Low-accruing clinical trials delay translation of research breakthroughs into the clinic, expose participants to risk without providing meaningful clinical insight, increase the cost of therapies, and waste limited resources. By tracking patient accrual, Clinical and Translational Science Awards hubs can identify at-risk studies and provide them the support needed to reach recruitment goals and maintain financial solvency. However, tracking accrual has proved challenging because relevant patient- and protocol-level data often reside in siloed systems. To address this fragmentation, in September 2020 the South Carolina Clinical and Translational Research Institute, with an academic home at the Medical University of South Carolina, implemented a clinical trial management system (CTMS), with its access to patient-level data, and incorporated it into its Research Integrated Network of Systems (RINS), which links study-level data across disparate systems relevant to clinical research. Within the first year of CTMS implementation, 324 protocols were funneled through CTMS/RINS, with more than 2600 participants enrolled. Integrated data from CTMS/RINS have enabled near-real-time assessment of patient accrual and accelerated reimbursement from industry sponsors. For institutions with bioinformatics or programming capacity, the CTMS/RINS integration provides a powerful model for tracking and improving clinical trial efficiency, compliance, and cost-effectiveness.

ABSTRACT IMPACT: The Independent Investigator Incubator program provides 1:1 mentoring from ‘super-mentors’ to enhance junior faculty careers in research. OBJECTIVES/GOALS: In 2014, the Indiana University School of Medicine (IUSM) in collaboration with the Indiana CTSI established the Independent Investigator Incubator (I3) Program. The I3 Program is designed to provide 1:1 mentoring for new research faculty during the crucial early years of their careers. Our goal is to provide an overview of the I3 design and 5-year data. METHODS/STUDY POPULATION: The I3 Program employs a resource-sharing, centralized design that provides concentrated 1:1 mentorship from a senior faculty ‘super mentor’ as well as other resources, such as grant writing support. Unlike many mentorship programs, I3 mentors closely interact with the mentees within the School and are compensated for their efforts (5% full-time equivalency per mentee, max of 15%). The number of ‘super mentors’ has grown from 6 to 15 faculty over 5 years, and mentors typically serve 4 to 5 mentees. Mentee applications are accepted on a rolling enrollment basis. The I3 mentees represent a diverse group based on sex, ethnicity, terminal degree, academic track, and discipline. Mentors and mentees have annual reviews through the program. RESULTS/ANTICIPATED RESULTS: In five years, 110 mentees have enrolled in the I3 program. Upon entering, 53% had no external funding, 28% had internal funding, 12% had K-awards, 7% had R03/R21 awards. Over the first five years, 75% have received extramural funding. The median funding was $340,000 with nearly a third of mentees securing grants > 1 million in direct costs. For mentees who joined the program in its first three years (n=59), the average time to a notable extramural grant (defined as a NIH or foundation grant >$300K direct costs) was 2.2 years (median - 2.6 years). Nearly all mentees were satisfied with their mentor pairing based on the mentor’s ‘availability’ and ‘valuable feedback,’ and all mentees wanted the mentoring relationship to continue DISCUSSION/SIGNIFICANCE OF FINDINGS: Since 2014, the I3 Program has had a positive impact on the careers of junior faculty at IUSM as determined by faculty satisfaction and funding metrics. Future focus areas will include developing criteria/models for graduating from the program to balance fiscal sustainability with mentee needs during their transition to mid-career.

