bluuebunny/crossref_metadata_2025 huggingface dataset:
4159 Prostate cancer multiparametric MRI comparison study of 3T versus 7T in terms of lesion detection and image quality
Authors: Leng Ethan , Spilseth Benjamin , Chauhan Anil , Gill Joseph , Rosa Ana , Koopmeiners Joseph , Warlick Christopher , Metzger Gregory
Published: July 2020

OBJECTIVES/GOALS: The goal of this study was to perform a comparative, multi-reader, retrospective clinical evaluation of prostate multiparametric MRI (mpMRI) at 3 Tesla (3T) vs. 7 Tesla (7T) primarily in terms of prostate cancer localization. Subjective measures of image quality and artifacts were also evaluated. METHODS/STUDY POPULATION: Nineteen subjects were imaged at 3T and 7T between March 2016 and October 2018 under IRB-approved protocols. Four radiologists retrospectively and independently reviewed the data, and completed a two-part assessment for each dataset. First, readers assessed likelihood of cancer using Prostate Imaging Reporting & Data System (PI-RADS) guidelines. Accuracy of cancer detection was compared to findings from prostate biopsy. The numbers of correctly or incorrectly classified sextants were summed across all four readers, then used to summarize detection performance. Second, readers assigned a score on a five-point Likert scale to multiple image quality characteristics for the 3T and 7T datasets. RESULTS/ANTICIPATED RESULTS: Sensitivity and specificity of 3T and 7T datasets for sextant-wise cancer detection were compared by paired two-tailed t-tests. Readers identified more sextants harboring cancer with the 3T datasets while false-positive rates were similar, resulting in significantly higher sensitivity at 3T with no significant differences in specificity. Likert scores for image quality characteristics for 3T and 7T datasets were compared by applying paired two-tailed t-tests to mean scores of the four radiologists for each dataset. Readers generally preferred the 3T datasets, in particular for staging and assessment of extraprostatic extension as well as overall quality of the contrast-enhanced data. DISCUSSION/SIGNIFICANCE OF IMPACT: Readers agreed 7T prostate mpMRI produced images with more anatomic detail, though with equivocal clinical relevance and more pronounced artifacts. Reader unfamiliarity with 7T images is a major extenuating factor. Forthcoming technological developments are anticipated to improve upon the results.
4293 Relationship between recent drinking history, subjective response to alcohol, and sex in HRV in non-dependent drinkers
Authors: Sundar Sachin , Stangl Bethany L. , Momenan Reza , Ramchandani Vijay A. , Corey Kristin , Plata Khem
Published: July 2020

OBJECTIVES/GOALS: Previous research has shown acute and chronic alcohol effects on cardiac function, including elevated heart rate (HR) and lowered heart rate variability (HRV). This study aimed to examine the relationship between cardiac reactivity and subjective response following intravenous (IV) alcohol in non-dependent drinkers. METHODS/STUDY POPULATION: Non-dependent drinkers (N = 46, average age = 25.2) completed a human laboratory IV alcohol self-administration (IV-ASA) session. Subjective response to alcohol was assessed using the Drug Effects Questionnaire (DEQ) and Alcohol Urge Questionnaire (AUQ). Drinking behavior was assessed using the Alcohol Timeline Followback (TLFB) and Alcohol Use Disorders Identification Test (AUDIT). HR was recorded using the Polar Pro Heart Rate monitor throughout the session. HRV measures were calculated using guidelines determined by the Task Force of the European Society of Cardiology and The North American Society of Pacing and Electrophysiology. RESULTS/ANTICIPATED RESULTS: Recent drinking history as measured by the AUDIT and TLFB was not significantly different by sex. Results showed heavier drinking measures (AUDIT and TLFB) were positively associated with HRV measures (all p-values < 0.02). Those who reported a greater increase in alcohol craving (AUQ score) and wanted more alcohol (DEQ) following an alcohol prime, showed a greater change in HRV (p < 0.005). When examining HRV change from baseline throughout the priming session, there was a significant sex interaction for NN50 (p < 0.03) and a trend for PNN50 (p-value < 0.07). DISCUSSION/SIGNIFICANCE OF IMPACT: Acute IV alcohol alters cardiac reactivity measures in non-dependent drinkers. Future directions include examining the role of sex in HRV changes during alcohol consumption during IV-ASA. Understanding the effect of alcohol on cardiac reactivity and physiology may help characterize those at risk for alcohol use disorders.
4148 Thrombocytopenia and whole blood transfusion in children with severe falciparum malaria
Authors: Ippolito Matthew M. , Kabuya Jean-Bertin , Hauser Manuela , Kussin-Shoptaw Benjamin , Peer Austin , Ruegg Marco , Baschong Albert , Louis Thomas , Moss William
Published: July 2020

