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ObjectiveTo evaluate association between biomarkers and outcomes in COVID-19 hospitalised patients. COVID-19 pandemic has been a challenge. Biomarkers have always played an important role in clinical decision making in various infectious diseases. It is crucial to assess the role of biomarkers in evaluating severity of disease and appropriate allocation of resources.Design and settingSystematic review and meta-analysis. English full text observational studies describing the laboratory findings and outcomes of COVID-19 hospitalised patients were identified searching PubMed, Web of Science, Scopus, medRxiv using Medical Subject Headings (MeSH) terms COVID-19 OR coronavirus OR SARS-CoV-2 OR 2019-nCoV from 1 December 2019 to 15 August 2020 following Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines.ParticipantsStudies having biomarkers, including lymphocyte, platelets, D-dimer, lactate dehydrogenase (LDH), C reactive protein (CRP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, procalcitonin (PCT) and creatine kinase (CK), and describing outcomes were selected with the consensus of three independent reviewers.Main outcome measuresComposite poor outcomes include intensive care unit admission, oxygen saturation <90%, invasive mechanical ventilation utilisation, severe disease, in-hospital admission and mortality. The OR and 95% CI were obtained and forest plots were created using random-effects models. Publication bias and heterogeneity were assessed by sensitivity analysis.Results32 studies with 10 491 confirmed COVID-19 patients were included. We found that lymphopenia (pooled-OR: 3.33 (95% CI: 2.51–4.41); p<0.00001), thrombocytopenia (2.36 (1.64–3.40); p<0.00001), elevated D-dimer (3.39 (2.66–4.33); p<0.00001), elevated CRP (4.37 (3.37–5.68); p<0.00001), elevated PCT (6.33 (4.24–9.45); p<0.00001), elevated CK (2.42 (1.35–4.32); p=0.003), elevated AST (2.75 (2.30–3.29); p<0.00001), elevated ALT (1.71 (1.32–2.20); p<0.00001), elevated creatinine (2.84 (1.80–4.46); p<0.00001) and LDH (5.48 (3.89–7.71); p<0.00001) were independently associated with higher risk of poor outcomes.ConclusionOur study found a significant association between lymphopenia, thrombocytopenia and elevated levels of CRP, PCT, LDH, D-dimer and COVID-19 severity. The results have the potential to be used as an early biomarker to improve the management of COVID-19 patients, by identification of high-risk patients and appropriate allocation of healthcare resources in the pandemic.

In the spring of 2020, New York City was at the epicenter of the COVID-19 pandemic in the USA, resulting in disruption of TL1 and KL2-mentored Clinical and Translational Science (CTS) research at the Icahn School of Medicine at Mount Sinai (ISMMS). The impact of the pandemic on trainees’ research productivity and career plans was explored using a qualitative survey. Participant responses were analyzed using coding and categorization. Six key themes emerged: redirection of effort, reduced access to people, lack of access to resources, home as a workplace, future uncertainty, and stress and anxiety. Insight into participant experiences allows for the development of support strategies and resources to address trainee needs.

The constitutively active BCR-ABL tyrosine kinase is the cause of chronic myeloid leukemia. Imatinib is the first small synthetic molecular inhibitor of the BCR-ABL tyrosine kinase with clinical activity in chronic-phase myeloid leukemia. This 5-year follow-up of patients with the disease who began continuous treatment with imatinib reports that the drug can induce durable hematologic and cytogenetic responses in a high proportion of patients. This 5-year follow-up of patients with chronic myeloid leukemia who began continuous treatment with imatinib reports that the drug can induce durable hematologic and cytogenetic responses in a high proportion of patients. Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the expansion of a clone of hematopoietic cells that carries the Philadelphia chromosome (Ph). 1 The Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, t(9;22)(q34;q11). 2 The molecular consequence of this translocation is a novel fusion gene, BCR-ABL, which encodes a constitutively active protein, tyrosine kinase. 3 – 5 Imatinib (Gleevec, Novartis; formerly called STI571) is a relatively specific inhibitor of the BCR-ABL tyrosine kinase and has efficacy in CML. 6 – 11 Before the availability of imatinib, interferon alfa plus cytarabine was considered standard therapy for patients . . .

