Objectives/Goals: Discriminatory experiences within healthcare settings significantly hinder equitable health access for sexual minority groups (SMPs) in the USA. These discriminatory experiences can manifest in various forms (e.g., refusal of care). We aimed to explore different types of discrimination encountered by SMPs in the healthcare settings. Methods/Study Population: This study utilized secondary data from the NIH All of Us Research Program. For this analysis, we selected cohorts self-identifying as gay (n  =  9,454), bisexual (n  =  15,284), lesbian (n  =  5,267), and straight (n  =  349,748), enabling robust comparisons across SMPs and straight individuals. We employed analysis of variance and Chi-square analyses to assess group differences in healthcare discrimination, using key indicators from the Discrimination in Medical Settings Scale. These indicators captured experiences such as being treated with less respect or courtesy and feeling ignored by healthcare providers, providing a comprehensive view of discriminatory encounters in healthcare settings for SMPs. Results/Anticipated Results: Our analyses revealed that bisexual individuals reported the highest levels of healthcare discrimination (mean  =  3.64, SD  =  2.45), followed by lesbians (mean  =  3.37, SD  =  2.47), other SMPs (mean  =  3.36, SD  =  2.53), gay (mean  =  2.69, SD  =  2.47), and straight participants (mean  =  2.60, SD  =  2.42). Among the seven discrimination indicators, the most reported experience was feeling like a doctor or nurse was not listening, with 76.8% of bisexual participants, 72.3% of lesbians, 68.8% of other SMPs, and 56.9% of gay participants reporting this experience. This was followed by reports of being treated with less respect and being treated with less courtesy in healthcare settings. These findings highlight the pervasive nature of healthcare discrimination among SMPs, particularly bisexual individuals. Discussion/Significance of Impact: SMPs experience higher levels of discrimination in healthcare settings compared to their straight counterparts. Our results underscore the urgent need to foster respectful, inclusive healthcare environments and ensure that healthcare providers are adequately trained to address the unique health needs and experiences of SMPs.

OBJECTIVES/GOALS: Mayo Clinic implemented a CRC Placement Hub to improve hiring experiences for candidates and hiring managers. Candidates apply to a centralized posting. A Placement Coordinator handles administrative and screening responsibilities, allowing hiring managers to focus on selecting best candidates. METHODS/STUDY POPULATION: The CRC Placement Hub was implemented in phases. Initially, first and second interviews were conducted using Zoom and hiring manager utilization of the Hub was voluntary. Positive candidate and hiring manager feedback shifted Hub utilization to the standard practice and hiring managers must request an exception to post separately for unique candidate requirements. The third phase progressed to utilizing the HireVue hiring platform. Qualified candidates are invited to complete an on-Demand interview at their convenience, which hiring managers utilize to select candidates to continue through the interview process. HireVue utilization has decreased time to fill metrics for CRC candidates. RESULTS/ANTICIPATED RESULTS: The intentions for the CRC Placement Hub are to offer a positive hiring experience for candidates and reduce administrative burden for the hiring managers, while maintaining autonomy of hiring decisions. Additional purposes for the Hub are to increase the candidate pool by developing recruitment pipelines and decrease overall timeline to fill an open position. Qualitative and quantitative metrics were established to monitor performance. Metrics depict positive experiences for candidates and hiring managers, and decreased timelines to fill open positions. Candidate pools continue to increase as the Hub Placement Coordinator holds off-campus and online recruitment events. DISCUSSION/SIGNIFICANCE: The CRC Placement Hub provides candidates a positive experience, allowing them to apply to one posting but considered for all open positions. The Hub decreases administrative burden for hiring managers, allowing them to focus on critical aspects of candidate selection and managing clinical research.