OBJECTIVES/GOALS: Severe malarial anemia due to Plasmodium falciparum is often accompanied by thrombocytopenia. Treatment includes transfusion of whole blood, which contains erythrocytes, platelets, and other blood components. The objective of the study was to assess the effect of whole blood transfusion on survival in children with severe falciparum malaria and to examine the potential interaction of thrombocytopenia with malaria mortality and transfusion response. METHODS/STUDY POPULATION: We analyzed a retrospective cohort of 842 hospitalized children in Zambia with severe malarial anemia (703 transfused, 139 not transfused due to stock-out or other reason). Severe malarial anemia was defined as a positive rapid diagnostic test or blood smear in combination with an admission hemoglobin concentration ≤5 g/dL. RESULTS/ANTICIPATED RESULTS: Mortality was 13% (94/703) in the transfused group and 24% (34/139) in the non-transfused group. Kaplan-Meier survival estimates stratified by transfusion status and thrombocytopenia (150,000/μL threshold) showed increased mortality in children with thrombocytopenia who did not undergo transfusion, with no differences in mortality among the other transfused and non-transfused groups (log-rank test P = 0.0001). Effect modification analysis by Cox proportional hazards regression adjusted for age, sex, hemoglobin concentration, blood group type, and eosinophilia showed a significant interaction between platelet count and transfusion status (P = 0.028). Children with thrombocytopenia who were transfused and died had little or no post-transfusion increase in platelets, in contrast to those who survived. Freshness of transfused whole blood, construed from expiration dates, correlated with greater platelet recovery and improved survival. DISCUSSION/SIGNIFICANCE OF IMPACT: The role of platelets in malaria pathophysiology is complex and incompletely understood; prior studies describe preferential binding of platelets to parasitized erythrocytes and direct parasitocidal activity, whereas others detailed deleterious effects in malaria involving the central nervous system vasculature. These findings point to a potential clinical role for platelet-directed transfusion strategies to improve survival in children with severe falciparum malaria, which should be further assessed in randomized interventional studies.
4252 Automated Fetal Brain Volumetry on Clinical Fetal MRI Using Convolutional Neural Network
Authors: Tran Carol , Glenn Orit , Hess Christopher , Rauschecker Andreas
Published: July 2020

OBJECTIVES/GOALS: We seek to develop an automated deep learning-based method for segmentation and volumetric quantification of the fetal brain on T2-weighted fetal MRIs. We will evaluate the performance of the algorithm by comparing it to gold standard manual segmentations. The method will be used to create a normative sample of brain volumes across gestational ages. METHODS/STUDY POPULATION: We will adapt a U-Net convolutional neural network architecture for fetal brain MRIs using 3D volumes. After re-sampling 2D fetal brain acquisitions to 3mm3 3D volumes using linear interpolation, the network will be trained to perform automated brain segmentation on 40 randomly-sampled, normal fetal brain MRI scans of singleton pregnancies. Training will be performed in 3 acquisition planes (axial, coronal, sagittal). Performance will be evaluated on 10 test MRIs (in 3 acquisition planes, 30 total test samples) using Dice scores, compared to radiologists’ manual segmentations. The algorithm’s performance on measuring total brain volume will also be evaluated. RESULTS/ANTICIPATED RESULTS: Based on the success of prior U-net architectures for volumetric segmentation tasks in medical imaging (e.g. Duong et al., 2019), we anticipate that the convolutional neural network will accurately provide segmentations and associated volumetry of fetal brains in fractions of a second. We anticipate median Dice scores greater than 0.8 across our test sample. Once validated, the method will retrospectively generate a normative database of over 1500 fetal brain volumes across gestational ages (18 weeks to 30 weeks) collected at our institution. DISCUSSION/SIGNIFICANCE OF IMPACT: Quantitative estimates of brain volume, and deviations from normative data, would be a major advancement in objective clinical assessments of fetal MRI. Such data can currently only be obtained through laborious manual segmentations; automated deep learning methods have the potential to reduce the time and cost of this process.
4044 A Cardiovascular Health and Wellness Mobile Health Intervention Among Church-going African-Americans: Formative Evaluation of the FAITH! App
Authors: Brewer LaPrincess , Kumbamu Ashok , Smith Christina , Jenkins Sarah , Jones Clarence , Hayes Sharonne , Patten Christi A. , Cooper Lisa A. , Burke Lora
Published: July 2020

OBJECTIVES/GOALS: To evaluate the FAITH! (Fostering African-American Improvement in Total Health) App mHealth lifestyle intervention by using post-intervention feedback obtained from participants in our intervention pilot study. METHODS/STUDY POPULATION: We used qualitative methods (focus groups) to elicit post-intervention feedback. Participants who completed the pilot study were recruited to one of two focus groups. Semi-structured focus groups were conducted to explore participants’ views on the app functionality, utility and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded, transcribed verbatim and qualitative data were analyzed by systematic text condensation thematic analysis. RESULTS/ANTICIPATED RESULTS: Nine individuals participated (N = 4 and N = 5) in each of the two focus groups. Their mean age was 47.9 years (SD 12.1), 67% were women, and all had at least an education level of some college. Six overarching themes emerged from the data: (1) overall impression, (2) content usefulness (3) formatting, (4) implementation, (5) impact and (6) suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules and social networking. Among the suggestions for improvement were streamlining of app self-monitoring features, personalization based on individual’s cardiovascular risk and attentiveness to nuanced cultural perspectives. DISCUSSION/SIGNIFICANCE OF IMPACT: This formative evaluation found the FAITH! App mHealth lifestyle intervention had high reported satisfaction and impact on the health-promoting behaviors of African-Americans, thereby improving their overall cardiovascular health. The findings provide further support for the acceptability of mHealth interventions among African-Americans. CONFLICT OF INTEREST DESCRIPTION: None.
4230 An App a Day: Examining Clinical Evidence for Safety and Efficacy of Diabetes Mobile Health Apps
Authors: Pathak Avantika , Bain Susan , Pacifici Eunjoo
Published: July 2020

