bluuebunny/crossref_metadata_2025 huggingface dataset:
4559 TX TM: Formalization and Institutional Investment in a Model Designed to Advance Research Translational to Community Transformation
Authors: Akintobi Tabia Henry , Akintobi Tabia Henry , Blaess Breana , Bethea Brittaney , Floyd Virginia , Hefner David , McClure Shelia , Bond Vincent , Hooker Sandra Harris , Taylor Herman
Published: July 2020

OBJECTIVES/GOALS: Morehouse School of Medicine (MSM), TxTM is a scientific philosophy promoting interdisciplinary approaches towards exponential advances in community and population health. Objectives are to detail the model, pilot funding mechanism, early research findings and infrastructure investments. METHODS/STUDY POPULATION: The health research system has widely acknowledged challenges that can delay research translation to systems that advance health for chronically disadvantaged health disparity population groups. MSM’s vision is to lead the creation and advancement of health equity. The vision-aligned strategic plan prioritized formalization of a TX TM implementation priority. The study population was the institution’s research faculty and leaders, research administration, and communication arm. Through a cross-institutional working group, a plan was deployed to 1) assess the institutional landscape, 2) review the grey and peer reviewed literature on translational research and 3) invest in a pilot research funding mechanism. RESULTS/ANTICIPATED RESULTS: Over $700K has been invested in TX TM implementation. Over half of research faculty completed an institutional landscape assessment to identify translational research expertise, interests and points of interest in new collaboration. The most frequently cited collaborative research interests were clinical research with human subjects, patient-centered outcomes and laboratory-based research with human subjects/specimens. Funded multidisciplinary and/or community-engaged pilot studies investigate the role for circadian rhythms and shift work, cultural variables influencing mental health among Haitians living in the US and integrating prescription reconciliation telehealth in primary care. DISCUSSION/SIGNIFICANCE OF IMPACT: TX TM requires interdisciplinary collaboration across translational research spheres and beyond the academy. Institutional investment, infrastructure support and senior-level champions are central to awareness and rewarding such scholarship towards scaling approaches that advance health equity. CONFLICT OF INTEREST DESCRIPTION: Coined at Morehouse School of Medicine (MSM), Tx TM symbolizes an approach and scientific philosophy designed to intentionally promote and support convergence of interdisciplinary approaches and scientists to stimulate exponential advances for the health of diverse communities.
4407 Adapting CAPABLE as CAPABLE-FAMILY for the caregiver-care recipient dyad with Alzheimer’s dementia
Authors: Rivers Emerald , Taylor Janiece , Hornstein Erika , Szanton Sarah
Published: July 2020

OBJECTIVES/GOALS: The purpose of this 4-phase exploratory study is to create a human-centered protocol for a new program, CAPABLE-FAMILY, to address older adults with physical disability and dementia and their caregivers. METHODS/STUDY POPULATION: The Szanton-Gill Resilience Model, Verbrugge & Jett Disablement, and Life Span Theory of Control are theoretical frameworks guiding this study. Phase 1. Using qualitative research (n = 10 dyads) methods (ex. Photovoice) we seek to understand the context for older adults with dementia regarding disability. Phase 2. Using synthesis/ideation (n = 10 dyads) tools (ex. Journey Maps) we will synthesize the qualitative research during group ideation sessions with stakeholders. Phase 3. Using prototype testing (n = 3 dyads) methods (ex. Semantic Differentials, Storyboards), we will build the most promising prototypes. Phase 4. Using an open-label pilot (n = 3 dyads), we will test the interventions. RESULTS/ANTICIPATED RESULTS: We will assess disability (ADL, IADL), environmental changes pain, depression, polypharmacy, provider communication needs, and caregiver burden. We will interview the dyads and multiple CAPABLE Registered Nurses (RN), Occupational Therapists (OT), and Handymen (HM) about their prior experiences and perceptions of the pilot. CFQ, MocA, pain (BPI), and ZBI will be measured pre/post RN, OT, HM visit. While there are evidence-based programs to separately address cognitive impairment and physical disability, we anticipate this is the first study to develop a community-based goal-directed, human-centered approach for the maintenance of physical function for persons with dementia in the home. DISCUSSION/SIGNIFICANCE OF IMPACT: Persons with more cognitive impairment did not improve as much as those with less cognitive impairment in the original CAPABLE study, an evidenced based program which reduced disability. This suggests the need to adapt CAPABLE to reduce the burden of disability in persons with Alzheimer’s dementia. CONFLICT OF INTEREST DESCRIPTION: None
4185 Assessing Barriers to Retention in Care Continuum Among HCV Positive Homeless Adults of New Orleans
Authors: Santiago Riley Eli , Wisniewski Janna
Published: July 2020