Abstract Clinical rotations are often not included in graduate-level cancer biology curricula; however, basic insight into clinical oncology is often crucial for developing translational research that addresses unmet needs with the potential to benefit cancer patients. We describe a needs assessment, design, implementation, and descriptive evaluation of an oncology-specific pilot clinical encounter program developed for PhD students in the Cancer Biology Training Area (CAB) in the Graduate School of Biomedical Sciences (GSBS) and Tisch Cancer Institute (TCI) at the Icahn School of Medicine at Mount Sinai (ISMMS). Prior to the development of this pilot program, CAB students, in years 2–5 + , were surveyed to determine their interest in a structured clinical experience. Seventeen out of thirty-one students responded (55%) to the survey. Of those seventeen respondents, fifteen (88.2%) expressed that exposure to cancer patients in the clinical setting would be useful for their pre-doctoral biomedical science and cancer biology training and indicated an interest in participating in the clinical encounter program. Based on these responses, a three-session clinical encounter pilot program was designed. Two separate cohorts of 5 students participated in this pilot program. During a formal debrief, following the clinical experience, students commented on the resilience of patients and the importance of research on clinical decision making, and reported that they found the experience motivational. Five out of 10 students responded (50%) to a post-program assessment survey; all five respondents answered that they would recommend the clinical encounter program to their peers. While limited in size and scope, this pilot TCI Clinical Encounter Program proved feasible and has the potential to enrich and inform the experience of PhD students pursing advanced degrees in a cancer biology.

Cancer research has led to unprecedented advances in treatment in recent decades. Physician-scientists have played a crucial role in these advances given their unique perspective at the intersection between basic research and clinical care, though their representation in cancer research has been in progressive decline. Cancer research programs that feature strong mentorship at the medical student level are associated with increased likelihood of alumni choosing a cancer research career path. In an effort to increase the cancer research medical student training pipeline, senior research faculty from the Tisch Cancer Institute (TCI) at the Icahn School of Medicine at Mount Sinai (ISMMS) developed the TCI Scholars Program, a rigorous mentored research training program funding medical students’ summer research. This program is currently in its third year and has garnered significant interest among mentors and students alike from all four TCI Cancer Center Support Grant (CCSG)–funded research programs. Herein, we describe the development, implementation, evaluation, and major outcomes of this program.

OBJECTIVES/SPECIFIC AIMS: Science and clinical practice are widely regarded as being complementary and synergistic. In an effort to enhance the team science, translational research capacity of the TL1 scholars at Icahn School of Medicine at Mount Sinai (ISMMS), the InCHOIR learning lab aims to provide an accessible, workforce-wide lecture series on the fundamental methods and concepts of randomized clinical trials. METHODS/STUDY POPULATION: The InCHOIR learning lab is a monthly 1 hour lecture series delivered by a range of expert clinical and translational researchers, followed by a 1 hour “Meet the Expert” session. The InCHOIR lecture series has covered a wide range of topics including, but not limited to: Decision Models; Race and Causal Inference; Innovative Strategies for Assessing Environmental Health across the Life Course; Statistics for Geneticists and Genetics for Statisticians; and From the Lab to Translation to Policy—The Neuroscience of Addiction. The “Meet the Expert” session offers TL1 predoctoral and postdoctoral scholars and KL2 scholars the opportunity to have intimate, informal discussions with experts about their career trajectories. RESULTS/ANTICIPATED RESULTS: Feedback from participants has been overwhelmingly positive. Participants have gained important insights into key topics relevant to early stage researchers. The “Meet the Expert” sessions have yielded honest and important conversations about crucial topics ranging from finding effective mentors to essential strategies for establishing a work-life balance, to overcoming adversity as underrepresented minorities and women in translational research. DISCUSSION/SIGNIFICANCE OF IMPACT: Attendance at the InCHOIR learning lab is increasing month on month, indicating the perceived need for this learning not just from early stage researchers, but also from students, senior faculty, and research staff more generally. The InChoir series provides added value through the creation of a video library, fostering new collaborations and contributing to the Icahn School of Medicine at Mount Sinai and Graduate Medical Education landscape. Priorities for the program are to increase internal visibility, in order to continue to grow attendance by MSHS students, research staff, nurses, postdoctoral fellows and residents. The program is also exploring how to engage external participation from regional CTSAs and from community advocates actively involved in community-academic research partnerships.

