OBJECTIVES/SPECIFIC AIMS: To characterize parent communication frequency and content between systems of care (medical, school, and sports/recreation) of concussed youth who are in prolonged recovery. METHODS/STUDY POPULATION: In this ongoing study, 16 concussed youth (average age=14.9 years, SD=1.5; 31.2% female and 68.8% male) and their parent study partner (average age=44.3 years, SD=4.3; 87.3% female and 12.5% male) have been enrolled to date from sports medicine clinics. Demographic information was obtained during the initial clinic intake session. Weekly phone calls were also conducted with the parent and child until the child was considered asymptomatic (ie, reporting no symptoms on the SCAT3), to collect data on communication with the school, sport/recreation, and medical systems throughout the recovery process. For the purpose of this study, we evaluated communication patterns of those parents who had a child in prolonged recovery (ie, symptomatic 14 d or more post-concussion injury). Communication variables included frequency (ie, number of times a parent contacted or attempted to contact a system of care) and content or topic discussed during the contact event. RESULTS/ANTICIPATED RESULTS: Of the 16 enrolled participants to date, 68.8% (n=11) experienced concussion related symptoms 14 days postinjury (M=22.2, SD=4.6) at the time of their 2 week follow-up call and were thus considered to be in prolonged recovery. Of those 11, 81.8% (n=9) of parents reported communicating with the school system at some point between the initial clinic intake session and the 2 week follow-up phone call. The frequency of communication for this period ranged between 0 and 10 instances of contact (M=2.5, SD=2.9). Of the 11 prolonged cases, 8 participants were members of sports teams. Sixty-three percent (n=5) of those parents with a child on a sports team communicated with a coach while none of the parents contacted a team athletic trainer. The frequency of communication with the coach ranged from 0 to 8 (M=1.5, SD=2.5) over the course of 2 weeks from enrollment. With regards to the medical system, the majority of parents (72.7%, n=8) communicated at least once with a medical professional during the same time period. The frequency of communication with the medical system ranged from 0 to 8 (M=2.2, SD=2.6) points of contact. Themes that arose for communicating with the school system included informing school personnel of academic accommodations prescribed by the physician, explaining absences, and concerns about missed academic work and grades. The content of communication with the sports system (ie, coach) pertained to return-to-play issues as well as progress updates on recovery. Themes for communication with the medical system were centered on scheduling appointments, attending follow-up medical appointments, and starting return-to-play protocols. DISCUSSION/SIGNIFICANCE OF IMPACT: Parents of concussed youth who were still in prolonged recovery, for the most part, appear engaged in communicating with multiple systems of care. However, a subset of parents did not participate in contact with these systems. Further discussion of these findings will highlight areas for improvement in concussion management as well as strategies parents can utilize to advocate for their child in terms of return-to-learn and recovery.

OBJECTIVES/GOALS: Transportation is a barrier to research participation, especially for participants from disadvantaged backgrounds. Our goal was to review existing policies and create recommendations for institutional guidance on research-related transportation to support a long-term birth cohort study. METHODS/STUDY POPULATION: To summarize existing institutional policies on research-related transportation (i.e., transportation of participants or research staff travel to/from research activities), we requested and, in addition, searched for such policies across 28 sites involved in the NIH HEAL Initiative’s HEALthy Brain and Child Development (HBCD) study. The HBCD study plans to enroll 7,500 pregnant/postpartum persons, follow their children and families long-term, and assess factors influencing brain and child development. The obtained policies were then summarized, followed by identification of gaps in their recommendations and guidance. RESULTS/ANTICIPATED RESULTS: Outreach to the HBCD study sites and search of their institutional websites resulted in identification of 6 institutional policies or other guidance related to research-related transportation across five HBCD study sites. Three policies/guidance related to ride-share programs in research, two related to reimbursement for participant travel, and the fifth was about car seats. Through the online search, we also found policies or written guidance about employee-related transportation within 15 HBCD study sites in total; they largely pertained to employee business travel and did not specifically address research-related transportation. DISCUSSION/SIGNIFICANCE: To optimally support research teams, participants, and to promote the enrollment and retention of participants from diverse backgrounds, it is critical for research institutions to develop and implement guidance on research-related transportation and remove barriers to participation in research.

