OBJECTIVES/SPECIFIC AIMS: This study seeks to evaluate the role of PCOS in insulin resistance and sleep apnea in adolescents. METHODS/STUDY POPULATION: 37 adolescent patients 13-21 with PCOS (27 obese, 11 lean), along with 8 controls ages 18-21 were recruited. Subjects underwent a hyperinsulinemic euglycemic clamp study and a proportion of the PCOS subjects also underwent polysomnography. Baseline parameters were compared and M/I (index of insulin sensitivity), and GIR were compared. RESULTS/ANTICIPATED RESULTS: M/I was only statistically significantly different between obese PCOS subjects vs control (0.056 vs 0.17, p=0.0061). GIR was higher in the obese PCOS group compared to the lean PCOS group (2.48 vs 6.79, p=0.0001). There were no differences in GIR between the lean PCOS subjects and control (6.79 vs 9.08, p=0.30). 21 obese PCOS subjects and 10 lean PCOS underwent polysomnography. None of the lean PCOS subjects had obstructive sleep apnea (OSA). 8 of the obese subjects had OSA. DISCUSSION/SIGNIFICANCE OF IMPACT: More studies are needed to assess insulin sensitivity and sleep apnea in adolescents with lean PCOS. Our study did not find more insulin resistance in adolescents with PCOS compared to lean controls apart from what would be expected from obesity. Of adolescent obese subjects with PCOS, OSA seems quite prevalent and providers should consider screening and referral for these patients.

Objectives/Goals: Community-based practices have limited research opportunities for providers. As a rural community-based health system, Mayo Clinic Health System (MCHS) sought to create intramural funding mechanisms to help early-stage researchers conduct pilot research so they are more competitive to compete for more robust extramural funding opportunities. Methods/Study Population: We created a Research Seed Grant Program infrastructure across our four MCHS regions (Southwest and Southeast Minnesota, Northwest and Southwest Wisconsin). This model program featured an initial research funding announcement call based on 6 prioritized programs (AI Validation & Stewardship, Cancer, Health Equity, Population Health, Rural Health, Learning Healthcare System [LHS]), with submissions uploaded to a central electronic repository. Proposal review and ranking was organized on a regional basis, with ranking of all proposals by at least 2 clinical scientist reviewers according to the NIH domain-specific framework (i.e., 1.0 best > 9.0 worst). Awards were competitively selected by conformity to prioritized research areas and through ranking of most competitive overall application scores. Results/Anticipated Results: For our inaugural RFA, we received 55 grant application submissions across the MCHS regions. Fifteen of the most highly ranked applications were selected for awards on a per region basis, providing direct funding as well as protected investigator research time of 10% for up to six months. The selected projects address several research priorities including improving access, reducing health disparities, improving behavioral health in our communities, increasing cancer screening and prevention, and community-based pragmatic trials and interventions. Outcomes from these now completed pilot projects remain pending at this time. Funding for this seed grant program was supported by philanthropy, Mayo Clinic Research Administration, Mayo Clinic Comprehensive Cancer Center, and the Mayo Clinic CCaTS Rural Core. Discussion/Significance of Impact: We present this framework for a LHS-focused Seed Grant program model for consideration of adoption by other national/international LHS. Future plans include tracking of outcome metrics (e.g., published peer review articles, extramural grant applications) of this initial cycle and future expansion of this program to support the goals of our LHS.