OBJECTIVES/SPECIFIC AIMS: N/A. METHODS/STUDY POPULATION: N/A. RESULTS/ANTICIPATED RESULTS: N/A. DISCUSSION/SIGNIFICANCE OF IMPACT: There is an increasing need to foster cross-disciplinary research to address complex problems within healthcare. The Sinai Team-based Translational Education Program: the URM Propeller (STTEP-UP) is a NCATS funded program through the Icahn School of Medicine at Mount Sinai. Its goal is to facilitate URM post-doctoral trainees becoming innovative leaders in clinical and translational research. The program includes a team-based research component, where fellows collaborate on a project. This year, disciplines represented by the four fellows include Cardiology, Psychiatry, Neurology, and Pediatrics. Identifying a clinical question and designing an investigation was facilitated by group brainstorming meetings with program mentors. Fellows designed a project to identify medical testing and prescribing that were not clinically indicated throughout the healthcare system, with the goal of exploring whether an intervention, including provider education, could reduce ordering practices. In addition to regular in-person meetings, a licensed virtual learning environment and free web-based sharing platform were used to foster collaboration. Challenges faced throughout this process, included fellows struggling to find protected time, difficulties accessing broad sets of data across the healthcare system, and overcoming administrative barriers between departments. Strengths of this approach, included fellows learning new research strategies and feeling a deeper sense of commonality with their peers. Overall, this experience supports the idea that cross-disciplinary research improves the collaboration and education of emerging researchers. However, addressing logistical and systems-based barriers may better facilitate this education and research.

OBJECTIVES/SPECIFIC AIMS: “Cure Quest” is an adventure quest game for mobile tablets that aims to teach the player about the complexities of discovery and development of new medicines. The game instills a sense of wonderment into the learning process, taking the player to a world of magic where a mysterious condition has affected the land and they must follow the steps of the discovery and development process to find a treatment. METHODS/STUDY POPULATION: The game is being developed through a collaboration between faculty and students at ISMMS and the Games and Simulation Arts and Science Program at Rensselaer Polytechnic Institute. The first target audience is 2nd–3rd year medical students, with the future goal of adapting the game to a broader population. RESULTS/ANTICIPATED RESULTS: The game is currently in development, but the project has yielded insight into the design process for serious games in medicine. We found that for a game of this type it is essential not just to have both designers and subject matter experts, but to enable cross-pollination of modes of thinking. Through multiple design iterations and focus groups, we found that a game design approach rooted in narrative and allegorical abstraction would have a better ability to engage the target audience than one focused only on realistic simulation. When complete, we anticipate that the game will improve understanding of the core concepts in drug discovery. DISCUSSION/SIGNIFICANCE OF IMPACT: If successful, the game-based learning approach can help fill key gaps in current formal medical and scientific training, as well as gaps in understanding among the general public. The design process serves as an informative model of evolving collaborative team science.