OBJECTIVES/GOALS: AI is diagnosed when peak cortisol level after a cosyntropin stimulation test is <18 mg/dL using polyclonal antibody (pAb) immunoassay. However, the polyclonal assay is being replaced by a specific monoclonal antibody (mAb) immunoassay which yields lower cortisol levels, leading to the over diagnosis of AI and use of unnecessary steroid use. METHODS/STUDY POPULATION: We obtained 36 samples from patients undergoing 1 mcg cosyntropin stimulation tests for diagnosis of AI. Samples were analyzed using pAb immunoassay (Abbott Architect Cortisol), mAb immunoassay (Roche Elecsys Cortisol II), and mass spectrometry (MS). AI was diagnosed if serum cortisol level was <18 using the pAb immunoassay. Measurements by MS and mAb immunoassay were individually used in simple logistic regression models to predict AI. For each model, we calculated a cortisol level corresponding to a 50% probability (median) of AI and used the delta method to determine the standard error and 95% confidence interval of the median. We used receiver operator characteristic (ROC) curve, area under the curve, sensitivity, and specificity to evaluate the potential of the median values as thresholds for each predictor. RESULTS/ANTICIPATED RESULTS: Data showed a mean cortisol level of 17 mcg/dL using the pAb immunoassay, 12 mcg/dL using the mAb immunoassay, and 12.96 mcg/dL using MS. The mean difference in cortisol level between the mAb immunoassay and the pAb immunoassay was 5.12 mcg/dL (p-value <0.01). The ROC curve model indicated an area under the curve of 0.997 with a median value of 11.2 mcg/dL for the mAb immunoassay. This provides a sensitivity of 95%, specificity of 95%, positive predictive value of 95%, and negative predictive value of 94%. This new threshold has a Kappa coefficient of 0.89 when compared to the pAb immunoassay. DISCUSSION/SIGNIFICANCE: New and highly specific mAb immunoassays are being used more widely but yield lower cortisol results. This reflects the need for further studies to determine new cut off points for highly specific cortisol immunoassays. A cut off level of 11.2 mcg/dL would provide a sensitivity of 95% and specificity of 95%.

OBJECTIVES/GOALS: The primary objective of this study was to define the transcriptomes and transcriptional regulatory network required for the development and function of adaptive Natural Killer (NK) cells in donors with latent human cytomegalovirus (HCMV) infection. METHODS/STUDY POPULATION: Eight healthy adult human spleens were obtained from four HCMV seropositive and four HCMV seronegative donors. Spleens were provided by the Versiti Organ Donor Center of Wisconsin and were processed to a single cell suspension. CD7+ CD3E- CD14- CD19- CD20- NK cells were isolated, using the BD FACSAria sorter. Following cell sorting, single-cell RNA sequencing (scRNA-seq) was performed, and cDNA libraries were constructed and sequenced via NextSeq 550. Cell Ranger was then used to algin the cDNA reads and the Seurat R package was used to analyze the transcriptional data. Cells were filtered and clustered based on the number of uniquely expressed genes. The monocle software was used for single cell trajectory analysis and the SCENIC software was used to decipher gene regulatory networks. RESULTS/ANTICIPATED RESULTS: Eight healthy spleens from four HCMV seropositive and four HCMV seronegative donors were obtained and their NK cells were sorted and captured for scRNA-seq. Donor median age was 59 [IQR 48.5-56.5], 50% (n=4) were female and all donors were not experiencing any acute or chronic symptoms. Using scRNA-seq, we observed elevated numbers of NKG2C+ adaptive NK cells in HCMV seropositive individuals when compared to HCMV seronegative individuals. In addition, we identify a set of transcription markers and regulators that are responsible for the development and function of adaptive NKG2C+ NK cells. Finally, our trajectory analysis of adaptive NKG2C+ NK cells revealed a unique developmental pathway. DISCUSSION/SIGNIFICANCE: Here, we demonstrate that HCMV infection can induce the formation of adaptive NKG2C+ NK cells that display a unique transcriptional and developmental profile. These findings have the potential to influence the future application of adaptive NK cells in cellular immunotherapies.