OBJECTIVES/GOALS: Mobile health applications are widely used by the public but vary in how they are classified and regulated. This study examines the evidence of the safety and efficacy of mobile medical applications specifically focusing on those that are used to manage diabetes. METHODS/STUDY POPULATION: To understand the current regulatory landscape of mobile health applications (mHealth apps) for diabetes, a literature survey was conducted using the Pubmed database. Top mHealth apps were identified by searching the Apple store website using 10 key terms associated with diabetes management applications. A maximum of ten results, when available for each key term, were studied by exploring the FDA databases to understand how the products were regulated and if any were subject to recalls. These selected mHealth apps were also searched on clinicaltrials.gov to see if there were ongoing or completed clinical trials and if the trials were designed to include efficacy and safety outcome measures. RESULTS/ANTICIPATED RESULTS: Of the 71 mHealth apps for diabetes management that were identified, 16 were regulated. These products spanned a diverse range of functions including device data and decision support systems. Although 11 had clinical trial data demonstrating efficacy, only 4 had data demonstrating both efficacy and safety. Two of the regulated applications were subject to product recalls due to programming errors that resulted in incorrect insulin dose recommendations. These two applications had clinical trials evaluating efficacy but not safety. The companies noted that the incorrect insulin calculation from their respective mHealth app could cause either a low- or high-impact hypoglycemic event. DISCUSSION/SIGNIFICANCE OF IMPACT: With little to no clinical trial data to support their safety and efficacy, mHealth apps in the diabetes marketplace pose risks for patients as evidenced by recent safety-related recalls. The results of this study indicate that these products may need to be more tightly regulated.
4101 Creating a Culturally Sensitive Report Card for African American (AA) Kidney Transplant Candidates
Authors: McKinney Warren , Bruin Marilyn J. , Chu Sauman , Kasiske Bertram L. , Israni Ajay K.
Published: July 2020

OBJECTIVES/GOALS: AA are over-represented on the waitlist for kidney transplant and are often unaware of how waitlist acceptance practices differ across transplant programs and influence access to transplant. We will develop a culturally sensitive transplant program report card to communicate these variations. METHODS/STUDY POPULATION: Scientific Registry of Transplant Recipients (SRTR) data will be used to identity clinical factors strongly associated with AA access to transplant. Interviews and focus groups with AA kidney transplant candidates and their families will collect feedback on the SRTR report card and inform the development of the culturally sensitive report card. Additional focus groups will evaluate its effect on knowledge and medical decision making. We will collaborate with the stakeholders, including AA transplant candidates and their families, transplant programs, SRTR, and providers, to identify strategies to disseminate the report card in the AA community RESULTS/ANTICIPATED RESULTS: To date, no investigation has systematically collected feedback on the SRTR transplant program report card from AA candidates to ensure that the tool is accessible and effective in the AA community. We hypothesize that a culturally sensitive report card will improve AA candidates’ knowledge of program factors that impact access to transplant and enable informed decisions about where they pursue a transplant evaluation. The results of this study have the potential to change how AA patients are counselled while seeking transplantation. DISCUSSION/SIGNIFICANCE OF IMPACT: A culturally sensitive report card can reach more AA patients and enable more informed decision making by providing education about differences in transplant programs that may impact their access to transplant. In the future, we will design a trial to evaluate the prototype.
4197 A Landscape Analysis of CTSA websites for Clinical Research Professional Training Opportunities
Authors: Carter Karen K , Jones Carolynn Thomas
Published: July 2020

OBJECTIVES/GOALS: We conducted a review of CTSA websites to understand the current landscape for CRP institutional professional development and training revealed in the CTSA hub websites. METHODS/STUDY POPULATION: We accessed and reviewed 59 currently funded CTSA hub websites for evidence of CRP training opportunities. Parameters reviewed included: 1) opportunities were specified for CRPs versus K and T trainees; 2) mandated training; 3) leveling; 4) delivery methods/resources; 5) public accessibility; 6) unique features. The website reviews informed a REDCap survey sent to the CTSA Administrators (n = 149) and the Coordinator Taskforce (n = 105) listservs to gain additional knowledge of CRP training available at the institution. A subsequent repeat review of the CTSA hub websites will be conducted to determine evolving trends. RESULTS/ANTICIPATED RESULTS: A total of 40 responded to the survey from 59 CTSA hubs. Survey results are being analyzed. Website review data are being tabulated and the subsequent review of websites will be collected in February. Those findings are pending and will include a comparison of prior findings. 42% of CRP hubs list CRP training within the CTSA hub website. Required onboarding training (beyond CITI certificates) is revealed for some hubs (15%). DISCUSSION/SIGNIFICANCE OF IMPACT: On our initial website review less than half of the CTSA hub websites list specific CRP training on their website. Many were hidden behind firewalls and could not be reviewed for content. The REDCap Survey will provide more granular descriptions of programs. Data from a second website review will be collected for comparison. Based on a preliminary re-review of sites, there is a suggestion of increasing CRP workforce development information. CTSAs are well-positioned to be a central hub for promoting educational excellence of the institutional workforce, for medical centers and in other venues where clinical research is performed.
4172 Introduction to R Programming and GitHub: Developing Automated Analysis of Complete Blood Count Data as a Translational Science Undergraduate Project
Authors: Robinson Jeffrey , Wayman Annica
Published: July 2020

