5998/ MDCL 101) in CTR of Title V Coop were designed to provide the participants from higher education institution (HEI) in Puerto Rico (PR), interdisciplinary – interprofesional knowledge in CTR. METHODS/STUDY POPULATION: Since April 2017, Research Education Towards Opportunities (RETO) and Mentoring Offering Training Opportunities for Research (MOTOR) 1 - 2 trainings were offered as part of the Title V Coop. In addition, since January 2020, as part of the institutionalization of the trainings in CTR, two elective courses (INTD 5998 and MDCL 101) were created-offered. The trainings/courses present the main concepts underlying CTR performance through lectures, workshops and presentations, in hybrid modalities, as well as the services-resources of the Center Research Education and Science Commnunication Opportunities (CRESCO). These programs have given students (undergraduate and graduate) and faculty the opportunity to get started in CTR and to integrate in Clinical and Translational Mentoring Teams (CTMT). RESULTS/ANTICIPATED RESULTS: Eight (8) cycles of RETO-MOTOR 1 and seven (7) cycles of RETO-MOTOR 2; two sessions of INTD 5998 and one session of MDCL 101 were offered. The RETO-MOTOR 1 training was completed by 219 participants and RETO-MOTOR 2 by 130 participants. The INTD 5998 course was completed by 22 students and the MDCL 101 course by 18 students. A total of 389 participants have been initiated in the CTR. Of the trainings, 90% indicated that the knowledge acquired in CTR was invaluable, 85% understand that the most significant achievement, as students, was present at a scientific conference, and 100% indicated interest in continuing to do CTR. Of the courses, 100% indicated that they were a good learning experience, helped them increase their knowledge in CTR, met their expectations and would recommend other students to take the course. DISCUSSION/SIGNIFICANCE: The RETO-MOTOR 1, RETO-MOTOR 2 trainings and CTR courses provide a based of research knowledge and valuable interprofessional experience for those who whish to start in the clinical and translational research. The Title V Cooperative Project provides this opportunity to undergraduate and graduate students such as faculty of HEI in PR.
531 Telehealth, associated changes in EHR use patterns, and implications for physician burnout in the ambulatory care setting
Authors: Lim James , Adler-Milstein Julia
Published: April 2022

OBJECTIVES/GOALS: The objective of this study is to examine the associated changes in the EHR use patterns after the widespread implementation of telehealth in the ambulatory care setting after the COVID pandemic. METHODS/STUDY POPULATION: The study sample will be all attending ambulatory care physicians at UCSF Health. Signal measures captured by Epic Systems are markers of EHR use pattern that characterize EHR use at the individual provider level in terms of time spent performing certain activities, time spent at particular times of the day, and the number of EHR tools being used. We will use the Single Interrupted Time Series framework to analyze the changes in Signal measures that occur after the widespread implementation of telehealth with pre-telehealth time period defined as Jan 2018 – Feb 2020 and post-telehealth time period defined as March 2020 – present. RESULTS/ANTICIPATED RESULTS: The outcomes of this study will reveal how the increased use of telehealth following the COVID pandemic has changed the way providers utilize various functions within EHR (e.g. time in EHR at particular time of day, documentation, medication and non-medication orders, chart review, etc). These results can, in turn, inform us potential impacts of increased telehealth use on physician burnout given that a number of markers of EHR use pattern (i.e. Signal measures) in previous studies have been associated with burnout. In addition, a stratified version of Interrupted Time Series by specialty and clinical work volume may inform us how different subgroups of providers exhibit varying EHR use patterns in response to the increased use of telehealth. DISCUSSION/SIGNIFICANCE: The use of telehealth will likely remain a strong presence in health care delivery in the post-COVID era. This study can serve as a baseline study on the influence of telehealth on EHR use. Future studies may focus on potential targeted interventions to best support the usage of telehealth.
134 Impact of shifting engagement strategies during COVID: Are rural counties on equal footage? The Ohio HEALing Communities Study (HCS)
Authors: Salsberry Pamela , Freisthler Bridget , Jackson Rebecca
Published: April 2022