OBJECTIVES/SPECIFIC AIMS: Characterize microbiome metadata describing specimens collected, genomic pipelines and microbiome results, and incorporate them into a data integration platform for enabling harmonization, integration and assimilation of microbial genomics with exposures as spatiotemporal events. METHODS/STUDY POPULATION: We followed similar methods utilized in previous efforts in charactering and developing metadata models for describing microbiome metadata. Due to the heterogeneity in microbiome and exposome data, we aligned them along a conceptual representation of different data used in translational research; microbiomes being biospecimen-derived, and exposomes being a combination of sensor measurements, surveys and computationally modelled data. We performed a review of literature describing microbiome data, metadata, and semantics [4–15], along with existing datasets [16] and developed an initial metadata model. We reviewed the model with microbiome domain experts for its accuracy and completeness, and with translational researchers for its utility in different studies, and iteratively refined it. We then incorporated the logical model into OpenFurther’s metadata repository MDR [17,18] for harmonization of different microbiome datasets, as well as integration and assimilation of microbiome-exposome events utilizing the UPIE. RESULTS/ANTICIPATED RESULTS: Our model for describing the microbiome currently includes three domains (1) the specimen collected for analysis, (2) the microbial genomics pipelines, and (3) details of the microbiome genomics. For (1), we utilized biospecimen data model that harmonizes the data structures of caTissue, OpenSpecimen and other commonly available specimen management platform. (3) includes details about the organisms, isolate, host specifics, sequencing methodology, genomic sequences and annotations, microbiome phenotype, genomic data and storage, genomic copies and associated times stamps. We then incorporated this logical model into the MDR as assets and associations that UPIE utilizes to harmonize different microbiome datasets, followed by integration and assimilation of microbiome-exposome events. Details of (2) are ongoing. DISCUSSION/SIGNIFICANCE OF IMPACT: The role of the microbiome and co-influences from environmental exposures in etio-pathology of various pulmonary conditions isn’t well understood [19–24]. This metadata model for the microbiome provides a systematic approach for integrating microbial genomics with sensor-based environmental and physiological data, and clinical data that are present in varying spatial and temporal granularities and require complex methods for integration, assimilation and analysis. Incorporation of this microbiome model will advance the performance of sensor-based exposure studies of the (UPIE) to support novel research paradigms that will improve our understanding of the role of microbiome in promoting and preventing airway inflammation by performing a range of hypothesis-driven microbiome-exposome pediatric asthma studies across the translational spectrum.

ABSTRACT IMPACT: The impact of this study is that the results may lead to the development of effective educational programs and a comprehensive cancer control program while verifying patients and medical care providers adherence and compliance with cancer clinical guidelines. OBJECTIVES/GOALS: The objective of this study is to assess risk factors, preventive measures, and screening practices for human papilloma virus (HPV) associated cancers in a sub-population in Central-Eastern Puerto Rico (PR). METHODS/STUDY POPULATION: This is a sub-analysis from an annual descriptive cross-sectional questionnaire of risk factors, preventive measures, and screening practices for cancer in PR administered at a private hospital campus using a convenience sample of healthy and non-healthy adults. RESULTS/ANTICIPATED RESULTS: Out of 345 enrolled subjects in 2019 for the questionnaire, 67 were enrolled by the first author, from which 66 (19%) subjects qualified for this sub-analysis for completing the study: 79% females. When analyzing HPV risk factors, 5% of the participants were smokers. Eleven percent of the subjects received the preventive HPV vaccine. Among those non-vaccinated and eligible for vaccination, 95% were willing to get it. Seventy one percent of females 21-29 years old and 97% of 30-65 years olds had age-appropriate cervical cancer screening. DISCUSSION/SIGNIFICANCE OF FINDINGS: Despite the low prevalence of HPV vaccination, almost all of the subjects within the age range for HPV vaccination were willing to get it. Also, there was a lower prevalence of cervical cancer screening in females 21-29 years old when compared with 30-45 years old. In conclusion, there is a need for more education about HPV associated cancers and vaccine.

The availability of large healthcare datasets offers the opportunity for researchers to navigate the traditional clinical and translational science research stages in a nonlinear manner. In particular, data scientists can harness the power of large healthcare datasets to bridge from preclinical discoveries (T0) directly to assessing population-level health impact (T4). A successful bridge from T0 to T4 does not bypass the other stages entirely; rather, effective team science makes a direct progression from T0 to T4 impactful by incorporating the perspectives of researchers from every stage of the clinical and translational science research spectrum. In this exemplar, we demonstrate how effective team science overcame challenges and, ultimately, ensured success when a diverse team of researchers worked together, using healthcare big data to test population-level substance use disorder (SUD) hypotheses generated from preclinical rodent studies. This project, called Advancing Substance use disorder Knowledge using Big Data (ASK Big Data), highlights the critical roles that data science expertise and effective team science play in quickly translating preclinical research into public health impact.