OBJECTIVES/SPECIFIC AIMS: The American Academy of Pediatrics (AAP) recommends that preschool-aged children spend no more than 2 hours/day using digital screens such as TVs. However, there is a proliferation of digital screens in children’s daily lives both at school and at home. The purpose of this study was to examine factors that contribute to children’s screen-time, including their demographic characteristics and whether or not they have screen-time at school. METHODS/STUDY POPULATION: In total, 59 children (3.3±0.4 years of age; 47% female) enrolled in 3 child care centers participated. Center directors reported school screen-time; 1 center was classified as not providing screen-time and 2 centers were classified as providing screen-time. Parents reported child’s age, sex, and maternal education as a proxy for socio-economic status. Parents reported child’s out-of-school screen-time by responding to the question “During the past 30 days, on average how many hours per day did your child sit and watch TV or videos outside of school?” Additional questions queried how many hours per day did the child “use a computer or play computer games,” “play video games,” “use a smartphone,” and “use an iPad or tablet.” Children’s height and weight were collected using standard clinic procedures and body mass index (BMI) was calculated. T tests were used to examine differences in screen-time by age, sex, and school screen-time. General linear models were used to examine the influence of school screen-time (1=no screen-time, 0=between 1 and 60 min/day of screen-time), age, BMI, and maternal education on out-of-school screen-time and time spent with each device. Logistic regression analysis was used to examine likelihood of meeting screen-time recommendations based on the same characteristics. RESULTS/ANTICIPATED RESULTS: Parent-reported total screen-time was 6.3±3.6 hours/day (h/d); specifically, 2.5±1.1 h/d watching TV, 1.5±2.2 h/d using a smartphone, 1.1±0.9 h/d using a tablet, 0.8±1.0 h/d on a computer, and 0.5±0.7 h/d playing video games. Based on total screen-time, 15% of children met AAP recommendations; based on TV viewing only, 52% met AAP recommendations. The 4-year-old children viewed more screen-time overall compared to the 3-year-old children including on TV, computer, and tablet (p<0.05), but there were no sex differences. In fully adjusted linear models, out-of-school screen-time was lower among those who had no screen-time at school (p=0.02) and higher among older children (p<0.01). Computer use was higher among older children (p=0.02). Older children and those with lower maternal education were less likely to meet clinical recommendations based on TV viewing (p<0.05). There were no observed associations with likelihood of meeting clinical recommendations based on total screen-time. BMI was not a significant predictor of screen-time. DISCUSSION/SIGNIFICANCE OF IMPACT: The majority of children exceeded AAP screen-time limits, with screen-time sharply higher among older children, and the associations did not vary by weight status. Children who attended schools that allowed screen-time had higher amounts of out-of-school screen-time. Pediatricians and healthcare providers should query parents on children’s screen-time practices at home and at school and offer strategies to help families meet the clinical recommendations.

OBJECTIVES/GOALS: This project has two linked aims. (1) It seeks to integrate the TSBM into specific practices and processes to advance its integration into translational research and translational science processes. (2) Via this integration, it aims to determine ways to expand the TSBM as a conceptual model. Ultimately, we aim to advance the TSBM framework and use. METHODS/STUDY POPULATION: We developed a process that implemented and integrated the TSBM within three intentionally-distinct processes. First, we expanded the use of the TSBM case study from a focus on research studies to a focus on translational research programs, and specifically workforce development programs. Second, we integrated TSBM domains and indicators into a new Duke CTSA-wide database used to track, monitor, and assess activities and achievements across the CTSA. Third, we embedded TSBM and its indicators into our Pilots projects application and review process as well as ongoing reporting. RESULTS/ANTICIPATED RESULTS: We were able to successfully integrate the TSBM model into the processes indicated in methods, yet this integration identified opportunity to improve the model to enhance its applicability and value. We found the TSBM applies in distinct ways to translational science programs compared to research studies, with added indicators better accommodating TSBM application to programs. To properly integrate TSBM into progress monitoring systems, we found added needs to ensure comprehensibility for a wide array of researchers and program implementers. Across uses, we identified challenge distinguishing between TSBM benefits as demonstrated versus potential and ambiguity in potential as based on time to benefit realization, likelihood of realization, or centrality of a specific project to realization. DISCUSSION/SIGNIFICANCE: Our session contributes significantly to the field of translational research and science through its focus on advancement and implementation of an innovated model in its early stages, including how researchers and translation science entities can incorporate this model into their own work beyond the traditional use of case studies.

ABSTRACT IMPACT: Our research has the potential to impact human health by identifying gender specific neural markers of emotion regulation in alcohol use disorder. OBJECTIVES/GOALS: Emotion dysregulation is known to be mediated by altered functional organization of the limbic system in addiction. This preliminary study sought to identify gender effects in the association between emotion regulation and resting-state functional connectivity (rsFC) of a negative affect network. METHODS/STUDY POPULATION: 55 individuals receiving treatment for alcohol use disorder (˜2 weeks of abstinence) were recruited for this study and included in this analysis (N=55; Age: M=41.78, SD=10.66; 21 females). RsFC within a network involved in the withdrawal/negative affect stage of addiction and Personality Inventory for DSM-5 (PID-5) metrics were collected from all participants. RsFC data were preprocessed using the Human Connectome Project pipelines. Correlations between (a) rsFC within the withdrawal/negative affect network and the (b) scores of the negative affect subscale of the PID-5 instrument were conducted for each gender separately. RESULTS/ANTICIPATED RESULTS: Independent samples t-test showed a statistically significant gender difference in the PID-5 negative affect scores (Males: M=1.02, SD=0.66; Females: M=1.53, SD=0.51); t(55)=-3.002, p=0.004. Only females showed a significant correlation between rsFC within the withdrawal/negative affect network and negative affect scores of the PID-5 (r=0.51, p<0.05). Fisher r-to-z test showed significant gender differences (z=-1.91; p=0.03, 1-tailed) in correlations coefficients representing the relationship between rsFC of the withdrawal/negative affect network and negative affect (PID-5 subscale). DISCUSSION/SIGNIFICANCE OF FINDINGS: Preliminary findings suggest that the relationship between neural networks mediating emotion regulation and negative affect is only found in females. These results provide valuable data to inform personalized chemical dependency treatment that targets emotion regulation specific to females.