Objectives/Goals: The goal of this poster is to 1) describe the development of a graduate certificate program for community-engaged research for health (CEnRH) in a Clinical and Translational Science Awards-funded institution; 2) describe the initial impact of the program; and 3) discuss strengths, implications, and potential improvements for the future. Methods/Study Population: The CEnRH graduate certificate is a 12-credit, postbaccalaureate program offered at the University of Cincinnati co-created by faculty from the Community Engagement and Translational Workforce Cores of the CCTST with community partners. The goal is to support learning about community-engaged research (CEnR) and enhances capacity for academic-community partnered research. Student demographics are collected as part of university registration. Quantitative course evaluations are collected each semester. Program evaluations including qualitative data are collected from students enrolled in the program during and upon completion of the certificate. Results/Anticipated Results: The CEnRH curriculum includes 3 existing courses/electives in the College of Medicine and Psychology and three new courses in social justice and action research methodologies. Notably, the committee advocated for a scholarship to cover tuition for the certificate program to promote access for community partners. Since the fall of 2022, 17 students have enrolled in the CEnRH program, including 9 Faculty/Staff within CCTST institutions, 2 University of Cincinnati PhD Students, 5 Fellows, and 1 Community Member (who receives the scholarship). Notably, 24% of these students are from underrepresented minority backgrounds. Impact and evaluation data, as well as lessons learned, will be presented. Future directions for the CEnRH program will also be discussed. Discussion/Significance of Impact: The CEnRH is an impactful program for trainees, faculty, and staff who are planning to conduct CEnR, while also strengthening research capacity among community partners and advocates. This certificate program may be especially valuable to academic researchers as more funding agencies require community and stakeholder engagement in their proposals.

OBJECTIVES/GOALS: This poster will explore lesion-symptom mapping and resting state functional magnetic resonance imaging (rsfMRI) in participants with aphasia. This analysis aims to reveal the behavioral impact of distinct lesions to the left inferior frontal gyrus (LIFG) and the potential for rsfMRI to provide evidence of cortical reorganization. METHODS/STUDY POPULATION: The analyses will be conducted on a small sample of approximately six participants with post-stroke language impairment (i.e., aphasia) recruited as part of an ongoing study. Lesion load in the anterior LIFG (aLIFG), consisting of the orbital (BA 47) and triangular (BA 45) parts, and the posterior LIFG (pLIFG), consisting of the opercular part (BA 44) will be correlated with performance on tasks of semantic and phonological processing. Functional connectivity will be determined between regions of interest (i.e., anterior superior temporal, posterior middle temporal, angular, and supramarginal gyri) in the left and/or right hemispheres based on rsfMRI data. RESULTS/ANTICIPATED RESULTS: Lesion load in the aLIFG is expected to correlate to performance on the semantic task, whereas lesion load in the pLIFG is expected to correlate to performance on the phonological task. For participants whose behavioral performance exceeds expectations based on lesion load (e.g., larger aLIFG lesion load, yet better semantic task performance), rsfMRI connectivity is expected to be greater (e.g., between the posterior middle temporal and angular gyri), suggesting cortical reorganization. DISCUSSION/SIGNIFICANCE: If our hypotheses are supported, our results will corroborate evidence of a functional spectrum (i.e., semantic-phonological) in the LIFG. Future work will compare rsfMRI connectivity to neurotypical controls and sites of connectivity may be used as targets in studies of non-invasive brain stimulation as an adjuvant to behavioral therapy.

OBJECTIVES/GOALS: To establish the root causes of vaccine hesitancy in populations who have less equitable access to health and healthcare services, and experience healthcare inequities, related to the environmental and social determinants of health, through community engagement and conversations, collaboration, circulation, and communication. METHODS/STUDY POPULATION: Existing data from a cross-sectional survey, vaccine hesitancy (VH) parent study, entitled 'Western New York (WNY) COVID-19 Collaborative to Promote Vaccine Acceptance,' conducted July to November 2022, after IRB approval, will be qualitatively analyzed. In the parent study, surveys were administered in WNY community congregations and community centers to individuals that historically have less equitable access to healthcare resources and may encounter health and healthcare disparities. Minorities, in urban and rural areas, age eighteen and older were identified through the NYS Department of Health’s Immunization Information System for daily vaccination rates. A qualitative analysis, promoting fact base HL, and building an inferential statical machine learning tool are the next steps. RESULTS/ANTICIPATED RESULTS: We anticipate the results to show an interplay of multiple factors, including personal, cultural, historical, social, and political, and varies depending on circumstances of time, place, and the type of vaccine being offered. Additionally, a lack of awareness or understanding of vulnerabilities and seriousness of vaccine-preventable diseases, lack of trust in health care providers, social norms, distrust of the healthcare system, biomedical research, and government policy, limited knowledge and understanding of vaccine safety and efficacy, and fear/uncomfortable with needles, as well as the less addressed environmental and social determinants of health associated with racial/ethnic minorities in communities with limited resources may also contribute to VH and less favorable health outcomes. DISCUSSION/SIGNIFICANCE: Identifying people who historically have less equitable access to healthcare resources and may be more likely to resist healthcare services, due to distrust in the system is important. Creating and evaluating an innovative tool to predict refusal of public health interventions is essential to avoid spreading preventable diseases.

