Objectives/Goals: To determine the safety and feasibility of single-pulse transcranial magnetic stimulation (spTMS) for assessing corticospinal tract (CST) excitability and integrity in infants with perinatal brain injury, bridging foundational neuroscience to potential early diagnosis and clinical interventions during critical neuroplasticity periods. Methods/Study Population: Nineteen infants with perinatal brain injury underwent 1–3 spTMS sessions at three developmental time points: 3–6 months, 12 ± 1 month, and 18 ± 1 month. spTMS targeted the primary motor cortex to elicit motor-evoked potentials (MEPs), recorded via electromyography (EMG) from bilateral wrist flexor muscles. Safety monitoring included heart rate (HR), respiratory rate (RR), the Modified Behavioral Pain Scale (MBPS), and caregiver feedback. Feasibility was evaluated based on the ability to elicit MEPs, the number of trials that elicited MEPs, and procedure tolerability. Pre- and post-spTMS physiological and behavioral data were analyzed using linear mixed-effects models (LMEM) to account for repeated measures within subjects. Results/Anticipated Results: Thirty-five spTMS sessions were conducted in 19 infants (mean age 8.75 ± 5.12 months) with perinatal brain injury, delivering 1936 pulses with a median inter-pulse interval of 24.7 seconds. Analysis with LMEM found no significant changes in HR (mean difference  =  0.51 bpm, p  =  0.81) or RR (mean difference  =  0.69 breaths/min, p  =  0.66). MBPS scores showed a small statistically significant increase (mean difference  =  0.57, p  =  0.046), but overall remained low (mean score change from 1.94 to 2.51 on 0–10 scale). The median change score was 0, and 18/35 sessions showed no change in MBPS, indicating low discomfort with TMS. No adverse events were reported during or after the sessions. The feasibility of eliciting MEPs in this population was confirmed, with 235 MEPs identified in 17/19 participants. Discussion/Significance of Impact: Understanding neurodevelopment after injury is crucial for early diagnosis and targeted rehabilitation. Our study demonstrates that spTMS is a safe, feasible tool for assessing motor pathways in infants with early brain injury, highlighting its potential for clinical translation in neurodevelopmental disorders, and offering a pathway to improved care.

OBJECTIVES/SPECIFIC AIMS: Alcohol use disorder (AUD) has previously been studied using Timeline Followback (TLFB) interview measures and administration of alcohol within laboratory sessions. However, most of those studies supplied alcohol orally and analyzed drinking across a range of drinking intensity and frequency measures. High intensity binge drinking, i.e., drinking alcohol at multiple levels of the binge threshold (5+ drinks for males, 4+ drinks for females) has been identified as a significant risk factor for developing AUD. In the present study, we examined the relationship between high intensity binge drinking with the behavioral and subjective response to intravenous alcohol in a lab study. METHODS/STUDY POPULATION: Two hundred participants completed a 90-Day TLFB interview, wherein the maximum number of drinks in a day established the participant’s binge level status as a Non-Binger (N = 37), Binge Level 1 (N = 96), Binge Level 2 (N = 44), or Binge Level 3 (N = 22). Binge Level 1 corresponds with at least one binge (4-7 drinks for women, 5-9 drinks for men); Binge Level 2 requires at least twice the binge level (8-11 drinks for women, 10-14 drinks for men); and Level 3 necessitates a participant to drink at least three times the binge level (12+ drinks for women, 15+ drinks for men) on one day. Non-Bingers had no binge level drinking in the 90-day interview. Participants also underwent a 150-minute intravenous-alcohol self-infusion, where participants would press a button to receive an infusion of an ethanol solution. During this, participants also completed subjective questionnaires including the Alcohol Urge Questionnaire (AUQ), Biphasic Alcohol Effects Scale (BAES), and Drug Effects Questionnaire (DEQ). Kruskal-Wallis and chi-square tests were used to examine the effect of group on alcohol infusion and subjective response measures. RESULTS/ANTICIPATED RESULTS: A chi-square test for association showed significant statistical differences by groups in reaching binge level status (0.08% breath alcohol content) during the alcohol infusion session in the lab, X2 (3) = 23.321, p < 0.001. However, mean difference was not significantly different between Binge Level 2 and Binge Level 3 (0 < 1 < 2 = 3). Binge level groups showed significant differences in the number of button presses during the lab session (H(3) = 36.955, p < 0.001), peak breath alcohol concentration in the lab session (H(3) = 19.870, p < 0.001), and total binges in the TLFB (H(3) = 90.296, p < 0.001). Increased self-administration measures were proportional to the binge intensity level across groups, with no differences between Binge Level 2 and Binge Level 3 (0 < 1 < 2 = 3). For subjective measures, a Kruskal-Wallis H median test showed statistically significant differences between groups in the AUQ score following the priming infusion, H(3) = 11.489, p = 0.009, with bingers at all levels reporting higher scores compared to non-bingers (0 < 1 = 2 = 3). There was also a statistically significant difference between groups in the BAES Stimulation score following the priming infusion, H(3) = 9.023, p = 0.029, with differences seen between non-bingers and level 2 and level 3 bingers (0 = 1 < 2 = 3). DISCUSSION/SIGNIFICANCE OF IMPACT: This study demonstrated that high intensity binge drinkers were more likely to reach binge level and overall greater alcohol consumption during a human lab alcohol administration study. Binge intensity level was also associated with higher stimulation and urge for alcohol following priming exposures, which may in turn drive the consumption of greater amounts of alcohol, which we know to be associated with greater risk for AUD.