OBJECTIVES/SPECIFIC AIMS: Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences.The objective was to test the effectiveness of a prediabetes SDM intervention. METHODS/STUDY POPULATION: This was a cluster-randomized controlled trial in 20 primary care clinics within a large regional health system. Participants were overweight/obese adults with prediabetes (BMI>24 kg/m2 and HbA1c 5.7-6.4%) were enrolled from 10 SDM intervention clinics. Propensity score matching was used to identify control patients from 10 usual care clinics.Intervention clinic patients were invited to participate in a face-to-face SDM visit with a pharmacist who used a decision aid (DA) to describe prediabetes and four possible options for diabetes prevention; DPP, DPP +/− metformin, metformin only, or usual care. RESULTS/ANTICIPATED RESULTS: Uptake of DPP and/or metformin was higher among SDM participants (n=351) than controls receiving usual care (n = 1,028; 38% vs. 2%, p<.001). At 12-months follow-up, adjusted weight loss (lbs.) was greater among SDM participants than controls (−5.3 vs. −0.2, p < .001). DISCUSSION/SIGNIFICANCE OF IMPACT: A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4-months and weight loss at 12-months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk.

OBJECTIVES/SPECIFIC AIMS: There are currently over a million survivors of childhood, adolescent, and young adult cancer in the United States, many of whom were treated with radiation therapy. Chest radiation with fields including the coronary arteries is a risk factor for cardiovascular disease. Of note, survivors are often unaware of this increased cardiovascular disease risk or, if they are aware, do not know how to mitigate the risk. Visual aids and communicating risk in terms of absolute risk reductions are shown to improve patients’ understanding. The Institute of Medicine recommends use of decision aids to optimize patient discussions of benefits and harms of therapies. Our goal is to develop and pilot test a statin therapy risk communication tool for use in high-risk cancer survivors to improve shared decision making and patient knowledge of coronary artery disease risk. METHODS/STUDY POPULATION: Participants were recruited from the adult long-term follow-up clinic at Sloan Kettering Cancer Center into 2 arms, usual care Versus intervention with the statin risk communication tool. The post-visit assessment used Likert-like scales to explore patient perceptions of statin use. The study was not powered for significance as it was a feasibility study; descriptive statistics were run to compare the 2 groups. RESULTS/ANTICIPATED RESULTS: Participants (n=45) had a mean age of 45. In the intervention group, 92% felt the information given was right compared with 73% of the usual care group. In all, 63% of the intervention arm felt the information was helpful, compared with 47% of those in usual care. And 53% of usual care would recommend the method to other patients and for other treatment choices compared to 67% of those in the intervention arm. DISCUSSION/SIGNIFICANCE OF IMPACT: This risk communication tool was assessed for acceptability and found to be more acceptable compared with usual care. In addition, we will gather further information on knowledge enhancement and decisional conflict as well as qualitative data regarding the shared decision making experience. With this information, a future randomized-controlled trial across institutions could provide information on how childhood, adolescent, and young adult survivors approach shared decision making with risk communication tools.

OBJECTIVES/GOALS: The purpose of this report is to describe the role of Periodontal Disease (PD) in Coronary Artery Disease (CAD) in a Hispanic country. METHODS/STUDY POPULATION: Literature and Puerto Rican experience was reviewed and will be discussed. RESULTS/ANTICIPATED RESULTS: PD produces inflammatory disease by bacterial infection in the gingiva. This factor PD activates an inflammatory process affecting the CAD cascade inducing myocites, endothelial cells activation and cytokines. The incidence of gingival disease in the Puerto Rican population (P) is around 50%; of this group 80% will develop periodontal disease. Including this factor and diabetes mellitus Type 2, still the incidence of CAD is 20-30% less than the U.S.A. DISCUSSION/SIGNIFICANCE OF IMPACT : CAD is a systemic disease related to genetic factors and inflammation. PD is related to an inflammatory process, which will activate the CAD process, producing tissue infarcts. The daily use of resolving or liquid Omega 3 in the gingival tissue is useful in the prevention of gingival and periodontal disease. CONFLICT OF INTEREST DESCRIPTION: All authors have no relationship with any industry or financial associations in connection with the submitted abstract.