OBJECTIVES/GOALS: This study examines the impact of COVID restrictions on the process of engagement in the Ohio-HCS site. The goals are to: examine the impact of COVID restrictions on the process of engagement; 2) determine differences in process measures by geographic region (rural, urban). METHODS/STUDY POPULATION: Engagement activities collected as part of the Ohio HCS include an engagement log, coalition meeting type and attendance, tracker of implementation strategies. Study period: January 2020 to October 31, 2021. Measures are defined below. Meeting occurrence, type by month: Data report on whether a meeting occurred, was scheduled and cancelled, or a scheduled off-month. The meeting platform was also recorded (in-person, hybrid, virtual). Coalition meeting attendance by month: Number of community members in attendance. Engagement communications by type, by month: Counts and percent (types: email, calls, zoom, or in person). Evidence-Based Practices(EBP) delivery option: in person, virtual, or hybrid. Counties: 9 Ohio counties, 5 rural, 4 urban. RESULTS/ANTICIPATED RESULTS: Coalition meetings were cancelled in 40% of rural counties; none in the urban counties. Two rural counties switched back to in person or hybrid meetings by late 2020; urban counties remain 100% virtual. Rural counties had a drop-off in attendance in June 2021 with no decrease seen in urban counties. During first two months of 2020 engagement in rural and urban communities occurred in person; by March that shifted to 80% by email, which continued within rural counties. In urban counties that dropped to 50% by August of 2020, with zoom calls accounting for 30%. In-person strategies for naloxone distribution remained high in both county types (90%); urban counties use of in-person only strategies for medication for OUD (rural: 83%, urban 52%) and safer prescribing (rural:74%, urban:10%) were much lower than rural counties. DISCUSSION/SIGNIFICANCE: Results show that rural counties continue to rely on in person engagement strategies, making COVID restrictions more disruptive for rural counties. These results suggest that new supports and strategies may be needed to assure that rural regions are equally equipped to engage in research in a virtual environment.
151 The Impact of Minimum Volume Thresholds on Geographic Access to Stroke Thrombectomy
Authors: Leykina Liza , Kim Anthony
Published: April 2022

OBJECTIVES/GOALS: At least 15 stroke thrombectomies per proceduralist per year are required for Thrombectomy-Capable and Comprehensive Stroke Centers. We sought to estimate the potential impact of these minimum volume thresholds on geographic access to stroke thrombectomy (ST). METHODS/STUDY POPULATION: Using the Florida State Inpatient Database, we will identify patients discharged with acute ischemic stroke from 2015-2019 and all non-federal facilities that performed â‰¥1 ST procedure per year. We will then calculate the proportion of stroke patients who live within 20, 65, 115, 165 and 200 miles (correlating with estimated ground transport times of 1, 2, 3, 4 and 5 hours, respectively) of centers that perform ST using ArcGIS software and evaluate the impact of varying the threshold ST volume required by each facility on this proportion. We will then perform multiple two proportion z-tests to compare proportions of patients within driving distance over time. RESULTS/ANTICIPATED RESULTS: We hypothesize that over time, and particularly after the pivotal trials of ST were published in 2015, that the number of facilities that perform ST have increased over time, which would increase the geographic access to ST. We also hypothesize that since the Joint Commission set the minimum procedural volume for proceduralists at Thrombectomy-Capable and Comprehensive Stroke Center to 15 per year, this would work to increase regionalization and could work to decrease geographic access to ST. However, we hope to elucidate the net impact of the interplay between these two opposing factors on regionalization of care over time which is currently unclear. DISCUSSION/SIGNIFICANCE: Current ST volume thresholds have focused on technical proficiency but may impact regionalization of care and geographic access to ST. Since access to ST is time-sensitive, a data-driven approach and better coordination on a regional level may be necessary to ensure timely access to ST.
157 Evaluating Interest in Clinical Trial Participation for the Treatment of Pediatric Food Allergy
Authors: Catlin Perry A. , Van Hecke Amy , Assa’ad Amal , Gupta Ruchi
Published: April 2022