OBJECTIVES/GOALS: Falls are very common among persons with multiple sclerosis (PwMS) due to the disabling symptoms associated with the disease. The relationship between pain and falls is underexplored. This study investigated the relationship between the facets of pain (intensity and interference) and falls in the context of co-occurring symptoms of MS. METHODS/STUDY POPULATION: This is a survey-based study that included 915 adults with MS. Participants provided data on demographics, clinical data, concerns about falling, symptom severity, and occurrence of falls in the past 6 months. Participants also completed the Patient Reported Outcome Measurement Information System (PROMIS) pain interference and pain intensity short forms. Pain interference and pain intensity were separately entered into univariate and multivariable logistic regression models developed to examine the associations between falls incidence and pain. Multivariable models were adjusted for age, sex, years since diagnosis, MS type, Patient Determined Disease Steps, MS status, concerns about falling, fatigue severity, PROMIS depression short form, and PROMIS physical function short form. RESULTS/ANTICIPATED RESULTS: Univariate regression analyses indicated that pain interference (OR = 1.05; 95% CI 1.03 to 1.06; p < 0.01) and pain intensity (OR = 1.03; 95% CI 1.02 to 1.04; p < 0.01) were both associated with falls. Only pain interference remained significantly associated with falls in multivariable regression analysis (OR = 1.02; 95% CI 1.00 to 1.05; p = 0.03). The model explained 25% of the variance in falls. Pain intensity was not associated with falls (OR = 0.98; 95% CI 0.95 to 1.01; p > 0.05) in multivariable regression analysis. DISCUSSION/SIGNIFICANCE: The findings suggest that pain is associated with falls among PwMS. Interventions designed to reduce falls incidence among PwMS may consider the inclusion of pain management as an integral component of those programs.

Research is increasingly conducted through multi-institutional consortia, and best practices for establishing multi-site research collaborations must be employed to ensure efficient, effective, and productive translational research teams. In this manuscript, we describe how the Population-based Research to Optimize the Screening Process Lung Research Center (PROSPR-Lung) utilized evidence-based Science of Team Science (SciTS) best practices to establish the consortium’s infrastructure and processes to promote translational research in lung cancer screening. We provide specific, actionable examples of how we: (1) developed and reinforced a shared mission, vision, and goals; (2) maintained a transparent and representative leadership structure; (3) employed strong research support systems; (4) provided efficient and effective data management; (5) promoted interdisciplinary conversations; and (6) built a culture of trust. We offer guidance for managing a multi-site research center and data repository that may be applied to a variety of settings. Finally, we detail specific project management tools and processes used to drive collaboration, efficiency, and scientific productivity.

In 2009, the University of Michigan’s Michigan Institute for Clinical and Health Research developed a three-session K Writing workshop. Beginning in 2016, we implemented a non-attendance fee to encourage attendance across the three sessions. We examined whether this fee improved attendance, increased submission of an NIH K or R grant proposal, and improved success rates. Between 2012 and 2021, 373 participants attended the workshop. After the non-attendance fee was implemented, significantly more participants attended all three sessions of the workshop, and there was a statistical trend suggesting an increase in the success rate, while submission rates remained constant.