OBJECTIVES/GOALS: Early clinical case reports have described incidental epileptiform changes during electrophysiological monitoring. The objective of this study was to perform a systematic review of all existing investigations of epileptiform activity during sevoflurane use in pediatric anesthesia. The heterogenous EEG data will be analyzed in a meta analysis METHODS/STUDY POPULATION: A targeted, PICO-based clinical question was crafted and registered a priori on PROSPERO on 3/19/21. Under the guidance of a librarian from the Albert Einstein College of Medicine, a boolean search string was generated to search articles and gray literature for terms such as pediatric, sevoflurane and electroencephalogram in PubMed, OVID, Cochrane, Google Scholar, etc. We utilized the software platform tool COVIDENCE to manage our review. 495 references were imported for initial screening. 56 English-language, full-text studies were included for further review. The final 13 references were included in data extraction and Newcastle-Ottawa bias assessment. The characteristics of the studies and their primary outcomes were collected in tabular form. Strategies for data synthesis were discussed weekly. RESULTS/ANTICIPATED RESULTS: Epileptiform changes reported in the literature during pediatric sevoflurane anesthesia ranged from 0 - 95%. EEG data were acquired using a variety of recording systems with variable number of leads and heterogeneous outcomes reported. The periods of anesthesia monitoring were also heterogeneous. Characteristics of the studies are presented in Table 1. 495 references were imported for screening with 13 final references for data extraction. EEG abnormalities were reported in 204/649 (31.4%) subjects ranging in age from neonate to 18 years; the majority of studies utilized less than 16 channels of (10/13, 76.9%) (Table 1). There was variability in sevoflurane dosing, premedication (e.g., midzolam, hydroxyzine), and periods of anesthesia monitored. DISCUSSION/SIGNIFICANCE: There was heterogeneity noted across reviewed literature including study design, phases of anesthesia, ventilation methods, number of EEG leads recorded and adjuvant anesthetics administered. Nevertheless, this review rigorously classified epileptiform activity during Sevoflurane thereby influencing modern anesthesia.

For decades, the research community called for streamlined Institutional Review Board (IRB) review processes for multisite studies. Department of Health and Human Services and National Institutes of Health (NIH) recognized this need and implemented single IRB (sIRB) of record mandates. However, announcing mandates without sufficient operational guidance and tools is insufficient to foster the desired change. Nearly 4 years into implementation of the NIH’s sIRB mandate, operational challenges remain. Fortunately, NIH supports a web-based sIRB platform, the IRB Reliance Exchange (IREx), to facilitate sIRB communication and documentation. IREx has received continuous NIH funding supporting its evolution since 2011 and is now used by over 5,000 Human Research Protection Program and research personnel, 35 sIRBs, and 415 participating sites to operationalize sIRB review and approval on over 400 studies. IREx supports over 2300 reliance relationships with an average of 7 sites per study. The platform is continually used by sIRBs and relying sites, providing a valuable centralized portal for promoting a harmonized sIRB review process. IREx can promote transparency, standardize practice, minimize workflow variation, and mitigate the need for sIRBs to implement significant technical changes to their local electronic systems. IREx has proven to be nimble and adaptable with practice and policy changes over the past decade, as evidenced by continually increasing platform utilization.

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.