OBJECTIVES/GOALS: This study has two primary aims: 1) evaluate points of success and failure in connecting hepatitis C virus (HCV) positive homeless patients to care following a preliminary positive rapid HCV test result, and 2) describe the barriers cited by patients who drop out at each step in the care continuum. METHODS/STUDY POPULATION: A retrospective longitudinal analysis of adult (18 years or older) homeless individuals accessing shelter at six homeless shelters in New Orleans, LA was conducted. Every patient who came through a testing site received a survey collecting information on demographics, barriers to healthcare, and recent utilization of health services. A retrospective chart review of hospital and homeless clinic medical records was used to track patient linkage to care and their progress through the HCV care continuum. We defined successful linkage to care as attendance at the first scheduled follow-up appointment for treatment with a primary care physician. RESULTS/ANTICIPATED RESULTS: A total of 1719 unique patients were identified from August 2016 through August 2019 which included 36% self-identified as African American/Black, 55% identified as White and 8% identified as mixed-race or other. A total of 24% of individuals reported no insurance coverage while 66% of patients reported having insurance. Overall, 85 patients reported they experienced no barriers to healthcare. Of those who reported barriers, 44% reported trouble with finances or insurance, 22% transportation, 18% personal drug use, 9% personal alcohol use, and 7% reported a distrust of healthcare providers or the system. Other barriers included long wait times, distance, and recent incarceration. DISCUSSION/SIGNIFICANCE OF IMPACT: Although screening for HCV is readily available, barriers exist which prevent diagnosis and treatment. We implemented a HCV testing and linkage-to-care program between local homeless shelters and health centers in New Orleans in an effort to reduce HCV-related morbidity and mortality.
4284 Development of a Survey Instrument to Predict Uptake of and Adherence to Active Surveillance among Men with Low-Risk Prostate Cancer
Authors: Seaman Aaron T , Taylor Kathryn L. , Davis Kimberly , Nepple Kenneth G. , Mengeling Michelle A. , Reisinger Heather Schacht , Hoffman Richard M.
Published: July 2020

OBJECTIVES/GOALS: Active surveillance (AS) is a recognized strategy to manage low-risk prostate cancer (PCa) in the absence of cancer progression. Little prospective data exists on the decisional factors associated with selecting and adhering to AS in the absence of cancer progression. We developed a survey instrument to predict AS uptake and adherence. METHODS/STUDY POPULATION: We utilized a three-step process to develop and refine a survey instrument designed to predict AS uptake and adherence among men with low-risk PCa: 1) We identified relevant conceptual domains based on prior research and a literature review. 2) We conducted 21 semi-structured concept elicitation interviews to identify patient-perceived barriers and facilitators to AS uptake and adherence among men with a low-risk PCa who had been on AS for ≥1 year. The identified concepts became the basis of our draft survey instrument. 3) We conducted two rounds of cognitive interviews with men with low-risk PCa (n = 12; n = 6) to refine and initially validate the instrument. RESULTS/ANTICIPATED RESULTS: Relevant concepts identified from the initial interviews included the importance of patient: knowledge of their PCa risk, value in delaying treatment, trust in urologist and the AS surveillance protocol, and perceived social support. Initially, the survey was drafted as a single instrument to be administered after a patient had selected AS comprising sections on patient health, AS selection, and AS adherence. Based on the first round of cognitive interviews, we revised the single instrument into two surveys to track shifts in patient preference and experience. The first, administered at diagnosis, focuses on selection, and the second, a 6-month follow up, focuses on adherence. Following revisions, participants indicated the revised 2-part instrument was clear and not burdensome to complete. DISCUSSION/SIGNIFICANCE OF IMPACT: The instrument’s content validity was evaluated through cognitive interviews, which supported that the survey items’ intended and understood meanings were isomorphic. In the next phase, we plan to conduct a large-scale prospective cohort study to evaluate the predictive validity, after which it will be available for public research use.
4464 Effect of Surface Topography on In Vitro and Mechanical Performance of 3D Printed Titanium
Authors: Abar Bijan , Kelly Cambre , Pham Anh , Allen Nicholas , Barber Helena , Kelly Alexander , Gall Ken , Adams Samuel
Published: July 2020

OBJECTIVES/GOALS: The goal of the study is to understand how changing the surface roughness of 3D printed Titanium either by processing printed samples or artificially printing rough topography impacts the mechanical and biological properties of the Titanium. METHODS/STUDY POPULATION: Titanium dog bones and discs were printed via laser powder bed fusion. groups were defined as 1. polished, 2.blasted, 4.as built, 4.sprouts and 5.rough sprouts. Roughness was measured with line measurement using a confocal microscope. Tensile testing of dog bones produced stress strain curves. MC3T3 preosteoblast were seeded on discs. Samples were analyzed at 0, 2, and 4 weeks. A cell viability assay and confocal fluorescent microscopy assessed cell growth. Alkaline Phosphatase (ALP) assay and Quantitative Polymerase Chain Reaction (qPCR) examined cell differentiation. Extracellular matrix (ECM) was stained for collagen and calcium. Scanning Electron Microcopy (SEM) was done on sputter coated discs. RESULTS/ANTICIPATED RESULTS: Measured roughness defined by Rz, maximum peak to valley distance of the sample profile ranged from 2.6-65.1 µm. The addition of printed roughness in the sprouts and rough sprouts group significantly diminished ductility resulting in early strain to failure during tensile testing. Cells adhered and proliferated on discs regardless of roughness group. There was no statistical difference in ALP activity, but qPCR showed that rough groups (sprouts and rough sprouts) had diminished Osteocalcin gene expression at week 2 and 4. The ECM in the rough groups was more resistant to repeated washes and was more extensive with SEM. DISCUSSION/SIGNIFICANCE OF IMPACT: Printing roughness diminished mechanical properties without clear benefit to cell growth. Roughness features were on mesoscale, unlike samples in literature on microscale that increase cell activity. Printed topography may aid in implant fixation and not osseous integration as hypothesized. CONFLICT OF INTEREST DESCRIPTION: Dr. Samual Adams, Dr. Ken Gall and Cambre Kelly own stock and/or stock options in restor3d, Inc.
4364 Ethicists’ Viewpoints on Face Transplant: A survey study to guide clinical practice
Authors: Suchyta Marissa , Sharp Richard , Amer Hatem , Bradley Elizabeth , Mardini Samir
Published: July 2020