OBJECTIVES/SPECIFIC AIMS: Leadership is an essential and recognized team science competency. Modeled after the successful LEAD (Leadership in Emerging Academic Departments) program at University of Texas Southwestern (UTSW), ConduITS LEAD Program is designed to: (1) provide personal and professional development opportunities for participants; (2) promote organizational change through applied leadership skills; (3) provide a platform for integrating multiple disciplines and fostering interprofessional relationships among investigators and clinicians. METHODS/STUDY POPULATION: The 1-year structured LEAD program curriculum includes monthly interactive seminars covering: personal and situational leadership; unconscious bias; communication and influence; navigating personal conflict; negotiation and networking; selecting and managing the right team; teamwork; financing the academic mission, budgets and business plan development; strategic planning and vision; presentation skills. To foster the development of leadership skills participants engage in Hogan Assessments, individual and peer mentoring from an executive coach and self-directed learning activities and assignments. Completion of an individual Capstone leadership project empowers learners to enact practice change through the implementation of leadership concepts in practice. RESULTS/ANTICIPATED RESULTS: In collaboration with the Office of Academic Enrichment & Development (OADE), the first competitive RFA was issued in November of 2016. In total, 63 applications were received including: gender: 29 M: 34 F; URM: 10; Degrees: M.D. (40); Ph.D. (11); M.D./Ph.D. (6); M.D./M.P.H. (3); M.D./M.S.C.R. (2); PharmD (1); Departments: 19; Institutes/Centers: 12; MSHS: 3 sites. Through a competitive and rigorous application process, 24 junior faculty with evidence of leadership potential and trajectory were chosen to participate. The current cohort of LEAD participants joined in February 2017, and will complete the program in January 2018. Using qualitative and quantitative survey methodology, participants will be evaluated for self-reported change to attitudes, belief, skills and development of new relationships and collaborations. Submitted Capstone projects were mainly focused on implementing situational and personal leadership concepts to practice, with one additionally focused on the use of behavioral interviewing techniques to optimize team building and teamwork. At the time of abstract submission 30% of the cohort has implemented their Capstone project in practice. Participants will be followed-up in 6 months’ time to evaluate the impact of the LEAD program on their practice. Following a second RFA, 24/52 candidates have been selected as our next cohort, and will start in February 2018. DISCUSSION/SIGNIFICANCE OF IMPACT: Leadership is known to be a core component of team science, and the ability to implement leadership into practice may advance personal and professional change. This program addresses the need to empower Junior Faculty to engage in leadership in practice. In addition, this program is able to provide added value to extend the reach of the OADE, promote new individual collaborations and facilitate additional leadership training efforts at our Institution. Future collaborative studies will focus on common outcomes as well as institutional differences between these 2 CTSA institutions.

We evaluated the ability of human recombinant granulocyte colony-stimulating factor (rhG-CSF) to prevent chemotherapy-induced neutropenia or to accelerate recovery from this complication and thus allow patients to receive full doses of antineoplastic agents on time, according to protocol design. Twenty-seven patients with transitional-cell carcinoma of the urothelium who were undergoing treatment with methotrexate, doxorubicin, vinblastine, and cisplatin were given rhG-CSF (up to 60 μg per kilogram of body weight per day) before their first cycle of combination chemotherapy, during the first cycle, or at both points. Treatment with rhG-CSF before chemotherapy resulted in a dose-dependent increase in the absolute neutrophil count. Treatment with rhG-CSF after chemotherapy significantly reduced the number of days (91 percent) per patient on which the absolute neutrophil count was 1000 per microliter or less (P = 0.0039), reduced the number of days (1 vs. 35) on which antibiotics were used to treat fever and neutropenia, and significantly increased the percentage (100 vs. 29 percent) of patients qualified to receive planned chemotherapy on day 14 of the treatment cycle (P = 0.0015). In addition, the incidence of mucositis was significantly decreased (11 vs. 44 percent, P = 0.041), as was its severity. These findings demonstrate that rhG-CSF is a potent stimulus of normal neutrophil proliferation and maturation. In addition, its administration can reduce both the hematopoietic and oral toxicity of chemotherapy. (N Engl J Med 1988; 318:1414–22.) NEUTROPENIA is a major factor contributing to infection, morbidity, mortality, and underdose in patients undergoing chemotherapy for cancer. 1 An agent capable of either accelerating recovery from or preventing chemotherapy-induced myelosuppression would clearly be beneficial. Recently, colony-stimulating factors, which control the proliferation of granulocytes and macrophages, have been purified, molecularly cloned, and expressed as recombinant proteins. 2 3 4 5 These hematopoietic glycoproteins have been shown to increase leukocyte counts in nonhuman primates and in patients. 6 7 8 9 In addition, the administration of a specific growth and differentiation factor for neutrophil granulocytes — recombinant human granulocyte colony-stimulating factor (rhG-CSF) — has shortened the period of neutropenia in . . .