Objectives/Goals: Community engagement in pediatric emergency medicine research is completed mostly when an exemption from informed consent (EFIC) is involved. A campaign was designed to engage the community surrounding an academic pediatric emergency department in an informal discussion on any pediatric acute care and research topics they felt were important. Methods/Study Population: A flyer inviting members of the community to a virtual session was circulated through social media and word of mouth. Five members of the community attended the first session, including one with healthcare expertise and another with clinical research experience. The participants were not asked any personal characteristic questions and were allowed to self-identify during the discussion, to maintain the informal nature of the session. Results/Anticipated Results: All the participants identified as women, and mothers to children ranging in age from 11 weeks to 14 years. The participants highlighted community engagement as pivotal for advancing children’s health. They stressed the inclusion of groups traditionally underrepresented in healthcare systems, including patients and families who rarely utilize acute services and whose children have no chronic medical conditions. Critical issues in emergency and urgent care for children were extensively discussed, with a focus on when acute medical treatment is necessary and determining appropriate healthcare settings – emergency departments, urgent care centers, or primary care offices. The participants unanimously supported research leading to practical solutions for improving children’s health outcomes. Discussion/Significance of Impact: A group of community caregivers can lead to an established collaborative effort to enhance children’s healthcare outcomes through community engagement, informed decision-making, and practical application of research findings to families and caregivers. A standing community meeting is planned based on the feedback from the first session.

Objectives/Goals: To describe the evaluation processes of screening services implemented in community pharmacies. Methods/Study Population: A systematic literature review will be conducted from the last 20 years in Ovid Medline, APA PsycINFO, Clinialtrials.gov, and International Pharmaceutical Abstracts. Inclusion criteria are written in English, describes a clinical or health-related screening service in a community pharmacy, and evaluation of said health screening service is included. Approximately 950 articles have been initially identified. Two authors will screen each title, abstract, and full text for inclusion. Subsequent data extraction will occur including elements of 1) evaluation framework, 2) evaluation outcomes assessed, and 3) evaluation results. All elements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be followed. Quality of articles will be assessed using the MMAT. Results/Anticipated Results: Results are expected to show limited evaluation of screening services in pharmacies. Clinical conditions included in the screening services are expected to vary greatly. High-quality evaluations will be noted as templates for future evaluation of screening services in community pharmacies. Discussion/Significance of Impact: This systematic review will describe the current literature on evaluation of health screening services in community pharmacies. This will give readers an overview of how evaluations are currently being carried out in this setting, as well as provide them with templates of high-quality evaluations for future evaluation of screening services.

OBJECTIVES/GOALS: A primary care clinic is opening in the Eva Rothwell Center (ERC) located in the Keith Neighbourhood of Hamilton, Ontario. This new clinic aims to address rampant health disparities in the community. Effective delivery of health services requires a robust model of care that meets and sustains the specific needs of the community and clinic providers. METHODS/STUDY POPULATION: The primary objective of this study is to describe the current health needs of Keith Neighbourhood residents. The secondary objective is to describe the needs of health providers working within the ERC health clinic. Data collection will involve the collection of primary data (through methods such as surveys and interviews) and secondary data (including historical and current census data). Primary data analysis for primary will use conventional quantitative and qualitative methods. Finally, researchers will use the analyzed data to develop a context-appropriate initial model of care for the ERC health clinic and a subsequent evaluation plan to assess the model’s effectiveness and sustainability. RESULTS/ANTICIPATED RESULTS: All primary and secondary data will be synthesized into a report that will inform the development and implementation of two main deliverables. The first deliverable will be a framework for the clinic’s initial model of care that is context-appropriate to the current needs of the Keith Neighbourhood. The model of care will be culturally sensitive and trauma-informed. The second deliverable will be an evaluation plan for the clinic that can be used to continuously iterate on the initial model, ensuring its sustainability. Furthermore, the project’s process may be extrapolated into a framework that could be used to establish primary care clinics within other priority communities. DISCUSSION/SIGNIFICANCE: The proposed model of care will enable practitioners to deliver relevant and timely health services while being adaptable to the community’s evolving needs. It will help improve the Keith Neighbourhood residents' long-term health and social outcomes. This project will contribute to and inform the development of the field of translational science.

