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- Creators: Economics Program in CLAS
- Creators: Numani, Asfia
2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.
2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers, but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.
This venture is unique in that it is an interdisciplinary fusion between students, health professionals, and non-profit organizations empowering underserved refugees. A refugee is an individual forced to leave their country because of persecution, war, or violence. Once they arrive in the United States, they are forced to restart their lives, often with little to no financial assets, minimal English literacy, and a lack of transferable skills from their previous occupations in their home countries. In addition to these socioeconomic disparities, it is common for refugees to face health disparities. Consequently, refugees are one of the most vulnerable populations in our society.
Our organization provides value to the refugee community through our three key services. These are made up of supplemental resources, educational workshops, and clinical services. Our supplemental materials include resources that our clients will use after they have left our care to further improve their health and quality of life. These items include personal hygiene kits, informational pamphlets, and nutritional foods.
The educational workshops we provide specifically address identified knowledge gaps that impede the autonomy of our clients’ health and wellbeing. Several of the topics that we cover (but are not limited to) are diabetes, postpartum depression, nutrition, dental hygiene, AHCCCS, and nutrition. The clinical services that the clinic will provide will be supplementary primary care services that will encompass basic physical exams, A1C blood pressure checks, and vaccinations. These services all are aimed at alleviating the barriers to health that refugees face and ultimately improve their quality of life.
Our venture seeks to maintain positive and sustained relationships with our client segments through continuous community engagement. In conjunction with providing educational workshops and clinical care in the future, REACT continually engages the community by planning formal and informal programming with the refugees based on the needs and wishes of individual communities.
REACT generates these services through the work of medical students from Mayo Clinic Alix School of Medicine and undergraduates from Arizona State University. Our team brings together the experience from hundreds of hours of work in the community, collaborations with refugee community leaders, and the insight of professionals in the healthcare/social-work industry.
Further, our members have had extensive experience working with refugees, training in culturally sensitive practices, and delivering care to those that need it most. With the cost of healthcare exponentially rising, there is little hope for refugees to find adequate culturally competent healthcare. This leads to an increase in chronic diseases, preventable health issues, and increased hospitalization costs. Supporting REACT is not only an investment in the health of the refugees but the health of our entire healthcare system.