OBJECTIVES/SPECIFIC AIMS: The primary aim of this study is to conduct a within-child comparison of in-school PA while attending nature-based and traditional preschool programs. The secondary aim is to observe the types of activities performed at each preschool location to determine which activities lead to greater and lesser amounts of school-based PA. METHODS/STUDY POPULATION: This will be a within-subjects repeated measures study in which participants will be recruited from a single preschool program where they spend two days per week (Monday/Wednesday) at a nature-based site, and two days per week (Tuesday/Thursday) at a traditional preschool location. All participants will be outfitted with a waist-worn Actigraph GT3X accelerometer, which they will wear from the moment they arrive to their preschool location until the moment they leave. Measurements will be conducted for four consecutive school days across two separate measurement periods, once in the winter and once in the spring. Additionally, a trained researcher will be present for the entirety of each measured day to document the types of activities participants engage in throughout the day, when these activities occur, and for how long. Accelerometer data will be analyzed using total counts, a reflection of total PA across all intensities, to determine school-based PA. Total activity counts will also be reduced to counts per minute and cross referenced with direct observation data to determine which activities contribute to higher and lower periods of PA throughout the day. Within child comparisons using two-tailed t-tests be made at both measurement periods between both preschool sites to determine whether significant differences in PA levels exist in children while attending either a nature-based or traditional preschool program. Logistic regression will also be applied to assess variables contributing to children’s PA including, preschool location, weather, and time spent outside. RESULTS/ANTICIPATED RESULTS:. It is hypothesized that preschool children will engage in significantly more PA while attending a nature-based preschool program compared to a traditional preschool classroom setting. Opportunities for free and unstructured play will be greater in a nature-based setting compared to a traditional preschool location. Time spent outdoors will be the determining difference between preschool children’s PA behaviors at a nature-based versus traditional preschool program. Variations in PA levels as a result of seasonal weather differences will be minimized on days in which children attend a nature-based preschool program. DISCUSSION/SIGNIFICANCE OF IMPACT: To our knowledge, this will be one of the first studies conducting a within child comparison of preschool-aged children’s PA levels between a nature-based and traditional classroom setting. If, as hypothesized children engage in significantly more PA while attending their nature-based preschool program, the comparison to their traditional preschool site will provide insight into the magnitude of differences and where these differences in PA behaviors may occur throughout the school day. This information may then be used to inform future intervention’s focusing on better aligning children’s PA levels in a traditional school setting with what might be achieved through a nature-based educational program.

Objectives/Goals: Second-generation antipsychotics (SGA) are used to treat mental disorders in youth but are linked metabolic syndrome (MetS). Most data on prescribing practices and risk factors are from short-term studies (6–12 months). We aim to characterize prescribing and identify clinical and genetic predictors of MetS using electronic health records (EHR). Methods/Study Population: EHR data were extracted from Cincinnati Children’s Hospital Medical Center (CCHMC) for patients aged ≤21 years prescribed SGAs from 7/1/2009 and 7/1/2024, identifying prescribing prevalence. Next steps are to create an SGA-MetS case–control dataset 8 weeks after an SGA prescription. A case will be defined by meeting 3 of 5 criteria: 1) BMI ≥95th percentile for age/sex; 2) fasting glucose ≥100 mg/dL or use of anti-diabetics; 3) triglycerides ≥110 mg/dL; 4) HDL-C ≤40 mg/dL; 5) systolic/diastolic BP ≥90th percentile for age/sex or use of antihypertensives. The prevalence of SGA-MetS will be calculated by dividing SGA-MetS cases by total SGA users. Logistic regression will identify clinical predictors of MetS, and we will evaluate the association of polygenic risk scores (PRS) of BMI and type 2 diabetes with SGA-MetS risk. Results/Anticipated Results: Our preliminary analysis identified 30,076 patients who were prescribed SGAs (mean age 12 years, SD = 4; 58.8% female; n =  17685). Most self-identified as non-Hispanic (95%, n = 28,595) and of White race (76%; n =  22,935), with 18.5% self-identifying as Black or African American (n = 5,579). The most commonly prescribed SGAs were risperidone (n = 12,382, 41.1%), aripiprazole (n = 9,847, 32.7%), and quetiapine (n = 5,263, 17.5%), with much lower prescribing rates of other SGA known of their low risk of MetS (e.g., ziprasidone 5.5%, lurasidone 1.4%, paliperidone (n = 316, 1.1%), or others cariprazine (n = 72), asenapine (n = 43), brexipiprazole (n = 39), iloperidone (n = 24), and clozapine (n = 20). Discussion/Significance of Impact: Our analyses found that risperidone, quetiapine, and aripiprazole were the most prescribed SGA, with risperidone/quetiapine linked to a higher risk of MetS. We will present ongoing work identifying risk factors for SGA-MetS and examining the association with PRS. Our work has the potential to identify high-risk patients for personalized treatment.