Objectives/Goals: The Research Education and Community Health (REACH) coalition proposes to develop the infrastructure for continuous and comprehensive collection of community health data to drive programs, education, and funding priorities across municipal agencies, institutions, and nonprofit organizations in Galveston County. Methods/Study Population: The workgroup through REACH will organize and adopt a comprehensive community health needs assessment that 1) accumulates existing, readily available data for shared use (e.g., Center for Health Care Data at the UT School of Public Health, the Texas Department of State Health Services Center for Health Statistics, and Epic Cosmos, a data aggregation tool, used by UTMB and other health systems to improve patient care); 2) utilizes data collected throughout the community (i.e. non-profits, municipal agencies, and law enforcement); and 3) applies qualitative data from focus groups and/or key informant interviews, so we can hear directly from community members about what their needs are. By doing so, we hope all can benefit from having access to current and relevant data to drive our programs, education, and funding. Results/Anticipated Results: This Community Health Needs Assessment is being coordinated by a diverse workgroup including community organizations, researchers, and policy makers who will benefit from access to current and relevant data. The Galveston Youth Risk Student Survey, completed every three years and most recently in 2024, revealed lingering health and mental health effects of the COVID-19 pandemic on County youth. This highlighted the need for community access to current, accurate, and ongoing data to drive programming, interventions, and education. The REACH Coalition, made up of 23 UTMB Centers and Institutes and 39 community organizations, is spearheading this effort as a part of its mission to facilitate collaborative research, service, and educational efforts. Discussion/Significance of Impact: Collected data will be used to establish and support ongoing, coordinated interventions in response to identified needs. Shared ownership of data and project implementation optimizes resources and reduces gaps and/or redundancy in community programming.

OBJECTIVES/GOALS: 1. Understand the association between patient perceptions of care measured by the Interpersonal Processes of Care (IPC) Survey and glycemic control, appointment no-shows/cancellations and medication adherence in patients with type II diabetes. 2. Determine how these relationships differ by race for non-Hispanic White and Black patients. METHODS/STUDY POPULATION: This is a cross-sectional study of a random sample of 100 White and 100 Black Type II diabetic patients followed in Duke primary care clinics and prescribed antihyperglycemic medication. We will recruit through email and phone calls. Enrolled patients will complete the Interpersonal Processes of Care Short Form and Extent of Medication Adherence survey to measure patient perceptions of care (predictor) and medication adherence (secondary outcome). No show appointments and cancellations (secondary outcomes) and most recent hemoglobin A1c (primary outcome) will be collected from the Electronic Medical Record. We will also collect basic demographic information, insurance status, financial security, significant co-morbidities, and number and type (subcutaneous vs oral) of antihyperglycemic medications. RESULTS/ANTICIPATED RESULTS: -The study is powered to detect a 0.6% difference in HbA1c, our primary outcome, between high and low scorers on the Interpersonal Processes of Care subdomains. -We expect that higher patient scores in the positive domains of the IPC survey and lower DISCUSSION/SIGNIFICANCE OF IMPACT: This study will provide information to develop and implement targeted interventions to reduce racial and ethnic disparities in patients with Type II diabetes. We hope to gain information on potentially modifiable factors in patient-provider interactions that can be intervened upon to improve prevention and long-term outcomes in these populations.