OBJECTIVES/GOALS: The purpose of this study was to develop behavioral economic purchase tasks to assess interest in CM as a function of treatment cost and perceived effectiveness of CM as a function of abstinence incentive size in alcohol drinkers. Additionally, these purchase tasks are being assessed for their clinical utility in an ongoing clinical trial. METHODS/STUDY POPULATION: Alcohol drinkers recruited from Amazon Mechanical Turk completed behavioral economic purchase tasks measuring demand for CM based on targeted abstinence intervals and treatment effectiveness and alcohol use disorder severity assessments. Nonlinear mixed effects modeling was used to fit demand curves and assess the relationship between individual characteristics and demand metrics for CM. Ongoing analyses involve administering the same behavioral economic purchase tasks in heavy alcohol users in the ongoing clinical trial, which is aimed at reducing alcohol use through remotely implemented CM. RESULTS/ANTICIPATED RESULTS: Mechanical Turk participants reported higher probability of abstinence when offered larger incentives and required larger incentives when duration of abstinence required to earn the incentive was increased. Additionally, willingness to pay for treatment increased as effectiveness of treatment increased. It is anticipated that these patterns will be observed in the clinical trial participants. DISCUSSION/SIGNIFICANCE: Abstinence interval and treatment effectiveness are important features to consider when developing effective CM for widespread use, as these variables affected participants likelihood of being abstinent and their interest in treatment. We are currently working on verifying the results of these assessments in clinical trial participants.

OBJECTIVES/GOALS: To examine pharmacy students’ and patients’ perspectives on use of an automatic pill dispenser (APD) and adherence device, and secondly, to identify patient characteristics impacting selection of an APD. This knowledge will assist pharmacists in making appropriate device recommendations that improve medication adherence and effectiveness. METHODS/STUDY POPULATION: One hundred fifty-three pharmacy students participated in a personal APD simulation, living the life as a person taking medication. Students then each identified an actual patient exhibiting medication nonadherence from pharmacy records at their work setting, provided them with an APD free of charge and instructed them on its use. The students later interviewed their patients and reported on their patients’ ability to use the APD, as well as their perspectives (likes and dislikes) on the features of the device. Students identified individual patient characteristics associated with successful use of the APD. This new knowledge will aid these future pharmacists in making recommendations for medication adherence devices for their patients. RESULTS/ANTICIPATED RESULTS: In general, patients perceived more difficulty with use of the 10 APD features than did students. Over half of the patients indicated that the following features were a distinct advantage in adherence: individual medication compartment size, method of loading medications, alarm, flashing light, ability to lock the dispenser, and method of retrieving the medication from the device. Patients felt that the biggest disadvantage was its bulky size and lack of portability. In spite of individual difficulties with use, the research findings showed that persons who are elderly, homebound, have memory problems, take multiple medications and/or have complex regimens are most likely to benefit from the device features and exhibit improved adherence to their prescribed medication regimen. DISCUSSION/SIGNIFICANCE: Medication adherence rates in the U.S are agreed upon to be about 50% - highly relevant to healthcare practitioners since several studies suggest a correlation between adherence and improved health outcomes. Pharmacists must be knowledgeable about non-adherence tools and consider patient characteristics when recommending an adherence aid.