OBJECTIVES/GOALS: The objective is to describe the process for developing two measurement tools to measure confidence (self-efficacy) of the anti-racist advocate in an academic setting. METHODS/STUDY POPULATION: We proposed five spheres encountered by the academic trainees: Academic/Research, Clinical, Policy, Interpersonal, and Intrapersonal. We evaluated a book, by Shereen Daniels, used in anti-racism literature: The Anti-Racist Organization - Dismantling Systemic Racism in the Workplace. Using the proposed metric of RACE framework, Recognize the problem, Analyze the impact, Commit to action, Empower for change, we sought to establish readiness on the spectrum of anti-racism advocacy. We developed a list of anti-racism and anti-bias advocacy skills based on: 1) Informational interviews with anti-racism and anti-bias experts, 2) Scoping literature review and 3) Academic trainees’ and faculty lived experience. RESULTS/ANTICIPATED RESULTS: The first assessment, “5-Spheres”, consists of 10 items that perform, 1) Analysis of readiness on the spectrum of anti-racism advocacy using RACE framework (Figure 1 [https://drive.google.com/file/d/1A3nMArEn7ZSxZSuSgDkYl_row-VOhOXf/view?usp=drive_link]), 2) Assessment of workplace environment. The second assessment, “Skills”, consists of 25 items (Figure 2 [https://drive.google.com/file/d/1GTdfSgn0-mPu-flSUVSN-vIKTxBCkFW3/view?usp=drive_link]) that perform assessment of confidence of specific skills within each of the five spheres using the following scale: 1 – Not confident at all, 2 – Lacking some confidence, 3 – Somewhat confident, 4 – Completely confident DISCUSSION/SIGNIFICANCE: This proposed measurement tool can extend to anti-bias as well as anti-racism. Potential uses of the self-assessment includes: 1) Measurement and 2) Gap-spotting.

OBJECTIVES/GOALS: Obsessive compulsive disorder (OCD) is a serious and impairing disorder. The peripartum is associated with changes in pre-existing OCD, including exacerbation and improvement of the disorder. This meta-analysis seeks to understand the proportion of women reporting a change in OCD during this time. METHODS/STUDY POPULATION: Nine studies with independent samples examining change in obsessive-compulsive symptomology (OCS) in the peripartum were included in the meta-analysis. Studies were included if the sample examined with women with a clinical diagnosis of OCD that pre-existed pregnancy onset. The meta-analysis was conducted using R Studio with Meta, Metafor and Weightr packages. A moderation analysis was conducted to examine the impact of gestational period on OCD symptoms. Gestational periods were defined as pregnancy, postpartum, or the peripartum. Peripartum refers to a collapsed postpartum/pregnant period such that the period was not identified or specified during data collection. RESULTS/ANTICIPATED RESULTS: The summary proportion of women who experienced no change in symptoms was 46.7% (CI: 42.0-51.4%). No change by period was: pregnancy 49.6% (CI: 36.3-62.9%); postpartum 45.6% (CI: 41.4-49.9%); peripartum 52.4% (CI: 42.4-50.3%). The summary proportion of women who experienced exacerbation was 39.2% (CI: 33.5-45.5%). Exacerbation by period: pregnancy 35.5% (CI: 24.8-47.9%); postpartum 42.9% (CI: 34.8-51.4%); peripartum 34.6% (CI: 23.7-47.4%). The summary proportion of women who experienced improvement was 11.5% (CI: 9.3-14.4%). Improvement by period: pregnancy 42.9% (CI: 14.7-77.0%); postpartum 7.8% (CI: 5.7-10.4%); peripartum 19.6% (CI: 13.7-27.3%). Gestational period had a moderating effect. DISCUSSION/SIGNIFICANCE OF IMPACT: During the peripartum 46% report no change, 40% a worsening and 12% an improvement. Improvement typically occurs during pregnancy and may be followed by a postpartum worsening. This may reflect a hormonally-sensitive subsection of women impacted by the acute changes that occur during this time.

OBJECTIVES/GOALS: Optimize an Individual Retention Conversation (IRC) toolkit aimed at enhancing trust amongst CRPs and leadership via a 2-phase project wherein 9 academic medical centers (AMCs) with significant CRP workforces developed and assessed a 16 question IRC guide and accompanying manager/leader instructional guide. #_msoanchor_1 METHODS/STUDY POPULATION: Significant interest in adapting the Stay Interview concept for the CRP workforce led to a 2-phase pilot to optimize the re-envisioned IRC toolkit. Representatives from nine AMCs and research sites volunteered to navigate their respective institutional IRB processes to initiate the assessment. Additional sites, such as Frontiers Clinical and Translational Institute (Frontiers) launched variations of the IRCs outside of the structured QI project to meet the needs of their institutional environments and reported feedback to the larger group. Feedback on both the standardized IRC, as well as Frontiers’ tailored version, will be presented. This will serve as an entryway into Phase 2, a multi-institutional mixed methods evaluation project open to all AMC members of ACTS and the CRPT SIG. RESULTS/ANTICIPATED RESULTS: To date, 7 institutions have initiated IRCs with test groups at their institutions. Each institution had unique requirements, but all IRBs deemed Phase 1 to be exempt/not human research. Preliminary data suggest not only that the IRC process is valuable to both employee and their manager/unit leadership, but also that the simple act of conducting IRCs was found to be unique and meaningful to employees. For example, in their tailored IRC process, Frontiers found that the 90% of their team found the process to be beneficial (n=9). DISCUSSION/SIGNIFICANCE: By acknowledging issues, understanding motivations, and increasing engagement, IRCs foster positive change, allowing team leaders to take immediate action on important issues. By doing so, retention and engagement of team members, and the CRP workforce as a whole, is likely to grow and strengthen, as supported by results from our initial test pilots.