OBJECTIVES/GOALS: Post-traumatic stress disorder (PTSD) develops in a subset of individuals (15-25%) exposed to trauma. We report our preliminary findings investigating underlying peripheral immune responses related to risk and resilience to PTSD. METHODS/STUDY POPULATION: Sprague-Dawley rats (half male) were exposed to predator scent stress in the form of the fox pheromone 2,5-dihydro-2,4,5-trimethylthiazoline (TMT) once for 10 minutes. Seven days later, rats were assessed for persistent anxiety-like behavior using the acoustic startle response task (ASR) and elevated plus maze (EPM). Tail blood was collected for later inflammation analysis at three time points: 1) prior to experiment start, 2) after TMT exposure, and 3) after ASR and EPM. Using a with-in subjects design, our experiment elucidates the connection between PTSD-like symptoms and baseline immune function, inflammatory stress responses, and chronic inflammatory state after stress exposure. RESULTS/ANTICIPATED RESULTS: In comparison to healthy controls, humans with PTSD show elevated blood levels of inflammatory markers. Human studies also show a relationship between baseline immune dysfunction and later PTSD development. In agreement with this literature, we anticipate PTSD-like rats will have increased blood levels of inflammation markers at all three time points compared to resilient and control rats. These findings will back-translate human findings in support of the predator scent stress preclinical model of PTSD. DISCUSSION/SIGNIFICANCE: Our findings will elucidate the temporal aspects of proinflammatory markers and PTSD development. This study will indicate if baseline peripheral immune dysfunction, inflammatory response immediately after stress exposure, and/or chronic inflammatory state predicts ptsd-like behavior in rats.

OBJECTIVES/GOALS: The aim of thispaper is to raise awareness of the limitations of the current pMRI training paradigm and to recommend a standardization of skills to expand diversity among field-based neuroimaging technicians. METHODS/STUDY POPULATION: Currently, there are seven international brain research initiatives. The goal is to establish and understand the cultural values a society holds and how the outcomes of research may be adopted into societal practice. We must also consider the benefits of early detection amongst minoritized communities in neuroscience research. Neuroimaging in remote settings can allow patients to advocate more accurately for timely medical care which can lead to better health outcomes. According to the Journal of Neurological Sciences, neuroscience accounts for 9% of total medical publications. RESULTS/ANTICIPATED RESULTS: Neuroimaging research continues to evolve in terms of resolution and portability. T By harnessing diverse data, we are able to utilize advanced neuroimaging techniques and software technology to recognize trends amongst subgroups of individuals who were previously considered geographically inaccessible. DISCUSSION/SIGNIFICANCE: Despite the excitement and promise of portable neuroimaging devices, there is a fundamental need to establish standardized training procedures that can be accessed by individuals of all socioeconomic backgrounds.

OBJECTIVES/SPECIFIC AIMS: Childhood obesity has become an issue of some concern worldwide. Some reviews and a recent study in adults have indicated that obesity-related inflammatory responses produce brain damage. However, studies exploring associations between inflammation and executive functions in children are overlooked. Therefore, the objective of this cross-sectional study is to determine whether difficulties in executive functions and emotional processing are associated with obesity and inflammation. METHODS/STUDY POPULATION: We have recruited 12 of a total of 60 children aged 6–8 years old. They have completed the NIH Toolbox Cognition Battery and the NEPSY II Affect Recognition tests. Samples of plasma and saliva were collected to quantify inflammatory biomarkers cytokines (IL-6 and TNF-α) assay by Luminex procedure. We performed descriptive analysis and Mann-Whitney U test to compare obese Versus nonobese groups. RESULTS/ANTICIPATED RESULTS: Obese children have lower scores in measures of affect recognition than healthy weight children. They also showed higher median scores in both salivary and plasma IL-6 and TNF-α. DISCUSSION/SIGNIFICANCE OF IMPACT: Although no statistical differences were found among groups in either measurement, these preliminary data based on the initial recruitment suggest that children with higher body mass index may have difficulties in emotional processing. More data will be available after completing recruitment to determine if the association between obesity and affect recognition is significant and if it is mediated by inflammation.