OBJECTIVES/SPECIFIC AIMS: The study aims to determine the current clinical research training interventions of MD-PhD programs and how effective they are in promoting clinical research self-efficacy. METHODS/STUDY POPULATION: A national survey of MD-PhD trainees was conducted in 2018 to identify clinical research training methods and self-efficacy for clinical research skills. MD-PhD program directors and coordinators from 108 institutions were asked to distribute the survey to their students. Responses were received from 61 institutions (56.5%). Responses were obtained from 647 MD-PhD students in all years of training, representing 17.9% of the 3613 possible participants at the 61 medical schools represented. No compensation was provided for this study. RESULTS/ANTICIPATED RESULTS: The primary methods of clinical research training reported by students included didactics, mentored clinical research, didactics plus mentored clinical research, didactics plus clinical research practicum, and didactics plus mentored clinical research plus clinical research practicum. A quarter of all participants reported having no clinical research training. Clinical research self-efficacy was then correlated with the amount of clinical research training. Students exposed to no clinical research had the lowest self-efficacy in clinical research skills and students experiencing didactics plus mentored clinical research plus clinical research practicum had the highest perceived self-efficacy in clinical research domains. DISCUSSION/SIGNIFICANCE OF IMPACT: This is one of the first studies assessing clinical research training methods for MD-PhD students and assessing their efficacy. We found that of all students questioned, 25% mentioned had not received any type of clinical research training. The remaining students identified 5 research training methods that institutions currently use. This work highlights the importance of clinical research experience students need to improve their self-efficacy, a major influence on research career outcomes.

OBJECTIVES/SPECIFIC AIMS: The purpose of this study is to use the baboon as a novel animal model for breath research and to identify and characterize baboon breath metabolites that reflect cardiometabolic function to inform us in the development of a noninvasive, cost-effective, and repeatable point-of-care diagnostic breath test. METHODS/STUDY POPULATION: Blood and urine was collected from control and IUGR at the approximate age of 3.5 years. Both groups were then placed on a high fat, high sugar, high salt diet for 7 weeks, after which blood, urine, and breath were collected. The breath samples were then subjected to comprehensive, 2-dimensional gas chromatography coupled with time-of-flight mass spectrometry. Using ChromaTOF software, breath VOCs were identified with at least an 80% spectral match against the National Institute of Standards and Technology (NIST) chemical reference library. The raw data were then statistically analyzed using MetaboAnalyst. We then interrogated multiple online databases to characterize and identify the role of VOCs that were present in both control and IUGR groups. RESULTS/ANTICIPATED RESULTS: Preliminary analyses of the breath VOCs indicate differences in expression between sexes and in control Versus IUGR groups. These results indicate unique “breath signatures.” Further analysis of the breath VOCs reveals the presence of metabolites that are involved in β-oxidation and oxidative stress pathways. DISCUSSION/SIGNIFICANCE OF IMPACT: This breath study, a first of its kind, will develop the baboon as a superior animal model for breath biomarker research. Our observed unique “breath signatures” indicate changes in lipid metabolism and oxidative stress pathways, which we hypothesize are the early metabolic changes at the cellular level that are not yet reflected in clinical lab measures. Future directions include analyzing breath VOCs that did not meet 80% spectral match, validation using SPME technology and commercial standards, and initiating a human pilot study in clinically obese, at-risk children in collaboration with physicians at the Children’s Hospital of San Antonio to develop a noninvasive, cost-effective, rapid, and repeatable point-of-care diagnostic breath test.