OBJECTIVES/GOALS: Introduce students to programming and software development practices in the life sciences by analyzing standard clinical diagnostic bloodwork for differential immune responses. Including lectures and a semester project with the goal of enhancing undergraduate students’ education to prepare them for careers in translational science. METHODS/STUDY POPULATION: The educational content was taught for the first time as a component of the newly developed course BTEC 330 “Software Applications in the Life Sciences” in UMBC’s Translational Life Science Technology (TLST) Bachelor’s degree program at the Universities at Shady Grove campus. Eleven students took the course. All were beginners with no programming background. Lectures provided background on the diagnostic components of the CBC, criteria for differential diagnosis in the clinical setting, and introduction to hematology and flow cytometry, forming underpinnings for interpretation of the CBC results. Weekly computer lab practical sessions provided training fundamentals of R programming language, the R-studio integrated development environment (IDE), and the GitHub.com open-source software development platform. RESULTS/ANTICIPATED RESULTS: The graded assignment consisted of a coding project in which students were each assigned an individual parameter from the CBC results. These include, for example, relative lymphocyte count or hemoglobin readouts. Students each created their own R-language script using R-studio, with functional code which: 1) Read in data from a file provided, 2) Performed statistical testing, 3) Read out statistical results as text, and charts as image files, 4) “Diagnosed” individuals in the dataset as being inside or outside the clinical normal range for that parameter. Each student also registered their own GitHub account and published their open-source code. Grading was performed on code functionality by downloading each student repository and running the code with the instructor as an outside developer using the resource. DISCUSSION/SIGNIFICANCE OF IMPACT: In this curriculum, students with no background in programming learned to code a basic R-language script and use GitHub to automate interpretation of CBC results. With advanced automation now becoming commonplace in translational science, such course content can provide introductory level of literacy in development of clinical informatics software.
4484 The Entrepreneurship for Biomedicine (E4B) Training Program
Authors: Garbutt Jane M. , Grailer Joseph , Levin Lillie , Mozersky Jessica , Schulke Antes , Kinch Michael , Toker Emre
Published: July 2020

OBJECTIVES/GOALS: Regardless of their career choices, today’s biomedical researchers need to blend great science with core skills ininnovation and entrepreneurship (I&E). The objective of this NIH-funded education program was to develop and test a pragmatic training program to teach relevant I&E skills. METHODS/STUDY POPULATION: We used a modified Delphi approach to identify 15 relevant competencies for I&E and the essential topics to include in the program. Learner interviews identified preferences for online training programs (short, high-quality audio-visual content, ability to self-navigate, peer and instructor interactions). The inaugural program included 7 short, online courses that addressed how to identify and validate opportunities for innovation, sell your innovation to diverse audiences, assess its ethical consequences, work in teams, and develop resilience as an innovator. It also included mentor support, a team-based capstone project, and an optional in-person boot camp. RESULTS/ANTICIPATED RESULTS: 51 students enrolled and 41 participants from 9 institutions completed the program, including pre- and post-doctoral students and junior faculty. They organized into 10 teams to complete the capstone project, with 6 teams pitching their innovation to fellow students and mentors at the boot camp. Students rated satisfaction with courses highly overall, with 79% stating they would be disappointed if the program was no longer available. Preliminary results suggest participants increased their knowledge about and ability to perform tasks taught throughout the program. Suggestions for improvement included providing more practical advice and real-world examples to complement educational videos. DISCUSSION/SIGNIFICANCE OF IMPACT: The inaugural E4B program was well received and effective in increasing I&E skills. Improvements will include increased opportunity for mentor interactions and for advanced entrepreneurial training. The program is open for biomedical research trainees from all institutions with a CTSA award.
4401 Incidence, management, and outcomes of immune-related adverse events (irAEs): an analysis of a multidisciplinary toxicity team for cancer immunotherapy related irAEs
Authors: Balaji Aanika , Zhang Jiajia , Naidoo Jarushka
Published: July 2020