OBJECTIVES/GOALS: The goal of this study is to demonstrate growth in leadership skills in areas of milestone selection, conditions of success, and self-efficacy for females in the Capita3 Leader Launch (LL) Program. METHODS/STUDY POPULATION: Forty females were self-selected to participate in the LL Program, a 21 day program which is organized around a highly significant career goal that each participant selects. The program is designed to guide participants through a unique and transformative process to increase the probability that each participant will achieve their selected career goal. In the fall of 2022, seventy people participated in the LL program. Participants were asked to fill out a Leadership assessment prior to participation and then again following participation in the program. RESULTS/ANTICIPATED RESULTS: Immediately after the program, participants self-report 86% increased confidence, 85% being on track to achieving their selected milestone or an appropriate pivot, and 80% feel more equipped to navigate their external environment. DISCUSSION/SIGNIFICANCE: This study demonstrates that the LL Program addresses barriers that are neither fully understood nor addressed by existing programs and policies for women. Future programs can use the LL Program to help females take on high visibility assignments, larger organizational roles, and leadership positions within the current organization environment.

OBJECTIVES/GOALS: Same-day discharge (SDS) after mastectomy without reconstruction (MwoR) is cost-effective with equivalent complications rates when compared to patients discharged the day after surgery. Despite this, facilities SDS rates after MwoR vary from <10%-80% (20% overall). We aimed to explore barriers to and strategies for implementing SDS after MwoR. METHODS/STUDY POPULATION: We conducted semi-structured interviews with surgeons currently performing MwoR and practicing in the state of Michigan. Recruitment was done through purposeful and snowball sampling methods. Interviews ranged from 40-60 minutes in length. The interview guide was based on the Tailored Implementation of Chronic Disease framework. Interviews were transcribed then analyzed by 3 independent reviewers. A framework matrix was created to identify common themes. RESULTS/ANTICIPATED RESULTS: Participants (n=15) included general surgeons, breast surgeons, surgical oncologists, and both university and non-university affiliated practices were represented. Surgeons either discharged patients the same-day or the day after MwoR. All surgeons who didnt routinely discharge patients the day of surgery (n=9) believed their facility had the resources to implement this practice and it would be safe for most patients. Identified barriers to same-day discharges included provider preoperative expectation setting, patient anxiety about managing their wound drain, and practice standards at their facility. Potential strategies for implementation included incorporating drain teachings with patients before surgery and explaining the benefits of same-day discharge with other providers at your facility. DISCUSSION/SIGNIFICANCE: We identified novel barriers to same-day discharge after MwoR. These barriers are potentially targetable with interventions addressing patient anxiety surrounding drain management, and education of providers across the care continuum.

Objectives/Goals: This study looks to investigate the relationship between body mass index (BMI) and the treatment effect of cancer immunotherapies. Specifically, we will assess whether there is a significant difference in survival curves associated with varying BMI levels and track trends in BMI reporting over the last decade. Methods/Study Population: An individual patient meta-analysis will be conducted by reanalyzing raw data of phase 3 cancer immunotherapy trials (2013–2023) accessed via the database Vivli. Prior to making a formal data request, an exploratory search will be first done through clinicaltrials.gov to assess viability. Studies that report baseline BMI and treatment efficacy will be included. BMI will be analyzed as a continuous variable, with survival curves compared across different BMI ranges using restricted mean survival time and log-rank tests. Trials will be stratified by drug class and adjusted for race, age, and gender to account for potential sources of confounding/bias. Results/Anticipated Results: Results are currently still a work in progress as I am in the process of getting the dataset from Vivli. I anticipate that treatment effects in cancer immunotherapies will vary significantly by BMI. Furthermore, I expect to see significant disparities in survival outcomes between patients assigned to a low and high BMI category. Lastly, trends in the reporting of BMI across immunotherapy trials are expected to be inconsistent which highlights the need for more standardization in clinical trial datasets. Discussion/Significance of Impact: This study should address critical knowledge gaps in how BMI level is associated with immunotherapy outcomes. These findings could potentially guide personalized treatment strategies and highlight the importance of standardizing the variables clinical trials chose to report.