OBJECTIVES/GOALS: A new researcher-facing module to support community engaged research has been added to the updated COALESCE website and user traffic was tracked since last reporting. We describe the process of development and the features of the new module, past 2-year traffic, and plans to develop a community facing module. METHODS/STUDY POPULATION: We monitored the number of unique users of COALESCE (teamscience.net) between 2017 and 2019 to determine if traffic slowed, stayed the same, or increased since teamscience.net was physically updated to function on mobile devices. In December 2019, a new module was launched to introduce researchers to the stages of team science community engaged research. To develop the module, we collaborated with academic partners at University of Illinois-Chicago to identify 3 local historic research case studies in and to characterize how each exemplified a team science stage: assembly, launch, or maturation. After interviewing key team members from each study, we iterated storyboards and scripts in collaboration with community engaged research experts and case study team members. The module was built, tested, and launched. RESULTS/ANTICIPATED RESULTS: In the 6 years between 2011 through 2017, the site attracted 16,016 unique visitors (approximately 2699 per year). In 2 years from 2017 through 2019, since the modernization of the website, user traffic has held steady or grown, attracting 6992 unique visitors (approximately 3496 per year). Our newly posted researcher-facing module highlights team assembly in the case a task force charged with reducing disparity in breast cancer outcomes in Chicago, team launch in a study to improve asthma management in a local FQHC, and team maturation in a study comparing clinic-based to public school-based treatment of disruptive behavior. We will soon create a companion community-facing module and resources to address identified needs for community partners engaging in research with academic institutions. DISCUSSION/SIGNIFICANCE OF IMPACT: COALESCE (teamscience.net) remains the first and only open-access, online training in team science for health professionals. Recent updates have improved usability and expanded available resources. We launched a comprehensive module for academics interested in community engaged research; future work will develop parallel community facing resources.

Objectives/Goals: Clinical research professionals (CRPs) are vital to the conduct of clinical research and require ongoing, high-quality training to be effective. This poster will explore participating CRPs’ assessments of the impact of the inter-institutional Research Professionals Network (RPN) Workshops on their work and ability to perform their roles. Methods/Study Population: The RPN Workshops are a consortium of four academic medical centers and their affiliates that collaborate to host peer-led workshops for CRP continuing education. CRP presenters and attendees include a wide variety of roles, responsibilities, and levels of experience. From September 2023 to December 2024, workshop attendees received bi-annual evaluations to assess the workshop impact, including skill application and understanding of topics. Responses from these bi-annual evaluations, along with monthly session evaluations, were analyzed to identify key outcomes on the workshops’ impact in regard to participating CRP application of learnings and confidence in their role. Results/Anticipated Results: Preliminary review of the bi-annual RPN Workshop Impact Survey data, alongside monthly workshop evaluation responses from workshop participants, revealed attendees indicated that they valued the topics presented. Key findings indicated that CRPs’ participation in the workshops: reinforced their existing practices,tncreased their confidence in knowledge and/or skills discussed, enhanced their collaboration with CRPs from other institutions, and more detailed results of the analysis will be presented. Discussion/Significance of Impact: Overall results demonstrated increased confidence in CRP roles. Participants valued the inter-institutional collaboration, which is facilitated by the sharing of best practices and diverse perspectives within the workshop format.

