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.

An increasingly urgent issue in healthcare is the scarcity of available organs for transplant procedures—both live and cadaveric. Recent proposals have pushed for fiscal incentives and a monetary scheme to encourage live donation, specifically for kidney and liver donations. Such propositions are inherently unethical, contradicting the three guiding principles of organ donation: utility, justice, and respect for persons. Furthermore, these additional economic elements will perpetuate the exploitation of vulnerable communities. The intersecting low socioeconomic quintile populations are threatened the most by a monetary scheme; their need to better their financial status allows them to be taken advantage of easily by third parties. This instigates a cycle in which the vulnerable individuals who volunteer to donate for compensation are actually pushed deeper into poverty. In advocating for monetization, it would permit the public sale of human organs—the commodification of the human body. Alternative solutions must be considered in which the donors and recipients are treated not as a means, but as an end in themselves.

This thesis creative project involved the planning, preparation, and facilitation of a community-wide event targeting Diabetes Awareness. The event was hosted March 16, 2022, on ASU west campus and includes a PowerPoint presentation of the overall process. It also includes a reflection of successes, challenges, and experience gained from planning and facilitation. At the end, there is information analyzing how the event could be improved upon for the future, and a summary of key ideas discussed throughout the project. There is also a paper with the description of the presentation and an embedded link to the recorded presentation of the project during the defense.