OBJECTIVES/GOALS: This study aims to assess the outcomes of a new virtual multidisciplinary immune-related toxicity (IR-tox) team implemented at Johns Hopkins Hospital. In particular, to understand if the IR-tox team’s input reduced the number of inpatient hospitalizations for irAEs for referred patients. METHODS/STUDY POPULATION: Since August 2017, nearly 250 patient referrals to the IR-tox team have been created and stored in an electronic database. Through retrospective chart review, hospitalization and irAE management data will be collected for these patients to assess whether rates for suspected irAEs have decreased. These rates will be compared against historical controls. We will assess the features of hospitalized patients, their immunotherapy regimens, and management to identify high-risk groups who may require early intervention. Additionally, we aim to understand what patient features are associated with IR-Tox team referral and subsequent hospitalization. RESULTS/ANTICIPATED RESULTS: The IR-tox team provided a new multidisciplinary channel to help physicians diagnose and manage complex irAEs. The goal of the team was the reduce the number of irAE-related hospitalizations as, historically, 85% of high-grade irAEs have required hospitalization. A clinically meaningful reduction is defined as lowering the hospitalization rate to 75%. Planned analyses includes calculating the hospitalization rate, using descriptive statistics to summarize patient features, multivariate analyses to understand features associated with both IR-Tox team referral and hospitalization, and computing the relative risk reduction to assess the efficacy of subspecialist referral implementation. DISCUSSION/SIGNIFICANCE OF IMPACT: IrAEs are challenging to diagnose and treat. They contribute to a notable proportion of hospitalizations in those treated with immunotherapy. With expanding use of immunotherapy, widespread implementations of IR-Tox teams may help reduce hospitalizations and costs associated with care for irAEs.
4455 Advancing the Science of Community Engagement with Human-Centered Design
Authors: Poll Jordan , Buyktur Ayse , Doshi Aalap , Huang Linde , Piechowski Tricia , Spiroff Meghan , Marsh Erica
Published: July 2020

OBJECTIVES/GOALS: To describe how the Community Engagement (CE) Program at the Michigan Institute for Clinical & Health Research (MICHR), a Clinical & Translational Science Award (CTSA) site at the University of Michigan, is adopting human-centered design (HCD) to advance the science of community engagement in translational research and CE’s programmatic efforts. METHODS/STUDY POPULATION: The MICHR CE Program supports academic-community partnerships to transform translational research across the state of Michigan. As the team aims to better engage partners to help guide the direction of their work, CE is collaborating with MICHR’s Design and Innovation Core to incorporate human-centered design (HCD). HCD is an approach that prioritizes the needs, values, and perspectives of direct users during the creation of a new product or service. The MICHR team created interactive HCD activities for two statewide retreats to elicit feedback from community and academic members on ways to enhance community-engaged research (CEnR). Retreat participants worked on a variety of problems, such as barriers to partnering and defining impact for CEnR. These activities generated authentic, contextual, and multi-view data captured in various artifacts for systematic analysis. RESULTS/ANTICIPATED RESULTS: In the first retreat, a HCD activity had participants reflect on their own barriers to partnering in research and potential solutions. In the second retreat, an HCD activity facilitated participants interviewing each other on their views of the impact in CEnR. Results from the first activity identified a set of common barriers to CEnR, some related to partnership formation, communication, and partner equity, among others. These led the CE Program to specific programmatic efforts, such as designing a statewide partnership platform, hiring a communication program manager, and sponsoring community partners to join national conferences. The second retreat activity produced rich data to identify overlaps between different perspectives to inform how impact can be defined and measured in CEnR. DISCUSSION/SIGNIFICANCE OF IMPACT: HCD activities provide means to include community and academic members in the science of CEnR. They allow systematic ways to gather information directly from the diverse set of current or prospective partners of community engagement programs about their needs, experiences, and values, which can be translated to programmatic innovation.
4463 An Intervention Mapping Approach to Develop Interventions to Improve Access to Kidney Transplant
Authors: D’Cunha Hannah , Partin Melissa , McKinney Warren , Bruin Marilyn , Hart Allyson
Published: July 2020

OBJECTIVES/GOALS: Kidney transplant is superior to dialysis for the treatment of end-stage kidney disease, but accessing transplant requires high patient engagement. We sought to develop a group counseling intervention with patients and their social support members using an evidence-based, stakeholder-engaged approach. METHODS/STUDY POPULATION: We employed an Intervention Mapping approach to incorporate qualitative data from stakeholders on barriers to accessing kidney transplant. Data were collected from 13 focus groups of African American (AA) and white adult kidney transplant candidates and their social support networks in Minnesota and Georgia. We completed this process through (1) qualitative data collection, (2) utilizing data and intervention mapping methods to develop a conceptual framework to describe associations between behavioral determinants and desired outcomes, and (3) using these products to identify evidence-based approaches to modify behavioral determinants through a theory based intervention. RESULTS/ANTICIPATED RESULTS: Participants describe experiences of overwhelm, isolation, helplessness, and difficulty communicating. In addition, AA participants expressed distrust in the medical system. We systematically incorporated these themes into a conceptual model of behavior change that identifies determinants of necessary actions to obtain transplant, including knowledge, self-efficacy, reduced decisional conflict, and perception of social support. Evidence-based methods to modify these determinants, such as modeling, goal-setting, and mobilizing social support, were incorporated into the design of a group education and counseling intervention with an individualized risk calculator. DISCUSSION/SIGNIFICANCE OF IMPACT: Intervention mapping allows for behavior change theories to be incorporated into counseling sessions with patients and their social support networks. This approach translates qualitative data into an evidence-based intervention which will be piloted in a randomized controlled trial (RCT) to determine feasibility for a larger RCT.
4200 Assessment of differential access to patient online portal (POP) by socioeconomic status (SES) and its impact on asthma care and research
Authors: Juhn Young J , Wi Chung-il , Ryu Euijung , Sohn Sunghwan , Park Miguel , Muth Joy Fladager , Seol Hee Yun , King Katherine , Liu Hongfang
Published: July 2020