OBJECTIVES/GOALS: The discipline of plastic and reconstructive surgery (PRS) is poorly understood by the public, primary care physicians, and nurses. The aim of our study is to assess medical students’ knowledge and perceptions of PRS as a discipline and explore factors influencing these opinions. METHODS/STUDY POPULATION: To assess medical student’s knowledge and perception of PRS, we distributed an online survey to all medical students at all training levels (i.e. first year to fourth year) enrolled at UCSF School of Medicine, San Francisco, CA during 2019-2020 academic year. In the survey, participants were asked to match 12 surgical subspecialties with 36 operative procedure scenarios. In addition, the survey included questions investigating the most common social medical platform used by medical students and the role of medical social media accounts in contributing to their knowledge of surgical subspecialties. RESULTS/ANTICIPATED RESULTS: Medical students demonstrated a profound gap in knowledge in plastic surgery. The majority of respondents correctly identified plastic surgeons as the primary surgeons performing the cosmetic procedures listed (abdominoplasty, facelift, and liposuction). PRS was identified as the primary specialty involved in breast reconstruction (94.4%) and burns surgery (88.9%). There was poor understanding of the role of plastic surgeons in hand surgery(16.6%), craniofacial surgery(14.8%), and head and neck cancer surgery(9.3%). 52.4% of respondents follow medical social media accounts and 45.6% of respondents indicated that social media contributed to their knowledge of surgical subspecialties. DISCUSSION/SIGNIFICANCE OF IMPACT: Medical students, who form the next generation of doctors, have limited knowledge regarding versatile applications of PRS. Misconceptions about the discipline of PRS negatively impacts resource allocation and hinders the delivery of care to patients that would profoundly benefit from this specialty. CONFLICT OF INTEREST DESCRIPTION: No authors have financial disclosures or conflicts of interest to declare.

OBJECTIVES/GOALS: Translating the science of vaccines to health and public health practice requires understanding how vaccine risks and benefits are understood and applying that knowledge to community translation. During the pandemic the lack of this knowledge became apparent. METHODS/STUDY POPULATION: Through the PACER community engagement special interest group of the ACTS, the University of Florida(UF)/Florida State University and 5 other CTSIs community engagement programs received Center for Disease Control and Prevention funding for the Program to Alleviate National Disparities in Ethnic and Minority Immunizations in the Community (PANDEMIC) to translate vaccinations into the community. At UF, HealthStreet’s Community Health Workers, CTSI Mobile Health Vehicle nurses, and Institute of Food and Agricultural Sciences extension agents collaborated to engage adults throughout the North and Central part of the state on their vaccine status and perceptions and to offer them vaccines. RESULTS/ANTICIPATED RESULTS: Through UF, 4,587 people have been interviewed in community settings using the Survey of Perceptions; 25% (1,125) had not received any COVID-19 vaccine. Among differences in perceptions, those vaccinated versus unvaccinated perceived people to be getting vaccines because they cut down on disease spread (28.9% vs. 15.2%), and perceived people NOT to be getting vaccinated because of misinformation/ignorance (27.1% vs. 11.0%) and political beliefs (16.3% vs. 6.7%). Both vaccinated and not perceived lack of trust as a reason to not get vaccinated (41.3% vs 46.4%). When asked what people were doing instead of vaccination, those vaccinated versus unvaccinated responded that people were doing nothing/very little much more often (40.6% vs. 21.8%) but were less likely to say ’trying to stay healthy’ (9.1% vs. 18.9%). DISCUSSION/SIGNIFICANCE: The science of translating from bench through clinical trials and to common health and public health practice requires knowledge of reasons for successful adoption. This survey adds to knowledge of perceptions towards vaccines that inhibit translation and biases toward the vaccine-hesitant.

OBJECTIVES/GOALS: Clinical and epidemiological studies focusing on Hispanics/Latinos are often designed by academic researchers with little input from mental health professionals in underserved communities. Our objective is to establish an academic-community partnership in South Texas to help improve mental health outcomes of Hispanics. METHODS/STUDY POPULATION: Hispanics in the Rio Grande Valley (RGV, South Texas) are burdened with high rates of diabetes and obesity, and interventions have been identified for these conditions, but there is less information about strategies that may help improve their mental health status and address needs. We have explored mental health and psychological factors in Hispanics/Latinos in Latin America (Gil etal., 2021) and consider community participation in the research process to be an understudied topic. Thus, in the present study, we recruited mental health professionals in the RGV to establish an academic-community partnership as a strategy to facilitate translational research that focuses on RGV Hispanics. Partners worked as a team to generate information, identify problems and solutions, and design future projects. RESULTS/ANTICIPATED RESULTS: Our academic team (at the University of Texas Rio Grande Valley) successfully established a partnership with the Cameron County Mental Task Force (CCMHTF), a non-profit organization in South Texas that seeks to “meet the mental and behavioral health needs of the people” in South Texas. The CCMHTF comprises 12 board members that are representative of RGV mental health providers: counselors, social workers, academic clinicians, hospital and county employees, and mental and behavioral health facility providers/clinicians. Our partnership generated qualitative descriptions of the mental health needs of RGV Hispanics/Latinos and barriers to access and utilization of mental health services in South Texas. In the future (phase 2 of the study), we plan to report results of focus groups and mental health assessments. DISCUSSION/SIGNIFICANCE: Hispanics/Latinos are underrepresented in clinical/translational research, and this lack of representation is particularly true for Hispanics/Latinos living along the U.S.-Mexico border of the RGV, South Texas. Our academic-community partnership may serve as a model to facilitate translational research in underserved Hispanic communities.

OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.

OBJECTIVES/SPECIFIC AIMS: Deep brain stimulation is currently being evaluated as an experimental therapy for various psychiatric disorders, as well as being investigated as a method for mapping emotional brain functions. This growing area of research requires sensitive measures to quantify effects of stimulation on emotional processing. The current study examined the effects of acute stimulation to 2 limbic regions—the subcallosal cingulate (SCC) and the amygdala—on bias in the perception and evaluation of emotional facial expressions. We hypothesized that transient electrical stimulation to the limbic system would produce acute reductions in negative bias, consistent with its antidepressant effects in patients with severe depression. METHODS/STUDY POPULATION: The current study uses a novel affective bias task, developed to rapidly and covertly quantify emotional state. Over 4–6 minutes, patients rate the intensity and valence of static images of emotional facial expressions. We examined effects of electrical brain stimulation in 2 groups: patients with treatment-refractory depression undergoing SCC DBS therapy, and epilepsy patients undergoing amygdala stimulation via stereo-EEG electrodes during inpatient intracranial monitoring. DBS patients completed the task under stimulation and sham conditions during monthly visits over the first 6 months of therapy, as well as daily during a 1 week, blinded period of DBS discontinuation at the 6-month time point. Epilepsy patients completed the task under stimulation and sham conditions at a single visit. Mixed linear models and paired-samples t-test were used to investigate effects of stimulation as well as depression scale scores on affective bias ratings. RESULTS/ANTICIPATED RESULTS: Four SCC DBS patients showed significant effects of stimulation (p<0.0001) and depressive state (p<0.0001) on affective bias scores across 6 months of chronic DBS therapy, where emotional faces were perceived as less sad with stimulation ON, as well as during visits in which patients were nondepressed (typically later in the treatment course). Furthermore, 2 DBS patients showed rapid negative shifts in bias following acute blinded discontinuation of chronic stimulation, an effect which persisted over the 1-week period of discontinuation (t29=−2.58, p=0.015), in the absence of any self-reported change in mood. Likewise, 6 epilepsy patients showed significant positive shifts in affective bias with acute amygdala stimulation (t5=−4.75, p=0.005). Current analyses are investigating electrophysiological, autonomic and facial motor correlates to affective bias in these patients. DISCUSSION/SIGNIFICANCE OF IMPACT: Affective bias has revealed rapid, significant changes with stimulation at 2 limbic targets—one a white matter hub and one a nuclear subcortical structure—suggesting the task’s utility as an emotional outcome measure in brain stimulation studies. These stimulation-sensitive measures may provide a new metric to track treatment response to deep brain stimulation therapy for affective disorders. Future studies will determine whether affective bias can predict neuropsychiatric complications in patients undergoing stimulation mapping of brain circuitry ahead of resection surgery for epilepsy.