OBJECTIVES/SPECIFIC AIMS: The goals of this retrospective cohort study is threefold: 1) to assess how many pregnant women at Boston Medical Center from 2012 to 2017 have had their vitamin D status checked prior to and during pregnancy, 2) determine associations between vitamin D levels, birth outcomes and demographics and 3) assess how many of those found to have lower than satisfactory vitamin D levels (<30ng/mL) received interventions, including receiving vitamin D supplementation and/or being referred to an appropriate specialist such as an endocrinologist or a nutritionist. METHODS/STUDY POPULATION: Our study population is mothers over age 18 who received care at Boston Medical Center during their pregnancy from 2012 to 2017. Our primary outcomes are vitamin D utilization rates and associations between vitamin D levels with clinical outcomes during pregnancy and at birth. Secondary outcomes are demographic predictors of mothers who receive vitamin D testing and those who have complications associated with low vitamin D. We will conduct multiple linear regressions to check for associations between vitamin D levels, birth outcomes and demographic variables. We will adjust vitamin D levels with maternal BMI. De-identified clinical data was gathered from Boston University Medical Center’s (BUMC) Clinical Data Warehouse. This retrospective study was approved with a HIPAA waiver by the BUMC Institutional Data Warehouse. All statistical analysis was completed using SAS version 9.4 and was primarily done by the student PI and reviewed by Dr. Hossein, the co-investigator who is trained as a statistician and geneticist. The team also utilized Boston University’s Biostatistics, Epidemiology & Research Design (BERD) team to check the feasibility of the statistical methods. RESULTS/ANTICIPATED RESULTS: We anticipate that our descriptive demographic data will reflect the medical center’s predominantly black/Hispanic and low-income profile. Based on previous literature, we expect low vitamin D levels to have positive associations with gestational diabetes, pre-eclampsia, and preterm birth. Analyses are currently actively in progress and we expect to have results before the ACTS conference date in March, 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Vitamin D is an essential part of the human body system. It is well documented in current literature that vitamin D is correlated with bone health, mental health and maternal health. Moreover, there is evidence that maternal vitamin D supplementation prevents vitamin D deficiency in newborns. Previous literature suggests that low vitamin D may be associated with gestational diabetes, pre-eclampsia, and pre-term births. Boston Medical Center is Massachusetts’ largest urban medical center and acts as its only safety-net hospital, serving predominantly low-income and socially marginalized patient populations. There is limited existing research on assessment of maternal vitamin D in urban hospital settings. Pregnant women rarely receive vitamin D screenings as part of their prenatal checkups as current national and regional guidelines do not require pregnant women to be screened for vitamin D deficiency or insufficiency. The results will demonstrate the potential effects vitamin D supplementation, or lack thereof, in expectant mothers living in urban, safety net communities. We hope to inform prenatal care practices and attitudes of vitamin D supplementation in maternal health with the results of our study.

Objectives/Goals: Discharges before medically advised (BMA) – also known as “against medical advice” – after an asthma exacerbation are associated with adverse outcomes, including recurrent hospitalization, but the reasons for this are unclear. We sought to evaluate whether gaps in prescribing maintenance inhalers were associated with recurrent hospitalization. Methods/Study Population: All asthma exacerbations, defined by ICD-10 codes, among adults requiring an emergency department (ED) visit or hospitalization at any of 5 hospitals in our health system were classified as BMA or non-BMA (i.e., planned) discharges using EHR data. We evaluated whether an inhaled corticosteroid and long-acting beta-agonist (ICS/LABA) inhaler was prescribed on discharge, and whether they had a recurrent exacerbation within 30 days. We used logistic regression models adjusted for age, sex, exacerbation history, medical center, encounter type (ED or admission), BiPAP use, insurance, prior ICS/LABA prescription to evaluate risk of 30-day re-exacerbation by ICS/LABA prescription, BMA discharge, and the interaction between those variables. Results/Anticipated Results: This cohort included 13,064 exacerbations, and 330 (2.5%) resulted in BMA discharge. Compared to non-BMA discharges, those discharging BMA were younger (40 vs 43 years) and less often female (48% vs 64%). Those discharging BMA were less likely to receive an ICS/LABA prescription (16% vs 23%, p=0.01) and more likely to experience 30-day re-exacerbation (12% vs 7%, p=0.001). In adjusted analyses, BMA discharge increased the risk of 30-day re-exacerbation (OR 1.79, 95% CI: 1.22-2.64) and ICS/LABA prescription was protective (OR 0.79, 95% CI: 0.65-0.96). There was a significant interaction (OR for interaction: 0.11, 95% CI 0.01-0.85), indicating a stronger protective association of ICS/LABA among those discharging BMA. Discussion/Significance of Impact: Prescribing an ICS/LABA at discharge protects against recurrent severe asthma exacerbations within 30 days. This association is strongest among those discharging BMA, highlighting this susceptible population as requiring further attention to address gaps in care.