OBJECTIVES/GOALS: Patient online portal (POP) allows patients to access electronic health records (EHRs) and have efficient communication with their clinicians. We assessed disparities in access to POP by families with different SES and its impact on asthma research which is little known in the literature. METHODS/STUDY POPULATION: A randomized controlled trial testing the efficacy of an EHRs-based clinical decision support (CDS) system was conducted at a pediatric primary care setting of Mayo Clinic. Asthma Control Test (ACT) questionnaire was administered to parents every 3 months through phone or email for this study after consenting, and reminders were sent to unanswered subjects through the POP. SES was measured by HOUSES (in quartiles), a validated individual-level SES index based on housing features (the higher HOUSES, the higher SES).The association of HOUSES with availability of POP access and missing ACT score rate was assessed. RESULTS/ANTICIPATED RESULTS: The mean age of 184 participants was 9.0 years (57% male) and parents of 152 (83%) children had POP. Only 68% of children from lowest HOUSES (Q1) had access to POP (vs. 74% (Q2), 88% (Q3), and 92% (Q4; highest SES); p = .02). ACT score was completed by 144 (78%), 150 (82%), 171 (94%), and 164 (95%) at each intervention conducted every 3 months with a total of 61 (33%) missing at least once. Overall, children whose parents had access to POP had a lower missing rate in ACT score at all interventions during the study; 16% (those with access to POP) vs. 47% (those without), 13% vs. 44%, 3% vs. 16%, and 1% vs. 23% for 1st, 2nd, 3rd, and 4th intervention, respectively (p < .007 for all). DISCUSSION/SIGNIFICANCE OF IMPACT: There are significant disparities in access to POP by SES defined by HOUSES which impact availability of ACT score resulting in a systematic bias in asthma research and potentially widening disparities in asthma care. CONFLICT OF INTEREST DESCRIPTION: NA.
4437 The Prevalence of Food Insecurity Among University of Utah Medical Students: Documenting the Need for Supportive Programs
Authors: Thorman Alyssa , Dhillon Harneet Kaur
Published: July 2020

OBJECTIVES/GOALS: Undergraduates experience food insecurity at rates 21% higher than the general population. Because professional students have been omitted from these studies, the goal of this project is to determine the prevalence of food insecurity among medical students at one academic institution. METHODS/STUDY POPULATION: A cross-sectional research design was used to quantify the food insecurity status of medical students at the University of Utah. The USDA’s validated 6-item Food Security Survey Module was distributed via email to all currently matriculated medical students. Student’s responses were anonymous but questions about gender and age were included. Respondents (N = 200) were scored per the module as food secure, food insecure, or very low food security. RESULTS/ANTICIPATED RESULTS: Statistical analysis included frequencies and chi-square tests. Medical students (N = 166) showed 50.6% of respondents experienced food insecurity in the past 12 months, 16.3% experienced very low food security.While there were no significant relationships between food security status and gender or age, general trends did show divorced and separated students had higher food insecurity risk 82%. A similar study in 2014 surveyed undergraduates at the same location; 51% of respondents (N = 221) experienced food insecurity. While medical students experience food insecurity at rates much higher than the national average, prevalence is lower than undergraduates at the same institution. DISCUSSION/SIGNIFICANCE OF IMPACT: Burnout and suicide in medical training are at an all-time high; professional and academic pursuits are limited when physiological needs of food security are not being met. Study results suggest, 50% of respondents are food insecure. This should inform the development of supportive programs.
4119 Cholecystokinin (CCK) Receptor Antagonist Reverses Nonalcoholic Steatohepatitis (NASH) by Reducing Hepatic Macrophages and Inflammatory Cytokines
Authors: Gay Martha , Safronenka Anita , Cao Hong , Tucker Robin , Shivapurkar Narayan , Kruger Annie , Smith Jill
Published: July 2020

OBJECTIVES/GOALS: NASH increases the risk of cirrhosis and liver cancer. High-fat diets increase CCK levels and CCK receptors have been identified on fibroblasts and immune cells. We hypothesized that CCK receptor blockade could prevent NASH by altering the hepatic microenvironment and macrophage activation. METHODS/STUDY POPULATION: Female mice were fed a Choline Deficient Ethionine supplemented (CDE) saturated fat diet or control high-fat diet for 18 weeks. Mice in each group were treated with a CCK receptor antagonist, proglumide (0.1 mg/ml) in the drinking water or regular water. Resected livers were stained for H&E for features of NASH and F4/80 for macrophages analysis. Liver RNA was evaluated for the expression of cytokines and chemokines using an 84-gene Profiler array (Qiagen). Oxidative stress was analyzed by qRT-PCR for heat shock proteins (HSPs) 27, 60, 70 and 90 and for glutathione by a fluorometric assay. Differences in CDE fed and CDE/proglumide-treated mouse livers were evaluated. RESULTS/ANTICIPATED RESULTS: Livers from mice on the CDE diet displayed histologic features of NASH that were prevented by proglumide. Cytokines and chemokines expression, especially CCL20 and CCL2, were increased in the CDE fed mice and these levels were reduced greater than 20-fold with proglumide. Infiltration of F4/80+ macrophages was markedly increased in the CDE livers and these were reduced by > 50% (p < 0.0001) with proglumide. RNA expression of HSP70 (p = 0.006) and HSP27 (p = 0.011) were reduced with proglumide. Hepatic glutathione concentration more than doubled in the CDE/proglumide treated mice compared to CDE mice. CCK-B receptor expression increased in the CDE-fed mouse livers compared to controls. DISCUSSION/SIGNIFICANCE OF IMPACT: CCK receptor blockade decreases NASH by reducing hepatic macrophages, oxidative stress, and blocking inflammatory cytokines and chemokines. This data supports our novel hypothesis that CCK receptors play a role in NASH and proglumide may provide an innovative treatment for this condition.
4277 Functional consequences of the juvenile idiopathic arthritis risk variant at 1q24.3
Authors: Moncrieffe Halima , Dunn Katelyn , Huang Yongbo , Chen Xiaoting , Langefeld Carl D. , Weirauch Matthew T. , Harley John B. , Kottyan Leah C. , Thompson Susan D. ,   Juvenile Arthritis Consortium for the Immunochip
Published: July 2020