OBJECTIVES/GOALS: Face transplant can offer functional and aesthetic restoration to patients who have exhausted reconstructive options. Ethical issues in face transplant still abound, including that of patient selection. The goal of this study was to assess ethicists’ viewpoints on face transplant. METHODS/STUDY POPULATION: A large-scale online survey of attendees of the International Conference on Clinical Ethics Consultation (N = 401) was performed to assess ethicists’ opinions on issues in face transplant. Questions were asked regarding the risk-benefit ratio of immunosuppression, permissibility of face transplant for more recipient subpopulations (including children and blind patients), donor-recipient age, gender, and ethnicity mismatches, and ethics committee make-up. RESULTS/ANTICIPATED RESULTS: Among 84 respondents, 84% agreed it is permissible to perform a face transplant on an adult with no medical contraindications. The majority of respondents agreed that it is permissible to perform a face transplant on a child or blind recipient. An issue of continued concern was risk of immunosuppression. Respondents had a high threshold of permissibility for ethnic mismatches between donor and recipient, and 43% reported it is permissible to have a gender mismatch. A 10 year age difference between donor and recipient was the most commonly accepted. Questions regarding the ideal composition of a face transplant ethics committee demonstrated consensus on the roles that should be represented. DISCUSSION/SIGNIFICANCE OF IMPACT: This study provides insight into ethicists’ viewpoints on face transplant, which demonstrates a high level of permissibility towards the procedure. This may be due to the early success of face transplants and the shifting ethical issues in the field to practical aspects of the procedure. This research also provides guidance to programs regarding questions of donor and recipient selection, ethics committee composition, and offers insight into strengthening the ethical framework of the field.
4025 Fall Risk Screening and Referrals to Community-Based Programs among Physical Therapy Professionals
Authors: Vincenzo Jennifer L. , Shubert Tiffany , Brach Jennifer S. , Tripken Jennifer , Schrodt Lori , Sidelinker Jennifer C. , Hazan Patrice , Hergott Colleen , Shirley Kathleen , Rhorer Beth
Published: July 2020

OBJECTIVES/GOALS:

To describe trends in fall risk screening and referrals to community-based programs among physical therapy professionals.

To compare fall risk screening practices to clinical practice guidelines among

To identify gaps in fall risk screening and referrals to community-based programs among physical therapy professionals.

METHODS/STUDY POPULATION: A panel of experts between the American Physical Therapy Association (APTA) - Geriatrics, and the National Council on Aging (NCOA) developed a web-based survey to identify practices among physical therapy professionals (PTs) for fall risk screenings and community-based referrals for older adults. The web-based survey was disseminated to PTs via email, e-blasts, and social media. The survey focused on questions related to knowledge of fall risk screening tools, fall risk management for older adults, and knowledge of and referrals to community-based interventions. RESULTS/ANTICIPATED RESULTS: To date, 453 PTs representing 50 states completed the survey. The majority of PTs (50.9%) had over 20 years of experience in various settings. Eighty-three percent regularly screen older adults for fall risk. Approximately 40% conduct community-based screenings. The majority (81.3%) were somewhat to very familiar with the CDC-recommended STEADI (Stopping Elderly Accidents, Deaths, and Injuries) screening toolkit. Despite familiarity, only 32% responded to the question if they used STEADI for screening. Of those, 83.4% used the tool. The majority (73.4%) of PTs were aware that NCOA recommends evidence-based programs to address health needs of aging adults and 59.6% refer. PTs did not refer due to lack of knowledge that programs existed (21.3%) or lack of knowledge of availability (33.3%). DISCUSSION/SIGNIFICANCE OF IMPACT: Although PTs are have some familiarity with the STEADI for fall risk screening, the tool is not common in practice. PTs are lacking awareness of local evidence-based community programs to address health needs of aging adults. Educational efforts should target these knowledge gaps and provide additional resources to improve referrals.
4115 Fostering a learning environment to train and support versatile scientists who integrate science into real world operations of complex, dynamic health and public health systems
Authors: Kuo Tony , Inkelas Moira , Arah Onyebuchi A. , Manuel Vladimir G.
Published: July 2020

OBJECTIVES/GOALS: The UCLA Clinical and Translational Science Institute’s Population Health Program is creating versatile scientists who can solve population health problems. This means building learning capability in health care and public health agencies, and fostering a cross-sector, outcomes-based, regional ecosystem for implementation and improvement. METHODS/STUDY POPULATION: A synthesis of achievements and lessons learned reveals the Program’s trajectory. It maps progress in science leading to sustainable interventions for target populations. PHP goals are predicated on networked team science, rather than disorganized assortment of individual studies and interventions, and emphasize design, modeling and iteration. Evolving metrics include network analysis to document collaborative impact; extent of integrating real-world application into systems science and learning system curriculum; legislative and institutional policies developed and adopted; evidence of system orientation, cross-sector focus, and implementation research in scientists’ portfolios; and demonstration of population health impact. Barriers offer the opportunity for iteration and improvement. RESULTS/ANTICIPATED RESULTS: The PHP has progressed in its envisioned shared university-public health stewardship of translation and transformation. Milestones included galvanizing activities such as annual regional dissemination, implementation, and improvement (DII) symposia and Public Health Science Summits; pre- and post-doctoral experiential learning of system science and learning system methods based in Los Angeles County Health Agency initiatives; development of a regional CTSA network for implementation science training; strengthened public health policy practice (e.g., establishing a new Office of Youth Diversion and Development); learning healthcare system capability; and prototypes of population learning systems focused on hypertension, food insecurity, tobacco/vaping, and complex care management. DISCUSSION/SIGNIFICANCE OF IMPACT: PHP is committed to advancing science for population health. Prototypes were an essential initial phase. New areas include use of methodological advances (e.g., artificial intelligence, rapid assessments) in health and public health systems; an academic home for full-time, population-focused clinicians; and social policy innovations.
4098 Health and HIV: Weight status associations with multiple co-morbidities
Authors: Butler Kierra Renee , Harrell Faye R. , Robinson Jeffrey , Rahim-Williams Bridgett , Henderson Wendy A.
Published: July 2020