OBJECTIVES/GOALS: To characterize the various social and health trajectories of women released from jail, and how these trajectories influence women’s risky sexual and drug behaviors. To identify areas in which prevention programs and community interventions can be implemented to improve social and health outcomes. METHODS/STUDY POPULATION: The present study analyzes data collected as part of the sexual health empowerment (SHE Project) health literacy intervention. Participants were recruited from three county jails in the greater Kansas City area. At baseline, participants completed a survey that assessed participants’ sociodemographic characteristics and social histories prior to incarceration. Women were recruited between 2014-2016 and followed up annually after program completion to complete follow-up surveys to assess long-term health and social circumstances. The present study is a secondary analysis of baseline and follow-up data. Final analyses will include survey data from 126 women. RESULTS/ANTICIPATED RESULTS: In this study, we use Hobfoll’s Conservation of Resources (COR) Theory to conceptualize the impacts of stress on the social and health behaviors of justice-involved women in the years following release from jail. We hypothesize that “loss spirals”, a term coined by Stevan Hobfoll, creates psychological stress that drive justice-involved women to assume behaviors that will generate more resources and help to cope with the stress. We expect to find that women struggle to maintain ties to stable housing, employment, and support, which we believe to be central to “loss spirals.” Additionally, we expect to find that these “loss spirals” are associated with sexual and drug health risks. DISCUSSION/SIGNIFICANCE OF IMPACT: This study aims to define a succinct longitudinal timeline assessing biopsychosocial outcomes of women released from jail in order to improve prevention and intervention techniques for the improvement in social and health circumstances of women leaving jail and their reduction in recidivism.

Objectives/Goals: Nucleoside transport by ENT2 facilitates transit of the lupus anti-DNA autoantibody Deoxymab into cells and across the blood–brain barrier into brain tumors. This work examines the Deoxymab-nucleoside interactions that contribute to membrane crossing and apply them in brain tumor therapeutics. Methods/Study Population: Deoxymab interactions with individual nucleosides, nucleobases, and pentose sugars are examined by surface plasma resonance (SPR) and cell penetration assays in a panel of cell lines including glioblastoma, breast cancer, and normal breast epithelial cells. Deoxymab-conjugated gold nanoparticles are generated and tested for binding to normal human astrocytes and glioma cells, and the impact of supplemental nucleosides on this binding is determined. Deoxymab-gold nanoparticles are tested for brain tumor localization by systemic and local administration in mice bearing orthotopic glioblastoma brain tumors and enhancement of laser interstitial thermal therapy (LITT) examined. Results/Anticipated Results: Individual nucleosides significantly increase the efficiency of cell penetration by Deoxymab in all cell lines tested. In contrast, component nucleobases and pentose sugars significantly suppress the uptake of the autoantibody into cells. Deoxymab-conjugated gold nanoparticles bind DNA in vitro and to astrocytes in culture and are anticipated will enhance the efficacy if LITT in vivo by associating with DNA released by necrotic tumors and/or by locally administered nucleosides in brain tumor environments and subsequently act as heat sink to amplify LITT impact. Discussion/Significance of Impact: Deoxymab is a DNA-targeting, cell-penetrating autoantibody. These findings establish nucleosides as the components of DNA that promote autoantibody membrane crossing through ENT2 activity and indicate potential for use of Deoxymab-gold nanoparticles in combination with LITT for brain tumor therapy.