OBJECTIVES/GOALS: Roughly 8% of children in the United States have a diagnosed food allergy (FA). The ubiquity of most food allergens increases the potential for accidental exposures. Clinical trials (CT) are used to test novel treatments for FA. This project will evaluate the influence of biopsychosocial factors on interest in CT participation for pediatric FA. METHODS/STUDY POPULATION: This project is subsumed under the FORWARD study (5R01AI130348-04), a multisite study currently underway at four pediatric FA clinics across the United States. Eligible participants include patients and families who meet the following criteria: 1) New clinic visit presenting for a possible FA complaint and/or has a physician diagnosis in a follow-up clinic visit; 2) child is between the age of 6-months and 12 years at intake visit; 3) are English speaking, and 4) no history of developmental disorders. Parents are asked to complete an intake survey, followed by a series of quarterly surveys administered via REDCap. A single variable from the intake survey queries interest in CT participation; quarterly surveys assess FA knowledge, attitudes, health beliefs, and management practices. RESULTS/ANTICIPATED RESULTS: To date, 890 families have completed the intake survey. Working hypotheses include: 1) parents of older children and children with a higher condition severity rating will report greater levels of interest in CT participation; 2) parents with greater FA knowledge, more health management beliefs that support action, and less FA-related anxiety, will report greater levels of interest in CT participation; 3) relative to White families, African American families will be less interested in participating; 4) families with >1 child with FA will report greater levels of interest in CT participation; 5) families who are uninsured, low-SES, and are unemployed will report lower levels of interest in CT participation; and 6) families with higher educational attainment will report lower levels of interest in CT participation. DISCUSSION/SIGNIFICANCE: This study will advance decision science, address existing disparities, and have far-reaching clinical implications. This novel approach will enhance our ability to predict who is at the greatest risk of anaphylaxis and help healthcare providers identify families who could benefit from experimental treatment options for pediatric FA.
158 Effect of maternal exposure to violence at different life stages on the risk of obesity among postpartum women
Authors: López Mancebo Lorelle R. , Acosta-Pérez Edna , Rosario-Matos Nicolas , Orraca Zilkia Rivera , Laras-García Linda , Kallis-Colón María , Rivas-Tumanyan Sona , Campos-Rivera Maribel
Published: April 2022

OBJECTIVES/GOALS: Determine if exposure to violence at different life stages (childhood versus recent exposure) in postpartum women is associated to increased risk of weight retention more than 1 year and no more than 2 years after delivery, thus increasing health risk in short and long term. METHODS/STUDY POPULATION: Participants will be recruited from a cohort of post-partum women who received services from the Puerto Rico Women and Children Program (PR WIC) during pregnancy and postpartum period as per PR WIC established criteria. Families that have completed their participation in a Lifestyle intervention trial will be paired 2:1 with eligible nonparticipants that fulfill trial enrollment criteria. Language, culture validated instruments will be used to document maternal violence exposure in childhood and recent exposure, defined as within the last 12 months. To asses weight retention, pre-pregnancy weight will be compared to actual weight at the moment of evaluation, anthropometric measurements (weight, length, body composition, and fat mass) will be used to determine the health risk category for each participant. RESULTS/ANTICIPATED RESULTS: Expected results will be that there is an association between violence exposure and weight retention among post-partum women, thus influencing their weight status. The use of the questionnaires as screening tool for history of violence and whether recent or childhood exposure should be considered a health risk during pregnancy and post-partum predisposing women to adipose tissue related disorders. DISCUSSION/SIGNIFICANCE: Findings will reinforce the importance of integrated screening and proactive management of social determinants of health within clinical and social services that target this population. Also, contribute to the development of strategies tailored to break violence cycle as a public health measure.
160 Sustaining community engagement during COVID-19: High stress and loneliness reported
Authors: Striley Catherine Woodstock , Varma Deepthi S. , Chaudhari Piyush V. , Cottler Linda B.
Published: April 2022