OBJECTIVES/GOALS: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatologic disease childhood and a cause of pain and potential disability. JIA has a strong genetic component and no known cure. The goal of this study is to evaluate allele-dependent effects of a novel JIA risk variant at 1q24.3. METHODS/STUDY POPULATION: JIA patients meeting criteria for the two most common disease subtypes (oligoarticular and RF neg polyarthritis) were genotyped using the Immunochip, an Illumina array with dense coverage of the HLA region and 186 other loci previously reported in autoimmune diseases. Phase I association findings (Hinks, 2013) and Phase II analysis (unpublished) of an expanded cohort (4,271 JIA and 14,390 controls) identified new risk loci, including rs78037977 at 1q24.3. We prioritized rs78037977 and predicted possible impacted mechanisms based on Bayesian predictions of attributable risk, the surrounding chromatin landscape, and transcription factor binding data. A luciferase reporter assay was used to assess allele-dependent enhancer activity. RESULTS/ANTICIPATED RESULTS: rs78037977 is located between FASLG and TNFSF18 at chromosome 1q24.3 is associated with JIA (p = 6.3x10−09), and explains 94% of the posterior probability at this locus; no other SNPs in linkage disequilibrium (r2>0.6). The chromatin landscape around rs78037977 contains H3K4Me1 and H3K27Ac marks, which are indicative of enhancer activity. Further, >160 transcription factors have chromatin immunoprecipitation followed by sequencing (ChIP-seq) peaks overlapping rs78037977 in various cellular contexts. In luciferase reporter assays, the region around rs78037977 containing the reference A allele had ~2-fold increased enhancer activity compared to the non-reference allele. DISCUSSION/SIGNIFICANCE OF IMPACT: This work provides in vitro evidence to support allele-dependent enhancer activity of a novel JIA-risk variant at 1q24.3. Our ongoing work investigates the effect of the DNA-containing region of rs78037977 on gene expression and differential transcription factor binding at rs78037977.
4311 Inflammatory biomarkers of cognitive dysfunction in pediatric obesity: associations between Executive Function, C-Reactive Protein, Interleukin 6, and Tumor Necrosis Factor alpha
Authors: Prendergast Kathryn , Keller Caroline , Dowla Shima , Gowey Marissa
Published: July 2020

OBJECTIVES/GOALS: Executive function (EF) deficits lead to poorer adherence and weight loss in obesity treatment. Conversely, untreated obesity leads to both EF impairments and risk of chronic disease. EF deficits in children with obesity have begun to be associated with biomarkers of chronic disease risk such as glucose and cortisol. Elevated pro-inflammatory biomarkers, such as C-Reactive Protein (CRP), Interleukin 6 (IL-6), and Tumor Necrosis Factor a (TNFa), indicate risk for obesity-associated chronic disease and may represent another candidate biomarker of EF deficits in pediatric obesity. These inflammatory markers tend to be elevated in obesity but have yet to be examined in association with EF in pediatric obesity. This represents an opportunity to identify potential biomarkers of EF which may serve as novel treatment targets that could improve outcomes and chronic disease prevention. Thus, the present study aims to explore associations between EF and blood serum CRP, IL-6, and TNFa. METHODS/STUDY POPULATION: Treatment-seeking children aged 8-12 years with BMI>95th percentile were recruited from a pediatric weight management clinic and attended baseline assessments for a family-based behavioral intervention program for pediatric obesity. Demographics and medical history were assessed via parent questionnaire. Height and weight were measured by research staff and converted to zBMI. Child performance-based EF was assessed via the NIH Toolbox Cognitive Battery iPad application. Blood draws, assays, and Dual-energy X-ray Absorptiometry (DXA; measuring adiposity) were conducted by trained research personnel. Pearson’s correlations were conducted to explore associations between EF (NIH Toolbox Cognitive Battery, fully corrected T-scores) and CRP, IL-6, and TNFa. RESULTS/ANTICIPATED RESULTS: Children (n = 12) were primarily female (76.5%) and African American (64.7%). Correlation coefficients between inflammatory markers and EF were highly variable (r = −0.39 to 0.52). CRP showed small, negative associations with Cognitive Flexibility (r = −0.39) and Inhibitory Control (r = −0.34). IL-6 also demonstrated a small, negative association with Inhibitory Control (r = −0.37). TNFa was positively and moderately associated with working memory (r = 0.53). Remaining associations were weak (−0.3<r<0.3). DISCUSSION/SIGNIFICANCE OF IMPACT: Signals of higher inflammation, measured via CRP and IL-6, in association with EF deficits were identified in a small sample of children with obesity, as hypothesized. However, signals in the opposite direction were identified as well, measured via TNFa. CRP and IL-6 may represent candidate biomarkers of executive dysfunction in obesity that warrant further domain and biomarker-specific research, with potential long-term implications for improving pediatric obesity treatment.
4108 Artificial Intelligence-Based Quantification of the General Movement Assessment Using Center of Pressure Patterns in Healthy Infants
Authors: Johnson Tara Lynn , Kapil Namarta , Escapita Alexa , Majmudar Bittu , Siddicky Safeer , Wang Junsig , Mannen Erin
Published: July 2020