ABSTRACT IMPACT: This real-world study of what students value in crisis leadership fills an important gap in the literature and may inform future leadership development programs in undergraduate medical education. OBJECTIVES/GOALS: Leadership training is of growing importance and prevalence in medical education. The COVID-19 pandemic provides a unique insight into the qualities students value in leaders. Our qualitative study examined these leadership themes and provides a grounding for future development of leadership programs. METHODS/STUDY POPULATION: A conventional qualitative approach was used in order to allow open expression of ideas related to leadership in a pandemic. The authors developed a 5 free-text question survey instrument aimed to uncover student perceptions of leadership both during the current pandemic and in crises in general. A participant pilot was performed in order to ensure readability and ease of understanding. We used thematic analysis to examine the content of the survey responses, and inductive coding of the responses allowed identification of emerging themes. Medical students at the University of Michigan were surveyed. RESULTS/ANTICIPATED RESULTS: In total, 162 students completed the survey. The demographic characteristics of participants are shown in Table 1. Median age was 25 years old (range, 22-39). There was good representation from the 4 classes in the medical school with 20-30% from each medical school class and 5% of dual degree students. Thematic analysis demonstrated that students value personal characteristics of excellence in their leaders with an orientation towards helping other people. Students believe that leaders must know how to interpret and use information and then that these leaders must be able to communicate expertly to guide organizations. The final theme that emerged is that effective leaders must commit to decisive action. DISCUSSION/SIGNIFICANCE OF FINDINGS: This study took place at a time of unprecedented crises and response examples were grounded in this real-world practice of leadership. These results and themes that emerged fill a critical gap and may facilitate future curriculum development for medical students and trainees.

OBJECTIVES/SPECIFIC AIMS: N/A. METHODS/STUDY POPULATION: Over a million people gained insurance in Los Angeles (LA) County under the Affordable Care Act (ACA). The vast majority gained Medicaid—government sponsored insurance with low-cost sharing. LA County also made significant investments in the safety net including a program called MyHealthLA, which provides primary and tertiary care for the residually uninsured including poor undocumented individuals at specific sites. Despite this insurance expansion, approximately 3 quarters of a million people in the county remain uninsured. Regardless of insurance status, nearly a quarter of LA County residents reported having difficulty obtaining needed medical care, and among those making less than the poverty level, 43% had difficulties. There is still much to understand about barriers to obtaining insurance and accessing healthcare in Los Angeles in the post-ACA era. Our primary objective was to understand how safety net patients are obtaining, maintaining and using their insurance after the ACA. Specifically we hope to understand the barriers and drivers of these three processes. RESULTS/ANTICIPATED RESULTS: We conducted a qualitative study of 34 safety net patients with 3 different insurance types in LA County. We conducted in-person interviews with adult patients (ages 18–64 years), who had either MediCal, MyHealthLA, or were unsinsured. Our interview guide was based on existing literature, a previous qualitative study conducted in Massachusetts and input from experts in the field. We pilot tested our interviews in English and Spanish and then recruited our participants from 3 sites: LAC+USC (a publically funded county hospital), The Wellness Center (a resource center for safety net patients), and White Memorial Medical Center (a private safety net hospital). We approached patients in the ED and urgent care waiting rooms and obtained informed consent for this IRB approved study. We excluded patients who were non-English and non-Spanish speaking or too ill to interview. We recorded interviews, which were then transcribed and translated into English by a contracted agency. We analyzed our interviews using a framework approach, which included a set of a priori codes from the literature as well as emerging codes from patient responses. We will check a sample of our transcripts for coding consistency (aiming for an inter-rater reliability of >80%). DISCUSSION/SIGNIFICANCE OF IMPACT: We recruited a diverse group of patients that were demographically representative of those who gained insurance under the ACA (childless adults making less than 138% of the Federal Poverty Level). Our preliminary results (based on 17 transcripts), suggest that patients, regardless of insurance type have difficulty accessing primary care. We identified seven domains under the broader theme of barriers to accessing primary care: finding a primary care clinic or physician (PCP), getting timely appointments, geography and transportation, continuity of care, using the Emergency Department (ED) or urgent care as a PCP, switching PCPs or clinics, and cost or coverage.