ABSTRACT IMPACT: Understanding the needs and barriers or facilitators to participation in research, especially among minority communities is critical not only for COVID-19 research but also for future clinical and translational research and health disparities studies. OBJECTIVES/GOALS: The overall goal of this project is to enhance education, awareness, access, and inclusion of underserved communities across Florida in COVID-19 research, especially among Black and Hispanic minority groups that are disproportionately affected by COVID-19. METHODS/STUDY POPULATION: Through strategic partnership among five academic institutions and community-based organizations across the state of Florida, the FL-CEAL team will implement focus groups and surveys in minority communities in Florida to gauge the awareness and understanding of COVID-19, and the barriers and facilitators for participation in COVID-19 research studies. These communities include but are not limited to Latinx and Black populations in South and Central Florida, and Black communities in North Florida. The outcomes will help shape strategies for outreach and dissemination activities and minority recruitment plans to promote participation of minorities into vaccine and therapeutic trials. RESULTS/ANTICIPATED RESULTS: An estimated 75-125 participants will be recruited for focus groups. Four focus groups with minority communities have been conducted and the results are being analyzed. A common Community-Based Needs Assessment survey is being finalized and will be deployed across the 11 states that are part of the national CEAL consortium. Community Health Workers are being engaged to support outreach and dissemination to educate targeted communities on COVID-19 research and the importance of participation in COVID trials. To date, 243 CHWs and 880 community members have been engaged. Minority participation in COVID-19 vaccine trials at University of Miami has been higher than the national average. DISCUSSION/SIGNIFICANCE OF FINDINGS: The FL-CEAL Alliance has successfully demonstrated a coordinated effort to engage minority communities affected by COVID. Through strategic geographic partnerships, FL-CEAL will positively impact minority communities throughout the state that has one of the most diverse populations in the nation.

OBJECTIVES/SPECIFIC AIMS: The goal of the study was to assess the acceptability of a culturally targeted narrative video and identify potential avenues for dissemination in a sample of bilingual community health workers who provide services to the Latino community in the United States. METHODS/STUDY POPULATION: We piloted the video in a sample of bilingual community health workers who provide services to Latinos (n=31). After watching the video, participants filled out a survey. The survey captured sociodemographic data (e.g. education), their role and experience working with Latinos (e.g. patient navigators), acceptability of the video (e.g. general satisfaction, length of the video, amount of information), and potential dissemination (e.g., dissemination channels, preferred settings to watch the video, and preferred context). Three open ended questions captured information about how the video could be useful for the Latino community, what they liked the most from the video, and suggestions for improvement. Data was entered in SPSS version 25. We used descriptive statistics to analyze the survey, and content analysis to summarize the feedback from the open-ended questions. RESULTS/ANTICIPATED RESULTS: Participants (n = 31) had an average age of 46 years (SD=16.99), all self-identified as Hispanic or Latinos, most were female (90.3%), and worked as patient navigators (29%) or community outreach workers (25.8%). The video’s general acceptability was very high. Participants reported high ratings for overall satisfaction, how much they liked the video, enjoyed it, and considered it to be interesting (all means >9.6, range 1-10). Most participants strongly agreed or agreed that the length was adequate (80.7%), that the information presented was very helpful (100%), that the video could be useful for the Latina community (96.8%), and that they would share the video with women at-risk of HBOC (100%). The highest endorsed channels for dissemination were Facebook (90.3) and YouTube (87.1%). The highest endorsed settings were community centers (100%), churches (96.8%), and hospitals (80.6%). Most participants (90.3%) considered that the best context to watch the video would be with relatives, followed by watching with other women at-risk of HBOC (71.0%), friends (71.0%), and lastly by oneself (41.9%) DISCUSSION/SIGNIFICANCE OF IMPACT: This study represents a multidisciplinary approach to intervention development that aims to reduce well-documented knowledge gaps and disparities in the use of GCRA among at-risk Latinas. A culturally targeted video has the potential to reach underserved populations with low literacy and English proficiency and it can be widely disseminated. The video was well received by community health workers who reported high acceptability. These findings are promising given that community health workers could play a key role in the dissemination of the video if it is proven to be efficacious.