OBJECTIVES/GOALS: One in six children in the U.S. has a Neurodevelopmental Disability (NDD). Prechtl’s General Movement Assessment (GMA) is a qualitative predictor of early motor dysfunction. However, no quantitative biomechanical assessment exists to more accurately identify all patients with NDD. METHODS/STUDY POPULATION: With UAMS IRB approval, as part of a larger study, healthy infants were filmed while lying supine on a force plate for 2 minutes. We studied 12 healthy full-term infants (gestational age: 38.9±1.5 weeks, age: 2.1-7.0 months; 7M, 5F; length: 64.0±5.2 cm; weight: 7.2±1.3 kg). Within our data set there were 3 infants transitioning to fidgety period (≤3 months), 4 in the fidgety period, (3-5 months), and 5 that matured beyond fidgety period (>5 months). Center of pressure (COP) path-lengths were gathered from the force plate at 1000 Hz. We grouped our data with K-means clustering and performed statistical analysis with ANOVA. RESULTS/ANTICIPATED RESULTS: We divided our data into 3 distinct clusters. The first group contained infants with moderate variability of movements which included 2 infants between 3 and 5 months and 2 infants slightly outside of this range. The second group, with mild variability in movements, included 4 infants between 2 and 3 months as well as 2 infants just older than 5 months. The third group, with little variability in movements, included 2 infants older than 5 months. A GMA reader (TJ) qualitatively confirmed these findings with video footage. Using a threshold of p<0.05, data sets within the clusters were similar and significantly different from other clusters. DISCUSSION/SIGNIFICANCE OF IMPACT: Fidgety infants have greater variability in COP patterns than their mature counterparts. We anticipate additional COP measurements will correspond with qualitative GMA analyses. Artificial Intelligence-based quantification of the GMA may be useful in earlier detection or prediction of NDD outcomes.
4023 Catecholamines and Opioid Therapy Requirements for the Management of Acute Post-Procedural Pain: The clinical Trend to Identify Remarkable Elements in Opioid Drug Dependency
Authors: Rivera Armando Uribe , Machado Perez Ana Carolina , Malmstrom Hans , Ren Yang-Fan , Rasubala Linda , Carinci Adam J
Published: July 2020

OBJECTIVES/GOALS: To compare the opioid drug requirements amongst those individuals with high levels of catecholamines in blood and acute post-procedural pain, by ICD9/10 codes (experimental) to those with normal levels of catecholamines and acute post-procedural pain (AP-PP) only (controls) METHODS/STUDY POPULATION: In collaboration with both the Informatics and the Biostatistics Departments at CTSI and under the auspices of the IRB at the University of Rochester, we completed the collection of ~8,000 electronic health records(EHRs) of adults 18 years and older with surgical appointments at Strong Memorial Hospital (SMH), who met inclusion criteria, from January 2006 to September 2019 and received Fentanyl therapy for AP-PP management. Subjects were categorized in a two-arm-matched case-control fashion. A ratio of 1(Experimental):1(Control) was utilized. Analytic comparisons were completed using normal distribution statistical methods with p >0.1 for significance. RESULTS/ANTICIPATED RESULTS: After removal of duplicates and exclusion of EHRs, a total of 17 subjects met inclusion criteria for the experimental group. We matched controls (n = 17) with experimental subjects for age, gender and surgical procedure for accurately compare opioid requirements in the postoperative recovery. Mean age of subjects was 69(+/-10.1235) years old. Most of subjects were females (70%). Mean Fentanyl requirement was significantly different in the experimental group 466.17(625.621)mcg compared to 215.58(353.323)mcg in the controls (p value 0.07832) DISCUSSION/SIGNIFICANCE OF IMPACT: It is suggested that healthy individuals with genetic variations in pain pathways including; the COMT and MAOA rendered individuals with higher levels of catecholamines in the body driving abnormal responses to pain sensitivity. We emulated this genetic variation for clinical purposes using ICD10/9 codes of those with conditions related to higher catecholamine levels in the body. Based on our preliminary results, we suggest that COMT and MAOA genetic variations could impact opioid drug use and the current opioid dependency and epidemics in the U.S. This study will address remarkable questions and identify strategies about this topic.