Objectives/Goals: CTSA programs’ requests for applications (RFAs) can be hindered by misalignments with grantees’ needs and expectations. Using a customer discovery approach, we identified real and perceived barriers to conducting pragmatic EHR-embedded trials (PEET) to inform RFA optimization, demonstrating how this funding opportunity addressed barriers. Methods/Study Population: Using Colorado Profiles, a research networking tool, we identified investigators who engaged in PEET-type research across the Colorado Clinical and Translational Sciences Institute (CCTSI) partnering institutions. We invited 33 investigators representing key centers and departments to participate in 30-minute, virtual customer discovery interviews about their experiences conducting PEET-type research within CCTSI’s PEET health system partner, UCHealth. Interviews were conducted using a semi-structured interview guide and were synthesized using a Value Proposition Canvas to identify relevant investigator “jobs-to-be-done,” pain points and potential benefits and strategies to optimize our internal RFA (now in its third year) to address these. Results/Anticipated Results: Twenty-one investigators participated in interviews, including five previous applicants. Two key “customer segments” emerged from interviews: 1) early-career investigators, who wanted to build connections and competencies related to PEET-type research and were often transitioning to independent funding; and 2) experienced investigators, who were focused on larger grants, but valued support in interfacing with UCHealth around both research implementation and informatics. For both groups, while the research funding was seen as beneficial, the true value of the PEET support was the facilitation of a relationship with the health system. Potential changes to the PEET RFA include eligibility clarifications, increased emphasis on health system liaison support, and increased budget flexibility. Discussion/Significance of Impact: In PEETs, alignment of the health system, research infrastructure, and investigators is essential to trial success. Through this process, we identified key unmet needs for investigators and opportunities to optimize this internal RFA to enhance overall alignment between institutional capacities and investigator needs.

OBJECTIVES/GOALS: There is a need to better understand how governments develop strategies to adopt, evaluate, and implement novel health technologies in a public healthcare system. The goal of this project is to understand this strategy development process for the translation of pharmacogenomic (PGx) testing in Ontario, Canada. METHODS/STUDY POPULATION: This observational case study of the Ontario Health PGx Working Group focused on developing recommendations for a PGx testing implementation strategy in the province. The group included 9 individuals affiliated with Ontario Health and 13 healthcare experts from multiple clinical fields. Ontario Health is the government agency that oversees provincial healthcare planning and service delivery. Guided by the Translational Thinking Framework and qualitative research methods, we observed the working group’s activities for eight months. We collected meeting recordings, slideshow decks, emails, and group characteristics. We used descriptive statistics and a nine-step inductive approach to analyze the data to create process maps, a case report, and key decision summaries. RESULTS/ANTICIPATED RESULTS: There were 19 meetings conducted remotely with videoconferencing technology. Throughout the working group’s activities, we identified 15 key decisions related to either administrative processes or PGx scientific content. We further stratified these two categories into four main themes relating to decisions about 1) membership involvement, 2) logistical management, 3) discussion and recommendation scope, and 4) information dissemination. These four decision themes represent tools by which Ontario Health guided the expert group activities and achieved their goal of generating a strategic roadmap for PGx testing implementation in Ontario. DISCUSSION/SIGNIFICANCE: The Ontario government makes decisions about how expert groups function by monitoring and controlling the group’s activities to ensure efficiency, standardization, and practicality. Describing expert group decision-making increases transparency and highlights the critical role they play in the translational pathway of health technologies.

ABSTRACT IMPACT: To date, our Scholars have been highly productive in the conduct of impactful research and have contributed to the literature through dissemination of their findings. OBJECTIVES/GOALS: The primary purpose of the Great Plains IDeA Research Scholars Program (RSP) is to support the development and retention of early-career faculty preparing to compete for external funding as clinical-translational research (CTR) investigators. We developed processes for RSP applications, prioritization, and selection criteria. METHODS/STUDY POPULATION: In year 1, we admitted 4 Scholars and have since added 5 additional Scholars. Scholars are retained in the program until they receive R- or K-level funding or if progress is deemed to be substandard on two consecutive 6-month reviews (no awards revoked to date). Each scholar was assigned a mentor(s) or mentoring team. Each participant developed 1-year goals and a 4-5-year plan that included a refined proposal to collect preliminary data, a timetable for grant submissions (with a focus on R01 applications or equivalent), and personal goals to enhance chances of success. Scholars composed an Individual Development Plan (IDP) with mentor(s) feedback to identify the skills needed to achieve goals. Each Scholar completed pilot work to generate the requisite preliminary data for an extramural grant application. RESULTS/ANTICIPATED RESULTS: Over four years, we have had 9 scholars from 4 sites with 51 total applications. All scholars completed required grant writing seminar courses, an 8-hour Responsible Conduct of Research course, and were given access to seminars and workshops sponsored by the Great Plains IDeA CTR. Scholars received 0.5 FTE in research support and $50,000 annual funding to support their research and/or career development activities. Seven of 9 scholars have completed the program to date, collectively receiving an R01 (1), a U01 (1), a K23 (1), a VA Career Development Award (1), or COBRE pilot projects leadership roles (3). All remain active faculty at their institution. Two remaining scholars are working towards independent funding: both have submitted extramural grant applications with anticipated funding this year. DISCUSSION/SIGNIFICANCE OF FINDINGS: To date, our Scholars have been highly productive in the conduct of impactful research. They have submitted 36 grants; culminating in 27 funded projects and >$7.5 million in total funding for 7 graduates. They have disseminated their findings through 121 publications and 48 invited regional/national presentations.