OBJECTIVES/GOALS: Highly Active Antiretroviral Therapy (HAART) is beneficial for managing HIV infection, however the long-term use of HAART may be problematic for healthy weight maintenance. The aim of the study was to investigate the association of race, weight status, and co-morbidities among individuals with HIV. METHODS/STUDY POPULATION: Self-reported data from 283 participants who completed the Symptom Checklist, the Co-Morbidity Questionnaire, and the Sociodemographic Questionnaire were included in the data analyses. Data were analyzed using Latent Class Analysis on JMP 13. Approximately 50% of participants self-identified as Black, 69% as male, and 35% as having AIDS. Participants’ age ranged from 25 to 66 years (mean age = 43.70 years, SD = 8.14). Participants were grouped by race (self- reported Black or non-Black), and then each group was clustered based on the top three most prevalent symptoms. The clusters identified were least symptomatic, weight gain, and weight loss. RESULTS/ANTICIPATED RESULTS: The non-Black weight gain cluster reported a higher incidence of AIDS (70.6% vs 38.2%), nausea (70.6% vs 17.6%), diarrhea (70.6% vs 26.5%), and shortness of breath (58.8% vs 20.6%) compared to the Black weight gain cluster. The Black weight loss cluster reported a higher incidence of cardiovascular symptoms including chest palpitations (42.2% vs 2.7%), chest pain (44.4% vs 8.1%), and shortness of breath (73.3% vs 35.1%) and a higher incidence of all GI symptoms with the most prominent being diarrhea (71.1% vs 48.6%) compared to the non-Black weight loss cluster. DISCUSSION/SIGNIFICANCE OF IMPACT: Future studies supporting these results will assist practitioners to target treatments that may prevent adverse health outcomes for individuals with HIV on HAART. Further studies will also assist with setting standards that allow practitioners to provide personalized care for individuals with HIV on HAART.
4288 Identifying Predictive Variables of High-Intensity Binge Drinking Through the Use of a Machine Learning Algorithm
Authors: Morris James Keoni , Gowin Josh L. , Schwandt Melanie L. , Diazgranados Nancy , Ramchandani Vijay A.
Published: July 2020

OBJECTIVES/GOALS: To test if a machine learning algorithm could predict a person’s capacity to binge drink and explore what measures might be important for identifying individuals at risk for high-intensity binge drinking behaviors. METHODS/STUDY POPULATION: The sample included 1177 (474 female) non-treatment-seeking drinkers (age: 18-91 years), that were assigned to a group based on their heaviest drinking day reported in a 90-Day Alcohol Timeline Followback questionnaire. The groups were Non-Bingers (female: 12 drinks, male:>15 drinks). The sample was divided into a training sample (N = 884) and a testing sample (N = 293). A machine learning algorithm called random forest was then used to generate a predictive model based on measures of substance use, personality traits, and trauma. The model was applied to the testing sample to determine accuracy. RESULTS/ANTICIPATED RESULTS: The first model correctly assigned 190 out of 293 subjects, giving it a total error rate of 0.35, with lowest rates for non-binge (0.19) and high-intensity (0.18), while medium-intensity had the highest error rate (0.86). The most important variables for the accuracy of the model included: total score on the Alcohol Use Disorder Identification Test, first five sub-score of the Self-Reported Effects of Alcohol, Compulsive Drinking subscale, and presence of a current psychiatric diagnosis. As a follow-up analysis, we built and tested another random forest model without the use of drinking dependence measures. This model had a total error rate of 0.39, and introduced other important variables such as smoking behaviors, perceived stress, IQ, and number of negative life events. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study showed that it was possible for a machine learning algorithm to predict binge drinking intensity better than chance. Drinking patterns were the most robust predictors, and stress, IQ, and psychiatric diagnoses were also useful in predicting binge drinking intensity.
4488 Neural Network of the Cognitive Model of Reading
Authors: Posner Joseph , Dickens Vivian , DeMarco Andrew , Snider Sarah , Turkeltaub Peter , Friedman Rhonda
Published: July 2020