OBJECTIVES/SPECIFIC AIMS: Despite the high prevalence of individuals diagnosed with sickle cell disease (SCD) in Tennessee, comprehensive care and education for patients with SCD is not as widely available as healthcare services for individuals managing other chronic illnesses. We aimed to engage SCD stakeholders in patient-centered outcomes research (PCOR) as a mechanism for advancing care and translational research for this rare disease population. METHODS/STUDY POPULATION: Through a partnership with the Sickle Cell Foundation of Tennessee, we implemented Community Health Ambassadors to systematically engage patient partners with SCD and their caregivers, aged 18–50 from rural and urban communities throughout Tennessee, in PCOR to establish a sustainable infrastructure, focused on connecting the SCD community through a service providing community-based organization to offer (1) information on how to connect with other families; and be informed about SCD community activities, or educational offerings; (2) training in basic research principals; and (3) opportunities to contribute to PCOR, including feedback on effective and practical ways for providing input on research efforts through patient centered input, comparing urban and rural area preferences. Community ambassadors utilized health fairs, clinic days at various hospitals and community centers, and social media to spread awareness of the project, in addition to boosting the recruitment process. RESULTS/ANTICIPATED RESULTS: A statewide SCD network was developed to offer social support and increase access to education, medical care, and engagement in research activities. Findings include: recruitment of 150 patients and 35 executive committee members (local physicians, community leaders, adults with SCD and parents of children with SCD). DISCUSSION/SIGNIFICANCE OF IMPACT: Most rural and urban families affected by SCD have no systematic way to engage in, or lend their expertise to, PCOR. A statewide network of patient partners, community stakeholders, researchers, and medical professionals will ultimately increase the standard of care for patients, and provide valuable insight for SCD research. The opportunity to create the underpinnings for coordinated patient-centered education for patients with SCD and their caregivers holds promise for developing a scalable PCOR process model for replication and implementation in other states and emulate this model with other rare disease populations.

OBJECTIVES/SPECIFIC AIMS: Patient factors such as body mass index and functional status are commonly used in surgical decision-making and prediction of outcomes. Morphomic analysis uses semi-automated 3D cross-sectional imaging analysis to quantify tissue, organ, and bone geometry and density. These data can be used to assess patient health status. There is an emerging trend of using morphomic variables such as muscle mass and bone mineral density to predict surgical and medical outcomes. In certain cases, it has been shown to predict cancer survival more accurately than conventional staging methods. With the growing popularity of morphomic analysis, it is vital to establish baseline variability against which patient populations can be validated. Of populations receiving radiographic imaging, trauma patients are approximately representative of the general population. We created a reference population of morphomic variables from over 6000 University of Michigan patients presenting with trauma. METHODS/STUDY POPULATION: Computed tomography (CT) scans were obtained for all patients who underwent scans for trauma indications at the University of Michigan starting from April 1998. High throughput image processing algorithms written in MATLAB 2015a were used to semi-automatically process chest, abdomen, and pelvis CT scans. Scans were referenced to a common coordinate system based on vertebral levels and body anatomy. Measurements of adiposity, muscle group, and bone density measurements were performed at each level. Percentile curves of morphomic measures of body composition by age and sex were created. The reference population dataset is periodically updated and is publicly accessible. RESULTS/ANTICIPATED RESULTS: As of July 2017, over 6000 patients aged 1–81 years have been included in the Reference Analytics Morphomics Population. Patient CT scans were analyzed at the T10, T11, T12, L1, L2, L3, and L4 vertebral levels. Morphomic measures analyzed include body depth, body cross-sectional area, vertebral trabecular bone density, visceral fat area, fascia area, subcutaneous fat area, central back fat, and psoas muscle area. DISCUSSION/SIGNIFICANCE OF IMPACT: We created reference curves for several morphomic variables from a Reference Analytic Morphomics Population of over 6000 University of Michigan patients presenting with trauma.

OBJECTIVES/GOALS: Single-cell and spatial transcriptomics have revealed high heterogeneity in the tumor and microenvironment. Identifying populations of cells that impact a patient’s prognosis is an important research goal, so researchers can generate hypotheses and clinicians can provide targeted treatment. METHODS/STUDY POPULATION: DEGAS uses deep-transfer-learning to identify patterns between patient tumor RNA-seq and clinical outcomes and map these associations on to higher-resolution data like spatial and single-cell transcriptomics. We apply DEGAS to prostate and pancreatic cancer spatial transcriptomics samples, as well as one normal sample of prostate tissue. We used the TCGA prostate cancer cohort to with the accompanying survival information and publicly accessible prostate cancer ST data from 10X Genomics to predict survival associations in the ST slides derived from the TCGA patients. Based on these survival associations, we identify higher risk subsections of ST slides which can be further studied. RESULTS/ANTICIPATED RESULTS: We were able to validate our method by comparing it to Scissor and were able to show that the number of high-risk regions in prostate cancer slides increased with the stage of disease. Furthermore, we identify transcriptomic signatures enriched for ontology terms associated with growth regulation and apoptosis, inflammation, immune signaling, and autophagy in histologically normal prostate tissues and adjacent normal pancreatic cancer tissues that were identified as high-risk by DEGAS. The regions highlighted by DEGAS could reflect transcriptional precursors to intraepithelial neoplasia–a well-recognized premalignant morphological change in glandular epithelium. DISCUSSION/SIGNIFICANCE: Identifying biomarkers of tissue stress that precede morphologic diagnosis of high-grade pre-malignant lesions by a pathologist may help triage patients at high risk for future development of cancer, or aid in better understanding whether histologically normal pre-malignant tissues at tumor margins contribute to recurrence.