OBJECTIVES/GOALS: The objective of this study is to examine implementation science and clinical outcomes of telemedicine ID consultation at a rural Missouri hospital. METHODS/STUDY POPULATION: Pilot study, hybrid type 2, studying clinical outcomes (mortality, readmission, hospital transfer) and implementation outcomes assessed by survey and chart review (feasibility, acceptability, appropriateness, fidelity to guideline-based care). Telemedicine ID consultations are carried out for patients at Missouri Baptist Sullivan Hospital (MBSH) with positive blood cultures and charts reviewed for 30 days after hospital discharge. Patients, physicians, and staff complete surveys for implementation outcomes. The practical, robust implementation and sustainability model (PRISM) was chosen as the framework for this study and its future scale-up. RESULTS/ANTICIPATED RESULTS: There were 46 patients with positive blood cultures at MBSH, 20 of which were transferred or left from the ER before consultation could be offered. Eighteen patients had telemedicine ID consultation. The remaining 8 patients had contaminants in their blood cultures and therefore no consultation was offered. Of eligible patients not transferred, recruitment rate was 100% (18/18). Average total time per consult was 52.8 minutes on day 1, 8.5 minutes on day 2. 30-day mortality was 0%, 30-day readmission rate 5.5% (n = 1), hospital transfer rate 5.5% (n = 1). 13 patients and 9 providers completed the feasibility, acceptability, and appropriateness survey with zero negative responses on any measure. DISCUSSION/SIGNIFICANCE OF IMPACT: Telemedicine ID consultation at a single rural hospital has thus far been received as feasible, acceptable, and appropriate. Scale-up of this model of care remains to be studied.

OBJECTIVES/GOALS: Familial Hypercholesterolemia (FH) is a common disorder that is vastly underdiagnosed and causes an increased risk for sudden cardiac death. Cardiology providers (CHCPs) are in an ideal position to care for patients with FH. This research aimed to assess the knowledge of CHCPs in the screening, diagnosis, and management of FH. METHODS/STUDY POPULATION: Adaptation of an existing knowledge tool guided survey development. FH knowledge domains included description of FH, prognosis, prevalence, inheritance, diagnostic criteria, and management options. CHCPs were asked to select their provider type (MD, PA, NP, RN) and years in clinical practice (less than 1-5 years, 6-10 years, 11-20 years, and greater than 20 years).Convenience and snowball sampling recruited CHCPs in the Division of Cardiology at Columbia University Irving Medical Center (CUIMC). Descriptive statistical analysis was performed on quantitative survey data using R. Frequency counts of provider type and years in clinical practice were calculated. Comparisons of scores between provider types and years in clinical practice were made using ANOVA. RESULTS/ANTICIPATED RESULTS: 70 surveys were analyzed (30.2% response rate). 50% of CHCPs identified as MDs, 24.2% as RNs, 12.9% as NPs, and 12.9% as PAs. With regards to clinical experience, 21.4% of CHCPs had 1-5 years, 25.7% had 6-10 years, 24.3% had 11-20 years, and 28.6% had greater than 20 years. The average overall score across all CHCPs was 55.4%, with the highest on the description knowledge domain (81.4% correct), followed by management (61.8%), diagnostic criteria (60.6%), inheritance (58.6%), prevalence (44.3%), and prognosis (25.2%). Physicians had the highest average score of 66.0%, followed by NPs (50.3%), PAs (49.7%), and RNs (39.3%). There was no significant difference in scores across experience levels, provider types, and knowledge domains based on experience levels. DISCUSSION/SIGNIFICANCE: CHCPs across all provider types and years of experience had limited FH knowledge. There exists an opportunity to improve CHCPs’ knowledge of FH through education (didactic knowledge) or practice (experiential knowledge). Future interventions should aim to increase didactic and experiential knowledge of CHCPs through a variety of methods.