OBJECTIVES/GOALS: A particularly debilitating consequence of stroke is alexia, an acquired impairment in reading. Cognitive models aim to characterize how information is processed based on behavioral data. If we can concurrently characterize how neural networks process that information, we can enhance the models to reflect the neuronal interactions that drive them. METHODS/STUDY POPULATION: There will be 10 unimpaired adult readers. Two functional localizer tasks, deigned to consistently activate robust language areas, identify the regions of interest that process the cognitive reading functions (orthography, phonology, semantics). Another task, designed for this experiment, analyses the reading-related functional-connectivity between these areas by presenting words classified along the attributes of frequency, concreteness, and regularity, which utilize specific cognitive routes, and a visual control. Connectivity is analyzed during word reading overall vs. a control condition to determine overall reading-related connectivity, and while reading words that have high vs. low attribute values, to determine if cognitive processing routes bias the neural reading network connectivity. RESULTS/ANTICIPATED RESULTS: The localizer analysis is expected to result in the activation of canonical reading areas. The degree of functional connectivity observed between these regions is expected to depend on the degree to which each cognitive route is utilized to read a given word. After orthographic, phonologic, and semantic areas have been identified, the connectivity analysis should show that there is high correlation between all three types of areas during reading compared to the control condition. Then the frequency, regularity, and concreteness of the words being read should alter the reliance on the pathways between these area types. This would support the hypothesized pattern of connectivity as predicted by the cognitive reading routes. Otherwise, it will show how the neural reading network differs from the cognitive model. DISCUSSION/SIGNIFICANCE OF IMPACT: The results will determine the relationship between the cognitive reading model and the neural reading network. Cognitive models show what processes occur in the brain, but neural networks show how these processes occur. By relating these components, we obtain a more complete view of reading in the brain, which can inform future alexia treatments.
4532 Pancreatic Cyst Risk Stratification for Early Detection of Pancreatic Cancer Using Quantitative Radiomics and Activity-Based Biomarkers
Authors: Hernandez Sophia , Lourenco Andre Luiz , Calabrese Evan , York Tyler , Glencer Alexa , Behr Spencer , Wang Zhen Jane , Koay Eugene , Craik Charles , Kirkwood Kimberly
Published: July 2020

OBJECTIVES/GOALS: Pancreatic cysts are comprised of both precancerous mucinous lesions and non-mucinous lesions with minimal malignant potential. Our goal is to improve our ability to classify the type of cyst using a combination of novel radiomic features and cyst fluid proteolytic activity. METHODS/STUDY POPULATION: Preoperative pancreatic protocol CT images from 30 patients with proteolytic assay characterization, followed by surgical resection with a pathologically confirmed pancreatic cyst diagnosis between 2016-2019 will be used in this study. We will contour images using the widely available software 3D Slicer, and extract radiomic features using IBEX software. We will analyze area under the ROC curves to identify the radiomic features that best differentiate mucinous from non-mucinous cysts, and identify features to be cross validated. The predictive ability of identified radiomic features combined with proteolytic assay will be determined by performing multiple logistic regression analysis and comparing AUROC analysis. We will determine sensitivity and specificity for individual, as well as combinations of, analytes to determine the optimal classifier. RESULTS/ANTICIPATED RESULTS: We anticipate that the predictive ability, sensitivity, and specificity of utilizing radiomic features combined with proteolytic assay data will exceed the performance of any individual test. DISCUSSION/SIGNIFICANCE OF IMPACT: This work is designed to provide a predictive radiomic model that will enable us to better identify mucinous cysts that require further evaluation, and potentially prevent unnecessary surgery in other patients. Ultimately, we would like to improve the accuracy of noninvasive radiographic evaluation using radiomic markers. CONFLICT OF INTEREST DESCRIPTION: Dr. Charles Craik is a co-founder of Alaunus Biosciences, Inc.
4012 Positive Deviants for Medication Therapy Management: A Mixed-Methods Comparative Case Study of Community Pharmacy Practices
Authors: Adeoye-Olatunde Omolola A , Lake Leslie M. , Hudmon Karen S. , Zillich Alan J. , Snyder Margie E.
Published: July 2020

OBJECTIVES/GOALS: To optimize medication use in older adults, Medication Therapy Management (MTM) was launched as part of Medicare Prescription Drug (Part D) policy. The objective of this study was to generate hypotheses for strategies that contribute to community pharmacies’ ability to achieve high performance on policy relevant MTM quality measures. METHODS/STUDY POPULATION: This mixed-methods comparative case study design incorporated two conceptual models; the Positive Deviance model and Chronic Care Model. The study population consisted of pharmacy staff employed by a Midwestern division of a national supermarket-community pharmacy chain. Data consisted of semi-structured interviews and demographics. Qualitative and quantitative data were analyzed abductively or using descriptive statistics, respectively. Case comparisons were synthesized using the Framework Method. MTM quality measures used to evaluate participant pharmacies’ MTM performance mirrored quality measures under Domain 4 (Drug Safety and Accuracy of Drug Pricing) of the 2017 Medicare Part D Plan’ Star Rating measures. RESULTS/ANTICIPATED RESULTS: Staff at 13 of the 18 selected pharmacies (72.2%) participated in interviews. Interviewees included 11 pharmacists, 11 technicians and three student interns. Strategies hypothesized as contributing to MTM performance included: 1. Strong pharmacist-provider relationships and trust, 2. Inability to meet patients’ cultural, linguistic, and socioeconomic needs (negatively contributing), 3. Technician involvement in MTM, 4. Providing comprehensive medication reviews in person vs. phone alone, 5. Placing high priority on MTM, 6. Using maximum number of clinical information systems (CISs) to identify eligible patients. 7. Technicians using CISs to collect information for pharmacists, 8. Faxing prescribers adherence medication therapy problems (MTPs) and calling on indication MTPs. DISCUSSION/SIGNIFICANCE OF IMPACT: Our study resulted in eight strategies hypothesized to contribute to community pharmacy performance on MTM quality measures. To inform MTM policy recommendations, future research should engage stakeholders to assist with prioritizing hypotheses to be tested in a larger representative sample of pharmacies. CONFLICT OF INTEREST DESCRIPTION: This research was supported, in part, with support from the Indiana Clinical and Translational Sciences Institute funded, in part by grant number TL1TR001107 from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. Dr. Adeoye-Olatunde is a part-time employee and Dr. Lake is a full-time employee at the Midwestern division, national supermarket-community pharmacy chain, where study procedures were conducted. Dr. Snyder reports personal fees from Westat, Inc., outside the submitted work.
4516 Sex Differences in the Cortical Structure in Children with Irritability and Disruptive Behavior
Authors: Ibrahim Karim , Li Fangyong , He George , Pelphrey Kevin , McCarthy Gregory , Sukhodolsky Denis
Published: July 2020

