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.

Diabetes affects millions of people globally and can lead to other severe health complications when undiagnosed or not properly managed. The incidence of diabetes has rapidly increased over the past several years, however, not all individuals have access to affordable or convenient healthcare. We hypothesize that wastewater-based epidemiology (WBE) has the potential to assess community health status by analyzing biomarkers indicative of human health and disease, including diabetes. Used in tandem with current methods, monitoring indicators of diabetes in community wastewater could provide a comprehensive assessment tool for disease prevalence in large and small populations. Specifically, the proposed targeted biomarker evaluated in this study to indicate population-wide diabetes prevalence was 8-hydroxy-2’- deoxyguanosine (8-OHdG). This work combines a rigorous literature review and initial laboratory studies to explore the possibility of diabetes monitoring at the community level using WBE. Here, 24-hour composite wastewater samples were collected from within two wastewater sub-catchments of Greater Tempe, AZ. Overall goals of this study were to: i) Determine the feasibility to detect endogenous markers of diabetes in community wastewater; ii) Assess the potential impact of confounding factors, such as smoking, cancer, and atherosclerosis, through a literature analysis; and iii) Evaluate the socioeconomic status and demographics of the study population. Preliminary results of the experiments suggest this methodology to be feasible, as indicated by the observation of detectable signals of 8-OHdG in community wastewater collected from the sewer infrastructure; however, future work and continued experimentation will be required to address low signal intensity and assay precision and accuracy. Thus, the work presented here provides valuable proof-of-concept data, with detailed information on the method employed and identified opportunities to further determine the relationship between 8-OHdG concentrations in municipal wastewater and diabetes prevalence at the community level.