OBJECTIVES/SPECIFIC AIMS: Peripheral neuropathy is the dose limiting toxicity of paclitaxel treatment. Paclitaxel pharmacokinetics (PK), specifically the Cmax and amount of time the concentration remains above 0.05 µM (Tc>0.05), have been associated with occurrence of severe, clinician-documented neuropathy. The objective of this study was to confirm that paclitaxel PK predicts progression of patient-reported neuropathy. METHODS/STUDY POPULATION: This observational trial enrolled breast cancer patients receiving weekly 1-hour paclitaxel infusions (80 mg/m2×12 cycles) at the University of Michigan Comprehensive Cancer Center. Paclitaxel concentration was measured via LC/MS in plasma samples collected at the end of (Cmax) and 16–24 hours after (Tc>0.05) first infusion. Patient-reported neuropathy was collected (EORTC CIPN20) at baseline and each cycle. The rate of neuropathy severity increase per treatment cycle is being modeled for each patient. Cmax and Tc>0.05 values will be introduced into the model to confirm that PK independently contributes to neuropathy progression. RESULTS/ANTICIPATED RESULTS: PK and neuropathy data have been collected from 60 patients for ongoing analysis. Our initial model will characterize the expected severity of neuropathy after each cycle of paclitaxel treatment. The PK-neuropathy model will include either PK parameter to validate their contribution to the progression of neuropathy severity during treatment. We anticipate, based on our preliminary analysis of the first 16 patients, that both PK parameters will significantly contribute to the model but Tc>0.05 will be more strongly associated with neuropathy progression. DISCUSSION/SIGNIFICANCE OF IMPACT: This project will generate a model that can be used to predict a patient’s neuropathy severity throughout treatment using a single, conveniently collected and easily measured PK sample during their first cycle. The next steps of this project include identifying genetic and metabolomic biomarkers that predict which patients experienced more severe neuropathy than would be anticipated based on their paclitaxel PK, and a planned interventional trial of personalized paclitaxel dosing to enhance efficacy and/or prevent neuropathy.

Objectives/Goals: Findings from cohort studies report a 1-year major adverse cardiac event (MACE) rate of 15% after vascular surgery. However, the real-world evidence (RWE) of the timing, incidence, and profile of these events is limited. We hypothesize that the MACE rate from RWE data will exceed current estimates. Methods/Study Population: Patients undergoing elective, intermediate- or high-risk vascular surgery at University of Maryland Medical System (1/1/2016—9/30/2025) were analyzed retrospectively. Data on six MACE outcomes (all-cause mortality, myocardial infarction, coronary revascularization, heart failure decompensation, cardiogenic shock, nonfatal cardiac arrest) were extracted from the Electronic Health Record utilizing algorithms incorporating ICD-10 codes, Current Procedural Terminology (CPT) codes, and clinical variables. We calculated the cumulative postoperative MACE incidence at 7-days, 30-days and 1-year following surgery. Results/Anticipated Results: We identified 9,490 patients of whom N=6,180 (65%) were male, N=6,327 (67%) were white, and N=2,755 (29%) were black or African American. We will describe baseline characteristics, comorbidities, pre-operative radiographic results and laboratory values for the study cohort. The primary endpoint is cumulative MACE incidence at 30-days. Secondary endpoints include composite MACE incidence at 7-days and 1-year, as well as outcomes stratified by individual MACE parameters. Discussion/Significance of Impact: This retrospective study aims to provide a detailed characterization of MACE following vascular surgery. The derived data are anticipated to inform pre-operative risk stratification for real-world scenarios and in doing so identify opportunities for preventative interventions targeting MACE.