OBJECTIVES/GOALS: This study examines sex differences in brain structure in youths with disruptive behavior disorders (DBD). We use measures of gray matter volume (GMV) in regions-of-interest implicated in the pathophysiology of conduct problems and a whole-brain analysis of cortical thickness. We also examine unique associations between brain structure and callous-unemotional traits. METHODS/STUDY POPULATION: This study included 90 children with a DBD (30 females) aged 8-16 and 50 Healthy Controls (20 females) matched for age and IQ. Children received a diagnostic evaluation using the K-SADS. Pre-processing was conducted using FreeSurfer. For ROI analyses, multivariate GLM models were conducted in SPSS for estimates of GMV to examine the main effects of diagnosis and sex, and sex-by-diagnosis interactions. Whole-brain analyses were conducted in FreeSurfer. Associations were examined between structure and parent ratings of callous-unemotional (CU) traits using the Inventory of Callous-Unemotional Traits in regression analyses in the DBD group, while controlling for the variance in aggressive behavior using the Child Behavior Checklist Aggressive Behavior Scale. All analyses controlled for differences in intracranial volume. RESULTS/ANTICIPATED RESULTS: Relative to controls, children with DBD showed reduced GMV in the bilateral amygdala (left: p = .004; right: p = .04). Sex-by-diagnosis interactions were observed in the left ventromedial prefrontal cortex (p = .004), right insula (p = .001), right inferior frontal gyrus (p = .02), and bilateral anterior cingulate (left: p = .02; right: p = .01) in which DBD males showed lower and DBD females showed higher GMV relative to respective controls. For whole-brain analyses, a significant sex-by-diagnosis interaction was observed in the left ventromedial prefrontal cortex and supramarginal gyrus indicating that DBD males showed lower and DBD females showed higher cortical thickness relative to respective controls. Sex-by-CU traits interactions were observed for left amygdala and ACC volumes. DISCUSSION/SIGNIFICANCE OF IMPACT: The current study provides evidence of reduced amygdala volume in children with DBD, and interactions between sex and diagnosis in the ventromedial prefrontal cortex and supramarginal gyrus, which may have implications for identifying sex-sensitive neural biomarkers. CONFLICT OF INTEREST DESCRIPTION: Disclosures: Dr. Sukhodolsky receives royalties from Guilford Press for a treatment manual on CBT for anger and aggression in children. Drs. Ibrahim, He, Pelphrey, McCarthy, and Mr. Li have no biomedical financial interests or potential conflicts of interest to declare related to this present study.
4402 The effects of hemodilution in vitro on coagulation in term parturients using thromboelastometry
Authors: Getrajdman Chloe , Sison Matthew , Lin Hung-Mo , Katz Daniel
Published: July 2020

OBJECTIVES/GOALS: Little is known about the effect of hemodilution with crystalloid on blood coagulation in obstetric patients. The purpose of our study was to examine the impact of hemodilution on components of blood coagulation using rotational thromboelastometry (ROTEM®) in term parturients METHODS/STUDY POPULATION: This is a prospective, observational pilot study including 35 healthy, pregnant patients at term (≥37 weeks) without history of bleeding or clotting disorder or on medication affecting coagulation. Venous blood samples were collected from all patients and divided into specimen tubes to generate varying degrees of hemodilution with Plasma-Lyte (0%, 20%, 25%, 30%, 35%, 40%, 45%, 55%, 60%, 65%, 70%, 75%, 80%). Rotational thromboelastometry was then performed on samples to assess for coagulation changes. RESULTS/ANTICIPATED RESULTS: EXTEM (extrinsically activated assay) clotting time (CT) became prolonged at 65% hemodilution and above, and the median CT was in the coagulopathic range (>80 seconds) at a dilution of 80%. FIBTEM (extrinsically activated assay with platelet inhibitor, primarily measuring contribution of fibrinogen to coagulation) amplitude at 5 minutes (A5) began to diminish at 35% hemodilution, with the median A5 in the coagulopathic range (<12 mm) at 55% hemodilution. The area under the curve (AUC), a marker of clot strength, for EXTEM and FIBTEM consistently declined as hemodilution increased. Greater decreases in FIBTEM AUC were seen compared to EXTEM AUC, with the ratio of FIBTEM:EXTEM AUC at each dilution demonstrating a statistically significant difference from baseline. DISCUSSION/SIGNIFICANCE OF IMPACT: All thromboelastometry values demonstrated a hypocoagulable trend as hemodilution increased. However, the samples analyzed by the FIBTEM assay trended toward a coagulopathy at a lower degree of hemodilution compared to the EXTEM assay. As FIBTEM tests analyze the role of fibrinogen in hemostasis and EXTEM tests analyze the role of platelets, our findings suggest that platelets may be able to withstand higher degrees of hemodilution before impairing hemostasis compared to fibrinogen. These findings support the growing body of literature that in early stages of severe obstetric hemorrhage, the prioritization of fibrinogen replacement may be critical in preventing further coagulopathy. CONFLICT OF INTEREST DESCRIPTION: All authors have no conflicts of interest to report.
4540 THE IMPACT OF SURGEON AND HOSPITAL VOLUME ON 30-DAY OUTCOMES AND COST FOR RENAL CANCER SURGERY
Authors: Wainger Julia , Cheaib Joseph , Patel Hiten , Huang Mitchell , Biles Michael , Johnson Michael , Canner Joseph , Allaf Mohamad , Pierorazio Phillip
Published: July 2020