The rate at which the coronavirus disease (COVID-19) spread required a rapid response across many, if not all, industries. Academic medical centers had to rapidly evaluate, prioritize, and coordinate the multiple requests for clinical trial participation. This involved redirecting resources and developing a collaborative system for assessment, decision making, and implementation. Our institution formed a team with diverse representation from multiple stakeholders to review and prioritize all research protocols related to COVID-19. To accomplish this, a prioritization matrix was developed to help determine the order in which the protocols should be placed for consideration by the treating clinician. The purpose of the team was to review the COVID-19 clinical trials in the pipeline, prioritize those trials that best met the needs of our patients, oversee training and resource needs, and lead the formulation of procedures for integration with clinical care. Resources from the Clinical Research Unit were then allocated to support the swift execution of such studies. This manuscript describes that process, the challenges encountered, and the lessons learned on how to make all clinical trials more successful in a complex and dynamic environment.

Racism shapes the distribution of the social determinants of health (SDoH) along racial lines. Racism determines the environments in which people live, the quality of housing, and access to healthcare. Extensive research shows racism in its various forms negatively impacts health status, yet few studies and interventions seriously interrogate the role of racism in impacting health. The C2DREAM framework illuminates how exposure to racism, in multiple forms, connects to cardiovascular disease, hypertension, and obesity. The goal of the C2DREAM framework is to guide researchers to critically think about and measure the role of racism across its many levels of influence to better elucidate the ways it contributes to persistent health inequities. The conceptual framework highlights the interconnectedness between forms of racism, SDoH, and the lifecourse to provide a greater context to individual health outcomes. Utilizing this framework and critically contending with the effects of racism in its multiple and cumulative forms will lead to better research and interventions.

OBJECTIVES/GOALS: A negative circumferential resection margin (CRM) after surgical resection of rectal cancer decreases local recurrence and increases overall survival. While MRI is used to predict this risk, there is no predictive model that incorporates clinical factors to predict the risk of CRM positivity. METHODS/STUDY POPULATION: Utilizing the National Cancer Database from 2010-2014, we performed a retrospective study evaluating factors predictive for positive CRM after surgical resection of rectal cancer. The primary outcome was positive CRM (tumor≤1 mm from the surgical margin). Our population included patients with clinical stage I-III rectal cancer who underwent total mesorectal excision. For the primary outcome, multivariable logistic models were used to estimate the probability of a positive CRM. Model performance was evaluated by using the area under the receiver operating characteristic curve (AUC). Model calibration was assessed by examining the calibration plot. Bootstrapping method (300-iteration) was used to internally validate and estimate optimism-adjusted measures of discrimination and overall model fit. RESULTS/ANTICIPATED RESULTS: There were 28,790 patients included. 2,245 (7.8%) had positive CRM. Older age, race, larger tumor size, higher tumor grade, mucinous and signet tumor histology, APR, open operative approach, facility location, higher T stage, lymphovascular invasion, lack of neoadjuvant chemotherapy/radiation, and perineural invasion were all significantly associated with positive CRM (p DISCUSSION/SIGNIFICANCE: An objective model that predicts positive CRM and associated poor clinical outcomes is possible to be used in conjunction with MRI. Positive CRM is associated with specific patient demographics, tumor characteristics, and operative approach. These factors can be used to predict CRM positivity in the preoperative period and plan accordingly.