OBJECTIVES/GOALS: COVID-19 has taken a big toll on health, mental health and community well-being. COVID-19 has also presented unique opportunities for community engagement programs to sustain their work within communities. Low-tech methods of engagement might provide opportunities for success. METHODS/STUDY POPULATION: When we could not be in the field due to COVID-19, we recontacted our 12.4k HealthStreet members by phone and in 12 months successfully contacted 3.2k. By contrast, over the two COVID affected years (2019 & 2020), our in-person recruitment efforts in the community fell to 832 from 1817 in the two prior years (2017 & 2018). Reconnecting with existing members is an important aspect of sustainable community engagement. RESULTS/ANTICIPATED RESULTS: While 8/10 of the 3.2 K sample had internet access in their homes, 9/10 said having it was somewhat to very important. Importantly, 1 in 3 people who had additional needs or suggestions were looking for better COVID-19 knowledge or ways to reduce the threat of illness, 1 in 4 wanted resources; and 1 in 5 encouraged us to keep doing what we were doing. Among recontacted members, 30.2% indicated a high stress level (8 & over on a 10 point scale) while 15.2% reported a high level of loneliness (8 & over on a 10 point scale). High stress was significantly more likely among those identifying as African American (23.1%) compared to non-African American (16.6%). Loneliness did not vary (10.1% among both). DISCUSSION/SIGNIFICANCE: Sustainable community engagement was important to reach community members during the pandemic, especially given the high rates of stress and loneliness among members contacted. In-person connections were reduced, but phone contact provided an opportunity for successful engagement.
176 COVID-19 infection risk in patients with non-syndromic orofacial clefts during pandemic in Puerto Rico
Authors: Victoria Yinayra , Debs Natalio , Elias Augusto , Buxo Carmen J
Published: April 2022

OBJECTIVES/GOALS: Patients with nsCL/P are prone to infections due to their open like wound cleft and immune system susceptibility. COVID-19 affected nsCL/P patients access to care and treatment delays. This study will determine COVID-19 infection risk between children with nsCL/P compared to those unaffected. METHODS/STUDY POPULATION: Retrospective cohort of children 5 years old and under with nsCL/P (exposed group) and children without nsCL/P (unaffected group); matched by age and gender. Participants will be selected from ongoing case-control study (n=500), School of Dental Medicine, and Pediatric University Hospital. Power analysis will calculate minimum sample size (power=0.80 alpha=0.05). Exclusion criteria: syndromic clefts, patients without diagnosis information and with history of co-morbidity. Other bacterial and viral infections present at the time of COVID-19 diagnosis, sex, age, geographic location, COVID-19 vaccination status and others will be considered as possible cofounders. Descriptive statistics, Chi-square, Odds Ratios at 95% confidence intervals and multiple logistic regression will be estimated. RESULTS/ANTICIPATED RESULTS: We hypothesize that we will identify an increased risk of COVID-19 infection in children with nsCL/P than in those unaffected or children without nsCL/P. Children with nsCL/P will also have an increased risk of symptoms and complications of COVID-19 infection than those unaffected. DISCUSSION/SIGNIFICANCE: Knowing the increased risk of COVID-19 infection in children with nsCL/P will aid to prioritize treatment. If a higher risk of COVID-19 infection is found, it will generate a need to modify elective surgery status to semi-elective; minimizing delayed treatments, unnecessary hospitalizations, complications and increased cost of treatment.
179 Responsible Conduct of Research for Undergraduates
Authors: Moses Jennifer , Donnelly Anne , Leonard Michelle
Published: April 2022