OBJECTIVES/GOALS: Provider and hospital factors influence quality, but granular data is lacking to assess their impact on renal cancer surgery. The Maryland Health Service Cost Review Commission (HSCRC) is an independent state agency that promotes cost containment, access to care and accountability. Within HSCRC, we aimed to assess the impact of surgeon and hospital volume on 30-day outcomes after renal cancer surgery. METHODS/STUDY POPULATION: Data on renal surgery were abstracted from the Maryland HSCRC from 2000-2018. We excluded patients younger than 18, patients without a diagnosis of renal cancer, and patients concurrently receiving another major surgery. Volume categories were derived from the distribution of mean cases performed per year. We used adjusted multivariable logistic and linear regression models to identify associations of surgeon and hospital volume with the length of stay, days in intensive care, cost, 30-day mortality, readmission, and complications. RESULTS/ANTICIPATED RESULTS: A total of 10,590 surgeries, completed by 669 surgeons at 48 hospitals, met criteria. The 25th percentile for cases per year was 1, the 50th percentile was 1.2, and the 75th percentile was 2.6. After adjusting for patient factors and cumulative surgeon experience, high volume surgeons had the greatest decrease in length of stay (β: −1.65, P<0.001) and mortality risk (OR: 0.27, 95% CI: 0.10-0.71) compared to rare volume surgeons. Low volume surgeons had the greatest cost decrease (β: -$7,300, P<0.001) compared to rare volume surgeons. Medium volume hospitals had statistically lower average costs than rare volume hospitals (β: $−2,862, P = 0.005). There were no other clinically and statistically significant relationships between volume and measured outcomes. DISCUSSION/SIGNIFICANCE OF IMPACT: Almost half of the urologists studied performed an average of one renal cancer case per year. Greater surgeon volume was associated with shorter length of stay and decreased mortality risk. Hospital volume did not have a meaningful relationship to outcomes. Other factors such as tumor, surgeon, and hospital characteristics or case-mix may associate with outcomes and could be confounders.
4024 Theory and Scale Development for Cancer-Related Self-Efficacy in Partners of Breast Cancer Survivors
Authors: Cohee Andrea , Draucker Claire , Monahan Patrick , Champion Victoria
Published: July 2020

OBJECTIVES/GOALS: Specific aims are to: (Qualitative aim) Develop a new measure of cancer-related self-efficacy in partners (BCSES-P) and obtain feedback on the items (Quantitative) Evaluate the psychometric properties of the BCSES-P including: dimensionality, factor analysis, and construct validity assessing the relationships posited METHODS/STUDY POPULATION: 2-Phase Approach: 1) Item development and 1) Item testing Phase 1 Stage 1: Literature review to identify additional covariates Stage 2: Focus groups and individual interviews to determine partners’ needs Sample size: 20 partners (18 years of age or older, identifying as being in a committed relationship with a BCS) Design: cross-sectional, qualitative interviews Stage 3: Develop candidate items Stage 4: Cognitive interviews Stage 5: Finalize items with research team Phase 2 Preliminary psychometric testing Dimensionality Internal consistency reliability Construct validity Sample size: 150 partners Design: cross-sectional, online survey RESULTS/ANTICIPATED RESULTS: The BCSES-P will be unidimensional as assessed by exploratory factor analysis. The BCSES-P will demonstrate an internal consistency coefficient of 0.70 or above. Construct validity of the BCSES-P will be demonstrated by support of the following theoretical relationships: Cancer-related self-efficacy will be positively related to marital satisfaction and sexual functioning (social well-being) and the distal outcome, overall QoL. Cancer-related self-efficacy will be negatively related to fatigue (physical well-being), fear of recurrence, depression, and anxiety (psychological well-being). DISCUSSION/SIGNIFICANCE OF IMPACT: Findings will guide intervention development to improve partners’ quality of life The BCSES-P will be the first scale to measure partners’ cancer-related self-efficacy. This study will highlight a holistic approach to studying the long-term effects of breast cancer on partners.
4397 Virtual Reality Meditation for Acute Post-Operative Pain of Inpatient Adults: Preliminary Results
Authors: Dreesmann Nathan J. , Thompson Hilaire J. , Buchanan Diana T. , (Jean) Tang Hsin Yi , Sharar Sam R. , Rayhill Stephen C. , Furness Thomas A.
Published: July 2020