Objectives/Goals: The overarching goal of the GRAMM study is to address racial health disparities by increasing access to genetic counseling and testing among the Black community. Specific objectives are to determine patient acceptability of risk assessment at time of mammography and to evaluate subsequent access to and uptake of genetic counseling and testing. Methods/Study Population: All women presenting for screening mammography at the Ypsilanti Health Center under the University of Michigan were invited to enroll. After providing written informed consent, study participants entered family cancer and personal health information in the InheRET software tool which links to the National Comprehensive Cancer Network genetic testing guidelines. Upon completion, each participant was informed immediately if they did or did not meet the criteria to meet with a genetic counselor. For those who met the criteria, referral to genetic counseling was provided. All enrollees were invited to complete a post-assessment survey on acceptability of the service and genetics knowledge. Patients will be followed over time for completion of genetic counseling and testing. The study was approved by the Umich IRB. Results/Anticipated Results: As of 10/18/24, a total of 53 were enrolled, with 52 eligible for the study and were between the ages of 30–75 years. 51 identified as women and 1 identified as nonbinary. 21 (40.4%) identified as Black, 30 (57.7%) identified as White, 2 (3.8%) identified as Hispanic, and 1 (1.9%) identified as mixed race. Of the total enrolled, 25 (48.1%) met criteria to meet with a genetic counselor. Twelve (23.1%) have been scheduled to with meet with a genetic counselor and 2 (3.8%) of this group completed their appointment, but did not pursue genetic testing. 28 (53.8%) completed the survey and reported that they were satisfied with the service. Of the 16 people who screened positive and completed the survey, all 16 (100%) stated that they intended on proceeding with testing. Our study is still ongoing. Discussion/Significance of Impact: While this model has demonstrated acceptability so far, there are still possible barriers to genetic counseling and testing after the referral has been provided that need to be explored. However, this approach could provide a novel framework for combining risk assessment with screening mammography for all women nationwide.

OBJECTIVES/GOALS: The current proposal seeks to investigate the effect of early life antibiotic use in the development of functional gastrointestinal (GI) disorders. We propose that infants exposed to antibiotics will present with gut microbial dysbiosis, changes in fecal bile acid concentrations and develop more GI symptoms compared to unexposed children. METHODS/STUDY POPULATION: We analyzed fecal samples from 174 subjects at 12 months of age, of whom 52 were exposed to antibiotics in their first year of life. Of these, 33 subjects were sampled again at 24 months of age. DNA from 200mg of frozen stool (−80C) was isolated with the Qiagen DNeasy PowerSoil kit. Shotgun libraries were generated using the NexteraXT kit and sequenced on the Illumina HiSeq 2500 using 2x125 bp chemistry. Sequence data were analyzed using the Sunbeam metagenomics pipeline. The abundance of bacteria was estimated using Kraken version 2.0.8. Fecal bile acids will be quantified by liquid chromatography–mass spectrometry (LC-MS). RESULTS/ANTICIPATED RESULTS: Overall bacterial community composition at 12 or 24 months was not associated with antibiotic exposure (PERMANOVA test, Bray-Curtis distance). An increase in Enterobacteriaceae, in particular Escherichia coli, is a signature of antibiotic-induced dysbiosis, but also of early infant gut. Children with antibiotic exposure had slightly higher abundance of Escherichia coli compared to those with no exposure (p = 0.03). At 24 months, the abundance of Bacteroides caccae, a commensal gut species, was decreased for children exposed to antibiotics in the first year of life (fdr = 0.02). We will perform further analysis of bile acid modifying bacteria, fecal bile acid concentrations and correlate to GI symptoms. DISCUSSION/SIGNIFICANCE OF IMPACT: Our findings suggest a significant but nuanced impact of early life antibiotic use on the composition of the gut microbiota. The association of antibiotic exposure with B. caccae and E. coli warrant further attention in the context of the rapidly developing early-life microbiome. CONFLICT OF INTEREST DESCRIPTION: The authors declare no conflicts of interest relevant to this work.