OBJECTIVES/GOALS: In spite of significant growth in undergraduate research, there is little accessible RCR training material targeting this group. The goal of this project was to develop level appropriate RCR materials and test them for effectiveness of teaching basic knowledge of RCR. It was developed cognizant of the type of learning preferred by this group. METHODS/STUDY POPULATION: Todays undergraduate students are digital natives accustomed to using on-line resources for learning and value the ability to work independently. An asynchronous, online series of eight RCR modules were developed using PowerPoint. Audio instruction was overlaid over the presentations and uploaded to YouTube. Each module includes quiz at the end that must be completed with a 90% score in order to continue and students can retake each quiz until correct. Case studies, a plagiarism game, and additional resources such as infographics created by the Office of Research Integrity were included. 275 first year undergraduates completed the pilot and the on-line retrospective pre-post assessment that included 28 Likert scale items and two open-ended questions that were analyzed with RapidMiner. RESULTS/ANTICIPATED RESULTS: Participants rated their ability prior to and after the course to recognize the roles/responsibilities of a mentor, maintain and organize data records, recognize what constitutes research misconduct and multiple types of plagiarism, define ethics of authorship and the types of peer review, recognize responsible handling of human and animal subjects and to define collaborative research. Responses were analyzed using t-Tests and all items showed a significant increase. Students reported between a 28% and 50% increase in knowledge in each topic and gains in understanding where to report RCR violations. Text analysis using RapidMiner provided developers with suggestions on how to enhance the project. Students reported finding the course concise and easy to understand and valued the included case studies. DISCUSSION/SIGNIFICANCE: This study demonstrated that RCR materials developed specifically for todays undergraduate students, presented an easily accessible format, effectively conveys the basics of RCR. The on-line, asynchronous format made it accessible to those for whom in person course is not possible. This model fills the gap in RCR training for early researchers.
181 Identifying Racial Disparities in the Pain Management of Hidradenitis Suppurativa
Authors: Weir Sydney , MacLennan Paul A. , Kole Lauren C.S.
Published: April 2022

OBJECTIVES/GOALS: The purpose of this study is to evaluate average pain scores in patients with Hidradenitis Suppurativa (HS) and determine if racial disparities influence HS-related pain management. METHODS/STUDY POPULATION: We surveyed 3,140 adult patients about demographics, HS, pain levels, medical history, and health-related quality of life. Among respondents (N=162), pain scores (0-10) were grouped as high (8+, N=54) and low (<7, N=108). We used logistic regression to calculate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). RESULTS/ANTICIPATED RESULTS: Respondents were female (88.9%), Black race (59.4%), with a median age of 36 (IQR 25-42) and a mean pain score of 7 (IQR 5-8). Half (48.2%) of respondents disagreed or strongly disagreed with, “I am satisfied with how my pain related to HS is being managed by my doctors.” Independent risk factors for high pain included Black race (aOR=7.95, 95% CI 3.11-20.26), history of prescribed pain medications (aOR=2.37, 95% CI 1.06-5.30), and former/current tobacco use (aOR=4.12, 95% CI 1.76-9.64). DISCUSSION/SIGNIFICANCE: The preliminary data support the hypothesis that race influences HS-related pain. In addition, less education, a history of prescription pain medication use, and tobacco use are all independent risk factors contributing to higher pain scores in patients with HS. Further analysis will be conducted to evaluate racial influences on pain management.
183 Advancing Structural and Systematic Equity in Epidemiological Analyses of Large Datasets
Authors: Carvour Martha L.
Published: April 2022

OBJECTIVES/GOALS: Health inequities represent complex structural and systematic processes that lead to disparate outcomes for populations or subgroups within populations. This project aims to improve the available structural and systematic approaches to the study of such inequities at the population level. METHODS/STUDY POPULATION: Using examples from diabetes research, two critical factors that may impact the validity or utility of health equity models will be examined; and proposed methodological approaches to offsetting potentially resulting biases will be offered. The factors include: (1) inequitably missing and misclassified data in large datasets and (2) the presumed positioning of socially constructed variables such as race, ethnicity, and gender within modeled structural and systematic mechanisms. This examination intersects theories and praxis in epidemiological modeling and health equity promotion with the goal of advancing rigorous, equity-focused epidemiological methods. RESULTS/ANTICIPATED RESULTS: Inequitably missing and misclassified data are generally expected to obscure inequities. Treatment of missing or misclassified data as informative measures of inequity is expected to partially offset this bias. The implicitly modeled components of socially constructed variables are expected to be non-uniform across structural and systematic mechanisms of inequity. Models that apply these variables as informatively heterogeneous constructs, using multi-phase analyses to test modeling assumptions and to assess intersectionality, may provide better context about the mechanisms by which inequity has been distributed and, perhaps, by which equity may be achieved. DISCUSSION/SIGNIFICANCE: Equitable epidemiological methods are essential to the advancement of evidence-based health equity on the population level. Potential structural or systematic inequities in large-scale datasets and traditional data analyses should be thoughtfully reviewed through a health equity lens.