OBJECTIVES/GOALS: This study’s goal is to examine the feasibility and acceptability of using VRM to impact the APP of adults in the inpatient setting. Aims include examining the: 1) feasibility of VRM for APP management; 2) acceptability of using VRM for APP management; and 3) experience of VRM for APP management. METHODS/STUDY POPULATION: To comprehensively examine participants’ experience of using VRM for APP, this study will employ a convergent mixed-methods design in which living kidney donors (N = 45) will be recruited to serially use VRM during their hospital stay. Feasibility and acceptability will be evaluated using descriptive and inferential statistics evaluating patient-reported outcome (PRO) measures taken pre-, post- and 1-hour post-VRM, PRO measures extracted from the participant’s electronic health record and data on VRM use. Semi-structured interviews will allow formulation of inferences based on participants’ experience of VRM for APP management and their insights on content, deployment, and clinical use of VRM. RESULTS/ANTICIPATED RESULTS: This in-process study expects: 1) an adequate sample of participants undergoing living kidney donor surgery who agree to enroll with retention of >90% of participants (Aim 1); 2) participants to report VRM as an acceptable and suitable treatment, feel “present” and interested in the VR environment, and feel comfortable using VRM in the hospital (Aim 2); and 3) to provide insight into participants’ experience of VRM for APP, understanding of extended VRM use for APP analgesia, examination of key variables affecting participants’ experience of VRM for APP and feedback about VRM procedures and protocol to inform future VRM use for APP management (Aim 3). DISCUSSION/SIGNIFICANCE OF IMPACT: Results of the proposed study will inform future clinical testing and deployment of VRM, guide future use of VRM as an adjunct for inpatient APP management, and provide insight into inpatients’ experience of VRM for APP analgesia.
4163 Aging and Smoking Exacerbates Post-Stroke Complement Driven Neuroinflammation
Authors: Couch Christine
Published: July 2020

OBJECTIVES/GOALS: Following stroke, complement-dependent neuroinflammation exacerbates secondary injury and worsens acute and chronic outcomes. We have shown that an injury site-targeted complement inhibitor (B4Crry), that targets specifically to the ischemic brain, inhibits complement activation leading to improved outcomes. Stroke comorbidities have been shown to promote a pro-inflammatory environment in the brain and systemically, and to exacerbate inflammatory responses after injury. We investigated the impact of age and smoking on acute outcomes after stroke and assessed whether increased complement activation contributes to the worsening outcomes with these stroke comorbidities. METHODS/STUDY POPULATION: Mouse brain endothelial cells (bEnd3) were exposed to hypoxia followed by exposure to serum that was derived from either cigarette smoke (CS)-exposed mice or naïve mice, and IgM and C3d deposition assessed. Adult (12 weeks) and aged (1 year) mice were subjected to 1h transient middle cerebral artery occlusion. Animals were exposed to CS for 3-6 months (5hr/day, 5days/week) by burning 3R4F cigarettes using a smoking machine. Animals were treated with B4Crry or vehicle intravenously 2h post-MCAO. Survival analysis and neurological deficit scores were performed up to 7 days. Brains were extracted for histological and molecular analyses. RESULTS/ANTICIPATED RESULTS: Following hypoxia, bEnd3 cells exposed to serum from CS-exposed mice had higher C3d and IgM deposition compared to naïve serum. Older and CS-exposed mice had significantly worse neurological deficits and mortality compared to younger adults post-MCAO. B4Crry reduced mortality and motor deficits in young, old and old+CS mice with a higher effect size in comorbid animals. Age and/or CS exposure resulted in larger infarct volumes, and increased levels of C3d deposition and microglial activation compared to young adults, but aged/CS animals treated with B4Crry fared comparable to young adults. DISCUSSION/SIGNIFICANCE OF IMPACT: The pro-inflammatory effects of aging and smoking contribute to worse stroke outcomes, and these effects can be successfully mitigated by injury site-targeted complement inhibition.
4427 Angiopoietin F-domain valency determines outcome of Tie2 receptor engagement and accelerates angiogenesis in tissue regeneration
Authors: Zhao Yan Ting , Fallas Jorge , Saini Shally , Ueda George , Somasundaram Logeshwaran , Zhou Ziben , Seller Drew , Baker David , Ruohola-Baker Hannele
Published: July 2020

OBJECTIVES/GOALS: Lack of blood vessels remains a major obstacle in tissue regeneration. Angiopoietin 1 and 2 modulate angiogenesis through the Tie2 receptor tyrosine kinase. Ang1 activates pAKT to promote endothelial cell survival while Ang2 antagonizes these effects. We aim to dissect the Ang/Tie2 pathway to uncover the molecular basis for these opposing effects. METHODS/STUDY POPULATION: Ang1 and Ang2 bind Tie2 via nearly identical F-domains (Fd). To investigate the molecular basis regulating the Tie2 pathway, we generated a series of computationally designed self-assembling protein scaffolds presenting F-domains in a wide range of valencies and geometries using Rosette Molecular Modeling Suite. We examined the protein kinase activation, cell migration, and blood vessel formation produced by the designed proteins in human umbilical vein endothelial cells. RESULTS/ANTICIPATED RESULTS: Two phenotypic classes were demonstrated by the number of presented F domains: scaffolds presenting 3 or 4 Fd have Ang2 like activity, upregulating pFAK and pERK but not pAKT and failing to induce cell migration and tube formation; scaffolds presenting more than 6 Fd have Ang1 like activity, upregulating the three signaling branches and enhancing cell migration and tube formation. Scaffolds with 8 or more Fd show superagonist activity, producing significantly stronger phenotypes than Ang1. These results suggest that Fd valency largely determines Ang1 vs Ang2 signaling outcomes, and our designed superagonists can outperform Ang1 in vascularization and wound healing. In in vivo experiments, nanoparticles displaying 60 copies of Fd produce significant revascularization in hemorrhagic brains. DISCUSSION/SIGNIFICANCE OF IMPACT: Targeting the Tie2 pathway is a new paradigm in regenerative medicine. Our designed constructs will enable us to generate high-affinity Tie2 agonists and antagonists as drugs to control angiogenesis, enabling tissue regeneration that recapitulates the biological architecture of the native tissue physiology, improving organ transplant outcome.