OBJECTIVES/GOALS: Decongestion, or fluid removal, is an important goal in the management of acute heart failure (AHF) among patients with heart failure with reduced ejection fraction (HFrEF). We sought to examine whether the rate of decongestion is associated with mortality and cardiovascular (CV) outcomes. METHODS/STUDY POPULATION: Using data from the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) trial (n=4133), we evaluated the rate of decongestion by using linear mixed models to derive the in-hospital slope of b-type natriuretic peptide (BNP) and hematocrit as proxies of volume overload and hemoconcentration, respectively. A propensity score was developed to match patients from the quartile with most rapid rates of decongestion to the three quartiles with slower rates. Cox proportional hazards regression models were fitted to assess the association between rate of decongestion with risk of all-cause mortality and a composite of CV mortality or AHF hospitalization. RESULTS/ANTICIPATED RESULTS: Slower rates of in-hospital decongestion were associated with increased risk of both outcomes over a median 10-month follow-up. Those with slower rates of BNP decline, in comparison to the propensity-score matched patients with the most rapid rates of BNP decline, had higher hazards of mortality (HR=1.73 [1.23, 2.42]) and the composite outcome (HR=1.48 [1.18, 1.86]). Those with slower rates of hematocrit increase, in comparison to the propensity-score matched patients with the most rapid rates of hematocrit increase, showed a trend toward higher hazard of mortality (HR=1.17 [0.95, 1.43]) and an increased risk of the composite outcome (HR=1.26 [1.08, 1.47]). DISCUSSION/SIGNIFICANCE: Among patients with HFrEF admitted for AHF, slower rates of decongestion are associated with increased risk of mortality, CV mortality and AHF hospitalization. It remains unknown whether more rapid decongestion provides cardiovascular benefit or if it serves as a proxy for less treatment resistant heart failure.

OBJECTIVES/GOALS: To determine the impact of fertility preserving treatment (FPT) on likelihood of live birth in a cohort of reproductive-age women (18-45 y) after diagnosis of gynecologic malignancy or pre-malignancy METHODS/STUDY POPULATION: We performed a retrospective cohort study of women ages 18-45 seen by gynecologic oncologists for newly diagnosed cervical cancer (CC), endometrial intraepithelial neoplasia (EIN) or endometrial cancer (EC), and borderline ovarian tumor (BOT) or invasive ovarian cancer (OC) at an academic center from 2015-2019, excluding women who completed childbearing. Our primary outcome was live birth after diagnosis and our exposure was FPT defined as services received by reproductive endocrinology and infertility specialists. We performed Pearsons Chi-squared and log binomial regression to assess association between live birth and FPT with adjustment for patient demographic and disease factors. RESULTS/ANTICIPATED RESULTS: Out of 220 women (median age 36 y), most were White (54% vs. 25% Black) and 37% percent were diagnosed with BOT/OC (vs. 35% EIN/EC; 28% CC). After diagnosis of disease, 19% of women (n=41) had documented FPT and 8% of women (n= 17) had a live birth. By the end of follow-up, 6% of women who did not receive FPT had a live birth (n=11/178) compared to 15% of those who did (n=6/40, p=0.12). In univariate regression, women who received FPT were 2.4 times more likely to have a live birth after disease diagnosis that those who did not receive FPT (p-value = 0.06). However, after adjusting for age at diagnosis, relationship status, disease stage and disease type, the association between FPT and live birth was less robust (RR = 1.4, p-value = 0.6). DISCUSSION/SIGNIFICANCE: In this study, a minority of women had FPT or live births. Our data suggest that FPT benefit should be considered in context of age, relationship status, and disease characteristics for reproductive-age women diagnosed with gynecologic malignancies. Given the complexity, women should be offered referral for consultation with a fertility specialist.